By Kim Nelson, MA, with Becky Shipkosky
Let’s say you’re a person with a mental health diagnosis—maybe it’s bipolar, or schizophrenia, or perhaps a personality disorder. There’s a good chance that your contact with mental health providers has felt “top-down” or prescriptive, as opposed to collaborative. This is probably owing to the fact that the medical model of mental health care has been the prevailing one for the past several decades, and it takes a biological view—that is, that mental-health disorders have a physical or biological cause and should be treated as such.
This perspective has contributed profoundly to the mental health field, particularly in the areas of genetics and pharmaceuticals. It has, however, received a good deal of criticism as well. Author, anthropologist, and psychotherapist James Davies has shared his opinion that “The medical model has presided over four decades of flat-lining outcomes.” Davies goes on to cite the absence of improvement in psychiatric medications since the 1980s and the decline in life expectancy among patients with serious mental health conditions (Davies, 2022).
The good news is that there is another way of addressing mental health, and it has become the standard of care in most private service settings. To say it’s replacing the medical model isn’t quite accurate; better to say that it is weaving wisdom from the medical model into a more holistic context. This recovery model of mental health sees you as a whole person capable of directing your own care and dictating your own outcomes.
Defining the Recovery Model
Mental health recovery is a person-centered, respectful approach: “a transformative process through which individuals enhance their health and wellness, lead self-directed lives, and strive to reach their full potential” (SAMHSA).
Psychologist, advocate, and person with lived experience of schizophrenia Patricia E. Deegan, Ph.D. offered a more vivid definition:
To me recovery means I try to stay in the driver’s seat of my life. I don’t let my illness run me. Over the years, I have worked hard to become an expert in my own self-care. For me, being in recovery means I don’t just take medications. Just taking medications is a passive stance. Rather, I use medications as part of my recovery process. (Deegan, 1993)
At its heart, mental health recovery is focused on your strengths, not on what’s “wrong” with you. Its goal is to support you in living a life that integrates all your parts. In recovery, you will do the work toward:
- identifying what you want for your life
- embracing and leveraging your strengths
- accepting and working with your challenges
- developing tools for living life on life’s terms
- loving yourself
- grounding in your community
- meeting your own goals and expectations
It’s a progress-not-perfection proposition meant to foster a fulfilling life, however that may look for you.
What to Expect in Mental Health Recovery
Naturally, different providers will interpret and apply the guiding principles of recovery in different ways. In fact, the principles themselves may even vary a bit depending on who you ask, but certain core elements are considered essential to the recovery model. The following are qualities you can expect to find some variation of in nearly any recovery-based service (Schactman, 2024):
- Self-directed: Self-direction, or self-determination, is central to the recovery model: You are the expert on you. When you enter a recovery program or begin recovery work with a therapist, your provider(s) will give only as much guidance and prompting as you require to help you define what you want your life to look like. You will shape your own recovery and future.
- Hopeful: Hope is a cornerstone of recovery, but don’t worry; you’re not expected to conjure it out of nowhere. When you begin working with a recovery-focused provider, part of their role in supporting you is to hold hope for you until you’re able to hold it for yourself. As you go, you’ll build a stronger support network, and people in that network will also be hope-bearers when you falter, as we all do.
- Relational: Recovery is done in a relationship. Relationship with self, family, community, peers, and more. The hope-bearers will also be the accountability holders, tear wipers, witnesses to your growth, and recipients of your gifts as you show up more and more with your full self.
- Respectful: There has been, historically, a certain paternalism pervasive in mental health care. Recovery programs and services, on the other hand, are designed around dignity and respect. Unconditional positive regard, respectful language, and provider integrity are absolute must-haves in mental health recovery settings, whether or not you are in the room.
- Individualized: If there’s one thing the recovery model is not, that’s one-size-fits-all. Rather, you and your provider(s) will identify what works for you and create a customized plan according to your desires, needs, values, religion, culture, etc. And flexibility is built in so if something changes, so can your approach to your mental health. (You may also see this framed as cultural responsiveness.)
- Holistic: In recovery, you will look at every aspect of your life to consider what’s working and what isn’t. If you have unaddressed dental-care needs, you’ll make plans to see a dentist. If your living situation doesn’t support recovery, you’ll work on repairing it, reframing it, or moving on. Are your spiritual needs being met? Are you accessing all of the community resources that are available to you?
This is not an exhaustive list. Other important elements may include strengths-focus, peer support, personal responsibility, empowerment, and addressing trauma. In any case, recovery places you at the center of your own mental health journey, interweaving personal empowerment, community support, and respect for your unique life experience with insights gained from science. The golden nugget of any mental health recovery effort is that you’re a whole person capable of self-determination and deserving of support, love, community, and the life you desire.
To find a therapist, visit the Psychology Today Therapy Directory.
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