A conceptual introduction to recovery
The notion of recovery has become the focus of a considerable amount of dialogue and debate between and among various constituencies within the mental health and addiction communities. Before we talk about how to bring this vision to reality within the DBH system we thought it important to clarify these confusions, some of which are due to the fact that the notion of recovery is in transition, moving gradually from a well-established vision among people with addictions or mental illnesses to exerting more influence on behavioral health care providers' service practices.Being "in recovery" has long been the guiding vision and goal of self-help within the addiction community. Primarily a force within self-help, this notion has not played as much of a role historically within the addiction service provider community, where concepts of treatment and relapse prevention have been more central. Having a fifty-year history of peaceful, if benign, co-existence, these two complementary approaches have recently entered a period of partnership. This partnership offers the potential to promote a unified vision of recovery among people with addictions that incorporates the contributions of both natural and formal supports.
On the other hand, the notion of "recovery" has emerged as a dominant force within mental health just within the last decade. Most recently, it has taken center stage through its prominent role in both the Surgeon General's Report on Mental Health and the President's New Freedom Commission on Mental Health. In its influential Final Report, the Commission strongly recommended "fundamentally reforming" all of mental health care to be based on the goal of recovery.
In both of these reports, however-as well as in clinical and rehabilitative practice-there is considerable ambiguity and lack of clarity about what is meant by recovery in mental health. As in addiction, much work remains to be done in mental health in developing a coherent vision of recovery that can be acceptable (as well as useful) to all involved parties.
Given its multiple and complicated parentage and the diverse groups involved, it is not surprising that it has been difficult to reach consensus on any one definition, or even on any one list of essential aspects, of the concept of recovery in behavioral health. For the sake of clarity-as well as to facilitate future discussions-we propose the following distinction to guide the development, monitoring, and evaluation of clinical and rehabilitative services and supports offered within a recovery-oriented system of behavioral health care. These two concepts are intended to be somewhat overlapping and complementary. The eventual goal is to join them into a unified vision that can be promoted equally by people in recovery, their loved ones, behavioral health care providers, and the community at large.
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