Constructing the Elements of the “Recovery in” Model through Positive Assessments during Mental Health Home Visits
1.1. “Recovery in” Model and Home as a Scene of Service Delivery
Recovery is variously described as something that individuals experience, that services promote, and that systems facilitate, yet the specifics of exactly what is to be experienced, promoted, or facilitated—and how—are often not well understood either by the consumers who are expected to recover or by the professionals and policy makers who are expected to help them.
1.2. Positive Assessments and Supportive Communication
2. Research Design
2.1. Research Question and Aim
2.2. Setting and Data
2.3. Research Ethics
2.4. Method and Analysis
3.1. Elements of RIM Embedded in Positive Assessments
3.2. Elements of RIM in Home Visit Interaction
3.2.1. Encouraging Doing the ‘Right’ Things
- PROFESSIONAL: So, when you get the unpaid (rent) payments taken care of, you may then try to put a little money aside.
- CLIENT: And in July I will already pay July’s rent, so then it will be leveled!
- PROFESSIONAL: Oh right, wonderful!
- CLIENT: Yes, I counted it already in advance. This month I will still pay March’s (rent), so it is already paid.
- PROFESSIONAL: How about the dishes?
- CLIENT: The dishes have been taken care of.
- PROFESSIONAL: The dishes have been taken care of. Okay, good, good.
- PROFESSIONAL: All right, good. This would also be a kind of an important thing to remember to take care of brushing your teeth every day.
- CLIENT: Yes, I try.
- PROFESSIONAL: Keep the plug in the wall socket so that the toothbrush will recharge.
- CLIENT: Yes, I always try.
- PROFESSIONAL: All right, that’s already a lot.
- CLIENT: Yes.
- PROFESSIONAL: In what kind of condition have you been, all things considered?
- CLIENT: Pretty good.
- PROFESSIONAL: As there have been changes in medication and in other things?
- CLIENT: Yes, I haven’t been talking any rude things and I have not been ringing anyone’s doorbell.
- PROFESSIONAL: So, you have been behaving very wisely, yeah?
- CLIENT: I still sang sometimes on the balcony. I apologize if someone hears.
- PROFESSIONAL: Yes, it easily resounds, if you sing loudly because here is so much those high-rise apartment buildings.
3.2.2. Encouraging Right Kind of Personal Growth
- PROFESSIONAL: Yes, so there would probably be a possibility, let’s say to be a camp leader.
- CLIENT: Mm, and then also the Lutheran church has these summer camps where they always need staff for the summer. And then there was, the city also had something (a work offer), I can’t now remember what it was, but something I should know how to do.
- PROFESSIONAL: Yes. But you already have experience as you have been going to for example a center or what was there where you were arranging those group activities and everything like that, so yes, for sure you have competences. But then of course according to your strengths it is important that you do not take too large a task for yourself.
- CLIENT: Yeah, yes that’s it. But as all is just fine now, that I have four hours a week there and additionally all kinds of things going on, so in the end it is almost like having a part-time job.
- PROFESSIONAL: Indeed.
- CLIENT: Well, one example, once I thought I was coming from (a name of a residential area). I had had very much all sorts of things going on, and so... Then I got this terrible... nearby is a small bar and it ‘pulled’ me like a magnet and I was thinking what will I do now... that things will only go badly, so I called my dad and right away when I told the situation to him, it ‘snapped’, it stopped like a ‘cold turkey’ that ‘pulling’. And after that I got to come home peacefully. That is effective.
- PROFESSIONAL: Indeed, that is your way to manage, and so yes, it really does the trick.
- PROFESSIONAL: Right. So, just tell straight out, are you going to go and become familiar with the activity center just to please us support workers, or are you going there because you want to?
- CLIENT: Perhaps mainly to please the support workers.
- PROFESSIONAL: Okay. So, what is yours, honestly, your will, your desire and your wish?
- CLIENT: That, at the moment I don’t want to go (to the day activity center).
- PROFESSIONAL: You don’t?
- CLIENT: I would not want to go.
- PROFESSIONAL: Okay, it is good that you said this at this point, there is no point that we go to the activity center, that you go there, if you go there just to please me, or you assume that it is something that I would wish you to do. So, there is no use, it doesn’t lead anywhere.
- CLIENT I don’t know about the end of the summer, if then I would be more willing.
- PROFESSIONAL: That is really good, very good that you said it, what do you think and feel about that, what feelings do you have.
- PROFESSIONAL: How does it feel being asked to take part in that kind of activity (to be one of the leaders of a bauble course)?
- CLIENT: Yes, I will go alright, or there will probably be more than one (course), because probably not everyone will necessarily fit in.
- PROFESSIONAL: But, so, after all, you can be proud of yourself that you have been asked to that kind of, that in my opinion, it is a great thing. Surely it will be fun.
- CLIENT: Yes, at least something a bit different.
- PROFESSIONAL: Yeah. And as you apparently are good at this jewelry making, after all, it is great, then you have a possibility to share your own expertise with others.
- CLIENT: This organizing thing at home comes at a good time, now all the missing pieces of jewelry may be found.
4.1. Summary of the Results
4.2. Culturally Laden, Negotiable, and Interactional RIM
4.3. Critical Remarks and Limitations of the Study
5. Conclusions and Practical Implications
Conflicts of Interest
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|Upper-Category||Sub-Categories||Elements of ’Recovery in’ Model in Sub-Categories|
|Encouraging Doing the Right Things||Taking care of everyday matters||Financial issues and commitment to agreed appointments.|
|Taking care of home||Cleaning: washing dishes, vacuuming, laundry, taking trash out.|
|Taking care of oneself||Personal hygiene, medication, exercising, healthy eating, sufficient sleeping.|
|Behaving in a normal way in the community||Appropriate behavior and social participation.|
|Encouraging Right Kind of Agency||Doing life planning||Continuality, contemplating and committing to future plans.|
|Doing illness management||Recognising symptoms and own ways to manage with the illness.|
|Being self-governing and knowing agent||Recognising own strengths and will.|
|Being skillful community member||Recognising own skills and wishes to participate in communal actions.|
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Raitakari, S.; Holmberg, S.; Juhila, K.; Räsänen, J.-M. Constructing the Elements of the “Recovery in” Model through Positive Assessments during Mental Health Home Visits. Int. J. Environ. Res. Public Health 2018, 15, 1441. https://doi.org/10.3390/ijerph15071441
Raitakari S, Holmberg S, Juhila K, Räsänen J-M. Constructing the Elements of the “Recovery in” Model through Positive Assessments during Mental Health Home Visits. International Journal of Environmental Research and Public Health. 2018; 15(7):1441. https://doi.org/10.3390/ijerph15071441Chicago/Turabian Style
Raitakari, Suvi, Suvi Holmberg, Kirsi Juhila, and Jenni-Mari Räsänen. 2018. "Constructing the Elements of the “Recovery in” Model through Positive Assessments during Mental Health Home Visits" International Journal of Environmental Research and Public Health 15, no. 7: 1441. https://doi.org/10.3390/ijerph15071441