[RS3450] Enabling Occupation:
Psychosocial Practice
[RS5362] OT for Psychosocial
Dysfunction
Dr. Sunny Chan
Nov 2019
PERSONAL RECOVERY
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Who are you?
• Any experience or encounter with people who
have mental illness?
• How do you feel?
• What do you think?
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WHAT IS MENTAL ILLNESS?
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Is mental illness a fact or a myth?
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.
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Who? Where? What?
• I want to go to where to do what ??
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Recovery-oriented practice
• Life Goals
• Individual-Tailored Services
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Life Goals
Definition
• Perceptions of the extent to which staff help with
the development and pursuit of individually
defined life goals (O’Connell et al., 2005)
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Life Goals
• Staff actively assist people in recovery with the
development of career and life goals that go
beyond symptom management and stabilization
• Staff routinely assist individuals in the pursuit of
educational and/or employment goals
• The role of agency staff is to assist a person with
fulfilling their individually-defined goals and
aspirations
• Agency staff are diverse in terms of culture,
ethnicity, lifestyle, and interests
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Life Goals
• Procedures are in place to facilitate referrals to
other programs and services if the agency
cannot meet a person’s needs
• Staff play a primary role in helping people in
recovery become involved in non-mental
health/addiction related activities, such as
church groups, special interest groups, and adult
education
• Staff use a language of recovery (i.e. hope, high
expectations, respect) in everyday conversation
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Life Goals
• Agency staff believe that people can recover and
make their own treatment and life choices
• The achievement of goals by people in recovery
and staff are formally acknowledged and
celebrated by the agency
• Staff and agency participants are encouraged to
take risks and try new things
• Staff are knowledgeable about special interest
groups and activities in the community
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Individually-Tailored Services
Definition
• Perceptions of the extent to which services are
tailored to individual needs, cultures, and
interests, and focus on building community
connections (O’Connell et al., 2005)
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Individually-Tailored Services
• This agency offers specific services and
programs for individuals with different cultures,
life experiences, interests, and needs
• All staff at this agency regularly attend trainings
on cultural competency
• Helping people build connections with their
neighborhoods and communities is one of the
primary activities in which staff at this agency
are involved
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Individually-Tailored Services
• This agency provides education to community
employers about employing people with mental
illness and/or addictions
• Every effort is made to involve significant others
and other natural supports in the planning of a
person’s services, if so desired
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Getting in the Driver’s seat
• “To me recovery means I try to stay in the
driver’s seat of my life. I don’t let my illness run
me. Over the years I have worked hard to
become an expert in my own self-care. Being in
recovery means I don’t just take medications …
Rather I use medications as part of my recovery
process…”
(Patricia Deegan, 1993)
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Getting in the Driver’s seat
Tondora et al., 2009
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Person-centered planning (PCP)
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Person-centered planning (PCP)
• A long and winding road map for
the self-directed journey to
recovery
• An acquired skill and a clinical
art that gives opportunities to
creative thinking
From Yale, RRCH (Program for Recovery and
Community Health)
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Person-centered planning (PCP)
Key principles & strategies
• Person as a partner in all activities / meetings
• Person receives education about the process
• Person has reasonable control over his/her
individual plan
• Person strengths, interests, vision & values
for recovery are emphasized
• Person’s life goals, hopes and dreams are at
the center
• Person’s natural / community support is
solicited
• Person always offered a copy of the plan
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Transition to recovery practice
• Personal-centered planning (PCP) warrants
changes not only in professionals’ behaviors and
in agencies’ policies but, more importantly,
dramatic shifts in individual beliefs and
organizational culture (Osher & Osher, 2001;
Osher, Osher, & Blau, 2005)
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Transition to recovery practice
• New way of doing things
In the past……
Nowadays……
Medical necessity
Human need
Mandated treatment
Service choice
Control & contain
Self-direction
Deficit-oriented
Strengths-based
Managing illness
Promoting recovery
Symptom relief
Personally-defined quality of life
They
Us
We are expert
We are partners
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Transition to recovery practice
• Some strategies are highlighted……
–
–
–
–
Use of recovery language
Strengths-based assessment
Personal-centered principles
Partnership / empowerment
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Use of recovery language
• Illustrate respect and concerns in didactic
dialogue – equal
• A lot of praises for both users and staff
• Motivate staff to change and pick the connection
• Positive and recovery oriented language and
vocabulary was promoted
• Words such as “hope” and “recovery” are used
frequently in documentation and delivery of
services
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Use of recovery language
• The power of language
• Deficit-based vs. strength-based
• The Glass Half Empty…The Glass Half Full
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A person diagnosed with…
Recovery coach/guide
Direct support staff
Person living with…SA interferes with…
Living with/recovering from
Recovery team
A person symptoms/addiction
interferes with the following…
Idealistic, high expectations
Disagrees with, chooses alternatives
Barriers to change; Support needs
Promoting life worth living
Takes risks to try new things/grow
Person uses tx as a tool in recovery
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Strengths-based assessment
• Discussion of strengths is a central focus of
every assessment, care plan, and case
management
• Assessment begin with the assumption that
individuals are the experts on their own recovery
• Initial assessments recognize the power of
simple, yet powerful questions, e.g. “What are
your goals in life?”
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Strengths-based assessment
• Explore other areas not traditionally considered
“strengths”
• Efforts are made to record the individual’s
responses verbatim, including his or her unique
goals
• Assessment remains narrative-based and
personal-centered.
• Assessment is conducted as a collaborative
process
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Person-centered principles
• Consistent with the “nothing about us, without
us” dictum, the therapist actively partner with the
individual in all planning
• The language of the plan is understandable to
all participants
• A diverse and flexible range of options must be
available so that people can access and choose
those supports that will best assist them in their
recovery
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Partnership / empowerment
• Not controlling people’s life
• Not therapist anymore
• Right to participate in different aspects of the
services including individual plan
• Working with them
• Praising them
• Use of strength
• Make decision on options
• Recognize possibilities and instill hope
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Words from Person in recovery
✓ “Be open-minded!”
✓ “If you think you can,
you can. If you think
you can’t, you can’t. It
is your right and
choice.”
✓ “People will live up to
your expectation or
live down to it. By
changing your
expectation, people
will live around it.”
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Go ahead…
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