Part I: Dynamics of Recovery: A Meta-Synthesis Exploring the Nature of Mental Health and Substance Abuse Recovery.

Recovery-oriented care has become a leading vision across countries. To develop services and communities in more recovery-oriented directions, enhanced understandings of recovery in terms of personal and social contexts are important prerequisites. The aim of this study is to explore the nature and characteristics of the experiences of recovery. The method used is a form of qualitative meta-synthesis that integrates the findings from multiple qualitative studies published by one research group. Twenty-eight empirical papers with a focus on recovery as personal and contextual experiences were included in this meta-synthesis. Five meta-themes were developed: (a) being normal, (b) respecting and accepting oneself, (c) being in control, (d) recovery as intentional, and (e) recovery as material and social. The themes describe how recovery encompasses dynamics between personal experiences and contextual dimensions. This meta-synthesis consolidated an understanding of recovery as dynamics of the self and others, and as dynamics of the self and material resources. This understanding of recovery suggests the need to work not only with the person, but also with families, networks, social systems, and local communities, thus developing mental health and substance abuse services in more collaborative, open-ended, and context-sensitive directions.

"Walking alongside:" collaborative practices in mental health and substance use care.

BACKGROUND: Although the importance of collaboration is well established as a principle in research and in theory, what it actually means for practitioners to collaborate in practice, to be partners in a collaborative relationship, has thus far been given less attention. The aim of this study was to identify key characteristics of the ways in which mental health practitioners collaborate with service users and their families in practice. METHODS: This was a qualitative action research study, with a cooperative inquiry approach that used multi-staged focus group discussions with ten mental health care and social work practitioners in community mental health and substance use care. Thematic analysis was applied to identify common characteristics. RESULTS: We identified three major themes related to practitioners' experiences of collaborative practices: (1) walking alongside through negotiated dialogues, (2) maintaining human relationships, and (3) maneuvering relationships and services. CONCLUSIONS: It appears that even with the rich knowledgebase that has developed on the merits of collaborative relationships, it continues to be challenging for practitioners to reorient their practice accordingly. The findings of this study indicate that the practitioners focus on two types of processes as characterizing collaborative practice: one focusing on conversations among practitioners and service users and their families and the other focusing on management and control among health care providers, service sectors, and service users (i.e., inter/intra-system collaboration).