People must find their own individual paths for recovery and set about rebuilding theirselves and futures in their own ways. A brief look at the writings of those who have faced this task is ample testimony to the personal, unique and very individual nature of their journeys. However, a number of authors have identified common features that may be involved in the recovery process (see, for example, Deegan 1988, 1993, 1996, Anthony 1993, Spaniol & Koehler 1994, Spaniol et al 1997, Vincent 1999, Young & Ensing 1999, May 2000).
These must not be taken as a recipe or set of predetermined stages. We present them here in order to illustrate the areas of which mental health professionals must be aware in order to facilitate the recovery process. Although, for the purposes of description, each area is described separately, it will become clear that all are intimately inter-related.
The accounts of people who have experienced mental health problems consistently, and poignantly, emphasise the importance of hope - a perspective shared by many professionals (Marcel 1962, Kubler-Ross 1969, Stotland 1969, Brunner 1972, Dufault & Martocchio 1985, Plugge 1979, Farran et al 1995, Holdcraft & Williamson 1991).
Lindsey (1976) describes hope as an anchor, stabilising our lives in the present and giving life meaning, direction and optimism'. It is neither passive waiting nor unrealistic forcing of circumstances that cannot occur, it is a state involving an inner readiness and activeness, a psychic concomitant to life and to psychosocial and spiritual growth' (Fromm 1968).
There exists a considerable body of research into the importance of hope in coping with physical illnesses (e.g. Hickey 1986). In the mental health arena, it has long been recognised that hope is one key to successful psychotherapy (Menninger 1959, Frank 1968). A number of studies have demonstrated a relationship between hopelessness and suicide (Drake & Cotton 1986, Beck et al 1990), and an increasing number of authors have stressed the importance of mental health workers' hopefulness in the treatment of schizophrenia and the process of rehabilitation (for example, Anthony et al 1990, Woodside et al 1994, Kirkpatrick et al 1995, Kanwal 1997).
'A multidimensional dynamic life force characterised by a confident yet uncertain expectation of achieving a personally significant goal.' (Dufault & Martocchio 1985)
'Hope is a state characterised by an anticipation of a continued good state, an improved state, or a release from a perceived entrap naent. The anticipation may or may not be founded on concrete, real world evidence. Hope is an anticipation of a future which is good and is based upon : mutuality (relationships with others), a sense of personal competence, coping ability, psychological well-being, purpose and meaning in life, as well as a sense of 'the possible.' (Miller 1992)
Such definitions emphasise the highly individual nature of hope. Hope relates to the achievement of goals that have a significance for the concerned, and it does not have to relate to specific outcomes. Dufault & Martocchio (1985) distinguish between two major types of hope:
(1) generalised hope related to a sense of some future beneficial developments but not linked to any particular concrete goal;
(2) particularised hope related to a specific, valued outcome or state of being, like getting a job, getting married, or having a place of your own.
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