# Recovery psychology/Lesson7

* South African Curriculum Consumer Studies Textbook
* Introduction to Moral Reasoning Textbook

## The problem

* History of Mental Health on Wikipedia
* Comfortably Numb by Charles Barber on npr
* Lessons Learned About the Chronic Mentally Ill Since 1955 by John A. Talbott

## Lawrence Kohlberg's Theory on the developmental phases of ethics and how this relates to the evolution of the mental health system

Lawrence Kohlberg developed the concept of the stages of moral development moral development where he describes a human beings mental capacities for moral reasoning and establishment of ethical values through stages of progressing growth. The view in the recovery movement is that society as well as the mental health system is not unlike a child maturing to an awakening of adult responsibility.
* Preconventional Morality
* Stage 1-Punishment and Obedience Orientation (Might makes right orientation)
* Stage 2-Instrumental purpose and exchange
* Conventional Morality
* Stage 3-Approval of Others
* Stage 4 Social System and Conscience
* Post-Conventional Morality
* Stage 5 Morality of Contract, individual rights and democratically accepted law
* Stage 6 Universal Principles
Essay Question: Where would you place the practitioners of mental health throughout history if you were to apply them to Kohlberg's theory of Moral Development?: 1. 500 years ago 2. Moral therapy era 3. 200 years ago 4. Sixty years ago 5.at the dawn of the deinstutionalization movement 6. Now

## The Recovery Movement and Transformation of the mental health system

The establishment of Fountain House in the 1940's seeded the development of the recovery concept and is considered by some to be the birthplace for the recovery movement. Many psychosocial rehabilitation centers, services and programs followed, many of which were founded by ex-patients. They were formed with the common purpose of improving the quality of life for individuals with mental illness. The consumer movement was fueled by righteous anger (that is, anger not associated with shame.) Beginning in the late 1950's with the invention of psychotropic medications, large numbers of persons were discharged from state psychiatric institutions. Many former patients were forced to fend for themselves on the street with virtually no support. This spurred the funding and development of community mental health centers (CMHC’s), and the development of services for this deinstitutionalized population.

## Clinicality

Clinicality may be referred to transinstitutionalization, which may be the result of the "Broken Promise" of deinstutionalization movement. This instutitionalized behavior or learned helplessness of clients in the mental health system the direct result of not having person centered values and being recovery oriented. Clinicality can be the life of living only to see the doctor, visit the Community Mental Health Clinic for the monthly, weekly or daily visit, signing papers without any true understanding of what is be signed or why to appease clinical staff, recieving Social security Disability and referring to it as "my check" as the primary event in one's life. Clinicality is both the behavior of the clinician towards the client and the behavior of the client who is institutionalized in to clinicality. Clinical psychology causes this to occur by the very nature of its approach toward persons with psychological disorders.

## Disability versus Quality of Life

QALY=Quality Adjusted Life Years DALY=Disability Adjusted Life Year Study from the World Health Organization finds that the Medical model has increased DALY's while PSR is about establishing QALYs

## Also See the following

* Regarding Kohlberg
* Development and Moral Education: An Overview
* Moral Stages
* Kolberg's Stages of Moral Development
* PDF about righteous anger in activism and recovery
* Identifying Dimensions of Empowerment in Consumers of Psychiatric Services Article abstract mentions Righteous Anger
* Leroy Spaniel and Anthony Zipple in 1994 introduced a concept acknowledging family recovery which often parallels the concept of recovery from psychological disorders. Spaniol & Zipple identified four essential stages of family recovery. Compare these four concepts to the six stages of Kohlberg's Moral Development or Kübler-Ross's stages of grievence.
* Second part of the Surgeon Generals Report
* Ruth o. Ralph Edmund S. Muskie School of Public Service University of Southern Maine Article on Recovery
* Pride and self contempt
* Patricia Deegan "What will endure" Watch it, listen to it, think about it, If you ever get the chance. She is very reflective, and she asks many rhetorical questions that stimulate "Righteous Anger in moral context on the ethics of mental health"
* As in the overall concept of recovery Abraham Maslows' hierarchy of needs, has the stage of Self-actualization at the apex of the pyramid, this can apply to all involved in recovery and comparable to these (above expressed ideas.)
* Reviewing theJudi Chamberlin article on where the recovery movement stands now we can see that it now has influenced the mental health system.

## REFLECTION ESSAY

* After reading about Kubler-Ross's greiving theory, Spaniol & Zipple's family recovery concept, Kohlberg's moral development, and Maslow's heirarchy of needs; can you reflect any personal values that you may have? (Subjective)
* Deinstitutionalization was influenced by antipsychiatry, mental health liberation, disability rights, civil rights and the development of new pharmacological drugs, after the 1999 Surgeon Generals Report and the 2001 Report of the Presidents Commission on Mental Health and the CATIE study on newer medication, this being the culmanation of the consumer/survivor/ex-patient movement and the psychiatric survivor movement and the psychiatric rehabilitation profession heralding it as the recovery movement. How does society and opposing prespectives influence the moral development of the scientific and professional communities?