Recovery v disease management

Recovery v disease management.

This is a really great post which is from a site called “Hopeworks community” aimed at people in the mental health field rather than alcohol, but is really relevant in my opinion. I always hated the disease theory that was pushed by members of AA as an excuse for their actions. I always felt describing addiction as an illness that could be treated was a better model. This post contrasts the two methods. I feel people who like the disease theory often point the finger at those who do not succeed, and blame them for the failure not the method of treatment (if you consider 12 methods treatment!)

Recovery v disease management

Recovery vs. Disease Management: The Core of the Argument



  •  Recovery  believes that individuals matter.  No degree of impairment or difficulty makes them matter less.
  •   Disease management believes that the disease or diagnostic label is the most important thing about anybody.
  • Recovery believes that if an individual is important then what is important to him is important: his thoughts, feelings, goals, aspirations, interests, hopes and dreams.  No amount of impairment or difficulty makes this less true.
  •  Disease management believes that many things that an individual values are a creation or result of his disease.  It believes that these things do not have as much validity as they do for people without a diagnosis.  It believes the most important thing is symptom management.  What is most important is not that people are people, but that they are “diseased.”
  •  Recovery believes that if an individual is important then what is most important is what he chooses for himself and not what others choose for him.
  •  Disease management believes that the disease destroys an individuals ability to be able to decide what is best for him and that those choices need to be carefully judged and when necessary made for the individual.
  •  Recovery  believes the primary thing the  individual recovers is  control over his own life through the acquistion of knowledge, the development of tools that enables him with the support and encouragement of others to begin building the type of life that enables him to be the best and most version of himself possible.  It believes that recovery involves success in activities, connection with other people, in the contetxt of a life of meaning and is important to that individual is important: his thoughts, feelings, goals, aspirations, and interests.  No degree of impairment makes those things matter least.
  • Disease management believes  that symptom management is the best things can be.  And for the most part it believes that those symptoms will be chronic, always in danger of reoccuring.  It largely believes that medication will be a life time need.
  • Recovery believes that mental health professionals are often essential for recovery, but their appropriate role is as a consultant or coach and not direct supervisor.
  • Disease management believes that mental health professionals direct and set the direction and tone for recovery.  The question is “medical judgement” and all opinions are not seen as equal or valid.  Ultimate authority is with the doctor.  More than any other question this probably seperates the two approaches.
  • Recovery assumes that hope is a real thing.  Life can and should be a movement towards better things.  The steps may be slow and require much in the way of patience, but no matter how slow or small they are they are real and should be valued and treasured.
  •  Disease managment believes that hope is limited to symptom management.  It assumes that people will need continual treatment and that life will always tend to be disrupted by the “course of the disease.”  Life never really gets better, the hope is that it get less worse.
  • Recovery assumes that mental illness does not cause you to lose anything essential to being a human being.  Mental illness may block you.  It may disrupt you.  It may damage you.  It may detour you.  It does not diminish what it means for you to be a human being.
  • Disease management believes that the much of what you do, much of what you think, much of  what you feel, and even much of what you believe is either a symptom of your disease or a reaction to a symptom of your disease.
  • Recovery assumes personal responsibility.  It is not something done to you.  It is not something you are given as much as it is something you get.
  •  Disease management identifies responsibility as following directions given to you by medical personal.
  •  Recovery assumes that you can develop and maintain relationships with other people.  That you can love and are worthy of being loved.
  •  Disease management believes the capacity for relationship is affected by the “disease.”  You will always have trouble getting along with others and others need to adjust their expectations of you down.
  •  Recovery assumes that you can support and help others, that often, the greatest help you get is in the help you give.
  •  Disease management believes that your capacity to give to others is not as great as people who are not “mentally ill.”  They do not believe you can be near as helpful as a medical person.
  •  Recovery assumes that mental illness does not make a happy life a delusional concept.
  •   Disease managment cautions against getting your expectations too high.  If you are “mentally ill” you are just not going to get as much as others do.
  •  Recovery assumes that mental illness (or whatever term you choose to substitute there) is real and the pain and desperation it brings to human life is real and that everyone is entailed to the help they need to regain the life they deserve to have a chance to live.
  •  Disease managment also believes that pain is real and that everyone deserves help.  It tends to assume though that life is nothing but pain.
  • Recovery assumes that people are biological, social, emotional, cognitive and spiritual beings and recovery to be real and meaningful may have to address each of these dimensions.
  •  Disease management believes that in the end the physical, biological aspects are most real and the real source of causation.
  •  Recovery assumes commitment.  It is not a given, a right or an entitlement.  While very possible it assumes the commitment of those seeking it and their determination to do whatever it takes to achieve it.
  •  Disease managment assumes that recovery  involves obedience.
  • Recovery assumes that all of us are more than the names we are called or the labels placed upon us and to reduce us to these names or labels is inherently unfair, wrong and misses the reality of who we are.
  •  Disease managment believes that diagnostic labels are the best indication of who you really are.
  •  Recovery assumes that since it is an individual thing and each of us has our own burdens that recovery will vary with each person in speed, distance, and kind.
  •  Disease managment assumes that recovery is basically the same process for everyone and differences in rate or degree somehow have to do with people not being as compliant with treatment as they should be.
  • Recovery assumes that while some burdens can be surmounted, others must be lived with and that recovery helps us to learn the difference and develop the skills to do each.
  •  Disease managment believes that nothing can be surmounted and everything must be lived with.

After looking at this what do you best believe describes the mental health system as you know it? 



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