Abstract
Objective
The authors assessed psychiatric trainees’ understanding of recovery-oriented care, a therapeutic philosophy with varied meanings but wide purchase in contemporary mental health policy.
Methods
Four cohorts of residents were presented with a clinical vignette as part of a written curricular evaluation and asked what it would mean to engage the patient from a recovery-oriented perspective. Responses were subjected to qualitative analysis, with the analysts examining each cohort independently, then meeting to discuss their findings and build consensus on the most pertinent themes.
Results
Nine themes emerged in trainees’ understanding of recovery-oriented care: (1) a person is more than his or her illness; (2) hope; (3) an emphasis on patient goals; (4) taking a collaborative approach; (5) an emphasis on level of social function; (6) valuing subjective experience; (7) psychosocial interventions; (8) empowerment of the patient; and (9) persistence of traditional attitudes.
Conclusions
Residents revealed an understanding of recovery that reflected many, but not all, of the guiding principles in the Substance Abuse and Mental Health Services Administration’s 2010 working definition. For many of these trainees, recovery-oriented care signified a shift in the traditional power dynamic between physician and patient that allowed patients to take an active role in their own care. Residents also recognized the importance of hope and the complexity of their patients’ social identities, though some trainees had difficulty reconciling a collaborative approach with their perceived responsibilities as physicians. If educators wish to incorporate elements of the American Psychiatric Association’s Recovery to Practice initiative into their curricula, they would do well to recognize residents’ variable receptivity to elements of the model.
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Acknowledgments
The authors wish to thank Larry Davidson, PhD, for his feedback on an earlier draft of the manuscript, as well as the journal’s anonymous reviewers. This research was supported in part by a National Institute of Mental Health Training Grant (T32MH062994-13) (MG).
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On behalf of all authors, the corresponding author states that there is no conflict of interest.
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Gambino, M., Pavlo, A. & Ross, D.A. Recovery in Mind: Perspectives from Postgraduate Psychiatric Trainees. Acad Psychiatry 40, 481–488 (2016). https://doi.org/10.1007/s40596-015-0414-x
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DOI: https://doi.org/10.1007/s40596-015-0414-x