NIne components of recovery - Part 3

I am reading another excellent book at the moment, A Practical Guide to Recovery-Oriented Practice by Larry Davidson and colleagues. Davidson has been a leading researcher at the forefront of the metal health recovery movement almost since it began.

In their book, Davidson and colleagues describe nine components of being in recovery from mental illness. I outlined the first three components in Part 1 and Part 2:

1. Renewing hope and commitment to one’s life
2. Being supported by others
3. Finding one’s niche in the community
4. Redefining self or changing one’s identity
5. Incorporating illness
6. Managing symptoms.

I now describe the last three components keeping close to Davidson’s description, but referring explicitly to addiction and serious substance use problems when necessary:

7. Assuming control
This refers to the processes by which people assume primary responsibility for their transformation from a person with a substance use problem to a person in recovery.

Taking responsibility for one’s life, and by extension, one’s recovery and treatment, increases a person’s sense of control over one’s self and increases one’s self-efficacy. Taking responsibility can help a person shed the role of the ‘victim’.

In order to take responsibility and make choices, however, people must be afforded opportunities to make their own decisions and must have options from which to choose. Otherwise, they cannot exercise and gain a sense of their own agency.

A recovery-oriented system can support the development of a sense of personal responsibility and control by:

• providing options people can chose from, and
• allowing people to take risks and experience the consequences of their own decisions, including their own failures.

8. Fighting stigma
This refers to both external and internalised stigma. Whilst we often think about external stigma, it is important to realise that stigma does become internalised.

The journey to recovery often involves addressing and overcoming this internalised stigma. A process of identity change, or redefining of self, is often intimately associated with dealing with this internalised stigma.

Since societal stigma cannot be easily simply ignored or dismissed, people travelling the road to recovery must find a way to deal with this problem that is comfortable for them.

Some people choose to fight stigma actively, becoming advocates, offering to give talks, or by sending letters to newspapers, etc.

Others find less direct or explicit ways of dealing with stigma, such as avoiding disclosing their past history as a substance user, and/or by avoiding situations or settings where they may experience this discrimination or prejudice.

Recovery-oriented systems must find ways to address the stigma and discrimination that exists in society. This involves working with communities to create environments that are more understanding and accepting of people who are in recovery or recovering, and those who are experiencing substance use problems.

These systems must also ensure that treatment services do not perpetuate stigma and discrimination through their own practices.

9. Being an empowered citizen
Empowerment, or gaining a sense of mastery and control over one’s environment and self, is implicit in Component 7 (described above). However, it also takes on a more social and political connotation, and in this regard is the flip side of stigma and discrimination.

To the degree that people are able to address, overcome, or bypass stigma effectively, they are able to reclaim the rights and responsibilities of citizenship that are their birthright.

A recovery-oriented system will aim to facilitate this sense of social or political empowerment by:

• offering people accurate and accessible information that they can use in their own decision making and recovery
• obtaining and valuing the input of people in recovery in all aspects and at all levels of the system
• validating the value of the experiences gained through the recovery process by hiring people in recovery as staff
• offer education and assistance for recovering people in how to advocate for themselves when needed
• offer an array of opportunites, from helping people to become involved in advocacy activities to giving back to their community (e.g. by helping others) and putting a positive face on recovery.