Approaches to Recovery and Social Inclusion: A Comparative Assessment of Medication and Wellness Recovery Action Plan

2021-07-27 14:19:48
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Boston College
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Introduction

In most cases, some people experience social seclusion or challenges as they try to cope up with a disability. The experiences of such individuals may alter the way they perceive life as well as the manner in which they interact with other people. Attitude, feelings, roles, and values of those affected could change to the extent that they might not be in a position to recognize the sense of self or purpose. Therefore, practitioners have capitalized on this need to develop methods and approaches meant to support those who are suffering from any form of illness or disability so that they can live a satisfying and hopeful life amid the limitations they are facing. Recovery and social inclusion is a comprehensive and person-centered process that assists a suffering individual to attain satisfaction by changing attitudes and perceptions to develop a new meaning and purpose in life. This paper is a critical comparative evaluation of medication and Wellness Recovery Action Plan (WRAP) as approaches to recovery and social inclusion as well as their implication on practice development.

Rationale for Selecting the Two Approaches

According to Slade (2009), the global trend characterizing recovery and social inclusion is shifting towards the endorsement of recovery principles as the primary foundation for practice and intervention implementation. Shepherd (2010) also affirmed the same scenario where the principles have been highlighted to be essential for psychiatric practice. The perception of recovery as a set of guiding values rather than a model to be adopted has called for a critical assessment of recovery intervention for an innovative practice development. Based on the definition of recovery, the need for the inclusion of the personal dimension while designing approaches has taken center stage. Therefore, medication and WRAP have been extensively studied to determine the level of efficacy associated with each method. On the other hand, these two approaches have attracted the attention of critics with a significant inclination towards WRAP (Slade, 2009). Hence, it was necessary to carry out a critical evaluation of the two methods and the associated evidence-based controversies and efficiency to determine how they impact practice innovation. The evaluation has focused on the background, effectiveness and efficiency, and the limitation of each approach as the baseline for contrasts development.

3.0 Critical Contrast

3.1 Medication

3.1.1 Overview of Medication

The narrations of recovery experiences have linked the use of medication as a successful method of psychiatric intervention. According to Cordle (2010) and Becker (2011), individualized experiences have outlined how the medication was central to their recovery. The approach includes the use of recommended regimens to get the exhibited symptoms under control and reduce their effects. The ability of the selected medicine to eliminate the symptoms allows the individual to build a meaningful life (Baker et al., 2013). While the focus of recovery is to improve the quality of life, medication is inclined towards the reduction or elimination of the symptoms through biological mechanisms. Therefore, the outcome of medication is tied to two possibilities depending on the nature of the illness and the experience of the affected person. Positive narration, as well as negative results, have been linked to the use of medicine as a recovery approach. Owing to the complexity of diagnosis, medication is subject to the accuracy of symptom interpretation as well as the interconnectedness of the prescription and the experience of the person.

3.2.2 Reliability and Effectiveness of Medication

The success of medication as a tool for recovery is linked to the thoroughness and adherence to prescription. Establishing a relationship with medication, which guarantees results, includes the assessment of both the benefits and the adverse effects where an informed decision is made (Baker et al., 2013). Moreover, medication is viewed as a tool among many that can be adopted as a single intervention combined with other measures to enhance the process of achieving the recovery goals. Extensive analysis of clinical evidence indicates that the existence of the negative outcomes cannot be used to rule out the success of the approach when seeking long-lasting symptom management. While medication is purely founded on the biological action rather than individual-guided change as depicted in WRAP, the commitment and thoughtful acceptance of use are central when seeking value and benefit. According to Slade (2009), when a critical evaluation of medication narrations was carried out, cases, where individuals cannot directly participate in decision-making regarding the use of medication, are exceptional. Such an outcome indicates the limited complexity chances of compromising the recovery principles.

3.1.3 The Existing Conflict and Limitation Associated with Medication

Although narrations of success have characterized medication, there exists differing perspective regarding the level of efficacy. It has been pointed out that the benefits outweigh the side effects, which indicates the lack of enough clinical evidence to support medication recommendations (Baker et al., 2013). Cases, where medication has been found to be insufficient, are common. In this case, using the approach has resulted in the inclusion of another psychosocial intervention or a self-help measure to improve the outcomes (Deegan, 2005). Marshall (2011) argues that the method is linked to a positive outcome, but psychiatrists have been using persuasion to improve adherence contrary to the meaning of prescription. Furthermore, the challenge of finding the right medication for an individual has contributed to the questions regarding the appropriateness of medication as a recovery intervention. The existence of limited information to the public, regarding the type of preferred medicine for specific cases, has escalated the traumatization and forced treatment (Baker et al., 2013). Therefore, the use of trial and error has increased the unsuccessful rate of the approach. On the other hand, with the use of medication, the possibility of lifetime dependability, where a person will have to use of regimens for throughout their life, cannot be ruled out (Cordle, 2010).

3.2 Wellness Recovery Action Plan (WRAP)

3.2.1 Overview of WRAP

As noted earlier Wellness Recovery Action Plan (WRAP) is a personal plan that is meant to enhance the prevention and wellness of an individual. The approach has been evaluated through evidence-based research, and the level of viability was ascertained. Therefore, WRAP is listed in the National Registry of Evidence-Based Programs and Practice. The history of WRAP dates back to 1997 when a group of individuals seeking to overcome their mental challenges focused on a routine that was tailored to enhance their wellness. The schedule has been extensively adopted by people facing different health challenges that affect their attitude and perspectives. According to Cook et al. (2011), WRAP is based on an individual assessment where the focus is set on the things that can repeatedly be practiced to influence attitudes and ignite a change process. Therefore, the objective of WRAP is to achieve wellness by adopting a set of behaviors, which will enable the person to live positively (Cook et al., 2011).

3.2.2 WRAP Structure and Design

The success of WRAP is based on the nature of the design, which includes multiple elements that define or impact wellness. WRAP assists individuals to discover their safe wellness tools by developing lists of things they can do to stay positive every time. Such a process included the identification of upsetting events, warning signs depicted at an early stage, and indicators of worse state. Once an individual has discovered the wellness tools, WRAP provides the mechanisms on how they can be used to enhance the experience of the affected person. On the other hand, the inclusion of actions plans to respond to the early, and late-stage signs form the center of the approach. A comprehensive wellness tool guarantees the ability to overcome the effect of upsetting or harmful events on attitude and perception of life. The crisis and post-crisis plan also form part of WRAP. Worth pointing out is that each WRAP element depends on the nature of the illness and implication on the quality of life; however, the levels and plans are complementary and sequential.

Wellness toolbox includes all the activities and actions that are included in WRAP, which include the resources that will be used to build wellness. In most cases, contacting friends or supporter, exercising, having enough rest, and peer counseling is examples of the tools that are adopted. Once the other hand, the Daily Maintenance Plan describes when a person is well and the list of things needed to maintain that status. Based on the plan a list of triggers is developed, which are the occurrences that make an individual feel uncomfortable. The list of the triggers is essential because they are used to determine whether the person has started to feel worse. Moreover, the Crisis Plan outlines the signs that will alert other people to take over the responsibility of deciding on behalf of the affected person and continue with the care process. This proactive plan is necessary because it tends to create a comfortable and safe internal atmosphere even when the affected individual is not in control. According to WRAP design, when developing the Post Crisis Plan, it is essential to focus on the activities that will enhance recovery; however, an individual will have a clear picture of what is needed after going through a crisis.

3.2.3 WRAP Reliability and Effectiveness

WRAP is offered between 8 to 12 week-based sessions where the individualized plan created by those who are affected is focused on achieving and maintaining recovery. The efficacy of WRAP is based on the underpinning theoretical framework (William, Lynch, & Glasgow, 2007; Williams et al., 2006). By learning, the affected persons are prepared to use maintenance strategies as outlined in the plan to identify and control the exhibited symptoms and triggers. The reliability of self-management of illness emanates from the psychological theory of self-determination. According to the postulates of the theory, lasting health behavior originate from internal motivation based on an individuals self-initiation experiences (Mueser, 2005; Salyers et al., 2009). Such an occurrence is subject to a supportive environment where practitioners offer information, avail choices for those affected, an...

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