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August 18, 2011 Volume 2, Issue 30
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As we have mentioned in previous Highlights, the mental health recovery movement was initiated and has been led primarily by people with histories of disabling mental health conditions and, as a result, has been most relevant for this population. As the movement has matured, however, the basic values and principles of recovery have come into dialogue with, and begun to influence, other traditions and approaches. This Weekly Highlight addresses the areas of commonality and overlap with marriage and family therapy in particular.
My Experiences as a Marriage and Family Therapist
by Glenn Kamber, M.A., M.S.
I am a trained marriage and family therapist, and it seems to me recovery principles of consumer-driven service and consumer-defined success are at the very core of what my profession teaches and strives to achieve among those who seek our assistance.

First and foremost, the goal of marriage and family therapy is to help people solve problems or issues identified by them. The process of marriage and family counseling, when done well, helps people to clarify issues, needs, and ways to move forward.

Second, marriage and family therapy is not rooted in a narrow medical model. Marriage and family therapists do not so much treat their patients through a hierarchical relationship. Rather, we join with people and seek to create a trusting environment in which avenues to change and growth are jointly explored, become less threatening, and are more likely to be pursued. We do this focusing not on a single "identified patient," but on the system in which people experience the issues that concern them. More often than not, that system is the family. While most people enter marriage and family therapy as parents with their children, or as couples, individuals will also seek the help of marriage and family therapists to uncover and address systemic issues in their youth (such as traumatic events) that have a persistent negative impact on their lives as adults—at home, work, or in the community. As such, marriage and family therapists do not speak of "informing or educating the family,” but rather of "engaging and working within a family system, often past and present," to bring about positive change.

Much of my experience as a marriage and family therapist has been with families in which one or more adolescent is identified by the juvenile justice or school system as using alcohol or other substances and displaying symptoms of persistent depression, anxiety, and antisocial behavior. I have counseled individual families in conjunction with moderating multifamily groups. Effective interventions with these families, as measured by a variety of outcomes including, but not limited to, adolescent cessation of substance use, mirror the best principles and practices of the recovery movement:
Positive Goals – Families with adolescents who are using substances seek not only an end to the use of drugs, but a variety of additional outcomes. Parents want to end the family disruption they perceive as caused by their children's difficulties. They want their adolescents to return to steady school attendance, achieve academically, and "get back on track" to becoming independent and self-sufficient adults. These adolescents initially want out of their predicament. Over time, however, they are helped by counselors, peers, and other families to work toward a set of healthier, age-appropriate objectives (often regaining aspirations lost through substance use).

Provider–Consumer Partnerships – As indicated, marriage and family therapists do not position themselves as family system experts who dispense advice. Rather, they seek to engage people in a process of discovery, which eventually helps them identify their goals, as well as paths to achieve those goals. In the case of families with adolescents who are using substances, parents are helped to identify how interactions among family members (adult to adult, adult to adolescent) impact healthy and dysfunctional behaviors. Through the process of structural systems therapy, parents and adolescents are helped to negotiate specific expectations (such as school attendance or curfews), which moves the family towards reestablishment of role-appropriate and healthy relations.

Peer Support – The power of peer groups cannot be overstated. Bringing families affected by substance use together in multifamily groups is one of the most effective ways to achieve service goals. I have seen firsthand—over and over again—the power of the group in presenting and reinforcing adolescent and family recovery principles and practices. Parents of adolescents who have progressed over time in reestablishing functional family structures and healthier adolescent behaviors (drug abuse cessation, school attendance, family participation) help newer families learn different ways to interact and overcome resistance to change. More "seasoned" adolescents connect with kids new to the program, role modeling more adaptive behaviors while providing tangible evidence that recovery is possible. Peer support in multifamily groups constantly recognizes and reinforces progress for those approaching completion of the process. For those new to service, peer support immediately addresses the sense of isolation experienced by parents, and assists teens to break out of the web of secrecy so common among substance-using adolescents. More importantly, multifamily groups provide adolescents with an opportunity to see firsthand what the road to recovery looks like among peers.
My experiences as a marriage and family therapist, both as a provider and consumer, continue to enrich my faith in personal and family empowerment, which are at the core of recovery from behavioral health conditions.

Glenn Kamber received his M.S. in Family and Child Development from Virginia Tech. He is a Senior Policy Advisor for Development Services Group, and a member of the Fairfax/Falls Church Community Services Board in Virginia.

Help SAMHSA Define Recovery
As part of its Recovery Support Strategic Initiative, SAMHSA has worked with the behavioral health field over the past year to develop a working definition of recovery that captures the essential, common experiences of those recovering from mental and substance use disorders, along with 10 guiding principles that support recovery.
Recovery from Mental and Substance Use Disorders: a process of change through which individuals work to improve their own health and well-being, live a self-directed life, and strive to achieve their full potential.

Guiding Principles of Recovery
  • Recovery is person driven.
  • Recovery occurs via many pathways.
  • Recovery is holistic.
  • Recovery is supported by peers and allies.
  • Recovery is supported through relationships and social networks.
  • Recovery is culturally based and influenced.
  • Recovery is supported by addressing trauma.
  • Recovery involves individual, family, and community strengths and responsibility.
  • Recovery is based on respect.
  • Recovery emerges from hope.
SAMHSA is inviting public comment on a working definition and the guiding principles of recovery. Building on past efforts, including discussions with people in recovery from mental and substance use disorders, we are developing a definition to identify the fundamental elements that constitute and support recovery. This definition can help policy makers, providers, funders, peers/consumers, and others design, deliver, and measure integrated and holistic services and supports to more effectively meet the needs of individuals served by behavioral health systems.

We are seeking feedback from the public, including key stakeholders and leaders in the behavioral health field, and highly encourage your comments and suggestions. Although we welcome feedback through a variety of mechanisms, for this particular purpose, we ask that stakeholders use our forum to provide comments. If you would like to read more about the feedback forum, please visit SAMHSA's blog and read the latest post: Recovery Defined – Give Us Your Feedback.

The feedback period begins August 12, 2011, and ends August 26, 2011, at 12 a.m. ET. At the end of this period, SAMHSA will review and analyze the feedback in addition to previously received comments. We will incorporate suggestions accordingly.

Make your voice heard! Go to the Definition of Recovery Forum and let us know your views on recovery. Feel free to share this message with others—all participation is welcome.

As a leader in the behavioral health field, SAMHSA relies on your input to help continue our efforts to advance recovery for all Americans.

Read more about the definition of recovery and provide feedback.

The New York Times: Lives Restored Series
Joe Holt spent years trying to determine the cause of his problems in life before deciding the real issue was finding a way to live with them. This is the second article in a series of recovery profiles about people who are functioning normally, despite having severe mental illness. In the first article, Marsha Linehan, a therapist and researcher who developed a widely used treatment for severely suicidal people, describes her own experience with borderline personality disorder.

To read the full article, please visit
http://www.nytimes.com/2011/08/07/health/07lives.html?pagewanted=all.

The RTP Resource Center Wants to Hear From
Recovery-Oriented Practitioners!
We invite practitioners to submit personal stories that describe how they became involved in recovery-oriented work, and how it has changed the way they practice.
The RTP Resources Center Wants to Hear From You, Too!
We invite you to submit personal stories that describe recovery experiences. To submit stories or other recovery resources, please contact Stephanie Bernstein, MSW, at 877.584.8535,
or email recoverytopractice@dsgonline.com.

We welcome your views, comments, suggestions, and inquiries.
For more information on this topic or any other recovery topics,
please contact the RTP Resources Center at
877.584.8535, or email recoverytopractice@dsgonline.com.


The views, opinions, and content of this Weekly Highlight are those of the authors, and do not necessarily reflect the views, opinions, or policies of SAMHSA or the U.S. Department of Health and Human Services.