WELLNESS & RECOVERY WHAT IS THE MEANING BEHIND THESE TWO POWERFUL TERMS?

Transcription

1 WELLNESS & RECOVERY WHAT IS THE MEANING BEHIND THESE TWO POWERFUL TERMS? Dr. Susanna Galea Consultant Psychiatrist & Service Clinical Director Community Alcohol & Drug Services, Auckland

2 Why do we do what we do? How do we know that we are achieving what we set out to achieve? Are we doing this effectively? Whose recovery are we talking about? A JOURNEY OF SELF-REFLECTION

3 HISTORY Fairly new concept Emphasizes individual s potential to recover Focuses on wellness rather than illness Started in the US NZ leads the way 12 step programme

4 EVOLUTION OF THE CONSTRUCT The consumer / survivor construct The clinical construct The social construct

5 DEFINITIONS: WELLNESS & RECOVERY Recovery focuses on wellness not illness Recovery is about one s personal journey A journey of healing & transformation Recovery is about finding meaning Focuses on consumer choice To challenge labels & prejudice

6 DEFINITIONS: WELLNESS & RECOVERY To recover is to find meaning When you start complaining or challenging, you know you are getting better...it s about regaining that place. We need to accept that sometimes we need support to get there Recovery is about discovery

7 DEFINITION: THE PUBLIC PERCEPTION Their understanding of a person in recovery from addiction to alcohol or other drugs: Trying to stop (62%) Free from the disease of addiction (22%) The majority of those who seek treatment for addiction to alcohol or drugs achieve life-long recovery: 50% disagree 19% unsure Most were optimistic about recovery

8 DEFINITION: THE 3 R CONFUSION Rehabilitatio n Reintegratio n

9 DEFINITION Not about achieving abstinence About fostering the ability to regain control over aspects of oneself, despite the chronic relapsing condition Does one ever get there? Does one ever reach the end of the road? Is it a life long process?

10 THE TIDAL MODEL Model of collaboration Continuous ebb & flow Begin the voyage of discovery when at their lowest ebb Reclaiming one s personal story by recovering their voice Human help What is important in the world? It is people, it is people, it is people

11 THE 10 COMMITMENTS I. Value the voice II. III. IV. Respect the language Develop genuine curiosity Become the apprentice V. Use the available toolkit VI. VII. VIII. IX. Craft the step beyond Give the gift of time Reveal personal wisdom Know that change is constant X. Be transparent

12 THE CONCEPTUAL MODEL A process linking internal and external conditions that define recovery Internal conditions: Attitudes, experiences and processes of change External conditions: Circumstances, events, policies and practices that facilitate recovery

13 THE CONCEPTUAL MODEL Internal conditions: Hope Healing Connection Empowerment External conditions: Human rights A positive culture of healing Recovery-orientated services

14 WHAT DOES RESEARCH TELL US? Longitudinal studies: WHO multinational studies schizophrenia: No further symptoms No use of psychotropic drugs Living independently in the community Working Relating well to others

15 WHAT DOES RESEARCH TELL US? Longitudinal studies: Treatment Outcomes Profile Study (UK): Substance Use Injecting Risk Behaviour Crime Health & Social Functioning Relating well to others Alcohol & Drug Outcome Measure (NZ): Alcohol & Drug Use Psychosocial Outcomes

16 WHAT DOES THE RESEARCH TELL US? Qualitative studies: First person accounts Condition: Spiritual crisis Biological problem Environmental or political Trauma Described the elements in the course of recovery

17 CORE ELEMENTS OF RECOVERY & WELLNESS Self Relationships & significant others Empowerment Social inclusion Meaning Coping strategies Hope Home

18 THE RESISTANCE Personal process Marginalize those that don t fit False hope Burden to providers Socio-political fad Linked to treatment: Medical model Devalues professionalism Organizational risk & liability Assessment

19 ARE OUR SERVICES READY? Person orientation Person involvement Self-determination & Choice Hope

20 COMMISSIONING FOR RECOVERY To achieve recovery focused outcomes, the treatment system needs to become more responsive to individual needs. Frames recovery as achievement of client goals & what is meaningful for that individual. Maximize the core elements of recovery.

21 COMMISSIONING FOR RECOVERY Collaboration: Client & their carers Access to employment, education, housing, etc Involve families The silent voice Local partnerships Optimal treatment options Robust supportive structures Competent staff & Good Clinical Governance

22 JAMIE S JOURNEY 30 year old Drinking & tramadol use Married and has a 4 year old child Not working Comes to the clinic every 2 weeks

23 JAMIE S DEFINITION OF WELLNESS & RECOVERY

24 MY DEFINITION OF JAMIE S WELLNESS & RECOVERY Attendance Appearance Alcohol Trouble with the police No physical health problems Not depressed

25 DEEGAN S DEFINITION: The goal of the recovery process is not to become normal. The goal is to embrace our human vocation of becoming more deeply, more fully human. Recovery as a journey of the heart. Psychosoc Rehabil J, 1996

26 THE FUTURE Are we for or against? Do NZ addiction services want to show leadership & direction? Collaboration???? How further can we go? Whose recovery are we talking about?