What is ‘recovery’?

What is ‘recovery’?• This is actually a big question!

• The answer is: ‘it depends’

– It depends on what someone in recovery thinks it means.

– It depends on how we define ‘recovery’ or ‘getting better’.

– It is easier to say what recovery is not.

What is ‘recovery’ (cont.)

• Recovery is not:

– What help agencies say is recovery

– Something you can easily measure

– Something you can apply to populations of patients/clients/service users

– A destination

– Something you achieve

What is ‘recovery’ (cont.)?So, recovery can be:

– What someone with a substance use issue identifies as ‘recovery’ for them.

– Something services need to identify through consultation with individual service users.

– A journey in which people gain improvement from their previous unwanted state.

– Something you can be in but not achieve.

What is ‘recovery’ (cont)?

Some definitions of ‘recovery’ have been attempted. Recovery is:

‘voluntarily sustained control over substance use which maximises health and wellbeing and participation in the rights, roles and responsibilities of society’ (UK Drug Policy Commission, 2008).

‘a process through which an individual is enabled to move from their problem drug use, towards a drug-free lifestyle as an active and contributing member of society’ (Scottish Government, 2008).

What is ‘recovery’ (cont.)?

• Amore useful way of looking at it is to see how it fits into treatment and care services.

• It may be easier to view recovery as something care services can help facilitate through treatment, support and signposting.

• It is suggested that people in early stages of recovery need the combination of support from treatment agencies and service user communities or self help groups, while people in more stable recovery are able to sustain their recovery after treatment through continuing mutual aid support (Laudet 2007).

Origins of recovery

The origins of recovery give an insight into what it might be:

– It emerged from mental health service users in the US who rebelled against being labelled as ‘ill’ and made to be dependent on mental health services.

– The US ‘mental health survivor’ movement developed its own ideas about what it was to be well with a mental illness.

Origins of recovery (cont.)• In the field of problematic substance use, especially alcohol

dependency, recovery became adopted by self-help and mutual aid groups such as Alcoholics Anonymous in the US.

• It has also become a movement for advocacy for people with problematic substance use (alcohol and other drugs) in both the US and the UK.

• In the UK it has links with SMART and 12-step approaches to substance addiction.

Recovery in the UK

In the UK, principles for recovery

for both mental health and

substance misuse are variously

identified, but there are some

common themes.

Recovery principles (Jacobsen & Greenley 2001)

Support for someone in recovery is likely to include:

– Social support and inclusion in society

– A whole systems approach: focus on strengths in the person, their community and networks

– Hope – that change is achievable

– Self-empowerment and self-development

Recovery communities (i.e. White, 2007)

The recovery community in the UK is adopting additional advocacy and social justice principles. It aims to:

– Reduce stigma of addiction through advocacy and role models.

– Counter public portrayals of people which dehumanise them.

– Enhance quality of treatment choices and provision.

– Promote social policies to reduce substance use problems.

Recovery – what does this mean to services?• Services providing support for people

with substance use problems are becoming recovery-oriented.

• Specialist substance use services are adopting recovery principles and being commissioned to provide recovery- and strengths-based services, developed with service user consultation.

• Services are increasingly working together with recovery groups.

Recovery principles and support approaches (Best 2012)

Evidence suggests that recovery can be supported when a whole systems approach is adopted to support the individual.

This reflects the principle of focusing on:

– The individual’s strengths and needs.

– Developing and using their social networks.

– Developing, supporting and using their community.

Recovery approaches – recovery capital (Granfield & Cloud 2001)

• Recovery Capital is described as the internal and external strengths and resources that a person has which may support them in their recovery.

• This means that a focus on the assets a person has, instead of the deficits, produces more hope, more support and reduces the negative identity usually associated with dependence:

– ‘Once a drunk, always a drunk’ becomes ....

– ‘Once a drunk, now a recoverist!’

Recovery capital (cont.) (Best & Laudet, 2010)

Recovery capital may have layers:

– Personal capital• The skills, experiences and strengths within a person.

– Social capital• The connections a person has with support from others.

– Collective capital• Aspects of community life which provides a recovery context

(i.e. availability of treatment, mutual aid groups, localised political will to support recovery).

References• Best D (2012) Addiction Recovery: a movement for social change and personal

growth. Brighton, Pavilion. • Best D & Laudet A (2010) The Potential for Recovery Capital. London, RSA. • Granfield R & Cloud W (2001) Social context and natural recovery. Substance Use

& Misuse, 36, 1543-1570. • Jacobsen N & Greenley D (2001) What is recovery? A conceptual model and

explication, Psychiatric Services, 52, 4, 482–5.• Laudet A (2007) What does recovery mean to you? Journal of Substance Abuse

Treatment, 33, 243-256.• UK Drug Policy Commission (2008). A Vision of Recovery. London, UK Drug Policy

Commission. • The Scottish Government (2008) The Road to Recovery. Edinburgh. The Scottish

Govt. • White W (2007) The new recovery advocacy movement in America. Addiction, 102,

696-703. • White W (2011) Professional service and recovery advocacy in England: an

interview with Mark Gilman. Available at: www.facesandvoicesofrecovery.org