Personal-recovery and agency-enhancing client work in the field of mental health and social rehabilitation: perspectives of persons with lived experience and specialists
Date
2019-09-19
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Abstract
Sotsiaalse rehabilitatsiooni ja vaimse tervise valdkonna spetsialistide ülesanne tänase ühiskonna ootuste kontekstis on toetada kestva haiguse ning vaimse tervise raskustega inimeste personaalset taastumist ja toimevõimekust. Personaalne taastumine on uus lähenemine vaimses tervises ja tähendab püüdlust elada elamisväärset ning isiklikult tähenduslikku elu päevast päeva koos haiguse ja raskustega. Uurimuste põhjal on vaja personaalseks taastumiseks (1) seotust teiste inimeste ja keskkonnaga, (2) lootuse tunnet, (3) positiivset suhtumist iseendasse, (4) elule tähenduse leidmist, (5) sisemise jõu leidmist. Toimevõimekus tähendab suutlikkust kujundada oma eesmärke, reguleerida sihipärast mõtlemist, tegutsemist ja kogetut lahti mõtestada ning vajadusel käitumist muuta, kuni soovitu saavutamiseni. Doktoritöö eesmärk oli tuua välja praktikute tegevused, mis reaalselt on aidanud edendada inimeste personaalse taastumise, toimevõimekuse, kuid ka iseseisvuse saavutamise protsessi. Uurimuses intervjueeriti vaimse tervise raskustega inimesi ja analüüsiti iseseisvuse arendamisele suunatud aspekte spetsialistide koostatud rehabilitatsiooni-tekstides. Tulemuste põhjal on võimalik öelda, et personaalse taastumise protsessi toetab see, kui praktik väärtustab koostöösuhtes samaväärsust, vastastikusust, on kohalolule orienteeritud, tunnustab edusamme, positiivset enesesse suhtumist, õpetab olema lootusrikas, on valmis ühiselt arutama elu tähenduse, haiguskogemuse, kaaskodanike sildistava suhtumisega hakkamasaamise teemadel ja on kaasategutseja kui inimene oma perspektiivide avardamise eesmärgil teeb uusi tegevusi. Inimese toimevõimekust arendab koostöö, kus lahendused ehitatakse rehabilitatsiooniprotsessis üles inimese ja tema keskkonna unikaalsetele ressurssidele.
In the context of today’s societal expectations, the mission of specialists in the social rehabilitation and mental health fields is focused on supporting personal recovery and the capacity for agency in persons with long-term illness and mental health difficulties. Personal recovery is a new approach to mental health which embraces the intention to live a daily life that is worth living and meaningful, alongside one’s illness. Studies show that personal recovery depends on: (1) a sense of connectedness to other people and the environment; (2) a feeling of hopefulness; (3) positive identity; (4) the discernment of meaning in life; (5) the discovery of inner strength. Agency denotes the capacity to formulate one’s goals, regulate purposeful thinking, take action and reflect upon the resulting experiences, and change behaviour if necessary, until the desired aims are achieved. The aim of the dissertation is to identify activities of practitioners that have been shown to promote personal recovery and the capacity for agency, as well as the process of achieving independence. For this study, persons with mental health difficulties were interviewed and aspects of practitioners’ work which promote the development of independence were analysed. Based on the results it can be said that the personal recovery process is supported when the practitioner places value on equality in the context of the working relationship; fosters reciprocity; is focused on being present; acknowledges progress; promotes a positive attitude toward oneself; coaches the person in maintaining a hopeful outlook; is ready to collaboratively discuss life’s meaning and the experience of illness; teaches coping skills related to building bridges with fellow citizens; and actively collaborates when the person chooses new paths of action in the name of expanding their horizons. In the rehabilitation process, the person’s capacity for agency is strengthened through a working collaboration in which solutions are creatively based upon the unique resources of the person and their environment.
In the context of today’s societal expectations, the mission of specialists in the social rehabilitation and mental health fields is focused on supporting personal recovery and the capacity for agency in persons with long-term illness and mental health difficulties. Personal recovery is a new approach to mental health which embraces the intention to live a daily life that is worth living and meaningful, alongside one’s illness. Studies show that personal recovery depends on: (1) a sense of connectedness to other people and the environment; (2) a feeling of hopefulness; (3) positive identity; (4) the discernment of meaning in life; (5) the discovery of inner strength. Agency denotes the capacity to formulate one’s goals, regulate purposeful thinking, take action and reflect upon the resulting experiences, and change behaviour if necessary, until the desired aims are achieved. The aim of the dissertation is to identify activities of practitioners that have been shown to promote personal recovery and the capacity for agency, as well as the process of achieving independence. For this study, persons with mental health difficulties were interviewed and aspects of practitioners’ work which promote the development of independence were analysed. Based on the results it can be said that the personal recovery process is supported when the practitioner places value on equality in the context of the working relationship; fosters reciprocity; is focused on being present; acknowledges progress; promotes a positive attitude toward oneself; coaches the person in maintaining a hopeful outlook; is ready to collaboratively discuss life’s meaning and the experience of illness; teaches coping skills related to building bridges with fellow citizens; and actively collaborates when the person chooses new paths of action in the name of expanding their horizons. In the rehabilitation process, the person’s capacity for agency is strengthened through a working collaboration in which solutions are creatively based upon the unique resources of the person and their environment.
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Keywords
vaimne tervis, psüühikahäirega inimesed, sotsiaalne rehabilitatsioon, personaalne taastumine, võimestamine, sotsiaaltöö