Table of Contents
Title Page
Copyright
Dedication
Preface
Part I: Introduction
Chapter 1: Person-Centered Practice and Recovery Principles
What is Person-Centered Practice?
What is Recovery?
Samhsa's Working Definition of Recovery for Mental Disorders and Substance-Use Disorders
Samsha's Guiding Principles of Recovery
Person-Centered Practice and Recovery
References
Chapter 2: Person-Centered Assessment and Individual Service Planning for Recovery
Person-Centered Assessment
Using the Recovery Planner
Developing a Person-Centered Recovery Plan
Creating a Person-Centered ISP for Recovery
Part II: Recovery Goals
Chapter 3: Mental Health and CO-Occurring Substance Abuse Supports
Individual's Recovery Focus
Beginnings
Moving Forward
Leaving Your Practitioner Behind (Usingnatural Environments)
Chapter 4: Housing
Individual's Recovery Focus
Beginnings
Moving Forward
Leaving Your Practitioner Behind (Usingnatural Environments)
Chapter 5: Education
Individual's Recovery Focus
Beginnings
Moving Forward
Leaving Your Practitioner Behind (Using Natural Environments)
Chapter 6: Legal
Individual's Recovery Focus
Beginnings
Moving Forward
Leaving Your Practitioner Behind (Using Natural Environments)
Chapter 7: Employment
Individual's Recovery Focus
Beginnings
Moving Forward
Leaving Your Practitioner Behind (Using Natural Environments)
Chapter 8: Financial Stability
Individual's Recovery Focus
Beginnings
Moving Forward
Leaving Your Practitioner Behind (Using Natural Environments)
Chapter 9: Self-Advocacy
Individual's Recovery Focus
Beginnings
Moving Forward
Leaving Your Practitioner Behind (Using Natural Environments)
Chapter 10: Family Relationships
Individual's Recovery Focus
Beginnings
Moving Forward
Leaving Your Practitioner Behind (Using Natural Environments)
Chapter 11: Health and Wellness
Individual's Recovery Focus
Beginnings
Moving Forward
Leaving Your Practitioner Behind (Usingnatural Environments)
Chapter 12: Community Involvement
Individual's Recovery Focus
Beginnings
Moving Forward
Leaving Your Practitioner Behind (Using Natural Environments)
Chapter 13: Stress Management
Individual's Recovery Focus
Beginnings
Moving Forward
Leaving Your Practitioner Behind (Using Natural Environments)
Chapter 14: Relapse Prevention
Individual's Recovery Focus
Beginnings
Moving Forward
Leaving Your Practitioner Behind (Using Natural Environments)
Chapter 15: Personal Crisis Planning
Individual's Recovery Focus
Beginnings
Moving Forward
Leaving Your Practitioner Behind (Using Natural Environments)
Chapter 16: Transportation
Individual's Recovery Focus
Beginnings
Moving Forward
Leaving Your Practitioner Behind (Using Natural Environments)
Chapter 17: Social Relationships
Individual's Recovery Focus
Beginnings
Moving Forward
Leaving Your Practitioner Behind (Using Natural Environments)
Chapter 18: Meaningful Activities
Individual's Recovery Focus
Beginnings
Moving Forward
Leaving Your Practitioner Behind (Using Natural Environments)
Chapter 19: Life Skills
Individual's Recovery Focus
Beginnings
Moving Forward
Leaving Your Practitioner Behind (Using Natural Environments)
Appendix: Blank Individual Service Plan Forms
Individual Service Plan
About the Authors
About the CD-ROM
Introduction
System Requirements
Using the CD with Windows
Using the CD with a MAC
What's on the CD
Content
Applications
End User License Agreement
Cover Design: Andrew Liefer
Cover Image: © shaunl/iStockphoto
This book is printed on acid-free paper.
Copyright © 2013 by John Wiley & Sons, Inc. All rights reserved.
Published by John Wiley & Sons, Inc., Hoboken, New Jersey.
Published simultaneously in Canada.
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Library of Congress Cataloging-in-Publication Data
Dulmus, Catherine N.
Person-centered recovery planner for adults with serious and persistent mental illness / Catherine N. Dulmus,
Bruce C. Nisbet.
pages cm
Includes bibliographical references.
ISBN 978-1-118-46435-9 (pbk. : acid-free paper)
ISBN 978-1-118-65335-7 (ebk.)
ISBN 978-1-118-65339-5 (ebk.)
1. Mental illness--Treatment.-Planning-Handbooks, manuals, etc. 2. Chronic illness-Treatment-Planning-Handbooks, manuals, etc. 3. Psychotherapy-Planning-Handbooks, manuals, etc. I. Nisbet, Bruce C. II. Title.
RC480.53.D85 2013
616.89--dc23
2012049068
In loving memory of my daughter Abby who always held tight to her hopes and dreams.
—CND
Dedicated to my mother, grandmother, father, and uncle who gave me the gift of a richly diverse childhood in an extended-family home.
—BCN
Preface
As friends and colleagues, we have had multiple conversations over the years about the challenges of preparing a workforce for a recovery-oriented practice, both from the perspectives of a social work educator and as a President/CEO of a community mental health agency. Our challenges were similar as we worked to prepare professionals to embrace person-centered planning within a recovery framework rather than the traditional top-down treatment planning approach when working with individuals with a serious mental illness. It was over dinner one evening that we once again had a conversation about recovery and the importance of moving the field forward, and it was where we came up with the idea of this recovery planner.
The field of mental health has become inundated with a variety of treatment planners, but they are not written as recovery planners incorporating person-centered planning and recovery-oriented principles that put the individual in charge of determining their own goals and their own path to recovery. With the publication of the Person-Centered Recovery Planner for Adults with Serious Mental Illness, practitioners now have a reference source to assist them in facilitating an individual developing their own person-centered recovery plan that meaningfully focuses on assisting them in achieving their hopes and dreams. This book will also be useful not only for the new practitioner but also the seasoned practitioner as they continue to build their creative approaches to being an effective person-centered facilitator and advocate for recovery. It will also serve well as both an undergraduate and graduate secondary textbook across disciplines (e.g., counseling, nursing, rehab, social work) that offer courses targeted to teaching students about working with individuals with serious mental illness.
Lastly, as Health Home care coordination programs are being established across the United States in response to incentives established under the Federal Affordable Care Act, the practices of person-centered recovery planning will need to be implemented as the most effective service approach to be used by these care coordination entities. The populations Health Homes exist to serve are high need Medicaid enrollees who are struggling with a serious mental illness and/or two or more chronic physical conditions. Enrollment by individuals is voluntary in these programs and person-centered recovery approaches will need to be utilized to build relationships that individuals will find engaging, empowering, and respectful. The Person-Centered Recovery Planner for Adults with Serious Mental Illness will be a valuable resource for these programs as they train their workforce in person-centered recovery planning in a Health Home care coordination environment.
We would like to extend our gratitude to the New York Care Coordination Project, Inc., who graciously allowed us to use many of their best practices and their Individual Service Plan forms within this book.
We also want to give a special thanks to Amy Millard, LCSW-R and Director of Intensive Services at Spectrum Human Services, Orchard Park, New York. Amy is a recognized expert in person-centered recovery planning and served as an invaluable consultant to us in the writing of this book. As she reviewed each draft chapter of this book her feedback consistently conveyed the profound respect and understanding of the recovery journeys of the multiple individuals she has worked with over the years. In the end Amy's valuable suggestions helped make this a better and more useful book for every reader.
Lastly we would like to thank our editor Marquita Flemming at John Wiley & Sons for her immediate enthusiasm for the recovery planner idea and for how quickly she moved the book proposal idea forward to contract.
We would be remiss not to acknowledge that our passion for persons with serious mental illness is a personal one, as we both have had family members who have been challenged by serious mental illness. We hope that this book will encourage and support practitioners in developing person-centered relationships with the persons they serve in order to embrace the hope and dreams of those they work with on their recovery journeys.
Catherine N. Dulmus
Bruce C. Nisbet
Person-centered practice and recovery are relatively new orientations to working with people with serious mental illness; they have been transforming the field since their inception in the late 1980s and early 1990s. The 1970s championed deinstitutionalization that rightly resulted in people with serious mental illnesses being returned to their communities. Unfortunately, though, communities were often ill-prepared to welcome their neighbors home. More often than not, inadequate services and limited knowledge and understanding of mental illness abounded, which resulted in individuals being faced with significant stigma and little reason for hope.
The 1990s, however, brought person-centered practice and recovery principles, which continue to transform the field into one in which individuals receiving services have a voice and hope for recovery. These practices are empowering each person to define what recovery is for them and to be the decision makers in all aspects of their recovery planning and delivery of services. Organizations and their members who have been at the forefront of implementing recovery-oriented services include the New York Care Coordination Project, Inc., National Council for Community Behavioral Healthcare, and the Case Management Society of America.
Person-centeredness is about developing a relationship with another individual where the practitioner relates to that individual not as a diagnosis, not as someone who needs to be “fixed,” but as another human being who desires to make changes in their life. It is a relationship in which the practitioner acts as a facilitator to assist that individual in moving forward on the changes and priorities that the individuals being served decide will improve their quality of life. As John O'Brien and Connie Lyle O'Brien (2002), leading thinkers on person-centered planning, have written, “Facilitation is a skillful process of realigning the energy around (the person)—eliciting, confirming, relating, summarizing, re-presenting, questioning, inviting, reflecting, focusing, pushing, encouraging, interpreting, checking out” (p. 16).
This book is written as a practical guide for new practitioners to support and encourage their own person-centered creativity as facilitators. More experienced practitioners will also find it useful as a desk reference when thinking about more complex sets of needs and desires on the part of individuals they are facilitating in the development and implementation of the individuals' recovery plan. The sample life goals, short-term objectives, and related recovery steps are only suggestions that are intended to prompt the practitioner's own creative thinking as a facilitator. Each recovery goal chapter suggests some life pathways and strategies that individuals being served can adapt to help themselves, when it fits their priorities. This is true whether they are at the beginning of their recovery journey, moving ahead, or at the point where they are ultimately leaving their practitioners behind as they progress on their own unique recovery paths and independence from ongoing paid mental health services and relationships. However, we also know that recovery is rarely a straight-line process, and it is always realistic to think that, even when individuals have reached a point where they have left their practitioners behind, periodically formal mental health services may be asked for or needed to assist individuals with their recovery journey.
When facilitating a recovery plan with individuals, it is the individuals who define what they deem to be their priority recovery goals. It is important to emphasize that the changes desired and priorities that are set are those of the individuals that are receiving services, and not those of the practitioner. Frankly, it is not important what the practitioner believes will improve the quality of life of individuals' they are working with but, rather, what the individuals see as the priorities to improve their own quality of life. Only in the case of health and safety or where individuals may be victims of abuse should practitioners take more direct and intervening roles to protect the individuals they are working with from harm. Otherwise, it is not the practitioners' place to decide; it is the responsibility of the individuals who are being helped to decide what their hopes and desires are. This includes the individuals' decisions about what objectives and recovery steps they choose to use in their recovery plan from those that have been offered or created within the working relationship. This is the essence of person-centered practice.
The New York State Care Coordination Program, Inc. (NYCCP), has been a regional and national leader in providing training and support for person-centered practice. Its website lists the following core values a practitioner must embrace to be person-centered in their practice (www.carecoordination.org/about_the_wnyccp.shtm):
The New York State Care Coordination Program, Inc., has also identified the hallmarks of person-centered practices that need to be evidenced by practitioners who are person-centered in their relationship and facilitation with individuals as follows (www.carecoordination.org/about_the_wnyccp.shtm):
The Person-Centered Recovery Planner for Adults with Serious Mental Illness is written to be consistent with these core values and hallmarks of person-centered practice. We seek to prompt and support the creative thinking and practice of a person-centered facilitator working with individuals in the development and implementation of their recovery plans.
There have been many definitions of mental health recovery for persons with serious mental illness since the findings of the President's New Freedom Commission on Mental Health in 2003. For the first time, the Commission embraced, at a national policy level, the concept that mental health recovery from serious mental illness was not only possible but, also, set as a priority that “care must focus on increasing consumers' ability to successfully cope with life's challenges, on facilitating recovery, and on building resilience” (President's New Freedom Commission on Mental Health, 2003, p. 2).