Four domains of recovery

Slade (2009) describes four domains of recovery from mental illness, which the therapist is tasked with supporting. Hope is the idea that personally valued goals are possible, and is important because the experience of mental illness and the way that it is viewed can remove hope for a positive future. The central question the client is asking in this domain is “What will happen to me?” (Slade, 2009, p. 78). Identity involves the unique characteristics of each individual that identify them and their relationship to the rest of the world. Mental illness can undermine personal and social identity, and clients want to know, “Who am I?” (Slade, 2009, p. 78). The domain of meaning can be understood as two sub-domains: direct meaning and indirect meaning.  Direct meaning describes the personally satisfactory understanding of one’s mental illness that is necessary for forward movement: “What has happened?” (Slade, 2009, p. 78). Indirect meaning describes the the re-evaluation of one’s values, goals, and purposes in life as a result of the mental illness: “What does this mean for me?” (Slade, 2009, p. 78). Personal responsibility is often wrongly perceived in the treatment of psychotic disorders as limited to a responsibility to take medication as prescribed. Yet clients want to know “What can I do?” as they strive to regain a meaningful life worth living, and medication is only one of many tools for recovery (Slade, 2009, p. 78).

Slade, M. (2009). Personal recovery and mental illness: A guide for mental health professionals. New York: Cambridge University Press.