Instructor Responses to Week 4 homework (Wellness and Recovery Promotion)

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    Kristen Erickson

    Wellness and Recovery Promotion in Behavioral Health Services

    Week 4 Instructor Responses to the Homework

    I have enjoyed reading your thoughtful responses to the homework exercises. Thanks for your participation throughout the course.

    1)What are your general reactions to Stephanie’s personal narrative?

    Most of you found Stephanie’s story to be powerful and very informative. JVillan was taken by her vulnerability. She commented, “She was vulnerable and honest and provided an opportunity to hear the shifting story of working within the mental health and SUD field.”

    I chose Stephanie’s story, because I think she is a great example as a person in recovery who discovered the power of peer support through her own story of lived experience and took up the banner of advocacy for peer support for people with mental disorders. For example,  Amy wrote: “She presented as articulate and was a good self-advocate, explaining that she is the authority on what kinds of help she feels would be of the most benefit to her as she works to meet her goals while also living with significant mental health health symptoms.”

    2)What are your thoughts on the difference between the medical model, pathology-based approach and a person-driven, recovery-oriented approach to helping as embodied by a peer recovery support approach that Stephanie describes in her story?

    I think that Stephanie’s story highlights the differences she experienced between being treated as someone with a pathology (i.e. medical model approach) versus being treated as an expert in her own life who could manage her life challenges with help from supportive peers (i.e. recovery oriented approach.) Robert pointed out how setbacks in recovery are treated differently in the two approaches, “Recovery-oriented approach focuses on the person. Setbacks could be seen as detrimental within the pathology-based approach and the individual would feel shame and failure. Whereas setbacks within the recovery-oriented approach setbacks would not be seen as detrimental and the individual would be encouraged to try again even amidst the setback.” Yes, great observation.

    Amy commented, “I agree that the person driven, recovery orientated approach to recovery that Stephanie describes with the support of a peer is going to be more effective than the medical model. I believe that the person looking for support is able to establish a more trusting relationship with someone who has “been there” and found their way through similar situations and life experiences.” Yes, another key ingredient of a recovery oriented approach is the trusted relationship with someone who has lived experience in recovery. This relational model is based on mutuality and equality in helping relationships. In the medical model the expert authority (i.e. doctor, therapist, counselor, etc.) is in a power over position in relationship to the patient/client. Just by the nature of this power differential, people with mental or substances use disorders are in a “one-down” position and therefore, there is much less mutuality and equality in the helping relationship. It is important to be aware of this power dynamic and strive to engage consumers in more equitable relationships where they are the experts in their own lives. As JVillian commented, “I am so grateful that as time has passed we are moving more away from this “power over” model of treatment and learning more to sit with people while they write their own destiny. As we step out of that “expert” role and allow opportunities for connection among peers we are creating a truly compassionate community for people to heal.

    I am not suggesting that peer supports are the only or best providers of mental and substance use disorder services; however, based on Stephanie and many other consumers’ experiences, a peer supporter can be extremely beneficial in helping people enter into and sustain recovery. As Amy noted, “If the person offering support and/or suggestions seems to have shared experiences with the person needing support, the peer’s concern, understanding, advice, and suggestions are probably viewed as being more credible. The person in need of support is probably then more like to be honest about their experiences and MH symptoms, not feel as judged, and may be more likely to take suggestions based on the peer’s experiences and successes with recovery.”

    3)What are some strategies you have or would use to link consumers to peer recovery support services in your community and develop collaborative relationships with peer specialists?

    Some strategies you mentioned to link consumers to peer recovery support services include:

    * I have had really good experiences connecting folks with NAMI through various groups and their warm line.

    *Here at the treatment program we spend a great deal of time focusing on the connection to others as a means of support and to learn from one another better coping skills and grace for the journey of recovery.

    * We work to expose the clients to peers as part of our model and encourage communication that involves compassionate listening versus giving unsolicited advice.

    4)Take a moment to reflect on the course material over the past four weeks and the new insights you have gained about wellness and recovery promotion. How do you envision bringing these new insights into your work with consumers?

    Here are some of your reflections on the course material and how you might bring new insights into your work:

    * This course has been interesting for me, while my work is with folks who are at the end of their lives I still see the need for knowledge on wellness and recovery, sometimes in the client I am working with and also with their family member

    * This course has taught me to spend more time talking with clients about their past successes when helping them to consider future goals. I am going to be making an effort to help clients break their goals down into smaller and more manageable action steps that are more easily attained.

    * For me, the most impactful part of the training was the focus on peer connection. I have been working for some time to implement a peer structure that is sustainable and offers the opportunity for social capital that is so important in the recovery process.

    * I also think that the focus on development of goals that are truly generated by the client and not as a means of satisfying licensing requirements allows an opportunity for connection between counselor and client, as well as meaningful goals that the client believes will have a positive impact on their recovery was helpful as well.

    *  A lot of patients have had bad experiences with 12 step programs so the idea of a recovery coach and peer recovery would be great for them and I will definitely be encouraging them to utilize those resources.

    *The individual seeking help might see the benefit of having a mentor or peer to speak with who has already gone through the process of getting help. The community approach might be seen as beneficial by the individual for collaboration and support.

    Thank you all again for engaging so thoughtfully with the reading and homework exercises. I appreciate your intention and commitment to a recovery oriented model of helping others.


    Amy Mihill

    Hi Patricia, Thank you for offering this training. In a short amount of time, I was able to consider different approaches to my work. I found the videos very informative. Have a great summer! Amy

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