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Clinical and Personal Recovery and Therapeutic Communication

Introduction to Mental Health Recovery

Mental illnesses manifest as multi-spectrum disorders that impact the physical, behavioural, and cognitive abilities of an individual (Ashford et al., 2018). The cause and treatment of mental illnesses have been explored way later than the conventional health sciences due to perceived stigma around the sphere of mental illnesses. However, the focus on the overall well-being of an individual with attention on mental health has now gained momentum in science as well as in the society in increased acceptance and the need of recovery (Bifarin & Jones, 2018). Recovery in mental health illnesses is defined as a means to gain and retain hope towards improvement and management of the health condition by the recovery-oriented care promoted by the Government of Australia (2016). This paper will provide a discussion on the differences in clinical health and personal recovery. Further, this paper will also highlight the importance of personal recovery in driving an overall beneficial change for an individual suffering from psychotic disorders. A personal reflection on how as a registered nurse in future the writer will be able to apply therapeutic communication to accelerate the course of recovery has also been included.

Clinical Health and Personal Recovery

The national standard for recovery-oriented care for patients with severe mental illnesses and experiences of psychosis includes a six-step strategy that focuses on asserting the importance of the uniqueness of the individual. The standards also demand acknowledgement of the choices, attitudes, and rights, treating the individuals with dignity and respect, promoting partnership and communication, and promote evaluation of the recovery process (Government of Australia, 2016). Clinical recovery is defined as a disease-free state of an individual where symptoms and signs of the illness are no longer visible. In contrast, personal recovery is the phenomenon of optimistic thinking and a means to live a meaningful life by an individual who has had an experience with a severe mental illness (Slade et al., 2017). Therefore, it can be asserted that clinical health recovery is the well-being of the physicality of the disease manifestation whereas personal recovery is an innate growth from experience of mental health that urges an individual to have a meaningful and purposeful life.

The idea of personal recovery originates from the recovery-oriented models that focused on the evaluation, treatment and management via self-reporting of mental health conditions of the patients that have lived through mental illness (Bifarin & Jones, 2018). The primary essence of these models is to empower and strengthen the self-esteem of patients that have suffered from a psychotic episode or a prolonged mental illness impacting their everyday activities. Personal recovery and recovery-oriented models are seen as an alternative to classical medical health models for patients with mental illness (Ashford et al., 2018). In essence, it has also bene derived that personal recovery and recovery oriented models are beneficial as they can help in understanding the manifestations and presentations associated with the patient and then thus assist in application of person-centered model of care to direct recovery (Cleary et al., 2017).

Mostly, psychotropic medications are given to the patients that suffer from severe mental illnesses like schizophrenia, bipolar disorder, and clinical depression. These medications not only alter the brain chemistry of the patient but also result in multiple behaviour changes bout also result in multiple side effects and physiological complications like weight gain and increased risk of diabetes that may pose an increased risk of secondary health problems. The prime focus of the alternate modes of management of mental health problems and to address the experiences of individuals in their course of recovery is to acknowledge that recovery is highly individualistic for every person and thus personalized models and acknowledgement of these personal experiences is needed (Waldemar et al., 2019).

Importance of Personal Recovery in Psychotic Disorders

Focus on personal recovery has been of prime importance in terms of mental health improvement and promotion of well being and inculcation of optimism in patients with psychotic disorders. Personal recovery has become a critical target for the mental health services (Davidson et al., 2017). Personal recoveries have been given a greater importance as they lay a direct focus on the patient and provide satisfying and contributing insights in the life of an individual to promote well-being. It has also been evidenced that focusing on personal recovery also contributes towards improvement and overall management of the clinical symptoms and thus promises a holistic approach for the betterment of the patient (Cleary et al., 2017). Along with medical support, an individual who has been through or is going through a psychotic illness requires emotional support and an optimistic approach for overall improvement. Personal recovery has been broadly classified into four steps, finding hope, reestablishment of identity, finding a meaning of life, and taking responsibility of recovery. Therefore, it can be assessed that personal recovery is inclusive of connectivity, hope, identity, meaning, and empowerment, also popularly known with acronym “CHIME” (Van Eck et al., 2018).

Focus on personal recovery has been of prime importance in terms of mental health improvement and promotion of well being and inculcation of optimism in patients with psychotic disorders. Personal recovery has become a critical target for mental health services. Personal recoveries have been given greater importance as they lay a direct focus on the patient and provide satisfying and contributing insights into the life of an individual to promote well being (Davidson et al., 2017). It has also been evidenced that focusing on personal recovery also contributes towards improvement and overall management of the clinical symptoms and thus promises a holistic approach for the betterment of the patient. Along with medical support, an individual who has been through or is going through a psychotic illness requires emotional support and an optimistic approach for overall improvement (Davidson et al., 2016). Personal recovery has been broadly classified into four steps, finding hope, the reestablishment of identity, finding a meaning of life, and taking responsibility for recovery. Therefore, it can be assessed that personal recovery is inclusive of connectivity, hope, identity, meaning, and empowerment, also popularly known with acronym “CHIME” (Van Eck et al., 2018). 

Personal Reflection on Mental Health Recovery

Therapeutic communication is defined as amalgamation of techniques that aim to prioritize the physical, mental and emotional wellbeing of the patients (Mabe et al., 2016). The technique is used to support the emotional well-being of the patients and ensuring a professional distance from the patient to ensure the comfort of the patient (Martin et al., 2016). Therapeutic communication is considered of high importance in mental health services and for the assistance of patients with psychotic illnesses as it functions as treatment adjunct and enhances communication with the patient (Townsend & Morgan, 2017). Successful application of therapeutic communications can assist in reducing anxiety and enhancing patient compliance and thus can help in the optimistic overall experience. As a registered nurse in future, I will ensure the application of therapeutic communication in conjunction with five critical components of effective communication. The five key components of effective communication include clarity, consistency, content, creativity, and connections. Through the application of these essential components of communication (Gaylle , 2019).

I will be able to develop a strong interpersonal relationship with the patient and promote a free exchange of thoughts and ideas and thus be able to cater to the patient needs more effectively and thus provide a better quality of care. The Nursing and Midwifery Board of Australia (2018) also identifies a key component of competent nursing. Therefore, through the adoption of strong communication skills and their successful application, I will be able to listen to the patient needs with severe mental illnesses, build trust, and promote better care facilitation. The three core parameters of therapeutic communication are active listening, probing, and empathetic responding. (Blake & Blake, 2019) As a registered nurse, I will ensure that I listen to the patient needs effectively and understand their care needs to deliver the required care and develop suitable strategies that promote recovery and optimism in the lives of the patient. Probing is a critical element of therapeutic communication (Donovan & Mullen, 2019). As a registered nurse, I will adopt probing in therapeutic communication by asking the relevant questions to the patient to identify the suppressed symptoms and thought processes.

Probing will also help in establishing a stronger relationship with the patient by asserting the understanding of the patient needs. Further, I will also promote empathetic responding in my conversations. Empathy is a critical aspect of mental healthcare as it helps in developing support and promotes engagement in conversation (Martin & Chanda, 2016). As a registered nurse, I will apply empathetic responding in therapeutic communication while catering patients with psychotic illnesses by understanding their clinical needs and promoting engagement by understanding the emotional and clinical aspects of the health. I will also ensure to use inclusive and accepting caring attitude and listen to the needs of the patient and responding. I will also make sure to use empathetic gestures and a caring attitude while catering to the needs of the patient. Through a competent and empathetic approach, I will assure that patient feels comfortable around me and can express all sorts of concerns that bother him or her. This can also help in the prevention of relapses and ease the sensory as well as emotional overload (Martin & Chanda, 2016). Therefore, by applying therapeutic communication in nursing practice I will be able to serve patients with mental illness in a recovery-oriented manner and provide holistic care. 

Conclusion on Mental Health Recovery

This essay provides a comprehensive discussion of severe mental illnesses in the context of psychosis and mania. This paper provides a detailed analysis of clinical health and recovery-oriented approaches adopted by the mental health experts and provide a discussion on how recovery-oriented healthcare is applied and assist in overall well-being for the patients with psychotic mental illnesses. Through analysis in this essay, the difference in clinical recovery and personal recovery has been established. Further, it has also been indicated how a focus on personal recovery can help in the improvement of the clinical health of patients as well. Further, this paper also presents an introspective reflective analysis of how the principles of effective and therapeutic communication will be applied by me in my future as a registered nurse to facilitate recovery and enhance the care of the individuals that suffer from psychotic illnesses. Though this paper, in conclusion, it can be drawn that personal recovery plays an essential role in the overall management and care of patients with psychotic illnesses. It can also be inferred that through the application of holistic care regimens that focus on empathy, therapeutic relationships, emotional as well as clinical support and enhanced communication, better care can be provided to patients with mental lionesses and promote their recovery. 

References for Mental Health Recovery

Ashford, R. D., Brown, A. M., & Curtis, B. (2018). Collegiate recovery programs: the integrated behavioral health model. Alcoholism Treatment Quarterly, 36(2), 274-285. https://www.tandfonline.com/doi/abs/10.1080/07347324.2017.1415176

Bifarin, O. O., & Jones, S. (2018). Embedding recovery-based approaches into mental health nurse training. British Journal of Mental Health Nursing, 7(5), 234-240. https://www.magonlinelibrary.com/doi/abs/10.12968/bjmh.2018.7.5.234

Blake, T., & Blake, T. (2019). Improving therapeutic communication in nursing through simulation exercise. Teaching and Learning in Nursing, 14(4), 260-264. https://www.sciencedirect.com/science/article/pii/S1557308719300551

Cleary, M., Lees, D., Molloy, L., Escott, P., & Sayers, J. (2017). Recovery-oriented care and leadership in mental health nursing. Issues in Mental Health Nursing, 38(5), 458-460. https://www.tandfonline.com/doi/full/10.1080/01612840.2017.1314738

Davidson, L., Carr, E., Bellamy, C., Tondora, J., Fossey, E., Styron, T., ... & Elsamra, S. (2016). Principles for recovery-oriented in patient care. In Handbook of recovery in inpatient psychiatry (pp. 39-58). Springer, Cham. https://link.springer.com/chapter/10.1007/978-3-319-40537-7_2

Davidson, L., Tondora, J., Pavlo, A. J., & Stanhope, V. (2017). Shared decision making within the context of recovery-oriented care. Mental Health Review Journal. 38(5), 48-56 https://www.emerald.com/insight/content/doi/10.1108/MHRJ-01-2017-0007/full/html

Donovan, L. M., & Mullen, L. K. (2019). Expanding nursing simulation programs with a standardized patient protocol on therapeutic communication. Nurse education in practice, 38, 126-131. https://www.sciencedirect.com/science/article/pii/S1471595318305651

Gaylle, D. (2019). In-simulation Debriefing Increases Therapeutic Communication Skills. Nurse Educator, 44(6), 295-299. https://journals.lww.com/nurseeducatoronline/Fulltext/2019/11000/In_simulation_Debriefing_Increases_Therapeutic.6.aspx

Government of Australia (2016). Recovery oriented care. https://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=&ved=2ahUKEwiT38Opu6nrAhXBb30KHWHlBYcQFjABegQICxAD&url=https%3A%2F%2Fwww1.health.gov.au%2Finternet%2Fmain%2Fpublishing.nsf%2Fcontent%2FCFA833CB8C1AA178CA257BF0001E7520%2F%24File%2Fservpri.pdf&usg=AOvVaw28qT3y1GWP-8rtQCbb8kbr

Mabe, P. A., Rollock, M., & Duncan, G. N. (2016). Teaching clinicians the practice of recovery-oriented care. In Handbook of recovery in patient psychiatry (pp. 81-97). Springer, Cham. https://link.springer.com/chapter/10.1007/978-3-319-40537-7_4

Martin, C. T., & Chanda, N. (2016). Mental health clinical simulation: therapeutic communication. Clinical Simulation in Nursing, 12(6), 209-214. https://www.sciencedirect.com/science/article/pii/S1876139916000256

Nursing and Midwifery Board of Australia (2018). Code of conduct. https://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=&cad=rja&uact=8&ved=2ahUKEwikhZqG4KzrAhUr7HMBHbjrDggQFjABegQICxAD&url=http%3A%2F%2Fwww.nursingmidwiferyboard.gov.au%2Fdocuments%2Fdefault.aspx%3Frecord%3DWD17%252F23850%26dbid%3DAP%26chksum%3DL8j874hp3DTlC1Sj4klHag%253D%253D&usg=AOvVaw2_EwvXELm1PrjH5t5kPGZh

Slade, M., Oades, L., & Jarden, A. (Eds.). (2017). Wellbeing, recovery and mental health. Cambridge University Press. https://books.google.com/books?hl=en&lr=&id=7YXuDQAAQBAJ&oi=fnd&pg=PR7&dq=mental+health+and+recovery&ots=Q3MOyCOcsW&sig=ZEyc8PzVRmStnqfk04frB1-ofhY

Townsend, M. C., & Morgan, K. I. (2017). Psychiatric mental health nursing: Concepts of care in evidence-based practice. FA Davis. https://books.google.com/books?hl=en&lr=&id=3a0-DwAAQBAJ&oi=fnd&pg=PA1&dq=therapeutic+communication+in+mental+health&ots=mS-lErNQxE&sig=IU94d9EJFBwX1XtHPs-JZpz1H4s

Van Eck, R. M., Burger, T. J., Vellinga, A., Schirmbeck, F., & de Haan, L. (2018). The relationship between clinical and personal recovery in patients with schizophrenia spectrum disorders: A systematic review and meta-analysis. Schizophrenia Bulletin, 44(3), 631-642. https://academic.oup.com/schizophreniabulletin/article-abstract/44/3/631/3964613

Waldemar, A. K., Esbensen, B. A., Korsbek, L., Petersen, L., & Arnfred, S. (2019). Recovery‐oriented practice: Participant observations of the interactions between patients and health professionals in mental health inpatient settings. International Journal of Mental Health Nursing, 28(1), 318-329. https://onlinelibrary.wiley.com/doi/abs/10.1111/inm.12537

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