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An electronic circular of the Coalition's Center for Rehabilitation and Recovery
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No. 73, July 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 Why Is It So Hard to Believe in Recovery? (Part 2) By Courtenay M. Harding, PhD Two NYC researchers, Pat and Jake Cohen undertook a very interesting study in the early 80s. Both were statisticians in two different departments of psychiatry in the city. Together, they had written one of the primary textbooks on multivariate analysis. In another collaborative study, they looked at the composition of physician caseloads, including, but not limited to, psychiatry. What they found was startling. Caseloads tended to be made up of two percent of the most seriously ill patients who were seen 64 more times than anyone else. This was called “The Clinician’s Illusion”(1). Two percent sixty four more times! It would certainly change one’s perception about what was and was not possible for people and would generate a different set of expectations. And that is also what happened to me as a neurosurgical ICU nurse. I saw so many kids with brain tumors that it seemed to me that every third child in America had one. I would rush home and hug my own three children and bless the good fortune we had. I wrote up a list of these dreadful diagnoses and gave them to my local pediatrician who was a superb diagnostician. His response was: “Well, I see one of those kids once very ten years or so.” He had a practice equal to that of three pediatricians and saw lots of children. I learned that I, too, had suffered from “The Clinician’s Illusion.” It had been all too easy to succumb to it. I suggest that many of our hard working clinicians have also succumbed especially because they are systematically deprived of good outcome information about previous service users. I believe that peer providers and other peers who are far along in their recovery process are the very best examples of an amazing process shown by people reclaiming their lives right in front of our noses. They have described many different phases involved in such a process. Phase One has been described as “feels confused, disconnected from others, powerless, and out of control.” Phase Two was defined as “coming to terms with disability and could live a satisfying life with a disability,” and Phase Three was living beyond the disability and “feels well connected to self and others in the living, learning, working environment and experiencing a sense of purpose and meaning in life.” (2) Most clinicians, these days, are beginning to see and promote Phase Two but many still doubt the idea of living beyond the disability and reclaiming life. What clinicians are not so aware of is how very hard the work is for a participant to reclaim a life! People have said they are recovering from “loss of self, connection, hope, roles and opportunities, rebounding from devaluing, and disempowering programs, practices, and other environments in which there are stigma and discrimination.” All of which has led to “internalized sense of oppression and shame!” (3) Spaniol, Gagne & Koehler go on to say that the amount of work to recover requires hard effort and a belief that it might be possible including the following: “taking stock and an active role, learning to rely on the self, finding supports, learning better coping and to love, increasing self-esteem and self-monitoring, building on reality, finding some kind of spirituality, and reclaiming hope.” (4). Inch by inch with two steps forward and one back, our old chronic system is beginning to reawaken to all sorts of new possibilities to help people learn to live beyond their struggles and to reclaim lives realizing now that significant improvement and even full recovery may really be possible for participants. References 1) Cohen, P. & Cohen, J. (1984) The clinician’s illusion. Archives of General Psychiatry, 42 (12): 1178- 1182. “There’s Always Another Tomorrow: The Evil Genius Procrastination” By Susan Blayer I have to resort to all types of tactics to get my 5 year old daughter to clean her room. Usually, I end up saying something like, “In the time it took you to argue with me, negotiate, and writhe on the floor in anguish, you could have had it done.” Yet, while it is my parental responsibility to push her to do her chores, can I really blame her for wanting to procrastinate when faced with them? Causes of Procrastination Types of Procrastinators
I would add a fourth type—the Activity Dreader, those who, (like my daughter at clean-up time), will find any excuse to avoid a particular undertaking. My sister and I have been known to engage in what we coined “procrasto-texting”—spending an inordinate amount of time texting one another in order to avoid unpleasant activities (in her case, schoolwork; mine, laundry—see cartoon above). Procrasto-texting, (or procrasto-emailing, procrasto-websurfing, procrasto-facebooking, etc.), represents the current zeitgeist of readily available and cunning diversions whereby we can convince ourselves that we are actually doing something productive while that pile of paperwork sits on our desk. Degree of Procrastination Pros of Procrastination I believe that for some people procrastination also serves the purpose of giving them time to process what they are feeling, whether it be regarding dreaded responsibilities or stress over a life-changing decision. Ironically, sometimes putting a bit of time between ourselves and the things we do not want to deal with can give us the space to work through complicated emotions and make better choices. Other times, we may just need to slow down the pace of our lives or perhaps balance our work and leisure activities in a more effective manner. Suggestions for Managing Procrastination
Today or Tomorrow? As a general rule, I’d say to employ one (or more!) of my suggestions if continuing to procrastinate causes serious negative consequences or emotional stress that is hindering your quality of life. If not, enjoy the day—make the most of doing nothing, or at least nothing productive. There’s always tomorrow. References
In Her Voice: Pat Feinberg Attends the National Council Mental Health and Addictions Conference The Center’s Peer Educator and benefits management expert, Pat Feinberg, was honored with a full scholarship to attend the 41th National Council Mental Health and Addictions Conference in California. Here she shares her experience: I was nominated by The Coalition to attend the 41st National Council Mental Health & Addictions Conference on May 2-4, 2011 in San Diego, CA. As healthcare goes through a time of unprecedented changes, it was an honor for me to be present at “Be the Change,” the theme of this 2011 conference. In addition, it was a chance for me to be informed and inspired as to exactly how we are going to meet the demands of this changing landscape. Dr. Donald Berwick, Administrator for the Centers for Medicare & Medicaid Services, stated we need to change our delivery system of care and the tools for change are in the Affordable Care Act. According to Dr. Berwick, cuts and decreased benefits and eligibility are not the solution. I agree with Dr. Donald Berwick’s viewpoint that there should be a move toward shifting “control and power out of the hands of those who give care and into the hands of those who receive it.” Dr. Berwick is dedicated to bringing better healthcare to the people as well as reducing costs. The Mental Health Center of Denver provided an example of new and exciting technology as another way to meet those demands of a changing landscape. I was impressed by the Mental Health Center of Denver and the utilization of four measures of recovery from the clinician as well as the consumer viewpoint. Especially notable was the visualization for the consumer and clinician to be able to intervene in a timely fashion as well as document recovery. Recovery is even more compelling when it is driven by data from different perspectives. In conclusion, I walk away inspired by the energy and creativity that we will weather the storm. Center Staff to Deliver Training for Peer Coaching Program at Howie the Harp The Center’s Associate Director, Aaron Vieira, is pleased to be delivering group leadership training for the Mind Your Health Peer Coaching Program (MYHPCP). This important program was originally developed by the NYC Department of Health and Mental Hygiene and has now been incorporated into Howie the Harp’s continuing education program. MYHPCP is designed to train a set of Peer Wellness Coaches so they can assist individuals in setting and achieving health goals. MYHPCP represents an exciting learning opportunity for peer specialists. The program will consist of 16 workshops, to be held weekly from September 12th to December 13th, 2011 from 6:00-8:30 p.m. on Monday and/or Tuesday evenings. Twenty-five applicants will be selected who are committed to being advocates for healthy lifestyles in the workplace and community. There is no cost to apply or attend the training. Applications will be accepted through Monday, August 1st, 2011. To download the application, click this link: Howie the Harp Mind Your Health Peer Coaching Program—Application Package. CALL TO PROVIDERS--Post Your Open Peer Position on our Peer Job Board: http://www.coalitionny.org/the_center/jobs/ Note: If you are typing the URL in your browser, the space between “the” and “center” is in reality an underscore symbol “_”.
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 “_”.
Come Celebrate the Coalition's 27th Annual Awards Reception
The Coalition of Behavioral Health Agencies cordially invites you to our 27th Annual Awards Reception. The Honorees this year for Leadership Awards are:
The Honorees for Member Service Awards this year are:
The deadline for ticket reservations is July 8, 2011. Please note that in addition to the regular ticket price of $225 per person, there is a government rate of $50 and a consumer rate of $35. If you have any questions ticket orders please contact Negri Management Resources by email at [email protected]. Date: July 13, 2011 Working and Winning In Queens Employment Conference The New York State Office of Mental Health, Bureau of Recipient Affairs; NYC Dept. of Health & Mental Hygiene, Office of Consumer Affairs; The Empowerment Center; Queens Client Committee of the NYC Federation; Howie the Harp Peer Advocacy and Training Center; Goodwill Industries; Elmhurst Community Services, Creedmoor Psychiatric Center; NYC Health and Hospitals Corporation are all sponsoring a seminar on “Working & Winning in Queens.” The Keynote Speaker will be Robert Goldblatt, Director of Rehabilitation, NYC Department of Health and Mental Hygiene. Consumers who are interested in information about going to work or are already working should attend the event. Seating is limited!! Date: July 18, 2011 Webinar: Promoting Recovery Through Psychological and Social Means The RTP Resource Center will be offering the third Webinar in a four-step series: ”Step 3 in the Recovery-Oriented Care Continuum: Promoting Recovery Through Psychological and Social Means.” This Webinar will describe approaches to promoting recovery that involve psychological and social interventions, including cognitive–behavioral methods of addressing serious mental illnesses (schizophrenia and bipolar disorder) and rehabilitation tools that involve in vivo support (supported employment, education, housing, etc.). Date: July 28, 2011 Save the Date: E/Quality Cares Conference for LGBT Consumers The Rainbow Heights Club will be sponsoring the E/Quality Cares one day conference, focused on enhancing the provision of affirming and culturally competent services to lesbian, gay, bisexual, and transgender people living with mental illness, substance abuse, alcoholism, and developmental disability. Complimentary breakfast and lunch will be served. Registration is free and required. Date: September 14, 2011 PROS & The City
Susan Friedlander, LCSW, OMH, Queens Borough Coordinator/Rehabilitation & Recovery Services, New York City Field Office has written and article entitled, “From the Field: PROS & The City.” This article provides a NYC PROS update, including hopeful recovery stories shared by PROS providers. To read, go to: http://www.omh.ny.gov/omhweb/resources/newsltr/2011/may/pros.html Alcohol Dependence: More Likely Among Adults with Mental Illness
A new SAMHSA survey from the Center for Behavioral Health Statistics and Quality National Survey on Drug Use and Health found that adults with ‘serious mental illness’ were almost 7 times more likely to be alcohol dependent than people without any mental health conditions (13.2% vs 2.2%). To read this “Data Spotlight,” go to: http://oas.samhsa.gov/spotlight/Spotlight027AlcoholDependence.pdf Also Available from SAMHSA: Toolkit for Preventing Senior Suicide “Promoting Emotional Health and Preventing Suicide: A Toolkit for Senior Living Communities” is now available from SAMHSA. This cutting-edge toolkit equips senior living staff with resources to promote emotional health and prevent suicide among residents. It includes guidelines for integrating suicide prevention into ongoing programs, hands-on tools, and comprehensive training manuals. To view the toolkit go to: http://store.samhsa.gov/product/SMA10-4515?WT.ac=EB_20110505_SMA10-4515. Exploring the Epidemic of Mental Illness
The NY Review of Books article, “The Epidemic of Mental Illness: Why?,” explores this question by focusing on three publications: The Emperor’s New Drugs: Exploding the Antidepressant Myth by Irving Kirsch; Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America, by Robert Whitaker; and Unhinged: The Trouble With Psychiatry—A Doctor’s Revelations About a Profession in Crisis, by Daniel Carlat. To read the first part of this two-part review, visit :http://www.nybooks.com/articles/archives/2011/jun/23/epidemic-mental-illness-why/?pagination=false&printpage=true Staying in Balance: Managing Stress in an Uncertain Economy
The Mental Health Association of New York City has launched Staying in Balance, a resource toolkit to help social service organizations respond in healthy ways to the high levels of emotional distress created by the economic recession. Staying in Balance offers a toolkit, training, and materials to help organizations promote emotional wellness and organizational health during the economic crisis, including guidance and resources for reducing worker stress. For more information, please contact Michelle at [email protected] or 212-254-0333 x750. Preventing the High Cost of Caring for Youth with Mental Illnesss According to the Institute of Medicine report, “Preventing Mental, Emotional, and Behavioral Disorders Among Young People,” psychiatric and behavioral disorders in our youth cost the nation approximately $247 billion annually with an estimated 14 to 20 percent of youths experiencing the conditions. First symptoms of the conditions occur two to four years before the onset of a full-blown disorder “creating a window of opportunity when preventative programs might make a difference,” according to the report, which you can read online, free of charge: http://www.nap.edu/catalog.php?record_id=12480 For Caretakers, download “Promoting Children’s Mental, Emotional, and Behavioral Health: A Resource for Parents”: http://www.bocyf.org/prevention_parent_brochure.pdf |
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