SAMHSA’s 10 Guiding Principles of Recovery
An estimated 50 million Americans cope with mental illnesses, like depression, anxiety, post-traumatic stress and bipolar disorders, every year. Studies show that during these episodes, individuals are three times more likely to fall prey to drug and alcohol dependency or addiction if they do not receive treatment.
SAMHSA’s Recovery Support Strategic Initiative includes the following four areas that will improve the prospect of successful recovery:
- Health – overall wellbeing begins with addressing symptoms of addiction that complicate physical and emotional health. Abstinence from alcohol, non-prescribed medications and illicit drug use is recommended so that any psychiatric disorders can be addressed and treated. This leads to more informed and healthier choices that will sustain ongoing recovery.
- Home – having a consistent, peaceful and stable place to return to each day will help remove uncertainty and anxiety that can lead to self-destructive behavior.
- Purpose – being productive, whether through volunteer work, employment or going to school, provides meaning for every person, especially those who are rebuilding a life in recovery.
- Community – an essential aspect of recovery from mental illness and addiction is understanding that others have experienced similar difficulties and struggles. Having non-judgmental support from friends, family members and others in recovery can be just the thing to help an individual gain momentum in recovery.
In addition to health, home, purpose and community, SAMHSA offers 10 Guiding Principles of Recovery, which include:
- Recovery emerges from hope– belief in the process and reality of recovery is vital for struggling individuals to face and cope with their disease or disorder
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 and 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.
Hope is Emergent.
- Recovery is person driven– each person is ultimately in charge of their own recovery, setting goals and creating a path to achieve them
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 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.
Self determination, autonomy, independence, empowered.
- Recovery occurs via many pathways– people recovering from substance abuse or mental disorders have different backgrounds and face unique challenges. As a result, the paths that people take toward recovery will vary from person to person
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. 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– in order for long-term recovery to take root, a person must address every aspect of their life, from mental and physical health to income and housing to seeking support and maintaining medication if needed
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, 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.
Integrated; mind, body, spirit, and community (environment); and coherent
- Recovery is supported by peers and allies– having peers that have experienced similar challenges and come through it provides a model for those in recovery to lean on, refer to and receive support from.
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 their recovery, their role for children and youth may be slightly different. Peer supports for families are very important for children with behavioral health challenges and can also play a supportive role for youth in recovery.
Experiential knowledge; social learning; belonging; relationship; valued roles; community
- Recovery is supported through relationships and social network– an emotional bond with family members, friends and peers that believe in a person’s ability to recover can offer the strength and determination to get through these difficult times
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 suggests strategies and resources for change (‘I’ statements). 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.
Vital support networks and engagement
- Recovery is culturally-based and influenced– services for recovery must consider an individual’s unique cultural beliefs, values and traditions
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.
Values, traditions, Beliefs. Cultural diversity. Personalized.
- Recovery is supported by addressing trauma– sexual assault, domestic violence, emotional abuse and any other trauma has to be treated if recovery is to be long lasting and successful
The experience of trauma (such as physical or sexual abuse, domestic violence, war, disaster, and others) is often a precursor to or associated with substance use, mental health challenges 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.
Operant conditioning; patterns, and filters.
- Recovery involves individual, family and community strengths and responsibility– each person in recovery is responsible for their own care, though families and significant others also bear a responsibility, especially with recovering teens or young people, to support their loved ones. Communities also have a responsibility to make sure that those in recovery can live free of discrimination and have opportunities to have housing, employment and education
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– recovering from addiction and psychiatric issues require bravery on the part of the individual. Communities and social systems that acknowledge this lessen the stigma associated with these disorders and offer people a healthier atmosphere in which they can get better and give back
Community, systems, and societal acceptance and appreciation for people affected by mental health and substance use challenges –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
Dignity. Stigmatization, marginalization.
SAMHSA released the original working definition of recovery and guiding principles in December 2011