Chapter 9 the personal recovery framework Flashcards
4 negative impacts following a diagnosis (Leroy Spaniol)
- loss of sense of self (identity as mental patient)
- loss of power (agency, choice, personal values)
- loss of meaning (loss of valued social roles)
- loss of hope (leading to giving up and withdrawal)
four processes from a review of personal accounts (Ruth Ralph)
- internal factors (insight, awakening, determination)
- self-managed care (coping)
- external factors (connection with others who express hope for the person)
- empowerment
HEART acronym
Hope
Esteem
Agency
Relationship
Transitions in identity (personal identity, Maori, cultural, gay/lesbian, leaving illness identity)
four emerging themes of recovery
hope
self-identity (future and current self image)
meaning in life (purpose and goals)
responsibility
hope =
a primarily future oriented expectation of attaining personally valued goals, relationships or spirituality, which lead to meaning and are subjectively considered possible
identity =
those persistent characteristics which make us unique and by which we are connected to the rest of the world
meaning =
- direct meaning: an understanding which makes adequate personal sense of the mental illness experience
- indirect meaning: an integration of the direct meaning into personal and social identity
personal responsibility=
a constellation of values, cognitions, emotions and behaviours that led to full engagement in life
welke vragen horen bij de 4 domeinen
hope - what will happen to me?
identity - who am i?
meaning - 1. what has happened? what does this mean for me?
personal responsibility - what can i do?
hope importance in mental illness=
mental illness and its devaluing consequences can take away hope for a good future
identity importance in mental illness
mental illnes undermines personal and social identity
meaning importance in mental illness
- mental illness is a profound experience which requests a personally satisfactory explanation
- mental illness leads to re-evaluation of values and personally meaningful life goals
personal responsibility in mental illness
the mental illnes itself, and responses from the person, mental health services and wider society can all undermine the ability to be responsible for one’s own life.
Andresen’s five-stage model of recovery
- moratorium (denial, confusion, hopelessness, identity confusion, self-protective withdrawal)
- awareness (the first glimmer of hope for a better life)
- preparation (starts working on recovery: taking stock of personal resources, values and limitations)
- rebuilding (hard work stage, involving forging a more positive identity/setting, striving towards goals and taking control)
- growth (whether or not symptom-free, the person knows how to manage their illness and stay well)
2 kritiekpunten op elk stage model
- models dont align with everyone’s unique experiences; therefore low external validity
- stage models can create expectations, making people who do not meet these expectations feel like a failure
advantages of models
- therapeutic optimism (want clinicians zien vooral mensen in crisis -> pessimistisch over treatment -> impact op treatment)
- provide a way of making sense of both progress and lack of progress in a non-stigmatising and non-pathologizing way
- they help clinicians to become better in provinding support, based on the persons stage of recovery
healing involves…
reclaiming
regaining
restoring
discovering oneself and one’s world
verschil personal identity en social identity
personal = unique, self image. social identity= the group memberships that define the individual
identity definitie
identity comprises those persistent characteristics which make us unique and by which we are connected to the rest of the world
3 component elements of identity as someone with a mental illness
a) i see myself as a person with a mental illness (personal identity)
b) others relate to me, and i relate to others as a person with a mental illness (social identity)
c) both a and b are ongoing (permanence)
4 tasks of recovery
- developing a positive identity
- framing the mental illness
- self-managing the mental illness
- developing socially valued roles
recovery task 1: developing a positive identity
me-it difference (je bent meer dan je mentale gezondheid), recognizing themselves as individuals whilst acknowledging their mental health condition. hope!
recovery task 2: framing the mental illness
developing a meaning to frame the experience fo the mental illness, framing this as part of the person rather than defining the person. emphasizing positive aspects.
recovery task 3: self-managing the illness
living with the illness, positive reframing, minimizing impact on identity, displacing it to focus on more important matters. taking personal responsibility, strength, resilience, hope and support
why are these latter tasks not the first
because a person focused on personal recovery prioritizes well being over illness: relying solely on passive treatment risks getting stuck in the mental illness role.
recovery task 4: developing valued social roles
focus on external perceptions and the creation of a rich and layered identity in the world. social interaction is hierbij belangrijk (ook in de anderen)
4 soorten connecties die onderdeel kunnen zijn van personal recovery
- relationship with a higher being or connection with others
- close relationships
- social roles as role models
- relationship with a specific mental health professional
zie personal recovery model in schrift + welke onderdelen
social environment + developing valued social roles
identity-enhancing relationships + developing a positive identity
identity + “mental illness” part & framing and self-managing
hoe komt het framework overeen met de 4 key domains of personal recovery
- hope: arises when the possibility of a more positive identity is felt
- identity: reclaiming a sense of personhood outside of mental illness
- meaning: framing the mental illness, finding a way of making sense of it
- personal responsibility: development of the ability to self-manage the mental illness and other life challenges
5 jobs of mental health professionals
- supporting hope (key mechanisms: fostering relationship, creating opportunities for growth)
- improving social inclusion
- supporting identity (promote well-being and goal-planning)
- supporting meaning
- supporting personal responsibility
