PSR Fundamentals: Putting Values into Practice Betty Dahlquist, MSW, CPRP

Learning Objectives Understand the basic principles and values of psychosocial rehabilitation. State the research outcomes that demonstrate that people do recover from schizophrenia Understand the principles of recovery, empowerment, and resilience in working with people with a psychiatric disability.

Redefining Mental Illness Redefining mental illness –Myths –Research –DSM vs. Functional Assessment –An alternative view of “symptoms”

Stigma, both externalized and internalized is based on myths about mental illness and the feelings generated by those myths.

Research Findings Vermont Study - Courtney Harding, 1987 –65% of people with schizophrenia experienced significant improvement. –80% of people with bi-polar disorder significantly improved. –65% of people with major depression significantly improved. COMPARED TO ROUGHLY 50% RECOVERY RATE FOR HEART DISEASE, DIABETES AND CANCER

Symptoms Are on a continuum. Have a variety of causes. Changes occur over time. Can be managed both with or without medication. May disappear entirely.

Why a psychiatric diagnosis? To categorize symptoms. To bill for services. Provides a common language for mental health professionals. Identifies deficits. Provides a basis for services.

Why a functional assessment? Describes the capabilities of the individual. Views the person in an environmental context. Focuses on both strengths and deficits. Determines skills needed to achieve goals. Considers developmental tasks based on life stage. Focuses on quality of life.

Principles which impact treatment approaches.

Social Rehabilitation Goals –Recovery –Community integration –Quality of life Values –Self-determination –Dignity and worth of every individual –Optimism –Capacity of every individual to learn and grow –Cultural sensitivity

Guiding Principles –Individualization of all services –Maximum client involvement –Normalized and community-based services –Strengths focus –Holistic approach –Vocational focus –Skills training –Environmental modification and supports –Partnership with the family –Outcome oriented focus –Focus on advocacy

Recovery Bill Anthony: “The development of new meaning and purpose as one grows beyond the catastrophe of mental illness.” “Wellness actualized.” Sheryle Stafford: “Recovery can only be defined be each person’s experience. It is entirely individualized.”

Central Recovery Concepts Hope Choice Responsibility Meaningful role

Empowerment Goals: –Recovery –Reaffirm essential wholeness –Validate the importance of relationships Values: –Shared responsibility –Mutuality in communication –Consumer directs treatment

Guiding Principles: –Use of peer support –Consumers hired as staff –Consumers involved in all aspects of their care –Consumers involved in program/system planning and management –Staff “partner” with consumers –Focus on relationship

Resilience Definition: “Bouncing back from problems and stuff with more power and more smarts.” Resiliency Attitude: “What is right with you is more powerful than anything that is wrong with you.”

CASRA PSR Curriculum Who’s It For? –Staff working in the field with no degree background. –Staff with degrees but no training in PSR. –Consumers who want to be providers.

Course Content Focus on entry-level skills Practical application Steeped in PSR values and recovery- oriented Gives a solid base of knowledge

Five Core Courses Introduction to Psychosocial Rehabitation The Helping Relationship Rehabilitation and Recovery Community Integration Fieldwork seminar in PSR

Resources for Developing a Recovery-oriented Workforce CASRA PSR Curriculum 5-Day Intensive in PSR/Recovery-oriented Practice Advance practice modules Train the Trainer Implement PSR Curriculum at local community college

Additional Resources Attend CASRA Fall Conference November 2-3 in Culver City Publications (Available from CASRA) –Best Practices in Psychosocial Rehabilitation –Psychological and Social Aspects of Psychiatric Disability –Psychiatric Rehabilitation –Mad in America –Taking Transformation Personally (video/DVD)

Become a Certified Psychiatric Rehabilitation Practitioner (CPRP) For information: –