Emerging Trends in Program and Workforce Development June 8, 2010

1. Implementing Recovery-Oriented Practices Emerging Trends in Program and Workforce DevelopmentJune 8, 2010 Chacku Mathai, CPRP, and Gail Smith New York Association of Psychiatric Rehabilitation Services (NYAPRS) John Morris, MSW, and Sue Bergeson Annapolis Coalition Larry Davidson, Ph.D. Development Services Group (DSG), Inc.

2. Emerging Trends in Program and Workforce Development SAMHSA’s Consensus Statement and the 10 Components “Mental health recovery is 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.” • Self-Direction • Individualized and • Person-Centered • 3. Empowerment • 4. Holistic • 5. Nonlinear 6. Strengths Based 7. Peer Support 8. Respect 9. Responsibility 10. Hope

3. Emerging Trends in Program and Workforce Development Webinar Agenda Webinar Agenda 3:00–3:05 p.m. WelcomeStacey Lesko SAMHSA/CMHS 3:05–3:10 p.m. Introductions and Overview of Larry Davidson Today’s WorkshopDSG, Inc. 3:10–3:35 p.m. A Practitioner’s PerspectiveChacku Mathai NYAPRS Personal Experience ReceivingGail Smith Conventional and Transformed Services Carmel, N.Y. 3:35–4:00 p.m. Involving Consumers and FamiliesJohn Morris in Curriculum DevelopmentThe Annapolis Coalition   Personal Experience as ConsumerSue Bergeson and Family Member as Workforce Leader Chicago, Ill.  4:00–4:30 p.m. Discussion

4. Emerging Trends in Program and Workforce Development Process for Our Questions, Answers, and Discussion Our speakers will present, followed by moderated questions and answers. We invite you to ask questions or make comments! To ask a question… either click on the Q/A tab andtype your question in the window that opens... OR press *1 for the operator, who will take your question in the order in which it is received. This Webinar will be recorded and archived for future use. Please visit http://www.dsgonline.com/rtp/resources.htmlfor more information.

5. Emerging Trends in Program and Workforce Development The Recovery to Practice Initiative… …fosters and advances a better understanding of recovery models, practices, and roles by • Developing, promoting, and implementing training manuals for five mental health professional disciplines • Creating a Resource Center that contains and disseminates • Technical assistance • Print products, such as brochures and tip sheets • Implementation tools • Extensive recovery materials database • Quarterly Webinar trainings • Quarterly e-newsletter

6. Emerging Trends in Program and Workforce Development Recovery to Practice Current Materials In development Resource Contribution Form

7. Emerging Trends in Program and Workforce Development Two Perspectives From NYAPRS* A Vision for a Recovery Framework in Behavioral Health SystemsPresented by Chacku Mathai Gail Smith *New York Association of Psychiatric Rehabilitation Services

8. Emerging Trends in Program and Workforce Development Vision for Recovery Outcomes • Believe that recovery is possible, even from the most tragic circumstances or disabling conditions. • Uncover abandoned hopes and dreams. • Discover our personhood through culture, • strengths, values, skills. • Engage communities as life-sustaining forces. • Re-author the way we see ourselves. • Reclaim a meaningful life and roles.

9. Emerging Trends in Program and Workforce Development Emerging Trends in Program and Workforce Development Emerging Trends in Program and Workforce Development An Emerging Focus on Implementation • Beyond train and hope approaches • Technical assistance related to supporting specific outcomes for people • Employment and economic self-sufficiency • Programmatic factors that can support wellness and recovery initiatives

10. Emerging Trends in Program and Workforce Development Emerging Trends in Program and Workforce Development Themes to Consider • Orientation to quality of life and symptoms • Capacity to individualize interventions • Discharge planning with emphases on peer and natural supports • Moving from diagnostically oriented tracks to fully integrated supports • Supervision models to build hope and to focus on recovery • Increased visibility of people in recovery and alumni as mentors and bridgers to community

11. Recovery Facilitation Capability Emerging Trends in Program and Workforce Development Emerging Trends in Program and Workforce Development Recovery Facilitation Capability

12. Emerging Trends in Program and Workforce Development Emerging Trends in Program and Workforce Development The Journey Through Services

13. Emerging Trends in Program and Workforce Development Emerging Trends in Program and Workforce Development Essential Features of a Recovery-Oriented Program • Pre-enrollment visits to check out the program. • Welcoming and friendly community. • Groups are designed to meet people’s individual needs. • Opportunity to address education and employment goals.

14. Emerging Trends in Program and Workforce Development Emerging Trends in Program and Workforce Development Essential Features of a Recovery-Oriented Program(cont’d) Focus on trauma (e.g., Invisible Heroes group) Availability of someone to talk to Regular opportunities to talk about my individual issues Coverage plans when primary staff are out Motivating environment—people are not just sitting around and smoking Encouragement and accountability of everyone

15. Emerging Trends in Program and Workforce Development Emerging Trends in Program and Workforce Development Two Perspectives From the Annapolis Coalition True North: Focus on People in Recovery and Families Presented by John Morris, MSW (Executive Director) Sue Bergeson, MBA (Board Member)

16. Emerging Trends in Program and Workforce Development Emerging Trends in Program and Workforce Development Overview • A little context from the production of the National Action Plan • The critical role of collaborative policy and practice development • The “True North” of workforce development • The expert involvement process

17. Emerging Trends in Program and Workforce Development Emerging Trends in Program and Workforce Development The Coalition and Workforce Paradoxes • Our work has been driven by a series of paradoxical phenomena that shape workforce development in the United States. • A couple of these paradoxes have special relevance for Recovery to Practice and behavioral health practitioners.

18. Emerging Trends in Program and Workforce Development Emerging Trends in Program and Workforce Development Two Relevant Paradoxes • Paradox 5: Consumers and families receive little educational support, and their lived experiences don’t inform the rest of the workforce. • Paradox 6: The diversity of the current workforce doesn’t match the diversity of those served.

19. Emerging Trends in Program and Workforce Development Emerging Trends in Program and Workforce Development A Couple of General Findings: National ActionPlan • High levels of dissatisfaction: • Persons in recovery and families • Workforce employers • “We” —disciplines, sectors, effort—are fragmented.

20. Emerging Trends in Program and Workforce Development Emerging Trends in Program and Workforce Development National Action Plan • Two years and 5,000 participants • Federally funded (all SAMHSA divisions) • Mental health and addictions • Treatment and prevention • Seeking to identify • A core set of strategic goals and objectives • High-priority action items by stakeholder • A planning resource • Call to action: based on principles of recovery

21. Emerging Trends in Program and Workforce Development Emerging Trends in Program and Workforce Development Planning Process • A range of tactics, including senior consultants; 12 expert panels and advisory groups (the first: Consumer and Family / Adult MH Panel) ; reviews of existing recommendations; planning sessions in existing meetings; targeted requests and open calls for recommendations • Creation of a National Steering Committee • The plan’s contents: general findings; seven strategic goals; objectives and actions; preliminary implementation tables with recommended stakeholders; special topics

22. Emerging Trends in Program and Workforce Development Emerging Trends in Program and Workforce Development How Can the Plan Support Practitioners? • A resource for addressing the central roles of people in recovery and families • Guidance on actions that individuals and groups can take to improve quality by focusing on recovery • A resource for emphasizing that there can be no lasting change in practice without attention to all elements of the workforce

23. Emerging Trends in Program and Workforce Development Emerging Trends in Program and Workforce Development The Plan

24. Emerging Trends in Program and Workforce Development Emerging Trends in Program and Workforce Development Goal No. 1 Significantly expand the role of individuals in recovery (and their families, when appropriate) to participate in, ultimately direct, or accept responsibility for their own care; provide care and supports to others; educate the workforce.

25. Emerging Trends in Program and Workforce Development Emerging Trends in Program and Workforce Development Goal 1. Persons in Recovery (Consumers/Patients) and Families • Objectives: • Increased educational supports • Shared decision-making • Expanded peer and family support • Greater employment as paid staff • Formal engagement as educators of the workforce “Transformational” in nature

26. Emerging Trends in Program and Workforce Development Emerging Trends in Program and Workforce Development Thirty-five years ago, when I was a medical student, we were taught to be paternalistic. We were trained to withhold information from patients, especially painful information about a potentially terminal illness; we were also instructed to take charge of interviews and to avoid getting “sidetracked” by patients’ “irrelevant” concerns. The handbook that my university developed to teach the clinical method referred to the interview as “the interrogation.” Patients who did not comply with “doctor’s orders” were called defaulters, untrustworthy, unreliable, or faithless. —W. Wayne Weston, M.D. Available athttp://www.cmaj.ca/cgi/content/full/165/4/438?ijkey=78221d977237b11133542f79e6aa22f300225260&keytype2=tf_ipsecsha.

27. Emerging Trends in Program and Workforce Development Emerging Trends in Program and Workforce Development We Are the Experts on Our Own Experience • Compliant • Failed the treatment • “The bipolar” • Treatment resistant • Minimal side-effect profile • Chronic • Crisis • High/low functioning • My client • The mentally ill • Decompensate • Adhering to our plan • Treatment failed me • The person • Considering other options • Major, real-life obstacles • In recovery • Intense experiences • Having a good/bad day • Person I work with • People • Having a bad day

28. Emerging Trends in Program and Workforce Development Emerging Trends in Program and Workforce Development Goal 1. Persons in Recovery (Consumers/Patients) and Families (cont’d) • What You Can Do: • Use Peers and Family members to do Illness and wellness education for all your BH patients. • Reach out to DBSA, CHADD, NAMI, MHA, and others to host support groups in your area and promote the availability of all of these free groups. • Offer written educational materials, ask consumer and family members to review before using them to ensure they are consumer friendly. • Ask peers/family members to do an in-service for your staff about the lived experience, language, and issues consumers are sensitive to around customer service. • Consider hiring a CPS/FSS.

29. Emerging Trends in Program and Workforce Development Emerging Trends in Program and Workforce Development Goal No. 4 • Increase the relevance, effectiveness, and accessibility of training and education.

30. Emerging Trends in Program and Workforce Development Emerging Trends in Program and Workforce Development Goal 4. Training: Relevance, Effectiveness, and Accessibility • Objectives: • Competency development • Curriculum development • Evidence-based training methods • Substantive training of direct care workers • Technology-assisted instruction • Addiction and co-occurring competencies in every staff member • Systematic support to sustain newly acquired skills

31. Emerging Trends in Program and Workforce Development Emerging Trends in Program and Workforce Development Effective Teaching Strategies • “No magic bullets” • Interactive sessions • Academic detailing / outreach visits • Reminders • Audit and feedback • Opinion leaders • Patient-mediated interventions • Social marketing

32. Emerging Trends in Program and Workforce Development Emerging Trends in Program and Workforce Development Implications for Recovery Into Practice • Involve people in recovery and families in all aspects of treatment, including providing education about recovery for you and with your staff. • Acquaint staff with the National Action Plan and its concentration on people in recovery and recovery principles.

33. Emerging Trends in Program and Workforce Development Emerging Trends in Program and Workforce Development Implications for Recovery Into Practice (cont’d) • Draw attention to the critical quality impact of having staff and services that are culturally and linguistically competent. • Help expand recognition of the critical role of people in recovery and families in behavioral health interventions, education, and policy development.

34. Emerging Trends in Program and Workforce Development Q and A, Discussion, and Summary To ask a question… either click on the Q/A Tab andtype your question in the window that opens... OR press *1 for the operator, who will take your question in the order in which it is received. Larry Davidson, Ph.D. Project Director, Recovery to Practice DSG, Inc. ldavidson@dsgonline.com Thanks for joining our Webinar today!

35. Emerging Trends in Program and Workforce Development Emerging Trends in Program and Workforce Development For more information… For a copy of today’s presentation: http://www.dsgonline.com/rtp/resources.html Recovery to Practice Resource Center: RecoverytoPractice@dsgonline.com New York Association of Psychiatric Rehabilitation Services: http://www.nyaprs.org/ ChackuM@nyaprs.org The Annapolis Coalition: http://www.annapoliscoalition.org jmorris@tacinc.org