April 1st, 2012

SAMHSA merges approaches for one recovery definition

Can recovery mean the same thing to someone with a mental health disorder and someone with a drug or alcohol addiction?

The answer is ‘yes’ under the Substance Abuse and Mental Health Services Administration’s new definition of recovery: “a process of change through which individuals improve their health and wellness, live a self-directed life and strive to reach their full potential.”

“Those words were chosen very carefully so that they did reflect what we thought was a lived experience,” says Kathryn A. Power, M.Ed., SAMHSA’s regional administrator in Boston.

Power says SAMHSA intends to use this new definition and an accompanying list of 10 guiding principles to promote the adoption of and financing of recovery services. SAMHSA’s Recovery Support Strategic Initiative has identified four major dimensions supporting recovery – health, home, purpose and community – that can help set funding priorities such as programs promoting stable housing.

The definition was announced last December after a year-long effort to gather public input. Last August, SAMHSA posted a draft definition with the 10 principles on its blog and invited comments on its Feedback Forums. The blog post received 259 comments and the forums generated more than 500 ideas and another 1,200 comments on the ideas.

The 10 principles include the belief that recovery emerges from hope, is person-driven, occurs via many pathways, is holistic and is supported by peers. Also, recovery is supported by relationships and by addressing trauma. It is also influenced by a person’s cultural background and the strengths of the individual, family and community. Finally, recovery is based on respect.

SAMHSA previously made separate distinctions in defining mental health recovery and addiction recovery.

In 2004, the agency convened the National Consensus Conference on Mental Health Recovery and Mental Health Systems Transformation which produced the following: “Mental health recovery is a journey of healing and transformation enabling a person with a mental health problem to live a meaningful life in the community of his or her choice will strive to achieve his or her full potential.”

In 2005, SAMHSA’s Center for Substance Abuse Treatment National Summit on Recovery produced this statement: “Recovery from alcohol and drug problems is a process of change through which an individual achieves abstinence and improved health, wellness, and quality of life.”

Erin Lane, Psy.D., clinical director of the Providence Center School, which plans to open a recovery high school in September, likes the new definition, especially the emphasis on social relationships and meaningful activities.

“I actually think the SAMHSA new definition is very much in line with our thinking about recovery,” Lane says.

The definition has to cover many developmental periods, experiences and ethnicities, so “we need something that goes to a higher level of abstraction,” says Alan E. Kazdin, Ph.D., ABPP, professor of psychology and child psychiatry at Yale University.

“We need it for all kinds of reasons that are concrete and practical,” Kazdin says. “It won’t be needed probably in the context of individual therapy for someone who’s got a serious anxiety disorder. It’s not going to be the therapist saying to the patient, ‘I don’t care what you say, you meet the new definition of recovery. I’m done.’ No one’s ever going to do that.”

By Janine Weisman

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