Title: Moving to Recovery and PersonCentered Practice Clinical Supervisor Training
1Moving to Recovery and Person-Centered
PracticeClinical Supervisor Training
- WNYCCP Spring 2006
- Neal Adams MD MPH
- Diane Grieder M.Ed
2- If you dont know where you are going, you will
probably end up somewhere else. - Lawrence J. Peter
3Agenda for AM
4Agenda for PM
5Assumptions
- This audience
- knows something about recovery principles and
person-centered care - is interested in moving from theory/values to
practical implementation strategies - wants to improve their clinical and supervisory
skills
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7Objectives
- Understand the concepts of medical necessity and
Medicaid coverage - Demonstrate knowledge of the technical elements
of the person-centered plan - Demonstrate ability to write a person-centered
plan using stages of change and medical necessity - Understand the role of the supervisor in
promoting good planning
8Planning Exercise
- What is your position at your organization?
- What are your likes and dislikes about planning?
- How does being recovery-oriented change your
practices? - What are you doing differently today about PCP at
your organization (since being trained) ? - Identify one barrier of change towards being a
more person-centered recovery-oriented system
that you have identified at your organization
9Medicaid/Medical Necessity
10Recovery
- The 2005 National Consensus Statement on Mental
Health Recovery from SAMHSA defines mental health
recovery as - a journey of healing and transformation enabling
a person with a mental health problem to live a
meaningful life in a community of his or her
choice while striving to achieve his or her
full potential
11Being Person-centered in Practice
- The consumer as a whole person
- Sharing power and responsibility
- Having a therapeutic alliance
- The clinician as person
- Language choices
12 Serving Two Masters
Understanding
- Person-centered
- Recovery
- Community integration
- Core gifts
- Partnering
- Supports self-direction
- Regulation
- Medical necessity
- Diagnosis
- Documentation
- Compliance
- Billing codes
Outcomes and Goals
13Medical Necessity
- History
- Current application
- Standard of service and quality
- Five elements
- indicated
- appropriate
- consider issues of culture
- efficacious
- effective
- efficient
14Where is Medical Necessity Documented?
- Treatment Plan
- formulation
- measurable objectives
- focus on skills development
- amelioration symptoms
- interventions
- specific services
- clear purpose or intent related to objective
- Service notes
- goal oriented record
- DAP / SOAP / PIE
15What is Medicaid?
- Multi-faceted and complex federal-state public
funded medical model insurance program - payor of last resort
- provides benefits for
- low-income families and children
- individuals with disabilities
- including adults with severe
mental illnesses in community
settings - largest and growing source of
funding for public MH services
16Program Characteristics
- Each state has
- its own CMS approved plan
- single designated state authority
- eligibility criteria
- Mandated and optional covered services
- public mental health services are provided under
various options and waivers - States responsible for medical necessity criteria
- criteria are embedded in states limitations on
the amount, duration, and scope of services
17Clinic vs. Rehab Option
- Clinic medical model core Medicaid benefit
- clinic based
- stabilization
- licensed practitioners
- outpatient programs
- Rehab recovery model state option
- active treatment and participation
- community based
- peer supports and professionals
- providing more than one covered service
18CMS Guidance for Clinic Option
- Services must be specified / furnished in an
individual plan of care - written plan to improve the patient's condition
so that continued services are no longer
necessary - contains a written description of
- treatment objectives for that patient
- treatment regimen
- projected service delivery schedule
- the personnel who will furnish services
- when reevaluations will be conducted to update
the POC
19CMS Guidance for Clinic Option
- Services must be specified / furnished in an
individual plan of care - POC must be reviewed no less frequently than
every 90 days - services that depart from the treatment plan
(e.g., emergency services) must be thoroughly
documented when billed
20Rehabilitation Option Services
- Individual and group clinic outpatient services
- Crisis services
- Family psychosocial education
- Peer support
- Life skills training and support across a variety
of community living dimensions - Assertive Community Treatment
- Medication education and management
- Community residential services and supports
- Illness and disability management
- Supported employment
21Focus on Skills
- 1992 HCFA (now CMS) memorandum to Regional
Administers - last broad federal policy guidance published
- distinguished between
- providing assistance (such as meal preparation)
for the individual (personal assistance) - teaching meal preparation skills to the person
(rehabilitation)
22Rehab Examples
- Basic Skills Training
- restoration of basic skills necessary to
independently function in the community - food planning and preparation, maintenance of
living environment, community awareness, etc. - Social Skills
- redevelopment of skills necessary to enable and
maintain independent community living - communication and socialization skills
- Counseling and Therapy Services
- directed toward the elimination of psychosocial
barriers that impede the development or
modification of skills necessary for independent
functioning in the community
23Transformation Principles
- services and treatments must be consumer and
family centered, geared to give consumers real
and meaningful choices about treatment options
and providers not oriented to the requirements
of bureaucracies - care must focus on increasing consumers ability
to successfully cope with lifes challenges, on
facilitating recovery, and on building
resilience, not just on managing symptoms -
- Presidents New Freedom Commission on Mental
Health
24Systems transformation begins with a
transformation of the life/services planning
process.
25Community Support
- CSS framework encompasses a core set of
principles to guide services for individuals with
serious mental illnesses - Services should be
- person-centered
- empowering of individuals
- ethnically and culturally appropriate
- flexible
- focused on a persons strengths
- normalized and incorporate natural supports
- tailored to meet special needs/coordinated
-
-
- USING MEDICAID TO SUPPORT WORKING AGE ADULTS
- WITH SERIOUS MENTALILLNESSES IN THE COMMUNITY A
HANDBOOK - SAMHSA 2005
26Caveats
- In deciding whether a service could be offered
under this coverage, states were advised that
while it is not always possible to determine
whether a specific service is rehabilitative by
scrutinizing the service itself, it is more
meaningful to consider the goal of the
treatment.
27NY Psych Rehab Plan
- Section 587.17 Service Planning for IPRT
- the psychiatric rehabilitation service plan shall
be a mutually agreed upon course of action which
identifies the following - 1) statement of rehabilitation
aspirations - 2) statement of service goals and
- objectives
- 3) identification of planned
interventions - 4) proposed time periods
28NY State Section 587.16
- Treatment Planning for Clinic Treatment Programs,
CDT, and Day Treatment Programs Serving Children - planning shall be based on an assessment of the
recipient's psychiatric, physical, social, which
identify - recipient's designated psychiatric diagnosis
- recipient's problems and strengths
- recipient's treatment goals consistent with the
purpose and intent of the program - the specific objectives and services necessary to
accomplish goals
29Reviewing the Plan
- A periodic review of the treatment plan shall
include the following - input
- of all staff involved in recipients treatment
- the recipient, his or her family and/or other
collaterals, as appropriate - assessment of the progress towards the mutually
agreed upon goals in the plan - adjustment of goals, time periods for
achievement, intervention strategies or
initiation of discharge planning, as appropriate - the signature of the physician involved in the
treatment
30DRA and Future of Medicaid
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32Supporting the Participant in Service Plan
Development
- Specify
- the supports and information that are made
available to the participant (and/or family or
legal representative, as appropriate) to direct
and be actively engaged in the service plan
development process - the participants authority to determine who is
included in the process.
33Service Plan Development Process
- Describe the process that is used to develop the
participant-centered service plan - who develops the plan, who participates in the
process, and the timing of the plan - the types of assessments that are conducted to
support the service plan development process - information about participant needs preferences
and goals, and health status - how the participant is informed of the services
that are available
34Service Plan Development Process
- Describe the process that is used to develop the
participant-centered service plan - how the plan development process ensures that the
service plan addresses participant goals, needs
(including health care needs), and preferences - how waiver and other services are coordinated
- how the plan development process provides for the
assignment of responsibilities to implement and
monitor the plan
35Service Plan Development Process
- Describe the process that is used to develop the
participant-centered service plan - how and when the plan is updated
- including when the participants needs change
- State laws, regulations, and policies cited that
affect the service plan development process are
available to CMS upon request through the
Medicaid agency
36The road to recovery...
- Person-centered planning
- is a collaborative process
resulting in a recovery
oriented treatment plan - is directed by consumers and produced in
partnership with care providers for treatment
and recovery - supports consumer preferences and a recovery
orientation - Adams/Grieder
37Perspectives
- There are no guarantees in life
- Quality of the documentation is the real problem
- Its not about the forms!
- Retreat to the medical model ?
- we dont agree!!!
- Best solution
- promote recovery principles
- carefully and consistently record clinical
thinking in a way that serves both masters - be proactive!
38Nuts and Bolts
39A Plan is a Road Map
- Provides hope by breaking a seemingly
overwhelming journey into manageable steps for
both the provider and the person served.
B
C
D
A
E
life is a journeynot a destination
40Building a Plan
Outcomes
Services
Objectives
Strengths/Barriers
Goals
Prioritization
Understanding
Assessment
Request for services
41Goals
- Long term, global, and broadly stated
- the broader the scope the less frequently
it needs to change - perception of time may be culture bound
- may influence expectations and participation
- Life changes as a result of services
- focus of alliance / collaboration
- readily identified by each person
- Linked to discharge / transition criteria and
needs - describes end point of helping relationship
42Goals continued
- Person-centered
- Ideally expressed in person serveds / familys
words - Easily understandable in preferred language
- Appropriate to the persons culture
- reflect values, life-styles, etc.
- Consistent with desire for
self-determination and
self-sufficiency - may be influenced by
culture and tradition
43Goals continued
- Three types
- life goals
- treatment goals
- quality of life / enhancement goals
- Essential features
- attainable
- one observable outcome per goal
- realistic
- written in positive terms
- built upon abilities / strengths, preferences and
needs - embody hope
- alternative to current circumstances
44Barriers
- What is keeping the person
from their goals? - need for skills development
- intrusive or burdensome symptoms
- lack of resources
- need for assistance / supports
- problems in behavior
- challenges in activities of daily living
- threats to basic health and safety
- Challenges / needs as a result of a mental /
alcohol and/or drug disorder
45Strengths
- Environmental factors that will increase the
likelihood of success community supports,
family/relationship support/involvement, work - Identifying the persons best qualities/motivation
- Strategies already utilized to help
- Competencies/accomplishments
- Interests and activities, i.e. sports, art
- identified by the consumer and/or the provider
46Examples of Strengths
- Motivated to change
- Has a support system friends, family
- Employed/does volunteer work
- Has skills/competencies vocational, relational,
transportation savvy, activities of daily living - Intelligent, artistic, musical, good at sports
- Has knowledge of his/her disease
- Sees value in taking medications
- Has a spiritual program/connected to church
- Good physical health
- Adaptive coping skills
- Capable of independent living
47Objectives
- Work to remove barriers and
- build on strengths
- Culture of persons served shapes setting
objectives - address culture bound barriers
- Expected near-term changes to meet long-term
goals - divide larger goals into manageable tasks
- provide time frames for assessing progress
- maximum of two or three per goal recommended
48Objectives
- Build on strengths and resources
- Essential features
- behavioral
- achievable
- measurable
- time framed
- understandable for the person served
- Services are not an objective
49Objectives
- Appropriate to the setting / level of care
- Responsive to the persons individual
- disability, challenges and recovery
- Appropriate for the persons age, development and
culture - The individual / family will
- changes in behavior / function / status
- described in action
words
50Interventions
- Actions by staff, family, peers, natural supports
- Specific to an objective
- Respect consumer choice and preference
- Specific to the stage of change/recovery
- Availability and accessibility
of services may be impacted by
cultural factors - Describes medical necessity
51Five Critical Elements
- Interventions must specify
- provider and clinical discipline
- staff members name
- modality
- frequency /intensity / duration
- purpose / intent / impact
- Clarifies who does what
- Include a task for the family, or other component
of natural support system to accomplish
52Carmenan 18 year old Latina
- High school senior
- preparing for graduation
- First generation
- parents monolingual Spanish speaking
- client bilingual
- observant Catholic family
- Lives in predominantly Anglo-American community
53Vignette continued
- Excellent student
- Active in school and social activities
- Recently unable to attend school because of
distress - Graduation from high school and college
attendance is core value for Carmen and family - Recent physical problems
- Nausea, vomiting, dizziness, headaches
- Parents believe she is suffering from susto
- Treatment from curandero
54Vignette continued
- Recent crisis
- Acute physical distress
- Admitted to hearing a baby cry while at school
- Reported feeling sad and blue
- Referred to mental health
- Embarrassed and resistant
- First family member to seek MH services
55Vignette continued
- Assessment with Latina provider in Spanish
- Revealed she had a miscarriage a year ago
- Feeling increasingly guilty and troubled
- Wants to die and join her baby
- Relationship with parents has become distant and
conflictual - father refusing to speak with her
56Formulation
- Identity
- first generation Latina
- bilingual
- Explanation of Illness
- what appeared to be a physical problem is a
mental health problem - somatization is idiom of distress
- shame, guilt and embarrassment are key themes
- Provider relationship
- Spanish preferred
- more open with Latina clinician
57Formulation continued
- Psychosocial environment
- lives with family, first generation
- some degree of acculturation and distance from
parents - difficult and painful
- Diagnosis
- consider possibility of culture bound syndrome
- Susto
- possible depression with psychotic features
- understanding her beliefs may be key to treatment
58Formulation
- Hypothesis
- Intergenerational issues of acculturation are a
major factor - age appropriate issues of individuation and
separation - some ambivalence about help-seeking
- school completion and education opportunity and
advancement are shared values /strengths to build
upon - need to help her reconcile feelings of guilt and
remorse - religious and spiritual factors may be
significant
59Stages of Change and Recovery
- Prochaska and DiClemente
- Ohio Department of MH
- The VillageLA County MHA
- Stanislaus County
- Boston University Center for Psychiatric
Rehabilitation Center - AACP / LOCUS
60Prochaska and DiClemente
- Precontemplation
- not yet considering change
- Contemplation
- considering change but remains ambivalent
- Preparation
- committed to change and planning to make change
in the near future - Action
- actively taking steps but has not stabilized
- Maintenance
- achieved change stabilized and maintaining
61Stages of Recovery and Treatment
62as suggested by Ed Knight
The person is
63Another view of recovery stages
derived from BU Center for Psych Rehab
64Meeting client where theyre at
ADDICTION RECOVERY
Relapse Prevention
Pre Contemplation
Sustained Recovery
Early Intervention
Action
Contemplation
Prevention
Each person is able to utilize interventions
responsive to their stage of change
Pre- Contemplation
Self Care
Engaged in Active Treatment and Rehab
Early Identification and Intervention
Prevention
Contemplation
MENTAL HEALTH RECOVERY
65Pre-contemplation
- The individual is often
- unwilling to consider change
- unaware of having a disease, disorder, disability
or deficit - unaware of the causes and consequences of the
disease, disorder, disability or deficit - unaware of the need for treatment and
rehabilitation - reluctant/opposed to engaging in treatment and
rehabilitation
66Pre-contemplation stage approaches
- Consciousness-raising interventions
- sharing observations, confronting the individual
with specific consequences of their behavior - Building a therapeutic alliance
- understanding and emotional relationship
- Non-possessive warmth
- provider relates to the person as a worthwhile
human being - shows unconditional acceptance of the person (as
opposed to the behavior, e.g., addiction, offense)
67Pre-contemplation stage approaches
- Empathic understanding
- provider tries to understand what the individual
is experiencing from the individuals frame of
reference - Catharsis
- provider engages in active listening skills,
empathic observations - Intervention
- confronting the individual in a gentle
non-judgmental, caring and loving manner
68Carmen Pre-contemplation
- Now assume that
- Carmen believes that her condition is utterly
hopeless, that her sins are unforgivable, that
she has irrevocably shamed her family, and that
she is doomed to a life of suffering.
69Carmen's Plan Pre-contemplation
- Goal
- I dont have any goals for my future
- Objective
- Within 6 weeks Carmen will share her daily mood
journal with her therapist.
70Carmen's Plan Pre-contemplation
- Intervention
- Olinda Garcia, LCSW, will provide Carmen with
supportive psychotherapy 1 hour/ week for 6 weeks
in order to build a safe and trusting
relationship that can help her to overcome her
fears and avoidance of treatment
71Contemplation/preparation
- The individual is often
- somewhat aware of their issues / problems/ needs
- partially able to acknowledge the need for change
- prepared to set goals and priorities for future
change - receptive to treatment plans that include
specific focus of interventions, objectives, and
intervention plans
72Contemplation stage approaches
- Continue with precontemplative stage
consciousness-raising interventions - Motivational interventions
- pay-off matrix
- Slowly introduce new interventions
- bibliotherapy
- psycho-education
- peer supports/modeling
- Early efforts at goal setting
73Contemplation stage approaches
- Presuppositional Questions
- used to encourage individuals to examine and
evaluate their needs - think about change in a non-threatening context
- Example
- consider an individual who is still not sure
he/she has a problem - Lets agree that what you are saying is true
...whats keeping you from doing what you really
want?
74Contemplation stage approaches
- Circular Questions
- used in a non-threatening manner to ask a
question about the individuals issues, situation
or predicament from the perspective of an
outsider - Example
- consider an individual who thinks others are
overstating his/her difficulties - How can you show your friends and family that
you are ready to move forward in your life?
75Contemplation stage approaches
- Miracle questions
- used as a method to assist an individual in
imaging change and with goal setting - Example
- Suppose you go to bed tonight, and while you are
asleep a miracle happens and all your issues,
situations, or predicaments disappear.
Everything is resolved to your liking. When you
wake up in the morning, how will you know that
the miracle happened? What would be the first
thing you would notice that is different?
76Preparation stage approaches
- Continue with contemplative stage awareness
enhancing interventions - Slowly introduce new interventions
- Encourage the individuals sense of
self-liberation and foster a sense of personal
recovery by taking control of his or her life
77Preparation stage approaches
- Identifying triggers
- the provider enhances the individuals awareness
of the conditions that give rise to his/her
issues, situations or predicaments - focus is on the presence or absence of
antecedents, setting events, and establishing
operations
78Preparation stage approaches
- Scaling Question
- used as a tool by the individual to buy into
the treatment planning process - obtain a quantitative baseline
- assist the individual to take the next step in
the process of recovery - encourage the individual to achieve recovery by
successive approximations - Example
- On a scale of 1 to 10, with 1 being totally not
ready and 10 being totally ready, how would you
rate your current readiness to make changes in
your life?
79Carmens PlanContemplation / Preparation
- Now assume that
- Carmen now understands that it is fairly normal
for teens in this culture to experiment with
relationships and sex, that people make mistakes
in their lives, and that it is possible for
things to change and improve. She feels less
negative and hopeless about the possibility of
going to college but cant imagine what else she
might do or how she can back on track.
80Carmens PlanContemplation / Preparation Stage
- Goal
- I need to know what my future will be
- Objective
- Within one month Carmen will have a plan for her
high school and college education
81Carmens PlanContemplation / Preparation Stage
- Intervention
- Susan Williams, Case Manager, will meet with
Carmen 2x per week for 1 month in order to help
her access home-schooling supports so that she
can graduate without returning to class - Beth Angeles, peer specialist, will meet with
Carmen one time per week for one month to provide
support and encouragement
82Action
- Characteristics
- making successful efforts to change
- developing and implementing strategies to
overcome barriers - requires considerable self-effort
- noticeable behavioral change takes place
- target behaviors are under self-control, ranging
from a day to six months
83Action Stage Approaches
- Cognitive-behavioral approaches
- Explore and correct faulty cognitions
- catastrophizing
- overgeneralizing
- magnification
- excessive responsibility
- dichotomous thinking
- selective abstraction
- Learning-based approaches
- Action-oriented approaches
- Skills and support rehabilitation
84Carmens Plan Action Stage
- Goal
- I want to graduate from high school
- Objective
- Carmen will return to class attendance for 10
consecutive full days within a month as reported
by Carmen / or support worker
85Carmens Plan Action Stage
- Possible interventions
- Psychiatrist to provide weekly to monthly
pharmacotherapy management for 3 months to
relieve acute sx of anxiety and depression - Social worker to provide one hour of
cognitive-behavioral psychotherapy X2/ week for
4 weeks to help Carmen resolve feelings of guilt
and loss - Support worker to meet with Carmen up to 3 hours
/ week for 4 weeks as required to coordinate /
facilitate return to school with school
counselors and mental health team - Carmen to attend weekly teen support group at
community center 3 months to address with peers
issues of identity and acculturation
86Maintenance/Relapse Prevention
- Characteristics
- Meet discharge criteria
- Be discharged
- Maintain wellness and enhance functional status
with minimum professional involvement - Live in environments of choice
- Be empowered and hopeful
- Engage in self-determination through appropriate
choice-making
87Maintenance Stage Approaches
- Adapt and adjust to situations to facilitate
maintenance - Develop personal wellness recovery plans
- Utilize coping skills in the rhythm of life,
without spiraling down (i.e., if substance use is
a problem, cope with distressing or faulty
cognitions without using drugs) - Learn about mindfulness, especially unconditional
acceptance, loving kindness, compassion for self
and others, and letting go
88Carmens Plan Maintenance Stage
- Goal builds on goal from active stage
- I want to succeed in college
- Objective
- Carmen will develop the cognitive and behavioral
skills to remain free of depressive symptoms as
measured by completing a first semester at
college
89Carmens Plan Maintenance Stage
- Interventions
- Continue with monthly pharmacotherapy with Dr.
Hall to prevent recurrence of symptoms for 6
months - Stacey Hahnemann, M.Ed, will provide CBT every
other week for 6 months to learn affect
management and conflict resolution skills - Continue to attend teen support group for 6
months at least one time per month for ongoing
support with acculturation issues
90The tale of two consumers
- Traditional Model
- What are Robertas strengths?
- What are Robertas goals in life?
- What are Robertas treatment goals?
- Recovery Model
- What are Ruths strengths?
- What are Ruths goals in life?
- What are Ruths treatment goals?
91Roles and Abilities of The Supervisor
- Coach
- Mentor
- Facilitator
- Solution-focused
- Competent (KSAs)
- Capable
- Expert
- Accessible
- Change agent
-
92Traveling the Transformation Highway
Transformation Highway
93Transformation
- A break with the past
- Quantum change
- More than just reorganizing
- new mission and vision for the organization
- Transformation virtually always refers to a
positive change - a movement to a new venture
- A radical redesign and new strategic intent for
the organization
94Transformation
(V B A) x (CQI)2
Resistance to change
V vision B beliefs A action
CQI continuous quality improvement
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100Youre the picture of healthand by the way, Im
totally in love with you
101Setting the Compass
Experience of Individuals, Families and
Communities
Microsystems of Care Where care occurs
Health Care Organizations
External Environment of Care Policy/Financing/Regu
lation
102 Change Model
Competency knowledge, skills and abilities
Transformation
Project Management work / business flow
Change Management behavior and attitude
103PCP Competencies
- Providers should be able to
- understand the concepts of
recovery, resilience, wellness, person-centered
and culturally competent approaches - understand and value the centrality of the
individual planning process as a roadmap to
recovery and wellness - understand how emerging new frameworks differ
from past and current practice - identify the elements of a plan and the criteria
for each element
104PCP Competencies
- Providers should be able to
- understand the concept
of medical necessity and key
elements of documentation - conduct a strengths based person-centered and
culturally competent assessment - create a formulation or integrated summary based
upon the assessment - evaluate the individuals/families stage of
change to inform and guide the planning process - help individuals/families articulate
person-centered goals and discharge/transition
needs
105PCP Competencies
- Providers should be able to
- help individuals/families articulate
person-centered goals and discharge/transition
needs - identify barriers and establish priorities to
attaining the goal's - elaborate objectives to resolve barriers in
partnership with the person and family served - build on strengths, choices, preferences and
stage of change to recommend interventions,
services, supports and other strategies to
promote positive change
106PCP Competencies
- Providers should be able to
- Specify a broad range of
culturally-competent stage
appropriate supports / services - Accept the individuals / families dignity,
ability to take risk and right to fail - Facilitate/monitor/coordinate plan implementation
- Provide timely update of assessment and plan
- Properly document plan elements and services
- Participate in an ongoing quality management
process - Provide outcome data to demonstrate effectiveness
107Competencies New Zealand MH
- A competent mental health worker
- understands recovery principles
and experiences in the Aotearoa /
NZ and international contexts - recognizes and supports the personal
resourcefulness of people with mental illness - understands and accommodates the diverse views on
mental illness, treatments, services and recovery
- has the self-awareness and skills to communicate
respectfully and develop good relationships with
service users
108Competencies New Zealand MH
- A competent mental health worker
- understands and actively protects service
users rights - understands discrimination and
social exclusion, its impact on
service users and how to reduce it - acknowledges the different cultures of
Aotearoa/NZ and knows how to provide a service in
partnership with them - has comprehensive knowledge of community services
and resources and actively supports service users
to use them
109Competencies New Zealand MH
- A competent mental health worker
- has knowledge of the service user movement and is
able to support their participation
in services - has knowledge of family/ individual perspectives
and is able to support their participation in
services
11012 Aspects of Staff Transformation
- Looking forward and rebuilding the passion
- Building inspiration and belief in recovery
- Changing from treating illness to helping people
with illnesses have better lives - Moving from caretaking to empowering, sharing
power and control - Gaining comfort with mentally ill co-staff and
multiple roles - Valuing the subjective experience
- Mark Ragins, MD
111Staff Transformation cont
- Creating therapeutic relationships
- Lowering emotional walls and becoming a guiding
partner - Understanding the process of recovery
- Becoming involved in the community
- Reaching out to the rejected
- Living recovery values
112The next step is
113Writing Plans
- In your teams write a person-centered plan
using the principles learned and the assessments
/ formulations provided - Choose a group recorder
- Select a person to role play the consumer in the
assessment - Write your teams plan on the transparency
- 1 goal, 1 objective, 2 to 3 interventions
- Choose a group spokesperson for the report out
114In Conclusion