title: Recovery in Mind: Perspectives from Postgraduate Psychiatric Trainees.
abstract: OBJECTIVE
  The authors assessed psychiatric trainees' understanding of recovery-oriented care, a therapeutic philosophy with varied meanings but wide purchase in contemporary mental health policy.
  
  
  METHODS
  Four cohorts of residents were presented with a clinical vignette as part of a written curricular evaluation and asked what it would mean to engage the patient from a recovery-oriented perspective. Responses were subjected to qualitative analysis, with the analysts examining each cohort independently, then meeting to discuss their findings and build consensus on the most pertinent themes.
  
  
  RESULTS
  Nine themes emerged in trainees' understanding of recovery-oriented care: (1) a person is more than his or her illness; (2) hope; (3) an emphasis on patient goals; (4) taking a collaborative approach; (5) an emphasis on level of social function; (6) valuing subjective experience; (7) psychosocial interventions; (8) empowerment of the patient; and (9) persistence of traditional attitudes.
  
  
  CONCLUSIONS
  Residents revealed an understanding of recovery that reflected many, but not all, of the guiding principles in the Substance Abuse and Mental Health Services Administration's 2010 working definition. For many of these trainees, recovery-oriented care signified a shift in the traditional power dynamic between physician and patient that allowed patients to take an active role in their own care. Residents also recognized the importance of hope and the complexity of their patients' social identities, though some trainees had difficulty reconciling a collaborative approach with their perceived responsibilities as physicians. If educators wish to incorporate elements of the American Psychiatric Association's Recovery to Practice initiative into their curricula, they would do well to recognize residents' variable receptivity to elements of the model.
authors.affiliation: University of Illinois College of Medicine at Chicago, Chicago, IL, USA. matthew.gambino@va.gov.
authors.forename: Matthew
authors.initials: M
authors.lastname: Gambino
authors.affiliation: Yale School of Medicine, New Haven, CT, USA.
authors.forename: Anthony
authors.initials: A
authors.lastname: Pavlo
authors.affiliation: Yale School of Medicine, New Haven, CT, USA.
authors.forename: David A
authors.initials: DA
authors.lastname: Ross
mesh_terms: D001291:Attitude of Health Personnel; D032882:Comprehension; D006801:Humans; D010347:Patient Care Planning; D010358:Patient Participation; D000067250:Psychiatric Rehabilitation; D011570:Psychiatry / Q000193:education*; D036301:Qualitative Research
keywords: Biopsychosocial formulation; Psychiatric education; Recovery model; Recovery-oriented care