CONSUMERS HAVE A RIGHT TO EXPECT AND PROFESSIONAL PRACTICE WOULD REQUIRE: –That to the extent possible, the service provider knows the consumer’s bio-psycho-

CONSUMERS HAVE A RIGHT TO EXPECT AND CONSUMERS HAVE A RIGHT TO EXPECT AND PROFESSIONAL PRACTICE WOULD REQUIRE:PROFESSIONAL PRACTICE WOULD REQUIRE:

– That to the extent possible, the service provider knows the consumer’s bio-psycho-social history and will have reviewed available outcome information prior to meeting with the client

– That the service provider will use their expertise and experience by sharing with the consumer their own perspectives and strategies.


– That the service provider recognizes the recovery planning process as a negotiation process and understands that it is the consumer who must eventually set the treatment goals

– That the service provider will help the consumer learn the recovery planning process and how to use outcome information within that process


– That there will be times when the

service provider may need to help the

consumer become more ready to

engage in the recovery process.

RECOVERY PLANNING WITH CLIENTS RECOVERY PLANNING WITH CLIENTS

Beginning the DialogueBeginning the Dialogue

Engaging and dialoguing with clients is an essential and ongoing part of community support practice. One important component of beginning any activity with a client is to open a dialogue with your client to orient her/him to the activity.



The following example illustrates how you might start a dialogue and orient your client the first time you jointly develop a recovery/service plan using Outcomes reports.



Ask your client if they recall answering questions on the Ohio Mental Health Outcomes Survey.

Remind and explain to your client the importance of providing answers to the questions on the Ohio Mental Health Outcomes Survey.



Explain to your client that one important use for the survey answers is to identify issues for her/him to discuss with you.

Explain to your client that the discussion around survey answers can be helpful to her/him when developing recovery plans with you.


Orienting ClientsOrienting Clients

The what, why, and how of using Outcome information in Recovery planning.



What1.) Discuss with your client what the

“Red Flag Report” and “Strengths Report”, or similar reports are and what they are for.

2.) Discuss with your client what a Recovery/Service Plan is and what it is for.



Why3.) Discuss with your client why

she/he should participate in the development of a Recovery/Service Plan.



How4.) Discuss how both you and

your client will participate in the development of the Recovery/Service Plan. Explain what your role is in the process and what is expected of her/him.

RECOVERY PLANNING WITH CLIENTSRECOVERY PLANNING WITH CLIENTS

Selecting And Prioritizing The Focus Of Recovery Goals

And Activities.


The Nine Recovery Components Are:

- Peer Support & Relationships -Work & Meaningful Activity

-Community Involvement -Access to Resources

-Family Support -Power & Control

-Clinical Care -Education -Stigma


Factors to consider when selecting and prioritizing the focus of recovery goals and activities.

Motivation - consumer interest/desire to focus on either strengthening or progressing on a particular recovery component or activity



Urgency - negative consequences for the consumer for not strengthening or progressing on a particular recovery component or activity



Support - anticipated support from others to attend to the components or activity

Ease - level of effort needed for consumer to either strengthen or progress on a particular recovery component or activity

Four Steps To Outcome-BasedFour Steps To Outcome-Based

Service/Recovery PlanningService/Recovery Planning

STEP 1Getting the Picture

Organize available information about the consumer’s bio-psycho-social history.

Consider their strengths, problems, life situations and social/cultural environments.

Consider information about progress you have from previous outcome data.

Try to get a mental picture of the person’s life.

Four Steps To Outcome-BasedFour Steps To Outcome-BasedService/Recovery Planning Service/Recovery Planning

STEP 2Common Understanding of Outcome Status

Picture

The goal of this step is for the service provider

and the consumer to work together to

integrate information, share perspectives

come to a common understanding of the

person’s present outcome status in the

context of their bio-psycho-social picture.




Picture

The client and the service provider engage in

meaningful discussions regarding Outcome

Reports produced by the ODMH Consumer

Outcomes System.




Picture

Service provider and consumer both prioritize

what issues or situations need changing the

most.




Picture

The best result is a negotiated and shared

view of present status in the context of the

person’s past picture and areas where change

is desired.



STEP 3Common Understanding of Recovery

Process & Status

Consumer and service provider work jointly to

get a shared sense of where the client might

be in terms of their recovery.




Process & Status

Service provider should see what view the

consumer has of their longer-term future.

Together they identify how present status

supports or presents challenges to the

consumer’s hopes.

Four Steps To Outcome-BasedFour Steps To Outcome-BasedService/Recovery PlanningService/Recovery Planning


Process & Status

Together they would review the components of

the Ohio Recovery Model and try to

determine which components might be most

relevant to the person at this point in time.

Similarities and differences in perspectives

should be noted and discussed.




Process & Status

ClinicalCare

PeerSupport

FamilySupport

Work &Meaningful

Activity

Power &Control

Stigma CommunityI nvolvement

Access toResources

Education



STEP 4Shared Service/Recovery Plan

Based on the joint assessment and integration of

information that has occurred in Steps 2 & 3, the

service provider and Consumer should identify

a limited number of activities to be

undertaken to address the recovery goals.

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Collect, identif y, and/ or organize available information about theconsumer in terms of their bio-psycho-social history. I dentif y patternsof strengths, problems, lif e situations and social/ cultural environments.What has been their history of symptoms, mental health treatment andsupport f rom their f amily and community? Think about patterns in theirlif e situations, strengths, symptoms, and social and cultural environments.What information about progress do you have f rom previous outcomedata? Write down a paragraph or two about them or try to get a mentalpicture of their lif e. I dentif y what you do not know about Mary’s picture.

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The goal of this step is for the service provider and the consumer to worktogether to integrate inf ormation, share perspectives about the meaningand importance of the information, and to come to a commonunderstanding of the person’s present outcome status in the contextof their bio- psycho- social picture.

Service provider should meet with their client one or more times todiscuss the “Red Flags Report” and the “Strengths Report” that areproduced by the ODMH Consumer Outcomes System. They should assistconsumer in learning how to read and use these reports. Together theyshould look at other information about the individual’s present condition orstatus (e.g., type of drug use or willingness to engage in the treatmentprocess).

Service provider should help consumers prioritize the f eelings,functioning or situations in their lives that they would like to see change.Service provider should share with consumers their own interpretationsand prioritizations of the information. The best result is a negotiatedand shared view of present status in the context of the person’s pastpicture and areas where change is desired.

Strengths Report Red Flags Report

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Service provider should work jointly with the consumer to get a sharedsense of where s/ he might be in terms of their recovery. Serviceprovider should see what view the consumer has of their longer-termfuture. Help them identif y how their present status (i.e. the impact ofmental health symptoms, ability to express anger, or feelings of powerand control) supports or presents challenges to their hopes.

Together they should review the components of the Ohio Recovery Modeland try to determine which components might be most relevant to theperson at this point in time. Service provider should fi rst find out whichof the Nine Components the consumer sees as most relevant. Forexample, in what area do they see the problem that is the cause of theirdissatisfaction with the amount of money they have?

Then the service provider should introduce their interpretations andperspective on the consumer’s recovery and those Recovery ModelComponents they see as most relevant at this point in time. Similaritiesand diff erences in perspectives should be noted and discussed.

Again, the best result is a negotiated and shared view of thecomponents of recovery most salient at this point in time. This willtake into account the person’s past picture, their present outcomestatus, and future goals.

ClinicalCare

Peer Support &Relationships

FamilySupport

Work &Meaningf ul

Activity

Power &Control

Most Relevant Recovery Components From Consumer’s Perspective(at this point in time)

Stigma CommunityI nvolvement

Access toResources

Education

ClinicalCare


Familysupport

Work &Meaningf ul

Activity

Power &Control

Most Relevant Recovery Components From Service provider’sPerspective

(at this point in time)Stigma Community

I nvolvementAccess toResources

Education

ClinicalCare


Familysupport

Work &Meaningf ul

Activity

Power &ControlMost Relevant Recovery Components From Shared Perspective

(at this point in time)Stigma Community

I nvolvementAccess toResources

Education

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Based on the joint assessment and integration of information that hasoccurred in Steps 2 & 3, the service provider and Consumer shouldidentif y a limited number of activities to be undertaken to address therecovery goals.

I n some cases it will also be important to identif y activities the providerfeels are important even though the consumer might not place as high apriority on them. For example, many consumers need to betterunderstand their own condition and its past and present impact on thembefore they are ready to engage in a recovery process.

Note: I f necessary for reimbursement purposes, be sure to identifyservices or activities whose “medical necessity” can be justified.

MARY’S PI CTURE

Mary is 48 years old. She has been in and out of State psychiatric hospitals sinceshe was in her early 20’s. She was initially hospitalized when she started hearingvoices telling her not to eat and not to talk to other members of her family. Shebecame violent when they eventually tried to feed her and was involuntarilyhospitalized for most of the next 10 years. Since being discharged, she has livedin either group homes or in apartments where agency case managers can visit herregularly. Over the last 10 years she has had to be re- hospitalized at least 5times, but only for periods of one to three months.During her hospitalizations, Mary was given many diff erent medications. Some ofthem worked for her and others did not. Her present medication is working tocontrol many of her symptoms, however she continues to experience side eff ectsfrom some of the medications she was given in the past. Adhering to a medicationregimen is very difficult for Mary. She was never provided with much informationabout her medications and still has a poor understanding of their purposes and sideeff ects. Because she was disappointed repeatedly by the failure of the previousmedications to alleviate her symptoms, her attitude toward taking them remainspoor.Mary also has diffi culty taking care of herself . She has diffi culty accomplishingeveryday tasks such as dressing, maintaining an adequate diet, going shopping, or doingother household chores. She seems to lack the motivation to initiate activities, givesup easily, and of ten does not f ollow through when she says she will do things.

At present, Mary lives alone and in general, is isolated socially. Her parents are both innursing homes and cannot come to see her. Her brother, however does visit andoccasionally includes her in some f amily activities. Mary has great diffi culty interactingwith others. She doesn’t know what to say to others, and tends to be fearful andsuspicious of them. At times Mary’s judgment is seriously impaired, and she maywander, get lost, and do bizarre things that f righten others. She doesn’t maintain goodpersonal hygiene and is easily recognized and f requently avoided by others in herneighborhood.

Over the years, Mary has tried to go to work several times, however her suspiciousnessalways led her to isolate herself f rom other workers or to get into conflicts with heremployers. With her present medication working better for her, she has again expressedan interest in working. She did graduate f rom high school, but has not been able topursue additional educational or vocational training opportunities.

FOUR STEPS TO OUTCOMES-BASED FOUR STEPS TO OUTCOMES-BASED

RECOVERY PLANNINGRECOVERY PLANNING

MARY: STEP BY STEP

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Collect, identif y, and/ or organize availableinf ormation about the consumer in terms of theirbio-psycho-social history. I dentif y patterns ofstrengths, problems, lif e situations andsocial/ cultural environments. What has been theirhistory of symptoms, mental health treatment andsupport f rom their f amily and community? Thinkabout patterns in their lif e situations, strengths,symptoms, and social and cultural environments.What information about progress do you have f romprevious outcome data? Write down a paragraph ortwo about them or try to get a mental picture oftheir lif e. I dentif y what you do not know aboutMary’s picture.

Mary is 48 years old and since her early 20’s,she has spent nearly 12 years in psychiatrichospitals. Hallucinations and suspiciousnesshave caused her considerable problems, butnow her new medication is showing signs ofbeing able to alleviate some of thesesymptoms. Mary has lived in the communityfor most of the last ten years, but she hashad diffi culty caring for herself, maintainingan adequate diet, and keeping her apartmentclean. At times Mary’s judgment has beenseriously impaired, and she has wandered,gotten lost, and done bizarre things that havefrightened others. She tends to be sociallyisolated even though her brother includes herin some family activities. She has difficultyinteracting with others, doesn’t know what tosay, and tends to be suspicious of them.Over the years, Mary has been employedseveral times, however her suspiciousness hasled her to isolate herself or to get intoconflicts with her employers. However, shehas again expressed an interest in working.

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The goal of this step is f or the service provider and theconsumer to work together to integrate information,share perspectives about the meaning and importanceof the information, and to come to a commonunderstanding of the person’s present outcome statusin the context of their bio- psycho- social picture.Service provider should meet with their client one ormore times to discuss the “Red Flag Report” and“Strengths Report” that are produced by the ODMHConsumer Outcomes System. They should assistconsumer in learning how to read and use these reports.Together they should look at other information aboutthe individual’s present condit ion or status (e.g., type ofdrug use or willingness to engage in the treatmentprocess). Service provider should help consumers priorit ize thef eelings, f unctioning or situations in their lives thatthey would like to see change. Service provider shouldshare with consumers their own interpretations andprioritizations of the inf ormation. The best result isa negotiated and shared view of present status inthe context of the person’s past picture and areaswhere change is desired.

Strengths Report

Mary does not allow anxiety tocreate panic or cause herphysical distress (weakness orheavy f eelings in her body)

Mary has some positivef eelings about her quality oflif e in terms of the amount off reedom she has, the way herf amily acts toward her, herliving arrangements andneighborhood, and her health.

Mary f eels the mental healthagency treats her with dignityand respect . (*C)

Mary’s new medication is moreeff ective that any she hasever taken. (*C & *SP)

*C= Consumer’s priority areas

*SP= SP priority areas

Red Flags ReportMary f eels dist ress f romsymptoms (e.g. nervousness,shakiness, being suddenlyscared f or no reason) (*SP)

Mary is unhappy about lack offr iends

Mary is unhappy about lack ofmoney f or a number of uses(*SP)

She would like moremeaningful activity in her life.(*C)

Mary f eels a lack of power andcontrol in many areas of herlife. (*C)

She lacks confidence inherself

She f eels she is notcompetent (*C)

She sees many barr iers toget ting what she needs and/orwants

She believes it ’s very diffi cultto overcome barriers

*C= Consumer’s priority areas

*SP= SP priority areas

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sService provider should work joint ly with the consumerto get a shared sense of where s/ he might be in termsof their recovery. Service provider should see whatview the consumer has of their longer-term future.Help them identif y how their present status (i.e. theimpact of mental health symptoms, ability to expressanger, or f eelings of power and control) supports orpresents challenges to their hopes.

Together they should review the components of theOhio Recovery Model and try to determine whichcomponents might be most relevant to the person atthis point in t ime. Service provider should fi rst findout which of the Nine Components the consumer seesas most relevant. For example, in what area do theysee the problem that is the cause of theirdissatisfaction with the amount of money they have?

Then the service provider should introduce theirinterpretations and perspective on the consumer’srecovery and those Recovery Model Components theysee as most relevant at this point in time. Similarit iesand diff erences in perspectives should be noted anddiscussed.

Again, the best result is a negotiated and sharedview of the components of recovery most salient atthis point in time. This will take into account theperson’s past picture, their present outcome status,and future goals.

I n talking to Mary we find out that while she wishes she hadmore money, she sees that as just another example that shehas litt le control over her own life. Because she has had lit tleopportunity to experience a sense of competence, she’s notsure there is anything she can do or even that others may beable to do, to improve the quality of her lif e. However shedoes now have a litt le sense of hope because her newmedication is working. She is concerned that her presentmedication will not continue to work, but is hesitant to talkwith her doctor about this.

The Service Provider points out that:

Mary has long history of hospitalizat ion resulting f romsevere psychiatric symptoms and anger

Unt il recently, medicat ions were not very eff ect ive f or her

She lost many opportunit ies to learn adult skills and rolesand is just now beginning to see what she missed and whatshe wishes to change in her lif e

Mary is not happy about the amount of money she has tospend

She sees many barr iers f acing her and of ten f eels as if shehas litt le power to change her situation, however she doesseem to want to try to experience more things and engage inmore productive act ivity.

Through the process of sharing and negotiating the focusbecomes Recovery Components involving “Power & Control”and “Work and Meaningful Activity” with “Clinical Care”and “Access to Resources” as secondary components.

Clinical Care Peer Support &Relationships

FamilySupport

Work &MeaningfulActivity

Power &Control

Most Relevant RecoveryComponents From Consumer’sPerspective(at this point in time) Stigma Community

InvolvementAccess toResources

Education

Clinical Care Peer Support& Relationships

Familysupport


Power &Control

Most Relevant RecoveryComponents From ServiceProvider’s Perspective(at this point in time)

Stigma CommunityInvolvement

Access toResources

Education


Familysupport


Power &ControlMost Relevant Recovery

Components From SharedPerspective(at this point in time) Stigma Community


Education

Outcomes & Recovery Training: Four Steps to Outcomes-Based Recovery/ Service Planning: Mary Step By Step Page 1 of 1

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nBased on the joint assessment and integration ofinf ormation that has occurred in Steps 2 & 3, theservice provider and consumer should identif y a limitednumber of activities to be undertaken to address therecovery goals.

I n some cases it will also be important to identif yactivit ies the provider feels are important even thoughthe consumer might not place as high a priority onthem. For example, many consumers need to betterunderstand their own condit ion and its past and presentimpact on them before they are ready to engage in arecovery process.

Note: I f necessary for reimbursement purposes, besure to identify services or activities whose “medicalnecessity” can be justified.

Severe Psychiatric symptomatology and long termhospitalization have limited Mary’s adult development.I n order to enhance her skills and increase herf eelings of control and power, the following recoveryactivities are proposed:

Mary and service provider will develop a list ofthings over which Mary would like to have morecontrol or say in.

They will determine what would have to happenfor Mary to have more control and power in theseareas.

Mary will then choose one or more of these towork on with the help of the service provider. (I twill be very important to allow Mary as muchcontol of this process as possible.)

Service provider will encourage Mary to talk toher doctor about her concerns about her newmedication. They will role play Mary askingquestions.

AT THI S POI NT I N HER RECOVERY, THE FOCUSI S ON ENHANCI NG MARY’S FEELI NGS OF POWERAND CONTROL

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Collec t , ident if y, and/ or or ganiz e avai lab le inf or mat ion ab out t heconsumer in t er ms of t heir b io- psycho- social h ist or y. I dent i f y pat t er nsof st r engt hs, pr ob lems , li f e sit uat ions and soc ial / cult ur al envir onment s .

W hat has been t heir hist or y of sympt oms , ment al healt h t r eat ment andsuppor t f r om t heir f amily and communit y? T hink ab out pat t er ns in t he irl i f e s it uat ions , st r engt hs , sympt oms, and social and cult ur al envir onment s .W hat inf or mat ion ab out pr ogr ess do you have f r om pr evious out comed at a? W r it e d own a par agr aph or t wo ab out t hem or t r y t o get a ment alpic t ur e of t heir li f e. I dent i f y what you d o not know about M ar y’s pict ur e.

M ar y is 48 year s old and s ince her ear ly 2 0 ’s, she has spent near ly 12 year s inpsychiat r ic hospit als . H alluc inat ions and suspic iousness have caused hercons ider ab le pr ob lems, but now her new medicat ion is showing signs of being ab let o alleviat e some of t hese sympt oms . M ar y has lived in t he communit y f or mos tof t he last t en year s, but she has had d iffi cult y car ing f or her self , maint aining anadequat e d iet , and keeping her apar t ment c lean. A t t imes M ar y’s j udgment hasbeen ser ious ly impair ed, and she has wander ed, got t en lost , and done b iz ar r et h ings t hat have f r ight ened ot her s . S he t ends t o be socially isolat ed event hough her b r ot her inc ludes her in some f amily act ivit ies . S he has d iffi cult yint er act ing wit h ot her s, doesn’t know what t o say, and t ends t o be suspic ious oft hem. O ver t he year s, M ar y has been employed sever al t imes, however hersuspiciousness has led her t o isolat e her se lf or t o get int o confl ict s wit h heremployer s. H owever , she has again ex pr essed an int er est in wor king.

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T he goal of t his s t ep is f or t he ser vice pr ovider and t he consumer t o wor kt oget her t o int egr at e inf or mat ion, shar e per spect ives about t he meaningand impor t ance of t he inf or mat ion, and t o come t o a commonunderstanding of the person’s present outcome status in the contextof their bio- psycho- social picture.

S er vice pr ovider should meet wit h t heir cl ient one or mor e t imes t od iscuss t he “Red F lag Repor t ” and “S t r engt hs Repor t ” t hat ar e pr oducedb y t he O D M H Consumer O ut comes S yst em. T hey should ass ist consumerin lear ning how t o r ead and use t hese r epor t s . T oget her t hey should lookat ot her inf or mat ion ab out t he ind ividual’s pr esent cond it ion or st at us (e.g.t ype of d r ug use or wi ll ingness t o engage in t he t r eat ment pr ocess).

S ervice provider should help consumers pr ior it ize the f eelings,f unct ioning or situat ions in their lives that they would like to seechange. S ervice provider should share with consumers their owninterpretat ions and pr ior it izations of the inf ormat ion. T he bes t r esultis a negot iat ed and shar ed view of pr esent s t at us in t he cont ex t of t heper son’s pas t pic t ur e and ar eas wher e change is desir ed .

S tre n g th s R e p o rtM ar y does not allow anx iet y t o cr eat epanic or cause her physical d ist r ess(weakness or heavy f eelings in herbody)

M ar y has some posit ive f eelings abouther qualit y of li f e in t er ms of t heamount of f r eedom she has , t he wayher f amily act s t owar d her , her livingar r angement s and neighbor hood, andher healt h.

M ar y f ee ls t he agency t r eat s her wit hd ignit y and r espect . (* C)

M ar y’s new med icat ion is mor eeff ect ive t hat any she has ever t aken.(* C & *S P)

*C= Consumer ’s pr ior it y ar eas*S P= S P pr ior it y ar eas

R e d F la g s R e p o rtM ar y f ee ls d ist r ess f r om sympt oms(e.g. nervousness, shakiness , beingsuddenly scar ed f or no r eason) (*S P)

M ar y is unhappy about lack of f r iends

M ar y is unhappy about lack of moneyf or a number of uses (*S P)

S he would like mor e meaningf ulact ivit y in her lif e . (* C & *S P)

M ar y f ee ls a lack of power and cont r olin many ar eas of her li f e . (* C)

S he lacks confi dence in her se lf

S he f ee ls she is not compet ent (* C)

S he sees many bar r ie r s t o get t ingwhat she needs and/ or want s

M ar y doesn’t int er act well wit h ot her s(*S P)*C= Consumer ’s pr ior it y ar eas*S P= S P pr ior it y ar eas

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S er vice pr ovid er should wor k j oint ly wit h t he consumer t o get a shar edsense of wher e s / he might b e in t er ms of t heir r ecover y. S er vicepr ovider should see what view t he consumer has of t heir longer - t er mf ut ur e. H elp t hem ident i f y how t heir pr esent s t at us (i .e. t he impac t ofment al healt h sympt oms, ab i li t y t o ex pr ess anger , or f ee lings of powerand cont r ol) suppor t s or pr esent s chal lenges t o t heir hopes .

T oget her t hey should r eview t he component s of t he O h io Recover y M odeland t r y t o det er mine which component s might be mos t r e levant t o t heper son at t h is point in t ime. S er vice pr ovider should fi r st fi nd out whichof t he N ine Component s t he consumer sees as most r elevant . F orex ample, in what ar ea do t hey see t he pr ob lem t hat is t he cause of t he ird issat is f act ion wit h t he amount of money t hey have?

T hen t he ser vice pr ovider should int r oduce t heir int er pr et at ions andper spec t ive on t he consumer ’s r ecover y and t hose Recover y M odelComponent s t hey see as most r elevant at t his point in t ime. S imilar it iesand d iff er ences in per spect ives should be not ed and discussed .

A gain, the best result is a negot iated and shared view of thecomponents of recovery most salient at this point in t ime. T his willtake into account the person’s past picture, their present outcomestatus, and f uture goals .

I n t alk ing t o M ar y we fi nd out t hat whi le she wishes she had mor emoney, she sees t hat as j us t anot her ex ample t hat she has li t t lecont r ol over her own l i f e. Because she has had l i t t le oppor t unit y t oex per ience a sense of compet ence, she’s not sur e t her e is anyt hingshe can d o or even t hat ot her s may b e ab le t o d o, t o impr ove t hequalit y of her l if e. H owever she does now have a li t t le sense of hopeb ecause her new medicat ion is wor k ing. S he is concer ned t h at herpr esent medicat ion wil l not cont inue t o wor k, but is hes it ant t o t alkwit h her doct or ab out t his .

T he S P point s out t hat :

M ar y has long his t or y of hospit aliz at ion r esult ing f r om sever epsych iat r ic sympt oms and anger

U nt i l r ecent ly, med icat ions wer e not ver y eff ec t ive f or her

S he los t many oppor t unit ies t o lear n ad ult sk i l ls and r oles and isj us t now beginning t o see what she missed and what she wishes t ochange in her l if e

M ar y is not happy ab out t he amount of money she has t o spend

S he sees many bar r ier s f ac ing her and of t en f eels as if she hasl it t le power t o change her s it uat ion, however she does seem t owant t o t r y t o ex per ience mor e t h ings and engage in mor epr oduc t ive ac t ivit y.

T hrough the process of shar ing and negot iat ing, the f ocusbecomes Recovery Components involving “Power & Control” and“W ork and Meaningf ul Act ivity” with “Clinical Care” and “A ccessto Resources” as secondary components.

ClinicalCare

Peer S upport &Relat ionships

FamilyS upport

W ork &M eaningf ul

A ctivity

Power &Control

Most Relevant Recovery Components From Consumer’s Perspective(at t h is point in t ime)

S tigma CommunityI nvolvement

A ccess toResources

Education

ClinicalCare


Familysupport

W ork &M eaningf ul

A ctivity

Power &Control

Most Relevant Recovery Components From S ervice Provider’sPerspective

(at t h is point in t ime)S tigma Community

I nvolvementA ccess toResources

Education

ClinicalCare


Familysupport

W ork &M eaningf ul

A ctivity

Power &Control

Most Relevant Recovery Components From S hared Perspective(at t h is point in t ime)

S tigma CommunityI nvolvement

A ccess toResources

Education

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B ased on t he j oint assessment and int egr at ion of inf or mat ion t hat hasoccur r ed in S t eps 2 & 3 , t he ser vice pr ovid er and Consumer shouldident if y a limited number of act ivit ies t o be under t aken t o addr ess t her ecover y goals .

I n some cases it wi ll also be impor t ant t o ident if y ac t ivit ies t he pr oviderf eels ar e impor t ant e ven t h ough t he consumer might not place as high apr ior it y on t hem. F or ex ample , many consumer s need t o bet t erunder s t and t heir own cond i t ion and it s past and pr esent impac t on t hembef or e t hey ar e r eady t o engage in a r ecover y pr ocess .

N ote: I f necessary f or reimbur sement purposes, be sure to identif yservices or act ivities whose “medical necessity” can be j ust ifi ed .

S ever e Psych iat r ic sympt omat ology and long t er m hospit aliz aion haslimit ed M ar y’s adult development . I n or der t o enhance her sk i l ls andinc r ease her f e el ings of cont r ol and power , t he f ol lowing r ecover yact ivit ies ar e pr oposed :

1. M ar y and S P wil l d evelop a list of t hings over which M ar y wouldlike t o have mor e cont r ol or say in.

2 . T hey wil l det er mine what would have t o happen f or M ar y t o havemor e cont r ol and power in t hese ar eas .

3 . M ar y will t hen choose one or mor e of t hese t o wor k on wit h t hehelp of t he Case M anager . (I t will b e ver y impor t ant t o allowM ar y as much cont ol of t his pr ocess as possib le.)

4 . S P wil l encour age M ar y t o t alk t o her doct or ab out her concer nsabout her new med icat ion. T hey w il l r ole play M ar y askingquest ions .

A T T H I S PO I N T I N H ER RECO VERY, T H E FO CUS I S O NEN H A N CI N G M A RY’S FEELI N GS O F PO W ER A N D CO N T RO L

Clinical Care Peer Support &Relationships

FamilySupport


Power &Control

Most Relevant RecoveryComponents From Consumer’sPerspective(at this point in time) Stigma Community


Education


Familysupport


Power &Control

Most Relevant RecoveryComponents From ServiceProvider’s Perspective(at this point in time)

Stigma CommunityInvolvement

Access toResources

Education


Familysupport


Power &ControlMost Relevant Recovery

Components From SharedPerspective(at this point in time) Stigma Community


Education

Documents

CONSUMERS HAVE A RIGHT TO EXPECT AND PROFESSIONAL PRACTICE WOULD REQUIRE: –That to the extent possible, the service provider knows the consumer’s bio-psycho-