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SRH is een van de meest gebruikte herstelondersteunende benaderingen in Nederland en België. Daarnaast wordt ze ook in een tiental andere landen toegepast. In dit artikel beschrijven we de ontwikkelingen die de benadering de laatste jaren heeft doorgemaakt. We beginnen met een korte geschiedenis. Vervolgens gaan we in op hoe SRH als vorm van relationele herstelgerichte zorg er anno 2021 uitziet.

BackgroundIncreasing attention has been paid to the ‘voice’ of people living with MCI or dementia, but there is a lack of clarity about how everyday life is exercised, lived, and understood from this insider’s perspective. The current study aimed to explore and identify the everyday life experiences, challenges and facilitators, of home living individuals with MCI and dementia.MethodOur study adopted a scoping review methodology, guided by the Joanna Briggs Institute Reviewers Manual. Eight databases were searched, resulting in 6345 records, of which 58 papers were included in the review. Only qualitative studies were included, published between 2011 and 2021. Analysis was done by descriptive content analysis.ResultIncluded study characteristics are summarized in Table 1. Our findings were categorized into seven spheres of everyday life: experiences related to the condition, the self, relationships, activities, environment, health and social care, and public opinions [Figure 1, Table 2]. Results show the many disruptions and losses in everyday life and the ways people try to adapt to these changes. Highlighted in every area is the importance of reciprocal relationships and being engaged as citizens in the community in a meaningful way. Included studies showed no differences between groups in the impact on the experience of everyday life, such as between MCI and dementia.ConclusionThis review shows that the change of focus from healthcare to all aspects of everyday life provides insight into the insider’s perspective of people living with dementia. The majority of included studies emphasize the social needs of people living with MCI or dementia. All areas of everyday life seem to be closely intertwined and reflect an socioecological model [1], [2], [3]. Furthermore, perhaps one of the defining aspects of MCI according to the current definition, that symptoms do not interfere with daily life, requires more nuance. More research is needed on factors that promote and impede the sense of reciprocity and belonging, as experienced by people living with MCI and dementia.

Increasing attention has been paid to the 'voice' of people living with mild cognitive impairment (MCI) or dementia, but there is a lack of clarity about how everyday life is perceived from this insider's perspective. This study aimed to explore the everyday life experiences, challenges and facilitators of individuals with MCI and dementia living at home. A scoping review of qualitative studies, guided by the Joanna Briggs Institute Reviewers Manual, was conducted. Eight databases were searched, resulting in 6345 records, of which 58 papers published between 2011 and 2021 were included. Analysis was carried out by descriptive content analysis. Findings were categorized into seven spheres of everyday life: experiences related to the condition, self, relationships, activities, environment, health and social care and public opinions. The results show many disruptions and losses in everyday life and how people try to accommodate these changes. In all areas of everyday life, people show a deep desire to have reciprocal relationships, stay engaged through participation in activities and have a sense of belonging in the community. However, more research is needed on the factors that promote and impede the sense of reciprocity and belonging. ispartof: International Journal Of Environmental Research And Public Health vol:19 issue:17 ispartof: location:Switzerland status: published

Purpose This study aims to explore the perspectives of mental health professionals who are in a process of integrating their own experiential knowledge in their professional role. This study considers implications for identity, dilemmas and challenges within the broader organization, when bringing experiential knowledge to practice. Design/methodology/approach As part of a participatory action research approach, qualitative methods have been used, such as in-depth interviews, discussions and observations during training and project team. Findings The actual use of experiential knowledge by mental health care professionals in their work affected four levels: their personal–professional development; the relation with service users; the relation with colleagues; and their position in the organization. Research limitations/implications Because of its limited context, this study may lack generalisability and further research with regard to psychologists and psychiatrists, as well as perceptions from users, is desirable. Social implications According to this study, social change starts from a bottom-up movement and synchronously should be facilitated by top-down policy. A dialogue with academic mental health professionals seems crucial to integrate this source of knowledge. Active collaboration with peer workers and supervisors is desired as well. Originality/value Professionals with lived experiences play an important role in working recovery-oriented, demonstrating bravery and resilience. Having dealt with mental health distress, they risked stigma and rejections when introducing this as a type of knowledge in current mental health service culture. Next to trainings to facilitate the personal–professional process, investments in the entire organization are needed to transform governance, policy and ethics.

Steunend Relationeel Handelen (SRH) is een door professionals in de ggz, de maatschappelijke opvang, het welzijnswerk en sociale teams veelgebruikte methodiek om mensen te ondersteunen bij herstel van autonomie, zelfredzaamheid en participatie. Deze ‘kleine gids’ geeft in vogelvlucht de belangrijkste principes en uitgangspunten van de SRH weer. De gids is een onmisbaar zakboek voor de SRH-geschoolde professional. Maar kan ook gebruikt worden als kompas bij het proces om samen met cliënten en hun omgeving op een betrokken en effectieve wijze te werken aan wensen, doelen en ondersteuningsbehoeften.

PurposeThe purpose of this paper is to focus on individuals who experience mental health difficulties with the services they receive from “support workers” as part of a personal recovery model, this study will obtain individuals reflections, experiences and opinions on how support helps them stay well and facilitates their personal recovery process. Recovery is seen through the lens of the CHIME framework (Connectedness–Hope–Identity–Meaning–Empowerment).Design/methodology/approachThe sample size included 13 people who experience mental health difficulties and are receiving support from mental health care services. The structured interview was designed based on the INSPIRE measurement and the CHIME framework structure. The qualitative content analyses, discursive framing approach and CHIME as a framework made it possible to examine the key activities of recovery-oriented support work revealed in the data.FindingsParticipants valued the enhancement of hope provided by support workers and also expressed it was important as they were non-judgemental. Identity and meaning in recovery could be enhanced by sharing powerful stories about the individuals’ own life and health experiences, and those of support workers or others. Inclusive behaviour in public spaces and trying out new interest-based activities together were considered as empowering.Originality/valueThis research helps to understand the value of personal recovery support activities given the societal changes (tension between survival vs self-expression values) and highlights the need for value-based recovery-oriented education and practice.

Samenvatting Veel gemeenten zien integrale samenwerking op het snijvlak van zorg & welzijn en werk & inkomen als een oplossing om meer mensen met problemen op verschillende leefgebieden naar betaald of vrijwillig werk toe te leiden. Met integraal samenwerken wordt bedoeld dat problemen op het gebied van bijvoorbeeld wonen, gezondheid of financien in samenhang aangepakt worden. Hiervoor is goede afstemming tussen professionals nodig. In drie Nederlandse gemeenten is in de periode 2018-2020 een kwalitatief onderzoek uitgevoerd dat inzicht biedt in knelpunten en oplossingen op het gebied van samenwerking. Er zijn gedurende deze periode bijeenkomsten georganiseerd waaraan in totaal circa 60 uitvoerende professionals (onder anderen sociaal werkers en klantmanagers) en beleidsmedewerkers deelnamen. Ook zijn meer dan 30 verdiepende interviews gehouden met professionals, beleidsmedewerkers en managers in het sociaal domein en circa 40 gesprekken gevoerd met inwoners. De resultaten laten zien dat het mogelijk is integraal werk vorm en inhoud te geven wanneer professionals in de gelegenheid worden gesteld om met elkaar af te stemmen, gebruikmaken van elkaars kennis en expertise, en werken vanuit een gezamenlijke visie op (arbeids)participatie. We concluderen dat dit vraagt om een ‘wendbare’, ‘responsieve’ overheid en een bijpassende sturingsfilosofie.

'Werken in verbinding' beschrijft de uitgangspunten van Steunend Relationeel Handelen (SRH) en hoe je ermee kunt werken. SRH is ontwikkeld om professionals in de GGZ, de Maatschappelijke Opvang en de Verslavingszorg handvatten te bieden om cliënten optimaal te ondersteunen bij herstel en kwaliteit van leven. In deze benadering zijn verschillende inspiratiebronnen geïntegreerd, zoals de presentiebenadering, het krachtgericht werken en de herstelbeweging. Werken met het SRH houdt concreet in: de ander ondersteunen bij kwaliteit van leven, bij betekenisvolle activiteiten en sociale rollen. Daarbij wordt de basis gevormd door een persoonlijk-professionele samenwerkingsrelatie. Bij SRH staan vier kernhandelingen centraal, dit zijn: - Verbinden: het aangaan van een samenwerking waarbij evenwaardigheid voorop staat. - Verstaan: begrijpen wat voor de ander belangrijk is en wat wensen en behoeften zijn. - Verzekeren: ondersteuning bieden bij kwetsbaarheid - Versterken: van zelfvertrouwen, identiteit, vaardigheden en sociale relaties. 'Werken in Verbinding' beschrijft hoe -op een methodische wijze- goede herstelgerichte zorg geboden kan worden. Het is een praktisch boek met veel voorbeelden en hulpmiddelen. Daarnaast is er nog het Handboek Steunend Relationeel Handelen (onder redactie van dezelfde auteurs) dat als naslagwerk veel informatie biedt over allerlei toepassingen van SRH. 'Werken in verbinding' is niet alleen geschreven voor professionals in de (O)GGZ maar is ook om te gebruiken voor training en in de opleiding. De auteurs zijn Dirk den Hollander, verpleegkundige en sociaal pedagoog, betrokken bij Nei Skoen Recovery Learning Community te Helmond en Jean Pierre Wilken, sociaal wetenschapper en psycholoog, lector Participatie, Zorg en Ondersteuning bij het Kenniscentrum Sociale Innovatie van Hogeschool Utrecht.

Person-centeredness refers to an individually-tailored, holistic approach to meeting a person's needs and recognizing the client as an expert and active participant in the rehabilitation process. This article focuses on a study conducted in Estonia to analyze the perceptions of persons with disabilities about person-centeredness by exploring their experiences about received disability services and participation in an initial rehabilitation needs assessment process. Twelve in-depth interviews were conducted in different regions of Estonia with persons with disability. Data were analyzed using qualitative thematic analysis. The aim of the research project (2010–2015) was to design a person-centered initial rehabilitation needs assessment instrument. Results revealed that in describing their experiences, study participants identified important components of person-centeredness: (1) understanding service users and meeting their individual needs, (2) connecting and partnering with service users, (3) providing appropriate information, and (4) addressing issues of power and empowerment. If these components are included, service users are more likely to become motivated to consider their situation and take more control of their lives. These findings may be of relevance for countries considering needs-based referrals to rehabilitation services and refocusing disability services using a person-centered approach.

This article focuses on difficulties that people with disabilities and reduced work capacity experience in employment and social participation, and on their rehabilitation goals, in order to make recommendations for policy and social and vocational rehabilitation service provision. A semi-structured interview procedure, which included the World Health Organization Disability Assessment Schedule 2.0, was used to conduct initial needs assessments with 85 persons in Estonia. Quantitative and qualitative data were gathered and analysed using descriptive statistics and thematic analysis. Results revealed that participants experienced multiple difficulties, which they mostly ascribed to unstable health conditions, that limited their abilities to participate in employment and social activities. A large number of participants also identified themselves as unemployed for health reasons and linked their rehabilitation goals to health restoration rather than becoming employed. Difficulties such as lack of work skills, unsuitable work tempo, mobility limitations, and emotional problems were also mentioned. To support people with disabilities in obtaining and maintaining employment, services must correspond to the persons´ need; and comprehensive, person-centred rehabilitation assessment, service planning, and budgeting mechanisms are needed. Supportive legislation, flexibility in service provision, and the availability of needs-based rehabilitation and other services, including lifelong learning opportunities, are also necessary to help people learn new work skill

Community support and participation among persons with disabilities. A study in three European countriesThis article describes a European project which was aimed at improving the situation of persons with psychiatric or learning disabilities with regard to social participation and citizenship. The project took place in three countries (Estonia, Hungary and the Netherlands) and four cities (Tallinn, Budapest, Amersfoort and Maastricht). The project included research and actions at the policy level, the organizational level and the practice level. At the policy level, the framework of the United Nations Convention on the Rights of Persons with Disabilities (United Nations, 2006) and the European Disability Strategy (European Commission, 2010) were used to look at national and local policies, at the reality of the lives of those with disabilities and at the support that professional services offer with regard to participation and inclusion. The project generated a number of insights, recommendations and methods by which to improve the quality of service and increase the number of opportunities for community engagement. In this article, we present some of the lessons learned from the meta-analysis. Although the circumstances in each country are quite different with regard to policy, culture and service systems, it is remarkable that people with disabilities face many of the same problems.The study shows that in all three countries, access to services could be improved. Barriers include bureaucratic procedures and a lack of services. The research identified that in every country and city there are considerable barriers regarding equal participation in the field of housing, work and leisure activities. In addition to financial barriers, there are the barriers of stigma and self-stigmatization. Marginalization keeps people in an unequal position and hinders their recovery and participation. In all countries, professionals need to develop a stronger focus on supporting the participation of their clients in public life and in the development of different roles pertaining to citizenship.Ondersteuning bij participatie in de samenleving van mensen met beperkingen. Een studie in drie Europese landenDit artikel beschrijft een Europees project dat gericht was op sociale participatie en burgerschap van mensen met een psychiatrische of verstandelijke beperking. Het project vond plaats in drie landen (Estland, Hongarije en Nederland) en in vier steden (Tallinn, Budapest, Amersfoort en Maastricht). Het omvatte onderzoek en activiteiten op het niveau van beleid, organisatie en uitvoeringspraktijk. Op beleidsniveau vormden het UN-Verdrag voor Mensen met een Handicap, en de European Disability Strategy het referentiekader om te kijken naar landelijk en lokaal beleid, naar de dagelijkse realiteit van mensen met een beperking en naar de steun die professionele organisaties bieden met betrekking tot participatie en inclusie. Het project leverde een aantal inzichten, aanbevelingen en methoden op, die de kwaliteit van de dienstverlening en de mogelijkheden voor participatie in de samenleving kunnen verbeteren. In dit artikel presenteren we een aantal bevindingen. Hoewel de omstandigheden in ieder land verschillend zijn qua beleid, cultuur en voorzieningen, valt op dat mensen met beperkingen gelijksoortige problemen ervaren.De studie laat zien dat in alle drie de landen de toegang tot hulp- en dienstverlening verbeterd kan worden. Barrières zijn onder andere bureaucratische procedures en een gebrek aan bepaalde diensten. In iedere stad en in ieder land zijn er aanzienlijke belemmeringen als het gaat om participatie op het terrein van huisvesting, werk en vrijetijdsbesteding. Naast financiële problemen is er de barrière van stigma en zelfstigma. Marginalisatie houdt mensen in een ongelijke positie en heeft een negatieve invloed op herstel en participatie. In alle landen zouden professionals een sterkere focus moeten hebben op het ondersteunen van hun cliënten bij participatie in de samenleving en op de ontwikkeling van verschillende rollen behorend bij burgerschap.

The Best Practice Unit: a model for learning, research and development The Best Practice Unit (BPU) model constitutes a unique form of practice-based research. A variant of the Community of Practice model developed by Wenger, McDermott and Snyder (2002), the BPU has the specific aim of improving professional practice by combining innovation and research. The model is used as a way of working by a group of professionals, researchers and other relevant individuals, who over a period of one to two years, work together towards a desired improvement. The model is characterized by interaction between individual and collective learning processes, the development of new or improved working methods, and the implementation of these methods in daily practice. Multiple knowledge resources are used, including experiential knowledge, professional knowledge and scientific knowledge. The research serves diverse purposes: articulating tacit knowledge, documenting learning and innovation processes, systematically describing the working methods that have been revealed or developed, and evaluating the efficacy of the new methods. Each BPU is supported by a facilitator, whose main task is to optimize learning processes. An analysis of ten different BPUs in different professional fields shows that this is a successful model. The article describes the methodology and results of this study. De Best Practice Unit: een model voor leren, onderzoek en ontwikkeling Het model van de Best Practice Unit (BPU) is een unieke vorm van praktijkgericht onderzoek. De Best Practice Unit is een variant van de Community of Practice zoals ontwikkeld door Wenger, McDermott en Snyder (2002) met als specifiek doel om de professionele praktijk te verbeteren door innovatie en onderzoek te combineren. Het model wordt gebruikt om in een periode van 1-2 jaar met een groep professionals, onderzoekers en andere betrokkenen te werken aan een gewenste verbetering. Kenmerkend is de wisselwerking tussen individuele en collectieve leerprocessen, het gebruik van meerdere kennisbronnen, de ontwikkeling van (nieuwe of betere) werkmethoden en de implementatie hiervan in de praktijk. De diverse kennisbronnen zijn: ervaringskennis, professionele kennis en wetenschappelijke kennis. Onderzoek dient verschillende doelen: het articuleren van taciete kennis, het documenteren van het leer- en innovatieproces, het systematisch beschrijven van geopenbaarde of ontwikkelde werkwijzen, en het toetsen van nieuwe methoden op hun effectiviteit. Een BPU wordt ondersteund door een zogenaamde facilitator, die als taak heeft leerprocessen te optimaliseren. De resultaten van een onderzoek naar tien BPU’s in verschillende professionele domeinen laten zien dat het een succesvol model is. Dit artikel beschrijft de belangrijkste methodologische kenmerken, en de resultaten van dit onderzoek.