The role of Peer Support is to

Tennessee Certified Peer Recovery Specialist
October 14, 2013
Montgomery Bell State Park
Burns, TN
“The Personal Journey to Recovery”
Peter Ashenden
Director of Consumer Affairs
Optum Health
[email protected]
Discuss recovery perspectives and my personal recovery
The skills I have acquired while in recovery
Surveys and Information that is helpful in demonstrating
that peer support is powerful
Things you can do to help you and your community
The President’s New Freedom Commission:
“We envision a future when everyone with a mental
illness will recover… and at any stage of life has access
to effective treatment and supports – essentials for
living, working, learning, and participating fully in the
The Consumer Perspective:
“Recovery is having a meaningful life in the
community of your choice.”
--- consumers
“Hope is to recovery
Oxygen is to the human body.”
--- Larry Fricks
Origins of Recovery: It’s mainstream now
1900’s MHA, The Bell
1940’s Psychosocial Rehabilitation programs
1950’s Medication, shock therapy
1960’s Anti Psychiatry Movement
1970’s Organized groups fighting for patients' rights
1980’s Consumers self-help/advocacy groups & peer-run services
• 1990’s Surgeon General’s report – peer services
/support mainstream
• 2000’s President's New Freedom
Commission validates the concept of recovery
• 2000’s IOM Quality Chasm mental health is key to
overall health
A Powerful Statement:
On August 11, 2008 in Bethesda, Maryland
at the “Returning Vets Conference”
Kathryn Power, Director of the Center for Mental Health
Services (former), a division of SAMHSA said:
“Restraint and Seclusion as well as any type of
FORCED SERVICES must be seen as treatment
FAILURE not treatment protocol.”
Bottom Line
People with mental illnesses
and chronic medical
conditions can and do get
Bella the Wonder Dog/Service Dog
My Story:
My Past
My Own Self-Destructive Behaviors
The Turning Point
Finding Support Groups
How I Maintain Wellness Today
Important information from Surveys
I am going to cover several surveys that let us know
what people are looking for from their mental
health service system
I wish my provider would:
Provide tangible things to do between appointments
Help me create a plan for my life with specific goals
Talk about my whole life, not just medication (54%)
Give me information about my illness (51%)
Provide choices instead of telling me what to do
Treat me like an individual, not a case (48%)
I want my provider to:
1. Give me hope for recovery
2. Listen deeply for what is important to me
3. Treat me like a person
4. Look at my whole life and build on my strengths,
instead of focusing on my deficiencies
5. Give me information I can use
6. Empower me to take more responsibility for my
But I know all this already: Keep an open mind
Survey results of over 500 providers and 2,000 of their patients reveal the
most basic of recovery/resilience practices are not occurring:
Explain your Illness to your satisfaction?
No: Psychiatrist 47%, PCP 63%
Explain your treatment to your satisfaction?
No: Psychiatrist 48%, PCP 57%
71% of Providers say they make joint decisions, but only 39% of their
patients say they were even asked their preferences
69% of Providers say they tell side effects, but only 16% of their patients
say they were told
What we think and how we are acting may not be in synch or we may know
less about how to incorporate recovery into practice than we think we do 13
Tools that help us to
take better care of
NEW: DBSA Wellness Tracker
Copeland Center on Wellness
WRAP – the Wellness Recovery Action Plan
WRAP is a structured system to monitor uncomfortable and
distressing symptoms that can help you reduce, modify or
eliminate those symptoms by using planned responses. This
includes plans for how you want others to respond when
symptoms have made it impossible for you to continue to
make decisions, take care of yourself or keep yourself safe.
WRAP is designed to:
Decrease and prevent intrusive or troubling feelings and
Increase personal empowerment
Improve quality of life
Assist people in achieving their own life goals and dreams.
Defining Recovery
As a process of discovery…
The Five Stages in the Recovery Process The Role of Peer Support is
(Fricks, 2011)
Promoting Hope and Fostering
Strengths The role of Peer Support is to:
1. Being overwhelmed by the disabling power of the
Decrease the emotional distress by reducing
2. Feeling like life is limited and will never be the
same again.
Instill hope, a sense of possibility, and rebuild a
positive self-image.
3. Recognizing that change is possible and believing
life can be different.
Empower the person to participate in their own
recovery by beginning to take small steps.
4. Making a commitment to change and exploring
the challenging and disabling power of the illness.
Help identify a person’s strengths and needs in
terms of skills, resources and supports.
5. Moving beyond the disabling power of the illness
and adopting actions for change.
Help a person to use their strengths and get the
necessary skills, resources, and supports.
Characteristics of a Recovered Person: Full Life in
the Community
Make their own decisions
Fulfilling network of friends
Major social role other than consumer
Uses emotional distress as an opportunity for growth
“Most untrained persons would not consider him/her sick”
Primary supports outside mental health system
Dan Fisher, MD, PhD
“Seven Dirty Words”
1. The bipolar in room six vs. Joe who lives with bipolar
2. Compliance vs. Adherence
3. Mary failed the treatment vs. the treatment failed Mary
4. The treatment team vs. member-centered treatment
5. The front lines vs. partner in care
6. Decompensate vs. having a bad day
7. Unmotivated vs. someone who we have not engaged
in strengths based recovery goal setting
Strengths Based
Recovery focuses on valuing and
building on the multiple capacities,
resiliencies, talents, coping abilities,
and inherent worth of individuals.
We can promote self-responsibility by supporting people
Making life and treatment choices for themselves, no matter
how different they look from traditional treatment
Building their own crisis and treatment plans
Having the ability to obtain all their records
Accessing information about medication side effects
Determining the potential outcomes of decisions
Choosing their own relationships and spiritual practices
Creating the life of their choice
Peer Support
Peer support provides…
Practical help
Reciprocal support
Friendship-based relationships
Experiential Knowledge
Alternative interpretations
Consensual validation
… does not refer to an end product or result. It does not
mean that one is "cured" nor does it mean that one is
simply stabilized or maintained in the community.
Recovery often involves a transformation of the self
wherein one both accepts ones limitation and discovers a
new world of possibility.
-Pat Deegan
The Cycle: based on a real person in our system
Man presents with depression
Is given an antidepressant
His symptoms worsen
His prescription is strengthened
His symptoms worsen
He is sent to talk therapy – and refuses
A second medication is added to the first
He ends up in the hospital after a suicide attempt
He is set up with talk therapy day treatment and a new
psychiatrist upon discharge
He does not show up for any appointments
The Cycle: same person, different look
Man presents with depression – he has chronic back pain and can
no longer work or have intimacy with his wife. She is the most
important thing to him in his life. He fears she will leave him.
No one asks about his back pain, employment or what he wants from
treatment. He is given an antidepressant that further impairs his
ability for intimacy.
His symptoms worsen as he blames himself and fears his wife will
leave him.
His prescription is strengthened which further worsens his issue
In despair he attempts suicide.
Still not asking him his goals or wishes, he is set up with a talk
therapist, day treatment and new doctor – how does this help him
achieve intimacy and get a job? The intervention makes no sense to
him. He does not show up at the appointments.
Did we make him better or worse?
The Cycle: a different look
Man presents with depression
He is asked what he cares most about and what he hopes will
occur from the visit.
He and the provider talk through a strategies for communicating
with his wife about his worries.
He and his wife are encouraged to go to no more than 2-3
sessions with a talk therapist to make it easier to communicate.
In the meantime he is set up with a new specialist to look at his
back issues.
He is set up in a job retraining program to discover things he can
do with his experience, mind, and skills even with back pain.
If still needed after a month, prescription for a mild anti-anxiety or
antidepressants with no intimacy side effects will be offered.
 Ways to motivate individuals to take action:
 Focus Groups
 Listening Sessions
 Educational Sessions
 Determining a Common Cause
 Voter Registration
 Peer Networking Groups
 Support Groups
 Drop-In Centers
 Ways to motivate individuals to take action:
 Prepare Questions before our Visits with Health
Care Providers
 Encourage Active Discussions with Health Care
 Ask for Information about any Treatment or
 Seek Support from Others
 Attend Online Support Groups
Watch your thoughts;
They become your words.
Watch your words;
They become your actions.
Watch your actions;
They become your habits.
Watch your habits;
They become your character.
Watch your character for it will
Become your Destiny.
Peter Ashenden
Director of Consumer Affairs
Optum Health
[email protected]

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