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April 12, 2013
Pebbles, Potholes, and Perspective
The Changing Face of Psychiatric Rehabilitation - Part 2
by Sarah Hancock

If you've never heard of the Recovery Model, don't worry, you're not alone. Although the concept has been around for more than 20 years, like many other psychiatric movements, it's taken awhile to catch on. Let me tell you, I'm grateful it's finally taking hold! Utilizing the Recovery Model is what got me back on track and progressing towards stabilization.

I do have to clarify one thing, the word "recovery" may lead you to assume that if a person follows this model they will have an absence of symptoms. However, recovery as described by this model of treatment is actually learning how to work around and minimize the impact of the symptoms. So while I am definitely on my road to recovery, that is not to say I am symptom free. It merely means that I have learned tools and skills which no longer cause my illness to control my life at all times. Now my recovery skills allow me to live a much fuller, richer life.

Unlike the Medical Model, the Recovery Model doesn't place any emphasis on diagnosis or medication. In some ways I think that's why it hasn't caught on. Insurance companies cannot bill without a diagnosis code and pharmaceuticals really make bucket loads of money which they aren't interested in sharing. So while the Recovery Model is more effective in my eyes, it's not out there generating income for all those hard working people associated with that business industry.

By now you're probably wondering, "If they don't focus on diagnosis and medication, how in the world do they treat psychiatric illness?" I guess it's right about now that I explain that, while there is a place for diagnosis and medication, the focus of the Recovery Model is wellness, accomplishments, abilities and peer support. Allow me to break them down for you as I understand them.

What comes to your mind when speaking of wellness? For me wellness includes my body, mind and environment. How I treat my body includes what I eat and how (or I should admit, IF) I exercise. It also excludes anything else I might do to or for my body. Heavenly Father taught this principle of the Recovery Model when he reveals to Paul at Corinth saying, "Know ye not that ye are the temple of God?" (1 Cor 3:16). The ancient medicine of many different cultures have always included every aspect of wellness in treating a person for any illness. Us Westerners are finally catching up! We need to care for our temples!

Accomplishments are a huge part of the road to recovery. When I first started out in this life I was as goal oriented and competitive as they come. I always had to do better and be better than anyone I knew. I don't know why. That was just how I popped out. I excelled in academics. If I didn't get an A, I considered myself a failure. As I graduated and went to college, I took 18-21 credits. I woke up early. I went to bed late. Then I was slammed with symptoms of my illness. Suddenly I was taking a single three credit class and unable to keep up because my medication slowed my brain down to the point that life was completely overwhelming. Getting out of bed and getting ready for school, getting to campus and making it to class consumed so much energy that I had nothing else to give myself or the teacher. I'm sure I fell asleep in many a class because I could hardly keep my eyes open through an hour. For me, an accomplishment became taking a shower. For years I let this drag me down rather than acknowledging it as the true accomplishment it was! I had to finally realize I wasn't lowering my standards. Once I let the guilt go--once those I knew let me let the guilt go--I was able to move forward and build on those accomplishments.

Abilities are the third focus of the Recovery Model. Abilities require you to focus on what you CAN do, not what you can't. So suddenly I was working on looking at my strengths, trying not to let myself (and others) stare at my weaknesses. I worked on building those abilities. Most importantly, I stopped comparing what I used to be capable of and focus on what I was now capable of now. That alone, made a HUGE difference. I learned I was just as capable of doing things as I was before, I just had to go about doing them differently. Different doesn't mean wrong. Different means different.

Peer support is vital, but it has to be the right kind of peer support. For me, it meant finding people who were living with my type of symptoms who, in my eyes, were living successfully. Now the psychiatric community is striving to train people with "lived experience" so that the people with a diagnosis can better help others new (or not so new) to the symptoms. If you've ever known someone who's participated with Alcoholics Anonymous, think of a peer specialist kind of like a sponsor. Same idea. A person who's learned how to walk the walk for long enough that they can support and help bring someone along the way.

As you can imagine, the Recovery Model can be applied to any illness, disorder or disability. The next five columns will look into the five pillars which strengthen the Recovery Model's Foundation: hope, choice, empowerment, recovery environment and spirituality. I look forward to discussing each pillar with you in depth. Maybe, just maybe, either you or someone you know, serve, work with or love can completely change their life for the better. I did.

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