1. Understanding and
Applying
the Recovery Model with
Older Adults
Lynn Northrop, PhD
Dara Bliss, MA
Sharp Healthcare

2. The Recovery Model
• History
– The Consumer Movement
– Psychiatric
Rehabilitation
Lynn Northrop, PhD

3. What does recovery mean to you?
Handout – 5 minutes
• How do you, as a clinician, define recovery?
• How do your clients define recovery?
• Do you believe in recovery? Can you think of
clients for whom you do not believe in recovery?
Lynn Northrop, PhD

4. US Surgeon General Report*
Recovery is variously called a process, an outlook, a vision, a
guiding principle.
There is neither a single agreed-upon definition of recovery nor a
single way to measure it.
But the overarching message is that hope and restoration of a
meaningful life are possible, despite serious mental illness.
Instead of focusing primarily on symptom relief, as the medical
model dictates, recovery casts a much wider spotlight on
restoration of self-esteem and identity and on attaining
meaningful roles in society.
*Office of the Surgeon General and various United States Government
agencies (1999)
Mental Health: A report of the Surgeon General. Section 10: Overview of
Recovery Lynn Northrop, PhD

5. Making it real
First…
Break up into groups of 3 to 5 people, preferably people you work
with who may know your clientele or who even work with some
of the same individual clients
And then…
Take a moment as a group to choose an single client to
consider during group exercises. Choose a older adult
with serious mental illness. Choose a client who has
been particularly challenging and/or is typical in
representing a hard to treat segment of clientele.
Respect confidentiality
Lynn Northrop, PhD

6. Who are they
10 minutes
• 20 word biography
• Strengths and weaknesses?
• Their Values and Goals?
• Past, present, or future focused?
• Where are they on Maslow s hierarchy?
• Current Role?
Respect confidentiality
Lynn Northrop, PhD

7. How are these concepts relevant to
individuals you chose?
• Hope
• Empowerment
• Self-responsibility
• A better life
Lynn Northrop, PhD

8. What gets in the way of your people
achieving the following?
• Hope
• Empowerment
• Self-responsibility
• A better life
How might YOU get in the way
of your people
achieving the above?
Lynn Northrop, PhD

9. Ground your work in these
shared goals.
• Hope
• Empowerment
• Self-responsibility
• A better life
Educate clients about the Recovery Model – including history.
May take time and effort to help clients believe that these concepts are
possible.
Each is a process, a life style, a somewhat moving target, waxes and
wanes. Keep your eye on the prize.
Lynn Northrop, PhD

10. Lynn Northrop, PhD
Goals of IMR*
1. Instill hope that change is possible
2. Develop a collaborative relationship with a treatment team
3. Help people establish personally meaningful goals to strive
towards
4. Teach information about mental illness and treatment options
5. Develop skills for reducing relapses, dealing with stress, and
coping with symptoms
6. Provide information about where to obtain needed resources
7. Help people develop or enhance their natural supports for
managing their illness and pursuing goals
*Illness Management and Recovery
http://mentalhealth.samhsa.gov/cmhs/communitysupport/toolkits/illness/
Evidence-Based Practices: Shaping Mental Health Services Toward Recovery

11. 1. Instilling hope that change is possible
• Model hope
• Educate: hopelessness is temporary symptom
• Cog: check/change inaccurate thoughts
• Hope IS a behavior. What does it look like?
• Stories of hope
• Hope mentors
• Offering to hold hope for someone.
Role Play – Clara feels no hope
72 y.o. depressed now and previously
Lives in SRO after eviction, NLR
Lynn Northrop, PhD

12. 2. Build a collaborative relationship
between client and team
• Be explicit about philosophy of collaboration – client
and clinician each come with expertise
• Collaborate
• Discuss Tx plan and goals – make
sure these goals are addressed and
updated
• Continuum of collaboration
In the long history of humankind...those who learned to collaborate and improvise most
effectively have prevailed -- Charles Darwin
Lynn Northrop, PhD

13. Collaboration
• What are some barriers? Tough case?
Lynn Northrop, PhD

14. 3. Establishing personally
meaningful goals.
• What are personally meaningful goals for a
person in recovery?
– Basic needs, symptom management, relapse
prevention, social support, roles, values, spirituality,
etc.
• Useful goals are:
– Realistic, specific, measurable, flexible, step-wise
AND meaningful
Lets create a goal together – case example from the room – someone who is lonely
Lynn Northrop, PhD

15. 4. Teach information about mental
illness and treatment options
Remember their expertise – you tell me
Handouts
Discussion How have you done this with
Classes current or former clients?
NAMI
Internet
Mentors
Facilitate discussion with MD, etc.
Have client educate others
Movies, books, lists of famous people
Lynn Northrop, PhD

16. 5. Develop skills for reducing relapses,
dealing with stress, and coping with
symptoms
Lynn Northrop, PhD

17. Component of WRAP
• What does well look like?
• EWS and Action Plans
• Triggers and Action Plans
• Daily Essentials
• Now and Then Essentials
• Crisis Plan
• Toolkit
Lynn Northrop, PhD

18. WRAP
Completed Completed Many
By Client For client Uses
case formulation & tx planning
Client s guide
Independently Family/CG education Tool
input from client
With min assist Common Language, culture
input from others
With max assist Staff training tool
Advocacy tool
Lynn Northrop, PhD

19. Lynn Northrop, PhD

21. 6. Provide information about where
to obtain needed resources
Keep in mind…
• Resource shortages can sabotage hope
• A map and compass or a limo and chauffeur?
• Don t be afraid to decrease reliance on you or
your organization
What are the barriers to (#6)?
Lets problem solve.
Lynn Northrop, PhD

22. 7. Help people develop or enhance their
natural supports for managing their illness
and pursuing goals
Social Support goals:
• Building a rationale for support
• Education about sources and types of support
• Support assessment (network, quality, satisfaction)
• Establishing new relationships
• Increasing quality or amount or type of support in existing
relationships
• Better utilizing support that is available
• Taking care to maintain the relationships you have
Lynn Northrop, PhD

23. Lynn Northrop, PhD

25. Practitioners’ Guide (Chapters 1-10) and
Educational Handouts
1. Recovery Strategies
2. Practical Facts about Schizophrenia/Bipolar Disorder/
Depression
3. The Stress-Vulnerability Model and Strategies for
Treatment
4. Building Social Support
5. Using Medication Effectively 329 pages!
6. Reducing Relapses
7. Coping with Stress
8. Coping with Problems and Symptoms
9. Getting Your Needs Met in the Mental Health System
Lynn Northrop, PhD

26. Final
Questions,
Comments,
farewells.
Lynn Northrop, PhD
lynn.northrop@gmail.com