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Recovery is a key goal for individuals, and services’ recovery orientation can facilitate this process. The independent mental health sector is increasingly important in Ireland, particularly in counselling and suicide prevention. We aimed to evaluate Pieta House as a recovery-oriented service through clients’ self-rated recovery; and clients’ and therapists’ evaluation of the service.
Methods
Clients completing therapy over a 3-month period were invited to complete the Recovery Assessment Scale (RAS) and the Recovery Self Assessment-Revised (RSA-R). Therapists completed the RSA-R staff version.
Results
Response rate was 36.7% for clients (n=88), 98% for therapists (n=49). Personal recovery was endorsed by 73.8% of clients, with highest agreement for factors ‘Willingness to Ask for Help’ (84.5%), and ‘Reliance on Others’ (82.1%). A smaller number agreed with factors ‘Personal Confidence and Hope’ (61.3%) and ‘No Domination by Symptoms’ (66.6%). Clients’ and therapists’ evaluation of the service showed high levels of agreement with factors of ‘Choice’ (90.9% clients, 100% therapists); ‘Life Goals’ (84.1% clients, 98% therapists) and ‘Individually Tailored Services’ (80.6% clients, 79.6% therapists). Client involvement in service management had the lowest level of agreement (36.4% clients, 30.6% therapists). Clients’ self-rated recovery correlated with their rating of the service (correlation value 0.993, p=0.01).
Conclusions
Clients’ self-rated recovery and the recovery orientation of Pieta House were rated highly, with areas for improvement in service user involvement, peer support and advocacy. The correlation of personal recovery and recovery orientation of the service may merit further study.
Kantian paternalism (KP) allows for paternalistic interference in order to help agents achieve the rationally chosen ends that constitute their conception of the good. It offers a necessary condition on paternalistic interference because it recognizes that the moral and non-moral costs of such interference can sometimes outweigh its benefits. Central to KP is the notion that paternalism is warranted when agents exhibit a certain form of instrumental irrationality. Intuitively, there is a difference between an agent irrationally choosing inadequate means to her chosen end and an irrational agent choosing inadequate means to her chosen end. The main normative power is the power of instrumental rationality, the power to determine the most effective means to the ends that constitute the conception of the good. Characterizations of rational suicide treat an individual's interests in a realist manner, as if what constitutes an individual's interests is wholly independent of her actual attitudes.
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