The Center

Psychiatric Rehabilitation – Choosing a Valued Role

Updated: June 21, 2006

Choosing a life goal that leads to success and personal satisfaction is not always an easy process for recipients of mental health services. For many reasons, especially a lack of opportunity and limited life experience, recipients struggle with making decisions that are well informed and suitable to personal preferences, abilities and needs. In the Psychiatric Rehabilitation Approach, a detailed and structured process – Choosing a Valued Role - exists to help individuals learn how to make meaningful decisions about their role in life, and how to apply this process to their own personal situation. Making an informed choice, not just any choice, about what one wants to do or where one wants to live involves more than simply selecting from among a few available options. Individuals require assistance in the form of information, education, support and encouragement to make choices that have a greater chance of working out for the person. Choosing a Valued Role helps individuals understand the implications and consequences of one decision over another: the idea is to help the recipient understand what they can expect from a particular environment. Consistent with all strategies in the Psychiatric Rehabilitation Approach, how the person is involved makes the real difference: this process is recovery-facilitating when recipients have the opportunity to dream and aspire toward desired goals while learning about the expectations and requirements associated with different choices. Not only does the process of Choosing a Valued Role yield an informed goal, the manner in which recipients are supported in making a choice, in and of itself, can be recovery enhancing, empowering and dignifying.

By the time an individual reaches the point of Choosing a Valued Role in the psychiatric rehabilitation process, they are motivationally ready: they understand that a need for change exists in a specific environmental role; they are committed to working with staff toward making a change; and they have acquired some insight into themselves and their surroundings. The next step is figuring out exactly what it is they want to do, and in the psychiatric rehabilitation approach, goals are explicit and specific, indicating a particular role, place and achievement date for the person. It’s not enough to say that a recipient wants to live on his or her own in supportive housing. Instead, the goal specifies the actual unit or residential address.

The three activities involved in Choosing a Valued Role are: ‘identifying personal criteria’; ‘describing alternative environments’; and ‘choosing the goal’. It is essential that individuals have some understanding of what is important to them before deciding where to live, learn, work or socialize. ‘Identifying personal criteria’ consists of assisting a recipient to determine the personal standards she or he will use to judge and compare different options or environments. Depending on the degree of personal insight and awareness, determining an inventory of personal criteria may be a challenge for some individuals. With assistance, guidance and structure however, individuals can be helped to analyze current experiences, determine what it is they like or dislike about these experiences, and ultimately infer preferences that will guide future decisions. ‘Describing alternative environments’ includes a methodology for identifying and developing detailed descriptions of potential places to live, learn, work or socialize. To the greatest extent possible, the recipient is involved in a research plan to obtain the information needed to understand the differences between places of interest. The process entails a thorough examination of the people, physical place and activities that characterize different options coupled with a systematic method for matching personal criteria to potential environments. Once a specific goal is stated, significant others' perspectives are gathered to gain a sense of potential support or resistance for the goal. Distinguishing the psychiatric rehabilitation approach from other goal setting processes is that fact that only once the goal is stated does the process of skill or support assessment and planning begin; skills and supports become the focus of future interventions now that the environment and demands of the environment are known.