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Section 6: Spreading Recovery Based System Transformation

Spreading Recovery Based System Transformation includes a variety of writings focusing on the practicalities of system transformation.  Many of them were first distributed as part of two Proposition 63 implementation toolboxes.  “Recovery Based System Planning (Part 1 and 2)” is my favorite for system transformation planning.  “The Power of Flow” is probably the most challenging.  “Creating a Recovery Transformation Plan” and “Designing Transformed Clinics” are probably the most practically useful for program directors.  This chapter also has several administrative tools for building a recovery-based infrastructure including the MORS and The Recovery Culture Progress Report as well as a set of recovery-based policies for staff-client interactions.  There are also curricula and staff training materials in this chapter.  

My presentations and these writings have brought me a great deal of satisfaction and recognition over the years, but grounding all of it is my clinical work.  Hundreds of people - coworkers, people with mental illnesses who I have worked with, their families, and even people in the community around us - have taught me so much about listening, hopefulness, compassion, and personal healing as we’ve struggled together to rebuild lives and attain recovery.  If nothing else, I hope that some of my passion for this work and the people around me comes through as you explore this book.

Early Ideas

Early Ideas

Spreading the Village – 1999

A list of a dozen “putting beliefs into practice” items that programs seeking to “replicate the Village” should look at

Wish List of Broken Rules -2004

A list of changes in administrative “rules” that would remove barriers and promote becoming a recovery based system

Defining the Goals

Recovery Based System Transformation Strategies: What Should We Do? - 2004

A brief set of goals for achieving system transformation that I described when California’s Proposition 63, the Mental Health Services Act, passed (Kate – begin the lead in comments to this one with the first two paragraphs from the section intro about prop 63)

Socially Responsible Mental Health Services – 2004

A discussion of public mental health services being not just medically responsible, but also socially responsible

Principles of a Recovery-Based Service System – 2005

A brief list of service principles based on recovery characteristics

Defining a Recovery Culture  – 2005

A brief early effort to define elements of a recovery culture including different points of view 

Speaking Out in Public – 2006 

A copy of a speech outlining the goals of the recovery movement for changing our community and the way people with mental illnesses are viewed

Recovery Based System Planning 

Recovery Based System Planning (Part 1 and 2) – 2005

A comprehensive tool for system and program planning based on three stages of recovery – unengaged, engaged but poorly self coordinating, and self responsible 


The Power of Flow – 2006

A detailed discussion of the issues around promoting growth and flow in our programs and systems to reduce stagnation, rising caseloads, and increasing front end rationing of services

50 Ways to improve Outreach and Engagement - 2014

A list of 50 practical strategies for improving outreach and engagement including needed infrastructure changes to sustain them

Facilitating Transformation

A Guide for Recovery-Oriented Leaders– 2005

A brief overview of the four values – hope, authority, healing, and community integration – we use in our recovery oriented leadership workshops

Facilitating Recovery Based Transformation:  Where Are You? – 2006 

A discussion guide following five stages of transformation to help plan transformation steps

A Recovery Based Program Inventory – 2004

This inventory is an effort to translate the recovery vision into a practical program evaluation tool made up of qualitative self-evaluation questions  

Creating a Recovery Based Transformation Plan – 2005

A tool for creating teams of line staff and consumers to empower them to take actions they choose to promote recovery

A Roadmap to Recovery Based System Transformation – 2008

A description of the administrative tools and strategies that can be used to promote system transformation based upon our experiences with LA County DMH

Including Psychiatrists in Recovery Advocacy and Planning – 2011

A plea for collaborating with psychiatrists to implement recovery transformation

Fighting for Recovery - 2013

An advocacy piece outlining counterarguments to several common anti-recovery arguments

Keeping Perspective and Staying Sane -2006

Some tips for transformation leaders to keep us going

Creating New Recovery Based Programs 

Designing Transformed Clinics – 2006 

A practical guide to transform the structure of traditional clinics into a recovery based, growth oriented structure


Staffing Full Service Partnership Teams – 2006

Nuts and bolts discussion of staffing issues for recovery based ACT teams (In California they’re called Full Service Partnerships.)


Building a Recovery Based Psychiatric Practice: Setting Priorities for Limited Resources – 2011

A concrete description of the hard choices and challenges for psychiatrists transforming to recovery within realistic limits


Can I Recover and Stop My Medications? – 2009

A lengthy response to a psychiatrist who wants to stop exposing her patients to recovery and the idea they can get off their medications

Innovative Program Ideas from the Mental Health Services Act

A list of innovative recovery ideas I collected while doing MHSA planning meetings around California

Building Infrastructure

New Rules for Staff to Work By (with Rod Shaner) – 2006

A comprehensive set of recovery promoting parameters for service relationships developed and adopted by LA County DMH (that doesn’t prohibit hugs) for people who say “that’s against the rules”

Mark Ragins’ MediCal / Medicaid Thoughts -2006

A brief list of recommended changes in MediCal / Medicaid’s overarching design that would promote TV network ery

A Guide to the Milestones of Recovery Scale (with David Pilon) – 2006

A scale that tracks people’s progress in recovery and can help guide administrative and service decisions.  The MORS has been highly developed by us including testing, training, and tracking.  

Rating Engagement on the MORS - 2010

A discussion with lots of examples detailing the engagement dimension of the MORS

Tracking Recovery With the Milestones of Recovery Scale: A Case Example  (with David Pilon) – 2011

An article we wrote for the e-news MI Watch that describes using MOR clinically tracking the progress of a person’s recovery and the services we provided

A Recovery Based Progress Report Card – 2009

An auditing tool that tracks progression in seven key areas of recovery based culture to see if programs are

Training and Workforce Development

Curriculum Outline Proposal – Helping Relationship Skills – 2005 

Recommendations for a curriculum for training people, professional or not, to have relationship skills to help people recovery

Transforming Psychiatric Residencies – 2005

Recommendations for a model psychiatric residency training program to promote community based recovery psychiatry

MHSA Psychiatrist Manpower Proposal -2006

A proposal for implementing some of the ideas in the previous article in our local psychiatric residency training programs using MHSA funds

Hiring and Supporting Consumer Staff – 2006

A discussion of the importance of hiring consumer staff, the roles they serve, and the support and supervision needed to succeed

Curriculum for Staff Transformation -2005

I revisited the popular paper “12 Aspects of Staff Transformation” and tried to create an experiential curriculum for a two hour / week class for existing staff that might promote the desired changes.  

Recovery, Resilience, and Wellness Core Competencies Project - 2017

A comprehensive set of training materials specifically tied to the areas of recovery, resilience, wellness including pre and post tests, vignettes, curriculum objectives, and annotated bibliography

Recovery Based Staff Development Assessment- 2012

One page tool for staff evaluations based on their career development as recovery professionals

Defining Goals
Recovery Based System Planning
Facility Tranformation
Creating New Recovery Based Programs
Building Infracture
Training & Workforce Development
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