Community Support Services Training Supervisor Series-Session 6. Learning Objectives. What are Evidence-Based Practices?

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1 Community Support Services Training Supervisor Series-Session 6 Zakia Clay, MSW, LCSW Zakia.Clay@shrp.rutgers.edu Ann Reilly, MA, LSW, CPRP Reillya2@shrp.rutgers.edu Anthony Zazzarino, MA, LPC, CPRP Anthony.Zazzarino@shrp.rutgers.edu Rutgers, The State University of New Jersey Learning Objectives Become familiar with Evidence-Based Practices Learn the relationship between recovery and Illness Management and Recovery (IMR) Learn strategies and content in IMR groups Learn/review skills necessary to facilitate a structured task group Become familiar with characteristics and skills of an effective group facilitator What are Evidence-Based Practices? Integrated Dual Diagnosis Treatment (IDDT) Assertive Community Treatment (ACT) Pharmacologic Treatment Psycho-Education for Families Supported Employment Illness Management and Recovery (IMR)

2 What makes IMR an evidenced-based practice? (Pratt, Gill, Barrett & Roberts, 2014) Illness Management and Recovery(IMR) IMR is an evidence-based practice that helps people with mental illness: Set meaningful personal goals Acquire skills necessary to cope with and manage their illness Make progress toward their recovery How does IMR relate to Community Support Services (CSS)? Improved ability to manage one s illness is a common recovery goal Avoiding relapses and re-hospitalizations gives people greater control over their lives Less time spent dealing with mental illness allows more time to be spent on personal recovery Less distress due to symptoms leads to a better quality of life Increases independence through skill development

3 Components of IMR Program Standardized curriculum Individual or small group format (8-10) Nine months of weekly sessions Structured and step-by-step People set personal recovery goals and pursue them throughout the program Core Values of IMR Hope is the key ingredient Practitioners of IMR are partners The person is the expert Practitioners demonstrate, not dictate Personal choice is a must Respect is always present IMR Modules Recovery Strategies Practical Facts about Mental Illness The Stress-Vulnerability Model Building Social Support Using Medication Effectively Drug and Alcohol Use Reducing Relapses Coping with Stress and Common Problems Coping with Symptoms Getting your Needs Met in the Mental Health System Healthy Lifestyles

4 Strategies Motivational -Convey confidence and hope -Relate learning to goals -Explore pros and cons of change Educational -Active teaching -Multiple methods -Simple, normalizing language Strategies, cont d Cognitive Behavioral Shaping Role Playing Modeling Reinforcement Homework Jointly agreed upon Individualized and goal related Behaviorally specific May involve or be facilitated by others Should be followed up Group Activity Pay Off Matrix Partner up and utilize the pay off matrix with your partner to discuss a change you would like to make Each person will get a turn(8 min each) Facilitators will role play activity first.

5 Anticipated Outcomes Reduce relapses/re-hospitalization Reduced symptom severity Increased knowledge base Increased medication management Improved coping skills Increased hopefulness and optimism Improved social skills Improved collaboration Module Exercise Discussion Questions What is a group? In what situations are you called on to facilitate a group? How can you support your staff in their efforts to facilitate a group?

6 What impacts a group? Content- materials brought to group Dynamics-internal issues (interrelationships between members) Forces- external issues (time of day, membership, environment) Leadership- attitude, preparedness Curative Factors in Groups Installation of Hope Development of Social Skills Imitative Behavior Universality Corrective Recapturing of Family Group Interpersonal Learning Imparting of Information Altruism Group Cohesion Yalom, 1983 Types of Groups Counseling Groups focus on growth and development Psychotherapy Groups focus on antecedents/diagnosis/links to present Self-Help Groups peers share, support, and learn from each other Task/structured Groups skills learning and development (our focus)

7 Task/Structured Groups Characterized by a central theme Often singular or short-term Include readings, structured exercises and practice opportunities (homework) Don t require advanced clinical training Serve a variety of purposes: provide information, problem solving, teach skills, share ideas, provide support NOT therapy or counseling groups Structure of the Group Each group has a lesson plan Plan describes the purpose and direction of the group (the what, why, how) Each session addresses a topic based on the plan Group leader is responsible for maintaining focus on the group s purpose Group Planning Process Protocol Activity (10min) Lesson Plan Check List

8 Characteristics of a Productive Group There is a focus on the here and now Goals of members are clear and specific Cohesion is high a sense of emotional bonding in the group Conflict in the group is recognized and explored Members are willing to make themselves known Trust is increased and there is a sense of safety (Corey, 2002) Characteristics of a Nonworking Group Mistrust is manifested by an undercurrent of unexpressed feelings Participants focus more on others than themselves Participants hold back-disclosure is minimal Members may feel distant from one another Conflicts are ignored or avoided Communication is unclear and indirect (Corey, 2002) The Group Counselor: Person and Professional Courage Modeling Goodwill and caring Openness Non-defensiveness Becoming aware of your own culture Personal power Stamina Willingness to seek new experiences Self Awareness Sense of humor Inventiveness Dedication and commitment

9 Group Leadership Skills Active Listening Reflecting Clarifying Summarizing Facilitating Empathizing Interpreting Questioning Linking Confronting Supporting Blocking Evaluating Terminating Facilitating maintaining focus Focus refers to the topic, activity or person that is the current emphasis of the group Strategies for establishing focus: a) Stating topic area b) Using audio-visuals c) Using exercises d) Using dyads or rounds e) Others? Dyads Good in first group develop comfort Good warm-up and energy builder Processing information and exercises Finishing a topic saves time Helping participants to bond or work issues out Leader can pair with someone Changes up the usual format Time out for leader

10 Round Exercise References Corey, M.S., Corey, G. (2002). Groups: process and practice. Pacific Grove, CA. Wadsworth Group. Jacobs, E. E., Masson, R.L., Harvill, R.L., Schimmel, C.J. (2009). Group counseling strategies and skills. (7 th ed.) Belmont, CA: Brooks/Cole. Pratt, C. W., Gill, K. J., N.M, & Roberts, M. M. (2014). Psychiatric Rehabilitation. (3 rd ed.) San Diego, CA: Elsevier Inc. Yalom, Irvin D. (1983). Inpatient Group Psychotherapy. Basic Books, NY.