A Pilot Randomized Control Trial of Autovideography Intervention to Enhance Recovery for People with Severe Mental Illness

Recovery has long been accepted as the standard of care for medical illnesses, but in the mental health practice domain it is a relatively new phenomenon (Barber, 2012). With the issuance of the 1999 Surgeon General's report on mental health (U.S. Department of Health and Human Services, 1999) and the 2003 President's New Freedom Commission report (New Freedom Commission, 2003), recovery has become the major emphasis in mental health services for the United States. Employing a recovery-oriented approach to service delivery requires a major shift in practice for providers as well as for the clients they serve. The provision of services is no longer about the providers being the experts and dictating treatment for their clients. Recovery is about empowering consumers to make their own treatment choices, often in consultation or collaboration with providers, and about providers respecting those decisions even if they are not considered to be the best option (National Association of Social Workers, 2006). This paradigmatic reorientation, which necessitates retraining of providers, resulted in the Substance Abuse and Mental Health Services Administration (SAMHSA) instituting in 2009 a Recovery to Practice Initiative to advance a recovery-oriented service approach for the primary providers of mental health services, including psychiatrists, psychologists, psychiatric nurses, social workers, and peer specialists.This new emphasis requires dedicated education and promotion of a recovery approach for those living with severe mental illness who were well socialized into accepting provider decisions and believing provider messages that they were incapable of making their own decisions regarding treatment or basic life choices. Consequently, mental health agencies are now offering educational programs on recovery, often followed by interventions directed at enhancing clients' ability to engage in their own recovery.This article will report on a pilot randomized controlled trial of an autovideography intervention for a small group of consumers immediately following their completion of a recovery educational program at a local mental health association. Those assigned to the experimental group received an inexpensive video camera to film what recovery meant to them and the ways in which recovery was pursued in the context of daily life, thereby reinforcing and engendering hope in the possibility of recovery as well as empowering them to actualize recovery goals and to teach others about recovery through the videos created. Because similar interventions, such as photovoice, have been found to empower consumers in their own recovery (Russinova et al., 2014), the authors hypothesized that those using the video camera for one month would achieve higher scores on the Recovery Assessment Scale at the twelfth week post-test than those in the control group.Defining and Understanding RecoveryRecovery has diverse conceptual meanings. Recovery in a traditional medical orientation designates a cure or a return to the physical or mental state prior to the illness with no presence of symptoms. This type of recovery is often referred to as clinical recovery or the medical model outcome orientation of recovery (Andresen, Oades, & Caputi, 2003; Barber, 2012). This definition is reserved for curable diseases in which individuals can regain their functionality in all domains of life but is not applied to chronic illnesses, which include severe psychiatric illnesses. In long-term or chronic illness, recovery is used in the context of managing the illness with regard to both controlling and monitoring symptoms (Barber, 2012) or managing the consequent disability of the illness when employing the rehabilitation model (Andresen et al., 2003). In accordance with this long-term management conceptualization of recovery, a number of illness self-management programs have been promoted that are designed specifically for persons with severe mental illness including Wellness Recovery Action Planning (WRAP), developed by a consumer (Cook et al. …