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Transforming Systems of Care: The American Association of Community Psychiatrists Guidelines for Recovery Oriented Services

Community Mental Health Systems

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Abstract

Thinking about recovery has grown significantly over the last 70 years, and particularly in the past fifteen. Promotion of recovery has recently been recognized as an organizing principle for the transformation of behavioral health services. Recovery is a personal process of growth and change which typically embraces hope, autonomy and affiliation as elements of establishing satisfying and productive lives in spite of disabling conditions or experiences. Recovery oriented services replace paternalistic, illness oriented perspectives with collaborative, autonomy enhancing approaches and represent a major cultural shift in service delivery. Recovery oriented services replace the myth of chronicity and dependence with a message of individualism, empowerment and choice in the context of collaborative relationships with service providers. The American Association of Community Psychiatrists has developed Guidelines for Recovery Oriented Services to facilitate the transformation of services to this new paradigm. The guidelines are divided into three domains: administration, treatment, and supports, each consisting of several elements for which recovery enhancing characteristics are defined. Several example indicators are also provided for each element. This paper presents these guidelines and discusses their application.

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References

  • AACP. (2000). Principles for the Care and Treatment of Persons with Co-Occurring Psychiatric and Substance use Disorders, http://www.communitvpsychiatry.org

  • AACP. (2001a). Continuity of Care Guidelines: Best Practices for Managing Transitions Between Levels of Care, http://www.communitypsychiatry.org

  • AACP. (2001b). Position Paper: Involuntary Outpatient Commitment. http://www.communitypsychiatry.org

  • AACP. (2001). Position Statement on Housing Options for Individuals with Serious and Persistent Mental Illness (SPMI). http://www.communitypsvchiatry.org

  • AAAP/AACP. (2002). Joint Task Force on Public Sector Interventions for Addictions Continuity of Care Guidelines for Addictions and Co-occurring Disorders, http://www.communitypsychiatry.org

  • InstitutionalAuthorNameAlcoholics Anonymous World Service, Inc. (1976) Alcoholics Anonymous (the Big Book) AA World Service Inc New York City

    Google Scholar 

  • M. H. Allen D. Carpenter J. L. Sheets S. Miccio R. Ross (2003) ArticleTitleWhat Do Consumers Say They Want and Need During a Psychiatric Emergency? Journal of Psychiatric Practice 9 39–58 Occurrence Handle15985914

    PubMed  Google Scholar 

  • W. A. Anthony (1993) ArticleTitleRecovery from mental illness: The guiding vision of the mental health service system in the 1990s Psychosocial Rehabilitation Journal 16 11–23

    Google Scholar 

  • W. A. Anthony (2000) ArticleTitleA recovery-oriented service system: Setting some system level standards Psychiatric Rehabilitation Journal 24 159–168

    Google Scholar 

  • W. A. Anthony (1993) ArticleTitleRecovery from mental illness: The guiding principle of the mental health service system in the 1990s Psychosocial Rehabilitation Journal 16 11–23

    Google Scholar 

  • W. A. Anthony W. A. Kennard W. F. O’Brien R. Forbess (1986) ArticleTitlePsychiatric Rehabilitation: Past Myths and Current Realities Community Mental Health Journal 22 249–264 Occurrence Handle10.1007/BF00754379 Occurrence Handle3829601

    Article  PubMed  Google Scholar 

  • W. A. Anthony R. P. Liberman (1986) ArticleTitleThe Practice of Psychiatric Rehabilitation: Historical, Conceptual, and Research Base Schizophrenia Bulletin 12 542–559 Occurrence Handle3810064

    PubMed  Google Scholar 

  • E. A. Baxter S. Diehl (1998) ArticleTitleEmotional stages: consumer and family members recovering from the trauma of mental illness Psychiatric Rehabilitation Journa 21 349–355

    Google Scholar 

  • D. A. Bigelow M. J. Gareau D. J. Young (1990) ArticleTitleA quality of life interview for chronically disabled people Psychosocial Rehabilitation Journal 14 94–98

    Google Scholar 

  • P. Carling (1995) Return to community: Building support systems for people with psychiatric disabilities Guilford Press New York

    Google Scholar 

  • L. S. Carlson C. A. Rapp D. McDiarmid (2001) ArticleTitleHiring consumer-Providers: Barriers and alternative solutions Community Mental Health Journal 37 199–213 Occurrence Handle10.1023/A:1017569913118 Occurrence Handle11440422

    Article  PubMed  Google Scholar 

  • J. Chamberlain (1984) ArticleTitleSpeaking for ourselves: An overview of the ex-psychiatric inmate’s movement Psychosocial Rehabilitation Journal 8 56–64

    Google Scholar 

  • J. Chamberlain (1990) ArticleTitleThe ex-patients’ movement: Where we’ve been and where we’re going Journal of Mind and Behavior 11 323–336

    Google Scholar 

  • S. K. Cheung S. Y. K. Sun (2001) ArticleTitleHelping processes in a Mutual Aid Organization for persons with emotional disturbance International Journal of Group Psychotherapy 51 295–308 Occurrence Handle10.1521/ijgp.51.3.295.49888 Occurrence Handle11447781

    Article  PubMed  Google Scholar 

  • M. J. Chinman R. Weingarten D. Stayner L. Davidson (2001) ArticleTitleChronicity reconsidered: Improving person-environment fit through a consumer-run service Community Mental Health Journal 37 215–229 Occurrence Handle10.1023/A:1017577029956 Occurrence Handle11440423

    Article  PubMed  Google Scholar 

  • G. D. Chowanec (1994) ArticleTitleContinuous quality improvement: Conceptual foundations and application to mental health care Hospital and Community Psychiatry 45 789–793 Occurrence Handle7982694

    PubMed  Google Scholar 

  • M. E. Copeland (1997) Wellness Recovery Action Plan Peach Press Brattleboro, VT

    Google Scholar 

  • G. W. Currier M. H. Allen (2000) ArticleTitleEmergency psychiatry: Physical and chemical restraint in the psych emergency service Psychiatric Services 51 717–719 Occurrence Handle10828101

    PubMed  Google Scholar 

  • L. C. Curtis S. S. McCabe W. Montague (1991) Strategies for increasing and supporting consumer involvement in mental health policy/planning, management and service delivery Center for Community Change through Housing and Support Trinity College of Vermont Burlington, VT

    Google Scholar 

  • S. Davis (2002) ArticleTitleAutonomy versus Coercion: Reconciling competing perspectives in community mental health Community Mental Health Journal 38 239–25 Occurrence Handle10.1023/A:1015267707856 Occurrence Handle12046677

    Article  PubMed  Google Scholar 

  • P. E. Deegan (1998) ArticleTitleRecovery: The lived experience of rehabilitation Psychosocial Rehabilitation Journal 11 11–19

    Google Scholar 

  • C. C. Diclemente D. Schlundt L. Gemmell (2004) ArticleTitleReadiness and stages of change in addiction treatment American Journal on Addictions 13 103–119 Occurrence Handle10.1080/10550490490435777 Occurrence Handle15204662

    Article  PubMed  Google Scholar 

  • L. Dixon N. Krauss A. L. Lehman (1994) ArticleTitleConsumers as service providers: The promise and challenge Community Mental Health Journal 30 615–625 Occurrence Handle10.1007/BF02188599 Occurrence Handle7835046

    Article  PubMed  Google Scholar 

  • R. E. Drake S. M. Essock A. Shaner et al. (2001) ArticleTitleImplementing dual diagnosis services for clients with severe mental illness Psychiatric Services 52 469–476 Occurrence Handle11274491

    PubMed  Google Scholar 

  • C. J. Felton P. Stastny D. Shern A. Blanch S. A. Donahue E. Knight C. Brown (1995) ArticleTitleConsumers as peer specialists on intensive case management teams: Impact on client outcomes Psychiatric Services 46 1037–1044 Occurrence Handle8829785

    PubMed  Google Scholar 

  • D. B. Fisher (1994a) ArticleTitleHealth care reform based on an empowerment model of recovery by people with psychiatric disabilities Hospital and Community Psychiatry 45 913–915

    Google Scholar 

  • W. A. Fisher (1994b) ArticleTitleRestraint and seclusion: A review of the literature American Journal of Psychiatry 151 1584–1591

    Google Scholar 

  • M. Galanter (1988) ArticleTitleZealous self-help groups as adjuncts to psychiatric treatment: A study of recovery, Inc The American Journal of Psychiatry 145 1248–1253 Occurrence Handle3421346

    PubMed  Google Scholar 

  • F. J. Friese J. Stanley K. Kress S. Vogel-Scibilia (2001) ArticleTitleIntegrating evidence-based practices and the recovery model Psychiatric Services, Nov 52 1462–1468

    Google Scholar 

  • Harding, C. (1987). The vermont longitudinal study of persons with mental illness 1. American Journal of Psychiatry, 144, 718–726 and Harding, C. The vermont study of persons with mental illness II. American Journal of Psychiatry, 144, 727–735

    Google Scholar 

  • D. M. Harding J. Zubin J. S. Strauss (1987) ArticleTitleChronicity in schizophrenia: fact, partial fact, or artifact? Hospital and Community Psychiatry 38 477–486 Occurrence Handle3297969

    PubMed  Google Scholar 

  • J. K. Iglehart (2004) ArticleTitleThe mental health maze and the call for transformation New England Journal of Medicine 300 507–514

    Google Scholar 

  • N. Jacobson L. Curtis (2000) ArticleTitleRecovery as policy in mental health services: Strategies emerging from the states Psychiatric Rehabilitation Journal 23 333–341

    Google Scholar 

  • J. A. Joinkas J. A. Cook C. Rosen A. Laris J. Kim (2004) ArticleTitleA program to reduce use of physical restraint in psychiatric inpatient facilities Psychiatric Services 55 818–820

    Google Scholar 

  • C. L. Kauffmann P. D. Freund J. Wilson (1989) ArticleTitleSelf help in the mental health system: A model for consumer-provider collaboration Psychosocial Rehabilitation Journal 13 5–21

    Google Scholar 

  • L. F. Kurtz (1990) ArticleTitleThe self-help movement: Review of the past decade of research Social Work with Groups 13 101–115

    Google Scholar 

  • A. A. Low (1950) Mental health through will training EditionNumber21 Christopher, 136 North Quincy, MA

    Google Scholar 

  • A. F. Lehman R. Goldberg L. B. Dixon S. McNary L. Postrado A. Hackman K. McDonnell (2002) ArticleTitleImproving employment outcomes for persons with severe mental illnesses Archives of General Psychiatry 59 165–171 Occurrence Handle10.1001/archpsyc.59.2.165 Occurrence Handle11825138

    Article  PubMed  Google Scholar 

  • M. M. Linehan (1993) Cognitive-behavioral treatment of borderline personality disorder Gilford Press New York

    Google Scholar 

  • C. Macias P. Barreira M. Alden J. Boyd (2001) ArticleTitleThe ICCD benchmarks for clubhouses: A practical approach to quality improvement in psychiatric rehabilitation Psychiatric Services 52 207–213 Occurrence Handle10.1176/appi.ps.52.2.207 Occurrence Handle11157120

    Article  PubMed  Google Scholar 

  • M. McCubbin D. Cohen (1966) ArticleTitleExtremely unbalanced: Interest divergence and power disparities between clients and psychiatry International Journal of Law and Psychiatry 19 1–25

    Google Scholar 

  • S. Mead M. E. Copeland (2000) ArticleTitleWhat recovery means to us: Consumer’s perspectives Community Mental Health Journal 36 315–331 Occurrence Handle10.1023/A:1001917516869 Occurrence Handle10933247

    Article  PubMed  Google Scholar 

  • W. R. Miller S. Rolnick (1991) Motivational interviewing: Preparing people to change addictive behavior Gilford Press New York

    Google Scholar 

  • C. T. Mowbray D. P. Moxley S. Thrasher D. Bybee N. McCrohan S. Harris G. Clover (1996) ArticleTitleConsumers as community support providers: Issues created by role innovation Community Mental Health Journal 32 47–67 Occurrence Handle10.1007/BF02249367 Occurrence Handle8635317

    Article  PubMed  Google Scholar 

  • K. T. Mueser P. W. Corrigan D. W. Hilton B. Tanzman A. Schaub S. Gingerich S. M. Essock N. Tarrier B. Morey S. Vogel-Scibilia M. I. Herz (2002) ArticleTitleIllness management and recovery: A review of the research Psychiatric Services 53 1272–1284 Occurrence Handle10.1176/appi.ps.53.10.1272 Occurrence Handle12364675

    Article  PubMed  Google Scholar 

  • R. L. Munich E. Lang (1993) ArticleTitleThe boundaries of psychiatric rehabilitation Hospital and Community Psychiatry 44 661–665 Occurrence Handle8354505

    PubMed  Google Scholar 

  • P. Murray (1996) ArticleTitleRecovery, Inc. as an adjunct to treatment in an era of managed care Psychiatric Services 47 1378–1381 Occurrence Handle9117478

    PubMed  Google Scholar 

  • InstitutionalAuthorNameNAMI Policy Research Institute (2003) Seclusion and Restraint task force report National Alliance for the Mentally Ill Arlington, VA

    Google Scholar 

  • NMHA News Release. (2002). Advance Directives Help Prevent Psychiatric Crises and Promote Recovery

  • New Freedom Commission on Mental Health (2003). Achieving the promise: Transforming mental health care in America. Executive Summary. DHHS Pub. No. SMA-03-3831. Rockville, MD

  • New Mexico Human Services Department (2004). New Mexico Interagency Behavioral Health Purchasing Collaborative Concept Paper

  • InstitutionalAuthorNameOffice of the Surgeon General (1999) Mental health: A report of the surgeon general Public Health Service Rockville, MD

    Google Scholar 

  • Onken, S. J., Dumont, J. M., Ridgeway, P., Doman, D. H., & Ralph, R. O. (2002). Mental health recovery: What helps and what hinders? A National Research Project for the Development of Recovery Facilitating System Performance Indicators

  • G. Pitschel-Walz S. Leucht J. Bauml et al. (2001) ArticleTitleThe effect of family interventions on relapse and rehospitalization in Schizophrenia: A meta-analysis Schizophrenia Bulletin 27 73–92 Occurrence Handle11215551

    PubMed  Google Scholar 

  • S. G. Resnick R. R. Rosenheck A. F. Lehman (2004) ArticleTitleAn exploratory analysis of correlates of recovery Psychiatric Services 55 540–548 Occurrence Handle10.1176/appi.ps.55.5.540 Occurrence Handle15128962

    Article  PubMed  Google Scholar 

  • D. Roe D. J. N. Weishut M. Jaglom J. Rabinowitz (2002) ArticleTitlePatients’ and staff members’ attitudes about the rights of hospitalized psychiatric patients Psychiatric Services 53 87–91 Occurrence Handle10.1176/appi.ps.53.1.87 Occurrence Handle11773655

    Article  PubMed  Google Scholar 

  • L. E. Rootes D. L. Aanes (1992) ArticleTitleA conceptual framework for understanding self-help groups Hospital and Community Psychiatry 43 379–381 Occurrence Handle1577431

    PubMed  Google Scholar 

  • Roth, D., Crane-Ross, D., Hannon, M., & Hogan, M. (1999). Toward best practices: Top ten findings from the longitudinal consumer outcomes study

  • D. Roth B. G. Lauber D. A. Crane-Ross J. A. Clark (1997) ArticleTitleImpact of state mental health reform on patterns of service delivery Community Mental Health Journal 3 473–48

    Google Scholar 

  • Sachs, S. (1997). Recovery, Inc.: A wellness model for self-help mental health, Association for ambulatory behavioral healthcare. Developments in Ambulatory Mental Health Care Continuum, 4

  • Schmook, A. (undated). Creating a recovery vision statement. Distributed by the National Association for State Mental Health Program Directors

  • D. E. Smith M. E. Buxton R. Bilal R. B. Seymour (1993) ArticleTitleCultural points of resistance to the 12-step recovery process Journal of Psychoactive Drugs 25 97–108 Occurrence Handle8483054

    PubMed  Google Scholar 

  • E. L. Simpson A. D. House (2002) ArticleTitleInvolving users in the delivery and evaluation of mental health services systematic review BMJ 325 1265 Occurrence Handle10.1136/bmj.325.7375.1265 Occurrence Handle12458241

    Article  PubMed  Google Scholar 

  • W. E. Sowers (1997) ArticleTitleTreatment of persons with severe mental illness and substance use disorders in addiction programs Drug and Alcohol Forum 1 15–21

    Google Scholar 

  • D. S. Srebnik J. Russo J. Sage T. Peto E. Zick (2003) ArticleTitleInterest in psychiatric advance directives among high users of crisis services and hospitalization Psychiatric Services 54 981–986 Occurrence Handle10.1176/appi.ps.54.7.981 Occurrence Handle12851434

    Article  PubMed  Google Scholar 

  • W. C. Torrey P. Wyzik (2000) ArticleTitleThe recovery vision as a service improvement guide for community mental health center providers Community Mental Health Journal 36 209–216 Occurrence Handle10.1023/A:1001802612944 Occurrence Handle10800868

    Article  PubMed  Google Scholar 

  • S. Tsemberis L. Gulcur M. Nakae (2004) ArticleTitleHousing first, consumer choice, and harm reduction for homeless individuals with a dual diagnosis American Journal of Public Health 94 651–656 Occurrence Handle15054020 Occurrence Handle10.2105/AJPH.94.4.651

    Article  PubMed  Google Scholar 

  • J. Westermeyer (1999) ArticleTitleThe role of cultural and social factors in the cause of addictive disorders The Psychiatric Clinics of North America 22 253–273 Occurrence Handle10385932

    PubMed  Google Scholar 

  • W. White (1998) Slaying the dragon: The history of addiction treatment and recovery in America Chestnut Hill Systems Bloomington, IL

    Google Scholar 

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  1. American Association of Community Psychiatrists, Allegheny County Office of Behavioral Health, 304 Wood Street, 5th Floor, Pittsburgh, PA, 15222, USA

    Wesley Sowers M.D.

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  1. Wesley Sowers M.D.
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Sowers, W. Transforming Systems of Care: The American Association of Community Psychiatrists Guidelines for Recovery Oriented Services. Community Ment Health J 41, 757–774 (2005). https://doi.org/10.1007/s10597-005-6433-4

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