Medical Health Recvery Exercises - A Review

Transcription

1 Mental Health Recvery Exercises fr Students 1 Mental Health Recvery Exercises fr Students The fllwing exercises are intended fr use with scial wrk students in either classrm r field settings. Mst f the exercises were identified thrugh a review f recvery-riented scial wrk syllabi, which were gathered thrugh a call fr master s level syllabi in They are reprinted here with permissin f the authrs. Fr mre resurces n recvery, see the CSWE website ( 1. Summary and Analysis f First-Persn Accunt (Russell, Meath, Russell, & Auberger, 2010) Read a first-persn accunt written by a persn with lived experience f mental health recvery, such as: An Unquiet Mind: A Memir f Mds and Madness (Jamisn, 1997), Scattersht: My Biplar Family (Lvelace, 2008), The Center Cannt Hld: My Jurney Thrugh Madness (Saks, 2007). An expanded list f first-persn accunts can be fund in the Mental Health Recvery Bibligraphy and the Sample Clinical Syllabus fr Mental Health Recvery; these resurces are available n the CSWE website ( Prvide a brief 6-8 page summary f the bk. Discuss the fllwing: 1) Hw des the authr s stry reflect the cncepts f mental health recvery and resilience? 2) What were sme f the mst significant strengths f the authr and hw were these utilized in his/her recvery? 3) What were the mst significant challenges that the authr faced? 4) What were the mst imprtant psitive aspects f the mental health care that the authr received? 5) What natural supprts were helpful in the authr s recvery jurney? 6) What aspects f this stry wuld yu share with smene wh had a similar diagnsis? Why? 1

2 7) Hw des this stry impact yu as a Scial Wrker? Mental Health Recvery Exercises fr Students 2 2. Strengths Based Plan fr Recvery (Mayeda, 2013) The student will select a client t wrk with fr all 6 parts f this prject. The client must be smene wh will wrk with the student fr three r mre sessins. The client must want help with smething, anything. (A mandated client wh wants help with smething is acceptable.) If the student is unable t select an apprpriate client in the current field placement, a case is available. It is recmmended that yu include many qutatins frm the persn with whm yu are wrking. 1) Assessment - Brief descriptin f persn Demgraphics What is the persn requesting help with? (This is ne f the mst imprtant questins f this assignment.) Presenting symptms Identificatin, frequency, duratin, intensity Gals and Values f the Client (nt the clinician s gals and values) 2) Therapeutic Relatinship - Plan fr trusting relatinship with this persn Welcming and engagement (Hw was this executed?) Unique and nging dynamics (What is unique abut yur wrk with this client?) Apprpriate self-disclsure (Yur s with client) Apprpriate use f humr (Yur s with client) Apprpriate sharing f emtins (Yur s with client) Sadness tears Excitement Use f tuching (hugging, etc.) Other 3) Shared Stry f Illness - Cntributing Factrs Precipitating events Factrs that increase stress and vulnerability - Trauma and significant lsses - Symptms f illness Multiaxial Diagnses (use prper frmat, nt a paragraph) Differential Diagnses Justify all diagnses Example: List DSM criteria Hw client manifests this symptm. 2

3 Mental Health Recvery Exercises fr Students 3 Remaining questins What infrmatin are yu seeking t rule ut r rule in diagnses? (Be sure t have a crrect understanding f the term Rule Out ). - Hw are behavirs and symptms bstacles t gals and values? Be specific. Name gal / value and discuss impact f each. 1) Shared Plan f Recvery - (We knw that high quality in these areas cntribute t stability and increased quality f life. Use academic references t supprt yur assertins. Be sure that yu are articulating the specific plans fr the future f each area. Be sure t write ut all headings. In yur paper, yu may want t cmment n past and present situatins f each. Hwever, the essence f this paper lies in planning fr the increased quality f each area. Cnsider bth very small and lng term gals. Use references t assert that these areas are imprtant in recvery.) - Cut and paste demgraphic infrmatin frm Part 1. - What des the persn mst want help with? - Resurces that will help t vercme illness and ther bstacles. (Heading placehlder.) - (It is preferred t use all the headings, including subheadings and list all at far left margin. Use at least 4 references. May be frm reading list. Fr each item, begin with a few assertins, with references, abut hw each area increases quality f life in peple with mental illnesses.) - It is nt enugh t just list histry in all these areas. The student will demnstrate that he/she has had a meaningful cnversatin with the client abut each area. It is nt enugh t say that client is nt interested. Peple with mental illnesses are scialized t settle fr lw standards. The student will educate client abut each area and the benefits f each area. Even having this educatinal cnversatin will instill hpe that there can be a higher quality f life and that the client deserves this. Then, the student will walk the client thrugh, step by step, each area and demnstrate a cncrete example f mving frward fr each. That said, sme clients, fr example may have cme frm abusive families and d nt want t have any cntact with them. D nt push in areas in which these pints will cause the client any distress. Describe with as much detail as pssible. (These are areas that yu and yur client discuss tgether abut the future. This is nt intended t address the past. What are yur client s ideas abut each f these areas?) Areas t cnsider Physical Health Bdy Dental Mental Health Therapist 3

4 Mental Health Recvery Exercises fr Students 4 Psychiatrist Scial Friends Hbbies Husing Emplyment Family Partner Children Parents Siblings Educatin Other 2) Summary f Prcess - Tell the stry f yur experience with this persn in chrnlgical time. (Use the fllwing headings.) Beginning Middle End - Within the abve headings, include the fllwing details. (Bld r italicize each term s as t make it bvius. Use references.) Aspects f Recvery Hpe Empwerment Self-respnsibility Achieving meaningful rles Essential Therapeutic Skills Creating a trusting relatinship Cnstructing a shared stry f hw the persn gt int truble Hw symptms and behavirs creates barriers t achieving gals and hw t vercme them In-viv skill building Creating a healing envirnment Therapeutic bundaries 3) Reflectins f a Recvery Minded Scial Wrkers (Use all the headings as listed belw.) - Tell 3 stries that I will mst remember abut wrking with this persn. - What interventins did nt wrk? - What resurces were lacking that wuld have helped? - What d I knw t be true abut wrking with peple wh have been diagnsed with severe and persistent mental illnesses? 4

5 Mental Health Recvery Exercises fr Students 5 3. Client Histry Analysis (Keefe, 2010) Thrughut yur scial wrk career yu will wrk with clients wh have used many different mental health services. It is rare that yu will see a client wh has never used services, at whatever level, at sme pint in his/her life. In this paper yu will explre a client s trajectry thrugh the mental health and related scial services, including yur wn placement agency, and examine the services that were prvided t the client. Yu will determine the usefulness, if any, f each service t the client, and examine why the service was successful r unsuccessful. Yu will als cnsider hw mental health services develped t nurture client wellbeing may simultaneusly traumatize clients unless the services rendered are trauma-infrmed. Recmmended length is 5-8 pages. The paper yu write will have several interrelated sectins: 1) A thrugh psychscial client histry. This will require yu t interview nt nly the client but bviusly with apprpriate cnsent previus service prviders as well. Include a mental health risk assessment, lethality assessment, and mental status exam. 2) Presentatin and analysis f each f the services. Yu shuld describe the services, and explain hw each failed, helped, r may have helped the client. (Clients and service prviders may have very different pinins abut hw helpful a particular service was.) 3) Describe and discuss the public plicy influences n yur client s service trajectry. Relate the abve infrmatin t yur reading and t class discussins. 4) Describe hw (if at all) this analysis f yur client s service histry will influence the treatment yu prvide r arrange fr this client. 5) Describe hw while agencies are develped t nurture client wellbeing and prmte self-determinatin they ften serve t traumatize clients in varius ways. Think abut a client s race, ethnicity, r ther scial lcatin. 6) Select a theretical apprach t use while wrking with this client and why yu believe it is apprpriate. 7) Hw will the abve infrmatin serve t help yu prvide services in a trauma-infrmed manner while als helping yu t reflect n the care yu prvide? 5

6 Mental Health Recvery Exercises fr Students 6 4. Agency Visit and Critique (Mathiesen, 2010) The purpse f this assignment is fr each student t gather infrmatin t dcument their perceptins and respnses t the setting, prgram structure, service delivery apprach, and attitudes regarding an agency that serves the seriusly mentally ill ppulatin. It is als intended t serve as a useful tl in evaluating cllateral resurces in the cmmunity, and as an pprtunity t share these resurces with fellw student prfessinals. The critique shuld be abut 5-6 pages in length. 1) Each student will first chse a particular diagnstic grup (1-schizphrenia, 2- biplar disrder r majr depressin, r 3-c-ccurring disrders) and a particular target ppulatin where there is an unmet need. The target ppulatin may be defined by an aspect f the illness (e.g., cultural issues assciated with the diagnsis, r the impact n family) r a subppulatin (e.g., thse diagnsed with their first episde, r lder adults r adlescents), r a treatment setting (schl, etc.). 2) The assignment requires each student t visit a lcal agency that fcuses n psychscial rehabilitatin, gather and summarize infrmatin, and write a critique f the agency in terms f the missin, gals and mdel used by the prgram within the cntext f the published literature fr the chsen ppulatin. 3) Depending upn the number f students in the class yu will frm teams f 2-3 students and arrange t visit a psychscial rehabilitatin and recvery center in the lcal area. This is nt a grup assignment. The purpse f frming the grup will be t minimize the disruptin t the agency by having ne interview/visit scheduled per semester. Beynd the grup interview/visit with the agency representative, all written wrk and bservatins will be made independently. After rganizing schedules within the team, ne team member shuld cntact the persn in charge, and clearly identify him/herself as a scial wrk student. Arrange a time when all members f the team can visit the agency if pssible. NOTE: Students may nt select an agency r prgram where they are currently interning r where they have previusly served as an intern r been emplyed. 4) During yur visit, yu will all be adpting the rle f scial wrkers that are learning abut cmmunity resurces fr the seriusly mentally ill. Each team member will make independent bservatins, and will gather material that is individually determined t be imprtant in understanding the functining f the agency. As yu make yur bservatins, think abut the target ppulatin that yu have chsen and if they wuld be best served in this setting and mdel, and what ppulatins/prblems/treatment issues wuld r wuld nt be apprpriately addressed. While many agencies may perate frm a similar mdel, inquire abut and describe the unique aspects that the individual prgram ffers within the general mdel. 5) If pssible and apprpriate, tur the facility. Gather relevant dcuments abut the agency that are available t the public and ther prfessinals. If a tur is nt 6

7 Mental Health Recvery Exercises fr Students 7 pssible, include that in yur reprt and make every effrt t bserve aspects f the agency that will help yu t frm impressins abut the prgram. Include in yur paper hw yu felt during yur visit there e.g., did it feel like a cmfrtable place t yu? The gal is access multiple and distinct surces f infrmatin: yur bservatins, the perspective f the agency representative, written materials prvided by the agency. 6) While each student will gather different infrmatin, all students shuld, at a minimum, btain the fllwing infrmatin during the interview with an agency representative and use it in yur critique. - Frm the representative s perspective: Descriptin f the agency and/r prgram; Descriptin f the prgram s missin; Agency definitin f psychscial rehabilitatin; What particular mdel r cmbinatin f mdels their prgram fllws; Perspective n the rle f scial wrkers at the agency; Cultural make-up f clients and staff; Impact f client's culture n interactins within prgram, if any; What skills are imprtant fr thse interested in wrking with the ppulatin; What they feel are the majr strengths f the agency; What they wuld like t see change abut the prgram. - Frm the student s perspective: Persnal reactins t setting, clients, staff Observatins f relevant interactins, implementatin issues Strengths, limitatins f bservatins - Frm curse readings and ther schlarly literature: Backgrund n gals, ideals f the mdel used by the agency EBP with the diagnstic area and target ppulatin chsen 7) Based the infrmatin gathered at the agency and yur bservatins, each student will write a brief critique f the agency. A summary f the infrmatin yu gathered will be placed in a table r in bullet frm in an appendix. The critique will include yur subjective impressins, bth psitive and cnstructive, and the perspectives prvided by the agency representative. These persnal accunts will be integrated with curse readings and ther schlarly literature abut evidence-based practices fr the diagnstic area and with the target ppulatin yu have chsen, and the degree t which best practices are utilized bth in principle (gals, missins, etc.) and in the implementatin f the prgram. 7

8 Mental Health Recvery Exercises fr Students 8 5. Cmmunity Invlvement (Giia, 2012) Get invlved in a Natinal Alliance fr Mental Illness (NAMI) event. 6. Adapted Versin f Hearing Vices (Deegan) Have yur student fill ut ne f the agency s intake frms. At the same time they are filling it ut, the field instructr talks t them r plays a recrding simulating auditry hallucinatins. Time hw lng it takes fr them t fill it ut. After they are dne, debrief with them n what the experience was like (anxietyprvking, irritating, discncerting?). Explain the simulatin as an empathy building activity t put them in the shes f the client. Ask the student t cnsider what they culd d as a scial wrker t assist the client. 7. Secnd Life Simulatin (University f Califrnia, Davis) Use Secnd Life virtual registratin prcess t experience entrance t a mental health agency and sign-in prcess first hand while experiencing hallucinatins. 8. Cllabrating with Peer Specialist Wrk cllabratively with a peer specialist n a prject. If a cllabrative prject isn t pssible, have the student meet with the peer specialist t find ut abut their wrk, their apprach, and hw t make referrals. 9. Self-Help/Peer Supprt Reflectin Attend self-help r peer supprt grup fr a relevant issue (e.g., NAMI, Overeaters Annymus, PFLAG, etc.) and reflect n the experience. 10. Interviewing Persn in Recvery Ask student t interview smene with lived experience. Over the curse f the interview, student shuld ask questins like: Hw have yu managed t cme s far/achieve s much? Can yu identify turning pints? What and wh was mst helpful? 8

9 Mental Health Recvery Exercises fr Students 9 References Deegan, P. The hearing distressing vices simulatin - Giia, D. (Spring 2012). SWCL 730: Clinical scial wrk in relatin t chrnic mental illness. University f Maryland Schl f Scial Wrk. Keefe, R. H. (Fall 2010). SW 572A: Mental health and disability scial wrk. University at Buffal, State University f New Yrk Schl f Scial Wrk. Mathiesen, S. G. (Spring 2010). SW 781: Seminar Psychscial rehabilitatin fr individuals with serius mental illness. San Dieg State University Schl f Scial Wrk. Mayeda, S. (2013). Scial Wrk 618: Systems f recvery frm mental illness in adults. University f Suthern Califrnia Schl f Scial Wrk. Russell, R., Meath, M., Russell, B., & Auberger, K. (Spring 2010). SWK 508: Diagnstic prcess: A strengths-based scial wrk perspective. Greater Rchester Cllabrative MSW Prgram. Cllege at Brckprt, State University f New Yrk. University f Califrnia, Davis. Virtual Hallucinatins - 9