Recovery and medical model – yes, science does matter

Authors' reply We welcome Holloway's (2008) commentary on our article ‘Recovery and the medical model’ (Mountain & Shah, 2008) and agree that the article raises further questions. We would, however, like to clarify that the medical model described relates to evidenced interventions practised by a range of professionals, including doctors. Doctors are certainly not the only professional group to use evidenced-based interventions. We agree that the task of answering the question ‘Does recovery work?’ is complex and Holloway helpfully describes some of the methodologies that may have to be deployed.

We acknowledge that by using the four elements of Resnick's work other important themes, such as meaning and self-management, were not explored. However, should Resnick's work be considered less relevant than the work of others? Of course the user perspective is central to the recovery agenda but this raises the issue of professional involvement in this agenda. In the same way that users advocate to be active participants in their care, professionals should also be actively included as equal partners to progress and mainstream recovery practice. If this is not encouraged, the view of psychiatrists as authoritarian and of professional care as ‘something to get away from’ could be needlessly promulgated, to the detriment of both parties and of developing recovery-oriented services. The relationship is complex, given service users' drive for self-determination, influenced by their experience of professional care and complicated by the potential power differential between the professionals and the often vulnerable individuals seeking their help. However, in working together to understand and develop recovery-based practice we must not let that dynamic persist. It is in developing humanistic skills while not foregoing our other professional skills that we find more in common with our patients than what separates us. This could be the common ground allowing all parties to use their unique sets of skills and capacities.