Recovery is the normal adaptational process that follows destruction just like grief is the normal adaptational process that follows loss. Often the two processes supplement each other. The fluid stages of grief – denial, anger, bargaining, depression and acceptance – were first described in the complex context of death and dying, but have been found to be highly generalizable to other serious losses. Recovery has been described in a number of fields, our own work is in the complex context of serious mental illnesses, but any successful description ought to be highly generalizable to other serious destructions. Our present description has four fluid stages – hope, empowerment, self-responsibility, and having a meaningful role in life.

In the blackest times of despair what’s needed first is hope as a light at the end of the tunnel, some idea that things can get better, that life will be more than the present destruction. Without hope there’s no real possibility of positive action. To be truly motivating, however, hope has to be more than just an ideal. It has to take form as an actual image of how things could be if they were to improve. It’s not so much that people will attain precisely the vision they create, since realistically most outcomes are products of chance and opportunity more than careful planning. But is does seem essential to have some clear image, if people are to make difficult changes and take positive steps.

To move forward, people need to have a sense of their own capability, their own power. Their hope needs to be focused on things they can do rather than new cures or fixes someone else will discover or give to them. It is often needed for someone else to believe in them before they’re strong enough to believe in themselves and to start focusing on their strengths instead of their losses. It also often takes some actual experience of success to really believe one can be successful. Waiting until someone is ready to move on can often be stagnating and disempowering, because "readiness" often occurs only in retrospect after something has been done successfully.

At some point most people who recover realize that no one else can do it for them, that they have to take charge of their recoveries. People can, and often need, to be supported in their efforts to recover, but they can’t be caretaken or protected into recovery. Taking one’s own risks, setting one’s own goals and path, and learning one’s own lessons are essential parts of recovery. The appeals of dependency and being taken care of can derail a recovery as can being too frightened or traumatized to take risks.

Ultimately to recover one must achieve some meaningful role apart from the destruction. Becoming a destruction victim is not a recovered role, and frankly, neither is destruction survivor. After achieving increased hopefulness, inner strength and self responsibility, these traits are applied to meaningful roles apart from the destruction. The blackness of destruction that once seemed to swallow the person whole recedes in importance as the person’s other meanings emerge. Connectedness to other people, belonging, and feeling accepted, that may have for awhile only been possible with others who had experienced related destructions, within families, or with compassionate helpers becomes possible in a variety of contexts. The isolation and aloneness the destruction imposed is increasingly broken and life re-entered.

Put together as a coherent series of stages these descriptions can provide a roadmap, albeit a fluid one, of the process of recovery generally and can be applied specifically to our work in helping people recover from the destruction of serious mental illness.

The stages of grief have sometimes been applied to medical oncology service by including a specialized counselor or social worker. Sometimes a special hospice service is provided separately from the medical oncology service and "appropriate" people are referred to it when they are ready. Rarely an entire oncology service is built upon these stages and experiential values and it infuses the entire service. The stages of recovery have sometimes been applied to a psychiatric mental health service by including a specialized rehabilitation worker or consumer advocate. Sometimes a special rehabilitative or clubhouse service is provided separately from the psychiatric mental health service and "appropriate" people are referred to it when they are ready. Rarely an entire mental health service is built upon these stages and experiential values and it infuses the entire service. The Village Integrated Services Agency is an entire comprehensive, integrated mental health service built upon rehabilitation/recovery principles and values.

Now in our tenth year of proven success with a variety of people with serious mental illnesses, including homeless, jailed, " high-utilizing", state hospital, and conserved people, we have become a powerful model of a recovery based program. We have been involved in numerous efforts to spread our principles and practice, working towards widespread system change.