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For nearly 20 years, the U.S. Substance Abuse and Mental Health Services Administration (SAMHSA) has fostered social inclusion for Americans with mental and/or substance use disorders. SAMHSA has done this by promoting the recovery paradigm, an approach predicated on a positive, strength-based, and person-centered view of those with behavioral health conditions. SAMHSA has provided leadership by promoting policies, programs, practices, and public awareness initiatives that advance recovery, recovery support services, and recovery-oriented service delivery systems. SAMHSA’s approach has been participatory, engaging a variety of stakeholders, and comprehensive, focusing on multiple strategies in targeted priority areas., Depuis presque 20 ans, the U.S. Substance Abuse and Mental Health Services Administration (SAMHSA) a favorisé l’inclusion sociale des États-uniens ayant des troubles de santé mentale ou de consommation de substances. SAMHSA a fait la promotion du paradigme du rétablissement, une approche positive et centrée sur la personne ayant des troubles de comportement et prenant en considération ses forces. SAMHSA s’est avéré un leader en la matière, fournissant des politiques, des programmes, des pratiques et des initiatives de sensibilisation du public facilitant le rétablissement, les services de soutien au rétablissement, et les systèmes de prestation de service liés au rétablissement. L’approche de SAMHSA est participative, engageant une série d’acteurs, et globale, se concentrant sur des stratégies multiples dans des domaines prioritaires.

Narrative Exposure Therapy (NET) is a relatively novice treatment that may be beneficial for use with individuals who suffer from Post-traumatic Stress Disorder (PTSD). The aim of this review was to explore the mechanism, evidence-base and effectiveness of NET in remediating PTSD symptoms. A literature search was carried out using Medline, PsycINFO, EMBASE and The Cochrane Central Register of Controlled Trials (CENTRAL). Reference lists of papers, review articles and grey literature were also hand searched. Findings were presented in a narrative review. The emerging research on NET presents it as a potentially effective and accessible treatment of PTSD symptoms though careful consideration of cultural issues must be made prior to and during application. Current research on NET provides evidence on its effectiveness especially with refugee populations for whom it was initially intended. It also has additional attractive characteristics such as its accessibility and cultural consideration. However methodological limitations of existing studies, in particular the small sample sizes, have to be noted., peer-reviewed

La práctica del consentimiento informado (CI) en Salud Mental es inhabitual, más aún para los pacientes psicóticos, a pesar de que tanto la legislación vigente, como las declaraciones de asociaciones profesionales, organizaciones de pacientes y códigos deontológicos defienden el consentimiento informado y la autonomía del paciente, también para las personas con psicosis. Es habitual que pacientes y allegados desconozcan el alcance, límites y riesgos del tratamiento farmacológico usual o la existencia de otros abordajes Las razones del déficit de CI pueden hallarse en las peculiaridades de estos pacientes, pero también en el presupuesto de que la psicosis impacta en el mismo núcleo de la persona, y por ello se ve al afectado como incapaz de comprender y consentir. Coexisten hoy dos estilos diferentes de acoger al paciente con dificultades de tipo psicótico: uno, la corriente principal que tiene como objetivo bloquear el proceso psicótico y revertirlo mediante el uso principal de antipsicóticos, y otro, que incluye diversos modelos que acogen a la persona psicótica con sus dificultades, que propone construir un marco de comprensión para sus experiencias. Los resultados no muestran superioridad del modelo dominante, más bien todo lo contrario. Cuando se da la palabra a los usuarios estos defienden su autonomía y derecho a decidir, rechazando los modelos coercitivos. El CI, dar poder para decidir al paciente, además de un derecho es también un factor de recuperación para muchos pacientes. Su puesta en práctica necesitaría cambios significativos en la formación de los profesionales y en la constitución de las actuales Redes Asistenciales de Salud Mental., Informed consent (IC) in Mental Health care is unusual, especially for psychotic patients. However, current legislation, statements of professional associations, patient organizations and deontological codes advocate informed consent and patients' autonomy, also for people with psychosis. Patients and their relatives usually are unaware of the scope, limits and risks of drug treatment and the existence of other approaches. The reasons for the IC’s lack can be found in the peculiarities of these patients, but also on the assumption that psychosis impacts the core of the person, and therefore they are unfit of understanding and consent. Today there are two different ways to receive the patient with psychosis problems: first, the mainstream whose objective is to block the process and reverse psychotic symptoms principally using antipsychotics drugs, and another one, that includes various clinic models, that receive psychotic person with their difficulties, proposing to build a framework of understanding for their experiences. The outcomes don’t reveal superiority for the mainstream model, rather the opposite. When listening to the users, they clearly opt for their autonomy and right to choose, rejecting coercive models. Informed consent is a right that empowers the patients and also a recovery factor for many of them. Its implementation will require significant changes in the training of professionals and in the current Mental Health Care networks.

Informed consent (IC) in Mental Health care is unusual, especially for psychotic patients. However, current legislation, statements of professional associations, patient organizations and deontological codes advocate informed consent and patients' autonomy, also for people with psychosis. Patients and their relatives usually are unaware of the scope, limits and risks of drug treatment and the existence of other approaches. The reasons for the IC’s lack can be found in the peculiarities of these patients, but also on the assumption that psychosis impacts the core of the person, and therefore they are unfit of understanding and consent. Today there are two different ways to receive the patient with psychosis problems: first, the mainstream whose objective is to block the process and reverse psychotic symptoms principally using antipsychotics drugs, and another one, that includes various clinic models, that receive psychotic person with their difficulties, proposing to build a framework of understanding for their experiences. The outcomes don’t reveal superiority for the mainstream model, rather the opposite. When listening to the users, they clearly opt for their autonomy and right to choose, rejecting coercive models. Informed consent is a right that empowers the patients and also a recovery factor for many of them. Its implementation will require significant changes in the training of professionals and in the current Mental Health Care networks. La práctica del consentimiento informado (CI) en Salud Mental es inhabitual, más aún para los pacientes psicóticos, a pesar de que tanto la legislación vigente, como las declaraciones de asociaciones profesionales, organizaciones de pacientes y códigos deontológicos defienden el consentimiento informado y la autonomía del paciente, también para las personas con psicosis. Es habitual que pacientes y allegados desconozcan el alcance, límites y riesgos del tratamiento farmacológico usual o la existencia de otros abordajes Las razones del déficit de CI pueden hallarse en las peculiaridades de estos pacientes, pero también en el presupuesto de que la psicosis impacta en el mismo núcleo de la persona, y por ello se ve al afectado como incapaz de comprender y consentir. Coexisten hoy dos estilos diferentes de acoger al paciente con dificultades de tipo psicótico: uno, la corriente principal que tiene como objetivo bloquear el proceso psicótico y revertirlo mediante el uso principal de antipsicóticos, y otro, que incluye diversos modelos que acogen a la persona psicótica con sus dificultades, que propone construir un marco de comprensión para sus experiencias. Los resultados no muestran superioridad del modelo dominante, más bien todo lo contrario. Cuando se da la palabra a los usuarios estos defienden su autonomía y derecho a decidir, rechazando los modelos coercitivos. El CI, dar poder para decidir al paciente, además de un derecho es también un factor de recuperación para muchos pacientes. Su puesta en práctica necesitaría cambios significativos en la formación de los profesionales y en la constitución de las actuales Redes Asistenciales de Salud Mental.

Research on recovery from addictive substances is necessary to provide a more complete picture of the addictive process. The proposed research was developed to further expand the knowledge base regarding the process of recovery with respect to two potential components of that process: spirituality and identity. First, spirituality has been considered a key component of recovery by adherents of the 12-Step model of recovery but has not been empirically validated within that context. As a concept, spirituality has not been well understood by researchers and many professionals, has often been defined solely as religiosity, and has frequently been regarded with disdain and/or suspicion. In this study, spirituality will be operationally defined and tested as a predictor of recovery. Second, early experience with substance use has been found to interfere with (e.g., delay, block)adequate resolution of relevant issues of psychosocial development, especially the identity crisis. Inadequate psychosocial development may also interfere with a person's ability to understand and commit to spirituality. Poor resolution of the identity crisis, then, may directly influence recovery and indirectly influence the association between spirituality and recovery. Therefore, assessment of the fifth stage of psychosocial development (identity versus role confusion) will be addressed in this research. The primary focus of this study is to examine the empirical association of the concept of recovery with several dimensions of spirituality and identity and to determine whether recovery acts as an intervening variable between identity and spirituality.