Mental Health

A Focus on Strengths

by: Jenn Cusick

Principles and Values #4

The World We Live In

When we really think about it, the culture we live in is very focused on deficits and problems. From a very early age we become keenly aware of our personal issues, flaws and problems. What is getting in the way of me being the best I can be? Why am I not living to my full potential? How can I fix this vexing problem within me? I need to lose a few pounds, then I’ll feel good about myself.

 

Even our organizations tend to take a problem-solving approach to change. What's wrong? What are the stumbling blocks that are keeping us from reaching our full potential? How do we fix this issue?

 

There is definitely a time and a place for a problem-solving approach. However, we need to keep in mind that generally this mindset keeps us stuck in a deficit-focused, glass half-empty paradigm.

In other words problem–solving keeps us tied to the problem.

 

This paradigm is so prevalent in our society today, that it is very easy to get caught up in it. Shifting our perspective to one that aligns with a strength’s approach can feel like swimming upstream.

 

I would venture to say at all of us in the PSR field know about the strength-based approach. Yet it can be easy to slip into a deficit–based mindset with the people we support.

 

People are coming to us for service because they have a problem. We are in the roles we are, because we are educated to provide support to others. So how do we approach our important recovery-oriented service with a strength-based approach, and shift away from focusing on deficits and problems? That almost seems like a contradiction to the way the system is set up...doesn’t it? When we apply overall cultural context, the strength’s approach, (and essentially PSR) is very counter culture.

 

The Strengths Model

Charles A. Rapp wrote the book, “The Strengths Model: Case Management with People Suffering from Severe and Persistent Mental Illness” in the 1990s. It continues to be a great resource for the strength-based approach. If you don’t already have it, it’s a great addition to your PSR library.

Rapp’s model is based on six principles.

1. The focus is on individual strengths rather than pathology

Work with clients is based on their interests, aspirations, and strengths. It is not focused on their symptomology, weaknesses and deficits.

2. The community is viewed as an oasis of resources

The community, and one’s environment is a source of strength, and opportunity.

3. Interventions are based on client-self determination

This approach is based on the belief that clients have the right to determine the kind of support they receive. The client is the director of their own care.

4. The case manager–client relationship is primary and essential

A focus on building a cooperative relationship. This often starts with simple getting-to-know-you fun things like playing a game, going for a walk or coffee. The client feels known.

5. Aggressive outreach is the preferred mode of intervention

This often means moving the work outside the office, into the community.

6. People suffering from severe mental illness can continue to learn, grow and change

A shift away from defining people by their illness. Instead seeing them as whole, people, worthy of having hopes, dreams and aspirations. (If you haven’t read Dr. Courteney Harding’s Vermont longitudinal study of people with schizophrenia, check that out here.)

 

Other Strength-Based Paradigms:

Intentional Peer Support (IPS)

Shery Mead–a leader in the Recovery Movement, created IPS. One of the keystones of IPS is the “Four Tasks of Peer Support.” Task four is Moving Towards–another way of focusing on strengths. We know that moving towards something we want/need is so much more freeing and inspiring than moving away from something that we don’t want. The former feels stifling and overwhelming.

 

When I managed a program a few years ago, I used to see people’s goal plans come across my desk. Often I saw the goal “decrease isolation” scribbled on people’s recovery plans. Honestly, I can’t think of a more uninspiring goal. First of all it didn’t feel very client-centered. Second, it was born out of a deficit or a problem, and offered no alternative way of being.

 

What if instead of framing a goal in such a negative way, we support people to explore how they want to feel–discover their desires?

What if we support people as they deepen their self-awareness, while they process their difficult experiences?

What if we focus on shining a light on people’s strengths, gifts, and abilities?

 

These qualities may have been significantly dimmed through their struggles. People may not even be able to see their own strengths because of the enormous challenges they have had to face. This doesn’t mean they are gone; they are just temporarily hidden from their own view.

Perhaps our role as supporters/practitioners is to support the rediscovery process of the person’s inner expert/teacher, and we do that by shining a light on their strengths.

 

We know that everyone wants to belong, as we are all wired for community. Where is this person’s community? What does this person want their role to be within their community? Where do they feel a strong sense of belonging? This can be where a peer support worker can come in and provide some extra support. Together they can unearth strengths, hopes and dreams, and explore the community at large to find that place of belonging.

 

Appreciative Inquiry (AI)

I won’t spend much time on this, but I think it's it’s worth noting, as we speak about strengths. AI is an approach for organizational change that focuses on harnessing the best of what is, instead of taking a problem-solving approach. We can learn a lot about the strength-based approach from AI: both in changing the culture of the mental health and addictions system, and in supporting the people we serve. Appreciative Inquiry isn't proprietary, however David Cooperrider is one of the founders of this school of thought. 

 

Changing the Way We See

Stephen Covey talks about how the key component for change is shifting the way we see the world. When we think about change we often start with what we DO, but real change comes from shifting the way we SEE.

 
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As Champions of Recovery–What Can We Do?

Heading in to the new year we ask ourselves what we can do to support the shift to a more strength-based system. What can we do to shift our perspective to one that’s grounded even stronger in a strength-based approach? How do we champion that perspective for our own lives, with our colleuges, and those we support? 

 

Shifting the prevailing paradigm can feel like a mammoth task. We can become discouraged and overwhelmed when we get push-back from others who might not align with the strength-based approach…yet.

 

Here at PSR/RPS Canada we want you to know that there is a movement of people with the same vision as you. We want to support you and provide both in-person and online environments where you can connect with like-minded people.

 

If you are interested in becoming a member of PSR/RPS Canada, check out our membership offerings.

 

If you have any ideas on how PSR/RPS Canada can facilitate more opportunities for you to connect with a PSR Community of Practice–please contact me–Jenn Cusick at jenndawncusick@gmail.com

 

If you wish to contribute an article for PSR/RPS Canada, please click here. We would love to share your thoughts, ideas or message! 

 

References:

Rapp, C. A. (1998). The strengths model: case management with people with psychiatric disabilities. New York, NY: Oxford University Press.

Mead, S. (2005). Intentional Peer Support: An Aternative Approach. West Chesterfield, NH. Self-published. 

Covey, S.R. (1989). The 7 Habits of Highly Effective People. New York, NY. Fireside.

 

 

 

 

Reference: William A. Anthony Article

 

It's hard to believe that this article is 25 years old! However, it has more than held up. The message of this paper is still of key importance in the work we do as recovery-oriented organizations. 

William A. Anthony was a front-runner, and a major leader in the PSR movement. His work made huge impact on what we do now, and continues to impact the PSR movement. 

Find the article "Recovery from mental illness: The guiding vision of the mental health service system in the 1990s" Here. 

On a google search I found this video from 2001 on YouTube. It's a talk with Dr. Courtney Harding, Dr. William Anthony, Judi Chamberlin & Dr.  Marianne Farkas. What a gift to hear from all of these revolutionary leaders!

 (Judi Chamberlin passed away in 2010. She was at the forefront of the Consumer/Survivor Movement since the early 1970s, and continued to make a huge impact until her death.) 

In the video Dr. Farkas takes about implementing recovery on a systems level. She says that a recovery system needs to have a culture that supports recovery, a commitment to recovery, and the capacity for delivering recovery services. In 2018, how do you feel the system is doing with culture, commitment and capacity? What is going well? What are some opportunities for growth?  

The message is as relevant for today, as it was then. It's definitely worth a watch! 

Championing Our Work with the Core Competencies–Webinar

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On December 15th the PSR/RPS Canada CEO, Vicky Huehn, and Board President, John Higenbottam, were guests on PSR Advanced Practice webinar, speaking about the PSR Practice Competencies.

This webinar production is brought to you in collaboration with PSR Canada. We will be sharing some new and exciting changes in mental health education and practice.

In September 2017, PSR Canada launched a revision of the Competencies of Practice for Canadian Recovery-Oriented Psychosocial Rehabilitation Practitioners. The Competencies are used to evaluate performance for organizations and staff practicing with a Recovery-Orientation. Read more about the Core Competencies HERE

The new updated 2017 Core Competencies include the following:

  •  Diversity and Inclusion
  • Professional Skills
  • Psychosocial Rehabilitation (PSR), Supporting Practices and Recovery-         Oriented Services
  • Equity and Social Participation
  • Facilitating Change and Providing Leadership

As with the previous edition of our competencies (2013) each competency has its own identified set of performance indicators. 

 

NEW 2017 Core Competencies and Why You Will Want to Take Note of Them!

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First of all what are the Core Competencies?
(Find the 2017 version HERE.)

 

Simply put, the Core Competencies are both a guide, and a measuring stick for organizations and staff practicing Recovery-Oriented Services.

If we say we practice PSR, how do we know that are actually doing it? How do we make sure that we are putting our money where our mouth is, so to speak? Knowing about evidence-based practices is one thing, and implementing into practice in a whole different ball of wax. It takes a tremendous amount of intention, teamwork, courage and determination to create a recovery-oriented culture.

 

Why You Need the Core Competencies

Bringing the culture of an organization to one that fully supports PSR and recovery in everything that it does, is no small feat for those involved.

There are so many facets of PSR, and to be honest the bar is set really high.

It takes a movement of like-minded people to see systems transformation come into being–a community of people who together provide support, accountability, encouragement, education and a springboard for innovative ideas. You can be a leader in this movement.

 

Doing this work also requires us to have a high level of self-awareness and intentionality. We all know that when we get busy and overwhelmed by the tasks of the day, it can be easy to slip into autopilot. There is a comfort in the old familiar ways of doing our work. However we all know that doing things in the same old way as we always have, does not create the change in culture that most of us are wanting.  

PSR/RPS Canada is committed to supporting you and your organization in your extremely important journey of deepening your PSR practice. 

That is why the Core Competencies are such a big priority for this work. It gives us direction for the important work we do.

 

Why the Revision?

The Core Competencies were first written in 2013. (Click HERE to read them. )

Recently a team of PSR Champions–Dr. John Higenbottam (UBC and Douglas College), Dr. Regina Casey (Douglas College and PSR Advanced Practice), and Michael Lee (UBC), took on the task of revising the competencies to meet the needs of the PSR movement in 2017.

They spent many volunteer hours collaborating, researching, and writing. The result of their work is stellar, and it moves the guideposts for Recovery-Oriented Practice into new areas.

The biggest change is the addition of Competency E (Facilitating Change and Providing Leadership).

 

Dr. Higenbottam says, “Each practitioner of PSR is a leader in their own right. We want to acknowledge that PSR practitioners are leading a significant change in the way we support people with mental health and addiction issues.”

 

If you are doing this work, you are a change agent.

You are a champion.

 

It is the goal of PSR/RPS Canada to create ways to foster the growth and development of leaders of this movement.

Please let us know if you have any ideas about how we can provide that support.

 

Other Important Points to Note

Dr. Higenbottam also stressed that the team felt it was really important that practitioners strengthen skills in evidence-based practices such as:

·      Cognitive Remediation

·      Assertive Community Treatment (ACT) approach

·      Cognitive Behavioural Therapy (CBT)

·      Supportive Employment

A significant change in recent years is the merger of mental health and addictions services. This brings new guidelines around continuity of care and skill development.

The team also acknowledged that there is a need for a basic understanding the basics behind the DSM 5 and medication management. Therefore that was added to the 2017 version.

 

You can access the full version of the 2017 Competencies HERE. 

We at PSR/RPS Canada wish to hear from you! Please let us know what educational and support services you need from us, and we will do our best to meet those needs!

 


The new updated 2017 Competencies are as follows:

A.   Diversity and Inclusion

B.    Professional Skills

C.   Psychosocial Rehabilitation (PSR), Supporting Practices and Recovery Oriented Services

D.   Equity and Social Participation

E.     Facilitating Change and Providing Leadership