Cambridge University Press 978-1-107-54305-8 — Wellbeing, Recovery and Mental Health Edited by Mike Slade , Lindsay Oades , Aaron Jarden Frontmatter More Information

Wellbeing, Recovery and Mental Health

© in this web service Cambridge University Press www.cambridge.org Cambridge University Press 978-1-107-54305-8 — Wellbeing, Recovery and Mental Health Edited by Mike Slade , Lindsay Oades , Aaron Jarden Frontmatter More Information

Wellbeing, Recovery and Mental Health

Edited by Mike Slade Professor of Mental Health Recovery and Social Inclusion, Institute of Mental Health, School of Health Sciences, University of Nottingham, United Kingdom Lindsay G. Oades Associate Professor of Positive Psychology, Centre for Positive Psychology, Graduate School of Education, , Aaron Jarden Senior Lecturer in Psychology and Research Oi cer at the Human Potential Centre, Auckland University of Technology, Auckland, New Zealand

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www.cambridge.org Information on this title: www.cambridge.org/9781107543058 © Cambridge University Press 2017 h is publication is in copyright. Subject to statutory exception and to the provisions of relevant collective licensing agreements, no reproduction of any part may take place without the written permission of Cambridge University Press. First published 2017 Printed in the United Kingdom by Clays, St Ives plc A catalogue record for this publication is available from the British Library. Library of Congress Cataloguing in Publication data Names: Slade, Mike, editor. | Oades, Lindsay G., editor. | Jarden, Aaron, editor. Title: Wellbeing, recovery and mental health / edited by Mike Slade, Lindsay Oades, Aaron Jarden. Description: Cambridge ; New York : Cambridge University Press, 2016. | Includes bibliographical references and index. Identii ers: LCCN 2016021863 | ISBN 9781107543058 (paperback) Subjects: | MESH: Personal Satisfaction | Psychotherapy – methods | Happiness | Mental Disorders – therapy | Psychiatric Rehabilitation – methods Classii cation: LCC RC480 | NLM WM 420 | DDC 616.89/14 – dc23 LC record available at https://lccn.loc.gov/2016021863 ISBN 978-1-107-54305-8 Paperback Cambridge University Press has no responsibility for the persistence or accuracy of URLs for external or third-party internet websites referred to in this publication, and does not guarantee that any content on such websites is, or will remain, accurate or appropriate.

Every ef ort has been made in preparing this book to provide accurate and up-to-date information which is in accord with accepted standards and practice at the time of publication. Although case histories are drawn from actual cases, every ef ort has been made to disguise the identities of the individuals involved. Nevertheless, the authors, editors and publishers can make no warranties that the information contained herein is totally free from error, not least because clinical standards are constantly changing through research and regulation. h e authors, editors and publishers therefore disclaim all liability for direct or consequential damages resulting from the use of material contained in this book. Readers are strongly advised to pay careful attention to information provided by the manufacturer of any drugs or equipment that they plan to use.

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Contents

List of Contributors page vii Foreword by Martin Seligman xi

1 Why Wellbeing and Recovery? 1 Section 2: What Does a Mike Slade, Lindsay G. Oades and Aaron Jarden Wellbeing Orientation Mean in Mental Health Services? Section 1: Where Are We Now? 9 Collaborative Recovery Model: 2 The Science of Wellbeing and From Mental Health Recovery to Positive Psychology 7 Wellbeing 99 Lindsay G. Oades and Lara Mossman Lindsay G. Oades, Frank P. Deane and Trevor P. Crowe 3 Recovery and Mental Health 24 Mike Slade and Genevieve Wallace 10 Positive Psychotherapy: A Wellbeing Approach to Recovery 111 4 35 Wellbeing Policy: An Overview Tayyab Rashid, Ryan N. Howes and Dan Weijers and Aaron Jarden Ruth Louden 5 Positive Psychology and Severe 11 WELLFOCUS PPT for Psychosis 133 Mental Ill Health: Strengths- Beate Schrank, Simon Riches and Based Cognitive–Behavioural Mike Slade Interventions in Psychosis 46 Pawel D. Mankiewicz and Julia C. 12 Mobile Health for Illness Renton Management 147 Dror Ben-Zeev and Nidhi Badiyani 6 Conceptual Framework for Wellbeing in Psychosis 59 13 Wellbeing and Recovery in the Mike Slade and Beate Schrank Emergency Services: How Do We Care for Those Who Care for Us? 157 7 75 Meaning in Life and Wellbeing Kristen Hamling and Aaron Jarden Michael F. Steger 14 Recovery Learning Communities 8 The Complete State Model of and the Road to Wellbeing 169 86 Mental Health Deborah Delman and Jonathan Corey L. M. Keyes and Chris C. Delman Martin

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vi Contents

1 5 Recovery Colleges and 21 Positive Tertiary Education in a Co-production 181 Residential Setting: Kooloobong Geof Shepherd, Jane McGregor, Sara Village 265 Meddings and Waldo Roeg Lindsay G. Oades and Gordon B. Spence 16 Wellbeing in Non-Western Cultures 194 22 Living Well in Cities: Towards a Samson Tse Location-Based Model of Perceived Urban Liveability 277 Section 3: Beyond Services: Pascal Perez and Mohammad-Reza Namazi-Rad What Would a Recovery- 23 Wellbeing-Enhancing Workplaces Supporting and Wellbeing- Kathryn M. Page, Allison J. Milner, Targeted Society Look Like? Amanda Allisey, Andrew Noblet and Anthony D. LaMontagne 289 17 Wellbeing Policy in Australia and 24 New Zealand 207 Need-Supportive Parenting and its Role in the Wellbeing and Recovery Rebecca Jarden, Aaron Jarden and of Individuals: A Self-Determination Lindsay G. Oades Theory Perspective 300 18 Population Level: Wellbeing in the Christopher P. Niemiec and Justin C. General Population 215 Coulson Sarah Stewart-Brown 25 Social Marketing of Wellbeing 311 19 Community Level: Translating Ross Gordon and Lindsay G. Oades Wellbeing Policy, Theory and 26 Evidence into Practice 231 Wellbeing and Recovery: A Possible Future 324 Tony Coggins Lindsay G. Oades, Mike Slade and 20 Positive Education: Visible Aaron Jarden Wellbeing and Positive Functioning in Students 245 Lea Waters, Jessie Sun, Reuben Rusk, Alice Cotton and Alice Arch Index 333

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Contributors

Amanda Allisey Deborah Delman Deakin Business School, Deakin Executive Director, h e Transformation University, Melbourne, Victoria, Australia Center, Roxbury, Massachusetts, US Alice Arch Jonathan Delman Melbourne Graduate School of Education, Systems and Psychosocial Advances Research University of Melbourne, Parkville, Center (SPARC), Department of Psychiatry, Victoria, Australia University of Massachusetts Medical School, Worcester, Massachusetts, US Nidhi Badiyani mHealth for Mental Health Program, Ross Gordon Geisel School of Medicine at Dartmouth Senior Lecturer in Marketing, Department College, Hanover, New Hampshire, US of Marketing and Management, Macquarie University, Sydney, New South Wales, Dror Ben-Zeev Australia mHealth for Mental Health Program, Geisel School of Medicine at Dartmouth Kristen Hamling College, Hanover, New Hampshire, US Faculty of Health and Environmental Sciences, Auckland University of Tony Coggins Technology, Auckland, New Zealand Head of Mental Health Promotion, South London and Maudsley NHS Foundation Ryan N. Howes Trust, London, UK University of Toronto Scarborough, Toronto, Ontario, Canada Alice Cotton Melbourne Graduate School of Education, Aaron Jarden University of Melbourne, Parkville, Senior Lecturer in Psychology and Victoria, Australia Research Oi cer at the Human Potential Centre, Auckland University of Justin C. Coulson Technology, Auckland, New Zealand Centre for Positive Psychology, Melbourne Graduate School of Education, University Rebecca Jarden of Melbourne, Melbourne, Victoria, Lecturer in Nursing, School of Clinical Australia Sciences, Auckland University of Technology, Auckland, New Zealand Trevor P. Crowe Illawarra Institute for Mental Health, School Corey L. M. Keyes of Psychology, , Department of Sociology, Emory Wollongong, New South Wales, Australia University, Atlanta, Georgia, US Frank P. Deane Anthony D. LaMontagne Illawarra Institute for Mental Health, Centre for Population Health Research, School of Psychology, University of School of Health & Social Development, Wollongong, Wollongong, New South Deakin University, Melbourne, Victoria, Wales, Australia Australia vii

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viii List of Contributors

Ruth Louden Lindsay G. Oades University of Toronto Scarborough, Associate Professor of Positive Psychology, Toronto, Ontario, Canada Centre for Positive Psychology, Melbourne Graduate School of Education, University Jane McGregor of Melbourne, Melbourne, Victoria, Independent education researcher Australia Pawel D. Mankiewicz Kathryn Page National Health Service, North-East Deakin Population Health Strategic London NHS Foundation Trust, Early Research Centre, School of Health & Intervention in Psychosis, London, UK Social Development, Deakin University, Chris C. Martin Melbourne, Victoria, Australia Department of Sociology, Emory Pascal Perez University, Atlanta, Georgia, US Professor and Director, SMART Sara Meddings Infrastructure Facility, University of Consultant Clinical Psychologist, Sussex Wollongong, Wollongong, New South Partnership NHS Foundation Trust, Wales, Australia Horsham, UK Tayyab Rashid Allison J. Milner Health & Wellness Centre, University of Centre for Population Health Research, Toronto Scarborough, Toronto, Ontario, School of Health & Social Development, Canada Deakin University, Melbourne, Victoria, Julia C. Renton Australia, and Centre for Health Equity, National Health Service, South Essex School of Population and Global Health, Partnership University NHS Foundation University of Melbourne, Melbourne, Trust, Dunstable, UK Victoria, Australia Simon Riches Lara Mossman Institute of Psychiatry, King’s College Centre for Positive Psychology, Melbourne London, London, UK Graduate School of Education, University of Melbourne, Melbourne, Victoria, Waldo Roeg Australia Peer Recovery Trainer, Central and North West London NHS Foundation Trust, Mohammad-Reza Namazi-Rad London, UK Senior Honorary Research Fellow, University of Wollongong, Wollongong, Reuben Rusk New South Wales, Australia Melbourne Graduate School of Education, University of Melbourne, Melbourne, Christopher P. Niemiec Victoria, Australia Senior Lecturer and Research Associate, Department of Clinical and Social Sciences Beate Schrank in Psychology, University of Rochester, Division of Social Psychiatry, Department Rochester, New York, US of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria Andrew Noblet Deakin Business School, Deakin Geof Shepherd University, Melbourne, Victoria, Senior Consultant, ImROC Programme, Australia Centre for Mental Health, London, UK

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List of Contributors ix

Mike Slade Samson Tse Professor of Mental Health Recovery Associate Dean (Undergraduate and Social Inclusion, Institute of Mental Education), Faculty of Social Sciences and Health, School of Health Sciences, Professor of Mental Health, Department University of Nottingham, UK of Social Work and Social Administration, h e University of Hong Kong, Hong Kong Gordon B. Spence Senior Lecturer, University of Wollongong, Genevieve Wallace Wollongong, New South Wales, Australia King’s College London, London, UK Michael F. Steger Lea Waters Director of the Center for Meaning and Professor and Gerry Higgins Chair in Purpose, Department of Psychology, Positive Psychology, Melbourne Graduate Colorado State University, Fort Collins, School of Education, University of Colorado, USA, and North-West Melbourne, Melbourne, Victoria, Australia University, Vanderbijlpark, Gauteng, Dan Weijers South Africa Lecturer in Philosophy, School of Social Sarah Stewart-Brown Sciences, University of Waikato, Hamilton, Professor, Warwick Medical School, N e w Z e a l a n d University of Warwick, Coventry, UK Jessie Sun Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Victoria, Australia

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F o r e w o r d

“Doctor, I hope you can cure what I have.” “Mister, I hope you have what I can cure.” When I started out as a therapist forty years ago, it was common for my patients to tell me, “I just want to be happy.” I replied, “You mean you want to get rid of depression.” Back then we did not have the tools for building well-being and, blinded by Freud and Schopenhauer (who taught that the best humans can ever do is to minimize their own misery), I had not even become aware of the dif erence. What I had was only the tools for relieving depression. But every person, every patient “just wants to be happy,” and this legitimate goal combines relieving suf ering and building well-being. Cure, to my way of thinking, uses the entire arsenal for minimizing misery – drugs and psychotherapy – and combines these with positive psychology. Further, being happy is every person’s birthright. And importantly for this volume, learning well-being may circle back and ameliorate misery. h e dirty little secret of biological psychiatry and of clinical psychology is that they both have given up the notion of cure. Cure takes too long, if it can be done at all, and only brief treatment is reimbursed by insurance companies. So therapy and drugs are now entirely about short-term crisis management and about dispensing cosmetic treatments. But pro- gress has come to a dead end at symptom relief. h ere are no curative drugs, and no drug is in development that I know of that aims at cure. I am by no means a Freudian, but one thing that I think was exemplary about Freud is that he was at er cure. Freud wanted a psy- chotherapy that worked like an antibiotic – killing the bacteria. Freud’s talking cure was an attempt to cure patients by ridding them of symptoms forever using insight and catharsis. h e decline of the Freudian inl uence, but much more importantly the stringencies of man- aged care, has seduced psychology and psychiatry into working only on symptom relief and not on cure. I’ve spent a good part of my life measuring the ef ects of psychotherapy and of drugs, and here’s another dirty little secret: almost always the ef ects are what is technically called “small.” Depression is typical. Consider two treatments that are certii ed by vast literatures to “work”: cognitive therapy of depression and selective serotonin reuptake inhibitors (SSRIs, e.g. Prozac). Taking an average over the entire huge literature, for each you get a 65% relief rate, accompanied by a placebo ef ect that ranges from 45% to 55%. h is 65% rate crops up over and over, whether you’re looking at percentage of patients or at percentage of relief of symptoms within patients. I call this problem “the 65% barrier.” Why is there a 65% barrier and why are the ef ects so small? From the i rst day I took up skiing until i ve years later when I quit, I was always i ghting the mountain. Skiing was never easy. Every form of psychotherapy I know, every exercise, is a “i ghting the mountain” intervention. In other words, these therapies are not self-reinforcing and so they fail to maintain themselves. In general, therapeutic techniques all share the prop- erty of being dii cult to do, no fun at all, and so they are dii cult to incorporate into your life. In fact, the way we measure how ei cacious therapies are is by how long they last before they “melt” once treatment ends. Every single drug has exactly the same property: once you stop taking the drug you are back to square one, and recurrence and relapse are the rule.

xi

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xii Foreword

Many of the positive interventions you will read about in this volume are, in contrast, self-maintaining – they are fun. In the therapeutic century we’ve just lived through, the therapist’s job was to minimize negative emotion: to dispense drugs or psychological interventions that make people less anxious, angry, or depressed. h ere is another, more realistic approach to dysphoria, how- ever: learning to function well even if you are sad or anxious or angry – in other words, dealing with it . h is posture emerges from the most important (and most politically uncongenial) research i nding in the i eld of personality of the last quarter of the 20th century. h is rock-solid i nd- ing disillusioned an entire generation of environmentalist researchers (me included), but it is true that most personality traits are highly heritable, and dysphorias ot en stem from these personality traits. Strong biological underpinnings predispose some of us to sadness, anxiety, and anger. h erapists can modify these emotions but only within limits. What can a therapist do if the heritability of dysphoria is one cause of the 65% barrier? Oddly enough, therapists can use information from the way that snipers are trained. (I’m not endorsing sniping, by the way; I only want to describe how training is done.) It takes about 24 hours for a sniper to get into position. And then it can take another 36 hours to get of the shot. h is means that snipers typically haven’t slept for two days before they shoot. h ey’re dead tired. Now, let’s say the army went to a psychotherapist and asked how she would train a sniper. She would use wake-up drugs or psychological interven- tions that relieve sleepiness (a rubber band on the wrist snapping you into temporary alertness ). h at is not how snipers are trained, however. To train them, you keep them up for three days, and you have them practice shooting when they are dead tired. h at is, you teach snipers to deal with the negative state they’re in: to function well in the presence of fatigue. h e modii ability of negative emotions and negative personality traits has very strong biological limits, and the best you can ever do with the cosmetic approach is to get patients to live in the best part of their set range of depression or anxiety or anger. h ink about Abraham Lincoln and Winston Churchill, two severe unipolar depressives. h ey were both enormously well-functioning human beings who dealt with their “black dog” and their sui- cidal thoughts (Lincoln likely tried to kill himself in January 1841). Both learned to func- tion extremely well even when they were massively depressed. So one thing that clinical psychology needs to develop in light of the heritable stubbornness of human pathologies is a psychology of “dealing with it.” We need to tell our patients, “Look, the truth is that many days – no matter how successful we are in therapy – you will wake up blue and hopeless. Your job is not only to i ght these feelings but also to live heroically: functioning well even when you are very sad.” h is volume discusses a new approach to cure that goes beyond this realism. It is possible that the positive interventions may break through the 65% barrier and move psychotherapy beyond cosmetic symptom relief toward cure. Psychotherapy and drugs as they now are used are half-baked. At their very, very best they remove the internal disabling conditions of life. Removing the disabling conditions, however, is not remotely the same as building the enabling conditions of life. If we want to l ourish and to have well-being, we must indeed minimize our misery, but in addition we must have positive emotion, meaning, accomplishment, and positive relationships.

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Foreword xiii

h e skills of l ourishing – of having positive emotion, meaning, good work, and positive relationships – are something over and above the skills of minimizing suf ering. h ese skills are documented to build well-being, and they also may act to relieve psychopathology itself. h is volume tells their story. Martin Seligman

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