The Importance of Small Things

Small Things, Micro-Affirmations and Helpful Professionals Everyday: 

Recovery-Orientated Practices According to Persons with Mental Health Problems

Community Mental Health Journal

Alain Topor· Tore Dag Bøe · Inger Beate Larsen

3 February 2018

This article is an open access publication

The aim of this study, co-authored by IMHCN Collaborator Alain Topor, is to present concrete descriptions of the content in the construction of helpful relationships with staff, according to users. Starting with the re-occurring concept of the meaning of “little things” in recovery studies, a literature review was done. A thematic analysis shows that small things play an important role in improving a person’s sense of self. Small things seem to be an invisible but effective parts of a recovery-orientated practice, but they might be defined as unprofessional and their efficacy negated.

“That wasn’t part of his job,” or “She didn’t have to do that,” were heard repeatedly from interviewees touched by practitioners’ willingness to “go out of their way” to be helpful”. (Ware et al. 2006, 556)



Knowledge about micro-affirmations and micro-aggressions could be used to create organizational conditions favorable to the emergence of micro-affirmations and improvement of

the quality of the care. In the aftermath of de-institutionalization, new ways of working have been developed. Most of these methods seem to have in common the creation of social contexts promoting the possibility for the subjectivity of the persons (users and professionals) to be expressed in social settings. Methods like “Hearing voices” (Romme and Escher 2011), “Open dialogue” (Seikkula and Olson 2003). “Individual Placement and Support” (Topor and Ljungberg 2016) and ways to organize mental health services, as in Trieste (Mezzina 2014) can be seen as conditions created to leave some space for actions, co-creations and relations for users and professionals.

These methods and organizational conditions might be understood as the re-entry of normal settings into the mental health field, where the person and his/her social context are regarded as full participants in designing the help and support applied. Research could play a role in this development by focusing on helping interventions and situations in daily practice. We should keep in mind that early studies about recovery showed a high percentage of persons in recovery (Warner 2004). The question remains: what were the helping factors behind recovery long before the age of recovery-orientated institutions and the latest bio-medical discoveries? It is also important to study micro-affirmations in everyday life, outside the professional-person relationships (Davidson et al. 2006; Topor and Ljungqvist 2017).

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