NUR-410-RECOVERY-MODELS-AND-SUICIDE-
PREVENTION-LECTURE-NOTES LECTURE 11:
RECOVERY
Recovery
Definition: process of movement towards improvement in health and
quality of life
—> recovery from mental health / substance abuse disorders are a process of change
individuals improve health / wellness, lead a self-directed life
Recovery model began in addictions field, referring to a person recovering from
substance abuse
4 Dimensions
Health: overcoming one’s disease and living in a healthy way
Home: stable and safe place to live
Purpose: meaningful daily activities
Community: relationships and social networks that provide
support, friendship, love, hope
Guiding Principles Emerges from
hope
Person-driven
Occurs via many pathways
Holistic
Supported by peers
Supported through relationships/ social networks
Culturally-based and influenced
Supported by addressing trauma
Involves individual, family, community Respect
Tidal Model
Authors use the power of metaphor to engage with patient
, First recovery model used by nurses
Uses a person-centered approach focuses on patients individual
story where problems first appeared where growth and
recovery can be found
Based upon values created by Buchanan-Barker
10 Tidal Commitments
1. Value to voice
2. Respect the language
3. Develop genuine curiosity
4. Become the apprentice
5. Use the available toolkit
6. Craft the step beyond
7. Give the gift of time
8. Reveal personal wisdom
9. Know that change is constant
10. Be transparent
Water = individuals in distress become emotionally, physically,
and spiritually shipwrecked
Wellness Recovery Action Plan (WRAP) Developed in 1997 by
group of 30 people
Step-wise process, individual able to monitor and manage
distressing sx
Others may be included in the process to assist, but
empowerment comes from self-administration 6 Steps:
1. Develop wellness toolbox
2. Daily maintenance list : 3 parts
3. Triggers : 2 parts
4. Early warning signs : 2 parts
5. Things are breaking down /getting worse : 2 parts
, 6. Crisis planning : 9 parts
Psychological Recovery Model
“ the establishment of a fulfilling, meaningful life and positive sense of identity
founded on hopefulness and selfdetermination”
4 Parts:
Hope, Responsibility, Self and Identity, Meaning and
Purpose
5 Stages:
1. Moratorium
2. Awareness
3. Preparation
4. Rebuilding
5. Growth
Nursing Interventions
“shifting the paradigm of care of persons with serious mental illness from
traditional medical psychiatric treatment toward the concept of recovery”
Help the client craft a psychiatric advanced directive for when
he can no longer care for himself
Public Stigma: a set of negative attitudes and beliefs that motivate individuals to fear, reject,
avoid, and discriminate against people with mental illness
—> associated with lack of engagement in mental health care and worse treatment
outcomes
Stigmatizing actions: preferences for social distance from individuals with mental illness
Social distance is a measure of exclusion of individuals in a variety of social situations
(e.g., unwilling to work closely with someone, to have someone as a
neighbor, to have someone
marry into your family) because of their mental illness
—> can lead to stereotypes, discriminatory behaviors, and negative attitudes
Substance use Mental
health
, Psychiatric Comorbidity (Dual Diagnosis) = mental illness +
substance abuse disorder mental illness can be considered a risk factor for substance use
disorder
Depression is most common
Anxiety second most common the percentage of adolescents who used
illicit drugs in the past
year was higher among those with a past year MDE (major
depressive episode) than it was among those without a past year MDE
—>illicit drugs highest, marijuana second highest, then
opioids, alcohol, cigarettes only about half of adults with mental illness substance use
disorder
received either substance use treatment at a specialty facility or mental health care
Schizophrenia
People with schizophrenia have positive and negative symptoms Recovery based on
philosophical background of empiricism focuses on external reality and observable
things: measurable
variables knowledge is acquired by experience
—> symptom remission, vocational functioning, independent
living, and peer relationships measured by the Brief Psychotic
Rating Scale (BPRS) score of four or less
Other criteria measured by at least 1/2 time of work / school,
independent management of funds and medication, and once weekly socialization of peers
for at least two years
Recovery assessment scale (RAS) also used measures personal confidence
and hope, willingness to
ask for help, reliance on others, no domination by
symptoms, and goal and success orientation
Mental health recovery measure (MHRM): a three-phase
model of recovery
1) overcoming stuckness
PREVENTION-LECTURE-NOTES LECTURE 11:
RECOVERY
Recovery
Definition: process of movement towards improvement in health and
quality of life
—> recovery from mental health / substance abuse disorders are a process of change
individuals improve health / wellness, lead a self-directed life
Recovery model began in addictions field, referring to a person recovering from
substance abuse
4 Dimensions
Health: overcoming one’s disease and living in a healthy way
Home: stable and safe place to live
Purpose: meaningful daily activities
Community: relationships and social networks that provide
support, friendship, love, hope
Guiding Principles Emerges from
hope
Person-driven
Occurs via many pathways
Holistic
Supported by peers
Supported through relationships/ social networks
Culturally-based and influenced
Supported by addressing trauma
Involves individual, family, community Respect
Tidal Model
Authors use the power of metaphor to engage with patient
, First recovery model used by nurses
Uses a person-centered approach focuses on patients individual
story where problems first appeared where growth and
recovery can be found
Based upon values created by Buchanan-Barker
10 Tidal Commitments
1. Value to voice
2. Respect the language
3. Develop genuine curiosity
4. Become the apprentice
5. Use the available toolkit
6. Craft the step beyond
7. Give the gift of time
8. Reveal personal wisdom
9. Know that change is constant
10. Be transparent
Water = individuals in distress become emotionally, physically,
and spiritually shipwrecked
Wellness Recovery Action Plan (WRAP) Developed in 1997 by
group of 30 people
Step-wise process, individual able to monitor and manage
distressing sx
Others may be included in the process to assist, but
empowerment comes from self-administration 6 Steps:
1. Develop wellness toolbox
2. Daily maintenance list : 3 parts
3. Triggers : 2 parts
4. Early warning signs : 2 parts
5. Things are breaking down /getting worse : 2 parts
, 6. Crisis planning : 9 parts
Psychological Recovery Model
“ the establishment of a fulfilling, meaningful life and positive sense of identity
founded on hopefulness and selfdetermination”
4 Parts:
Hope, Responsibility, Self and Identity, Meaning and
Purpose
5 Stages:
1. Moratorium
2. Awareness
3. Preparation
4. Rebuilding
5. Growth
Nursing Interventions
“shifting the paradigm of care of persons with serious mental illness from
traditional medical psychiatric treatment toward the concept of recovery”
Help the client craft a psychiatric advanced directive for when
he can no longer care for himself
Public Stigma: a set of negative attitudes and beliefs that motivate individuals to fear, reject,
avoid, and discriminate against people with mental illness
—> associated with lack of engagement in mental health care and worse treatment
outcomes
Stigmatizing actions: preferences for social distance from individuals with mental illness
Social distance is a measure of exclusion of individuals in a variety of social situations
(e.g., unwilling to work closely with someone, to have someone as a
neighbor, to have someone
marry into your family) because of their mental illness
—> can lead to stereotypes, discriminatory behaviors, and negative attitudes
Substance use Mental
health
, Psychiatric Comorbidity (Dual Diagnosis) = mental illness +
substance abuse disorder mental illness can be considered a risk factor for substance use
disorder
Depression is most common
Anxiety second most common the percentage of adolescents who used
illicit drugs in the past
year was higher among those with a past year MDE (major
depressive episode) than it was among those without a past year MDE
—>illicit drugs highest, marijuana second highest, then
opioids, alcohol, cigarettes only about half of adults with mental illness substance use
disorder
received either substance use treatment at a specialty facility or mental health care
Schizophrenia
People with schizophrenia have positive and negative symptoms Recovery based on
philosophical background of empiricism focuses on external reality and observable
things: measurable
variables knowledge is acquired by experience
—> symptom remission, vocational functioning, independent
living, and peer relationships measured by the Brief Psychotic
Rating Scale (BPRS) score of four or less
Other criteria measured by at least 1/2 time of work / school,
independent management of funds and medication, and once weekly socialization of peers
for at least two years
Recovery assessment scale (RAS) also used measures personal confidence
and hope, willingness to
ask for help, reliance on others, no domination by
symptoms, and goal and success orientation
Mental health recovery measure (MHRM): a three-phase
model of recovery
1) overcoming stuckness
