OT Mental Health Education Retooling for the Recovery

OT Mental Health Education: Retooling for the Recovery Paradigm David M. Merlo MS, COTA, CPRP www. davidmerlo. com merlodm@ecc. edu 716 851 -1312

AOTA Statement on Recovery • … individuals diagnosed with mental health conditions can and do recover and lead meaningful, satisfying, and productive lives. Champagne, T. , Gray, K. (2011). Occupational Therapy’s Role in Mental Health Recovery. AOTA.

10 Fundamental Components of Recovery SAMHSA. (2006). National Consensus Statement on Mental Health Recovery.

Erie Community College Occupational Therapy Assistant Program Psychosocial Rehabilitation OT-200 People System Process

Dave’s Top 10 List… 1. Rehabilitation versus Treatment 2. Person-centered planning, shared decision-making 3. Positive psychology, strength-based approaches 4. Peer perspective, practitioner-peer partnership 5. Supported Models: Employment | Education | Living 6. Recovery, psychiatric rehabilitation approach 7. Wellness, wellness self-management, WRAP 8. Therapeutic communication/relationships 9. Trauma-informed care 10. Group process

Pratt, C. , Gill, K. , Barrett, N. , Roberts, M. (Expected release date: Nov 2013). Psychiatric Rehabilitation, 3 rd Ed. Academic Press. ISBN: 9780123870025

Specialized Knowledge and Skills in Mental Health Promotion, Prevention, and Intervention in Occupational Therapy Practice Section 1: Section 2: Core MH Professional Knowledge and Skills Specific OT Knowledge and Skills Applied to MH Document reflecting competencies: USPRA CPRP Certification Exam Blueprint 2011 ACOTE Standards Barrows, C. , Clark, C. , Gupta, J. , et. Al. (2010). Specialized Knowledge and Skills in Mental Health Promotion, Prevention, and Intervention in Occupational Therapy Practice. AOTA.

USPRA CPRP Certification Exam Blueprint • 7 Domains: – Interpersonal Competencies – Professional Roles Competencies – Community Integration – Assessment, Planning, Outcomes – Interventions for Goal Achievement – Systems Competencies – Diversity and Cultural Competency October 2007, USPRA (currently under revision). Retrieved 4/2/13. https: //uspra. ipower. com/Certification/CPRP_Exam_Blueprint_2009. pdf

USPRA CPRP Certification Exam Blueprint Sample Knowledge Areas Sample Skill Areas • Core Principles of Psych Rehab • Strengths Model • Distinctions between medical and rehabilitation models • Impact of mental illness on function • Empowerment theories and approaches • Recovery • Normalization • Cultural differences in helpseeking behaviors • Preparing group activities in which individuals can learn specific skills • Teaching problem solving and conflict resolution • Modeling leadership skills • Providing feedback • Reinforcing newly learned skills and behaviors October 2007, USPRA (currently under revision). Retrieved 4/2/13. https: //uspra. ipower. com/Certification/CPRP_Exam_Blueprint_2009. pdf

A Few Examples… Hearing Voices Simulation Wellness Recovery Action Plan Passion Fair

Hearing Voices Simulation • Hearing Voices Curriculum – Participants use headphones for listening to a specially designed recording simulating the experience of hearing distressing voices. – Participants undertake a series of tasks including: • • social interaction in the community a psychiatric hospital interview cognitive testing activities group in a “day treatment program” – Followed by a debriefing and discussion period. – Curriculum also includes a video lecture presenting research on voice hearers and how they manage. – www. power 2 u. org

Specialized Knowledge & Skills in Mental Health: Specific OT Knowledge and Skills Applied to MH • Understand role of sensory system in regulating level of alertness. • How to use sensory tools to increase/decrease level of alertness to focus on/participate in chosen activities.

Wellness Recovery Action Plan • Key elements of WRAP: – Wellness Toolbox – Daily Maintenance Plan – Identifying Triggers and an Action Plan – Identifying Early Warning Signs and an Action Plan – Identifying When Things Are Breaking Down and an Action Plan – Crisis Planning – Post Crisis Planning • www. mentalhealthrecovery. com

WRAP as an Intervention • Support the creation and use of a wellness recovery action plan. – Teach/support use of coping strategies. – Identify/implement healthy habits, rituals, routines. – Identify personal values, needs, and goals to enable informed decision making. – Increase awareness of community-based resources. – Encourage self-monitoring of health concerns, managing symptoms, recognizing/responding to acute changes. – Engage in long-term planning that leads to meeting personal recovery goals. Champagne, T. , Gray, K. (2011). Occupational Therapy’s Role in Mental Health Recovery. AOTA.

AOTA Statement on Recovery • Shared decision-making process that is person -centered and client driven. Champagne, T. , Gray, K. (2011). Occupational Therapy’s Role in Mental Health Recovery. AOTA.

Specialized Knowledge & Skills in Mental Health: Specific OT Knowledge and Skills Applied to MH • Evaluate relationship among health, wellbeing, and participation in daily life activities. • Develop occupational profile using clientcentered strategies to gather information about a client’s: – occupational history and experiences – life roles – interests, needs, and concerns – strengths and limitations Barrows, C. , Clark, C. , Gupta, J. , et. Al. (2010). Specialized Knowledge and Skills in Mental Health Promotion, Prevention, and Intervention in Occupational Therapy Practice. AOTA.

Specialized Knowledge & Skills in Mental Health: Specific OT Knowledge and Skills Applied to MH • Design/implement interventions that support development of cognitive, sensory regulation, social, and communication skills requisite for role performance. • Choose interventions that fit the values and abilities of those providing and receiving care. Barrows, C. , Clark, C. , Gupta, J. , et. Al. (2010). Specialized Knowledge and Skills in Mental Health Promotion, Prevention, and Intervention in Occupational Therapy Practice. AOTA.

WRAP and OT Practice Framework Domain Process • OT Areas of Occupation: • OT Intervention Approach: – IADL (Health management and maintenance) – Rest and Sleep, Education, Work, Play, Leisure, Social Participation, ADL • Client Factors: – Values, Beliefs, Spirituality • Performance Skills • Performance Patterns: – Habits, Routines, Roles • Context and Environment • Activity Demands – Health Promotion – Prevention – Maintenance • OT Intervention Type: – Therapeutic Use of Self – Therapeutic Use of Occupations and Activities – Consultative process – Education process

Passion Fair • Plan/conduct a community “fair” focusing on: – – health and wellness community participation role participation quality of life • Using “passions” to address individual volition as a primary motivator and organizer of human occupation. • Address occupations of: – play/leisure exploration – volunteer exploration – social participation

AOTA Statement on Recovery • Facilitate resiliency, health, and wellness in the community of the individual’s choice… Champagne, T. , Gray, K. (2011). Occupational Therapy’s Role in Mental Health Recovery. AOTA.

AOTA Statement on Recovery • Emphasis on holism, function, participation, and partnership, is used to help support people to – develop skills – engage in activities of interest – meet individual recovery goals Champagne, T. , Gray, K. (2011). Occupational Therapy’s Role in Mental Health Recovery. AOTA.

Specialized Knowledge & Skills in Mental Health: Specific OT Knowledge and Skills Applied to MH • Determine how environmental supports and barriers influence participation in meaningful & productive roles in community. • Facilitate reducing barriers. Barrows, C. , Clark, C. , Gupta, J. , et. Al. (2010). Specialized Knowledge and Skills in Mental Health Promotion, Prevention, and Intervention in Occupational Therapy Practice. AOTA.

United States Psychiatric Rehabilitation Association • Administers Certified Psychiatric Rehabilitation Practitioner (CPRP) specialty certification • Annual Conference: June 9 -12, Atlanta Georgia • Journal: Psychiatric Rehabilitation Journal (published by American Psychological Association) • www. uspra. org

CPRE Consortium of Psychiatric Rehabilitation Educators • Develop, promote, and support academic initiatives and higher education programs specific to the contemporary practice of psych rehab. • Membership open to all MH educators (free!). • Annual Symposium: November 1 -2, 2013 University of Medicine & Dentistry of NJ School of Health Related Professions (Scotch Plains, NJ) • www. psychrehab. net

• Order free curricular materials including: – Lesson guides – Booklets and pamphlets – DVDs – CDs • www. SAMHSA. gov

• Creating and disseminating recovery-oriented training materials for mental health professions. • http: //www. samhsa. gov/recoverytopractice/

• Increase awareness and understanding of the concept and reality of recovery. – Articles – Books – Documents and Reports – Multimedia and Websites – Training and Technical Assistance • http: //www. bu. edu/cpr/repository/index. html

OT Mental Health Education: Retooling for the Recovery Paradigm David M. Merlo MS, COTA, CPRP www. davidmerlo. com merlodm@ecc. edu 716 851 -1312