Psychiatr Serv 56:619, May 2005
© 2005 American Psychiatric Association
Recovery and Wellness: Models of Hope and Empowerment for People With Mental Illness
edited by Catana Brown; Binghamton, New York, Haworth Press, 2001, 168 pages, $24.95 softcover
Jackie Goldstein, Ph.D.
The recovery model, a prevalent approach to the treatment of mental illness, suggests that, rather than being "cured," one learns to live with mental illness. The four stages of recovery are hope, empowerment, self-responsibility, and establishing a meaningful role in life. Underscoring occupational therapy's role in this model, University of Kansas researcher Catana Brown has edited Recovery and Wellness: Models of Hope and Empowerment for People With Mental Illness, which comprises ten chapters that explore recovery from three perspectives.
Part 1 offers the unique perspective of three authors who are both consumers and mental health professionals. Although none of us can truly know another's world, these articulate narratives can be beneficial in helping mental health professionals to gain deeper insight into their clients' experiences and perspectives.
Part 2 explores philosophical perspectives relative to both mental illness and the recovery model. A chapter by Juli McGruder, an occupational therapy professor at the University of Puget Sound, takes what might be considered an iconoclastic perspective when she suggests that the medical model can "[strip] away the meaning of the illness experience" and "schizophrenia will never be like diabetes." The other chapter in this section discusses patient psychoeducation. Of the three teaching approaches—executive, therapist, and liberationist—the final approach is seen as most consistent with the recovery model. And, because it is as concerned with how one learns as it is with what is learned, this approach presents a challenge for the practitioner-teacher who must be a "model" of acceptable behavior in the therapeutic process.
Part 3, "Application of Recovery Principles," opens with a chapter on the role of occupational therapy in community mental health. It describes seven functional steps in the recovery model, and author Jason Wollenberg echoes McGruder—and presumably others—in his assertion that "the medical model discount[s] the unique life experience of each individual [and] ... is not effective in establishing a collaborative and productive relationship with the consumer."
Brown herself authors another of this section's four chapters, describing the adult sensory profile and Dunn's model of sensory processing. She proposes that this profile and model can be useful in creating an individualized environment, consistent with one's sensory processing style, allowing the client to move more readily through the stages of recovery. The final two chapters present step-by-step instructions for a wellness recovery action plan (WRAP) and participatory action research (PAR), an approach that allows consumers to be both subjects and advisory members of the research team.
The recovery model is a reflection of the current effort to give more authority to the consumer. Practitioners, although they are motivated by a desire to protect their clients, are sometimes uncomfortable with this sharing of authority. Some simply lack experience with the model. In either case, with the recovery model as perhaps the current treatment approach, a book that includes description, from multiple perspectives, and application ideas is a useful addition to the literature.
Footnotes
Dr. Goldstein is professor of psychology at Samford University in Birmingham, Alabama.
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