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Principles for Recovery-Oriented Inpatient Care

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Handbook of Recovery in Inpatient Psychiatry

Part of the book series: Evidence-Based Practices in Behavioral Health ((EBPBH))

Abstract

This chapter defines and distinguishes between two related concepts of “recovery” in relation to serious mental illnesses and the provision of “recovery-oriented care.” With this distinction in place, the chapter then outlines four key principles for applying the principles of recovery-oriented care to inpatient psychiatry. This first principle is that it is the person’s own recovery, reframing the aim of inpatient care to preparing the person to manage his or her condition and life following discharge. The second principle that follows from this is that Recovery-oriented care needs to be person/family-centered and culturally responsive to be relevant to the person’s life. Given the high prevalence of trauma among persons with mental illness and the potentially traumatic nature of hospitalization itself, the third principle is that inpatient staff should anticipate, and welcome, trauma survivors through the provision of a safe, respectful, and collaborative environment. Finally, principle four is that the interdisciplinary team needs to be expanded to include the person him or herself, his or her identified family members, and the community-based providers who have worked with the person in the past and/or will work with the person following discharge. In closing, the respective role of each of these team members within the context of recovery-oriented inpatient care is described.

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References

  • Azeem, M. W., Aujla, A., Rammerth, M., Binsfeld, G., & Jones, R. B. (2011). Effectiveness of six core strategies based on trauma informed care in reducing seclusions and restraints at a child and adolescent psychiatric hospital. Journal of Child and Adolescent Psychiatric Nursing, 24(1), 11–15.

    Article  PubMed  Google Scholar 

  • Baker, E., Fee, J., Bovington, L., Campbell, T., Hewis, E., Lewis, D., et al. (2013). From taking to using medication: Recovery-focused prescribing and medicines management. Advances in Psychiatric Treatment, 19, 2–10.

    Article  Google Scholar 

  • Barker, P. J., & Buchanan-Barker, P. (2011). Mental health nursing and the politics of recovery: A global reflection. Archives of Psychiatric Nursing, 25(5), 350–358.

    Article  PubMed  Google Scholar 

  • Barker, P., & Buchanan-Barker, P. (2010). The tidal model of mental health recovery and reclamation: Application in acute care settings. Issues in Mental Health Nursing, 31(3), 171–180.

    Article  PubMed  Google Scholar 

  • Barton, S. A., Johnson, M. R., & Price, L. V. (2009). Achieving restraint-free on an inpatient behavioral health unit. Journal of Psychosocial Nursing, 47(1), 34–40.

    Google Scholar 

  • Bennington-Davis, M., & Murphy, T. (2005). Restraint and seclusion: The model for eliminating use in healthcare. Oregon: HCPro Inc.

    Google Scholar 

  • Bowers, L., Brennan, G., Flood, C., Lipang, M., & Oadapol, P. (2006). Preliminary outcomes of a trial to reduce conflict and containment on acute psychiatric wards: City nurses. Journal of Psychiatric and Mental Health Nursing, 13, 165–172.

    Article  PubMed  Google Scholar 

  • Caldwell, B. A., Sclafani, M., Swarbrick, M., & Piren, K. (2010). Psychiatric nursing practice and the recovery model of care. Journal of Psychosocial Nursing, 48(7), 42–48.

    Google Scholar 

  • Carr, E. G., Dunlap, G., Horner, R. H., Koegel, R. L., Turnbull, A. P., Sailor, W., et al. (2002). Positive behavior support evolution of an applied science. Journal of Positive Behavior Interventions, 4(1), 4–16.

    Article  Google Scholar 

  • Chandler, G. (2008). From traditional inpatient to trauma-informed treatment: Transferring control from staff to patient. Journal of the American Psychiatric Nurses Association, 14, 363–371.

    Article  PubMed  Google Scholar 

  • Chen, S.-P., Krupa, T., Lysaght, R., McCay, E., & Piat, M. (2011). The development of recovery competencies for inpatient mental health providers working with people with serious mental illness. Administration and Policy in Mental Health, 40(2), 96–116.

    Article  Google Scholar 

  • Chen, S.-P., Krupa, T., Lysaght, R., McCay, E., & Piat, M. (2014). Development of a recovery education program for inpatient mental health providers. Psychiatric Rehabilitation Journal, 37(4), 329–332.

    Article  PubMed  Google Scholar 

  • Corrigan, P. (2004). How stigma interferes with mental health care. American Psychologist, 59(7), 614–625.

    Article  PubMed  Google Scholar 

  • Coulter, A., Entwistle, V. A., Eccles, A., Ryan, S., Shepperd, S., & Perera, R. (2013). Personalized care planning for adults with chronic or long-term health conditions. Issue: The Cochrane Library. 5.

    Google Scholar 

  • Cusack, K. J., Frueh, B. C., & Brady, K. T. (2004). Trauma history screening in a community mental health center. Psychiatric Services, 55, 157–162.

    Article  PubMed  Google Scholar 

  • Davidson, L. (2003). Living outside mental illness: Qualitative studies of recovery in schizophrenia. New York: New York University Press.

    Google Scholar 

  • Davidson, L. (2005). Recovery, self-management, and the expert patient: Changing the culture of mental health from a UK perspective. Journal of Mental Health, 14(1), 25–35.

    Article  Google Scholar 

  • Davidison, L., & Roe, D. (2007). Recovery from versus recovery in serious mental illness: One strategy for lessening confusion plaguing recovery. Journal of Mental Health, 16(4), 1–12.

    Google Scholar 

  • Davidson, L., Rakfeldt, J., & Strauss, J. S. (2010). The roots of the recovery movement: Lessons learned. London: Wiley-Blackwell.

    Book  Google Scholar 

  • Davies, J., Maggs, R. G., & Lewis, R. (2014). The development of a UK low secure service: Philosophy, training, supervision, and evaluation. International Journal of Forensic Mental Health, 9(4), 334–342.

    Article  Google Scholar 

  • DHHS. (1999). Mental health: A report of the Surgeon General. Rockville, MD: Substance Abuse and Mental Health Services Administration.

    Google Scholar 

  • DHHS. (2003). Achieving the promise: Transforming mental health care in America. Rockville, MD: Substance Abuse and Mental Health Services Administration.

    Google Scholar 

  • Donat, D. C. (2005). Encouraging alternatives to seclusion, restraint, and reliance on PRN drugs in a public psychiatric hospital. Psychiatric Services, 56(9), 1105–1108.

    Article  PubMed  Google Scholar 

  • Fallot, R. D., & Harris, M. (2008). Trauma-informed approaches to systems of care. Trauma Psychology Newsletter, 3(1), 6–7.

    Google Scholar 

  • Fisher, W. (2003). Elements of successful restraint and seclusion reduction programs and their application in a large, urban, state psychiatric hospital. Journal of Psychiatric Practice, 9(1), 7–15.

    Article  PubMed  Google Scholar 

  • Gaskin, C. J., Elsom, S. J., & Happell, B. (2007). Interventions for reducing the use of seclusion in psychiatric facilities: Review of the literature. The British Journal of Psychiatry, 191(4), 298–303.

    Article  PubMed  Google Scholar 

  • Greene, R. W., Ablon, J. S., & Martin, A. (2006). Use of collaborative problem solving to reduce seclusion and restraint in child and adolescent inpatient units. Psychiatric Services, 57, 610–612.

    Article  PubMed  Google Scholar 

  • Hammell, K. W. (2004). Dimensions of meaning in the occupations of daily life. Canadian Journal of Occupational Therapy, 71(5), 296–305.

    Article  Google Scholar 

  • Hillbrand, M., Hawkins, D., Howe, D. M., & Stayner, D. (2008). Through the eyes of another: Improving the skills of forensic providers using a consumer-informed role-play procedure. Psychiatric Rehabilitation Journal, 31(3), 239–242.

    Article  PubMed  Google Scholar 

  • Huckshorn, K. A. (2004). Non-abusive psychological and physical intervention for a safer workplace. NAPPI International Training Program. Held on March 8–10, 2004. Augusta, ME: NAPPI, Inc.

    Google Scholar 

  • Jaeger, M., Konrad, A., Rueegg, S., & Rabenschlag, F. (2015). Patients’ subjective perspective on recovery orientation on an acute psychiatric unit. Nordic Journal of Psychiatry, 69(3), 188–195.

    Article  PubMed  Google Scholar 

  • Jamison, K. R. (1995). An unquiet mind: A memoir of moods and madness. New York, NY: Vintage.

    Google Scholar 

  • Kidd, S., McKenzie, K. J., Collins, A., Clark, C., Costa, L., Mihalakakos, G., & Paterson, J. (2014a). Advancing the recovery orientation of hospital care through staff engagement with former clients of inpatient units. Psychiatric Services, 65(2), 221–225.

    Article  PubMed  Google Scholar 

  • Kidd, S., McKenzie, K. J., & Virdee, G. (2014b). Mental health reform at a system level: Widening the lens on recovery-oriented care. Canadian Journal of Psychiatry, 59(5), 243–249.

    PubMed  PubMed Central  Google Scholar 

  • Kielhofner, G. (2009). Conceptual foundations of occupational therapy (4th ed.). Philadelphia: F.A. Davis.

    Google Scholar 

  • Knutson, M. B., Newberry, S., & Schaper, A. (2013). Recovery education: A tool for psychiatric nurses. Journal of Psychiatric and Mental Health Nursing, 20, 874–881.

    Article  PubMed  Google Scholar 

  • Krupa, T., Fossey, E., Anthony, W., Brown, C., & Pitts, D. (2010). Doing daily life: How occupational therapy can inform psychiatric rehabilitation practice. Psychiatric Rehabilitation Journal, 32(3), 155–161.

    Article  Google Scholar 

  • Leamy, M., Bird, V., Le Boutillier, C., Williams, J., & Slade, M. (2011). Conceptual framework for personal recovery in mental health: Systematic review and narrative synthesis. The British Journal of Psychiatry, 199(6), 445–452.

    Article  PubMed  Google Scholar 

  • LeBel, J., Stromberg, N., Duckworth, K., Kerzner, J., Goldstein, R., Weeks, M., et al. (2004). Child and adolescent inpatient restraint reduction: A state initiative to promote strength-based care. Journal of the American Academy of Child and Adolescent Psychiatry, 43, 37–45.

    Article  PubMed  Google Scholar 

  • Le Boutillier, C., Leamy, M., Bird, V. J., Davidson, L., Williams, J., & Slade, M. (2011). What does recovery mean in practice? A qualitative analysis of international recovery-oriented practice guidance. Psychiatric Services, 62, 1470–1476.

    Article  PubMed  Google Scholar 

  • McDermott, F., Hupert, D., Blashki, G., Stone, L., Epstein, M., Olsen, A., et al. (2012). Active participants in mental health services. In G. Meadows, J. Farhall, E. Fossey, M. Grigg, F. McDermott, & B. Singh (Eds.), Mental health in Australia: A collaborative community practice (3rd ed., pp. 267–319). Melbourne, Australia: Oxford University Press.

    Google Scholar 

  • McKenna, B., Furness, T., Dhital, D., Ennis, G., Houghton, J., Lupson, C., et al. (2014a). Recovery-oriented care in acute inpatient mental health settings: An exploratory study. Issues in Mental Health Nursing, 35, 526–532.

    Article  PubMed  Google Scholar 

  • McKenna, B., Furness, T., Dhital, D., Park, M., & Connolly, F. (2014b). The transformation from custodial to recovery-oriented care: A paradigm shift that needed to happen. Journal of Forensic Nursing, 10(4), 226–233.

    Article  PubMed  Google Scholar 

  • Master, K. J., Bellonci, C., & Bernet, W. (2002). Practice parameter for the prevention and management of aggressive behavior in child and adolescent psychiatric institutions, with special reference to seclusion and restraint. Journal of the American Academy of Child and Adolescent Psychiatry, 41(Suppl. 2), 4S–25S.

    Article  Google Scholar 

  • Mueser, K. T., Rosenberg, S. D., Goodman, L. A., & Trumbetta, S. L. (2002). Trauma, PTSD, and the course of severe mental illness: An interactive model. Schizophrenia Research, 53(1), 123–143.

    Article  PubMed  Google Scholar 

  • Muskett, C. (2014). Trauma-informed care in inpatient mental health settings: A review of the literature. International Journal of Mental Health Nursing, 23(1), 51–59.

    Article  PubMed  Google Scholar 

  • Nasar, S. (1998). A beautiful mind: A biography of John Forbes Nash. Jr: Simon & Schuster.

    Google Scholar 

  • National Association of Social Workers. (2014). Code of ethics of the National Association of Social Workers. Approved by the 1996 NASW Delegate Assembly and revised by the 2008 NASW Delegate Assembly. http://www.naswdc.org/pubs/code/code.asp

  • Polacek, M. J., Allen, D. E., Damin-Moss, R. S., Schwartz, A. J. A., Sharp, D., Shattell, M., et al. (2015). Engagement as an element of safe inpatient psychiatric environments. Journal of the American Psychiatric Nurses Association, 21(3), 181–190.

    Article  PubMed  Google Scholar 

  • Priebe, S., Bröker, M., & Gunkel, S. (1998). Involuntary admission and posttraumatic stress disorder symptoms in schizophrenia patients. Comprehensive Psychiatry, 39, 220–224.

    Article  PubMed  Google Scholar 

  • Repper, J. (2000). Adjusting the focus of mental health nursing: Incorporating service users’ experiences of recovery. Journal of Mental Health, 9(6), 575–587.

    Article  Google Scholar 

  • Robins, C. S., Sauvageot, J. A., Cusack, K. J., Suffoletta-Maierle, S., & Frueh, B. C. (2005). Consumers’ perceptions of negative experiences and “sanctuary harm” in psychiatric settings. Psychiatric Services, 56, 1134–1138.

    Article  PubMed  Google Scholar 

  • Saks, E. (2007). The center cannot hold. My journey through madness. New York: Hyperion Books.

    Google Scholar 

  • SAMHSA. (2011). Consensus definition of recovery in behavioral health. http://blog.samhsa.gov/2011/12/22/samhsa%E2%80%99s-definition-and-guiding-principles-of-recovery. Accessed February 1, 2015.

  • SAMHSA. (2014). http://archive.samhsa.gov/BRSS-TACS-Decision-Tool/. Accessed August 4, 2015.

  • Schmutte, T., Flanagan, E., Bedregal, L., Ridgway, P., Sells, D., Styron, T., & Davidson, L. (2009). Self-efficacy and self-care: Missing ingredients in health and healthcare among adults with serious mental illnesses. Psychiatric Quarterly, 80, 1–8.

    Article  PubMed  Google Scholar 

  • Schreiner, G. M., Crafton, C. G., & Sevin, J. A. (2004). Decreasing the use of mechanical restraints and locked seclusion. Administration and Policy in Mental Health, 31, 449–463.

    Article  PubMed  Google Scholar 

  • Seed, M. S., & Torkelson, D. J. (2012). Beginning the recovery journey in acute psychiatric care: Using concepts from Orem’s self-care deficit nursing theory. Issues in Mental Health Nursing, 33, 394–398.

    Article  PubMed  Google Scholar 

  • Sen, A. (1999). Development as freedom. New York, NY: Oxford University Press.

    Google Scholar 

  • Shanley, E., & Jubb-Shanley, M. (2007). The recovery alliance theory of mental health nursing. Journal of Psychiatric and Mental Health Nursing, 14(8), 734–743.

    Article  PubMed  Google Scholar 

  • Siu, B. W. M., Ng, B. F. L., Li, V. C. K., Yeung, Y. M., Lee, M. K. L., & Leung, A. Y. H. (2012). Mental health recovery for psychiatric inpatient services: Perceived importance of the elements of recovery. East Asian Archives of Psychiatry, 22(2), 39–48.

    PubMed  Google Scholar 

  • Slade, M. (2009). Personal recovery and mental illness: A guide for mental health professionals. Cambridge: Cambridge University Press.

    Google Scholar 

  • Smith, G. M., Davis, R. H., Bixler, E. O., Lin, H. M., Altenor, A., Altenor, R. J., et al. (2005). Pennsylvania State Hospital system’s seclusion and restraint reduction program. Psychiatric Services, 56, 1115–1122.

    Article  PubMed  Google Scholar 

  • Sullivan, D., Wallis, M., & Lloyd, C. (2004). Effects of patient-focused care on seclusion in a psychiatric intensive care unit. International Journal of Therapy and Rehabilitation, 11, 503–508.

    Article  Google Scholar 

  • Tee, S., Lathlean, J., Herbert, L., Coldham, T., East, B., & Johnson, T. J. (2007). User participation in mental health nurse decision-making: A co-operative enquiry. Journal of Advanced Nursing, 60(2), 135–145.

    Article  PubMed  Google Scholar 

  • Tondora, J. & Davidson, L. (2006). Practice guidelines for recovery-oriented behavioral health care. Connecticut Department of Mental Health and Addiction Services.

    Google Scholar 

  • Tondora, J., Miller, R., Slade, M., & Davidson, L. (2014). Partnering for recovery in mental health: A practical guide to person-centered planning. London: Wiley-Blackwell.

    Google Scholar 

  • Townsend, E. A., & Polatajko, H. J. (2007). Enabling occupation II: Advancing an occupational therapy vision for health, wellbeing and justice through occupation. Ottawa: CAOT Publications ACE.

    Google Scholar 

  • Tuke, S. (1813). A description of the retreat, an institution near York, for insane persons of the Society of Friends. York, England: W. Alexander.

    Google Scholar 

  • Wale, J. B., Belkin, G. S., & Moon, R. (2011). Reducing the use of seclusion and restraint in psychiatric emergency and adult inpatient services: Improving patient-centered care. The Permanente Journal, 15(2), 57–62.

    Article  PubMed  PubMed Central  Google Scholar 

  • Walsh, J., & Boyle, J. (2009). Improving acute psychiatric hospital services according to inpatient experiences. A user-led piece of research as a means to empowerment. Issues in Mental Health Nursing, 30(1), 31–38.

    Article  PubMed  Google Scholar 

  • Walsh, J., Stevenson, C., Cutcliffe, J., & Zinck, K. (2008). Creating a space for recovery-focused psychiatric nursing care. Nursing Inquiry, 15(3), 251–259.

    Article  PubMed  Google Scholar 

  • Wieman, D. A., Camacho-Gonsalves, T., Huckshorn, K. A., & Leff, S. (2014). Multisite study of an evidence-based practice to reduce seclusion and restraint in psychiatric inpatient facilities. Psychiatric Services, 65(3), 345–351.

    Article  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA

    Larry Davidson, Erika Carr, Chyrell Bellamy, Janis Tondora, Thomas Styron & Shady Elsamra

  2. Department of Occupational Therapy, Monash University, Melbourne, Australia

    Ellie Fossey

  3. College of Nursing, Sacred Heart University, Fairfield, CT, USA

    Maryanne Davidson

Authors
  1. Larry Davidson
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  2. Erika Carr
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  3. Chyrell Bellamy
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  4. Janis Tondora
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  5. Ellie Fossey
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  6. Thomas Styron
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  7. Maryanne Davidson
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  8. Shady Elsamra
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Corresponding author

Correspondence to Larry Davidson .

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Editors and Affiliations

  1. Department of Psychiatry and Health Behavior, Augusta University Medical College of Georgia, Augusta, Georgia, USA

    Nirbhay N. Singh

  2. Virginia Department of Behavioral Health and Developmental Services , Richmond, Virginia, USA

    Jack W. Barber

  3. Medical College of Georgia, Augusta University Medical College of Georgia, Augusta, Georgia, USA

    Scott Van Sant

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Davidson, L. et al. (2016). Principles for Recovery-Oriented Inpatient Care. In: Singh, N., Barber, J., Van Sant, S. (eds) Handbook of Recovery in Inpatient Psychiatry . Evidence-Based Practices in Behavioral Health. Springer, Cham. https://doi.org/10.1007/978-3-319-40537-7_2

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