Developing an understanding of strengths and strengths-based approaches is central to recovery and peer support practice.

Organisations that offer services to individuals with mental health problems sometimes use a medical model of intervention. In this model, the individual is usually perceived as someone with problems that need to be intervened with and resolved. This is often achieved by the use of medication, which tends to reinforce the view that the individual is, to a large extent, dependent on these medical interventions for their recovery.

Discovering strengths can be a difficult process as individuals may have been disempowered by experiences such as that described above and they may not initially recognise their strengths. How we engage with people to uncover their strengths and abilities is therefore important. A strengths based approach would:

• Ask open questions of the individual and encourage them to think about situations and the strengths they brought to the situation and how they managed it.
• Be focused on the individual uncovering their own strengths as this adds to their sense of mastery and empowerment.
• Acknowledge difficulties but do not let them be the defining factor.
• Prompt the person to start to feel more hopeful about their situation and more worthy of positive relationships and experiences as they identify strengths rather than deficits.
• Highlight the uniqueness of the individual and show interest in them.
• Enable the person to start building resilience and identify positive coping and management strategies they can use.

Strengths and deficits in mental health

Each person has their own unique strengths and abilities, but we tend to be more able to articulate and identify the things that might be considered deficits, weaknesses or problems. In fact, it is quite unusual to ever be asked about strengths and abilities out with a job interview.

An awareness of this focus on deficits over strengths is of particular relevance to mental health and recovery. When people first experience issues with their mental health they may seek help. Initially they are likely to be asked a series of questions about the nature and severity of the problems they are experiencing. Based on the problems identified a diagnosis may be assigned and treatments and services may be suggested. However what is offered will very much depend on the severity of the problems identified. Put simply, the worse things are, then the higher the priority for support and treatment.

Once through this initial process of assessment the person may be introduced to new professional helpers and services and at each juncture they are likely to be asked to recount and describe their problems. It is inevitable that after a while they get well versed in describing an illness story, and things start to feel pretty hopeless.

When further help outside the mental health service system is sought — like benefits or housing — again the support offered depends on the severity and nature of your problems. Those who are considered to have more problems or who are better able to articulate their problems will again be seen as being more in need and hence get more help.

Where resources are limited it is understandable that services and supports are offered on the basis of greatest need. However, we need to be aware of the potentially negative consequences that this can have — including the possibility of reinforcing an identity dominated by problems and illness.

If people are frequently asked to describe their problems, then there is a risk that they can become a deeply engrained part of our sense of self, and this can hamper growth and progression.

An unintended consequence of the rationing of services and support based on greatest need is that we potentially create a disincentive to recovery.

Strengths and recovery

In module 3 when we looked at recovery narratives, we learned that the process of re-authoring personal experiences to look for elements of wellness, hope and recovery over illness and disability can have a potentially transformative effect. Strengths-based appro aches build on this concept and offer a mechanism to support this process.

A strengths-based approach starts with what’s strong and not with what’s wrong.

In doing so it is possible to:

• Promote hope – knowing what you can do to and recognising your potential is a hopeful endeavour. Working with people to identify their strengths and abilities generates hope; a key ingredient of recovery.
• Encourage empowerment – being overly focused on problems and deficits is in itself disempowering. Strengths-based practice is one of the tools by which we encourageand foster empowerment so that people can become more aware of what is possible, identify goals and develop plans and strategies for achieving them. This creates a greater degree of control and participation in recovery and wellbeing.
• Promote resilience — people who are more aware of their strengths are more able to anticipate and bounce back from challenges.
• Recognise each person as a unique individual with strengths, goals and dreams rather than as a collection of problems. This helps us recognise and celebrate the unique contribution we all make.
• Recognise and validate the experience brought by people with experience of mental health problems. They can bring unique insight, knowledge and experiences that can be applied in the support of others.

Focusing on strengths does not mean that people will not experience problems, but it does help to foster environments and learning opportunities that support recovery As Pat Deegan states in the foreword of The strengths model: Case management with people with psychiatric disabilities:

[Strengths based practice is] ‘a powerful antidote to the high cost of the deficits approach. In this model, strength is not constructed as some superheroic state of invulnerability. Rather, we learn that even when people present with obvious vulnerabilities, they also have strengths. Their strengths are in their passions, in their skills, in their interest in their relationships and in their environments. If mental health practitioners look for strengths, they will find them.’ (Rapp, C A and Goscha, R).

The following table summarises some of the characteristics and potential consequences of focusing on deficits and problems or on strengths.

‘Language shapes how we see and construct the world, it is important to consider how language can encourage recovery i.e. to use shorthands which foster rather than inhibit the recovery journey.’ (Slade M, 2010)