Pernille Jensen

Towards Recovery Oriented Practices- Smooth implementation or unpredictable innovation?

Pernille Jensen, Milan 2012

Towards recovery oriented practices

1. Introductory: Can recovery be implemented?2. A closer look at a joint training program as an example3. Concluding challenges and some common factors

Can recovery be implemented?

• Recovery is a user practice: It does not refer to specific services, interventions or support (however recovery-oriented) but to what people do in order to cope and regain control over their lives and move beyond their illness or problems

• Recovery is not something you can do to others – it’s a personal journey, but with important travel companions

• There is no model, no concept or golden standard of recovery orientation

• What is – and what is not – recovery oriented practices is an empirical question!

Example: Joint training programme in a Danish MunicipalityJanuary – May 2011

• Mandatory for professionals• Open for users of services• More than 30 users participated in full training program

Training consisted of:

• Two half day seminars on recovery and rehabilitation

• Joint study groups with 8–10 participants for 6 x 2 hours

• Working with life domains based on personal experiences

• Concluding seminar of one day: dissemination of work in the study groups

Evaluation of the study groups

• Became a ”working group with a common target”

• New experience to meet in the roles of ”fellow students”

• Inspiring to see different sides of each other – but creating role strain as well

• Hard not to fall into old patterns – like professionals interviewing and interpreting users

• Need to practice talking together on difficult and potential conflicting subjects

Surprises

• Still lots of conversations among professionals without the user

• Things you don’t want the users to hear – in that form

• Demanding, difficult and time consuming to practice ’open dialogue’?

• Something that is not to be translated in to ”user acceptable language”?

• Have we become blind to how many conversations taking place without the users present?

• Without prior agreement – and without close follow up?

• Real danger that professionals continue to make decisions and plans for the user…

More surprises

• Users were more actively engaged in the work than expected (by professionals!)

• Often better prepared than professionals…

• Continuing tendencies to view users as ”not able”?

• Low expectancies – stigmatizing in it self

After thoughts

• Almost gratitude towards being listened to

• What kind of experiences and expectations are hereby reflected?

• Wishes and hope for continuation – having the opportunity of participating, sharing and contributing

Reflections

• First experiences acknowledging different types of knowledge

• The professional monopoly of knowledge (partly, for the time being) dissolved

• Upgrading of the lived experience

• Transcending the divide between knowledge about practice and knowledge in practice?

Focus on change

The change is complex – in systems, practice and thinking

• Where and how are users able to influence services for real?• Within given frames – or are they moveable as well?• Can we – by beginning to do things differently – clear the road

for other changes?• From a ”cute idea” to a Trojan horse - a disruptive innovation

(Pat Deegan)

Focus on partnership

“Nothing about us without us” – from slogan to reality?

• Basis: The users are always already involved!• A need to look into the quality and character of this involvement• Test and evaluate prototypical models of partnerships• Watch emerging partnerships and keep asking:

– How are the users invited to participate?– How to create possibilities for legitimate participation on

equal footing?

Concluding challenges:

1. Recovery orientation is a profound transformation, not adjustments in the margin or a new model to implement

• What are the possibilities in a political system – and what is possible in regard to administration and management?

• Will there be space for real innovation and tolerance of uncertainty, when there are no ready made answers to all the new questions?

Concluding challenges:

2. The users must lead the way – and real change will not happen unless we begin to do things differently

• It’s going to take time – it’s troublesome and untidy and creates a lot of role strain

• Will we be able to convince politicians and management that it’s worth while?

• Will we have access to the time and resources needed for these kind of processes in a time of economic crisis and with a public sector under pressure?

Common factors for the challenges:

• There is no magic bullet or quick fix since no process of organizational change will be simple or linear – it will be complex, multi-faceted, dynamic and interactive

• These are dilemmas we will have to live in and learn from

• We are facing a truly innovative process – and a disruptive such – since recovery is not fitting nice and compatible in to any existing systems as we see them today