Relationships-Based Recovery Revisited

By Ashcraft, Lori; Anthony, William A. | Behavioral Healthcare, October 2009 | Go to article overview
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Relationships-Based Recovery Revisited

Ashcraft, Lori, Anthony, William A., Behavioral Healthcare

Powerful results from strengths-based, peer relationships

Last month we told you about a great conference workshop by Dr. Bob Bohanske, Chief of Clinical Services and Clinical Training at Southwest Behavioral Health Services in Phoenix, Arizona. Dr. Bob maintains that a therapeutic relationship focused on the strengths of the individual being served is essential to producing a better recovery outcome. When this method was compared to the outcomes reached using a variety of other modalities, Dr. Bob concluded that we would be much more successful at promoting recovery if we trained our staff how to form effective, strength-based relationships with each individual.

Dr. Bob decided to put this theory to the test with a peer workforce because he wanted to know if peer-provided services really were viable or if they were based merely on political beliefs born out of past frustration with traditional services. For the sake of time we'll leave out the "research talk," except for one fundamental point that Bill has repeated over the past three decades: the most empirically supported principle of "helping" is that people who experience a positive relationship with a helper are more apt to achieve their goals.

This point reflects what Dr. Bob wanted to examine when he raised this question last month: "Since using strengthsbased relationships promotes recovery better than a variety of modalities, why don't we just teach staff how to form strengths-based relationships?"

One important tool in Dr. Bob's examination was the Relationship Rating Scale (RRS) by Duncan (2005). This four-item scale was designed to be completed by the person receiving services at the completion of each visit with a Peer Support Specialist. The people receiving services were asked to provide additional feedback to the Peer by completing the Core Relationship index, an eight-item sub scale of the Recovery Promoting Relationship Scale (RPRS). This is in Bill's territory, since this scale was developed at Boston University by his colleague, Zlatka Russinova, with tiic help of Sally Rogers and Marsha Ellison.

Zlatka's goal was to develop an instrument to measure recovery-promoting competencies of mental healtii providers. She knew this would help program administrators assess the skills and competencies of staff and that it could also be used to help target areas for staff development and training. Zlatka asked people receiving services to tell her what "ingrethents" should be used to identify "recovery-promoting" relationships. Here are the ingrethents she heard about and used to develop the scale:

* Having genuine respect for us

* Helping us develop skills to cope and manage symptoms

* Seeing us as persons apart from diagnosis and symptoms

* Helping us accept and value ourselves

* Listening to us without judgment

* Believing in our potential to recover

* Trusting the authenticity of our experience

* Caring about us

* Being accessible to us when we need help

* Understanding us

As mentioned, Dr. Bob used a sub-scale from the Recovery- Promoting Relationship Scale known as the Core Relationship Index (8 questions), as well as 4 items from the Relationship Rating Scale.

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