Chapter 9 the personal recovery framework

Question 1

4 negative impacts following a diagnosis (Leroy Spaniol)

Answer 1

1. loss of sense of self (identity as mental patient)
2. loss of power (agency, choice, personal values)
3. loss of meaning (loss of valued social roles)
4. loss of hope (leading to giving up and withdrawal)

Question 2

four processes from a review of personal accounts (Ruth Ralph)

Answer 2

1. internal factors (insight, awakening, determination)
2. self-managed care (coping)
3. external factors (connection with others who express hope for the person)
4. empowerment

Question 3

HEART acronym

Answer 3

Hope
Esteem
Agency
Relationship
Transitions in identity (personal identity, Maori, cultural, gay/lesbian, leaving illness identity)

Question 4

four emerging themes of recovery

Answer 4

hope
self-identity (future and current self image)
meaning in life (purpose and goals)
responsibility

Question 5

hope =

Answer 5

a primarily future oriented expectation of attaining personally valued goals, relationships or spirituality, which lead to meaning and are subjectively considered possible

Question 6

identity =

Answer 6

those persistent characteristics which make us unique and by which we are connected to the rest of the world

Question 7

meaning =

Answer 7

1. direct meaning: an understanding which makes adequate personal sense of the mental illness experience
2. indirect meaning: an integration of the direct meaning into personal and social identity

Question 8

personal responsibility=

Answer 8

a constellation of values, cognitions, emotions and behaviours that led to full engagement in life

Question 9

welke vragen horen bij de 4 domeinen

Answer 9

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?

Question 10

hope importance in mental illness=

Answer 10

mental illness and its devaluing consequences can take away hope for a good future

Question 11

identity importance in mental illness

Answer 11

mental illnes undermines personal and social identity

Question 12

meaning importance in mental illness

Answer 12

1. mental illness is a profound experience which requests a personally satisfactory explanation
2. mental illness leads to re-evaluation of values and personally meaningful life goals

Question 13

personal responsibility in mental illness

Answer 13

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.

Question 14

Andresen’s five-stage model of recovery

Answer 14

1. moratorium (denial, confusion, hopelessness, identity confusion, self-protective withdrawal)
2. awareness (the first glimmer of hope for a better life)
3. preparation (starts working on recovery: taking stock of personal resources, values and limitations)
4. rebuilding (hard work stage, involving forging a more positive identity/setting, striving towards goals and taking control)
5. growth (whether or not symptom-free, the person knows how to manage their illness and stay well)

Question 15

2 kritiekpunten op elk stage model

Answer 15

• 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

Question 16

advantages of models

Answer 16

1. therapeutic optimism (want clinicians zien vooral mensen in crisis -> pessimistisch over treatment -> impact op treatment)
2. provide a way of making sense of both progress and lack of progress in a non-stigmatising and non-pathologizing way
3. they help clinicians to become better in provinding support, based on the persons stage of recovery

Question 17

healing involves…

Answer 17

reclaiming
regaining
restoring
discovering oneself and one’s world

Question 18

verschil personal identity en social identity

Answer 18

personal = unique, self image. social identity= the group memberships that define the individual

Question 19

identity definitie

Answer 19

identity comprises those persistent characteristics which make us unique and by which we are connected to the rest of the world

Question 20

3 component elements of identity as someone with a mental illness

Answer 20

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)

Question 21

4 tasks of recovery

Answer 21

1. developing a positive identity
2. framing the mental illness
3. self-managing the mental illness
4. developing socially valued roles

Question 22

recovery task 1: developing a positive identity

Answer 22

me-it difference (je bent meer dan je mentale gezondheid), recognizing themselves as individuals whilst acknowledging their mental health condition. hope!

Question 23

recovery task 2: framing the mental illness

Answer 23

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.

Question 24

recovery task 3: self-managing the illness

Answer 24

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

Question 25

why are these latter tasks not the first

Answer 25

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.

Question 26

recovery task 4: developing valued social roles

Answer 26

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)

Question 27

4 soorten connecties die onderdeel kunnen zijn van personal recovery

Answer 27

1. relationship with a higher being or connection with others
2. close relationships
3. social roles as role models
4. relationship with a specific mental health professional

Question 28

zie personal recovery model in schrift + welke onderdelen

Answer 28

social environment + developing valued social roles

identity-enhancing relationships + developing a positive identity

identity + “mental illness” part & framing and self-managing

Question 29

hoe komt het framework overeen met de 4 key domains of personal recovery

Answer 29

• 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

Question 30

5 jobs of mental health professionals

Answer 30

• 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