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A Practical Guide to Recovery-Oriented Practice$
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Larry Davidson, Michael Rowe, Janis Tondora, Maria J. O'Connell, and Martha Staeheli Lawless

Print publication date: 2008

Print ISBN-13: 9780195304770

Published to Oxford Scholarship Online: November 2020

DOI: 10.1093/oso/9780195304770.001.0001

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PRINTED FROM OXFORD SCHOLARSHIP ONLINE (oxford.universitypressscholarship.com). (c) Copyright Oxford University Press, 2022. All Rights Reserved. An individual user may print out a PDF of a single chapter of a monograph in OSO for personal use.date: 26 January 2022

The Top 10 Concerns about Recovery Encountered in System Transformation

The Top 10 Concerns about Recovery Encountered in System Transformation

(p.62) 3 The Top 10 Concerns about Recovery Encountered in System Transformation
A Practical Guide to Recovery-Oriented Practice

Larry Davidson

Michael Rowe

Janis Tondora

Maria J. O'Connell

Martha Staeheli Lawless

Oxford University Press

The second chapter begins with descriptions of some of the many ways in which people with serious mental illness are key agents in their own recovery. In these descriptions, we fi nd that the cornerstones of recovery are both the hope that a better life is possible and the desire the person has to pursue such a better life once this hope has taken root. For an individual, both hope and action appear to be required to make recovery a reality. As we begin to understand more fully the role of systems of care and of the practitioners within those systems in facilitating recovery, we suggest that achieving, in the words of the New Freedom Commission report, “profound change—not at the margins of a system, but at its very core” also will require both hopeful attitudes and concerted efforts. While the remaining chapters in this volume will deal more explicitly with the kinds of concerted efforts required to achieve transformation, this chapter focuses primarily on attitudes toward recovery and the kinds of concerns systems and practitioners have raised (to date) as they have gone about the process of understanding and implementing recovery principles in practice. It has been our experience, however, that the federal mandate to transform systems of care to promote recovery has left many policy makers, program managers, practitioners, and even the recovery community itself under increasing pressure to move to a recovery orientation without fi rst examining the concerns of stakeholders within those systems about this new notion of recovery and its implications. As a result, we are all at risk of overlaying recovery rhetoric on top of existing systems of care, failing to effect any real or substantial—not to mention revolutionary—changes due to our urgency to just “get it done.” In this chapter, we pause to consider some of the more common concerns we have encountered in attempting to introduce and implement care based on the vision of recovery that we have articulated thus far. Addressing these concerns, we believe, is a necessary fi rst step in changing the attitudes that underlie current practices in the process of replacing these attitudes with the more hopeful, empowering, and respectful attitudes demanded, and deserved, by people in recovery.

Keywords:   Hippocratic dictum commitment, New Freedom Commission Report, Psychiatric rehabilitation, Reimbursement strategies, Risk assessment, Schizophrenia, Treatment process

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