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An electronic circular of the Coalition's Center for Rehabilitation and Recovery
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No. 67, January 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 “A Celebration of Strengths” By Courtenay M. Harding, PhD There are all sorts of definitions of strength: being strong in body or in numbers, mental force, potency, cogency of argument, effective action, intensity, endurance, sturdiness, efficacious, and vitality (1,2). After nearly 140 years of looking for deficits, damage, problems, and pathology, mental health care is beginning to turn upside down and is now learning to focus on strengths to build recovery from serious and persistent psychiatric problems (3,4). Positive Psychologists are now studying ingredients such as courage, hope, wisdom, creativity, perseverance, giving to others, happiness, autonomy, self-regulation, and future-mindedness (5,6). Imagine that! If you look beyond the diagnostic label and odd behaviors, you will undoubtedly unearth many strengths, such as aspirations, competencies and talents as well as environmental resources, social supports, and opportunities (if provided) which each individual has to use in bootstrapping themselves toward recovery (7). Much to our great surprise, people actually got better in spite of little or no insight, symptoms not going away first, history of substance abuse, traumatic experiences, mixed efficacy of medications, many medical problems, and even in spite of some kinds of help we offered (8). When we shifted from the list of problems to strengths we found all sorts of useful areas with which to engage people in their own recovery process. As an example in a group of people, we first looked at an overwhelming list of problems and pathology: depressed, delusional, assaultive, suicidal, manipulative, poor social skills, demoralized, acting out, angry, unpredictable, poor hygiene, unmotivated – the list went on and on. When we took a second or third look for strengths, this is what we found in the same group of individuals: a sense of humor, persistence, musical talent, artistic, cultural heritage, spiritual, educated, personable, feisty, charming, intelligence and again the list went on and on (8)! Think about it. Wouldn’t you rather people appreciate your own strengths and help you grow with those attributes rather than listing all the downsides that we, as fallible humans, have? The irony is, if you mostly ignore the problem areas and focus on the strengths, goals, and aspirations one has, the natural consequences, which impede growth, are gradually found to be intolerable to the person and lessen over time while dreams begin to come true. Ignoring problems is exactly the opposite of what clinicians have been repeatedly taught and at first it doesn’t make sense to our ears because we learned to “fix broken things.” But living broken things can indeed fix themselves when clinicians, family members, and friends hold up mirrors which reflect the healthy and competent parts of selves. Happy New Year! Selected References:
PROGRESS NOTES “Finding the Spiritual: The Chaos and Calm of Change" By Susan Blayer At the Center’s latest PROS Learning Collaborative, the subject of change and its companion, chaos, was a topic of discussion. I began to wonder, if change is always accompanied by a certain amount of disorder and anxiety, can spiritual practices help to alleviate some of this uneasiness? It seems that people, especially professionals, tend to shy away from talk of God and religion because there is great room for inappropriateness—by offending, or proselytizing, or being judgmental. Additionally, many individuals have found themselves greatly wounded by religious family members, friends, leaders, even entire communities. One’s concept of a spiritual self, including beliefs about God, something greater than oneself, is highly personal and profound, so discussions around these subjects need always be sensitive, gentle and exploratory. But if we are going to elicit change and work through its chaos—from converting to a PROS program to finding employment with mental health challenges to achieving New Year’s Resolutions-- these dialogues are worthy endeavors. The chaos of change typically manifests itself in the psyche as stress and in the body as illness. There is mounting evidence that connection to ones’ spirituality, whether in community or individually, has a positive impact on wellness. In a recent article on npr.org, Dr. Andrew Newberg discusses his work scanning the brains of praying nuns, chanting Sikhs, and meditating Buddhists. These scans have shown that such spiritual practices can actually shape a brain, increasing focus and memory. (1) George Koenig and his colleagues found that Judeo-Christian religious practices are associated with lower blood pressure, less hypertension and better immune function. (2,3) Robert Schneider and his groups found similar results when using meditation and relaxation practices which trace their origins to Vedic and Buddhist traditions. (4) Several studies have also indicated that Buddhist–based mindfulness practices are effective in reducing anxiety, depression, and somatization while enhancing participants’ social functioning, capacity for empathy and overall sense of well-being. (5,6) Perhaps you or those around you are struggling with the stress of change. That change brings with it a certain degree of chaos and ambivalence is inevitable, but it also brings an opportunity to seek serenity in a way you may not have before. It may be that in the midst of those fears and pressures, one can strive to connect to The Spiritual though mindfulness, meditation and relaxation practices, through being in community with those with similar beliefs or spending time immersed in music or nature. It can also be as simple as actively choosing behaviors that embody principals greater than oneself, such as generosity, patience, gratitude, tolerance, the ability to give and receive love, kindness, hope, faith in the good, and perseverance, to name a few. Who knows, some day these spiritual modalities may even qualify as Evidence-Based Practices. Selected References:
To give feedback or ask questions about this article, please feel free to contact Susan at [email protected]. For Susan Blayer’s professional background, refer to her announcement in the October 2010 issue of RECOVEReWorks. Center News Center’s Peer Job Board: A Way to Increase Peer Employment in PROS Programs As a growing number of agencies launch PROS programs in New York City, providers have become interested in hiring more peers. This is not easy to do, particularly when providers consider hiring peers who already receive services in one of their programs. Providers were able to explore this issue and generate solutions at a recent PROS Learning Collaborative. There can be many difficulties when providers hire peers who are also participants in one of their programs. Such an employment situation may place the agency at risk for violating the anti-kick-back statue in Medicaid. By hiring peers they may be open to the charge that employment is being used as a way to induce the peer to participate in the program. This situation is considered a conflict of interest. To address this potential problem, an agency can communicate directly with the Center for Medicare and Medicaid Services, though that can be an administrative headache. Another concern with hiring peers who are also participants is the peer provider’s dual role: staff member and participant. This can cause confusion for the peer, which can undermine his/her job performance and/or recovery. The dual role also creates difficulties from an employee relations perspective because the agency/employer has prior access to the peer provider’s clinical information. This can complicate supervision and may violate HIPAA regulations. Fortunately, many of these problems can be avoided if PROS providers hire peers from other programs outside of the agency. To facilitate this process the Center listened to providers and created a Peer Job Board, which the Center launched on its website last month. Beyond avoiding the difficulties mentioned above, the Peer Job Board offers many benefits:
We hope that PROS providers will discover creative ways to employ more peers in their programs, and utilize the Center’s Peer Job Board to advertise those openings. Additionally, agencies with Peer Advocacy programs are encouraged to introduce their members to the Job Board and ways it can work for them. To post or search job opportunities, please visit the Center’s Peer Job Board at:: http://www.coalitionny.org/the_center/jobs/The PROS Learning Collaborative Hosts Martha Long of The Village The PROS Learning Collaborative Meeting was held December 14th with Martha Long, the recently retired founder and CEO of the world-famous and recovery-oriented Village ISA in Long Beach California. She spoke about their initial start-up, which she admitted was much easier than the conversion of existing programs into PROS. She also talked about other challenges for staff and ways to reduce anxiety around the new billing language legitimizing the codes and dealing with retention issues. She closed the meeting talking about the ingenious ways that the Village celebrated successes, such as the annual Golden Ducky Award night based on the Oscars. Everyone dressed up, a limo was rented, flashbulbs flashed on the red carpet, and everyone was given a golden rubber duck for some achievement during the year .Center Sponsors Forum to Help Peers Earn & Save Money The Coalition’s Center for Rehabilitation and Recovery is pleased to sponsor an “Economic Self-Sufficiency Forum” for consumers who want to learn how they can earn and save money without losing their benefits. Center staff have worked with the Department of Health and Mental Hygiene, and several sponsors, to create a dynamic event that will equip consumers with knowledge and tools to climb out of poverty. The forum will feature a bevy of expert speakers, including financial educators, benefits specialists and people who have achieved economic self-sufficiency. Event details appear below: Date: Tuesday, January 25th, 2011 The Center encourages agencies to circulate this information among staff and consumers. Download the flyer for this event and learn more.
Inspiring Stories and Recovery Research: Hope and Resilience for Staff This half-day training will provide evidence from the eleven long-term studies of serious and persistent psychiatric problems, which revealed that most people can significantly improve and many even recover over time. The stories about how staff participated in helping people reclaim their lives inspire us all. Dr. Courtenay Harding will show that hope, temperament, and human resilience of both staff and consumers all play roles in the recovery process. Facilitator: Courtenay Harding, PH.D Dealing with Overpayments & Ask the Expert 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. Facilitator: Ed Lopez-Soto, Esq
The Must-Attend 2011 Behavioral Health Conference “Behavioral Health: How Does It Fit,” is a conference you will not want to miss. This event is an opportunity for providers to take a step back from the day-to-day challenges and think creatively about where behavioral health fits into state and national priorities in this changing environment. The conference features national and state government leaders together with thought leaders from the NY community to lay out a framework for both the immediate future and anticipated transformations going forward. The cost is $150 for Coalition members and $200 for non-members. Seats will go fast, so reserve yours by registering today. Keynote Speaker: Barbara Coulter Edwards, the Director of the Disabled and Elderly Health Programs Group in the Center for Medicaid, CHIP, and Survey & Certification at CMS Date: January 24, 2011 Call for Proposals for NYC’s 5th Annual Peer Specialist Conference The Peer Specialist Conference Planning Committee is currently seeking proposals from working peers for New York City’s 5th Annual Mental Health Peer Specialist Conference. This conference, entitled, “Working Peer Specialists: All workshops are 75 minutes long; please refer to the proposal form for topic examples. The deadline for submissions is January 20th, 2011. Peer Specialists, Peer Wellness Coaches, Peer Bridgers etc. who can provide insight on the future development of the role of peers in the workplace are encouraged to email their proposals to: [email protected] or mail to: The New York State Office of Mental Health Columbia University’s Center for Practice Innovations FIT Initiative Online Meetings in January The Center for Practice Innovations at Columbia University’s Focus on Integrated Treatment Initiative (FIT) offers web meetings so that providers may collaborate with FIT staff and other OMH and OASAS agencies in planning and improving your co-occurring services. Three FIT co-occurring disorder treatment webinars have been scheduled for January: Title: Developing Stage-Wise Treatment Groups Title: Implementation of Integrated Treatment for Co-occurring Disorders on an ACT Team: What does it take? Title: Clinical Supervision and Field Mentoring For more information and to register go to: http://www.practiceinnovations.org/ NYU Silver School Offering Continuing Education Course: Spirituality and Social Work If you are a Social Worker in NYC, you might want to consider investing in a continuing education course being offered by NYU Silver School of Social work which begins on January 7th. It is described as a post-Master’s certificate program which highlights the importance of spirituality in addressing presenting problems and demonstrates its value in a clinical setting. For more information, visit: http://www.nyu.edu/socialwork/pdf/continuing.education/spirituality.and.social.work.pdf) Supporting Self-Determination and Enhancing Career Development for Young Adults with Mental Health Diagnoses Webinar Providers are observing an increase in younger consumers in their programs, especially those seeking employment. This webinar, provided by the Research and Training Center for Pathways to Positive Futures, uses research to address how self-determination processes in career development for young adults with mental health diagnoses can enhance the capacity for effective career development activities. Date: January 25th, 2011 The Center invites your organization to announce upcoming trainings and events in RECOVEReWorks. Please send submissions to [email protected]. Educational Materials for Families Judith Carrington, the founder of Mental Health Resources, is now offering educational services to providers interested in learning how they can engage families to achieve better outcomes for consumers. Ms. Carrington co-authored the “Family Survival Handbook” which is co-sponsored and distributed by the NYS Office of Mental Health and the NAMI—NYC. To learn more about the services available through Mental Health Resources and to access family psycho-education materials, click the links below: SAMHSA’s RTP Recovery-Oriented Outreach and Engagement Download Now Available If last month you missed SAMHSA’s Recovery to Practice webinar, “Step 1 in the Recovery-Oriented Care Continuum: Outreach and Engagement,” it is now available for download from the RTP Resource website: http://www.dsgonline.com/rtp/resources.html |
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