Preamble: The Recovery Protocol Breakthrough operates on two sites. The site you are currently on is called the Home Site, and the second site is known as the Program Site. The Home site explains the background and rationale for the development of Brief Recovery Work (BRW). While the Program Site outlines the instructions for conducting this recovery practice. The Program site is linked and accessed from the home site under the menu title “Access Program Site”. The information contained on both sites is not written for academic and research readership but rather as a practical how-to guide to implementing this recovery-based practice for service providers who work with individuals experiencing protracted anxiety and depression illnesses with little effective support from medications (medication resistance).                                                              

The Recovery Protocol Breakthrough is a dynamic program designed for consumers requiring service from trained practitioners in Brief Recovery Work (BRW), Recovery Specialists, whether in mental health and personal growth circles, to offer a transformative way for people still languishing with mental health conditions like anxiety and depressive conditions even after multiple medication trials not yielding the expected results, to recapture a life worth living. These circumstances, such as this one, are called “medication resistance”. When prolonged medication use is ineffective, other means of treatment like psychotherapy or community mental health supports tend to have to work harder at supporting clients and achieve the service goals or more energy and inputs are required to keep the person afloat in their life. People who find themselves in this position, whether in care or not, are experiencing a stalled recovery where Illness-Led Living dominate, day in and out, as the norm. Additionally, living in this improvised position, people tend to experience a diminished sense of self, loss of confidence and lack of hopefulness to direct their lives, often seeing no way out or a future to live for. For many, this is a life of suffering that seems unending, with no relief in sight in the near future (See the chapter on Break the Cycle for an illustration).

With prolonged “Illness living” resulting from “medication resistance”, there can be a great loss of a person’s autonomy, empowerment, quality of life and their sense of self. However, researchers, over 30 years, have discovered and affirmed that principles of “recovery” in mental health, when applied effectively, move an individual away from a life dominated by Illness-based Living and instead transition them to Person-Led Living, a strong recovery position whether supported by medication or not (See chapter on What is a Recovery? for further insights). In such a strong recovery stance, people regain a sense of purpose, hope and meaning for living. They are seeing a future that can be shaped, leaving them feeling more empowered. Further to this, the gains observed from enacting recovery show the strength and grip of a person’s mental health conditions tend to weaken considerably as their personal influence on their life is enhanced.

The Term “Recovery”
The term “recovery” entered the mental health arena as a set of philosophical principles derived from research on people who in the 80’s were released from institutionalization as the states stopped funding many of these psychiatric hospitals, both in the US and Canada, due to consumer pressure to change the maltreatment of citizens with serious psychiatric illness. At that time, community support and community psychiatric services were lacking greatly when the mass releases occurred. Yet, when researchers went out to follow up on how these folks were doing some years later, they were astonished to see many people thriving in their own way, without psychiatric help or medication but who found community supports, engaging in friendships, exercising their interests, engaging their talents, involved with peer support to acquiring work and pursuing meaningful goals, as the ingredients that allowed them to realize new found life supporting mental wellness. The pioneer researcher, Dr. Patricia Deegan, leading these investigations at the time, named the nature of these ingredients “Personal Medicine”. Researchers also described participants sharing that if it were not for excising such factors, they would have no purpose or see a future, the key to thriving in one’s life. For these folks, this application of these factors became known in research and community circles as the principles of “recovery orientation”. They were a common set of empowering principles that researchers realized could account for the startling findings being witnessed. In the end, these principles formed the force behind recovery orientation to mental health, which opened a window where making a personal recovery became possible instead of just pursuing a psychiatric version of recovery provided by medication. This conceptualization led the way for decades of findings showing that when the mental health and psychiatric community buy into applying these principles with adults suffering from major mental illnesses, they tend to have greater success with recovery, and this was demonstrated with those suffering from schizophrenia at first.

The conception of recovery in mental health was originally applied as a system-wide, community service approach in its deployment and not as an interpersonal didactic practice between the provider and the client. The core framework stemming from these recovery principles can be characterized philosophically as a “strength-based set of principles”, “client-centred set of principles,”, and “community support principles” that cultivate a climate within the service system to support a person’s recovery drive.  In Brief Recovery Work (BRW), the client-centred and strength-based focus is at the core of the program, which can now complement the systems approach to recovery.  The application of peer support is growing and well accepted in the mainstream due to its discovered robust results. However, peer support in and of itself, on its own, separated from two-thirds of the components that cultivate a climate of recovery in a systems approach, has minimized its effectiveness as it is separated from two-thirds of its sisters, which as a whole led to the synergistic, robust results in recovery noted initially and throughout the decades. As the old age adage goes, the whole is the sum of its parts and each part, as an island unto itself, is less effective than the whole, this being a holistic perspective. In Brief Recovery Work (BRW), we work with the client and strength recovery principles in an interpersonal way as a program, while peer work is offered in the community. This preserves recovery’s holistic paradigm.

As mentioned, in the application of these principles as a systems approach, researchers noted that this was responsible for generating mental health wellness and a better quality of life for the folks in their studies. Aside from realizing benefits to consumers, this “recovery orientation” was to bring balance to the institutional norm in mental health practice that was and is still today based primarily on a problem-solving approach, a focus on what is lacking in a person that needs correcting, and the acquisition of skills related to symptom management meant to enhance mental wellness and better quality of life. The balance sought to,

a) keeping the person front and center (client-centred stance) with a focus on what a person brings to their life that is right, and

b) encourage the exercising of one’s strengths, whether in activity or by personal competences (inner resources).

This recovery-based balance brought a welcomed shift where the person, instead of being seen as a “passive recipient of care”, transitioned into a role as “active participant of care,” which made the person a therapeutic force in their treatment equation. (Read Chapter: The Framework of Recovery Orientation that underlines the principles that bring this balance). In Brief Recovery Work (BRW), the cornerstone of the person being an active participant of their care is paramount to the making of recovery.

To-date, the principles of recovery have been adopted by several countries (Australia, the US, Canada, Ireland, England and others) around the world as a service system guide to the delivery of community mental health services to cultivate a climate that fertilizes the conditions for an individual to realize personal recovery. As a community orientation practice to recovery, it has required a strong buy-in from multiple stakeholders in the system for this approach to be fruitful. This required a great amount of investment of time, coordination, and financial resources on a large scale. The adoption of “recovery”, however, was not considered a therapy, though it has been shown to have robust therapeutic results for mental health consumers. Researchers discovered people who were in recovery-oriented systems tended to realize greater freedom at the helm of their lives, a stronger sense of self, and an improved quality of living, compared to those in a traditional mainstream practice. A recovery approach has also been demonstrated to reduce the number of symptoms experienced, decrease the intensity of symptoms, reduce the frequency of symptom episodes, to offering less hospitalizations and a reduction in medication use. Though the conceptualization and community practice of recovery has borne fruit, the resistance to its ongoing adoption by the system has to do with the large degree of investments spoken of. While the case for a community recovery framework has been demonstrated, what has not followed is the formulation of recovery’s guiding principles into a protocol applied as a program that can be exercised within the office or meeting room of a service provider, be they psychotherapists, peer workers, case workers, recovery specialists (BRW) or life coaches.

The Breakthrough
While the principles of recovery have been accepted, the share investment is now making it less appealing to community mental health systems, as a system approach, to aid people in cultivating a recovery climate. However, there is now a complementary method that, as its better half, is known as The Recovery Protocol Breakthrough with Brief Recovery Work (BRW). This breakthrough involved taking the original philosophical principles from the recovery-orientation (client and strength focus) and formulating a set of protocols that can be enacted as a practice for service providers within the walls of their office or meeting room, on a one-to-one basis. The practice of BRW applies a unique dialogue protocol, housed in a program, with the aim to kick start, support and drive a recovery in addition to nutritional drivers that round out its holistic appeal. The nutritional drivers can be assessed independently in the community by nutritionists, dieticians and naturopaths who also specialize in mental health as an option in the program. These practitioners would not be affiliated formally with the practice but are considered an aspect of utilizing community resources that can add tremendously to the drive of making a recovery. This is an independent decision for the individual in consultation with their service provider. (See Flash Drive Forms for what the nutritional investigation can entail)

The nutritional drivers are an added feature due to their capacity to support and build mental well-being. Practitioners in Nutritional Psychiatry, for example, are well versed in the decades of research and clinical practice in this domain and the gains achieved that cannot be replicated under mainstream allopathic psychiatry. While the system approach to recovery has been established, there is now is a complementary sister to its practice, where the person and the provider can sit down and engage in a structured dialogue that situates the person as an active participant of care involved in building an empowering life compared to the one they are currently experiencing. Because Brief Recovery Work (BRW), as a practice, stands on the foundational principles, it is not considered a therapy. This program acts as an adjunctive, complementary approach for various mainstream client services like psychotherapy, peer work, case work, life coaching and for the first time with Recovery Specialists in mental health. Any of these disciplines can incorporate BRW into their practice.

Recovery Defined
In Brief Recovery Work (BRW), recovery can be defined as,

 The making of a personal recovery through an ongoing self-directed, empowering, transformative and collaborative journey of self- discovery where individuals uncover their strengths, capacities, hopes, purposes, and meaning for their life that is in greater alignment with their values, which has been subjugated due to prolonged illness-led life resulting from medications not being enough. When greater alignment with values forms, the person experiences enhanced confidence and self-assurance that places them at the center of their life, where they displace The Illness (mental health condition) from the center position in their life. This displacement changes the mental illness trajectory, where the Illness’s grip, strength, and influence lessen as the person’s degree of hopefulness, autonomy and empowerment increase. As a result, the recovery journey builds a person’s sense of “agency” and “hopefulness” that leverages their newfound purpose. From this position of living, the person can carry the weight and stress of living in a more freeing way, knowing they are shaping a future to look forward to.

Recovery as a philosophical practice of principles is a non-therapy approach to major mental illnesses and is not disease-specific in its application, though for this site, it is focused on Depression and Anxiety-led conditions. This means this breakthrough protocol program can be tailored to move beyond mental illnesses like depression and anxiety conditions.

The reading of The Fable on this site outlines the freeing proposition of recovery.

The Driving of a Recovery
Central to conducting the practice of Brief Recovery Work (BRW) are two proprietary core features housed in the program: 1) The Flash Drive Forms (get access on home site) and 2) Recovery-Based Interviews (RBI). The features serve two purposes. The Flash Drive Forms are used to gather vital recovery information that is applied in the Recovery-Based Interviews (RBI). It is also utilized as an evaluation tool to assess progress. From the Flash Drive Forms, the person and provider can determine the key drivers of recovery taken from their life that are applied in the program and amplified for its impact during the interview sessions. These drivers of recovery, negative loaded (hurdles to recovery) and positive loaded (activities of life, exercising of character strengths), are identified by the incumbent in these two forms on the Flash Drives. Both forms of drivers offer a positive influence in a person’s life towards making a recovery. In BRW, these drivers are the gateway through which the Recovery-Based Interviews (RBI) are used to illuminate for the individual their personal strengths, be they commitments, talents, leisure interests, recreational interests, hopes, purposes, dreams, skills, attitudes, and values as a person. When these recovery elements are put into play, their impact to “empower” and build “agency” for the person can be realized.

Program Structure
The program is 10 months in duration, where the person is seen at least once or twice in a 6-8 week period. The interview times are non-standard, with a length of 90 minutes in length.

Use of Practice
There are two ways service providers can select to implement the program,

a) as an intervention with the individual to support their service goals and self-confidence rather than recovery-focused.

b) as a standalone program focused on making a personal recovery.

As an intervention, facets of the BRW program are utilized with people in service where progress is slow and or stalled, and there exists apathy that is affecting what can be achieved. This, in part, is due to the diminished sense of self the person is experiencing and seeing no way out of or future other than existing as they have been. The intervention is aimed at strengthening their confidence and hopelessness that they are moving in the right direction with their service goals, and they have the capabilities to see themselves succeed. This focus builds their self-assurance and empowerment as a factor which can lead to mental health wellness and greater independence.

As a full program, BRW is geared towards re-establishing the person at the helm of their life, leading a Person-Oriented Life (Person-Led Living). This can be with an existing client or a new one. Such a person has lived with treatment resistance for so long and is exhausted with an illness-led life. They feel no hope for the future and have a poor sense of self. With this focus, the way the person holds their life
and mental illness (s), its weight and stress, transitions to a new way of holding these elements that is freeing and empowering. (Read the chapter on The Fable for further understanding. By discovering a new way of holding this weight and stress, they can live a strong recovery and a newfound way of living.

Terms of Use:  This program is for consumers with medication failure. No fees are required. Permission is granted to print materials from this site without prior consent from the site administrator. The consumer can port this protocol and introduce it to their non-clinical or clinical provider. The objective is to put into play this protocol to kick-start a recovery since medications are offering poor treatment returns, which is impacting a person’s quality of life and functioning from a recovery perspective.

Disclaimer:  The information provided on this site does not constitute medical advice or treatment. The information acts only as a guide to consider the elements for making recovery possible and how to institute such a program of practice within the Meeting Room space of one’s service provider.