Vol. 13, No. 6
Welcome to the September edition of Tips and Topics. Thanks to all the longtime readers and to the new subscribers this month.
David Mee-Lee M.D.
Earlier this month, Janelle Wesloh, Executive Director of Recovery Management at Hazelden Betty Ford Foundation asked me about the samples of recovery language which I have included in SKILLS this month. They do sound like things I have talked and written about before:
October 2010 SKILLS: https://www.changecompanies.net/blogs/tipsntopics/2010/10/
April 2009 SAVVY: https://www.changecompanies.net/blogs/tipsntopics/2009/04/
June 2008 SKILLS: https://www.changecompanies.net/blogs/tipsntopics/2008/06/
April 2007 SAVVY: https://www.changecompanies.net/blogs/tipsntopics/2007/04/
January 2006 SKILLS: https://www.changecompanies.net/blogs/tipsntopics/2006/01/
We couldn’t find the source except that it appeared to originate with Washington State Department of Social and Health Services published August 2, 2010. Zephyr Forest, Administrative Assistant for the Division of Behavioral Health and Recovery (email@example.com) was kind enough to try to track down the source, but he couldn’t trace its origins either. In the meantime though, he forwarded some equally stimulating resources some of which I am sharing in SAVVY this month.
Compare and contrast a pathology-oriented, deficit-based view of mental health versus a recovery, strength-based system of mental health services.
The following comparison was adapted from Ridgway, P. (2004). Research Findings: Key factors and elements of a recovery-enhancing mental health system. Document prepared for “Recovery in Action: Identifying Factors and Trends of Trans-formational Systems” meeting sponsored by CONTAC and NCSTAC. Indianapolis, Indiana.
Ridgway offers a comparison of the pre-recovery mental health system and a recovery enhancing mental health system.
Note how language matters. Consider these alternatives which promote recovery.
In the same module of the Washington State Certified Peer Counselor Training Manual
(MODULE 3: CORE PRINCIPLES OF RECOVERY & RESILIENCE), that referenced Ridgway’s work, there was a succinct list on page 37 emphasizing that language matters.
“When we talk about mental illness, the words we choose are very important. Respectful language can promote recovery and reduce stigma. A poor choice of words can have the opposite effect. Consider the following word choices:
“The words on the left are positive and have a sense of power to them. They engender hope and possibility. The words on the right are negative. Words can go a long way in facilitating someone’s recovery and combating stigma within and outside of the mental health system.” (page 37).
Harris and Felman provided their list of how “language that is commonly used within the mental health system can often be improved. The following are examples of simple, practical ways to reframe the conversation in recovery-oriented ways.”
Rather than these words: Use words that promote recovery:
1. Refused 1. Declined / Repeatedly said no
2. Resisted 2. Chose not to / Disagreed with the suggestion
3. Client believes that… 3. Client stated that…
4. Delusional 4. Experiencing delusional thoughts
5. Paranoid 5. Experiencing paranoid symptoms
6. Decompensate 6. Experiencing an increase in symptoms
7. Manipulative 7. Seeking alternative methods of meeting needs
8. Noncompliant 8. Not in agreement with the treatment plan
Difficulty following treatment recommendations
9. Unmotivated 9. Bored /Has not begun
10. Suffering from… 10. Has a history of…
11. Low functioning 11. Has difficulty with…
1. Washington State Certified Peer Counselor Training Manual (Revised July 2009). “Language Matters” in MODULE 3: CORE PRINCIPLES OF RECOVERY AND RESILIENCE, pp. 37-41. Washington State’s Division of Behavioral Health & Recovery. Prepared by the Washington Institute for Mental Health Research & Training.
2. Harris, Jamie & Felman, Kristyn (2012): “A Guide to the Use of Recovery-Oriented Language In Service Planning, Documentation, and Correspondence” Mental Health America Allegheny County, 100 Sheridan Square, 2nd Floor Pittsburgh, PA 15206 Phone: 1-877-391-3820 www.mhaac.net
It takes some practice and skill to avoid falling into the same old pathology-oriented and blaming language we get so used to doing. So here is the recovery language grid to helps re-frame and sharpen your skills. If you are aware of the source, please let me know at firstname.lastname@example.org.
Build your skills to move away from blaming or labeling language to respectful empowering terminology.
“The following are some of the terms we have traditionally used to describe people and/or their behaviors. These terms place judgment and blame on the individual and generalize their actions. It is much more helpful to describe the specific situation that a person is facing than to use generic and punitive clinical terms.”
Earlier this month I had to eat humble pie twice – all in the same shopping expedition- in the space of one hour. I consider myself a reasonably patient person……but not so fast. Because when it’s getting late and the shops will close soon and I haven’t finished my must-do errands, suddenly some old wisdom rears its ugly head:
“Patience is a virtue
Possess it if you can
Seldom found in women
Never in a man.”
Well it wasn’t found in this man, this writer, this month anyway.
I had just finished buying some printer cartridges at Office Depot before they closed. I wanted to get to next store before they closed too. Stuck behind a driver at a red light, I started fuming and judging his knowledge of the road rules. He just sat there and didn’t seem to know that you can, sir, turn right on red in the USA. Let’s get on with it; there’s no traffic coming; it is quite safe for you to turn on a red light and then I can get going on my errands. He still just sat there, apparently not getting my psychic message to get moving beamed from my car to his.
The light turns green. Finally, I’m thinking, he’ll turn now so I can rush to the next store. But he has already made me waste at least 45 seconds tolerating his stubbornness and refusal to turn right on red. So inconsiderate and ignorant of basic driving rules.
Oops! He didn’t turn right, because he was going straight ahead and had never even indicated he was going to turn right. That was all in my head, assuming that just because I was turning right, he must be going that direction too. Sheepishly, I ate some humble pie, noting how easy it is to see the world just through my eyes and perspective.
Not 10 minutes later…. I find my self stuck again behind an inconsiderate driver. This time, not stuck at a red light, but crawling along at 15 miles per hour in a 30 mph zone. Don’t they know where the accelerator is? I’m rushing to get to the next store before it closes. Do they really need to choose this time to drive slowly and smell the roses? I’m tempted to move closer and tailgate them to send a not-so-subtle message to “hurry up, will you!”
Oops again! Just as I start to speed up towards them, they turn right into the next street. They were not smelling the roses. Ironically they were turning right when I was focused on going straight ahead. That is why they were going slowly, preparing to turn.
There was the second slice of humble pie all in less than an hour. I had done it again – seeing the world just through my eyes and perspective. Now, who was the inconsiderate driver?
Until next time
Glad you could join us this month. See you in late October.