个人复元
「复元」着重复元人士在康复的过程中学习如何在小区克服生活上精神病带所带来的障碍,并活出一个有尊严并有意义的人生。「个人复元」翻译自「personal recovery」。这个词语既解作「恢复原状」,更加是指「恢复元气,从头开始」。「个人复元」不只衡量复元人士是否回复原来的状况(复原),更着重的是个人经历、自我接纳与成长,强调过程中萌生与生命力的再现,带来正面的结果。
复元的来源
最初,个人复元的概念是由戒毒者的自助组织所提出,后来紧接着七十年代的复元人士运动,精神病复元人士的互助组织亦沿用了复元的理念。近年,复元概念经过不断的修改与阐释,不单盛行于自助组织,更获应用在正式精神康复服务以及成瘾服务系统上。本港现时正处于起步阶段,一些服务机构以及医院正在试行应用复元理念于精神康复服务上。
希望
这不代表对自己讲一些看似很正面的说话,或是因为「我得你都得」,而是对将来存有希望和信心,相信痛苦会过去,只是暂时的。
整体性
精神病不是生命的全部,而「复元人士」只是自己其中一个身份,其中一部份。因此,明白自己在生命中会有不同的角色,建立不同方面的生活,着重身、心、灵以及社会参与,并照顾生活每一个部份,不单单是留意自己的病。
自主
让复元人士有自主权去选择自己所接受的服务,以及复元的路向。
个人化
由于每个人都是独特的,复元人士亦会有不同的意愿、能力,需要以及经历,同时可能选择用用不同的方式去努力。因此,就算患上同一个精神病,每个人都经历都会有所不同,因此每个人都是不一样的。
朋辈支援
透过有明显改善的复元人士分享自己的经验,互相鼓励和学习彼此成功的经验,同时着重同理心,不是抱着「我得你都得」的态度,而以用过来人的身份,明白大家的感受。
人际关系及社交网络
家人、朋友、小区、或是信仰的团体能给予更多的支持,增强复元人士的归属感,放下不健康、不美满的生活。
起伏中成长
复元的过程不是一条直线,中间会有起跌和挫折。重点是抱着开放的态度,从经验中学习,并且相信这些经验会令自己成长。正如身体的健康一样会时好时坏,精神健康亦会好转或复发。重点是跟自己的病共存,就算有病,都可能有一个富足的人生。
处理精神创伤
提供服务去支持有某些痛苦经历的复元人士,例如经历过暴力、性虐待、家庭暴力、战争、灾难等,因为这些经历常与酗酒、滥药及精神健康问题等有直接的关系。透过提供服务及支持,能够增加复元人士的生理及心理上的安全感,建立他们的信任。
重视个人优势
重视个人的优势,而不是病征。复元人士在个人、家庭以及小区之中都有其优势去帮助自己的复元过程。复元人士需要了解、重视及欣赏自己的优点,并发挥自己的长处照顾自己以及参加于自己的复元过程之中。
尊重
重视个人的价值及独特性,并着重去尊重每一个人。社会及大众对复元人士的尊重以及接纳,能消除社会对复元人士的标签和歧视,给予复元人士信心,帮助复元人士重新投入生活之中。而复元人士之间亦互相尊重彼此不一样的地方。
希望
这不代表对自己讲一些看似很正面的说话,或是因为「我得你都得」,而是对将来存有希望和信心,相信痛苦会过去,只是暂时的。
整体性
精神病不是生命的全部,而「复元人士」只是自己其中一个身份,其中一部份。因此,明白自己在生命中会有不同的角色,建立不同方面的生活,着重身、心、灵以及社会参与,并照顾生活每一个部份,不单单是留意自己的病。
自主
让复元人士有自主权去选择自己所接受的服务,以及复元的路向。
个人化
由于每个人都是独特的,复元人士亦会有不同的意愿、能力,需要以及经历,同时可能选择用用不同的方式去努力。因此,就算患上同一个精神病,每个人都经历都会有所不同,因此每个人都是不一样的。
朋辈支援
透过有明显改善的复元人士分享自己的经验,互相鼓励和学习彼此成功的经验,同时着重同理心,不是抱着「我得你都得」的态度,而以用过来人的身份,明白大家的感受。
人际关系及社交网络
家人、朋友、小区、或是信仰的团体能给予更多的支持,增强复元人士的归属感,放下不健康、不美满的生活。
起伏中成长
复元的过程不是一条直线,中间会有起跌和挫折。重点是抱着开放的态度,从经验中学习,并且相信这些经验会令自己成长。正如身体的健康一样会时好时坏,精神健康亦会好转或复发。重点是跟自己的病共存,就算有病,都可能有一个富足的人生。
处理精神创伤
提供服务去支持有某些痛苦经历的复元人士,例如经历过暴力、性虐待、家庭暴力、战争、灾难等,因为这些经历常与酗酒、滥药及精神健康问题等有直接的关系。透过提供服务及支持,能够增加复元人士的生理及心理上的安全感,建立他们的信任。
重视个人优势
重视个人的优势,而不是病征。复元人士在个人、家庭以及小区之中都有其优势去帮助自己的复元过程。复元人士需要了解、重视及欣赏自己的优点,并发挥自己的长处照顾自己以及参加于自己的复元过程之中。
尊重
重视个人的价值及独特性,并着重去尊重每一个人。社会及大众对复元人士的尊重以及接纳,能消除社会对复元人士的标签和歧视,给予复元人士信心,帮助复元人士重新投入生活之中。而复元人士之间亦互相尊重彼此不一样的地方。
Source: Substance Abuse and Mental Health Services Association (SAMHSA, 2012).
个人复元与医学模式的分别
个人复元与医学模式的分别,可以简单由基本概念、实践以及目标去看:
基本概念
医学模式
围绕着科学性、病历、诊断的结果、治疗,以及医护人员和病人的参与
个人复元
围绕着人道主义,个人的经历、意义、成长,并包括受培训及有经验的专家的参与(包括复元人士及照顾者)
实践的方式
医学模式
主要集中在疾病和病征,以减轻病征为基础,鼓励复元人士被动及顺从地适应康复计划
个人复元
着重了解个人情况,尊重复元人士的意愿,以个人希望、目标及能力为基础,让复元人士学会自我管理,促进自主权
服务目标
医学模式
目标为主医护人员主导,控制病情,预防复发,并回到病前的水平
个人复元
目标由复元人士主导,提升全人健康,对自己我的控制,不单恢复,更有成长和转变
*数据源: Slade, M. (2009). Differences between traditional and recovery-oriented services.
虽然「个人复元」和「医学模式」有着不同的地方,其实两者是可以并存的。当我们推行「个人复元」时,不代表不去减轻病征,亦不代表不重视治疗的科学性、病人的病历、诊断的结果、治疗,以及医护人员的参与等。
「个人复元」的突破
为什么要推行「复元」?因为…
1.
复元指的是无论你的身体状况如何,都可以有满足而丰盛的人生: 复元不是单单减少/减轻病征,更是能自己管理自己的生活,有满意的学业/工作表现,以及小区参与。
2.
复元过程是一个愈合和转化的旅程,复元人士可以自主地选择,过一个对自己有意义的人生,实现自己的潜能。
3.
复元亦包括包容、尊重及减少患病对复元人士的负面影响的过程,让复元人士发掘及建立自己的价值、兴趣,建立一个不单是「精神病患者」的身份及生活。
在复元的过程之中,除了复元人士有所改变,照顾他们的人亦会一起经历这些变化。因为在这个过程之中,不止是复元人士有情绪起伏,他们的家人、朋友或其他照顾者都会有感到不安、失落的时侯,亦有成长,感到有希望的时侯。 因此,「复元」包括了复元人士,亦包括了他们的家人/照顾者。

*数据源: Davidson et al., 2009, SAMHSA/div>
小区支援
社会的支持对复元人士非常重要。有研究指出有足够的社会支持能提升复元人士的心理健康、自尊心、自主权及倡导权、生活质素,从而有助个人的复元。接受过小区义工服务的复元人士亦表示感到更多的社会支持,而其全人健康亦有提升的趋势。
复元与家属的关系

1.
在复元的过程中,不只复元人士经历个人的改变及转化,家属也一起经历转化。
2.
家属会经历不安、失落,但同时也会经历成长,充满希望的时候。
3.
复元的对象是一个整体,包括了复元人士和他们的家属。
在明白复元的过程中,家属可以
1.
参与培训,学习如何协助复元人士 经过复元的过程;
2.
参与讨论、策划;
3.
参与及协助建立以复元为基础的服务。
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