5 Key Recovery Concepts: An Introduction

Mary Ellen Copeland

To learn about ways to cope with her own symptoms, Mary Ellen Copeland asked many people in mental health recovery about what helped them the most. She learned that these 5 key concepts were helpful to almost everyone she surveyed: responsibility, education, self advocacy, support, and hope.

We need to take responsibility for our own recovery; we cannot expect someone else to be able to fix or change us. By educating ourselves about wellness and our own needs, we learn what might help us. Advocating for ourselves helps us get the care we need and change the systems we are a part of. Giving and receiving support from family, friends, spirituality and other sources outside ourselves keeps us connected with our communities and the world around us. Hope for continued recovery keeps us going when all else fails.

These concepts describe simple and necessary aspects of successful recovery. How do each of them contribute to positive change in your life? 

Places to Look for Sex Positive Professionals (Finding the Right Therapist, part II)

I wrote before about some questions anyone might ask a therapist to assess whether you'll be a good match. How do find out who you might want to ask? For a person with alternative relationship styles or sexual preferences, this first step can be difficult. Word of mouth and referrals from other friendly professionals are the best option. When that fails, here are some existing referral lists that might help*.

Open Minds: Psychotherapists Affirming Sexual and Gender Diversity
Loving More Poly Professionals Listings
Poly-Friendly Professionals List 
The Open List : All kinds of professionals who have experience with or are open to alternative sexualities and lifestyles
Resources for LGBTQQI2S People in Alameda and Contra Costa Counties
Kink Aware Professionals

As I find more lists, I'll keep adding them. Many of the professionals on these lists may maintain there own referral lists, as well. Do you know of any others? Share them here!

*I know these lists by recommendation only. I have not evaluated these professionals, and I have never met most of them.

The Spoon Theory

But You Don't Look Sick is a site for people with invisible disabilities. In their words: "The mission of ButYouDontLookSick.com is to help everyone with a chronic illness or invisible disability, in order for them to live their lives to the fullest and not feel isolated and alone. We believe that our medical circumstances have put us in a unique and understanding position, so that we can help each other through similar difficult times. We hope the information and community on our site can aid people in leading better lives through knowledge, networking, friendship and most of all support."

My favorite page on But You Don't Look Sick describes "The Spoon Theory", a useful metaphor for how it can feel to live with the reduced energy capacity that can come from a chronic illness or disability. I believe this idea might be useful to anyone who may need to pay close attention to their stimulation levels such as Highly Sensitive Persons, people with autism, people with Asperger's Syndrome, or people with ADHD.

The Spoon Theory uses spoons to represent energy. We each get a limited allotment of spoons each day. When we use all of our spoons, our choice is to rest or take spoons from the next day. If we decide to take spoons from the next day, we will have fewer spoons to use tomorrow. This means we need to budget our "spoons" just like we might budget money or any other limited resource. This can be very useful for planning and prioritizing activities.

Here's an example of how I could use this idea to describe planning my day. Let's say I normally have 20 spoons per day. Taking the bus usually uses 2 spoons per trip, getting ready in the morning uses 1 spoon, and meals use 2 spoons per meal. (2 x 2 bus spoons) + 1 getting ready spoon + (3 x 2 meal spoons) = 11 spoons So, on any given day, I am likely to use at least 11 spoons. When I go to a street fair, I use 15 spoons for the fair in addition to 11 spoons I use every day. When I chose to go to a street fair on Saturday, I used at least 26 spoons. I had to borrow from the next day, so I only have 14 spoons for Sunday. If my friend invites me to go hiking Sunday (6 spoons), should I do it? Probably not, because I am likely to use at least 17 spoons, and I only have 14! I don't want to use spoons from Monday because I'm going to need all 20 spoons to work on Monday.

Another way to use the spoon theory is for prioritizing activities. I'll continue with the previous example. The Sunday after the street fair, I have 14 spoons. Hiking would take too many spoons, so I've chosen not to go. Can spend some time with my friend without taking spoons from the Monday? Yes! I can choose to spend fewer spoons with my friend. If my friend comes over, I don't have to take the bus, so I save 4 spoons! That means I'll only need 7 spoons for the rest of my necessary tasks. If my friend and I order take out, I could save 1 more spoon because take out uses 1 spoon instead of the 2 spoons it takes to cook. I'll still need to use 6 spoons for my day. There are plenty of fun things my friend and I could do with the remaining 8 spoons. The day is saved!

I can also plan ahead to save spoons for things I want to do in the future. I know that doing laundry uses a lot of my spoons. Going on a date also uses many spoons. This means I'd much less likely to choose to do laundry on a day that I have a date so I can save my spoons for what is more important to me. How do you prefer to use your spoons?

I find this metaphor most useful when I need to explain to others that I need to budget my energy like some people budget money or time. How is this idea useful for you?

One-Moment Meditation: "How to Meditate in a Moment"

WRAP for Health Conference

I feel so inspired by the WRAP for Health conference I attended yesterday! Mary Ellen Copeland, the author of Wellness Recovery Action Plan, was the keynote speaker. Her book, The Depression Workbook, really helped me in my own recovery process. Mary Ellen's work is focused on recovery and empowerment for people with mental health issues. When she was first beginning her own recovery, she researched what helped other people. She learned that the people she surveyed all were helped by these five key concepts of recovery: hope, personal responsibility, education, self advocacy, and support. It was wonderful to have the chance to thank her in person for her work.

I attended a session on some new programs that are intended to integrate primary medical care with mental health services. The reason for these programs are in response to a recent study reporting that people with severe mental illness (SMI) are dying 25-30 years earlier than the national average. Alameda County is responding with the 10 x 10 Campaign. According to the campaign website, the mission of this campaign is to "implement a holistic approach to increase life expectancy for persons with mental and substance use disorders by 10 years in 10 years." Some of the programs are bringing primary care to behavioral health clinics, while others are increasing the mental health services in medical clinics. These programs are inspiring to me, and I can see myself working in one. It's wonderful to get to be a part of an existing movement that's making things happen. I'm so happy that I moved back to California post Mental Health Services Act (MHSA)!

The second session I attended was about the Social Inclusion Campaign headed by PEERS. Though I didn't learn anything about the program I didn't already know, it was a great chance to witness the presenters stories and feel good about the connectedness in the room. I also got another idea for a workshop for PEERS. They seem to like my ideas, so look for my workshops on the PEERS calendar in the near future!

If you have the time and the inclination, I can't encourage you enough to get involved in the mental health consumer movement in Alameda County or wherever you live! Every event I attend inspires and motivates me. Like never before, I feel like I've found a home for the activist part of myself. ¡Viva la revolución!

Finding the Right Counselor and Getting What You Want from Therapy

Therapists are not one size fits all. Therapy is a unique relationship that will be most beneficial to you if you enter into it with a compatible professional.

What style of therapy might work for you?
Counselors and therapists use different theories and techniques. What might be the right one for you? If you'd had experience with therapy, you already know what you liked and didn't like about that experience. And it's okay if you have no idea! Either way, here are some questions that might help you and your potential counselor decide whether their approach is one you'd like to try. Do you want help discovering the underlying roots of your behaviors and beliefs, or are you more interested in solutions for a particular problem at hand? How have you successfully changed or solved problems in the past? What is your learning style? A visual learner might get good results an art therapist, for example. What do you enjoy doing? If you enjoy dancing, a therapist who does movement work might work well for you, but if you hate movement, you might prefer a therapist who focuses on talk. Are you looking for someone who is more of an expert, mirror, teacher, or friend? There is no one right answer to these questions; what are the right answers for you? Coming to your first session with some of these answers will help you and your potential therapist decide whether hir approach is compatible with your needs.

Know what you want to work on.
An initial interview with a therapist is a lot like a job interview, and *you* are the one hiring. You are responsible for bringing the therapist a "job description".  In other words, what are your reasons for coming to therapy? What do you hope to accomplish? You don't need to go into depth at this time; a quick description of what you'd like to be different at the end of the process will be helpful to both of you in deciding whether you're compatible.
 
Ask questions.
Find out what you can ahead of time so you know some of the questions you want to ask. A good counselor will be ready to talk to you about how they work, what kind of training they have, and anything else you need to know as you get started (like fees, cancellation policies, confidentiality, etc.). Feel free to ask any questions you have about what zie is telling you or what you read in the informed consent document. If you are confused or uncomfortable about something, your therapist can explain it further. You are entering into an agreement, and it is important that you understand and consent to that agreement. If you disagree with any aspect of the agreement, talk to your therapist about it. Some aspects might be negotiable. If something very important to you is not negotiable for that therapist, you may be able to find a therapist who can be more flexible on the matter. However, it is important to keep in mind that some things, like the legal limitations to confidentiality, for example, will be the same across all professionals because they are bound by legal and ethical codes.

Be ready to collaborate.
It is not a counselor's job to fix you or give you advice. No one else can change you; you have to be part of the process. Zie is not a mind reader. If there's something you need your counselor to know, it's better to bring it up as soon as you feel comfortable. And tell your therapist if something doesn't feel right. Practicing good communication and boundaries with your therapist can be good practice for your other relationships.

Trust the process.
Study after study reports that a high quality relationship between a client and their therapist leads to positive outcomes. (Flückiger, et. al. 2012) Once you find the right therapist for you, take some time to allow the relationship to build. As your trust and openness grows, your work together will help you grow and find the change you seek.

Good luck! And have fun!

Citation

How central is the alliance in psychotherapy? A multilevel longitudinal meta-analysis.

Flückiger, Christoph; Del Re, A. C.; Wampold, Bruce E.; Symonds, Dianne; Horvath, Adam O.

Journal of Counseling Psychology, Vol 59(1), Jan 2012, 10-17. doi: 10.1037/a0025749