Community Mental Health Journal

, Volume 41, Issue 1, pp 91–100 | Cite as

Recovery Principles and Evidence-Based Practice: Essential Ingredients of Service Improvement

  • William C. TorreyEmail author
  • Charles A. Rapp
  • Laura Van Tosh
  • Charity R. A. McNabb
  • Ruth O. Ralph


The two of the most commonly advocated service improvement proposals for adults with severe mental illnesses are to redesign services based on recovery principles and to increase the availability of services with strong research support. The two improvement strategies complement and inform each other much more than they conflict. To improve, the field needs the insights of people who have personally experienced severe mental illnesses and it needs the scientific process. Applied together, the two strategies can guide the development of an optimal service system: The kind of service system that most people would want for themselves or their family should they have the need.


severe mental illness schizophrenia illness management psychiatric rehabilitation recovery 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. Anthony, W. A. 1993Recovery from mental illness: The guiding vision of the mental health service system in the 1990sPsychosocial Rehabilitation Journal,16(4)1123Google Scholar
  2. Anthony, W. A. (2001). The need for recovery-compatible evidence-based practices. Mental Health Weekly, November 5.Google Scholar
  3. Anthony, W.A. 2003Studying evidence-based processes, not practicesPsychiatric Services54 7PubMedGoogle Scholar
  4. Anthony, W. A., Blanch, A. 1987Supported employment for persons who are psychiatrically disabled: An historical and conceptual perspectivePsychosocial Rehabilitation Journal11523Google Scholar
  5. Barton, R. 1998The rehabilitation-recovery paradigm: A statement of philosophy for a public mental health systemPsychiatric Rehabilitation Skills2171187Google Scholar
  6. Batalden, P. B., Stoltz, P. K. 1993A framework for the continual improvement of health care: Building and applying professional and improvement knowledge to test changes in daily workThe Joint Commission Journal on Quality Improvement19424445PubMedGoogle Scholar
  7. Bernstein, R. 2001Disintegrating Systems: The State of State’s Public Mental Health SystemsBazelon Center for Mental Health LawWashington DCGoogle Scholar
  8. Bond, G.R., Becker, D.R., Drake, R.E., Rapp, C.A., Meisler, N., Lehman, A.F., Bell, M.D., Blyler, C.R. 2001Implementing supported employment as an evidence-based practicePsychiatric Services52313322PubMedGoogle Scholar
  9. Brunette, M. F., Dean, W. 2002Community care for parents with severe mental illnessCommunity Mental Health Journal38153165PubMedGoogle Scholar
  10. Busch, A. B., Shore, M. F. 2000Seclusion and restraint: A review of the recent literatureHarvard Review of Psychiatry8261270PubMedGoogle Scholar
  11. Caras, S. (2001). It’s time for a new paradigm. Scholar
  12. Chambless, D.K., Baker, M. J., Baucom, D. H., Beutler, L. E., Calhoun, K. S., Crits-Christoph, P., Daiuto, A., DeRubeis, R., Detweiler, J., Haaga, D. A. F., Bennett Johnson, S., McCurry, S., Mueser, K.T., Pope, K. S., Sanderson, W. C., Shoham, V., Stickle, T., Williams, D.A., Woody, S. R. 1998Update on empirically validated therapies IIThe Clinical Psychologist51316Google Scholar
  13. Cohen, L. J., Test, M. A., Brown, R. L. 1990Suicide and schizophrenia: data from a prospective community treatment studyAmerican Journal of Psychiatry147602607PubMedGoogle Scholar
  14. Collins, M. E., Mowbray, C. T., Bybee, D. 2000Characteristics predicting successful outcomes of participants with severe mental illness in supported educationPsychiatric Services5177480PubMedGoogle Scholar
  15. Committee on Quality Healthcare in America,Institute of Medicine2001Crossing the Quality Chasm: a New Health System for the 21st CenturyNational Academy PressWashington, DCGoogle Scholar
  16. Deegan, P. E. 1988Recovery: The lived experience of rehabilitationPsychosocial Rehabilitation Journal111119Google Scholar
  17. Dickey, B. 2000Review of programs for persons who are homeless and mentally illHarvard Review of Psychiatry8242250PubMedGoogle Scholar
  18. Ditton, P. M. 1999Mental health and treatment of inmates and probationers(Special report NCJ 174463)U.S. Department of Justice, Office of Justice Programs, Bureau of Justice StatisticsWashington DCGoogle Scholar
  19. Dixon, L., McFarlane, W. R., Lefley, H., Lucksted, A., Cohen, M., Falloon, I., Mueser, K., Miklowitz, D., Solomon, P., Sondheimer, D. 2001Evidence-based practices for services to families of people with psychiatric disabilitiesPsychiatric Services52903910PubMedGoogle Scholar
  20. Drake, R. E., Essock, S. M., Shaner, A., Carey, K. B., Minkoff, K., Kola, L., Lynde, D., Osher, F.C., Clark, R. E., Rickards, L. 2001Implementing dual diagnosis services for clients with severe mental illnessPsychiatric Services52469476PubMedGoogle Scholar
  21. Drake, R. E., Goldman, H. H., Leff, H. S., Lehman, A. F., Dixon, L., Mueser, K.T., Torrey, W. C. 2001Implementing evidence-based practices in routine mental health settingsPsychiatric Services52197182Google Scholar
  22. Fisher, D. B. (1998). Recovery: The behavioral healthcare guidelines of tomorrow. Behavioral Healthcare Tomorrow, June, pp. 36–38.Google Scholar
  23. Harris, E. C., Barraclough, B. 1997Suicide as an outcome for mental disorders: A meta-analysisBritish Journal of Psychiatry170205228CrossRefPubMedGoogle Scholar
  24. Jacobson, N., Curtis, L. 2000Recovery as policy in mental health services: Strategies emerging from the statesPsychiatric Rehabilitation Journal23333341Google Scholar
  25. Jacobson, N., Greenley, D. 2001What is recovery?A conceptual model and explication. Psychiatric Services52482485Google Scholar
  26. Knight, E. L., Powell, I., Forbes, J. 2001A consumer view of an episode of care and how self-help helpsKiser, L.Lefkovitz, P. M.Kennedy, L. eds. The integrated behavioral health continuum: Theory and practiceAmerican Psychiatric PublishingWashington269280Google Scholar
  27. Koegel, P., Burnam, A., Baumohl, J. 1996The causes of homelessnessBaumohl, J. eds. Homelessness in AmericaOryxPhoenix2433Google Scholar
  28. Marshak, L. E., Bostick, D., Turton, L. J. 1990Closure outcomes for clients with psychiatric disabilities served by the rehabilitation systemRehabilitation Counseling Bulletin33247250Google Scholar
  29. Mellman, T. A., Miller, A. L., Weissman, E. M., Crismon, M. L., Essock, S. M., Marder, S. R. 2001Evidence-based pharmacologic treatment for people with severe mental illness: A focus on guidelines and algorithmsPsychiatric Services52619625PubMedGoogle Scholar
  30. Monahan, J., Lidz, C. W., Hoge, S. K., Mulvey, E. P., Eisenberg, M. M., Roth, L. H., Gardner, W. P., Bennett, N. 1998Coercion in the provision of mental health services: The MacArthur studiesResearch in Community and Mental Health101330Google Scholar
  31. Mueser, K. T., Corrigan, P. W., Hilton, D. W., Tanzman, B., Schaub, A., Gingerich, S., Essock, S. M., Tarrier, N., Morey, B., Vogel-Scibilia, S., Herz, M. I. 2002Illness management and recovery: A review of the researchPsychiatric Services5312721284PubMedGoogle Scholar
  32. Onken, S. J., Dumont, J. M., Ridgway, P., Dornan, D. H., & Ralph, R.O. (2002). Mental health recovery: What helps and what hinders? A National Research Project for The Development of Recovery Facilitating System Performance Indicators. National Association of State Mental Health Program Directors and the National Technical Assistance Center for State Mental Health Planning. Alexandria, VA.Google Scholar
  33. Persons, J. B., Thase, M. E., Crits-Christoph, P. 1996The role of psychotherapy in the treatment of depression: Review of two practice guidelinesArchives of General Psychiatry53283290PubMedGoogle Scholar
  34. Phillips, S. D., Burns, B. J., Edgar, E. R., Mueser, K. T., Linkins, K. W., Rosenheck, R. A., Drake, R. E., McDonell Herr, E. C. 2001Moving assertive community treatment into standard practicePsychiatric Services52771779CrossRefPubMedGoogle Scholar
  35. Polak, P., Warner, R. 1996The economic life of seriously mentally ill people in the communityPsychiatric Services47270274PubMedGoogle Scholar
  36. Pratt, S., Mueser, K. T. 2002Social skills training for schizophreniaHofmann, S.G.Thompson, M. C. eds. Treating chronic and severe mental disorders: A handbook of empirically supported interventionsGuilfordNew York1852Google Scholar
  37. President’s New Freedom Commission on Mental Health (2002). Interim Report to the President., October 2002.Google Scholar
  38. Ralph, R. O., Lambert, D., & Kidder, K. A. (2002). The recovery perspective and evidence-based practice for people with serious mental illness. The Behavioral Health Recovery Management Project, Peoria, Il, 2002.Google Scholar
  39. Ridgway, P. 2001ReStorying psychiatric disability: Learning from first person accounts of recoveryPsychiatric Rehabilitation Journal24335343PubMedGoogle Scholar
  40. Rosenberg, S. D., Goodman, L. A., Osher, F. C., Swartz, M., Essock, S.M., Butterfield, M. I., Constantine, N., Wolford, G. L., Salyers, M. 2001Prevalence of HIV, Hepatitis B and Hepatitis C in persons with severe mental illnessAmerican Journal of Public Health913137PubMedCrossRefGoogle Scholar
  41. Rosenberg, S. D., Mueser, K. T., Friedman, M. J., Gorman, P. G., Drake, R. E., Vidaver, R. M., Torrey, W. C., Jankowski, M. K. 2001Developing effective treatments for posttraumatic disorders among people with severe mental illnessPsychiatric Services5214531461PubMedGoogle Scholar
  42. Rosenberg, S. D., Mueser, K. T., Jankowski, M. K., & Hamblen, J. (2002). Trauma exposure and PTSD in people with severe mental illness. National Center for PTSD, Summer 1–8.Google Scholar
  43. Susser, E., Struening, E. L., Conover, S. 1989Psychiatric problems in homeless men: Lifetime psychosis, substance use, and current distress in new arrivals at New York City sheltersArchives of General Psychiatry46845850PubMedGoogle Scholar
  44. Swenson, C. R., Torrey, W. C., Koerner, K. 2002Implementing dialectical behavioral therapyPsychiatric Services53171178PubMedGoogle Scholar
  45. Teague, G. B. (2003). Consumer choice as a dimension of fidelity in evidence-based practice. Annual meeting of the American Evaluation Association, Reno, NV, November 6.Google Scholar
  46. Torrey, W. C., Drake, R. E., Dixon, L., Burns, B. J., Flynn, L., Rush, A. J., Clark, R. E., Klatzker, D. 2001Implementing evidence-based practices for persons with severe mental illnessesPsychiatric Services524550PubMedGoogle Scholar
  47. Torrey, W. C., Wyzik, P. F. 2000The recovery vision as a service improvement guide for community mental health center providersCommunity Mental Health Journal36209216PubMedGoogle Scholar
  48. U.S. Department of Health and Human Services1999Mental Health: A Report of the Surgeon GeneralU.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Mental Health Services, National Institutes of Health, National Institute of Mental HealthRockville, MDGoogle Scholar
  49. Tosh, L., Vecchio, P. 2000Consumer-Operated Self-Help Programs: A Technical ReportU.S. Center for Mental Health ServicesRockville, MDGoogle Scholar

Copyright information

© Springer Science+Business Media, Inc. 2005

Authors and Affiliations

  • William C. Torrey
    • 1
    • 2
    Email author
  • Charles A. Rapp
    • 3
  • Laura Van Tosh
    • 4
  • Charity R. A. McNabb
    • 4
  • Ruth O. Ralph
    • 5
  1. 1.Dartmouth Medical SchoolUSA
  2. 2.NH-Dartmouth Psychiatric Research CenterLebanonUSA
  3. 3.University of Kansas School of Social WelfareUSA
  4. 4.Mental Health Policy and Research Consultant.USA
  5. 5.Health Policy Institute at the Muskie School of Public ServiceUniversity of Southern MaineUSA

Personalised recommendations