CRITICAL REFLECTION ON PRACTICE DEVELOPMENT Recovery oriented conversations in a milieu therapeutic setting

Background: Norwegian health authorities place emphasis on recovery oriented practices in mental health services. Recovery is described as an active process with a focus on personal resources and supportive contexts. In the recovery process, the relationship between the person and the carer is of great importance. Conversation is a meaningful approach for developing a trusting relationship. Conversation also has importance in itself, because it establishes the foundation for human contact and gives the client the opportunity to be acknowledged as a person. Aim: The aim of the study was to describe and explore what health professionals focused on in recovery oriented conversations with patients in a Norwegian mental healthcare centre. Methods: This study was part of an action research project and had a qualitative and explorative design. Data were collected in multistage focus groups and were analysed using qualitative content analysis. Findings: The findings highlighted the prerequisites for conversation, the content of conversation and different views on the topics of conversation. Conclusions: The findings contribute knowledge about what promotes or inhibits recovery oriented conversations. Such conversations focus on the patients’ everyday life, appreciating them as actors in their own lives, and facilitate shared decision making processes and working with hope. The study demonstrates that individual, cultural and contextual aspects play an important part in recovery oriented conversations. Implications for practice: • Practice development involves acknowledging and re-evaluating the possibilities for using conversations with patients as an approach and as a tool in person-centred and recovery oriented practices • Relational competence is an essential part of enhancing recovery oriented conversation, and needs to be attended to in skills training and competence building • Awareness and critical analysis of the clinical context is important to promote an active and participative patient role. Authoritarian cultures with concern about what is permitted or not may well be a barrier to shared decision making