Recovery: a selective review of the literature and resources - Esec

REVIEW

Recovery: a selective review of the literature and resources Jerome Carson Clinical Psychologist, South London and Maudsley NHS Foundation Trust Gordon McManus Service user Anant Chander Assistant Psychologist, South London and Maudsley NHS Foundation Trust Abstract There has been a huge increase in the literature and resources devoted to the topic of recovery. Unusually in the mental health field, recovery is a concept that has been embraced by service users, professionals, mental health planners and governments. In this review, the authors offer a selection of what they feel are the top 10 on the topic of recovery in the following categories: journal papers; policy papers and reports; books; and websites. Gordon McManus gives his personal thoughts on his reading around recovery. The review ends with some reflections on the topic. Key words Recovery; Policy; Strengths; Hope; Self-determination

Top 10 journal papers on recovery 1. Recovery as a journey of the heart (Deegan, 1996) 4HEFIRSTINOURSERIESOFPAPERSISBYTHE !MERICANCLINICALPSYCHOLOGIST$R0ATRICIA$EEGAN 4HISHASBEENTHEMOSTINFLUENTIALPAPERFORUS $EEGANSTHEORIESAROSEFROMHEROWNEXPERIENCE ASAPSYCHIATRICPATIENT ANDSHEDRAWSON-ARTIN 3ELIGMANS THEORYOFLEARNEDHELPLESSNESS ASAWAYOFUNDERSTANDINGWHYSERVICEUSERSOFTEN GIVEUP3HESTATES @it is safer to become helpless rather than hopelessP 3HESUGGESTSTHREE MAINSTRATEGIESFORSTAFFTOCOPEWITHNEGATIVEAND APATHETICBEHAVIOUR&IRST STAFFNEEDTOTRYANDSEE @the behaviour in terms of its existential significance ... under the hardened heart is the breaking heart 3ECOND SHESUGGESTSTHATSTAFFTRYTOSEESERVICEUSERS

ASHEROES#OULDWEHAVESURVIVEDWHATTHEYHAVE SURVIVED4HIRD STAFFHAVETHEPOWERTOCHANGETHE HUMANINTERACTIVEENVIRONMENT@Relationship is the most powerful tool they have in working with people P 4HEGOALSHEARGUESFORALLOURSERVICEUSERS@is to become the unique, awesome, never to be repeated human being that we are called to be

2. The myth of recovery from mental illness (Whitwell, 1999) 7HITWELLUNDERTOOKRESEARCHINTHE"RISTOLAREA LOOKINGATTHEPROCESSANDEXPERIENCEOFRECOVERY 7HENHEASKEDPSYCHIATRISTCOLLEAGUESWHICHOFTHEIR PATIENTSTHEYFELTHADRECOVERED THEYNOMINATED ONLYSERVICEUSERSOVERANINE MONTHPERIOD -OSTOFTHESEPEOPLEFELT@that they had not really recovered4HEYWEREALSO@highly conscious of their impaired life position following their psychiatric

10.5042/mhsi.2010.0068 -ENTAL(EALTHAND3OCIAL)NCLUSIONs6OLUME)SSUEs&EBRUARY¥0IER0ROFESSIONAL,TD

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2ECOVERYASELECTIVEREVIEWOFTHELITERATUREANDRESOURCES

illness7HITWELLTALKSOFRECOVERYBEING@a mirage ANDTHAT@surviving mental illness may be a better description than recovery

3. The experience of recovery from schizophrenia: towards an empirically validated stage model (Andresen et al, 2003) !NDRESENANDCOLLEAGUESSURVEYEDTHESERVICE USERLITERATUREANDCAMEUPWITHFOURKEY COMPONENTPROCESSESINRECOVERY4HESEWERE DEVELOPINGASENSEOFHOPEASTRONGPERSONAL IDENTITYMEANINGINLIFEANDTAKINGPERSONAL RESPONSIBILITYFORRECOVERY4HEYALSOPROPOSEDA FIVE STAGEMODELOFTHERECOVERYPROCESS4HEFIRST STAGEISMORATORIUM(EREINDIVIDUALSMAYBEIN ASTATEOFDENIALORWITHDRAWAL4HESECONDSTAGE ISAWARENESS WHERETHEPERSONMAYBEGINTO BELIEVETHATRECOVERYMAYBEPOSSIBLE4HETHIRD STAGEISPREPARATION WHERETHEPERSONTAKESSTEPS TOCHANGETHEIRCIRCUMSTANCES SUCHASJOINING GROUPS4HEFOURTHSTAGEISREBUILDING4HISIS ABOUTTAKINGPERSONALRESPONSIBILITYFORRECOVERY ANDMAKINGPOSITIVELIFECHANGES4HEFIFTHAND FINALSTAGEISGROWTH(EREINDIVIDUALSHAVE DEVELOPEDAMOREPOSITIVEANDMEANINGFULLIFE ANDAREMORECONFIDENTINTHEIRABILITYTOMANAGE THEIRILLNESS!NDRESENANDCOLLEAGUESWENTON TODEVELOPAQUESTIONNAIRE BASEDMEASURETO ASCERTAINWHATSTAGEOFRECOVERYANINDIVIDUALMAY BEAT!NDRESENet al

4. The rediscovery of recovery: open to all (Roberts & Wolfson, 2004) 2OBERTSAND7OLFSONARGUETHATTHECONCEPTOF RECOVERYCANBETRACEDBACKOVERYEARSTO THE4UKESIN9ORK HENCEITSCURRENTREDISCOVERY 4HEYSUGGESTTHATTOMOVETOWARDSRECOVERY BASED SERVICES PROFESSIONALSNEEDTOTAKEONMOREOFA COACHINGRATHERTHANANEXPERTROLEFOCUSONHOPE ANDOPTIMISMNEGOTIATEMEDICATIONISSUESWORK WITHRISKANDDELIVERINTERVENTIONSINATIMELY MANNER4HEYCONCLUDETHAT@those leading the recovery movement are clear; it is an open-ended and cautiously optimistic process of sketching out a path forward and developing hope for a more satisfactory life, alongside whatever remains of the illnessP

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5. Concepts of recovery: competing or complementary? (Davidson et al, 2005) $AVIDSONANDCOLLEAGUESIDENTIFYTWOCONCEPTSOF RECOVERY&IRSTIS@an observable diminution of signs and symptoms of disorder and the restoration of cognitive, social and occupational functioning4HIS ISREFERREDTOASCLINICALRECOVERYBYOTHERAUTHORS 3ECOND WHATTHEYCALLTHEREHABILITATIONCONCEPT @refers to the person’s efforts to live his or her life in a meaningful and gratifying way despite the limitations imposed by enduring disabilityP 4HISHASBEENCALLEDSOCIALRECOVERYBYOTHER WRITERS4HEAUTHORSCONCLUDETHATBOTHCLINICALAND SOCIALRECOVERYAREEQUALLYIMPORTANT

6. Recovery from schizophrenia: a concept in search of research (Liberman & Kopelowicz, 2005) 4HESEAUTHORSCRITIQUEALOTOFTHERESEARCHON RECOVERY STATING@recovery has been associated with as many meanings as there are proponents of this termP 4HEYGIVEFOURCLINICALDEFINITIONS OFRECOVERY4HEIROWNDEFINITIONSTRESSESATWO YEARPERIODOFSYMPTOMREMISSION ENGAGEMENTIN WORKOREDUCATION INDEPENDENTLIVING GOODFAMILY RELATIONS BEINGINVOLVEDINRECREATIONALACTIVITIES ANDHAVINGASATISFYINGSOCIALNETWORK4HEY BELIEVETHATINDIVIDUALSSHOWINGTHISLEVELOFCLINICAL IMPROVEMENTSHOULDEQUALLYHAVEHIGHERLEVELSOF HOPE EMPOWERMENT PERSONALRESPONSIBILITYAND AUTONOMY

7. Recovery and positive psychology: parallel themes and potential synergies (Resnick & Rosenheck, 2006) 4HESEWERETHEFIRSTAUTHORSTOLINKTHE DEVELOPINGFIELDOFPOSITIVEPSYCHOLOGYWITH THATOFRECOVERY7HILEPOSITIVEPSYCHOLOGYHAS FOLLOWEDANACADEMICPATHANDISGROUNDEDIN SCIENTIFICRESEARCH RECOVERYHASNOT4HEPOSITIVE PSYCHOLOGYAPPROACH @stands in stark contrast to the recovery movement, a grassroots movement of the disenfranchised that has placed itself apart from the human services professionsP )NTHEIROWN CLINICALWORK THEAUTHORSAPPLIEDTHESTRENGTHS SURVEYSEEWWWVIASTRENGTHSORG WITHSERVICE USERSINTHEIRVETERANSADMINISTRATIONSERVICE

-ENTAL(EALTHAND3OCIAL)NCLUSIONs6OLUME)SSUEs&EBRUARY¥0IER0ROFESSIONAL,TD


8. Peer-professional first-person account: schizophrenia from the inside – phenomenology and the integration as causes and meanings (Chadwick, 2006) 0ETER#HADWICKLINKSTHEDEVELOPMENTOFHISOWN PSYCHOSIS WITHTHEBIO PSYCHO SOCIALMODELOF MENTALILLNESS(EISAMONGTHEBESTADVOCATESFOR THE@peer professionalOR@user academicPERSPECTIVE WHOCAN@straddle the chasm separating the insane from the sane and hence facilitate cross talk between themP )NDOINGSO HEWRITESFROMTHESAME PERSPECTIVEAS2ACHEL0ERKINS AND0ATRICIA $EEGAN )NHISOWNWRITINGS HEFOCUSESMORE ONHOWHISUPBRINGINGANDLIFESTYLECONTRIBUTED TOWARDSMAKINGHIMMORESUSCEPTIBLETOPSYCHOSIS

9. An analysis of the definitions and elements of recovery: a review of the literature (Onken et al, 2007) /NKENANDCOLLEAGUESTRACETHEHISTORYOFTHE CONCEPTOFRECOVERY4HEYIDENTIFYTHEKEYELEMENTS INPERSON CENTREDRECOVERY4HESEAREHOPE SENSE OFAGENCY AWARENESSANDPOTENTIALITY RE AUTHORING ELEMENTSOFRECOVERY COPING HEALING WELLNESS THRIVINGNOWOFTENREFERREDTOAS@FLOURISHING RECIPROCITYINRELATIONSHIPS SOCIALFUNCTIONINGAND SOCIALROLES POWER CHOICES SOCIALCONNECTEDNESS SOCIALOPPORTUNITIES INTEGRATIONANDREALISING RECOVERY

10. Recovery from schizophrenia and the recovery model (Warner, 2009) &ORMANYYEARS 7ARNERHASRESEARCHEDDIFFERENCES INRECOVERYOUTCOMESACROSSCULTURES(ESTARTS BYLOOKINGATOUTCOMESTUDIESINSCHIZOPHRENIA INTHEDEVELOPEDWORLD(ENOTES @xone of the most robust findings about schizophrenia is that a substantial proportion of those who present with the illness will recover completely or with good functional capacity, with or without modern medical treatment P 1UOTINGFINDINGSFROMTHE7ORLD(EALTH /RGANIZATION International Pilot Study of Schizophrenia HEPOINTSOUTTHATTHECOURSEOF ILLNESSANDOUTCOMEARESUPERIORINTHEDEVELOPING WORLD%QUALLYPUZZLINGISTHEFACTTHATMORTALITYIN SCHIZOPHRENIAISALSOLOWERINTHEDEVELOPINGWORLD (EPRESENTSRESEARCHEVIDENCETOSHOWTHATWORK

ISASSOCIATEDWITHBETTEROUTCOMES ESPECIALLYTHE INDIVIDUALPLACEMENTANDSUPPORTMODEL)03 (E NOTESTHATEMPOWERMENTANDREDUCINGINTERNALISED STIGMAMAYBEASIMPORTANTASHELPINGINDIVIDUALS DEVELOPINSIGHTINTOTHEIRILLNESSES

Top 10 policy papers and reports on recovery 1. NIMHE Guiding Statement on Recovery (National Institute for Mental Health in England, 2005) 4HEFIRSTREPORTINTHISSECTIONWASPUBLISHEDIN SHOWINGTHATCLINICALANDRESEARCHFINDINGS PRECEDEPOLICYCHANGE4HE.ATIONAL)NSTITUTE FOR-ENTAL(EALTHIN%NGLAND.)-(% PRODUCED a Guiding Statement on RecoveryINTHISYEAR WHICHDEFINEDRECOVERYAS@what people experience themselves as they become empowered to manage their lives in a manner that allows them to achieve a fulfilling, meaningful life and a contributing positive sense of belonging in their communities .OTETHATTHEREISNOREFERENCETOPSYCHIATRIC SYMPTOMS .)-(%LISTPRINCIPLESFORRECOVERY BASEDSERVICES EG0RINCIPLE @The user of services decides if and when to begin the recovery process and directs it; therefore, service user direction is essential through the process

2. Evidence of Recovery: The ups and downs of longitudinal outcome research (Dorrer, 2006) $ORRERREVIEWEDOUTCOMESTUDIESIN SCHIZOPHRENIA3HEPOINTSOUTTHATWHAT RESEARCHERSSEEASAGOODOUTCOMEISNOTWHAT SERVICEUSERSMAYSEEASAGOODOUTCOME4HE /HIO/UTCOMES4ASK&ORCESUGGESTEDTHATTHE FOURTOPRECOVERYINDICATORSFORSERVICEUSERS WEREHAVINGHOPE TRUSTINGYOUROWNTHOUGHTS ENJOYINGTHEENVIRONMENTANDFEELINGALERTAND ALIVE3TEWART (ERCONCLUSIONISTHAT@ around 40% of people diagnosed with a severe mental illness do get significantly better with time 9ETTHISIMPLIESTHATDONOTRECOVERORONLY PARTIALLYRECOVER

3. Whose Recovery is it Anyway? (Social Perspectives Network, 2007) In Whose Recovery is it Anyway? THE3OCIAL 0ERSPECTIVES.ETWORKPRESENTEDASERIESOF


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WORKSHOPSANDPRESENTATIONSTAKENFROMASTUDY DAYORGANISEDAROUNDRECOVERY4HEREISAWORRY THAT@xthe recovery agenda is being colonised by mental health services and inevitably being re-articulatedP )NHISINTRODUCTION +EATING SUGGESTSTHAT@xmental health professionals should be prepared to relinquish power and control and work in meaningful hope inspiring relationships with people who use their servicesP 4HISREPORT CONTAINSATHOUGHTFULCOLLECTIONOFPAPERS"UT ASTHETITLEOFTHECOLLECTIONREMINDSUS@Whose recovery is it anyway ... it is of course the service user’s recovery.

4. Recovery and Strengths Based Practice (McCormack, 2007) *OHN-C#ORMACKADDRESSESTHEISSUEOFSTRENGTHS ANDRECOVERY(ESTARTSFROMTHEPROPOSITIONTHAT MENTALHEALTHPROFESSIONALSTRADITIONALLYFOCUSON DEFICITS PROBLEMSANDDISABILITIES(EDRAWSON THESTRENGTHSAPPROACHFROMTHECASEMANAGEMENT FIELD4HISFOCUSESONSERVICEUSERSSKILLS COMPETENCIESANDTALENTS ANDNOTTHEIRDEFICITS(E OFFERSSOLUTION FOCUSEDTHERAPYASAWAYOFMOVING TOWARDSASTRENGTHS BASEDMODEL3TRENGTHSLIEIN INDIVIDUALSPASSIONS SKILLS INTERESTSANDINTHEIR RELATIONSHIPSANDENVIRONMENTSP

5. Life and Times of a Supermodel: The recovery paradigm for mental health. MindThink Report 3. (Mind, 2008) 4HE-IND2EPORT Life and Times of a Supermodel WASBASEDONAROUNDTABLEDISCUSSIONWITH ANUMBEROF"RITISHRECOVERYEXPERTS4HISIS PROBABLYONEOFTHEMOSTENGAGINGDISCUSSION DOCUMENTSONRECOVERY)NECHOINGTHETHEMEOF THELASTREPORT $EREK$RAPERCOMMENTED @Once a concept is taken up officially, it is a good bet that it will be defined and used in a way that won’t reflect the understandings and values of the people who framed it and need itP 4HEREWEREALSO COMMENTSONNEGATIVECHANGESTOTHEWELFARE SYSTEM @and a narrow focus on employment as the holy grail of recoveryP 4HEREPORT CONCLUDESTHAT@the recovery vision ... cannot be realised without significant changes to professional practice, social attitudes, public discourses, cultural norms and assumptions, and economic and social structuresP

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6. Making Recovery a Reality (Shepherd et al, 2008) 4HENEEDFORPROFESSIONALSTOCHANGETHEIRWAYS OFWORKINGISVERYMUCHATHEMETAKENUPINTHE 3AINSBURY#ENTREFOR-ENTAL(EALTHREPORT Making Recovery a Reality4HEAUTHORSSUGGEST FOLLOWING 2EPPERAND0ERKINS THATPROFESSIONALSNEED TOMOVEFROMAPOSITION@of being on top, to being on tap4HEYCITEWORKBY"ORGAND+RISTIANSEN THATTHEKEYPRACTITIONERRECOVERYSKILLSARE@openness, collaboration as equals, focusing on individual’s inner resources, reciprocity and a willingness to go the extra mile4HEYGIVEALISTOFTOPTIPS WHICH PROFESSIONALSNEEDTOASKTHEMSELVESAFTERSESSIONS WITHSERVICEUSERS EG@Did I convey an attitude of respect and a desire for an equal partnership in working together?’P

7. 100 Ways to Support Recovery: A guide for mental health professionals. Rethink recovery series: Volume 1 (Slade, 2009a) In 100 Ways to Support Recovery -IKE3LADE PROVIDESSTRAIGHTFORWARDGUIDANCEFORMENTALHEALTH PROFESSIONALS4HISISAVERYPRACTICALUSER FRIENDLY GUIDETOUNDERSTANDINGRECOVERY)TCOVERSPERSONAL RECOVERY RELATIONSHIPS THEFOUNDATIONSOFARECOVERY SERVICE ASSESSMENT ACTIONPLANNING SELF MANAGEMENT CRISES RECOGNISINGARECOVERYFOCUSINSERVICESAND TRANSFORMINGSERVICES

8. New Horizons: Towards a shared vision for mental health (Department of Health, 2009) New Horizons: Towards a shared vision for mental healthISTHEGOVERNMENTSSUCCESSORTOTHENational Service Framework for Mental Health $EPARTMENT OF(EALTH )TSETSOUT@THEROADMAPFORFUTURE MENTALHEALTHSERVICES POSITINGANUMBEROFCHANGES NOTJUSTINSERVICES BUTINSOCIETYATLARGE"YTHE YEAR FOREXAMPLE @ the stigma attached to mental health will have declined dramaticallyP )TSTWINAIMSARETOIMPROVE@the mental health and well-being of the populationANDTOIMPROVE@the quality and accessibility of services to people with poor mental healthP )TALSOTAKESALIFESPANAPPROACH 4HEVISIONIS@to create flourishing and connected communities through the promotion of well-being and resilience and the reduction of inequalitiesP 2ECOVERYISONLYONEPARTOFTHISVISION



9. Getting Back into the World: Reflections of lived experiences of recovery. Rethink recovery series: Volume 2 (Ajayi et al, 2009) !JAYIANDCOLLEAGUESSTUDIEDSERVICEUSERS VIEWSOFWHATMADETHEIRRECOVERYPOSSIBLE7HILE WEHAVEPREVIOUSLYFELTTHAT'ORDON-C-ANUS DEFINITIONOFRECOVERY @coping with your illness and having a meaningful life-C-ANUSet al WASASPARSIMONIOUSADEFINITIONAS ONECOULDWISHFOR THEREAREEQUALLYSUCCINCT DEFINITIONSHEREFROMOTHERSERVICEUSERS&OR INSTANCE @recovery is longevity in wellnessP @recovery is an individual journey towards a more valued lifeP AND@recovery is about getting things togetherP 4HEAUTHORSCONCLUDE THAT@recovery can only become a reality when the context and available opportunities allow the person to develop. This involves having basic needs covered, being in helpful relationships and receiving support and treatment to help control or minimise mental health problemsP

10. Recovery in Action Project Report (Mental Health Foundation, 2009) 4HERecovery in Action Project ReportFROMTHE 3TRATEGIC.ETWORKFOR-ENTAL(EALTHDESCRIBES SEVENDIFFERENTPROJECTSTHATLOOKEDATWAYSTO EMBEDRECOVERYWITHINTHEIRPRACTICE@Service users have given us a clear message. Recovery cannot be achieved by a one size fits all approach P 4HEPROJECTSDEVELOPEDARECOVERY TRAINING MODULE ASETOFSERVICEUSEROUTCOMES ACHECKLIST FORORGANISATIONSANDACTIONLEARNINGSETSFOR STAFFANDSERVICEUSERS@The idea of a Recovery in Action Project was daunting and exciting – exciting because there is no start and no endx P 3ERVICEUSERSRATEDTHEMOSTIMPORTANT ASPECTSOFRECOVERYAS@having hope, having their basic needs met, having the opportunity to be involved in personally meaningful activities, having helpers who care, being able to build on their own strengths and skills, having meaning in life, general health and well-being and having assistance in a crisisP 4HERANKINGOF THEIMPORTANCEOFNEEDSCHANGEDOVERTIME SUGGESTINGTHENEEDFORFLEXIBILITYINSERVICE PROVIDERS3ERVICEUSERSALSOREPORTEDADDITIONAL

NEEDSATFOLLOW UP INCLUDING@the need for patience, having self-confidence and a belief in oneself, and having opportunity to help others on their recovery journeys

Top 10 books on recovery 1. A Gift of Stories: Discovering how to deal with mental illness (Leibrich, 1999) )FRECOVERYISTRULYABOUTSERVICEUSERS THENTHIS BOOKCONTAINSTHEMOSTINSPIRINGSETOFSTORIES YETGATHERED4HEBOOKISLAVISHLYILLUSTRATEDWITH PHOTOGRAPHSFROMEACHSERVICEUSERSLIFE)N HEROWNSTORY ,EIBRICHSUGGESTSTHATTHEWORD @DISCOVERYMIGHTBEABETTERWORDTODESCRIBETHE PROCESSESTHATSHEANDTHEOTHERCONTRIBUTORSWENT THROUGH@Right now, the best way I can describe dealing with mental illness, is making our way along an ever-widening spiral of discoveryx P !S,EIBRICHALSOPOINTSOUT WHILE PROFESSIONALSHAVEKNOWLEDGEANDSKILLS THEY NEEDTOUSETHEMWITHRESPECTFORTHESERVICEUSER 3HECOMMENTS@some of us say mental illness is a gift – because you can discover many wonderful things about yourself through dealing with it P 1UITESIMPLY THISISTHEBESTBOOKWRITTEN ONRECOVERY

2. From the Ashes of Experience: Reflections on madness, survival and growth (Barker et al, 1999) 4HISBOOKHASANUMBEROFEXPERTCONTRIBUTORS WHOTELLTHEIROWNRECOVERYSTORIES4HE!MERICAN CONTRIBUTORSINCLUDE*UDI#HAMBERLIN ONEOF THEMOSTFAMOUSRECOVERYACTIVISTSAND$R$AN &ISHER APSYCHIATRISTWHOWASDIAGNOSEDWITH SCHIZOPHRENIA2ACHEL0ERKINSREMARKABLECHAPTER LOOKSATHERTHREEPSYCHIATRICCAREERSPSYCHOLOGIST MENTALHEALTHACTIVISTANDSERVICEUSER4HEEDITORS OFFERTHEFOLLOWINGWISDOM ‘Perhaps mental health professionals do not need new psychological tools, so much as old human ones: the capacities to display trust, to express love and to have faith – faith in themselves, faith in their own potential for human growth and development and also faith that the person they are helping will emerge, relatively unscathed, from their journeys.’ P


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3. The Power of Procovery in Healing Mental Illness (Crowley, 2000) !S7ILLIAM!NTHONYSTATESINHIS&OREWORD #ROWLEYSCONCEPTOFPROCOVERY@focuses on what the person with the diagnosis can do to take action – to move forward with one’s life – and how family and treatment staff can be more helpful in supporting procoveryPVII 0ROCOVERYUTILISESA@just start anywherePHILOSOPHY4HEBOOKCOMPRISESA NUMBEROFCHAPTERSTOBUILDPROCOVERY SUCHAS UNCOVERINGHOPE%ACHCHAPTERENDSWITHNOTESFOR CONSUMERS FAMILYMEMBERSANDSTAFF4HISISVERY MUCHINTHETRADITIONOF!MERICANSELF HELPBOOKS

4. Social Inclusion and Recovery: A model for mental health practice (Repper & Perkins, 2003) @When we think about disability, we think about inclusion: access to roles, activities and facilities. We think about people’s interests, aspirations and achievementsP )NTHISPUBLICATION THEAUTHORS PRESENTAMODELOFSOCIALINCLUSIONANDRECOVERY WITHTHREEMAINCOMPONENTS&IRST FACILITATING PERSONALADAPTATION EGHELPINGINDIVIDUALSTO DEVELOPASENSEOFCONTROLOFTHEIRILLNESS3ECOND PROMOTINGACCESSANDINCLUSION EGHELPINGTHE PERSONACCESSMONEY CLOTHINGANDACCOMMODATION 4HIRD CREATINGHOPEANDINSPIRINGRELATIONSHIPS EG SEEINGANDHAVINGCONFIDENCEINTHEPERSONSSKILLS ABILITIESANDPOTENTIALS4HEAUTHORSCONCLUDE@the essence of recovery lies not in the removal of mental health problems, but in recovering a meaningful and valued lifeP

5. Enabling Recovery: Principles and practice of rehabilitation psychiatry (Roberts et al, 2006) )NCHAPTERS THISBOOKCOVERSFOUNDATIONS THERAPEUTICPRACTICES SERVICESANDORGANISATIONAL PERSPECTIVES SPECIALGROUPSANDENDSBYASKING@Where are we going-OSTOFTHECONTRIBUTORSAREPSYCHIATRISTS ORCLINICALPSYCHOLOGISTS WITHSEVERALBEINGRECOVERY EXPERTS SUCHAS4OM#RAIG 'EOFF3HEPHERDAND0AUL 7OLFSON ASARETHEEDITORSTHEMSELVES4HEBOOK PROVIDESONEOFTHEBESTTECHNICALOVERVIEWSOFTHE FIELDFORPROFESSIONALS@A key issue for contemporary health and social services is to put the experience of the user ... at the heart of the way the service isP

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6. The World is Full of Laughter (Sen, 2006a) 4HISISAREMARKABLEACCOUNTOF$OLLY3ENSUPBRINGING ANDSUBSEQUENTBATTLESWITHMENTALILLNESS!SECOND VOLUME Am I Still Laughing?3EN B HAS MOREOFARECOVERYFOCUS7EHAVEBEENFORTUNATE ENOUGHTOKNOWANDWORKWITH$OLLY(ERSTORYIS ALMOST$ICKENSIAN WITHTHETALEOFHARDSHIPSTHATSHE ENDURED)TSHOULDBEREQUIREDREADINGFORALLTRAINEE PROFESSIONALS

7. Changing Outcomes in Psychosis: Collaborative cases from practitioners, users and carers (Velleman et al, 2007) 4HISBOOKREFLECTSAUNIQUECOLLABORATIONBETWEEN CARERS SERVICEUSERSANDPROFESSIONALS WITHONLYONE CHAPTERJUSTWRITTENBYPROFESSIONALS4HEAUTHORS SETOUTTODOTHISTOTRYANDREDUCESTIGMAAND DISCRIMINATIONANDTOPROMOTERECOVERYANDSOCIAL INCLUSION@Co-writing between users and providers of services throws up challengesP )NDEED TWO SERVICEUSERSWERETOOUNWELLTOCO AUTHORTHEIR CHAPTERS4HEYSUGGESTTHAT ‘... the healing pathway is most attainable when all care stakeholders (users, carers, practitioners) work closely together, as equals, over timeP

8. A Practical Guide to RecoveryOriented Practice (Davidson et al, 2009) )NASERIESOFVERYHELPFULTABLES THEAUTHORSOFTHIS PUBLICATIONDISTILWHATBEINGINRECOVERYMEANS&OR SERVICEUSERS HOPECANMEANFEELINGGOODABOUTTHE FUTUREORHAVINGDREAMSAGAIN&ORSERVICEPROVIDERS IT MIGHTMEANUSINGALANGUAGEOFHOPEANDPOSSIBILITY &ORMANAGERSITMAYMEANEMPLOYINGPEOPLEIN RECOVERYTOSERVEASROLEMODELSANDSOURCESOFHOPE FORPEERS4HEYGIVETWORECOVERYMARKERSFORHOPE &IRST THATSTAFFSHOULDPAYASMUCHATTENTIONTOTHOSE SERVICEUSERSWHOAREDOINGWELL ASTOTHOSEWHOARE STRUGGLING3ECOND THATSTAFFBELIEVEINTHEABILITYOF PEOPLETORECOVER4HEYOUTLINEAMODELOFCLINICAL CASEMANAGEMENTTHATEMBODIESRECOVERYPRINCIPLES 3UCHASYSTEMWOULDPROVIDECARETHATPROMOTES RECOVERYISSTRENGTHSBASEDISCOMMUNITYFOCUSEDIS PERSONDRIVENALLOWSFORRECIPROCITYINRELATIONSHIPS ISCULTURALLYRESPONSIVEISGROUNDEDINTHEPERSONS LIFECONTEXTADDRESSESSOCIO ECONOMICASPECTSIS RELATIONALLYMEDIATEDANDOPTIMISESNATURALSUPPORTS



9. Schizophrenia: The positive perspective (Chadwick, 2009)

3. The Scottish Recovery Network – www.scottishrecovery.net

0ETERISONEOFTHEMOSTELOQUENTWRITERSONTHE SUBJECTOFPSYCHOSIS4HISSECONDEDITIONOFHIS BOOKHASBEENCOMPLETELYUPDATEDANDALSOHAS NEWSECTIONSONCANNABIS5NDERSTANDINGTHE PROCESSESOFRECOVERY@needs a biological, an intrapsychic and an interpersonal perspective, taking subjective factors into account. Metaphors, narratives, self-talk and insight are just as important as neural pathwaysP !SINHISOTHERWRITINGS 0ETERCOMBINESHISOWNEXPERIENCEOFPSYCHOSIS WITHCONNECTIONSFROMTHERESEARCHLITERATURE IN AWAYNOOTHERWRITERACHIEVES(EHASWRITTEN NUMEROUSPAPERSANDSEVERALBOOKS ANDWHILE THISISTHEMOSTUPTODATE ONEOFHISOTHERBOOKS #HADWICK ISALSOHIGHLYRECOMMENDED

4HE3COTTISH2ECOVERY.ETWORK32. WEBSITEWAS LAUNCHEDININORDERTO@raise awareness of recovery from mental illnessANDHASFOURMAINSECTIONS nSTORIES RECOVERY RESOURCESANDACTIVITIES4HESTORIES SECTIONFEATURESTHERECOVERYJOURNEYSTORIESBOOKLET PUBLISHEDBYTHE32.ANDISAVAILABLEFORDOWNLOAD )NTHERESOURCESSECTIONTHEREAREARANGEOFDIFFERENT MEDIAnVIDEOS PODCASTSANDDOWNLOADABLEPDFFILES ONTOPICSSUCHAS@STAYINGWELLAND@ROUTESTORECOVERY

10. Personal Recovery and Mental Illness: A Guide for mental health professionals (Slade, 2009b) 4HISISPROBABLYTHEBESTSINGLEAUTHOROVERVIEW OFTHEFIELDOFRECOVERY4HEBOOKCOVERSABROAD RANGEOFRECOVERY RELATEDTOPICSFROMASSESSMENTTO SOCIALINCLUSION3LADEARGUESTHATPERSONALRECOVERY NOTCLINICALRECOVERY SHOULDBETHEDIRECTION OFTRAVELFORMENTALHEALTHSERVICES3LADEHIMSELF TRAVELLEDALLAROUNDTHEWORLDLOOKINGATRECOVERY BASEDSERVICES SOHISVIEWSHAVEBEENINFORMEDBY BESTPRACTICEACROSSTHEGLOBE

Top 10 websites on recovery 1. Recovery Devon – www.recoverydevon.co.uk 2ECOVERY$EVONISANEDUCATIONALWEBSITE4HERE ARELINKSTOVARIOUSSELF HELPTECHNIQUESANDSOME OFTHEKEYTHERAPIESAVAILABLE)TALSOPROVIDESAN EXTENSIVELISTOFUSEFULARTICLESANDOTHERMATERIALS THATAREAVAILABLEFORDOWNLOADDIRECTLYFROMTHE WEBSITE

2. Rethink – www.rethink.org 2ETHINKISTHEWEBSITEOFONEOFTHELEADING NATIONALMENTALHEALTHCHARITIES)THASUSEFUL RESOURCESONTHEEFFECTSOFMENTALILLNESS KNOWN CAUSESANDDIAGNOSES)TCOVERSLIVINGWITH MENTALILLNESSANDTALKSABOUTHOW2ETHINKCAN HELPTHROUGHTHEIRSERVICES SUPPORTGROUPSAND PUBLICATIONS

4. Mary Ellen Copeland and the Wellness recovery action plan – www.mentalhealthrecovery.com 4HISWEBSITEWASSTARTEDIN INCONJUNCTIONWITH THESTARTOF-ARY%LLEN#OPELANDSSTUDYINTOHOW PEOPLE@help themselves, get well and stay well4HE MISSIONOFTHESITEISTOTEACHPEOPLEABOUTSELF HELP STRATEGIESANDSELF MANAGEMENTSKILLS7ELLNESSRECOVERY ACTIONPLANS72!0 ANDWELLNESSTOOLSAREAKEYPART 4HEWEBSITEALSOHASSOMEUSEFULRECOVERYLITERATURE ANDANE LEARNINGSECTIONFOR72!0

5. The Mental Health Foundation – www.mentalhealth.org.uk 4HE-ENTAL(EALTH&OUNDATIONISANOTHERLEADING5+ CHARITY)TPROVIDES@information, conducts research, campaigns and works to improve services for anyone affected by mental health problems4HEMENTALHEALTH !n:SECTIONPROVIDESINFORMATIONABOUTARANGEOF DIFFERENTMENTALHEALTHPROBLEMS

6. National Alliance on Mental Illness of Santa Cruz County – www.namiscc.org/ mentalhealthrecovery.htm 4HE.ATIONAL!LLIANCEON-ENTAL)LLNESSISAFAMILY ORGANISATIONWHOSEROLEISTOWORKTOGETHERFOR THEMSELVES THEIRFAMILIESANDTHEIRCOMMUNITY4HEY PROVIDESUPPORTGROUPS ANDALTHOUGHAREONLYLOCAL THEYDOHAVEAWIDEVARIETYOFUSEFULRESOURCES4HE MOSTENDEARINGFEATUREONTHISSITEISITSINVOLVEMENTOF SERVICEUSERS

7. The Institute of Psychiatry and Recovery – www.iop.kcl.ac.uk/recovery 4HISISARELATIVELYNEWWEBSITE)THASLINKSTO THE)O0LIBRARY TOSOMEOFTHECURRENTRESEARCH


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BEINGUNDERTAKENANDMENTALHEALTHRESOURCES nINCLUDING@MENTALHEALTHCARE @GETTINGHELP AND@-INDSEARCH4HISISATOOLTOHELPCONNECT RESEARCHERSWITHMEMBERSOFTHEPUBLICWILLINGTO TAKEPARTINTHEIRSTUDIES

8. The National Empowerment Centre – www.power2u.org 4HISWEBSITESMISSIONSTATEMENTIS‘to carry a message of recovery, empowerment, hope and healing to people who have been labelled with mental illness)THAS USEFULLINKSTOARTICLESANDRESEARCH SERVICESOFFERED BYTHECENTRE RECENTANDUPCOMINGEVENTSANDSTORIES OFRECOVERY

9. The Hearing Voices Network – www.hearing-voices.org 4HEAIMOFTHISNETWORKISTORAISEAWARENESSOF HEARINGVOICES)TGIVESMEN WOMENANDCHILDREN WHOHAVETHESEEXPERIENCESANOPPORTUNITY TOTALK)TAIMSTOSUPPORTANYONEWITHTHESE EXPERIENCESSEEKINGTOUNDERSTAND LEARNANDGROW FROMTHEM4HEYOFFERINFORMATIONABOUTSELF HELP GROUPS PUBLICATIONSTODOWITHHEARINGVOICES NEWSANDEVENTSANDNUMEROUSLINKSTOOTHER GROUPSANDARTICLES

10. YouTube – www.youtube.com !LTHOUGH9OU4UBEISNOTSTRICTLYARECOVERYWEBSITE IT PROVIDESFREEANDEASYACCESSTOARANGEOFRECOVERY VIDEOS4HESEINCLUDEA MINUTEVIDEOOF-ARY%LLEN #OPELAND EXPLAININGINDETAILHERWELLNESSRECOVERY ACTIONPLANSANDPSYCHIATRIST$ANIEL&ISHERTALKING ABOUTHOPEANDRECOVERY

Gordon’s reflections on recovery papers )N AFTERHAVINGBEENDIAGNOSEDWITHPARANOID SCHIZOPHRENIA )RESOLVEDTO@REBUILDMYLIFE)DECIDED TOUSEWRITINGANDCHESSTOREBUILDMYINTELLECTUAL FUNCTIONING5NFORTUNATELY)BROKEDOWNIN 4WOBREAKDOWNSANDHOSPITALISATIONSWITHINATHREE YEARPERIODLEFTMEFEELINGTHAT)COULDNOTREBUILD MYLIFE)WASIN@LIMBOFORTHENEXTTHREEYEARS)N )WASFACEDWITHSEVERESCHIZOPHRENIABUTNOT QUITEABREAKDOWN0OLITICAL@VOICESWEREAFFECTING MESEVERELY)DECIDEDTOWRITEABOUTGLOBALISATION ANDSPENTTHENEXTSIXMONTHS FROM/CTOBERTO -ARCH!PRIL ONTHISPROJECT DESPITETHE@VOICES THAT)COULDHEARAND@FORMSTHAT)COULDSEE

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)WASREFERREDTOTHE0SYCHOLOGICAL)NTERVENTION #LINICFOR/UTPATIENTSWITH0SYCHOSISAT-AUDSLEY (OSPITAL ,ONDONBYMYTHENCONSULTANTPSYCHIATRIST $R-C'OWAN)N-AY )ATTENDEDCOUNSELLING THERAPY)TWASTHEBEGINNINGOFMYRECOVERYSTAGE ANDWASALSOTHEFIRSTTIMETHAT)CAMEACROSSTHE WORD@RECOVERY4HETHERAPYLASTEDFORSIXMONTHS )TWASTHEFIRSTTHERAPYTHAT)HADRECEIVED,ATERIN MYTHENCOMMUNITYPSYCHIATRICNURSE 3IMON 'ENT REFERREDMETO$R#ARSON)BEGANTHERAPY WITH$R#ARSONIN(EINTRODUCEDMETOTHE PSYCHOLOGICALCONCEPTOFRECOVERY -YRECOVERYREADINGBEGANIN WITHACOUPLE OFARTICLESBYINDIVIDUALSWHOHADSUFFEREDANDSTILL SUFFERFROMSCHIZOPHRENIA4HESEINDIVIDUALSWERE$R 0ATRICIA$EEGANAND*AMES"ELLAMY$EEGAN "ELLAMY !TFIRST )WASNOTINTERESTEDINREADING THESEARTICLES/NTHEWAYBACKHOME ONTHEBUS ) DECIDEDTOREAD*AMESSSTORY)TWASBRUTALLYHONEST AND)EMPATHISEDWITHHIM)WASSURPRISEDTHATGIVEN HISSCHIZOPHRENIAHECOULDWRITEABOUTHISCONDITION )WASAFRAIDTOEVENTHINKABOUTMYCONDITION LET ALONEWRITEABOUTIT)ALSOREAD$R$EEGANSARTICLEON THEBUS7HEN)GOTHOME)MADEACUPOFCOFFEEAND RE READTHESETWOARTICLES $R$EEGANSARTICLEHADAPROFOUNDEFFECTON ME3HETALKSABOUTTHESTAGEOFRECOVERY3HE STATESTHATRECOVERYISNOTACURE4HESTAGEOF RECOVERYISCONCERNEDWITHDEVELOPINGYOURSELFASA HUMANBEING WHILELIVINGWITHYOURDISABILITY3HE TALKSABOUTA@new sense of self4HISRESONATEDWITH MYAPPROACH 4HENEXTPERSONWHOHADAGREATINFLUENCEON MYRECOVERYISTHEPSYCHOLOGIST$R2ACHEL0ERKINS WHOSUFFERSFROMBIPOLARDISORDER0ERKINS 3HETALKSABOUTTHECONCEPTSOF@hopeAND@coping 4HESEWERETWOIMPORTANTCONCEPTSTHATHELPEDTO STRUCTUREMYRECOVERY $OLLY3EN WHOSUFFERSFROMMENTALILLHEALTH 3EN AB INSPIREDMETOWRITEABOUT MYCONDITIONANDTHISARTICLEISAPRODUCTOFTHAT INSPIRATION !NOTHERPERSONWHOHADANINFLUENCEWAS*ULIE ,EIBRICH WHOSEBOOK A Gift of Stories,EIBRICH SHOWEDMEHOWOTHERPEOPLECOPEDWITHTHEIR ILLNESSANDTRIEDTODEVELOPTHEMSELVES &INALLY THEREIS$R'LEN2OBERTS APSYCHIATRIST WHOSUFFERSFROMDEPRESSION(ESTATESTHAT @recovery is work, often hard work2OBERTS (EISQUITECORRECT



4HESEINDIVIDUALSHAVEHELPEDMETOFINDMY OWNUNDERSTANDINGORDEFINITIONOFRECOVERY&OR ME RECOVERYIS@coping with my illness and trying to have a meaningful life-C-ANUSet al 4HESEPEOPLEHAVESHOWNMETHATRECOVERYIS ASLOWPROCESSANDISHARDWORK4HESEPEOPLE INCLUDING$R#ARSON HAVEHELPEDMETORATIONALISE ANDOBJECTIFYMYCONDITION

Concluding comments 7EHAVEPROVIDEDANOVERVIEWOFLITERATUREAND RESOURCESINTHEFIELDOFRECOVERY4HENUMBER OFJOURNALPAPERS BOOKSANDREPORTSISGROWING RAPIDLY ESPECIALLYINTHELASTFEWYEARS4HEREIS NOWCOMMONACKNOWLEDGEMENTTHATRECOVERYIS MORETHANSYMPTOMATICIMPROVEMENT ANDTHATIT ALSOINVOLVESSOCIALANDPSYCHOLOGICALELEMENTS 7HILERECOVERYMAYORIGINALLYHAVEBEENGROUNDED INA@GRASSROOTSADVOCACYMOVEMENT THEREAREREAL DANGERSTHATMENTALHEALTHPROFESSIONALS ESPECIALLY IN!MERICA MAYTRYANDDIVERTTHEMOVEMENTAWAY FROMITSFOCUSONSERVICEUSERS TOWARDSSCIENTIFIC RESEARCHANDRANDOMISEDCONTROLLEDTRIALS

Acknowledgement 4HEAUTHORSAREGRATEFULTO0AUL(ARRINGTONAND 3HEILA7ATSONFORHELPWITHTHELITERATUREREVIEW *ANE&RADGLEYPROVIDEDTHEPHOTOS

References

!JAYI3 "ILLSBOROUGH* "OWYER4 "ROWN0 (ICKS! ,ARSEN * -AILEY0 3AYERS23MITH2 Getting Back into the World: Reflections of lived experiences of recoveryRethink recovery series: Volume 2,ONDON2ETHINK !NDRESEN2 /ADES,#APUTI0 4HEEXPERIENCE OFRECOVERYFROMSCHIZOPHRENIATOWARDSANEMPIRICALLY VALIDATEDSTAGEMODELAustralian and New Zealand Journal of Psychiatry 37 n !NDRESEN2 #APUTI0/ADES, 3TAGESOF 2ECOVERY)NSTRUMENTDEVELOPMENTOFAMEASUREOF RECOVERYFROMSEVEREMENTALILLNESSAustralian and New Zealand Journal of Psychiatry 40n n !NTHONY7 &OREWORD)N#ROWLEY+ The Power of Procovery in Healing Mental Illness,OS!NGELES +ENNEDY#ARLISLE0UBLISHING "ARKER0 #AMPBELL0$AVIDSON" From the Ashes of Experience: Reflections on madness, survival and growth,ONDON7HURR "ELLAMY* #ANYOUHEARMETHINKINGPsychiatric Rehabilitation Journal 24 n "ORG-+RISTIANSEN+ 2ECOVERY ORIENTED PROFESSIONALSHELPINGRELATIONSHIPSINMENTALHEALTH SERVICES Journal of Mental Health 13 n

#HADWICK0 Personality as Art: Artistic approaches to psychology2OSS ON 7YE0##3"OOKS #HADWICK0 0EER PROFESSIONALFIRST PERSONACCOUNT SCHIZOPHRENIAFROMTHEINSIDEnPHENOMENOLOGYAND THEINTEGRATIONASCAUSESANDMEANINGSSchizophrenia Bulletin 33 n #HADWICK0 Schizophrenia: The positive perspective ,ONDON2OUTLEDGE #ROWLEY+ The Power of Procovery in Healing Mental Illness,OS!NGELES+ENNEDY#ARLISLE0UBLISHING $AVIDSON, ,AWLESS-,EARY& #ONCEPTSOF RECOVERYCOMPETINGORCOMPLEMENTARYCurrent Opinion in Psychiatry 18 n $AVIDSON, 4ONDORA* ,AWLESS- /#ONNELL-2OWE - A Practical Guide to Recovery-Oriented Practice /XFORD/XFORD5NIVERSITY0RESS $EEGAN0 2ECOVERYASAJOURNEYOFTHEHEART Psychiatric Rehabilitation Journal 19 n $EPARTMENTOF(EALTH National Service Framework for Mental Health: Modern standards and service models ,ONDON$EPARTMENTOF(EALTH $EPARTMENTOF(EALTH New Horizons: Towards a shared vision for mental health,ONDON$EPARTMENTOF(EALTH $ORRER. Evidence of Recovery: The ups and downs of longitudinal outcome research'LASGOW3COTTISH 2ECOVERY.ETWORK ,EIBRICH* A Gift of Stories: Discovering how to deal with mental illness$UNEDIN5NIVERSITYOF/TAGO0RESS ,IBERMAN2+OPELOWICZ! 2ECOVERYFROM SCHIZOPHRENIAACONCEPTINSEARCHOFRESEARCHPsychiatric Services 56 n -C#ORMACK* Recovery and Strengths Based Practice'LASGOW3COTTISH2ECOVERY.ETWORK -C-ANUS' -ORGAN3 &RADGLEY*#ARSON* 2ECOVERYHEROESnAPROFILEOF'ORDON-C-ANUS! Life in the Day 13 n -IND Life and Times of a Supermodel: The recovery paradigm for mental health. MindThink Report 3,ONDON -IND -ENTAL(EALTH&OUNDATION Recovery in Action Project Report,ONDON-ENTAL(EALTH&OUNDATION .ATIONAL)NSTITUTEFOR-ENTAL(EALTHIN%NGLAND NIMHE Guiding Statement on Recovery,ONDON $EPARTMENTOF(EALTH /NKEN3 #RAIG# 2IDGWAY0 2ALPH2#OOK* !NANALYSISOFTHEDEFINITIONSANDELEMENTSOFRECOVERYA REVIEWOFTHELITERATUREPsychiatric Rehabilitation Journal 31 n 0ERKINS2 &IRSTPERSONYOUNEEDHOPETOCOPE )N'2OBERTS 3$AVENPORT &(OLLOWAY44ATTAN %DS Enabling Recovery: Principles and practice of rehabilitation psychiatry,ONDON'ASKELL 2EPPER*0ERKINS2 Social Inclusion and Recovery: A model for mental health practice,ONDON "ALLIÒRE4INDALL


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2ECOVERYASELECTIVEREVIEWOFTHELITERATUREANDRESOURCES 2ESNICK32OSENHECK2 2ECOVERYANDPOSITIVE PSYCHOLOGYPARALLELTHEMESANDPOTENTIALSYNERGIES Psychiatric Services 57 n

3LADE-A 100 Ways to Support Recovery: A guide for mental health professionals. Rethink recovery series: Volume 1,ONDON2ETHINK

2OBERTS' #OMINGHOME)N,$AVIDSON,,YNN %DS Beyond the Storms: Reflections on personal recovery in Devon%XETER$EVON0ARTNERSHIP.(34RUST

3LADE-B Personal Recovery and Mental Illness: A guide for mental health professionals#AMBRIDGE #AMBRIDGE5NIVERSITY0RESS

2OBERTS' $AVENPORT3 (OLLOWAY&4ATTAN4 Enabling Recovery: Principles and Practice of Rehabilitation Psychiatry,ONDON'ASKELL

3OCIAL0ERSPECTIVES.ETWORK Whose Recovery is it Anyway?,ONDON3OCIAL0ERSPECTIVES.ETWORK

2OBERTS'7OLFSON0 4HEREDISCOVERYOF RECOVERYOPENTOALLAdvances in Psychiatric Treatment 10 n 3ELIGMAN-%0 Learned Helplessness: Depression, development and death.EW9ORK7(&REEMAN 3EN$A The World is Full of Laughter"RENTWOOD #HIPMUNKA0UBLISHING 3EN$B Am I Still Laughing"RENTWOOD #HIPMUNKA0UBLISHING 3HEPHERD' "OARDMAN'3LADE- Making Recovery a Reality,ONDON3AINSBURY#ENTREFOR-ENTAL (EALTH

3TEWART% 4HE/HIO#ONSUMERS/UTCOMES)NITIATIVE 4HERELATIONSHIPSBETWEENEMPOWERMENTANDSYMPTOM DISTRESS0APERPRESENTEDATTHE)NTERNATIONAL!SSOCIATIONOF 2EHABILITATION3ERVICES#ONFERENCE n-AY 6ELLEMAN2 $AVIS% 3MITH'$RAGE-%DS Changing Outcomes in Psychosis: Collaborative cases from practitioners, users and carers/XFORD"03"LACKWELL 7ARNER2 2ECOVERYFROMSCHIZOPHRENIAANDTHE RECOVERYMODELCurrent Opinion in Psychiatry 22 n 7HITWELL$ 4HEMYTHOFRECOVERYFROMMENTAL ILLNESSPsychiatric Bulletin 23 n 7ORLD(EALTH/RGANIZATION International Pilot Study of Schizophrenia'ENEVA7ORLD(EATH/RGANIZATION

Jerome Carson Clinical Psychologist, South London and Maudsley NHS Foundation Trust 0HOTOBY*ANE&RADGLEY

Gordon McManus Service User 0HOTOBY*ANE&RADGLEY

Anant Chander Assistant Psychologist, South London and Maudsley NHS Foundation Trust 0HOTOBY*ANE&RADGLEY

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