Recovery colleges: one size does not fit all
19th April 2018
At the end of last year SRN brought together a range people and recovery initiatives to explore ‘If recovery colleges are the answer, what is the question?’ In this article SRN Director, Frank Reilly, reflects on the content and feedback from the event and outlines SRN’s next steps.
In recent months there has been a surge in interest in Recovery Colleges as a means to create an alternative to traditional medical and social care services. This may be the most opportune moment for experience led services or it may be a simple solution to the complex problem of a high demand for services in a period of austerity.
To explore what models might be best for Scotland SRN convened a meeting to explore the concept of recovery colleges from a range of perspectives. We are extremely grateful to South London and Maudsley (SLaM Recovery College), Dublin North, North East Recovery College (DNNERC), The LifeRooms from Merseycare in Liverpool, the Moray Wellbeing Hub and the Turning Point Scotland supported citizenship recovery community in Glasgow for their contribution to the day.
The original recovery education centres were first established in Boston in the United States (Ashcraft and Anthony 2005) using ‘transformative learning techniques’ and self-management to empower and enable recovery. The context is particularly important however: access to treatment in the traditional sense was limited, and based on insurance cover and/or ability to pay. Creating an alternative to traditional treatment provided the only option for many people but also created the conditions for a liberating recovery movement inspired by civil rights movements in the past. In keeping with these liberating ideals, the generation of the curriculum is based on a dialogue with people with lived experience, delivered initially in partnership with supporters and then wholly by tutors with lived experience. This emancipatory approach is wholly different from traditional didactic approaches (‘I teach, you learn’), where the teacher holds exclusive knowledge that only they can impart. The focus is on what Paulo Friere (1970) would call a ‘problem-posing dialogue’ where the ‘teacher’ and ‘student’ work together as equals, deciding what to learn and how to learn it. This is the core of effective and emancipatory recovery colleges.
Although a classroom was at the centre of recovery colleges, they were always intended to be about liberation, community and self-help: identifying what skills are inherent in a community but often unrecognised, perhaps because they were no longer valued by the person who had the skills. These were not disease-related management skills. They were not about acquiring and using the right sort of language in order for professionals to understand you and your deficits. They were about the things that you can and could do, the skills that other people valued, and gave you a value in the community you were part of.
Our UK health and social care systems seem to find this concept difficult to deal with. Knowledge appears to be valuable only when it is accredited: when there is a certificate. And yet we all know of people with a very particular set of skills: bakers and cooks who produce superlative food, crafts people who knit, draw and carve beautiful things, people who have untaught listening and support skills.
Our meeting sought to bring these concepts back to the fore and to begin to look again at what the question might be that recovery colleges were the answer to. At present it is difficult not to see the question being: how can we support people in distress for the least amount of money? This is a major driver in public services currently, the same driver that has increased interest in the term coproduction but without much evidence of investment in either.
Our event stripped the discussion right back to first principles. First and foremost, what would underpin a recovery college would be core values, that it should be:
- Designed and delivered by people with experience of distress
- Building on strengths
- A driver for connection in the community, not exclusively for people with a diagnosis
- Embodying a range of learning styles: not everyone needs or wants a certificate, but some do
- A stepping stone to great things, not an end point
- Able to offer what people want, not what others believe they should learn
- Allow people to contribute and in so doing revive their value for the community
- Free of labels
- Designed to include families and their experiences
- A stepping stone to learning and qualifications
What impressed the most was the importance that each different approach to recovery education and empowerment gave to the starting point for their initiatives. Being certain of the common values that underpin the slightly different approaches was central to ensuring that the colleges were owned by those who participated: the central importance of lived experience, the importance of connection, embodied hope, of an identity and meaning independent of ‘illness’ and hope for the future.
However, as the evidence demonstrated on the day, there is no ‘one size fits all’. The models that worked well adapted to their local circumstances and were not hide-bound by orthodoxy. If the demand from the community was for a certificated course, that’s what was delivered. If the demand was for a course on fishing, that is what was provided. The consequence of both is that a group of like-minded people come together and create a supportive community, learning about one another as well as generating recovery skills consequently. This approach may be challenged by funders who might find these consequential benefits difficult to fathom but as many of our contributors pointed out, it is not always about funds. The best models create value in the community that is then valued by local employers and business. In the case of The Life Rooms and DNNERC this has led to a form of bartering. Businesses who have benefited from recovery college inputs to their staff have reciprocated by offering apprenticeships or supported employment opportunities in return.
For recovery colleges to be effective they must be owned and valued by the people that use them. The underlying values must embody equity in the design and delivery of learning and recognise that all life experience is skilful and provides a means for everyone to contribute. They should also provide opportunities and connections for formal learning for those that wish to take that path. They should also reflect the community within which they are situated. The models that were presented on the day were diverse and each had their benefits which leads us again to the conclusion that there is no ‘one size to fit all’. For colleges to thrive the values of recovery, empowerment and lived experience have to be central.
It is SRN’s intention to continue to explore the opportunities for community and learning that recovery colleges encompass and in so doing to highlight innovations and best practice from within Scotland and internationally. Recently we have been successful in our bid to provide quality assurance to a cross border initiative for recovery on the island of Ireland. We anticipate learning from this different context what the benefits of virtual recovery colleges in predominantly rural countries may be, to reflect on best practice and share learning. We will also take our learning from our ‘If recovery colleges are the answer, what is the question?’ event and the years of work in SRN and Scotland on peer working to support our colleagues across Europe, the Americas and Australasia at the upcoming International Initiative on Mental Health Leadership in Sweden. Core to that discussion will be the experience of our colleagues from Moray Wellbeing Hub in creating shared learning spaces.
This is a journey of exploration. Not to say ‘this is the answer’ but to curate and consider a collection of models and approaches that can be useful to our country and to our communities.
Ashcraft, L. and Anthony, W.A. (2005), “A story of transformation: an agency fully embraces recovery”, Behavioral Healthcare Tomorrow, Vol. 14 No. 2, pp. 12-22
Freire, P. (1970), Pedagogy of the Oppressed, Herder and Herder, London
At the event five ‘recovery college’ initiatives gave PechaKucha style presentations showcasing different models of practice. Follow the links to view the presentations:
- SLaM recovery college (film)
- Dublin North, North East Recovery College (film)
- The Life Rooms (slides only)
- Turning Point Scotland (slides only)
- Moray Wellbeing Hub (film)
You might also be interested in this reflection from Ewan who participated in the event and is a Moray Wellbeing Hub Champion: “A very positive and inspiring day and it was good to meet up with others who are working towards making recovery a real phenomenon for everyone.” Read more