RTP Weekly Highlight Header

May 26, 2011 Volume 2, Issue 19
Please share the Recovery to Practice (RTP) Weekly Highlights with your
colleagues, clients, friends, and family!

To access RTP’s Weekly Highlights, quarterly e-newsletters, and Webinar recordings
and PowerPoint presentations,
please visit http://www.dsgonline.com/rtp/resources.html.

RTP Professional Discipline
Situational Analysis Executive Summary
This week, and every other week for the next several weeks, we will share summaries from the recently completed Situational Analyses conducted by each of the professional disciplines as part of the Recovery to Practice (RTP) initiative. The RTP Situational Analysis is a holistic description that captures unique characteristics of the current status of recovery-oriented practice within each discipline and then sets forth the approach that each will use to advance recovery principles and practices within its profession.

The teams synthesized findings from their yearlong, comprehensive assessment of both qualitative and quantitative data, collected in terms of (1) definitions and understandings of recovery used in their profession (as compared to the Substance Abuse and Mental Health Services Administration’s [SAMHSA’s] Consensus Statement recovery definition); (2) evidence of recovery-oriented practices being used; (3) evidence of the concept of recovery embedded in organizational infrastructure (i.e., in formal policies and procedures); and (4) evidence of recovery-oriented content in institutional training curricula.

The Situational Analysis forms the basis for determining strengths and identifying gaps as each professional organization designs and delivers its curriculum. Factors that make up the Situational Analysis are fluid and will evolve over time, as learning and practice grow. The Situational Analysis presented here, and in later Weekly Highlights, represent the current status of each discipline and its plans for the future. Readers who would like to provide feedback on these plans to any of the professional organizations involved are invited to do so, using the email address below.
American Psychiatric Association
and American Association of Community Psychiatrists
This Situational Analysis summarizes the information-gathering efforts of the 1st year of a multiyear project to develop and disseminate educational materials on recovery-oriented practices for psychiatrists. The project is a collaborative effort of the American Psychiatric Association and the American Association of Community Psychiatrists, with assistance from an advisory group of psychiatrists, other mental health professionals, and consumers. It is part of a larger SAMHSA effort to broaden and increase awareness, acceptance, and adoption of recovery principles and practices among mental health care providers.

This report looks at current knowledge and application of recovery-oriented practices among psychiatrists across the United States. It summarizes information from a variety of sources, including a review of existing literature and in-person dialogues and telephone conference calls involving psychiatrists, other mental health care providers, consumers, and family members.

Building on previous research and drawing from information provided by psychiatrists, consumers, and others, the report identifies barriers to recovery-oriented practice, including lack of practical knowledge and tools needed to put concepts into practice, perceptions/misperceptions about recovery and recovery-oriented practice, and systems-related issues, such as restrictions and limitations that largely result from scarcity of resources. An increasingly diverse population also poses challenges to providers and calls for understanding of cultural influences on perceptions and approaches to mental illness and recovery.

Following are some examples of comments and concerns from participants.

  • Perception of recovery being associated with substance use disorder and addiction recovery
  • Concerns relating to sharing power
  • Lack of knowledge and understanding about how to put recovery-based care into practice
  • Systems that limit the psychiatrist role in medication management and limit the potential time spent with individual consumers
  • Institutional/system pressure to treat as many individuals as possible
  • Separation of substance use disorder and mental health programs/treatment
Consumers/family members:
  • “The most powerful thing anyone said to me was ‘I have so much hope for you.’”
  • “Doctors need to speak in a language we can understand.”
  • “I want to viewed as a whole person, not as a diagnosis.”
  • The best source of hope is seeing a person in recovery and learning from their experience.
  • Family members can be an important resource and often bear much of the responsibility—but often feel left out of communication and not part of the team.
A number of recommendations for content and format of training emerged. The training materials should:
  • Connect to participants’ prior knowledge and experiences
  • Demonstrate recovery-oriented practices that address common clinical challenges
  • Focus on how to use recovery principles in real situations (e.g., within time/resource limitations)
  • Involve consumers as trainers and provide personal recovery stories.
In addition, given the time constraints experienced by most psychiatrists and the many topics competing for their attention, the information should be accessible and brief and should extend beyond written or lecture formats to include the use of interactive and experiential teaching strategies. Finally, in order to reach more people, training materials should be available online and should be available for continuing medical education credit.

For more information about this Situational Analysis, please contact the American Psychiatric Association’s RTP team at abondurant@psych.org.

Webinar: Introduction to Effective Behavioral Health Service Delivery
in Primary Care Settings
Wednesday, June 1, 2011
1:00–2:30 p.m. Eastern Time

To register

Looking for clarification on the differences between co-located behavioral health services and truly integrated care? This Webinar provides an introduction for clinicians in Federally Qualified Health Centers and Community Behavioral Health Organizations interested in evidence-based practices for integrating behavioral health into primary care. Participants gain valuable information to support their clinical practice—including the way behavioral health needs present in primary care, screening and diagnostic practices, clinical routines of integrated care, and team-oriented training.

Target Audience
Staff working in Federally Qualified Health Centers and Community Behavioral Health Organizations partnering with Community Health Centers

Webinar Objectives
  • Identify approaches you can take to integrate behavioral health into a primary care practice.
  • Learn the evidence-based and promising practices of integrated care.
  • Learn practical steps primary care teams can use to improve the identification and treatment of behavioral health problems in a primary care setting.
Alexander Blount, Ed.D., is a professor of family medicine and psychiatry at the University of Massachusetts Medical School in Worcester, Mass., and director of behavioral science in the Department of Family Medicine and Community Health. He teaches physicians the psychosocial skills of primary care practice and established the post-doctoral Fellowship in Clinical Health Psychology in Primary Care. Dr. Blount has extensive experience as a behavioral health clinician in primary care.

Miguel Olmedo is a family nurse practitioner with a doctorate in nursing practice. He has been a primary care provider at the Family Health Center of Worcester, a Federally Qualified Health Center, for 10 years. Dr. Olmedo and Dr. Blount have worked on this primary care team together for approximately 5 years.

About the Center
The Substance Abuse and Mental Health Services Administration–Health Resources and Services Administration (SAMHSA–HRSA) Center for Integrated Health Solutions (http://www.CenterforIntegratedHealthSolutions.org), run by the National Council for Community Behavioral Healthcare under a cooperative agreement from the U.S. Department of Health and Human Services, is funded jointly by SAMHSA and HRSA. The Center promotes the development of integrated primary and behavioral health services to better address the needs of individuals with mental health and substance use conditions, whether seen in specialty behavioral health or primary care provider settings. The National Association of Community Health Centers is a subcontractor on this collaboration.

SAMHSA Blog: Recovery Defined – A Unified Working Definition
In August 2010, leaders in the behavioral health field, including people in recovery from mental health and addiction problems, and SAMHSA met to explore the development of a common, unified definition of recovery. Prior to this conversation, the need for a common definition was very apparent. In fact, SAMHSA had separate definitions for recovery from mental and substance use conditions. These different definitions, along with other Government agency definitions, complicate the discussion as we work to expand health insurance coverage for treatment and recovery support services.

After many conversations and hard work with our partners in the field, a working unified definition and set of principles for recovery has been developed. The development of a standard, unified working definition of recovery will help ensure access to recovery-oriented services for those who need it, as well as reimbursement to providers.

Additionally, SAMHSA recognizes the importance of measuring the outcomes and quality of behavioral health services. As a result, SAMHSA is working to develop a set of measures to help assess a person’s recovery, with an emphasis on developing indicators that assess quality of life.

Following are the working definition recovery and guiding principles.

According to the working definition, recovery is a process of change whereby individuals work to improve their own health and wellness and to live a meaningful life in a community of their choice while striving to achieve their full potential.

The principles of recovery state that recovery:
  • Is Person-driven
  • Occurs via many pathways
  • Is holistic
  • Is supported by peers
  • Is supported through relationships
  • Is culturally based and influenced
  • Is supported by addressing trauma
  • Involves individual, family, and community strengths and responsibility
  • Is based on respect
  • Emerges from hope
Furthermore, SAMHSA’s Recovery Support Initiative identifies four major domains that support recovery:
  • Health: Overcoming or managing one’s disease(s) as well as living in a physically and emotionally healthy way
  • Home: A stable and safe place to live that supports recovery
  • Purpose: Meaningful daily activities, such as a job, school, volunteerism, family caretaking, or creative endeavors, and the independence, income, and resources to participate in society
  • Community: Relationships and social networks that provide support, friendship, love, and hope
There is no set time requirement for recovery, as it is recognized that this is an individualized process whereby each person’s journey of recovery is unique and whereby each person in recovery chooses supports, ranging from clinical treatment to peer services that facilitate recovery.

SAMHSA expects additional comments from the field as this definition evolves, and we continue to work together to help ensure recovery services are being provided, reimbursed, and measured in a consistent way. Check out SAMHSA’s Recovery Support Initiative for more information on recovery.

Australian National Standards for Mental Health Services
This document outlines a revised set of mental health service standards that can be applied to all mental health services, including Government, nongovernment, and private sectors across Australia.

To access, visit:

The RTP Resource Center Wants to Hear From
Recovery-Oriented Practitioners!
We invite practitioners to submit personal stories that describe how they became involved in recovery-oriented work and how it has changed the way they currently practice.
The RTP Resource Center Wants to Hear From You, Too!
We invite you to submit personal stories that describe recovery experiences. To submit personal stories or other recovery resources, please contact Stephanie Bernstein, MSW, at 1.877.584.8535,
or email recoverytopractice@dsgonline.com.

We welcome your views, comments, suggestions, and inquiries.
For more information on this topic or any other recovery topics,
please contact the RTP Resource Center at
1.877.584.8535 or email recoverytopractice@dsgonline.com.

The views, opinions, and content of this Weekly Highlight are those of the authors and do not necessarily
reflect the views, opinions, or policies of SAMHSA or the U.S. Department of Health and Human Services.