Preparation: Need to Know
1) It is recommended prior to engaging in Recovery Based Conversations(R.B.C.) the physician-led questions; sequence instructions, encouraging conversation questions, session starter questions, pause Protocol and session ending questions are printed and available for the physician, as a guide. See the appendix for printable core stream questions.

2) The structure of “Recovery Based Conversations” (R.B.C) exists within a recovery orientation framework (See Chapter on this framework). This framework outlines the posture held by both the consumer and the treating physician to maximize shaping the clinical environment for holding R.B.C. led by the treating physician.

3) The Thrust of R.B.C. is Twofold:
a) to lessen the grip, influence and strength of “The Illness” and diminish the contribution of the “Dragging Effect” (Section 2 of Flash Drive Forms) to supporting the illness environment.

b) to massage and strengthen the “personal agency” and “hopefulness” of a person with the intent of increasing the “Uplifting Force” (Section 1 of Flash Drive Forms) while diminishing the influence of “The Illness’s” grip on one’s life.

4) Copy of Texts
The consumer is asked to have their copy of “Flash Drive Forms”; “Terms and Definitions” and journal at each treatment appointment as a reference. The physician is required to have a copy of the Flash Drive Forms and a list of questions and discussion inquiries for each core stream program along with the sequencing instructions for the Advanced Core Stream, if in play.

The objective of this thrust is to break away from the hold of The Illness and increase one’s earned capacity to live a Person Directed Life, rather than languishing in living an Illness Centered Life.

With “The Recovery Protocol Breakthrough” in play, this is where treatment meets recovery. Here, the reliance on the “Pill” alone to make a psychiatric recovery is now partnered with a person’s psychology of recovery.

5) Equipment:
The consumer is required to present a journal book, a recording instrument like a pen and colored markers.

6) Naming Practices:
The definition and use of The Illness term, as outlined in Definitions and Terms are in play with the physician-led questions. However, with the patient’s input and decision, the term The Illness can be replaced with either the actual diagnostic label or another non-medicalized term that, metaphorically for the client, fits their personal experience of living with this mental health condition, more intimately. An example of this would be having the diagnostic label of major depression to replace The Illness or a more intimate term of endearment like “ You Fucker” for a better personal fit, for example. This name change can be applied to all poly-diagnoses, as well. With either form, the definition of The Illness is still applied. With poly-diagnosis, each diagnostic label receives its own round of R.B.C separately, if The Illness term, is not applied to capture all of the diagnoses.

Standards: For Physicians
1) Free Floating Question
The treating physician can float their own questions, if desired, at any point, to facilitate the discussion, aid in summarizing, or for clarification.

2) Encouraging Questions
The physician can use questions to further encourage a discussion by saying the following,
a) Please go on and tell me more
b) Expand more on what you are saying, please
c) Please say more, to help me further understand
d) Can you elaborate more on this, please

3) Session Starter
At the start of each treatment session, the physician asks the following of the patient,

“What, if any, have you noticed between appointments, whether minutely, small or large in scale, that has caught your attention about any recovery-like movements forward….what was it about these observations that merit capturing your attention;…what could this be telling you?”

4) Future Pacing Protocol:
These questions are posed by the physician to set the stage for the Session Ending Protocol,
1) Consider all that you have identified, understood and shared, so far collectively, as a resource. If, by chance, you were to draw on this as a resource, what ideas, if any, can flow from this that may lead to possible steps, small or large, which encourage making recovery possible?

2) What makes such ideas or steps, noteworthy in your mind as being in your favor?

3) By being in your favor, what can this possibly let you know about your intentions?

3) Is this a good position to find oneself in…. what leads you to say this?

5) Session Ending Protocol: This protocol signals the end of the Treatment Session by focusing on two themes,
1) The physician seeks clarification of points heard, if any, and summarizes for the patient what was heard to ensure accuracy and to inform patients that they were listened to.

2) A standing pair of closing questions are asked. They are,
a) With all of what you have shared and felt, what is your takeaway from our time together?
b) What is your best guess, about how your takeaway fits with your intentions for making a recovery possible…. what leads you to say this?

6) Wording of Questions
The structured list of questions for R.B.C. is constructed with specific purposes in mind. The physician is asked to say each question as written, word by word. If the patient is unclear, read the question again and if this is not sufficient, then the physician can ask, “What do you think this question is asking?” or offer their professional take. The patient needs to land on an understanding in order to proceed and the initial inquiry can be asked again.

For Clients
7) The Journal
We ask that you make journal entries on matters chosen to be of importance to you. All recordings, whether through a “pause” protocol applied (see below) or at any other time, are placed in a personal journal. The journal is for your eyes only and you decide who may view it and what content to view. Formal grammar, sentence structure and spelling are not a requirement nor is refined penmanship. Notations are brief and short and can be expanded at a later time. Drawings and pictograms for notations are welcomed, as pictures, as you know, paint a thousand words. Dating entries are recommended. Whatever the notations used, they are to be trigger points for recall.

You can refer to the subject of “Mind Mapping” as a way to construct journal notations. There are many books on how to do this simple yet powerful recording strategy.

8) The “Pause” Protocol
A “pause” can be called for by the patient to record reflections arising throughout the treatment room Recovery Based Based Conversations. The patient is instructed not to wait until after the appointment to use their memory to recall their reflections on the session but to record anything of curious value, no matter how small or seemingly insignificant, at that moment. Conversely, the physician can call a “pause” every five minutes if the patient has not. These reflections can arise as bubbling thoughts, revelations, insights, awareness, action steps, wonderings, musings, ideas, questions and affirmations. The entries are shared and discussed in the late stages before the treatment room appointment ends.

Between treatment room appointments, the journal entries are expanded by the patient to more fully flush out what this entry may mean and how this connects to making a recovery. These fuller entries are optional for discussion in the Treatment Room.

Content Reviews
1) Flash Drive Forms:
Ensure pertinent sections of the forms are reviewed at each treatment appointment by both the consumer and the treatment physician before engaging a program stream.

2) Core Program Streams:
Ensure all three core streams are discussed. All patients start at the Entry Core Stream level. If this program’s core level is receiving results, stay with it. Adding the Secondary Core level can be made to further strengthen the results being achieved or when there is not a sufficient recovery movement being made. These parameters also apply to proceeding with the Advanced Core Stream. (Note; Adding more core streams does not mean ceasing the proceeding streaming levels. All core program streams are in play at the same time.)

3) Guidance:
Review each session the Recovery Code Signature, the Recovery Prescription and the exercise from Who is at the Helm at a minimum, bi-annually. This review provides guidance with regard to what are the parameters of focus for each core program stream and the overall implementation of this recovery protocol in its entirety.

(See Appendix for printable Standard Protocol Questions)