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An electronic circular of the Coalition's Center for Rehabilitation and Recovery
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No. 70, April 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 REPURPOSING A LIFE By Courtenay M. Harding, PhD A person comes in with a psychotic episode. They are viewed as a car wreck. “My goodness, you poor thing. You have had a car wreck. Now let’s find out just how serious this wreck is.” “Do you have a broken windshield? Do you have a damaged fender? How about a broken axel etc?” “Now let’s find out what was happening in the environment at the same time. Did someone run a red light? Were the roads slippery? Was the visibility poor?” “Then, let’s find out what led up to why you had this accident. Were you drinking? Did you swerve to avoid a dog? Did you run the red light? Did you have an argument with your Mother?” (note: Psychiatrists always manage to ask that question!) By the time we get though, the person thinks of him or herself as a poor driver who has made a real mess of things but has a great new vocabulary to describe it all. Thus, they are reduced to patienthood as the primary purpose and meaning in their life. “Neurons that fire together wire together.” This means that the collateral damage of the narrow medical model is literally reducing neuroplasticity to a negative one of a narrow and rigid viewpoint and path, something, which we call chronicity. The collateral damage leaves a person thinking “I am someone with a broken brain. I am someone with screwed up neurochemicals, and with symptoms, which make me ill. I need medications to help these symptoms. I find I can act out, there is a bunch of people who tell me I need to get ‘fixed up’ if I ever want to be a real citizen in a real society again. So now the meaning and purpose in my life is patienthood. I am a consumer, a user of services, a ‘schizophrenic.’ I can talk about how angry I am that I wrecked the car or that the car got wrecked and that I must rely on others to get better. I have forgotten what it is like to feel better, forgotten my hopes and dreams. I have settled some of the chaos by clamping down on it, defining it with a name. I see the recovery process as needing to correct:
Rehabilitation is re-purposing a life. It undoes the inadvertent damage of a psychosis as well as the deliberate well meaning but true collateral damage which we have done by taking away personhood. Rehab holds up a mirror of possibilities or positive pathways to become a full person again. The rehab field says: “Let’s help you get your life back, undo the damage, focus on a home, a job, friends, fun, using your talents with a life full of dreams and hopes and citizenship.” In doing so you might also regain 4 new tires, straighten out the chassis, clear the windows, develop a strong drive train and good steering mechanism. Further, you will get a new GPS system to keep you on track. You start by walking with a compass and focus on your strengths. As you get stronger and stronger by focusing on the outside you will rebuild the inside. People, called patients, are already quite resilient having survived not only problems but the old system of care. They are already hopeful even if it is only for surviving until tomorrow. Let’s build on these strengths to help people repurpose their lives. *Spaniol, L., Gagne, C., Koehler, M.: (1999). Recovery from serious mental illness: What it is and how to support people in their recovery. In R.P. Marinelli & A.E. Dell Orto (Eds.) The psychological and social impact of psychiatric disability. (4th Edition). New York: Springer Publishing. “It’s A Family Affair: The Art of Creating Kin” By Susan Blayer
Family. It is a powerful and loaded word. More than a word, “family,” is a concept, a social construct which goes to the heart of who we feel we are, where we have come from, and often, what we have left behind. In mental health, we tend to ask questions which automatically assume that “family” equals “family of origin.” Yet it could be argued that consumers and civilians alike are constantly redefining what “family” looks like for us. No doubt, our primary caregivers and other “first family” members play a huge role in our formation. In adolescence, the need to “separate and individuate” often manifests itself in declarations of “friends as family.” Peer and intimate relationships outside of home take priority. The need to create identity within a larger social context takes precedence. In adulthood, many seek to have long-term partnerships, perhaps to raise children, and settle down into what was once called the “nuclear family.” That concept has largely been replaced by the reality of unique and blended families, extended families, single-parent families, grandparent-driven families, same-sex parent families, families purposefully without children. Perhaps without our awareness, creating kin has become the norm. We have a say in who we want in our lives and who we don’t. We can allow others to support us, and can work on acceptance when they do not. We can fight to fix broken relationships or detach with love. We can find comfort in the old adage that some people are in our lives for a reason, others a season, and still others, a lifetime. It has become our right to determine who we belong with, to choose who is with us. The Temple University Collaborative on Community Inclusion of Individuals with Psychiatric Disabilities website informs us that an estimated 50% or more of people with serious mental illnesses do not have contact with their families [of origin.]* Family psychoeducation, building natural support systems, and community integration are processes which often necessitate that consumers create “families” for themselves. For recovery, this is vitally important, as those who have been institutionalized, ostracized, marginalized and stigmatized can finally feel they are being seen and embraced for who they are. Thus, creating kin can be a gateway to creating a new identity, one that focuses on support, strengths and goals rather than illness, deficits and problems. Our Center Director, Dr. Courtenay Harding, is sharing a tool she developed to give consumers and providers a way to begin talking about the idea of “family,” which may be significantly painful for some. It is called The Star Chart, which is designed to assess the breadth and depth of a person’s social support system. This tool provides a method of gathering information in a systematic and structured way, but is fun and informative at the same time. With the Star Chart, consumers are able to identify which individuals in their lives, including providers, can take on various roles in helping them work toward recovery goals which increase autonomy in a way that feels safe and supported. This month, the New York State Office of Mental Health is offering a webinar entitled, “Recovery and Relationships.” This session will explore ways people living with mental illness can create deep connections with others, (even pets), as an essential component to rehabilitation and wellness. Participants will have the opportunity to interact with panelists who will be sharing their stories about how supportive, healthy relationships had a positive impact on their recovery. The process of constructing a family for oneself, with or without the barriers of mental illness, is an art, in that it requires not only creativity, but also the fearlessness vulnerability requires. Being open to showing people who we genuinely are, and allowing them in, (especially if we have experienced past rejection), takes courage. As providers, we can help by encouraging consumers to develop this “artistic skill” by developing services which utilize some of the tools mentioned in this article to keep the dialogue open about ways to create kin. For an extensive list of Community Inclusion resources, including peer reviewed publications and a downloadable version of Into the Thick of Things, the December 2010, 50-page compendium of three-dozen exemplary community inclusion initiatives, go to: http://tucollaborative.org/resources/resources.html For more information about personalized training using the STAR Chart, please contact Dr. Harding at [email protected] For more information and to register for the OMH “Recovery and Relationships” webinar on April 20th, please go to: https://www1.gotomeeting.com/register/406790064 * The Temple University Collaborative on Community Inclusion of Individuals with Psychiatric Disabilities, A National Rehabilitation Research and Training Center: http://tucollaborative.org/comm_inclusion/relationships.html
Center Staff Visits Bronx Real PROS On March 15th, Aaron Vieira and Courtenay Harding went up to the second to last stop on Subway #1, to visit the Bronx Real PROS program which is part of JBFCS. They attended groups and interviewed participants and staff about their views on PROS. Later, Dr. Harding provided a presentation on “Turning the Recovery Model Downside Up and Outside In.” To learn more about the Bronx Real Pros program, visit: http://www.jbfcs.org/programs.php?id=45
Center Training Schedule Available on Website Now you can plan ahead to attend upcoming Center trainings. Our calendar is now available for you to view and print from our website. Please go to: http://www.coalitionny.org/the_center/training/ and click on link to the right entitled, “Winter/Spring Schedule, 2011” to see what we have to offer. Note: If you are typing the URL in your browser, the space between “the” and “center” is in reality an underscore symbol “_”.
Please be advised that the following upcoming training sessions are now closed: Guiding the Group: Advanced Group Work, April 5th, 2011 Filled to Capacity! Comprehensive Benefits Management 3-Day Training, April 13-15 Filled to Capacity! Guiding the Group: Advanced Methods Prerequisite: The Center strongly recommends that participants complete our training, "Recovering Together: Introduction to Group Work", before taking this training. This half-day training is designed for experienced group leaders in mental health programs who are interested in learning cognitive behavioral techniques that help group members change their patterns of thinking, feeling and acting. 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. Facilitator: Aaron Vieira, LMSW Opening the Toolbox of Rehabilitation Resources Participants in PROS programs lead very complex lives as they strive to get their equilibrium back and pursue a life of purpose and meaning. Clinicians in PROS programs lead very complex lives as well. This workshop will provide concrete and practical tools and strategies for the clinician to help people move forward in reclaiming their lives. Each clinician needs a “little black bag” with tools of the trade stuffed inside to pull out when needed as the person with whom they are working wants to have a clearer head, a healthier body, “a home, a job and a date for the weekend!” This workshop will be interactive and fun. Facilitator: Courtenay Harding, PH.D To register for any Center training or to print our training schedule, please go to: www.coalitionny.org/the_center/training/ Note: If you are typing the URL in your browser, the space between “the” and “center” is in reality an underscore symbol “_”.
The Coalition’s Professional Learning Center’s Advanced Management Training Institute This year, the Coalition’s Advanced Management Training Institute will focus on effective management and leadership during difficult economic times. In a period of continuing reduction of scarce resources, being a manager in a behavioral health organization means confronting unprecedented challenges. Facilitators will lead six half-day workshops utilizing an interactive, seminar format and making use of case studies, role-play, simulation and group projects. Two April workshops: Title: Utilizing Performance Indicators / Maximizing Revenue Title: Managing Difficult Employees / Mediating and Resolving Conflicts Treating Tobacco Dependence in Mental Health Settings Last month, the RECOVEReWorks column “Progress Notes” highlighted the need for smoking cessation programs within mental health settings. The UMDNJ-Robert Wood Johnson Medical School in New Jersey is addressing this issue with a one-day event entitled, “Implementing a Wellness Curriculum on Tobacco to Engage Smokers with Mental Illness.” This Continuing Education training will teach providers in a behavioral health setting how to implement a group wellness curriculum with smokers who may not be ready to quit. The fee includes tuition, technical assistance, daily parking, breakfast, lunch, educational handout materials and continuing education credit. A discounted registration fee of $30.00 is available to peer specialists accompanying a registered clinical/administrative team member. (Completion of a pre-registration survey is required.) Date: April 7, 2011 RTP Resource Center 2011 Webinar Series—Note: Date Change This webinar, entitled, Step 2 in the Recovery-Oriented Care Continuum: Person-Centered Care Planning, will describe the approach of person-centered care planning as it is being developed for people with serious mental illnesses. This includes identifying and setting goals, identifying and building on personal and familial strengths, identifying and addressing barriers and obstacles to recovery, and convening and assigning relevant tasks to members of the person’s “team,” including family and other natural supports. Date: April 11, 2011 The NYAPRS Collective Presents The Executive Seminar on Systems Transformation NYAPRS is holding its 7th Annual Executive Seminar entitled, Integration Strategies for Behavioral Health: Managing Care, Outcomes and Costs While Preserving our Recovery Vision. Please mark your calendars for this very timely, information and input packed opportunity to help your hear and shape rapidly emerging changes that will dramatically change the face of behavioral healthcare service delivery in New York State. Date: April 27-28, 2011 Peers in the Workforce: Working Towards Recovery The NY Chapters of the American Associations of Community Psychiatrists and Psychiatric Administrators, with the American Psychiatric Association NY District Public Psychiatry Committee invite you to attend their 2011 conference, Peers in the Workforce: Working Towards Recovery. All human services providers are welcome. There is no registration fee. Breakfast (at 8:30am) and lunch (at 12:30pm) are provided. Date: April 29, 2011 Call to Action: National Children's Mental Health Awareness Day May 3, 2011 National Children's Mental Health Awareness Day is a day to join SAMHSA, communities, organizations and agencies, and individuals nationwide in raising awareness that positive mental health is essential to a child's healthy development from birth. This year, the national theme will focus on building resilience in young children dealing with trauma. Communities around the country will participate by holding their own Awareness Day events, focusing either on the national theme, or adapting the theme to the populations they serve. As always, the release of the SAMHSA Short Report, (which features how systems of care can positively affect children who have experienced trauma), will coincide with Awareness Day. For more information and ways to participate: http://www.samhsa.gov/children/national.aspx Save the Date: US Psychiatric Rehabilitation Association 36th Annual Conference The theme for the US Psychiatric Rehabilitation Association’s 36th Annual Conference in Boston is “It Began with a Vision…A new world of possibilities.” Boston is recognized as a city where the vision of psychiatric rehabilitation came to life. Here you will expand your knowledge and skills to implement psychiatric rehabilitation and recovery-oriented services at 70+ learning sessions, through networking, and world-renowned keynote speakers (including Patrick Kennedy, Patricia Deegan PhD, Robert Drake, MD, PhD, and Gary Bond, PhD). Dates: June 13-16, 2011 Announce Your Upcoming Event in RECOVEReWorks! Announcing Stigma Research and Action, a New Peer-Reviewed Open Access Journal Stigma Research and Action (SRA) is a new online, open access, not-for-profit peer-reviewed journal that offers international perspectives on stigma attached to illness, disability, and membership in marginalized groups. SRA is a multidisciplinary forum for the dissemination of information advancing both research and practice as applied to any stigmatized condition or group. Readers are encouraged to register via the Web site to receive publication notifications and calls for papers: http://stigmaj.org/ For more information and queries, please contact Amir Tal, SRA executive editor, at [email protected]. New Guide: Cultural Competency in Mental Health Peer-Run Programs and Self-Help Groups The NAMI STAR Center and the UIC National Research and Training Center partnered to create a user-friendly guide and tool to help mental health peer-run programs and self-help groups assess and cultivate their cultural competency. The tool guides users through a step-by-step process to identify strengths and limitations in meeting the needs of diverse program members. It overviews how to create action plans to enhance cultural competency in five key organizational areas. Download available now: http://www.consumerstar.org/pubs/SC-Cultural_Competency_in_Mental_Health_Tool.pdf Mental Health News Issue on Geriatric Mental Health The latest edition of Mental Health News on "The Mental Health Needs of Older Adults" features an article which reflects upon New York State's recent progress on geriatric mental health issues and outlines additional steps that need to be taken before the state is ready for the elder boom. Other articles discuss the need for integrated care, the importance of peer supports, barriers to accessing care, geriatric substance abuse, integrated housing, innovative dementia care, serving homebound elders, PROS for older adults, and more. For the online version of the issue, go to: http://www.mhnews.org/ |
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