Mental Health Nursing: Recovery Paradigms and Therapeutic Relationship

This report discusses mental health recovery, principles of recovery paradigms, and the nursing therapeutic relationship with consumers. It emphasizes the importance of developing trust, therapeutic communication, empathy, and empowerment in the therapeutic relationship. The report also highlights the principles of recovery paradigms, including the uniqueness of the person, rights and attitudes, and recovery evaluation.

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Table of Contents
Introduction................................................................................................................................1
Recovery in mental health care..............................................................................................1
Principle tenets of recovery paradigms..................................................................................2
How nurse develop therapeutic relationship..........................................................................4
Conclusion..................................................................................................................................6
References..................................................................................................................................7

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Introduction
Mental health is the emotional, social and psychological well-being of a person. It is a state of
well-being of an individual in that a person realizes his or her potential, ability to cope up
with the stressors, working ability for better results, and efforts to make in favour of the
community (WHO, 2018). The mental health problem is not a new concept for the world; it
has been affecting the people from every race and community for many years. One in five
people in America experienced mental illness once in a life, and it accounts for nearly 800000
deaths all over the world. Close to 51% youth with substance abuse in the United States also
suffer from psychological illness (USC Suzane Dworak-Peck, 2017). In this report, the
recovery in mental health care, three principles tenets of recovery paradigms, implications for
practice, and the nursing therapeutic relationship with consumers will be discussed.
Recovery in mental health care
Mental health recovery is not only focus on cure; it helps to recover the patient emotionally,
psychologically and mentally. Majority of the patient with a mental illness recover, but
predicting the time and to what extent the person will be treated is difficult. The recovery of a
person includes:
 Finding the possibility and developing the self-esteem and resilience
 to have the sense of purpose and the meaning of the person's life
 developing the positive relationship with the people in the individual’s community
 To gain independence in the patient's life.
Recovery in mental health is about gaining the recovery in all aspects of life rather than
concentrating on the physical and psychological problems only. Recovery in mental health is
different from the recovery from physical problems. The mental health recovery plan helps

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the person to work out on what type of life he or she wants to live, how to achieve that target,
tracking the mental health changes occurs with the recovery plan, and preventing the aspects
that might create the problem in recovery (Health direct, 2017).
Principle tenets of recovery paradigms
There are some principles set for the recovery paradigms in patients care. The purpose of
these principles of recovery framework is to make sure that the mental health interventions
are being provided in such a way that favours the recovery of the psychological or mental
health consumers. Some of the principles of mental health recovery paradigms are:
1. The uniqueness of the person
Recovery-oriented psychological or mental health practice:
 The main aim of these practices is to recognise that that recovery is not only about the
cure. It is about having opportunities for living a satisfying, purposeful and
meaningful life, and being a valuable member of the community.
 Accepting that the outcomes of recovery are unique and personal for each person and
going beyond the exclusive health focus to involve an emphasis on quality of life and
social inclusion.
 Empowering the people so they can recognize that they are the main center of the
health care they receive.
This can be implied by using the person-cantered care by the nurses or other healthcare
providers.
2. Rights and Attitudes
 It includes listening to the individual, working on the communications between the
person and the nurse.

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 It also promotes and protects the individual's citizenship, legal and human rights
 It also involves the support for the person to maintain and promote social,
occupational, recreational and vocational activities that are important for the
individual
 Develop hope in the person’s future and to promote the ability to live a happy life.
This principle is important to provide a care according to the law and not compromising with
the respect and privacy of the individual. Every health provider such as nurses and physicians
should be aware of these rights.
3. Recovery evaluation
Recovery evaluation is essential to make sure the continuous examination of the
recovery based practice at different levels.
The person and their carers can also track their own progress
This can be done by asking the post-recovery questions to the patient about how they feeling
and how they see things after the treatment (Australian Government department of health,
2010). The DSM (Diagnostic Statistical Manual) can be used for evaluation
(Ourconsumerplace, 2013).
Therapeutic Alliance/Relationship
Therapeutic relationship or alliance is an interpersonal, common, and negotiated
collaboration necessitated by and keep eyes on the resolution of identified needs and health
goals (Zugai, Stein-Parbury & Roche, 2015). Therapeutic relationships are associated with
the favorable outcomes of mental health consumers. Developing a strong therapeutic
relationship with consumers is directly linked with the reduction of hospital admission rates
and improved quality of the person’s life. Making a therapeutic relationship with consumers

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can significantly positively impact client’s outcomes and it is considered the most important
aspect helps to the effectiveness of the service (Evans, Nizette & O’Brien, 2016).
How nurse develop the therapeutic relationship
Trust
Trust is the key element of developing a strong therapeutic relationship with the consumers.
It is considered as one of the most important assets and foundation in the therapeutic alliance.
Developing trust serves as the foundation of the interpersonal relationship between patient
and the nurse. Without having trust between nurse and the mentally ill person it is not
possible to meet the needs of the individual health. The mentally ill person is not very open to
provide information about their health to the unknown person; therefore it is very important
to develop trust so that patient can easily discuss the symptoms and their feelings. This is
directly related to the person-centered principle of the recovery paradigms (Carter, 2009).
Communication
Healthy communication between the patient and nurses is very important to provide safe and
quality care. It is used at every stage of care planning such as while assessing the patient,
planning, implantation of intervention and evaluation. To develop good communication
nurses should understand and help the patients, showing courtesy, sincerity, and kindness.
The therapeutic communication helps the nurses to develop communication in such a way
that is favorable to the patient. Nurses are the first person who noticed the changes in the
status of the patient; they should have a strong communication and the continuous flow of
information. The main role of the nurses in relation to a patient is to make sure that the
communication is understandable to the patient and according to the values (Thompson &
McCabe, 2012). The communication can be improved by using some strategies such as

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including the patient as the partner in bedside handovers. When the communication is
improved, it is easy for the nurses to understand the safety problems of the patient.
Empathy
It is considered as the central factor of a therapeutic relationship. It enables the registered
nurses to remain objective throughout the discussion with the patient about their concern. It
basically allows the nursing professionals to involve in patients world. It also makes it easier
for the person to discuss their mental status. Empathy helps nurses to develop a good
relationship not only with patients but also with family carers. The nurses should concentrate
on their own feeling while talking to the patient, this helps to understand what the diseased
person must be feeling. The ability of the nurses develops with the time and interest. To
create a therapeutic alliance, nurses should respond to the clients empathetically, intelligently
and competently (Stuart, 2014). Being empathetic is related to the principle of rights and
attitudes, it is the right of the patient to receive care with empathy and respectfully.
Empowerment and genuineness
Empowerment is the process of involving the patient in the decision-making process. The
patient has the right of the person to take part in their care planning and implementation.
Empowerment is the state which arises from valuing other people, and nobody can value
other individuals unless they value themselves. Empowerment includes enabling the people
to achieve some measure on their own lives (Holmström & Röing, 2010).
Openness and genuineness are the important factors to develop a nurse-client relationship.
When the nurses are genuine, they are able to share the emotional reaction to the difficulties
of the patient. The nurses, who have knowledge and skills, should also be aware of the
feeling and emotions while communicating with the patient. These two factors expressed

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when nurses perform their duties and how it affects the patient. Being genuine to the patient
helps the nurses to gain positive health care result for their patient (Penda, 2017).
Conclusion
Mental health is considered the emotional, psychological and social well-being of an
individual. In most of the cases, the patient recovers with mental illness. The mental health
recovery is different from the cure and focuses on the patient as the person. It includes all the
aspects that affecting the patient’s mental health rather than giving priority to the physical
and psychological issues only. The principles such as the uniqueness of the person, rights &
attitude and recovery evaluation should be followed while providing care to the person. To
provide better healthcare to the mentally ill patient, it is necessary to develop a therapeutic
relationship by using some aspects such as building trust, therapeutic communication, being
empathetic and genuine to the patient, and involving the patient in the decision-making
process.

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References
Australian government department of health (2010). Principles of recovery-oriented mental
health practice. Available from:
http://www.health.gov.au/internet/publications/publishing.nsf/Content/mental-pubs-i-nongov-
toc~mental-pubs-i-nongov-pri [Accessed 30 July 2018].
Carter, M.A. (2009). Trust, power, and vulnerability: a discourse on helping in
nursing. Nursing Clinics. 44(4), pp.393-405.
Evans, K., Nizette, D., and O'brien, A. (2016). The effective nurse. Psychiatric and Mental
Health Nursing. Chatswood, NSW: Elsevier health sciences. pp. 3.
Health direct (2017). Recovery and mental health. Available from:
https://www.healthdirect.gov.au/mental-health-recovery [Accessed 30 July 2018].
Holmström, I. and Röing, M. (2010). The relation between patient-centeredness and patient
empowerment: a discussion of concepts. Patient education and counseling. 79(2), pp.167-
172.
Ourconsumerplace (2013). The Madquarry dictionary: A consumer’s guide to the language
of mental health. Available from: http://www.ourconsumerplace.com.au/consumer/index
Accesses 31 July 2018.
Penda, C. (2017). Establishing the Therapeutic Nurse-Client relationship with mentally ill
patient in a community. Available from:
https://www.theseus.fi/bitstream/handle/10024/137999/CECILIA%20FINAL%20DRAFT
%203.pdf?sequence=1 [Accessed 31 July 2018].

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Stuart, G. W. (2014). Principles and practice of Psychiatric nursing. 10th ed. Missouri, US:
Elsevier health sciences, pp. 31-33.
Thompson, L. and McCabe, R. (2012). The effect of clinician-patient alliance and
communication on treatment adherence in mental health care: a systematic review. BMC
Psychiatry. 12(1), p.87.
USC Suzane Dworak-peck (2017). 15 mental health facts you should know. Available from:
https://dworakpeck.usc.edu/blog/15-mental-health-facts-you-should-know Accessed 30 July
2018.
WHO (2018). Mental health: a state of well-being. Available from:
http://www.who.int/features/factfiles/mental_health/en/# [Accessed 30 July 2018].
Zugai, J., Stein-Parbury, J. & Roche, M. (2013). 'Effective nursing care of adolescents with
anorexia nervosa: a consumer perspective', Journal of Clinical Nursing, 22(13-14), pp. 2020-
9.