Teaching to Recovery Hope, Recovery, Relationships and Service Teaching to Recovery Service Mil Offering a “menu” of services + One choice is no choice + Community of choice is important + Done in the service of \neaningfl roles”Creating Choice Often folks in public mental health aren't offered real choice This is often due to: A belief on the part of providers thal the [person can't be rusted to chaose += Wo disagreo with tha choice = We believe the options to te mare lied than zeal fc = Enaaiple = S128 Community of Choice Jin social services we often peak et placements ana settings ~ Yau per” iets, et pene Pessoa ane eens” “he obee sneer be es! mrs, shot Exey esntiotr anyway. Lem oe Seer " ~ Peaple have a ncntve to gtk a «hore and echivetoremmisin sansa — Many houg utes ar to orcas Bans Tnnp tere er In service of “Meaningful Roles” + Yos, we're bing up Mecringful Roles again Boing fs ast boas eset ltr st ot Cece up te = Wary lus haven ptt forty erappe oe ‘ieemminiy Wate 29 ou peyt Ehiesieeeasec - EiorlesepsceDecision Making + Don't just do something, stand there + Is the purpose to make 2 batter client for the system or got the cilant out of the system? + Crisis fs not a four letter word, but living in ital the tme can be hell 914 10 414 Personal Limitations level of comfort that an individual worker experiences in sharing personal information or ‘behaving in curtain ny (.e, physteal expressions of affection) Stat wea rom eating sven elated to persoeal ints “eoundary leeuce"™* Py . . Aithical Considerations > eade of eis tat promotes respect : ‘and forbidd exploitation riot sectie maats + Si eee petal > Renaianseae etter ‘See eatinginh aig pews eo ae PE SSeS nr hk mn pot ‘Ask yourself, "Does this conversation, behavior or decision support the helping ralationship wilt this client? Clinical Concerns Aspects of some elents “ Bereanal ime ere rineetoa ceClient Expressed Preferences ‘What clients have to say bout staff behavior or interaction [+ 11s wrong to believe that stents ut pysiesl fou nd personal disclosure bysta ‘fuse aes Plaga om cepa ao Er ee /\ /N\ Roleesosciatons — SELES See Tha ig ear ‘ea Censieratony an xe ecu ©) Boat ON on‘The wecohias wit arse. su SatEeeaed ee ce © © =o eee ‘The shopaing empl santo C= reo 2) ©) raglan a ‘Shari your Veligious Baas examine ee rege © o* 5 RocaRisk and Recovery vs. Safety and Stability + We operais is a risk adverse system that Is crisis based, with a goat of stabity + How about a risk supportive system that is normalizing, with a goal of resilience? + Surting vs. reading weter How do we get there? + Prince gue work reuies the use of dyer rot lind adherence to rules «+b use of oagreent equies qualty principle fosed supervision These of arent oso reques an Tearcrrat tat perme of takes, and supports ening frm them + rors wht ws should be doing wth ests 1 Me cant elininate rk anyway + oes tis apply to es?Why don't we do this? + Change is hard + Fear + Finances| sm + Trouble meesuring recovery? MORS Components and Milestones of Recovery convenes of Recovery Mons f Rey 1. oe 2 Le of togegemet, 2 Levetor St and Stopes emreme iss High eskrengapea High Retsngaed Poot Coan? rerganes Poot Cxena/éngaved copsgyRerabinatng ary Reeoeey ‘aves Recovery Bene Early Recovery + Tae rua are acy manearg nee a ‘Sih Genny ine ocert ie atta tlh aT {Gee aged wearily vies opens {Be Fy rt wy Moka ms ap ra bee BERR de nvdaes one aiins rae Ran dg 6 98 clnathe se eankey ee ee Et caaiseeneeert, orate eee an easy ERS ein OE Seon tate hlLimitations of the Milestones + By cefinition, no dassffication system can do justice to the uniqueness of the individuals it is classtying + Many consumers resent (justifiably) any attempt to reduce their experience to a single number iliostonoc of Recovary Lavi of Service {acouery Basea Spectrum of Cara) = | a The Underlying Dimensions What do we mean by: + RISK + ENGAGEMENT + SKILLS AND SUPPORTS |RISK ‘The consumer's LEVEL OF RISK is comprised of three primary factors: 4) the consumer's likelthiod of causing ‘physical harm to self or others, 2) the consumer's (evel of participation in risky oF unsafe behaviors, and 3) the consumer's level of co-occurring disorders. ENGAGEMENT ++ The consumer’s LEVEL OF ENGAGEMENT is the leve! of “connection” between the ‘consumer and the mental health service system. What Engagement ISN'T + Engagement DOES NOT mean medestion compliance + Engagomant HOES NOT mean “rsight” Into oF “acceptance” of one's ments lines + Engagement DOES NOT mean total agreement vith the service ond treatment approaches of salt + Engagement DOSS NOT mean the tetal emount of services received I 10What Engagement IS + Engagement is about the quality of the relationship Cconnectedness"} between consumer and staff and does not require the consumer to accept that sfhe has @ ‘mental lines. Tt merely requires that the consumer is “solerant” of the presence of staff in his/her ie, SKILLS AND SUPPORTS + The consumer's LEVEL OF SKILLS AND SUPPORTS should be viewed as the ‘combination of the member's abilities and support network(s) and the level ta which the consumer needs staff support to meet bisther needs. Determining Milestones — ‘A Suggested Procedure + Step 1: The “Doing Badly/Poorly” vs. “Doing Okay/Well” Distinction (Milestones 1-5 vs. Milestones 6-8), otherwise known as “Below the line or Above the line” "1“The Line” 8. Advance Recovery 7. Ea Recovery 6. Coping /Rehetitting The Line” = 5. Poerly Coping / Engaged 4 Poorly Cagng /Unengaged 3, High Risk / Engaged 2. High Risk / Unengaged 1. extreme Rise SSA's estes of Recovery Data “atary 2005 Oetevr 2005 Future Directions and Questions 1 Are diferent sanics ceo ess eect at eran ‘ilsines of recovery? Can we use We resins to Sslgncarcumas fa dare types of cae? ‘+ What tha “ype patho 3 person recovery? Ia feteon ener dr sytem seh rik igsgecs owing (or avrabe) a ike for tor to Beco “epingtenabisting?” Hew fang unt nen eoveneesreaerys Ise posable to each “benchmarsfor sents routers? Can wa old covice pve srcounable Fes moving Sapte routs the miesones? Shook we Sek een or sere rowers to move cea evcentages of hee enrsurra te hirer letoe Ever set ore oF Be? 12