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An electronic circular of the Coalition's Center for Rehabilitation and Recovery
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No. 77, November 2011
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The Center for Rehabilitation and Recovery provides assistance
to the New York City mental health provider community through
expert trainings, focused technical assistance, evaluation,
information dissemination and special projects.
THE DIRECTOR’S NEW YORK MINUTE Everyone Has a Culture: By Courtenay M. Harding, PhD
When I was consulting to a group in San Diego, I visited many Latino sites and the closer I got to the border between the U.S. and Mexico, the more pronounced the impact of culture It is not just color or ethnicity or place of origin that decides culture. It can be level of acculturation, age, class, religious/spiritual beliefs, sexual orientation, or a disability (e.g. the deaf culture), or Hip Hop, or Santa Claus. Everyone has a culture or two or three. This fact of life means that in the process of engagement for services, goal selection, building a treatment plan, or crisis care, culture must be considered at every critical clinical juncture. It means that clinicians and care managers and the service system need to ask questions about culture and to really listen to the answers. The injunction is to not jump to conclusions based upon the listener’s preferences and inclinations. Even if there is an interpreter in the room, make sure that your questions and the answers are not being restated in a new way which often happens. In the late 1990s, while working out West, we received a contract from SAMHSA to gather together 72 people from all stakeholder groups (family members, peers, academics, administrators, and providers, and government officials). This group worked diligently under the coordination of A. Marie Sanchez at the Western Commission(1), and they produced literature reviews of the four underserved /underrepresented racial/ethnic groups for managed care in this country. When we gathered them all together in Georgetown University during one long weekend in 1997, they surprised us by putting aside all the hard work they just finished, and announced that they recognized that everyone in our country had a culture. Their new goal was to create a set of standards for all people entering care. They devised an incredible document which contains standards, implementation guidelines, performance indicators, benchmarks, and outcome measures, for both the system and for clinical care. They used 17 guiding principles for overall structure: cultural competence, consumer-driven, community-based, managed care, natural supports, sovereign nation status for Native Americans, collaboration and empowerment, holism, feedback, access, universal coverage, integration, quality, data-driven, outcomes, and prevention. Some of the work was derived from that produced in New York just prior to the project. All of their literature reviews were attached. The system implementation included planning, governance, benefit design, prevention, education, outreach, quality monitoring and improvement, decision support, management information systems, and human resources. These are all areas usually not touched by cultural issues. So what happened to this amazing document? At first, it achieved the status of the only national standards that SAMHSA ever approved of and was on their website. Then politics got in the way and it suddenly disappeared from view. I have the copy of it and would be happy to share with any interested party. I strongly feel that treatment and system organization must take these issues seriously if we are to develop efficacious and effective ways of helping struggling people reclaim their lives. And we need to encourage more and more people from a wide variety of cultures to join the pipeline of practitioners for the future. As the anthropologist, Margaret Meade(2), reportedly once said: “If we are to achieve a richer culture, rich in contrasting values, we must recognize the whole gamut of human potentialities, and so weave a less arbitrary social fabric, one in which each diverse human gift will find a fitting place.” References 1) Western Interstate Commission for Higher Education (WICHE) Mental Health Program: (Oct. 1997). Cultural Competence Standards in Managed Care Mental Health Services for Four Underserved/Underrepresented Racial/Ethnic Groups (Final Draft). Boulder, CO. 2) Meade, M. www.brainyquotes.com accessed 10/20/2011 In Hot Pursuit By Susan Blayer How often do you think about your happiness or the happiness of others? If you take all of the books, blogs, Facebook pages, support groups, televisions shows, movies, art, research, etc. devoted to finding happiness, losing happiness, longing for happiness, it seems like people think about it often. Last year, our I must admit, I have always been interested in this pursuit. I come from a long line of depressed women. Unhappiness, you could say, is in my blood, my genes, and to a certain extent, the environment within which I was raised. So at times, I have been in hot pursuit, like a car chase in an action movie, urgently trying to capture exactly what I would need to stop the nagging feeling that something was terribly wrong with me, that nothing good could last. I wanted the magic solution that would make me “normal,” thinking that most people didn’t have to work so darn hard simply to drag themselves out of bed and through a day. I tried just about everything—therapy, support groups, self-help books, medication, nutritional changes, exercise, affirmations, spirituality, love. Most of these things worked in their own ways, some even better when combined. But what really made me stop in my tracks and reassess the whole ball of yarn was, in my mid-twenties, stumbling upon a famous quote from Abraham Lincoln: “Most folks are about as they make up their minds to be.” It’s a simple idea—that happiness can be a choice- but for me, someone utterly and erroneously convinced that I was destined to be less happy than I wanted to be, it was revelatory. I now know that research actually substantiates this notion, that in spite of a predisposition toward depression, we can actually change our biology simply by choosing to focus on the things that make us happy. Psychologist Dr. Fred Luskin recently stated that happiness is only about 50% genetic, with some people being at “the lower end of the happiness scale.” This leaves the other half to alter, the half that we can control. Luskin asserts that wanting what you do not have causes stress chemicals in the body that cause some of us to “think we’re a lot more miserable than we actually are.” Instead, he contends that, “If you say, my life may not be perfect, but I'm going to focus a little more on what’s good, then you stop the release of the stress chemicals.” Additionally, choosing to think good thoughts actually produces more happy-neurochemicals and forces them away from the part of the brain (the limbic center) where negative memories are stored and toward the part of the brain where we think (the pre-frontal cortex). (1) A 2008 Time Magazine article featured research which concurred that genes account for about 50% of the variation in people’s levels of happiness. However, they found that this was due to underlying genetically determined personality traits. One of researchers, from the University of Edinburgh, Timothy Bates, claimed that “there’s always that other 50% of overall life satisfaction that is not genetically predetermined.”(2) Others, like the team from several major world universities that studied over 1,000 pairs of twins, concludes that the percentage was a bit lower, with only a third of the variation in people’s happiness as heritable.(3) Still others, like University of California professor of psychology, Sonja Lyubomirsky,Ph.D, believes from her research that the genetic and circumstantial factors account for about 60%, leaving up to 40% within your control to change.(4) It seems, to borrow from the title of a popular spiritually-based book, that Happiness is an Inside Job. Lyubomirsky, in her book, The How of Happiness: A New Approach to Getting the Life You Want, (4) provides concrete, intentional strategies for increasing one’s ability to be happy. She has even developed an iPhone app, called “Live Happy,” featuring these scientifically supported activities which, she claims, “performed as a whole, over time, can add up to a new mindset.”(5) Instinctually, when I decided to refuse to allow my feelings to determine my fate, I engaged in many of the practices she and other experts recommend, such as focusing on the positives, remaining active, exploring spirituality, cultivating gratitude and a sense of humor, partaking in life’s pleasures. I started off just being thankful that I was no longer miserable, but over time, I realized that I actually transformed into what I would consider to be a happy, optimistic person. I decided to put my self-assessment to the test and see where I landed on Lyubomirsky’s “Subjective Happiness Scale.” I answered the few questions honestly, without exaggeration, based on how I feel most days. The average happiness score runs from 4.5 to 5.5 out of a maximum of 7. I, happily, scored 6.25! One additional thing I found that has made a dramatic difference in becoming happy—passing it on to others. Spreading happiness, even in little ways, makes me feel good, and it seems I am not alone. Last April, Richard Layard, an economist who found that the happiness of society does not necessarily equate to its wealth, along with two of his colleagues launched, “Action for Happiness”’, a new mass movement to create positive social change. The website states their mission: “We're bringing together people from all walks of life who want to play a part in creating a happier society for everyone.” The site provides “10 keys to happier living” as well as several action steps to support their goal in community. If you are interested in becoming part of the movement, you can take the Action Happiness Pledge, as I recently did. It seems that happiness is an outside job, too. Wishing you the happiest day yet, today and every day! Remember, the fastest, easiest, scientifically proven way to boost your mood, RIGHT NOW, is to smile J. (6) References:
Center Staff to Present at NYAPRS PROS Academy
View or Download the Conference Program: http://www.nyaprs.org/conferences/pros-implementation-academy/documents/PROS-AcademySchedule11cond.pdf To Register: http://www.nyaprs.org/conferences/pros-academy/registration/index.cfm
Education and Training Introduction to Benefits Management This free half-day training is offered in various locations across the city, designed for clinicians and other Facilitators: Margie Staker and Patricia Feinberg, MS Dealing with Overpayments & Ask the Expert
Facilitator: Ed Lopez-Soto, Esq Registration Closed. Please check Center Training Schedule for future sessions. Leading Groups: An Introduction
Participants will be introduced to theoretical concepts and fundamental skills essential for leading various types of groups, including knowledge-based, skills-based and therapy groups. The focus will be on developing group dynamics that engage and empower group members, motivate them to achieve personal goals and help the group as a whole recover. Through didactic and experiential learning, participants will acquire the skills they need to plan and lead groups that are meaningful and alive. Facilitator: Aaron Vieira, LMSW New Fall/Winter 2011-12 Training Schedule Available!
Note: If you are typing the URL in your browser, the space between “the” and “center” is in reality an underscore symbol “_”.
Live Webinar: Medicaid & SSI Part I & II
Register: https://www1.gotomeeting.com/register/720916192 Addiction Treatment Needs of LGBT Persons with Co-occurring Disorders Lesbian, gay, bisexual and transgender persons with psychiatric disorders may Facilitators: : Penelope P. Ziegler, MD, FASAM Register: http://eventcallregistration.com/reg/index.jsp?cid=25150t11pkemail1 NAMI‐NYC Metro Public Education Event: Compulsive Hoarding: Hope and Help Hoarding behaviors have received a lot of recent media attention (including an article in last month’s eWorks ). In Facilitators: Sheila Delson and Madeleine DeNitto RSVP: Contact the NAMI Helpline at (212) 684-3264 Hearing Voices Network Workshop: Learn About The International Movement
The Hearing Voices Network, an innovative, international movement, will be presenting an informational workshop entitled, “Voices, Visions and Other Unusual or Extreme Experiences.” The purpose of hearing voices groups is to offer a safe haven where people feel accepted and comfortable, allowing for an opportunity to accept and “live with their voices.” Participants of this workshop will learn about the 25 year history of the Hearing Voices movement, and what we can do in NYC. Please note that space is limited and registration will be closed once space capacity is reached. Date: December 5th Serving Individuals with Psychiatric Disabilities In Centers of Independent Living
Click here to download the fact sheet and obtain access to resource links Self-Directed Psychiatric Rehabilitation Activities CD Boston University’s Center for Psychiatric Rehabilitation has created the Self-Directed Psychiatric Rehabilitation Activities, a new product designed to facilitate personal exploration, either independently or with support, through the recovery process of reintegration within the community by identifying and attaining roles and goals. The process in this manual is designed to assist a person to explore and learn about how to develop readiness for rehabilitation through activity outlines, examples and worksheets. To view an excerpt: http://www.bu.edu/cpr/products/curricula/sample-sdpra.pdf “Graduation” Webinar Now Available for Download
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became. The mental health center had a name in Spanish, the walls were painted in beautiful colors, and food abounded throughout the rooms. The ambience was warm and welcoming. Therapy was conducted in Spanish with a roomful of people (the consumer, his or her family members, the parish priest, and the Curandero, a native healer). Much to my surprise, families living in the U.S. went back to their families of origin south of the border for Sunday supper. How different from the Northern European models so prevalent for decades.
Center Director, Courtenay Harding, wrote her 
Dr. Courtenay Harding and Aaron Vieira are pleased to be presenting workshops at the upcoming NYAPRS
PROS Academy, which will be held November 17-18th in Albany, NY. In the opening plenary, senior leaders from the New York State Office of Mental Health and the Department of Health will be sharing their insights about the emerging managed care system and how it will impact PROS. Anyone interested in the future of PROS is encouraged to attend. 
staff interested in learning the nuts and bolts of benefits management. The latest changes in SSA guidelines will also be discussed. Participants will have the opportunity to: Understand the fundamentals of the Social Security System; Comprehend the difference between SSI, SSDI, Medicaid and Medicare; Gain knowledge of resources that support consumers in their living and working goals; Learn how to help consumers effectively use benefits to support their recovery.
This highly interactive full-day training will include updates on legislative and policy changes relevant to benefits management. Participants will learn how to assist consumers who have received more benefits than they are entitled to, such as when they are hospitalized or return to work. The focus will be on the most effective ways to respond to overpayments and to advocate for consumers. Participants will be taught how to complete a “waiver of overpayment” questionnaire and will be given valuable tips about how to navigate the Social Security bureaucracy. Participants will also have the opportunity to discuss their current cases, allowing for both expert guidance and input from colleagues. 
This full-day training is designed for mental health practitioners who seek to harness the power of groups to support individuals in their recovery. The training may be of particular interest to providers of Personalized Recovery Oriented Services (PROS) since group work is the main service modality in PROS programs. 
This webinar presentation, from OMH’s Bureau of Cultural Competencies, will focus on Medicaid, SSI and Medicaid Buy-in. The goal is to inform potential and current recipients of their rights and how to get information about these entitlements that would help them understand and advocate for these benefits. It will be held on two dates- the first will cover Medicaid and SSI, the second will cover Medicaid Buy-In.
experience a delay in diagnosis of addiction and may be prescribed medications that are unsafe for them. Alternatively, undiagnosed psychiatric illness may complicate primary addiction treatment and undermine ongoing recovery in these populations. This Webinar will review commonly diagnosed psychiatric disorders in LGBT populations, their clinical presentation, and special issues affecting addiction, its treatment and recovery. 
this lecture, “Compulsive Hoarding: Hope and Help for You or Your Loved One,” experts in this field will discuss what compulsive hoarding is and is not. Focusing on preventive measures for minimizing risks related to compulsive hoarding, their interventions highlight the importance of a client-centered approach that is supportive in nature. The speakers will introduce the ICD Clutter-Hoarding Scale, intended to assess health and safety issues involving clutter in the home. 
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The Temple University Collaborative on Community Inclusion of Individuals with Psychiatric Disabilities has revised and updated this factsheet primarily to assist those working with consumers in Centers of Independent Living . It also answers the questions, “Do people with Mental Illnesses Recover?” and provides a link to The National Empowerment Center’s guide Seven Characteristics of a Person Who Has Recovered from Mental Illness. 
It can be used independently, with a support person or in a small group of peers. The activities are written in pdf files on a CD, which allows the flexibility of printing out the sections as individuals go along in the process as well as the ability to print out extra worksheets as needed. Cost of the program is $39.95. 
In case you missed SAMHSA's Recovery to Practice PowerPoint October 6th, 2011 
webinar, "Step 4 in the Recovery-Oriented Care Continuum: Graduation," you may listen to or download a recording of it at: The Coalition Home | Center for Rehabilitation and Recovery | Site Map
Tel: (212) 742-1600 Fax: (212) 742-2132