Davidson Larry, Lawless Martha S, Leary Fiona
Program on Recovery and Community Health, Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut 06513, USA.
Curr Opin Psychiatry. 2005 Nov;18(6):664-7. doi: 10.1097/01.yco.0000184418.29082.0e.
Within the last 5 years, concepts of recovery have taken center stage in psychiatry as the overarching goal of mental health services. In the course of this shift towards recovery, clinicians and consumers (and many others) have struggled to make the concept of recovery both measurable and meaningful. The clinical concept of recovery has focused upon the remission of symptoms and restoration of functioning. A rehabilitation model of recovery has been a more subjective and consumer-oriented concept that focuses on the full lives that are lived within the context of enduring disability.
A review of the literature addressing the concepts of recovery over the last 2 years demonstrates that authors are rarely explicit about the perspective of recovery from which they are writing. Almost all of the representative papers, however, struggled with how best to define, measure and validate recovery in its broadest terms. Several authors reviewed the history of recovery and offered conceptual discussions of either their first-person experiences or implications for mental health practice. Other authors, regardless of their perspective on recovery, sought to more concretely define criteria for recovery, for the purposes of recovery measure development or more rigorous research of the concept.
As authors struggle to reconcile these often competing concepts of recovery, we suggest that both concepts are useful for different purposes and populations and that the synthesis of the two will offer a broader perspective on life with, after, or despite mental illness.
在过去5年里,康复理念已成为精神病学的核心,作为心理健康服务的首要目标。在向康复转变的过程中,临床医生、消费者(以及其他许多人)一直在努力使康复概念既具有可衡量性又具有意义。临床康复概念侧重于症状缓解和功能恢复。康复的康复模式是一个更主观、以消费者为导向的概念,关注在持续残疾背景下的完整生活。
对过去2年中涉及康复概念的文献进行的综述表明,作者很少明确说明他们撰写康复内容时所采用的视角。然而,几乎所有代表性论文都在努力探讨如何以最宽泛的方式最好地定义、衡量和验证康复。几位作者回顾了康复的历史,并对他们的第一人称经历或对心理健康实践的影响进行了概念性讨论。其他作者,无论他们对康复的看法如何,都试图更具体地定义康复标准,以便开发康复测量方法或对该概念进行更严谨的研究。
由于作者们努力调和这些往往相互竞争的康复概念,我们认为这两个概念对不同目的和人群都有用,并且将两者结合起来将为患有精神疾病、康复后或尽管患有精神疾病仍能生活的人提供更广阔的视角。