Transforming Systems of Care: The American Association of Community Psychiatrists Guidelines for Recovery Oriented Services

Allegheny County Office of Behavioral Health, 304 Wood Street, 5th Floor, Pittsburgh, PA 15222, USA.
Community Mental Health Journal (Impact Factor: 1.03). 01/2006; 41(6):757-74. DOI: 10.1007/s10597-005-6433-4
Source: PubMed


Thinking about recovery has grown significantly over the last 70 years, and particularly in the past fifteen. Promotion of recovery has recently been recognized as an organizing principle for the transformation of behavioral health services. Recovery is a personal process of growth and change which typically embraces hope, autonomy and affiliation as elements of establishing satisfying and productive lives in spite of disabling conditions or experiences. Recovery oriented services replace paternalistic, illness oriented perspectives with collaborative, autonomy enhancing approaches and represent a major cultural shift in service delivery. Recovery oriented services replace the myth of chronicity and dependence with a message of individualism, empowerment and choice in the context of collaborative relationships with service providers. The American Association of Community Psychiatrists has developed Guidelines for Recovery Oriented Services to facilitate the transformation of services to this new paradigm. The guidelines are divided into three domains: administration, treatment, and supports, each consisting of several elements for which recovery enhancing characteristics are defined. Several example indicators are also provided for each element. This paper presents these guidelines and discusses their application.

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    • "Knowledge of recovery has begun to influence policy in many countries and has challenged programs which provide care and support to people with mental illnesses to become more recovery-oriented, i.e. to focus more on services which support the individual´s wishes and participation, and less on services that focus exclusively on symptoms (Davidson et al. 2007; Lindqvist et al. 2010; Slade, 2012). Recovery is understood as an individual process that cannot be directed by professionals, but can be supported and facilitated at the program, organizational and system levels (Farkas et al., 2005; Sowers, 2005; Schön & Rosenberg, 2013). Current knowledge and understanding of personal recovery is substantially based on qualitative research (Onken et al., 2007; Slade et al., 2012) and reviews of the recovery literature have revealed a need for increasing our conceptual clarity as to the components of recovery that may be supported by programs and systems (Farkas et al. 2005; Onken et al., 2007; Leamy et al., 2011). "
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    ABSTRACT: Although there has been an emphasis on developing knowledge regarding recovery in Sweden, it is unclear to what extent this has been translated into a recovery orientation in the provision of mental health services. Instruments, which present the components of recovery as measurable dimensions of change, may provide a framework for program development. Involving users is an essential factor in the utilization of such tools. The purpose of this study was to evaluate the psychometric properties of the Recovery Self-Assessment (RSA) measure and its potential for being utilized in a Swedish context. The sample consisted of 78 participants from 6 community mental health services targeting people with serious mental illnesses in a municipality in Sweden. They completed the RSA at the study baseline and two weeks later. User panels participated in the translation and administration of the RSA and the reporting of results. The Swedish version of the RSA had good face and content validity, satisfactory internal consistency, and a moderate to good level of stability in test-retest reliability. The user panels contributed to establishing validity and as collaborators in the study. Establishing the RSA as a valid and reliable instrument with which to focus on the recovery orientation of services is a first step in beginning to study the types of interventions that may effect and contribute to recovery oriented practice in Sweden. (PsycINFO Database Record (c) 2015 APA, all rights reserved).
    Full-text · Article · Jun 2015 · Psychiatric Rehabilitation Journal
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    • "Administrative leadership and support. In the Guidelines for Recovery-Oriented Services developed by the Quality Management Committee of the American Association of Community Psychiatrists, the value of administrative leadership and support for recovery transformation is clearly articulated (Sowers, 2005). In particular, there is an emphasis on the role of administration in promoting an organizational mission and vision that embraces recovery as well as its willingness to commit organizational resources to recovery-oriented education and practice. "
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    ABSTRACT: The advocacy of recovery-oriented practices in mental health care with its emphasis on freedom and choice in care has been gaining considerable traction in recent years. In response to the growing recognition and promotion of recovery-oriented services, several training initiatives have been developed to bring about mental health care system transformation. These initiatives, however, have been primarily focused on broad organizational and procedural changes as well as hospital and clinic staff development. Relatively neglected have been initiatives to educate physicians and doctorally trained psychologists in the concepts and practices of recovery-oriented care. This article describes a case study of the efforts of Project GREAT (Georgia Recovery-Based Educational Approach to Treatment) that has aspired to transform the education and practice of an academic department of psychiatry into a recovery-oriented one with the focus on shaping the recovery knowledge, attitudes, and practices of psychiatry and psychology faculty and trainees. Core issues in the transformation effort were identified and led to the implementation of the following change interventions: (a) administrative leadership and support, (b) consumer mediated interventions, (c) educational presentations/materials, (d) interactive small groups/program champions, (e) reminders/prompts/practice tools, (f) newsletters/pamphlets, and (g) educational outreach visits. It is proposed that this transformation experience provided valuable lessons that are generally applicable to other academic programs for psychiatrists and psychologists attempting to adopt recovery-oriented training and care.
    Full-text · Article · Aug 2014 · Professional Psychology Research and Practice
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    • "Service user perspectives are essential for the evaluation and development of patient-centred, recovery-oriented mental health services (Sowers, 2005), and are beneficial to both user and provider of care (Priebe et al., 2012). Insights garnered from those with first-hand experience of services identify positive and negative aspects of care, which cannot be detected by service providers alone (Locker & Dunt, 1978). "
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    ABSTRACT: Abstract Background: Service user perspectives are essential for the evaluation and development of mental health services. Service users expressing less satisfaction with services subsequently have poorer treatment outcomes. Aims: To measure satisfaction with services following psychiatric admission, and to explore its relationship with a number of clinical and service factors. Methods: A multi-centre observational study was conducted across three mental health services in Ireland. Service users were interviewed and provided with self-report questionnaires. The Client Satisfaction Questionnaire (CSQ-8) was used to measure treatment satisfaction. Results: The overall level of satisfaction with services was good (CSQ-8 mean score 24.5). Service users who were admitted involuntarily, who experienced physical coercion and lower levels of procedural justice were less satisfied. A better therapeutic relationship, improved insight and better functioning were associated with higher levels of treatment satisfaction. Conclusion: Mental health services should implement strategies to ameliorate the effects of factors associated with lower levels of treatment satisfaction.
    Full-text · Article · Feb 2014 · Journal of Mental Health
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