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Implementing Recovery-based Care: Tangible Guidance for SMHAs - page 13 / 44





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NASMHPD/NTAC e-Report on Recovery – Fall 2004


“Sarah,” a member of a peer program, has been in the system for many years. She lives on Supplemental Security Income (SSI) income and her housing is contingent on her disability. Sarah is hearing her friends and even the clinical staff talking about recovery… What does that mean? She starts talking to others who say they’ve gotten jobs and gotten their high school equivalency or gone on to college. Her case manager has changed her title to recovery counselor and says that instead of doing a treatment plan they will do a recovery plan. Sarah is going to the peer center more often. But she is beginning to feel uncomfortable. If she “recovers,” where will she live? What if her benefits are taken away? Can she really support herself? One day there is some conflict at the center and she starts feeling a bit overwhelmed. Sarah decides she should call her case manager.

Sarah tells her case manager that her symptoms are really bad. Her case manager asks her if she’s taken her medication and asks if she’s safe. Sarah responds by saying that she’s taken her medication but it doesn’t seem to be working and she is not feeling safe… We know the end of the story.

How could a different response have changed the outcome? What if the case manager said, “Help me understand what it means for you when you say my symptoms are really bad,” or, “What’s going on at the peer center,” and, “Maybe that’s a pretty normal reaction to conflict…” Or even, “So what will you do to feel more comfortable?” Responses such as these could lead to potentially very different conversations and ultimately to much less dire outcomes.

Some of the current thinking in peer support and Wellness Recovery Action Planning has much to teach us about “unlearning the mental patient role.” These forums and environments can openly address roles, relationships, assumptions and worldview. New approaches are teaching people to challenge each other when they become aware of stuck roles and relational dynamics. Instead of responding from an assumption of “I’m fragile or sick,” more and more people are helping each other think differently about their experiences.

Now let’s look at another path for Sarah:

Sarah decides to join a group of peers who are working together developing Wellness Recovery Action Plans. She takes a close look at all the resources and strengths she has—her love of hiking, her interest in photography, her ability to write compelling short stories and to keep things well organized. She uses things like this, including other ideas from members of the group, to build her own Wellness toolbox.  

She works with them to develop a list of things she can do every day to stay as well as possible. She thinks about things that are upsetting to her and develops a plan of simple safe things she can do to help herself feel better (things from her

NASMHPD/NTAC e-Report on Recovery – Fall 2004

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