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.

PROGRESS NOTES

Top 5 Tips for New (& Overwhelmed) Providers

By Susan Blayer, LMSW, MDiv

Starting a career as a behavioral health professional can be challenging.  Wading through paperwork, meetings and deadlines, while trying to engage and serve consumers can be overwhelming.

On the other end of the spectrum are providers who have been working in the field for so long that burn-out has set in.  Handling various crises, documentation demands, and multi-tasking  year after year can take its toll on a professional’s enthusiasm and productivity.

Here are some suggestions for providers new to the field, which can also perhaps serve as a refresher for those feeling a bit fried:

1.  Manage Your Time & Stress
There are few things more important than finding ways to make the best use of limited time. Being organized, sending reminders, making checklists, and prioritizing tasks at the beginning and or end of each day and week can all do wonders for establishing a less chaotic work flow.  A certain degree of flexibility is also critical, since scheduling conflicts often arise.  Essential for provider self-care is remembering to take time apart from job responsibilities. Short breaks to stretch, a full lunch hour enjoyed away from the office, brief chats with colleagues can do wonders for managing on-the-job stress.

2.  Practice Unconditional Positive Regard
“Unconditional Positive Regard” is the practice of accepting and supporting the people served in behavioral health facilities no matter what they say or do. Cultivating this type of unwavering attitude towards consumers is directly related to their recovery process. While challenging, the more providers can work with individuals without judging them, give them the space to make poor choices without rejection, and set boundaries for appropriateness in a gentle but firm manner, the more we can build trust and rapport. Unconditional positive regard is the foundation of respect.

3.  Excel at Engagement, Outreach & Follow-up
Once providers begin practicing unconditional positive regard, the tendency is to become more effective at engaging clients in the process of identifying goals and making changes so that they are successful.  Engagement requires that providers are fully present for the individuals who seek assistance, that they  listen openly without presuming to know the answers or pushing a specific agenda on them.  Outreach and follow-up are also part of the engagement process—the more a provider can reach out to consumers and follow up on the issues that matter to them most, the more consumers will feel heard, understood and cared about.

4.  Prepare for Crisis & Conflict
Social service programs without periodic crises and conflict do not exist, especially in NYC.  Clashing personalities, high levels of stress, and unmanaged symptoms can cause tempers to flare, and even some bizarre behaviors to manifest themselves.  Providers must become well-informed of agency policies and procedures regarding consumer expressions of violence or aggression, use of mood-altering substances (other than medication) during program time, and reports of ideation of harm to self or others.  If providers have not been given documentation about such policies and procedures, they should ask their supervisor for guidance.  Preparation before a crisis actually occurs will more likely lead to calm, efficient and safe outcomes for the program and its participants.

5.  Setting Boundaries
The ability to set healthy boundaries is a foundation of emotional wellness.  Providers are role-models of appropriate interpersonal limits.  This includes starting and ending groups on time, appropriately negotiating therapeutic self-disclosure, and establishing a mutual respect for privacy. Part of the work of a behavioral health professional is learning how to maintain a therapeutic distance.  It can be a difficult, yet worthwhile endeavor for providers to support and encourage consumers without becoming overly invested in their behavior or outcomes.  Setting boundaries also includes the ability to create this type of interpersonal space between provider and consumer.  The professional is the one to set the standard for such practices, in part so that consumers can feel empowered to own their choices and behaviors.

6.  Cultivate a Creative Attitude
Even providers who feel they are creative by nature can feel hard pressed to think outside the box when they have a significant amount of stress or pressure at work.  But the more professionals are innovative about getting the job done, the less overwhelming tasks may seem.  For instance, discovering ways to incorporate personal interests into program services and activities can make them more exciting for everyone.  Perhaps coordinating with colleagues a time each week to do paperwork together, with fun music or while having a favorite treat, may make mundane tasks seem more pleasant.  Sometime cultivating a creative attitude simply means shifting perspectives about a part of the job that initially seems dreadful.  Lastly, supervision should not be overlooked as a valuable resource.  Skilled supervisors can help their staff find creative ways to tackle work-related issues and inspire unique problem-solving options.

Additional Resources:

• 5 Things Your Addicted Client Wants You To Know

• Burned out at work?

• Mental Health Basics & References from the CDC

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Peer Perspective  

Peer Wellness Counseling

By Linda Baron-Katz 

An important part of recovery is wellness.  Wellness is a process that helps a person become aware of and make better choices that involve his or her physical, social, occupational, environmental, mental or emotional needs.  Peer Wellness Coaches help consumers create an overall healthier lifestyle.

A Peer Wellness Coach is a mental health peer specialist that is trained to help others with mental illnesses make positive changes when it comes to their primary healthcare.  Some of the roles and responsibilities of a Peer Wellness Coach are assisting peers in choosing, obtaining, and keeping a wellness goal and asking questions to help peers gain insight into their own personal situations.  This service is needed now more than ever, given that people with mental illnesses are dying younger than the rest of the population, due largely to high-risk behaviors such as smoking, poor eating habits, and substance abuse.

Mr. Robert Potter is a Peer Wellness Coach at the Postgraduate Center for Mental Health.  After graduating from the Peer Specialist training at Howie the Harp, and completing an internship at New York Presbyterian Hospital, Mr Potter enrolled in Howie The Harp’s, “Mind Your Health Peer Wellness Coaching Program”.

Mr. Potter explained that the difference between being a Peer Specialist and being a Wellness Coach is that Wellness Coaches look at the whole person, not just their mental health.  Mr. Potter explained that as a Wellness Coach, his primary job is to meet consumers where they are and help them determine their health goals.  Then he tries to make their transition into wellness as easy as possible.  For example, newcomers to his exercise group start off slowly with chair stretches before trying the bicycle and treadmills.

In engaging his consumers to achieve a positive, healthy lifestyle, Mr. Potter works with a variety of resources and organizations such as SAMSHA (The Substance Abuse and Mental Health Services Administration). Mr. Potter also refers his participants to clinics for physicals and other medical needs.  Sometimes he brings consumers to doctor appointments, or escorts them to the emergency room as their health advocate. After the visits, his team supports the consumer with follow-up care.  Mr. Potter also does research on the Internet to answer some of his participants health concerns.  To help his consumers make progress towards their goals, his team gives them a free Metro card, water bottles for exercising regularly, a movie ticket, and other incentives.

Without a Peer Wellness Coach, it can be difficult for many adults and children living with a mental illness and other health care conditions, such as heart disease, diabetes, obesity, osteoporosis, to take better care of themselves.  Sometimes we just need someone there to guide us through the steps and be by our side.

Providers may want to share this article in consumer groups on wellness, or with participants interested in learning more about Peer Wellness Coaching.

Click this link for additional information about Howie the Harp’s Peer Training Program.

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Center News  

Change and Growth at the Coalition’s Center for Rehabilitation and Recovery

As you may have heard, the Coalition, with our Center offices, has had to temporarily relocate due to severe damage to our building at 90 Broad Street.  The kind folks at Public Health Solutions are housing Center staff at their 40 Worth Street location until we receive clearance to go back to our home base at 90 Broad Street.

The rest of the Coalition staff remains temporarily placed at The Jewish Funders Network, which has provided a voicemail on which you can leave messages for any Center staff.  All of our regular email addresses (first initial last [email protected]) are available, if you prefer to contact us that way.

Our gratitude goes out to the leadership of Public Health Solutions and The Jewish Funders Network for graciously letting us work amongst their staff, and, as well, to all of you who have helped us secure space for our trainings.  We will do our best to periodically keep you informed, via our website and our newsletters, as to any changes to scheduled trainings and meetings.

In spite of the setbacks and challenges, the Center for Rehabilitation and Recovery continues to move forward to bring providers relevant trainings on requested topics.  We find ourselves at an exciting juncture of change and growth and have begun visiting NYC behavioral health programs so that we may better serve your needs. To this end, we invite you to join this process – let us know if we might be able to come visit your program, or if you prefer, to discuss your needs via a phone consultation.  Because of our dislocation, the best option is probably to send us an email at [email protected] or [email protected].

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Center Education and Training

Vocational Rehabilitation: Making Employment Services Work for Your Program

DATE: January 30, 2013
TIME: 10:30am -12:30pm
LOCATION:  IAC at 150 West 30th Street, 15th floor
         Register Online Here »

Ticket to Work. Employment Networks. NYESS.  If your program offers vocational services, you may have heard of Ticket to Work, but you may not have gotten all the information you need about how to connect with these services and benefit from their many advantages. The Ticket to Work and Self Sufficiency (Ticket) program provides Social Security disability beneficiaries the choices, opportunities and support needed to become and stay employed, increase earnings, and eventually leave and remain off benefits by being fully self-supported.

This free, half-day workshop will provide an overview of Social Security's Ticket to Work program, as well as The NY Employment Service System (NYESS). Focus will be on NY's approach to the Ticket to Work program and the many benefits to your agency, if they participate as an Employment Network (EN).

For those programs who are already participating ENs, and/or using NYESS, there will be a substantial Q&A period. Please bring your questions with you to the workshop.

SPEAKER: Andrew Karhan, OMH Director of Employment Programs for NYESS.

In his current role, Mr. Karhan interfaces with providers around the NYESS system, and the NYS Administrative Employment Network. He has over 15 years of experience in the not-for-profit realm, managing employment services initiatives within three states.  Mr. Karhan has been nationally recognized for his work in Supported Employment services, and has worked extensively on the State level to enhance the overall employment services system in New York State.

FEE: FREE for Community-Based Providers

Register Online Here »

The Center continues to hold our trainings at various locations throughout NYC. However, due to having been temporarily relocated as a result of residual damage caused by Sandy, our training schedule is somewhat in flux. 

Please visit the Center’s training registration page (hyperlink--www.coalitionny.org/the_center/training/) for the latest information about upcoming trainings or contact Susan Blayer @ [email protected] with any questions you may have.

We hope to see you at a training soon.

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Other Community Education, Events &  News

Save the Date: The Coalition’s Annual Conference on January 24, 2013

For more information and registration go to our website »

New Publisher for Psychiatric Rehabilitation Journal

The American Psychological Association is pleased to announce that it is now the publisher of the Psychiatric Rehabilitation Journal (PRJ), the official journal of the United States Psychiatric Rehabilitation Association (USPRA) and the Center for Psychiatric Rehabilitation at Boston University. First published in 1977, the mission of the journal is to promote the development of new knowledge related to psychiatric rehabilitation and recovery of persons with serious mental illnesses.

The Psychiatric Rehabilitation Journal (PRJ) publishes original contributions related to the rehabilitation, psychosocial treatment, and recovery of people with serious mental illnesses. PRJ’s target audience includes psychiatric rehabilitation practitioners and researchers, as well as recipients of mental health and rehabilitation services.

PRJ encourages submissions regarding mechanisms of change in rehabilitation and psychosocial treatment programs, as well as evaluation studies of model programs, and investigations of effectiveness and cost-effectiveness of programs conducted in “real world” settings. Also welcome are descriptive studies of “cutting edge” programs, especially those informed by the lived experience of mental illness.

Prospective contributors and subscribers are encouraged to visit the Journal’s APA homepage:

NYS Office of Alcoholism and Substance Abuse Services RFQ: Authorization to Certify Peer Advocates

OASAS is seeking qualified organizations to become authorized to certify individuals as peer advocates to provide services, some of which may be eligible for Medicaid Reimbursement (in accordance with relevant OASAS laws and regulations; and, the OASAS Clinical and Billing Guidance manual regarding Ambulatory Patient Groups (APG)). 

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Benefits News

January brings adjustments to Social Security benefits.

People who receive SSI or SSDI should have received an Award Letter letting them know how much their monthly check will be in 2013.  The Red Book, available at www.ssa.gov has a full list of updates for the new year (look in "What's New for 2013").  Some examples of changes:

• Those who live alone (in New York State) will now receive $797 in SSI.
• The monthly earnings amount that will now be used to determine if that month counts for the Trial Work Period (TWP) is $750 per month, as of January 2013.  
• The Substantial Gainful Activity (SGA) amount for individuals with disabilities other than blindness is raised to $1,040, and the SGA amount for those who are blind is $1,740 for 2013.

IMPORTANT NOTE: All recipients of Federal benefits MUST arrange for direct deposit or direct debit card by March 1, 2013. Time is running out. Call 800-333-1795 or go to GoDirect.org to sign up.

If you have other questions or would like to schedule an on-site consultation, please contact the Center’s Benefits Experts, Margie Staker at [email protected] and Pat Feinberg at [email protected].

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Mental Health Articles, Publications and Reports

To read the full articles, click on this month’s headlines, below:

Relationship with Patient Can Determine Treatment Success (Psychiatric News, Dec. 2012)

Young Woman with Borderline Personality Disorder Uses Social Media to Transform the Pain of Her Experience (Brain & Behavior Research Foundation, Oct 2012)

Schizophrenia Gene Networks Found, with Link to Autism (Columbia Medical Center Newsletter, Nov. 2012)

With Peer Support, Recovery is Possible (SAMHSA News, Fall 2012)

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