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How does the ongoing recovery-orientation of mental health services affect everyday social work? And how does it in complex ways shape the «space of possibilities» that social workers as well as users act within? These are the guiding questions in the empirical analysis which this article offers insight into. The study behind this article shows how the attempts to move towards recovery-orientation are guided by a range of institutional imperatives, and that they tend to create a strong hierarchical focus on who «does it well» and who does not. Through analyses of concrete stories from social work practices, this study argues that the social work practices can be understood in more nuanced and complex ways with the concept of intertensionality. It is shown how the space of possibilities in mental health services are shaped by the intertensional relations between the «right practices» and the «wrong practices» appointed by the discourse of recovery-orientation.
An increasing number of policy documents are recommending that the recovery perspective be used as a guiding principle in the development of psychiatric care. The recovery perspective also implies a formalized user involvement in the planning and managing of treatment interventions. The present article questions whether it is possible to integrate this perspective in psychiatry’s current practice and body of knowledge. Three aspects are investigated: What are mental disorders? Who are the users? Which factors contribute to the recovery process? Psychiatry’s belief in chronic illnesses that follow a given course of development is contrasted with the view of mental problems as being related to life events with recovery as a likely course of development. The dominant view in psychiatry is that the patient is irrational and incapable of interpersonal relationships. Results in recovery research place the user in his or her social context and show that the managing of symptoms and stigma is possible. Where psychiatry focuses on specific treatment interventions, the users themselves point at a variety of helping factors where interpersonal relationships play a central role. An integration of users’ experience-based knowledge in the arena of psychiatry would deeply transform its current knowledge and practice.
During the last decades there has been considerable emphasis on systemizing and acknowledging service users’ experiences, as well as developing a comprehensive and wide knowledgebase for mental health service development. National strategies, financial incitements and processes of service transformation should all in all represent good frameworks for making recovery oriented practice real. The intentions have been the best, however, looking at the present discussions and practises one might well question the genuine interest of the authorities as well as central parts of the services. Is recovery primarily seen as theoretically interesting or politically correct? In this paper we will outline some radical changes needed in order to fulfil the intentions of valuing service users’ voices and preferences in recovery. We will discuss issues like power and knowledge, the potentials of recovery research and practice in promoting solid change and finally the prospective of bringing together various research, practice and experience based communities for working in partnership towards a recovery oriented mental health service transformation.
User involvement aims to make sure that users gain increased power and influence over their own lives. User involvement may be seen as a condition for a health - and coping promoting strategy. Sagatun Brukerstyrt Senter in Hamar has distinguished itself by the fact that users find the way back to work or education after some time»s use of the center. This article presents the center and its shared values and goals which have been developed in a qualitative study with focusgroups, using an action-oriented design. Respect is perceived as the chief value. Respect is created and maintained through the three values: Equality, Openness and Compassion. Based on this project, it was possible to outline a superior vision and some goals for further work at the center.
Children and adolescents are constantly developing – and our finest professional obligation is to create and participate in the best contexts for development. Our task is to spot the not yet seen or experienced potentials that every child and adolescent possess (as we all do). We have to discover the possibilities that develop when we look for them with special care and interest. They develop when we expect change to happen and when we, together with significant others, participate in processes built on our preferred professional understanding of problems as invitations to change.
This article discusses the preliminary experience from the Danish municipality Gladsaxe’s attempt to transform its psychosocial efforts to that of one based on the concepts of recovery and rehabilitation. The politically approved Vision and Plan 2020 is briefly discussed while being placed in context with the previous decade’s intensified focus on recovery-orientation of services. This process is then illustrated using an account of a newly completed joint training course for service users and professionals, where challenges concerning change and partnership are highlighted. It ends with a discussion on how evidence based praxis can be developed which genuinely acknowledges service users’ experiences and wishes and where openness and reflexivity is upheld – a real challenge for a municipality under pressure.