Chapter 2
Recovery and Beyond
Chapter Overview
This chapter traces the historical development, conceptual evolution, and ongoing debates surrounding the recovery model in community mental health, placing it within broader struggles for citizenship, social justice, and human rights. Starting with deinstitutionalization and the rise of community-based services, the authors explore how early service models often reinforced maintenance-focused practices and professional pessimism despite increased access to care. Using research, lived-experience narratives, and policy developments, the chapter documents the emergence of recovery as a counter-narrative to chronicity, as conceptualized by Bill Anthony’s influential reframing of recovery as a guiding vision rather than a specific clinical outcome. The chapter critically examines efforts to define, operationalize, and measure recovery, highlighting tensions between subjective lived experience and objective indicators such as symptom remission and social functioning. Special attention is given to critiques from psychiatric survivor movements, which argue that professionalized versions of recovery risk appropriating and diluting its emancipatory roots. The authors promote citizenship as a necessary extension of recovery, emphasizing participation, inclusion, agency, and social belonging as key outcomes of mental health services. Ultimately, the chapter contends that recovery-oriented practice must go beyond individual change to address structural barriers, coercive practices, and social inequalities. Re-centering lived experience, narrative authority, and rights-based frameworks is presented as essential to realizing recovery as both a personal and collective effort.
Reflective Questions
Designed to encourage critical thinking, real-world application, and meaningful discussion.
- How does the chapter define recovery differently from symptom remission?
- What historical forces shaped the recovery movement?
- How do agencies sometimes adopt recovery language without structural change?
Resource Connect
Links to professional standards, policy frameworks, and cross-referenced chapters that support deeper exploration.
SAMHSA Recovery Support Strategic Initiative
Substance Abuse and Mental Health Services Administration. (2012). SAMHSA’s working definition of recovery: 10 guiding principles of recovery (HHS Publication No. PEP12-RECDEF). U.S. Department of Health and Human Services. This official document connects the Recovery Support Strategic Initiative with four dimensions of recovery—health, home, purpose, and community—and ten guiding principles.
NASW Code of Ethics: Self-Determination
National Association of Social Workers. (2021). Code of ethics of the National Association of Social Workers: Standard 1.02, Self-Determination. Standard 1.02 addresses clients’ right to identify and pursue their own goals, subject to limited exceptions involving serious, foreseeable, and imminent risk.
CMS Guidance on Medicaid Reimbursement for Peer Support Services
- Centers for Medicare & Medicaid Services. (2007, August 15). State Medicaid Director Letter #07-011: Peer support services. This foundational guidance addresses Medicaid coverage, reimbursement, provider qualifications, supervision, training, care coordination, and plans of care.
- Centers for Medicare & Medicaid Services. (2013, May 1). Clarifying guidance on peer support services policy. This clarification expands on the 2007 guidance, including peer support provided to parents and legal guardians for the benefit of Medicaid-eligible children.
Cross-reference: Chapter 3 – Replacing Stigmatizing Beliefs and Behaviors
Further Resources
Suggested readings, research areas, and materials for extended learning.
Recovery-Oriented Practice
Davidson, L., Tondora, J., Lawless, M. S., O’Connell, M. J., & Rowe, M. (2009). A practical guide to recovery-oriented practice: Tools for transforming mental health care. Oxford University Press.
Intentional Peer Support
Mead, S., & MacNeil, C. (2006). Peer support: What makes it unique? International Journal of Psychosocial Rehabilitation, 10(2), 29–37. The Intentional Peer Support site provides access to the article and related writings by Shery Mead.
State Medicaid Coverage and Reimbursement Guidelines
Medicaid and CHIP Payment and Access Commission. (2019). Recovery support services for Medicaid beneficiaries with a substance use disorder. This issue brief includes a 50-state policy review of Medicaid coverage and payment for peer support and other recovery-support services. Because Medicaid requirements vary by state and change over time, readers should also consult the current Medicaid provider manual and state plan for their jurisdiction.
Lived-Experience Leadership, Panels, and Podcasts
- Substance Abuse and Mental Health Services Administration. (2025). Family peer support services: Broadening the view. This resource summarizes insights from people with lived experience participating as family members, advocates, leaders, and peer-support providers.
- National Alliance on Mental Illness. (2023). You Are Not Alone: Voices of Recovery. This podcast series presents first-person accounts from people living with mental health conditions and their families.
- National Alliance on Mental Illness. (2025). You Are Not Alone: Building a Life with a Diagnosis of Mental Illness. This recorded, SAMHSA-sponsored panel features three people discussing living well in recovery and what behavioral-health professionals should understand about patient-centered care.