What Is Hope in Mental Health Treatment?

"Hope is an active process that includes a vision or picture of a better future, imagination and fantasy of a better life with more opportunities, trusting that it can happen, and a conviction that it will. It is a belief, despite all odds, that a better life can come. Clients who experience severe and persistent mental illness for a long period of time, homeless individuals, and substance abusers often don't have the space to have hope, given their focus on survival and management of their daily lives."

"The adversity they face is too overwhelming, and they lack the agency to think about it, let alone pursue better lives. Hope is more defined by its absence rather than its presence in their world. A place to live, food to eat, and medication to alleviate symptoms are the most important contributors to hope. One might view these as welfare services, but they are hope-supporting services. Trust and authentic relationships support optimism and the development of the belief that positive relationships and life experiences are possible."

"Hope is essential for all mental health recovery. We as clinicians become the holders of hope for our clients (when they cannot), whether they suffer from debilitating mental illness, a personality disorder, or both. Clients with personality disorders pose a unique challenge for holding hope because they are complex, can be difficult, and treatment can take time and may also need a multi-disciplinary approach. Generally, the goal is to relieve immediate distress that may include anxiety, fear, and depression."

Hope requires a clear vision of a better future, imaginative possibility, trust that change can occur, and conviction that it will. Severe and persistent mental illness, homelessness, and substance abuse often remove the cognitive and material space needed for hope because daily survival consumes attention and agency. Meeting basic needs—stable housing, food, and medication—directly supports the emergence of hope. Trusting, authentic relationships foster optimism and belief in attainable positive experiences. Clinicians frequently act as holders of hope for clients who cannot sustain it themselves. Treatment for personality disorders should relieve immediate distress, reduce risk behaviors, improve interpersonal functioning, and offer varied, realistic options with active clinician participation.

Read at Psychology Today