Dr' Charles A' Rapp

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Recovery as the Heroic Struggle Over Disease
and Oppression

• Dr. Charles A. Rapp
• University of Kansas
• School of Social Welfare

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Slavery ComparisonOppression

• Slavery

• People with a
• Psychiatric Disability

• Space
• None they could call their own
• For females, even her own body was not her own

• Space
• Congregate residences
• Privacy in day programs
• Entrapped in impoverished neighborhoods
• Physical sexual abuse, like slave, their bodies
  treated like anothers property.

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Slavery ComparisonOppression

• Slavery

• People with a
• Psychiatric Disability

• Time
• Working hours taken without consent

• Time
• So-called need for structure
• Hour by hour activities in day treatment
• Failure to follow rule is received as resistance
  to therapy
• Congregate programs that dictate their schedule

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Slavery ComparisonOppression

• Slavery

• People with a
• Psychiatric Disability

• Energy
• They labored in the fields and kitchen for the
  gain and comfort of the master

• Energy
• Powerful drugs sap energy
• Energy is devoted to conforming to the dictates
  of professional staff, not creating a better life
• Energy devoted to capitulation assimilating into
  the patient culture

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Slavery ComparisonOppression

• Slavery

• People with a
• Psychiatric Disability

• Mobility
• Never permitted to venture beyond designated
  perimeter without a pass

• Mobility
• Rules of congregate facilities
• Lack of car ownership
• Lack of public transportation
• Reliance on MH transportation

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Slavery ComparisonOppression

• Slavery

• People with a
• Psychiatric Disability

• Bonding/Relationship
• Relationship between mother and child was
  violated
• Permission to marry was the slave-owners decision

• Bonding/Relationship
• In the company of other clients and staff
• Staff maintaining professional distance
• Different genders discouraged to live together
• Displays of affection are discouraged
• Courts remove kids from custody

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Identity

• I Am Illness
• Conspiracy of Understanding

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Recovery as an Outcome

• Community Integration
• competitive employment
• post-secondary education
• non-segregated independent living
• prevention of psychiatric hospitalization
• faith communities

• Psychological
• hope
• self-esteem
• confidence
• self-efficacy
• self-determination
• loneliness

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Strength-Based Approaches

• Individual Placement Support Model of Supported
  Employment
• Supported Education
• Peer to Peer Services
• Wellness Recovery Action Planning (WRAP)
• Supported Apartment Living
• Integrated Dual Diagnosis Treatment
• Shared Decision-Making and Decision Support
  Center
• Strengths-Based Case Management

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Common Denominators of Strengths-Based Approaches

• Based on consumer choice and self-determination
• The presumption is that people can learn, grow
  change
• Focused on strengths of the individual
• Place a premium on non-segregated/integrated
  community settings.
• The professional-consumer relationship is
  hope-inducing not spirit-breaking
• Most of the work is done in everyday community
  settings