Mental Health and Addiction

Recovery can be a difficult journey for many. The reality of having to change old habits for new ones can take a lifetime. The recovery approach/model realizes the struggle of change and transformation and makes it so that way emphasis is not placed on the destination, but rather the journey. Although other approaches like the disease/medical model aim to treat one aspect of recovery from addiction, the recovery model encompasses all aspects making it one of the most advantageous models to adopt to fight addiction.

The recovery approach/model to addiction and/or mental disorder places a strong emphasis on a support for an individual's potential for recovery. Recovery means a person undergoing a personal journey instead of determining and setting an outcome. This personal journey involves the development of hope, a sense of self, a secure base, social inclusion, meaning, empowerment, and coping skills that will take that person past the realm of despair and hopelessness into a world full of progress and self-actualization. With origins in the well-known 12-Step Program of Alcoholics Anonymous, the use of the idea within mental health arose as deinstitutionalization caused an increase in affected individuals living in the community.

The recovery model of treatment instills in those with mental health problems and those that abuse alcohol and drugs, that there is a means from which one can regain the life and normalcy that he or she once had. There is the notion that addicts and those that are mentally ill are not like normal people. However, recovery implies that these people can be normal and can achieve what they want to achieve, which is to be themselves. So many times in the past people working in mental health facilities have dehumanized the patients there. Therefore, the social movement came to be in order to show that these people are human and that they can gain back what makes them people through the process of recovery (Rosenberg & Rosenberg, 2013).

The recovery model adds social inclusion as a fundamental aspect to help those with these kinds of issues successfully recover. It has become a main mode of treatment for those suffering from mental health problems or substance abuse. The hope aspect of the model is what truly helps provide the kind of transformation required for true and lasting change.

The medical or disease model of addiction sees addiction as an illness with genetic, biological, neurological, as well as environmental sources of origin. "The disease model is a biomedical model that understands addiction as a physiological pathology that requires medical or pharmacological interventions. Proponents of the model use medical terminology to describe important addiction processes and treatment" (Miller, 2013, p. 71). The medical model does not see the way to recovery as a mean of building a strong support network like the recovery model does. Rather, the medical/disease models opt to treat the addiction via medical intervention.

It takes away the responsibility of the person towards recovery and instead puts the potential for recovery in a drug or treatment protocol that will seemingly alleviate said addiction or mental health problems. People with mental health problems typically are prescribed multiple medications to 'medically treat' their disorders. For example, depression is treated with anti-depressants like Lexapro and anxiety is treated with anti-anxiety medications. Although short-term it helps people cope with the realities of mental health issues, it does nothing to truly help solve the underlying causes. At least, that is what those against the medical model say.

The key difference between the recovery model and the disease model is the complexity or lack thereof for treatments. The recovery employs a multi-faceted approach to treatment, meaning addicts are encouraged to participate in their community, find constructive coping mechanisms and try to see their problems as steps towards recovery. The disease mode simply opts to treat the person with medication and see if that works for them. Heroin addicts for example, are given methadone to ease them into recovery. Although it helps some, it is not a permanent means of solving the problem of addiction.

Environment has been well-known to be a regulator of behavior. An example from literature is a man that saw his psychiatrist dressed in a different manner. Before he looked like a mental patient. But after he was immersed into a group of seemingly normal people, he began to dress like them, and thus appear differently (Rosenberg & Rosenberg, 2013). The recovery model takes into consideration the impact other people have on an individual in regards to recovery.

In a 2012 article that explains the positive aspects of the recovery paradigm, results show key predictors of recovery involvement in peer support activities and groups and active participation within the community. "Recovery requires a twin track approach: enabling and supporting individual recovery journeys, while creating environmental conditions that enable and support a 'social contagion' of recovery, in which recovery is transmitted through supportive social networks and dedicated recovery groups, such as mutual aid" (Best & Lubman, 2012, p. 593). By addicts becoming involved in society, they gain a purpose and build self-esteem. This self-esteem then translates to hope and empowerment. Such transformations from addict to recovered require these key feelings in order to effectively begin and finish the process.

It appears that active involvement in the community and having goals apart from the self enables faster recovery among addicts and makes for a strong advantage for the recovery model. As the previous study demonstrated when an addict seeks to make him or herself useful to society, the need for escape subsides.

Support perceived to be ineffective emerged in dyads with no operationalized goal, and high emotional availability with low degree of practical support. Support perceived to be effective was signified by the sponsor attending to power imbalance and the addict coming into position to help others and feel useful (Johansen, Brendryen, Darnell, & Wennesland, 2013, p. 1).

Although this has shown that people can and will progress towards their goals using the framework from the recovery model, there are some setbacks.

For example, some people just cannot find purpose within their community. Community, a support system, all these things involve success human to human interaction. Often times addicts and those that mentally ill cannot achieve this. They may have a horrible family, no friends, and no one there to actively enable their participation in a community. They may have socialization issues and cannot achieve these tasks by themselves. Thus the recovery model cannot work for them.

The recovery model is a useful model, but it involves people, not just the person involved. It would take great discipline, courage, and effort in order for the person to do these steps that are part of the model by themselves. This rings especially true for community participation because that involves a coordinated effort.

While some critics of the disease model of treatment believe labeling addiction as a disease is not conducive to encouraging recovery among addicts (Hammer et al., 2013), it is something that with new technology, researchers are investigating. "Advances in neuroscience identified addiction as a chronic brain disease with strong genetic, neurodevelopmental, and sociocultural components. Drug-induced impairments are long lasting; thus, interventions designed to mitigate or even reverse them would be beneficial for the treatment of addiction" (Volkow & Morales, 2015, p. 712). This combined with the recovery model can yield benefits that will lead towards progress. The recovery model of treatment asks the afflicted person to feel hope and be empowered to change. However, if that person cannot do so on their own, drug intervention may prove useful.

The benefits of the recovery model are that individuals treated in this way gain a sense of control and personal identity that more traditional methods would not yield. In addition, the stigma attached to being mentally ill or being an addict is removed/reduced. When people who have to deal with these personal problems look for and seek help, they do so assuming they will be ostracized as is the norm in society. Because of the recovery model, these people are no longer dehumanized and instead are made to feel like they can reach that level of normalcy they once had or could have should they successfully recover.

There is considerable indication of the numerous benefits to the implementation of a recovery-oriented mental health care model. Some of which are reduction in occurrence of violence, decrease in events of self-harm, shorter inpatient stays, as well as reduced need for the use of fetters and most significantly, greater independence and feelings of self-control for the patient (Barker & Buchanan-Barker, 2012). By removing the stigma attached to the patient, it invites the patient to take recovery into his or her own hands.

Hope in relation to the recovery model offers the motivating and essential message that there can be a better future. So many that become addicts or mentally ill feel the obstacles and barriers they face cannot be overcome. However, hope brought on by recovery helps them gain the strength to overcome them. Hope can be fostered through providers, peers, friends, and families and often if the catalyst and the most crucial step to the recovery process. Hope is often the first step towards completion of all the other steps in the treatment model (Rosenberg & Rosenberg, 2013).

Empowerment means giving the power of choice to the patient. Specifically choosing where to allocate the resources available to him or her as well as participate in all decisions that affect their lives. Empowerment in this mode of treatment means giving a voice to the patient in regards to their wants, aspirations and desires. By giving them a way to control their destiny, it helps them take more responsibility in the recovery process.

Self-responsibility is attached to empowerment because as the patient takes on the decisions that will affect them, they then become responsible for the outcomes. By taking ownership of their past, their present, and their future, they understand what it will take to break the cycle that brought on addiction and/or mental illness, and what steps to take to achieve full recovery. Self-responsibility also involves awareness and accepting that there is a problem that must be solved in order to recover. Recovery encompasses all aspects of life, including housing, education, employment, and social interaction. And thus when actively engaged in recovery all areas must be addressed (Miller, 2013).

The disease model of addiction is often used for those severely addicted who cannot find recovery under traditional means (Hall, Carter, & Forlini, 2015, p. 105). Some addicts like those addicted to prescription opioids can benefit from medical intervention and so the medical model of treatment may help them. As shown in this 2012 study, the majority of the patients treated experienced recovery through medical intervention.

93 patients (65%) continued to be maintained on the medication and seven completed treatments and were no longer taking any opioid (5%). Pain scores showed a modest, but statistically significant improvement on BUP/NLX, which was contrary to our expectations and may be an important factor in treatment retention for this challenging population (Pade, Cardon, Hoffman, & Geppert, 2012, p. 446).

This is important to note because of the stark difference of the recovery model to the disease model. There are however, similar modes of treatment that share similarities to the recovery model.

For example, the cognitive behavioral model involves the need to interpret one's thoughts and behaviors, change them so the patient can achieve a positive outcome. The recovery model and the cognitive behavioral model are similar in that there is a need to change how people respond and interpret things from the inside so change can take place on the outside. The key difference between the models is the lack of complete coverage of all aspects of the person's life that the recovery model posits instead of just the internal aspect of the cognitive behavioral model.

Another similar approach is the solution focused model where goals are set in accordance to the answers given by the patient after a series of questions are asked. Goals are an important aspect of the recovery model. However, with solution focused, goals are the main and practically only aspect. This again shows the recovery model is comprehensive whereas these models address certain parts of a person's potential recovery, rather than see the whole picture.