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Recovery in Mental Health: Reshaping scientific and clinical responsibilities



Recovery in Mental Health: Reshaping scientific and clinical responsibilities

Michaela Amering, Margit Schmolke

ISBN: 978-0-470-74316-4 February 2009 280 Pages


Winner of Medical Journalists’ Association Specialist Readership Award 2010

Recovery is widely endorsed as a guiding principle of mental health policy. Recovery brings new rules for services, e.g. user involvement and person-centred care, as well as new tools for clinical collaborations, e.g. shared decision making and psychiatric advance directives. These developments are complemented by new proposals regarding more ethically consistent anti-discrimination and involuntary treatment legislation, as well as participatory approaches to evidence-based medicine and policy.

Recovery is more than a bottom up movement turned into top down mental health policy in English-speaking countries. Recovery integrates concepts that have evolved internationally over a long time. It brings together major stakeholders and different professional groups in mental health, who share the aspiration to overcome current conceptual reductionism and prognostic negativism in psychiatry.

Recovery is the consequence of the achievements of the user movement. Most conceptual considerations and decisions have evolved from collaborations between people with and without a lived experience of mental health problems and the psychiatric service system.  Many of the most influential publications have been written by users and ex-users of services and work-groups that have brought together individuals with and without personal experiences as psychiatric patients.

In a fresh and comprehensive look, this book covers definitions, concepts and developments as well as consequences for scientific and clinical responsibilities. Information on relevant history, state of the art and transformational efforts in mental health care is complemented by exemplary stories of people who created through their lives and work an evidence base and direction for Recovery.

This book was originally published in German.  The translation has been fully revised, references have been amended to include the English-language literature and new material has been added to reflect recent developments. It features a Foreword by Helen Glover who relates how there is more to recovery than the absence or presence of symptoms and how health care professionals should embrace the growing evidence that people can reclaim their lives and often thrive beyond the experience of a mental illness.

Comments on German edition:

"It is fully packed with useful information for practitioners, is written in jargon free language and has a good reading pace."
Theodor Itten, St. Gallen, Switzerland and Hamburg, Germany

"This book is amazingly positive. It not only talks about hope, it creates hope. Its therapeutic effects reach professional mental health workers, service users, and carers alike. Fleet-footed and easily understandable, at times it reads like a suspense novel."
Andreas Knuf, pro mente sana, Switzerland

'"This is the future of psychiatry"' cheered a usually service-oriented manager after reading the book. We might not live to see it.'
Ilse Eichenbrenner, Soziale Psychiatrie, Germany


1 Introduction.

2 Recovery – Developments and Significance.

3 Recovery – Basics and Concepts.


Political Strategies.

Collaboration with Users of Psychiatric Services.

Resilience–a Dynamic Recovery-Factor.

Recovery, Prevention and Health Promotion.

Recovery and Quality of Life.

Recovery and Empowerment.

Recovery and Evidence-Based Medicine.

Recovery and Remission.

4 Personal Experience as Evidence and as a Basis for Model Development.

‘Recovery – an Alien Concept’ - Ron Coleman/UK.

‘Empowerment Model of Recovery’ – Dan Fisher and Laurie Ahern/USA.

‘Conspiracy of Hope’ – Pat Deegan/USA.

‘Holders of Hope’ – Helen Glover/Australia.

‘Wellness Recovery Action Plan (WRAP)’ – Mary Ellen Copeland/USA.

‘Two Sides of Recovery’ – Wilma Boevink/The Netherlands.

‘No Empowerment Without Recovery’ – Christian Horvath/Austria.

5 Recovery – Why Not?

The Slow Demise of Incurability.



Other misunderstandings.

Is the glass half-full or half-empty?

A Diagnosis or a Verdict – the Example of Schizophrenia.

Heterogeneity of Course Over Time.

Prognosis – ‘from demoralizing pessimism to rational optimism’.

Diagnosis – ‘a century is enough’.

Scientific and clinical responsibility.

Classic Dimensions of Madness.





Psychiatric Treatment and Services.

State of the art.


Recent developments.

Stigma and Discrimination.

Attitude research.

Iatrogenic stigma.

Stigma – experiences and expectations.

Internalized stigma and stigma resistance.

Social inclusion.

The hearing voices movement.

6 Recovery – Implications for Scientific Responsibilities.

New Directions.

The Increasingly Active Role of UK Users in Clinical Research.

Assessing Recovery.

Ruth Ralph and the Recovery Advisory Group.

Examples of published recovery instruments.

Recovery as a Process.

Turning points – living with contradictions.

Findings from four countries.

Identity and recovery in personal accounts of mental illness.

Recovery as lived in everyday practice.

Qualitative research as one royal road.

7 Recovery – Implications for Clinical Responsibilities.



Recovery-Factors in Therapeutic Relationships and Psychiatric Services.

Recovery-oriented professionals.

Recovery Self Assessment (RSA).

Measuring recovery-orientation in a hospital setting.

Recovery Knowledge Inventory (RKI).

Developing Recovery Enhancing Environments Measure (DREEM).

Initiatives of the World Psychiatric Association.

Psychiatry for the Person.

A Person-centred Integrative Diagnosis.

Recovery and Psychopharmacology.

New goals and new roles for psychopharmacologists.

Pat Deegan’s concept of ‘Personal Medicine’.

A programme to support shared decision-making.

System Transformation.

Recovery-oriented services.

Recovery-oriented mental health programmes.

A Recovery-Process Model.

Practice guidelines for recovery-oriented behavioral health care.

Peer support and consumer-driven transformation.

8 The Significance of Discovering Recovery for the Authors.



“Recovery is probably the most important new direction for mental health.  It represents the convergence of a number of ideas – empowerment, self-management, disability rights, social inclusion and rehabilitation – under a single heading that signals a new direction in services.   …  For those with an interest and some knowledge of recovery, the book provides a treasure trove of bite-size chunks of knowledge and theory.” (The British Journal of Psychiatry, 2010)