Below are recovery resources related to the Community Care Recovery Institute. These resources are included for your convenience and do not represent any endorsement by the Community Care Recovery Institute staff of their content or the organizations themselves.
CommonGround™: Recovery Oriented Practice
Patricia E. Deegan PhD
CommonGround: Recovery Oriented Practice is a comprehensive curriculum aimed at retraining the adult mental health workforce in the skills required to support clients in their recovery. Indeed, the President’s New Freedom Initiative has called for nothing less than a transformation of the mental health system towards a recovery orientation. Mental health transformation requires that the workforce learn the foundational values of recovery: choice, self-determination, hope and the importance of human relationships. But even more importantly, real transformation means learning how to operationalize these values in everyday practice with clients. For instance, although choice is a foundational value of recovery, how should staff approach a situation in which a client is making a self-defeating choice that may not promote personal recovery? How does the emphasis on relationships in the recovery process transform staff’s approach to negotiating professional boundaries with clients? What is the role of the direct service worker in non-office based work in the community and what are the ethical principles that guide staff through the ambiguities of role strain in their work with clients? How do staff communicate respect when writing program notes, psychosocial intakes and progress notes and how does attention to respectful communication transform agency culture to a recovery orientation?
CommonGround was developed over the past twelve years by Patricia E. Deegan PhD in collaboration with consumers and staff from eight mental health agencies across the United States. It is a practical guide to teaching the workforce how to support client recovery in everyday practice. Combined with ongoing consultation, CommonGround can help mental health systems achieve deep change and system transformation.
The CommonGround curriculum can be taught one domain at a time or as a whole. We can also train trainers to implement CommonGround in your agency. The component trainings are summarized below.
Developing Empathy for the Lived Experience of Psychiatric Disability: A Simulation of Hearing Distressing Voices
In this 3-hour workshop participants will listen to a lecture about the voice hearing experience, will use headphones to listen to a specially designed audiotape that simulates the experience of hearing voices that are distressing, and will participate in a discussion/debriefing after the simulation. The lecturer will review the research literature on voice hearing, review a number of self-help strategies and make suggestions for working with people who hear distressing voices. Through the simulation experience participants will increase their understanding of the lived-experience of psychiatric disability and increase empathy for those who struggle with it.
- To learn the types and varieties of voice hearing experiences.
- To increase empathy and understanding of the experienceof hearing distressing voices
- To learn more effective ways of helping people who hear distressing voices.
CommonGround: Supporting Client Choice
Client choice is a cornerstone value of recovery and empowerment. But how should staff respond when a client is making a choice that appears to be self-defeating or dangerous? In this 3-hour workshop developed by Patricia E. Deegan PhD, participants will learn a range of practical interventions for engaging with the choices that clients make, particularly when those choices appear to be self-defeating, to diminish quality of life and/or to involve risk and safety issues. Participants will learn skills associated with supporting client choice in ways that are respectful and that maximize client autonomy and self-efficacy. The workshop format includes lecture supported by PowerPoint slides, as well as options for role-playing and skill building work in dyads and small groups. Scenarios from real world clinical practice are the focus and participants are encouraged to bring examples from their own work.
- To understand why supporting client choice is important
- To learn how to assess an intervention for the presence of toxic help or help that works against recovery
- To learn practical skills about how to engage with client choice to create win/win outcomes
- To learn how to navigate through the Comfort Zone, the Conflicted Zone and the Non-Negotiable Zone and to learn the skill sets related to supporting client choice in each zone
- To learn how to shift agency culture toward a recovery orientation through more creative engagement with clients in the Conflicted Zone
The CommonGround Approach To Supporting Clients’ Use of Psychiatric Medications As Part of the Recovery Process
In this training participants will have the opportunity to learn about a recovery-oriented approach to supporting clients’ use of psychiatric medications. Based on the research of Dr. Deegan, participants will learn:
- The importance of personal medicine in the recovery process
- Medication traps and how to help clients avoid them
- The ethical, clinical and evidence-based rationale for shared decision-making vs. compliance
- Assessing clients’ decisional conflict regarding use of medications in the recovery process
- Practical skills for supporting clients’ journey through decisional conflict
- The role of the worker in helping clients prepare for meetings with psychiatrists
The training will include lecture, PowerPoint slides, audio-taped excerpts from interviews with service users, role-plays and small group work. There will be ample time for discussion and questions.
- Participants will learn the importance of personal medicine in the recovery process, how to support clients in identifying personal medicine and how to teach clients to effectively communicate it to psychiatrists.
- Participants will learn how to assess decisional conflict that clients may be experiencing with regard to use of medications in the recovery process.
- Participants will learn practical, person-centered strategies for supporting clients through decisional conflict with regards to using medications in recovery.
- Participants will learn common medication “traps” and how to avoid them
- Participants will learn to help clients set goals and prepare for medication appointments with medical staff
- Participants will learn how to support clients in the shared decision-making process
CommonGround Approach to Negotiating Professional Boundaries
Relationships are a foundational component of the recovery process. Traditional office-based approaches to establishing professional boundaries are not always applicable in the modern world of non-office based work in the community. Staff are frequently challenged with novel situations i.e., should I give this client a ride when I see him walking home in the rain; should I accept the client’s offer to buy me a cup of coffee; a client goes to the same AA meeting I go to – how should I handle that? How staff negotiate professional boundaries will either help or hinder recovery. In this institute Dr. Deegan will present a recovery-based model for helping staff negotiate professional boundaries with clients. Through lecture supported by PowerPoint slides, role-plays, and small group skill building, participants will learn a practical decision-making strategy for negotiating professional boundaries. The decision strategy is based on ethical, interpersonal, and role related factors that allow staff to be flexible and “human” but also disciplined and consistent. There will be ample time for questions and discussion.
CommonGround: The Role of Direct Service Worker in Supporting Client Recovery
The role of the direct service worker is to support clients in their recovery. During this workshop recovery and the role expectations that define the employees’ work with clients will be presented. Participants will learn practical skills associated with a person-centered versus disease centered approach to client care. Ethics, role strain, and the difference between being a direct service worker and a therapist will be explored. Additional topics include friendships between staff and clients, factors that lead to burnout, how to build supports for workers in the workplace and how to assess if you are doing a good job in supporting clients recovery. The workshop format includes lecture supported by PowerPoint presentation, as well as role-playing and intensive skill building work in dyads and small groups.
- To identify role strain and to learn what to do about it
- To learn the ethical principles associated with the role of the direct service worker and how to apply them to novel situations
CommonGround: The Role of the Peer Practitioner
Peer practitioners working the role of direct services workers often face special challenges that are specific to their status as people who have psychiatric histories and are working in the field. In this workshop participants will learn practical skills related to identifying mentalism in the workplace, micro-aggression and how to address it, the strengths and dangers of role-modeling, the use of personal disclosure to serve the client, requesting accommodations, and disability-cultural competence. The workshop format includes lecture supported by PowerPoint presentation, as well as role-playing and intensive skill building work in dyads and small groups.
CommonGround: Creating A Culture of Respect
Respect for clients is conveyed through the words we speak, the words we write, our actions, our silence and the overall culture of the agency. In this workshop participants will learn practical skills that convey respect and challenge disrespect. Application of these skills will change agency culture toward a recovery orientation over time. The workshop format includes lecture supported by PowerPoint presentation, as well as role-playing and intensive skill building work in dyads and small groups.
- To understand how our words and actions convey respect and disrespect
- To learn the skills to stand up for respectful communication in mental health workplaces
- To understand the concept of micro-aggression and agency-wide practices and policies that promote respect
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