Illness Management and Recovery: A Collaboration for an Evidence Based Practice

1. Illness Management and Recovery: A Collaboration for an Evidence Based Practice Presented by: Kerrin Westerlind, LICSW The Bridge of Central Mass Amy C. Morgan, LCSW, CPRP Advocates, Inc.

2. Learning Objectives • Identify the key components of IMR • Have knowledge about what makes an EBP an EBP • Have the knowledge to consider implementing IMR into existing programs • Understand the tools used as outcome measures in IMR

3. Other sources utilized include: • Illness Management and Recovery Implementation Resource Kit (Draft Version 2003) • Illness Management and Recovery Workbook for Clinical and Practical Supervisors • Substance Abuse and Mental Health Services Administration. Illness Management and Recovery. HHS Pub. No. SMA-09-4462, Rockville, MD: Center for Mental Health Services, Substance Abuse and Mental Health Services Administration, U.S. Department of Health and Human Services, 2009. • The above can be accessed at: http://store.samhsa.gov/product/Illness-Management-and-Recovery-Evidence-Based-Practices-EBP-KIT/SMA09-4463

4. What is Illness Managementand Recovery? IMR is a program that helps people: • set meaningful goals for themselves • acquire information and skills to develop more mastery over their “psychiatric illness” • make progress towards their own personal recovery

5. Who were the originators of IMR? • Kim Mueser and Susan Gingerich were the co-leaders of the team that developed the Illness Management & Recovery Program

6. IMR is an Evidence Based Practice IMR is an evidence based practice that was developed through a contract from the Substance Abuse Mental Health Services Administration’s (SAMHSA) Center for Mental Health Services (CMHS) and a grant from the Robert Wood Johnson Foundation (RWJF).

7. What is an Evidence Based Practice? Evidence based practices are services or programs designed for people with a diagnosis of a mental illness. There is consistent scientific evidence of improved outcomes for program participants as demonstrated by multiple research studies.

8. Evidence-Based Componentsof Illness Management • Psycho education improves individuals’ knowledge about “mental illness” • Behavioral tailoring for medication helps individuals take medication as prescribed • Relapse prevention training reduces symptom relapses and re-hospitalizations • Coping skills training reduces the severity and distress of persistent symptoms Gingerich,S., and Mueser, K.T. Illness Management and Recovery. In: Drake, R.E., Merrens, M.R., and Lynde, D.W., eds. Evidence-Based Mental health Practice: A Textbook. New York: norton,2005 p.401.

9. Core Values of IMR • HOPE is the key ingredient • The person is the expert in his her own life • Personal choice is paramount

10. Core Values of IMR • Practitioners are collaborators • Practitioners demonstrate respect for people who experience psychiatric symptoms • Individuals don’t fail the practice, the practice fails them

11. 6 Core Values in IMR • Hope is the key ingredient • The long term course of mental illness cannot be predicted • Being able to influence one’s own destiny is the basis for future hope and optimism • Having other people believe in us is essential to the empowerment process (therefore, practitioners may at times may “hold” the hope.)

12. 6 Core Values in IMR (continued) • The person is the expert in his her own life. • The person knows what strategies work and have not worked. • The person knows what has been helpful and what has not.

13. 6 Core Values in IMR (continued) • Personal choice is paramount • The ability and right to make one’s own decisions, including when those decisions differ from recommendations made by providers. • The task then becomes to work with individuals to evaluate the consequences of decisions in terms of their hopes and dreams. Acceptance is also paramount.

14. 6 Core Values of IMR (continued) • Practitioners are collaborators • Practitioners as consultants in a non-hierarchal relationship. • Practitioners participate in the practice. This includes working on a recovery goal and utilizing IMR skills.

15. 6 Core Values of IMR (continued) • Practitioners demonstrate respect for people who experience psychiatric symptoms • As capable decision-makers and active participants in their own treatment. • Respect for differing values and opinions. • To seek common ground when there is a difference in point of view.

16. 6 Core Values in IMR (continued) • Individuals don’t fail the practice,the practice fails them • Individuals are given unconditional support for their participation. • Programs work under easyre-entry and “fail safe” principles.

17. Core Ingredients of the IMR Program • 5 to 12 months of weekly sessions conducted by trained practitioners. • A collection of ten educational handouts that contain practical information and strategies. • A Practitioners’ Guide with tips for teaching people about mental illness and helping them implement strategies.

18. Essence of the IMR Practice • Emphasis on recovery goals • Encourages the involvement of significant others • Emphasis on the outside practice of skills

19. The Goals of Illness Management and Recovery: • Instill hope that change is possible • Develop a collaborative relationship with a treatment team • Help people establish personally meaningful goals to strive towards • Teach information about mental illness and treatment options

20. The Goals of IMR: (Continued) • Develop skills for reducing relapses, dealing with stress, and coping with symptoms • Provide information about where to obtain needed resources • Assist individuals in developing or enhancing their natural supports for managing their illness

21. Recovery Strategies Practical Facts about Mental Illness The Stress-Vulnerability Model Building Social Support Using Medications Effectively Reducing Relapses Coping with Stress Coping with Problems and Persistent Symptoms Getting Your Needs Met in the Mental Health System Drug and Alcohol Use (optional) 10 Topic Areas

22. Language and the IMR practice • Developed at a point in time • Advocates’ decision to change to WMR • Wellness Management and Recovery

23. A Collaboration Between Two Agencies • Advocates and the Bridge working together • Training • Monthly WMR Consultation Team

24. Developing Structures that Support Implementation • IMR Director • Agency Consultation Team • Program Consultation Teams • Clearly defining the role of staff • Comprehensive Training Series • Ongoing Assessment and Monitoring • Outcome measures • Fidelity/GOI

25. Contact Information Kerrin Westerlind, LICSW Director of IMR Services The Bridge of Central Ma kerrinw@thebridgecm.org 508-890-2299 ext. 134 Amy C. Morgan, LCSW, CPRP Assistant Director of Psychiatric Rehabilitation Services Advocates, Inc. amorgan@advocatesinc.org 508-612-5780

26. Resources www.mentalhealthrecovery.com www.tucollaborative.org www.alternativementalhealth.com www.realmentalhealth.comwww.power2u.orgwww.theicarusproject.netwww.mhselfhelp.org www.m-power.org