Personal recovery is an individual process. Just as there is no one right way to do or experience recovery, so also what helps us at one time in our life may not help us at another. One-size-fits-all approaches are inadequate to address the dynamic complexity of the individual personality.
It is crucial that the mental health community abandon the disease model Personal recovery is an individual process. Just as there is no one right way to do or experience recovery, so also what helps us at one time in our life may not help us at another.1 One-size-fits-all approaches are inadequate to address the dynamic complexity of the individual personality.
It is arrogant of recovery programs to favor diagnosis over the individual, and risky because of the abundance of misdiagnoses. Stereotyping is what people do when they are lazy, apathetic, or ignorant. Public opinion stereotypes a person with a mental malfunction as unpredictable, potentially violent, and undesirable2―a claim supported by the stigma triad of ignorance, prejudice, and discrimination. Clients are not their disorders, they are unique individuals with complex personalities impacted by a disorder. Their treatment program must be a custom integration of programs to address this individual personality/complexity.
Let us use the example of cognitive-behavioral therapy. Almost 90% of the approaches to recovery endorsed by the American Psychiatric Association involve cognitive-behavioral treatments. However, CBT is not all it is cracked up to be and is far less effective as a singular approach than in concert with others. Critical studies downplay CBT’s effectiveness, arguing it fares no better than non-CBT programs.3 Recent studies claim its effectiveness has deteriorated since its introduction, another study, concluding it is no more successful than mindfulness-based therapy for depression and anxiety.4 This singular approach is archaic and arguably detrimental, and tantamount to malpractice if other supportive options particular to the client are not considered.
Despite these criticisms, the program of thought and behavior modification pioneered by Beck in the 1960s is still useful in modifying the irrational thoughts and behaviors that sustain a disorder when used in concert neural restructuring and other approaches.
Cognitive Behavioral Therapy (CBT) addresses the mental and behavioral issues of Social Anxiety Disorder. Its primary function is replacing irrational thought and behavior patterns with positive and rational ones. It does this by bringing the client’s attention to their negative thoughts and behavior patterns and providing the means to address them through repetitive affirmation so that the ANT’s (automatic negative thoughts and actions) are replaced by ART’s (automatic rational thoughts and actions).5
Positive psychology has its critics, too; it is still in its formative stage. Positive psychology focuses on virtues and strengths that help individuals not only transform but also flourish. Until recently, the focus on optimal functioning’s positive aspects ignored the individual’s holism. The emergence of PP 2.0 rectified the lacuna. Positive psychology now emphasizes the positive while managing and processing the negative to increase wellbeing. Although positive psychology works best in conjunction with other programs, its mental health interventions have proved successful in mitigating the symptoms of depression, anxiety, and other malfunctions. “Growing research suggests that a positive psychological outlook not only improves ‘life outcomes” but enhances health directly.”6 In their study of positive psychology interventions, researchers found PPIs showed “significant improvements in mental wellbeing (from non-flourishing to flourishing mental health) while also decreasing both anxiety and depressive symptom severity.”7 Echoing that, Another meta-analysis of 51 studies with 4,266 individuals, found PPIs “significantly enhance wellbeing . . . and decrease depressive symptoms.8
An excellent therapeutic approach is a collaboration between theoretical construct and scientific evidence. There are a plethora of methods of recovery. The author of a definitive textbook cites 400 different schools of psychotherapy. “Negligible differences have been found among all these approaches, however; their efficacy in treating mental illness is due to factors shared among all of the approaches.”9 Recovery programs must be fluid. Addressing the complexity of the individual personality demands integrating multiple traditional and non-traditional approaches, developed through client trust, cultural assimilation, and therapeutic innovation. Any analysis must consider environment, hermeneutics, history, and autobiography in conjunction with the individual’s wants, needs, and aspirations. If they are not given consideration, the complexity of the individual is not valued.
1. Perkins R., & Repper, J. (2003). Social Inclusion and Recovery. London: Baillière Tindall.
2. Heary, C., Hennessy, E., Swords, L., Corrigan, P. (2017). Stigma towards Mental Health Problems during Childhood and Adolescence: Theory, Research and Intervention Approaches. Journal of Child and Family Studies, 26, 2949–2959 (2017). doi:10.1007/s10826-017-0829-y; Pinfold, V., Thornicroft, G., Huxley, P., & Farmer, P. (2005). Active ingredients in anti-stigma programmes in mental health. International Review of Psychiatry, 17(2), 123–131 (2005). doi:10.1080/09540260500073638
3. David, D., Cristea, I., Hoffman, S.G. (2018). Why Cognitive Behavioral Therapy Is the Current Gold Standard of Psychotherapy. Frontiers in Psychiatry, 9(4) (2018). doi:10.3389/fpsyt.2018.00004.
4. Lyford, C. (2017). Is Cognitive Behavioral Therapy as Effective as Clinicians Believe? Despite Longstanding Authority, New Research Questions CBT’s Reliability. Psychotherapy Networker. https://www.psychotherapynetworker.org/blog/details/705/is-cognitive-behavioral-therapy-as-effective-as-clinicians.
5. Richards, T.A. (2014). Overcoming Social Anxiety Disorder: Step by Step. Phoenix, AZ: The Social Anxiety Institute Press.
6. Easterbrook, G. (2001). Psychology discovers happiness. I’m OK, You’re OK. The New Republic, Article 27, p. 136
7. Schotanus-Dijkstra, M., Drossaert, C. H. C., Pieterse, M. E., Walburg, J. A., Bohlmeijer, E. T., & Smit, F. (2018). Towards sustainable mental health promotion: trial-based health-economic evaluation of a positive psychology intervention versus usual care. BMC Psychiatry 18:265, pp. 1-11 (2018). https://doi.org/10.1186/s12888-018-1825-5
8. Sin, N. L., & Lyubomirsky, S. (2009). Enhancing Well-Being and Alleviating Depressive Symptoms with Positive Psychology Interventions: A Practice-Friendly Meta-Analysis. Journal of Clinical Psychology: In Session, 65(5), 467–487 (2009). doi: 10.1002/jclp.2059
9. Farreras, I. G. (2020). History of mental illness. In R. Biswas-Diener & E. Diener (Eds), Noba textbook series: Psychology. Champaign, IL: DEF publishers. http://noba.to/65w3s7ex