Recovery from mental disorders and/or substance use disorders is a process of change through which individuals improve their health and wellness live a self-directed life, and strive to reach their full potential.
Four dimensions of supporting recovery
To achieve lasting recovery, people recovering from mental and substance abuse disorders need to have support in these four areas of their lives:
Health—Overcoming or managing one’s disease(s) or symptoms and making informed, healthy choices that support physical and emotional wellbeing
Home—A stable and safe place to live
Purpose—Meaningful daily activities, such as a job, school, volunteerism, family caretaking, or creative endeavors, and the independence, income and resources to participate in society
Community—Relationships and social networks that provide support, friendship, love, and hope
Guiding Principles of Recovery
Recovery emerges from hope:The belief that recovery is real provides the essential and motivating message of a better future—that people can and do overcome the internal and external challenges, barriers, and obstacles that confront them. Hope is internalized and can be fostered by peers, families, providers, allies, and others. Hope is the catalyst of the recovery process.
Recovery is person-driven: Self-determination and self-direction are the foundations for recovery as individuals define their own life goals and design their unique path(s) towards those goals. Individuals optimize their autonomy and independence to the greatest extent possible by leading, controlling, and exercising choice over the services and supports that assist their recovery and resilience. In so doing, they are empowered and provided the resources to make informed decisions, initiate recovery, build on their strengths, and gain or regain control over their lives.
Recovery occurs via many pathways: Individuals are unique with distinct needs, strengths, preferences, goals, culture, and backgrounds— including trauma experience — that affect and determine their pathway(s) to recovery. Recovery is built on the multiple capacities, strengths, talents, coping abilities, resources, and inherent value of each individual. Recovery pathways are highly personalized.
They may include professional clinical treatment; use of medications; support from families and in schools; faith-based approaches; peer support; and other approaches. Recovery is non-linear, characterized by continual growth and improved functioning that may involve setbacks. Because setbacks are a natural, though not inevitable, part of the recovery process, it is essential to foster resilience for all individuals and families. Abstinence from the use of alcohol, illicit drugs, and non-prescribed medications is the goal for those with addictions. Use of tobacco and non-prescribed or illicit drugs is not safe for anyone. In some cases, recovery pathways can be enabled by creating a supportive environment. This is especially true for children, who may not have the legal or developmental capacity to set their own course.
Recovery is holistic: Recovery encompasses an individual’s whole life, including mind, body, spirit, and community. This includes addressing: self-care practices, family, housing, employment, transportation, education, clinical treatment for mental disorders and substance use disorders, services and supports, primary healthcare, dental care, complementary and alternative services, faith, spirituality, creativity, social networks, and community participation. The array of services and supports available should be integrated and coordinated.
Recovery is supported by peers and allies: Mutual support and mutual aid groups, including the sharing of experiential knowledge and skills, as well as social learning, play an invaluable role in recovery. Peers encourage and engage other peers and provide each other with a vital sense of belonging, supportive relationships, valued roles, and community. Through helping others and giving back to the community, one helps one’s self. Peer-operated supports and services provide important resources to assist people along their journeys of recovery and wellness. Professionals can also play an important role in the recovery process by providing clinical treatment and other services that support individuals in their chosen recovery paths. While peers and allies play an important role for many in recovery, their role for children and youth may be slightly different. Peer supports for families are very important for children with behavioral health problems and can also play a supportive role for youth in recovery.
Recovery is supported through relationships and social networks: An important factor in the recovery process is the presence and involvement of people who believe in the person’s ability to recover; who offer hope, support, and encouragement; and who also suggest strategies and resources for change. Family members, peers, providers, faith groups, community members, and other allies form vital support networks. Through these relationships, people leave unhealthy and/or unfulfilling life roles behind and engage in new roles (e.g., partner, caregiver, friend, student, employee) that lead to a greater sense of belonging, personhood, empowerment, autonomy, social inclusion, and community participation.
Recovery is culturally-based and influenced: Culture and cultural background in all of its diverse representations—including values, traditions, and beliefs—are keys in determining a person’s journey and unique pathway to recovery. Services should be culturally grounded, attuned, sensitive, congruent, and competent, as well as personalized to meet each individual’s unique needs.
Recovery is supported addressing trauma: The experience of trauma (such as physical or sexual abuse, domestic violence, war, disaster, and others) is often a precursor to or associated with alcohol and drug use, mental health problems, and related issues. Services and supports should be trauma-informed to foster safety (physical and emotional) and trust, as well as promote choice, empowerment, and collaboration.
Recovery involves individual, family, community strengths and responsibility: Individuals, families, and communities have strengths and resources that serve as a foundation for recovery. In addition, individuals have a personal responsibility for their own self-care and journeys of recovery. Individuals should be supported in speaking for themselves. Families and significant others have responsibilities to support their loved ones, especially for children and youth in recovery. Communities have responsibilities to provide opportunities and resources to address discrimination and to foster social inclusion and recovery. Individuals in recovery also have a social responsibility and should have the ability to join with peers to speak collectively about their strengths, needs, wants, desires, and aspirations.
Recovery is based on respect: Community, systems, and societal acceptance and appreciation for people affected by mental health and substance use problems—including protecting their rights and eliminating discrimination—are crucial in achieving recovery. There is a need to acknowledge that taking steps towards recovery may require great courage. Self-acceptance, developing a positive and meaningful sense of identity, and regaining belief in one’s self are particularly important.
Sources: In December 2011, the Substance Abuse and Mental Health Services Administration (SAMHSA) released a working definition of recovery and a set of guiding principles, representing the culmination of a lengthy process that began with an August 2010 Dialogue Meeting and ended with a formal public engagement process in August 2011. Based on additional stakeholder input and dialogue with consumers, persons in recovery, family members, advocates, policy-makers, administrators, providers, and others, SAMHSA issued a slightly revised working definition and principles in March 2012.
SAMHSA recognizes there are many different pathways to recovery and each individual determines his or her own way. The revised definition and principles give more emphasis to the role of abstinence in recovery from addictions, and indicate that an individual may be in recovery from a mental disorder, a substance use disorder, or both. The definition and principles are intended to help with the design, measurement, and reimbursement of services and supports to meet the individualized needs of those with mental disorders and substance use disorders.
SAMHSA's Working Definition of Recovery (PEP12-RECDEF)
This brochure introduces a working definition for recovery from mental disorders and substance use, along with 10 guiding principles intended to help advance recovery opportunities and help clarify these concepts for peers, families, funders, providers, and others.
Recovering Your Mental Health: A Self-Help Guide (SMA-3504)
This booklet offers tips for understanding symptoms of depression and other conditions and getting help. Also details the advantages of counseling, medications available, options for professional help, relaxation techniques, and paths to "positive thinking.” 2001. 32 pp.
Recovering Your Mental Health: Building Self-Esteem - A Self-Help Guide (SMA-3715)
This booklet gives practical tips on ways to improve self esteem that includes activities that help people feel good about themselves and a list of other resources.
Recovering Your Mental Health: Making and Keeping Friends - A Self - Help Guide (SMA-3716)
This booklet provides suggestions for making and keeping friends and a list of other resources.
Recovering Your Mental Health: Dealing With the Effects of Trauma - A Self-Help Guide (SMA-3717)
This booklet focuses on helping individuals cope with traumatic events and makes suggestions of how they can take charge of their own recovery. It also provides a list of additional resources.
Recovering Your Mental Health: Developing A Recovery and Wellness Lifestyle - A Self-Help Guide (SMA-3718)
This booklet gives helpful tips on how individuals can think about areas of their lives that may need to be changed and possible changes they could make. Additional resources are also included.
Recovering Your Mental Health: Speaking Out for Yourself - A Self-Help Guide (SMA-3719)
This booklet addresses ways in which individuals can become self-advocates by taking control of the decisions that affect their lives. It provides simple assertiveness tips and other resources.
Recovering Your Mental Health: Action Planning for Prevention and Recovery - A Self-Help Guide (SMA-3720)
This booklet discusses strategies to help individuals learn how to consistently do those things that help in their recovery. These strategies were developed by people who experience emotional or psychiatric symptoms. Additional resources are also provided.