Recovery-Oriented Language
Creation of a recovery-oriented system of care requires behavioral health care practitioners to change how they look at mental illness and addiction, their own roles in facilitating recovery from these conditions, and the language they use in referring to the people they serve. The following glossary and associated tables are intended as tools for providers to use as they go about making these changes in practice. Not meant to be exhaustive, this material will be further enhanced in the process of implementing recovery-oriented practices across the state.
Given its central role in the remaining definitions, we will start with the term "recovery" itself, followed by a list, in alphabetical order, of other key terms.
Recovery: there are several different definitions and uses of this term in behavioral health. In the addiction recovery community, for example, this term refers to the achievement and maintenance of abstinence from alcohol, illicit drugs, and other substances (e.g., tobacco) or activities (e.g., gambling) to which the person has become addicted, vigilance and resolve in the face of an ongoing vulnerability to relapse, and pursuit of a clean and sober lifestyle.
Persons with less severe AOD problems also speak of moderated recovery-the sustained reduction of AOD use and related consequences to a point that such use no longer interferes with personal and interpersonal functioning. (See expanded discussion in definition of moderated recovery below.)
In mental health there are several other forms of recovery. For those fortunate people, for example, who have only one episode of mental illness and then return to their previous functioning with little, if any, residual impairment, the usual sense of recovery used in primary care is probably the most relevant. That is, such people recover from an episode of psychosis or depression in ways that are more similar to, rather than different from, recovery from other acute conditions.
Persons who recover from an episode of major affective disorder or psychosis, but who continue to view themselves as vulnerable to future episodes, may instead consider themselves to be "in recovery" in ways that are more similar to, than different from, being in recovery from a heart attack or chronic medical condition. Many others will recover from serious mental illness over a longer period of time, after perhaps 15 or more years of disability, constituting an additional sense of recovery found in some other medical conditions such as asthma.
More extended periods of disability are often associated with concerns about the effects and side effects of having been labeled with a mental illness as well as with the illness itself, leading some people to consider themselves to be in recovery also from the trauma of having been treated as mental patients.
Finally, those people who view taking control of their illness and minimizing its disruptive impact on their lives as the major focus of their efforts might find the sense of recovery used in the addiction self-help community to be most compatible with their own experiences. Such a sense of recovery has been embraced, for instance, among some people who suffer from co-occurring psychiatric and addictive disorders who consider themselves to be in "dual recovery."
The Philadelphia Department of Behavioral Health has adopted the following single definition to capture the common elements of these various forms of recovery:
"Recovery
is the process of pursuing a fulfilling and contributing life regardless
of difficulties one has faced. It involves not only the restoration
but also continued enhancement of a positive identity as well as personally
meaningful connections and roles in one's community. It is facilitated
by relationships and environments that provide hope, empowerment,
choices and opportunities that promote people reaching their full
potential as individuals and community members."
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