ILLINOISCERTIFIED RECOVERY SUPPORT SPECIALIST(CRSS) CREDENTIAL

STUDY GUIDE

November 2009

Developed in Collaboration by the:

• IllinoisCertificationBoardd/b/aIAODAPCA,Inc.• IllinoisDepartmentofHumanServices/DivisionsofMentalHealth,

RehabilitationServicesandAlcoholismandSubstanceAbuse• IllinoisMentalHealthCollaborativeforAccessandChoice

FOREWORD

Astheworldofmentalhealthandcombinedmentalhealthandsubstanceabusetreatmentevolves,newguidelines,regulationsandcredentialsaredeveloped.Asaresultofchangeandprogress,theCertifiedRecoverySupportSpecialist(CRSS)credentialhasbeenestablished.Oneoftherequirementstoobtainthiscertificationispassingthewrittenexamination.ItisourdesireforthisstudyguidetoassistthoseindividualspursuingtheCRSScredential.

Ifyouarereadingthisstudyguide,youmayalreadyhavethebooklet,IllinoisModelforCertifiedRecoverySupport Specialists which contains the model and application. If not, you can contact the IllinoisCertificationBoard(ICB)eitherbyphone,mailorourwebsitetoobtainacopy.

•Call1 (800) 272-2632

•Fax1 (217) 698-8234

•Visitwww.IAODAPCA.org

•Writeto:IllinoisCertificationBoard401E.SangamonAve.Springfield,IL62702

Thisstudyguidewasdesignedwithyouinmind.Theformatwasdevisedtobeasuser-friendlyaspossible.Attheendofthisguide,youwillfindanappendixofresourcesforfurtherstudy.

Lastly,theentirestaffandtheBoardofDirectorsoftheIllinoisCertificationBoard,commendyouforyoureffortstoobtainthiscredentialandwishyousuccessinyourpursuit!

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TABLE OF CONTENTS

TITLE PAGE

Introduction ............................................................................................................................... 3

Advocacy .................................................................................................................................... 7

Professional Responsibility .................................................................................................. 11

Mentoring ................................................................................................................................ 20

RecoverySupport..................................................................................................................... 24

WellnessRecoveryActionPlan(WRAP).................................................................................30

EvidenceBasedPractices.........................................................................................................31

IndividualPlacementandSupport(IPS)................................................................................33

Co-OccurringMentalIllnessandSubstanceAbuse(MISA)..................................................34

AdditionalResources.................................................................................................................35

CHAPTER 1: INTRODUCTION

CERTIFIED RECOVERY SUPPORT SPECIALISTSAslongastherehavebeenmentalillnessesandsubstanceabuse,therehasbeenrecovery.Nonetheless,thisisanespeciallyexcitingtimeforeveryonewhocaresabouttheirwell-beingandthatofothers.Personsinrecoverynowhavenewtoolstoworkmorecollaborativelytoimprovetheirlives,advancetheirrecovery,andshapeouroverallhealthcaresystem.

In 2003, the President’s New Freedom Commission on Mental Health was formed to conduct acomprehensive study of the United States mental health service delivery system. The Commission,involvingthe inputofpersonsparticipating inmentalhealthservices,providers, familymembersandadvocates,advisedthePresidentonmethodsofimprovingthesystem.Theyunitedaroundthefollowingdefinitionofrecovery:

Recovery:Theprocessinwhichpersonsareabletolive,work,learn,andparticipatefullyintheircommunities.Forsomeindividuals,recoveryistheabilitytoliveafulfillingandproductivelifedespiteadisability.Forothers,recoveryimpliesthereductionorcompleteremissionofsymptoms.Sciencehasshownthathavinghopeplaysanintegralroleinanindividual’srecovery.

-ThePresident’sNewFreedomCommissiononMentalHealth

Whenpersonswithaco-occurringmentalillnessandsubstanceabuseareinrecovery,itisimpliedthattheyareabstinentfromthesubstancecausingimpairmentandareabletoparticipateinlifeactivitiesthataremeaningfulandfulfillingtothem.AccordingtoLowinson,recoveryfromco-occurringconditionsconsistsof:

•Gaininginformation•Increasingself-awareness•Developingskillsforsoberliving•Followingaprogramofchange

OneofthemostexcitingdevelopmentsinthefieldofhumanserviceshasbeentheemergenceofRecoverySupportSpecialists:

Recovery Support Specialists:Professionalsemployedspecificallytousetheirpersonalrecoveryexperiencesbothtosupporttherecoveriesofothersandtohelpshapethehumanservicesystem.

RecoverySupportSpecialistsinfusethehumanservicesystemwithhope.Theyimproveopportunitiesforpersonstolivefullandproductivelivesintheirowncommunitiesandovercomeconditionsoncethoughttobeincurable.RecoverySupportSpecialistsalsoinfusethehumanservicesystemwithempowerment.Theyrepresenttheperspectivesofpersonsparticipatinginhumanservices.Moreimportantly,theycreateopportunitiesforpersonstobecomeinvolvedinthehumanservicesystemateverylevel.

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TheCRSScredentialprovidesRecoverySupportSpecialistsandorganizationsthatworkwiththemuniqueexperience,expertiseandqualifications.Thiscredentialis,therefore,animportantstrategicsteptowardtherealizationofthevisionofanIllinoishumanservicesystemwithhopeatitsfoundationwhere:

The Expectation is Recovery! All persons with mental illnesses can recover and participate fully in a life in the community.

-TheDHS/DMHVisionStatement

AsapersonwiththeCRSScredential,youwillbeequippedtoplayasignificantroleinadvancingthisvisionandmakingapositivedifferenceinthelivesofpersonswithmentalhealthandcombinedmentalhealthandsubstanceabusechallenges.

PURPOSE OF THE STUDY GUIDEThisguideisdesignedtoassistthosewhoarepreparingtotaketheCRSSexamination.Pleasenotethisguidedoesnotguaranteetocoverallinformationneededfortheexamination.ThemainfunctionoftheguideistoprovideabriefoverviewofthedifferentareasofimportancefortheCRSScredential.Itdoesnotensureapassingscore,norwillitprovideyouwithallthevitalinformationrequiredofthisprofession.Ultimately,wehopeitprovidesstructuretoyourpreparationfortheexamination.Weencourageapplicantstoreviewothersourcesofinformationaswell.Themoreyoulearn,thebetterpreparedyouwillbeforthetesttakingprocess.

FORMAT OF THE STUDY GUIDETheproceedingfourchaptersarebasedonthedomains,orprimaryfunctions,ofpersonswiththeCRSScredential.Thesedomainswereidentifiedthrougharatherextensiveandthoroughprocessknownasaroledelineationstudy:

• Advocacy• ProfessionalResponsibility• Mentoring• RecoverySupport

Inadditiontotheidentificationofdomains,thestudyalsoidentifiedtasks,knowledge,skillsandattitudesnecessaryforcompetencyinthefield.

Followingthedomains,youwillfindchaptersontheWellnessRecoveryActionPlan(WRAP),evidencebasedpractices, IndividualPlacementwithSupports (IPS),co-occurringmental illnessandsubstanceabuseandadditionalresources.Thesechapterswerechosentohelpyoupreparefortheexaminationandforuseinyourcareer.

SUGGESTIONS FOR EXAM PREPARATION

ChooseYourPreparationStyleEveryoneisdifferentwhenitcomestotesttaking.Somepreferindividualstudy,whileothersrequiregroupstudy.Ourfirstsuggestionistoidentifyyourpersonalpreferenceonhowtopreparefortheexamination.Askyourself,“HowdoIstudythebest?”Reviewprevioustestingsituationsanddecidewhatworkedforyouandwhatdidnotworkforyouinthesesituations.

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KnowtheFormatoftheExamKnowingtheformatoftheexaminationmayhelpyoutodeviseyourstyleofpreparation.Theexaminationiscomprisedof100 multiple choice questions.Youranswerstoquestionswilldemonstrateyourabilityto:

1) Recall:Bringbackfromyourmemoryconceptsexplainedinthisstudyguideandlearnedthroughexperience.

2) Comprehend:Gobeyondmemorizationbyunderstandingthemeaningofconcepts.

3) Apply:Showthatyouunderstandaconceptbybeingabletoputittouseinaparticularsituation.

Throughoutthestudyguide,youwillfindscenariosaccompaniedbyquestionsundertheheading“MakingItReal.”Thesequestionswillmodelanapproachtostudythatemphasizesrecall,comprehensionandapplicationthatyoucanapplythroughouttheguide.

Youwillhave2 hourstocompletetheexamination.AllowEnoughTimeforReviewIdentifyandlocatethedifferentresourcesyouwishtoreviewandgiveyourselfplentyoftimetodoso.Donotputitofftothelastminuteandthencramthenightbefore.Youmayevenwanttosetupareviewschedule.Youwillneedtobalancethedemandsoftestpreparationswithyourotherliferesponsibilities.Itisagoodideatoexpecttheunexpectedandschedulemorestudytimethanyouthinkyouwillneed.

PrioritizeIdentifyareasforreviewandprioritizeaccordingtohowfamiliaryouarewiththedifferentareasofstudy.Inotherwords,startwith the less familiarandmove to themore familiar inorder toensureenoughreviewtimeoverneededareas.

TakeNotesWritinginformationdownmayhelpyoutorecallwhatyouhavelearnedwhenitistimeforthetest.Youcanalsowritedownareasforadditionalrevieworforaquickreviewbeforetheexamination.

GetPlentyofSleepNotonlyiscrammingthenightbeforeastressproducer,italsocandepleteyouofneededsleep.Youdonotwanttobefightingtokeepyoureyesopeninthemiddleofyourexam.Fatiguecanaffectyourthoughtprocesses.

RemembertoDrinkWaterandEatDependingonthetimeoftesting,makesureyoueatanutritiousmealanddrinkwaterbeforetakingtheexam.Hungerandthirstduringanexammaydistractyouandaddtofeelingsofstress.

HaveSuppliesReadyinAdvanceTheAdmissionLetterprovidesyouwithalltheinformationyouneedtoknowfortheexam.Youwillneedtwoformsofidentification(onemustbeapictureID).

SecureDirectionstotheTestSiteYoushouldknowwhereyouaregoingandplantoarriveearly.Arrivingearlyatthetestsitewillhelpyoutogatheryourthoughtsandrelax.

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RelaxPracticerelaxationbeforetheexambegins.Sometesttakersfinditrelaxingtoreviewtheirnotesbeforeanexaminationortalktoothersaboutwhattheystudied.Othersprefertositquietlyorlistentorelaxingmusic,forexample.Trywhatyouthinkwillworkbestforyou.

RewardYourselfPlansomethingafterthetesttoshowappreciationtowardyourselfandperhapsyoursupporters.Whileyouareawaitingthetestresults,proceedwithmakingplansforcontinuingeducationontopicsinwhichyouwouldliketodevelopmoreconfidence.Theprocessishardwork,butthecredentialwillrecognizethetremendouseffortyouhaveputin.

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CHAPTER 2: ADVOCACY

SYSTEMS LEVEL ADVOCACYInordertobetterunderstandsystemsleveladvocacy,ithelpstobreakthistermdownintoitsparts.

• System:Asetofpartsworkingtogetherinanorganizedwayforacommonpurpose.• Advocacy:Communicatingeffectivelyinordertogetneedsmet.• Systems Advocacy:Communicatingeffectivelywithinanorganizationtogettheneeds

ofpersonsparticipatinginservicesmet.Thisofteninvolveschangesthataffectgroupsofpeople.

Therearemanywaystoadvocateinthehumanservicesystem,includingletters,facetofacemeetings,conductingtrainingsandrallies.ThepersonwiththeCRSScredentialusestheappropriatemeansfortheiraudience.Theyknowthathowyouapproachpeopleandthewayyoucommunicatearethekeystoeverythinginsystemsleveladvocacy:

• Beanadvocate,notanadversary.• Knowyouraudienceandthebeststyleforcommunicatingwiththataudience.• Givecreditandpraiseateveryopportunity.• Puttherequestinwritingandsuggestareasonabletimelinefortheorganizationtofollow

up.• Wheneverpossible,honoranorganization’schainofcommand.• Buildrelationshipsandsupportasyouadvocatewithinasystem.• Realizethebalancebetweenpersonalresponsibilityandsupport.• Prepareformeetingsbylistingyourpointsandquestions.Planresponsestoquestionsyou

maybeasked.• Ifyoudonotgetwhatyouwant,tryanewapproach.• Ifyoudogetwhatyouwant,alwaysexpressgratitude.

SELF ADVOCACY AS A KEY CONCEPT OF RECOVERYSelf-advocacyisabout“goingforit”withcourage,persistenceanddeterminationontheroadtorecovery.Attimesindividualsfindbarrierstoovercomeonthisjourneyoridentifyneedsthatmustbemetinordertoprogress.ThepersonwiththeCRSScredentialhelpsindividualslearntoexpressthemselvesclearlyandcalmlyinordertogettheirneedsmet.Sometimesthisinvolvescommunicatingwithfamilymembers,doctors,institutionsorplacesofemployment.CRSSprofessionalslearnwhatsteptheindividualisonandhelpthemprogresstowardgreaterselfadvocacy:

• Step 1: Modeling-TheRecoverySupportSpecialistadvocatesonbehalfoftheindividual• Step 2: Supporting-TheRecoverySupportSpecialistadvocatesalongsidetheindividual• Step 3: Empowering-Theindividualadvocatesforhim/herself

CRSSprofessionalsmodelchoosingthemostappropriatemethodofadvocacyfor thesituation.Theyalsomodelprofessionalismandgratitudethroughouttheadvocacyprocess,whentheygetwhattheywantandwhentheydonot.

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THE PERSON’S INDIVIDUAL SUPPORT SYSTEMSAsapersonmovesforwardintheirrecoveryjourneyanddevelopsorrecapturesasenseofselfapartfromtheirillness,thereisaneedtorecognizeexistingsupportsandbuildbridgestoadditionalsupports.Asanadvocate,thepersonwiththeCRSScredentialhelpstheindividualtoidentifypositivesupportsystems.Attimes,theremaybechallengesfromlifeeventsthatappeartobeobstaclestoforminghealthysupportiverelationshipsinthecommunity.ThepersonwiththeCRSScredentialhelpsindividualstobuildsupportiverelationshipsthathealandprovideastrongfoundationforrecovery.Theyhelp individualsmovefromsolerelianceontemporarysupportiverelationshipswithhealthcareprofessionalstopermanent,naturalsupportiverelationshipsinthecommunity.Thismayinvolvefriendships,family,organizationsofinterestorrelationshipsintheworkplace.

PROMOTING INDIVIDUAL CHOICE AND SELF-DETERMINATIONAs amentor and an advocate, the person with the CRSS credential supports individual choice andencouragesself-determination.Individualchoiceandself-determinationisrelevanttoeverythingfromtreatment options to housing and employment choices. They can discuss options provided by theindividualandencouragethemtoweighprosandconsandsetpriorities.Thekeyistoprovidesupportandencouragementratherthandefinitiveanswers.Thepersonservedmustultimatelyhaveownershipoftheprocessforittolast.

Inordertomakegoodchoicesapersonmusthavegoodinformation.Forinstance,anindividualreceivingdisabilitybenefitsmaybeinterestedingoingtowork,buthasheardmisinformationthatreturningtoworkinstantlycausesindividualstolosealloftheirbenefits.ThepersonwiththeCRSScredentialcanpromote individualchoicebyconnectingthe individualwithanexpertBenefitsCounselorthroughtheWorkIncentivePlanningandAssistanceprogram(seeChapter8).Havingaccurate informationabouthowworkingaffectsbenefitshelpstheindividualtomakeaninformeddecision.

ADVANCE DIRECTIVESAnAdvanceDirectiveisalegal documentcreatedwhenapersoniswell.Itdescribeswhatkindofmentalhealth treatment the individualprefersandwhatpersoncanmakedecisionsabout theircare if theybecomeunabletoduetoillness.Only the individual can decide if they want to create an advance directive and what it contains.Therearetwotypes:

ADeclaration for Mental Health Treatmentincludespersonalpreferencesabout:• Medication• Hospitalization• ElectroconvulsiveTherapy(ECT)• AnAttorneyinFact,chosenbytheindividual,whocanviewtheirmentalhealthrecordsand

makedecisionsabouttheindividual’scare,ontheirbehalf.

APower of AttorneyforHealthCare:• Isapersonchosenbytheindividualinadvance.• Candirectboththeindividual’smentalhealthtreatmentandothermedicalcare.

PsychiatricAdvanceDirectivesarevoluntary.Freeadviceandassistanceisavailablethrough:

Equip for Equality Illinois Guardianship and Advocacy Commission:Website:www.EquipForEquality.org Website: www.GAC.State.IL.US

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Forsampleadvancedirectiveforms,visit:

Illinois Department of Public HealthWebsite:www.IDPH.State.IL.US/Public/Books/Advin.htm

ADVOCATING WITHIN THE HUMAN SERVICE SYSTEMAdvocacywithinthehumanservicesystemcaneitherinvolvesupportingtheself-advocacyeffortsofanindividualoradvocatingforgroupsofpeopleatthesystemslevel.Ineithercontext,itisimportantforpersonswiththeCRSScredentialtohaveknowledgeofthesystemculturethatexistsandfamiliaritywiththesystemhierarchy.Advocacyisnotabout“winning”itisaprocessofbuildingbridges.Ahallmarkofgreatadvocatesistheabilitytobeassertiveandnotbecomeaggressive.Anassertiveprofessionaleffectively and appropriately expresses their feelings, thoughts and interests. They know their rightsandcancontroltheiremotions.Therearemanydifferentwaystocommunicateforadvocacyanditisimportanttochoosethemethodofadvocacythatfitsthesituationandtheleveloftheorganizationoneisadvocatingat.

PERSON DRIVEN RECOVERYInaperson-drivenorganization,personshavetheprimarydecision-makingroleregardingthecarethatisofferedandreceived.Treatmentinvolvesoptionsthattheindividualchoosesfromwithintherangeofwhatismedicallyappropriate.Thepersonisinformedofandinvolvedineverydecisionregardingtheircare,allthewayfrommedicationchoicestoemploymentoptions.Aboveall,theperson’slifegoals,hopesanddreamsaretheendthatalltreatmentandapproachesmustworktoward.Formoreinformation,seetheSubstanceAbuseandMentalHealthServicesAdministration(SAMHSA)AdvisoryCouncil’sdefinitionofpersondrivencareat

http://MentalHealth.SAMHSA.gov/ConsumerSurvivor/Programs.asp

PERSON CENTERED LANGUAGEInthehumanservicesfieldasinallhealthcarepractices,itiscrucialthat“person-centered”languagefocuses on the individual rather than the disability, diagnosis or label. At its core, person centeredlanguageisnotaboutpoliticalcorrectness,butaboutesteemingtheindividual.OneofthediplomaticskillsofthepersonwiththeCRSScredentialistheabilitytomodelandencourageempoweringlanguagewithoutexcessivelystiflingconversationsbycorrectingeachimproperterm.Thegoalofpersoncenteredlanguageisultimatelytochangeattitudesandpractices,notsimplytorenamethem.Herearesomeexamplesofpersoncentered language thathave thepotential tochange thewaypersons thinkandact:

Labeling Language Person Centered LanguageChronics PersonswhohaveexperiencedamentalillnessforalongtimePatients PersonsparticipatinginservicesSchizophrenics PersonswithschizophreniaCompliance SharedDecisionMaking

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DEMONSTRATING NON-JUDGMENTAL BEHAVIORAsapersonwiththeCRSScredentialitisimportanttofocusonanon-judgmentalapproachinmentoringothers in their personal recoveries. Personswithmental health and co-occurringmental health andsubstance abuse challenges have often faced prejudices or discrimination. Theymay have enduredexperiencesthattheyaresensitiveaboutsharing.ThepersonwiththeCRSScredential’sresponsibilityisnottojudgepersonsbydisability,symptoms,beliefs,behaviorsorworkplaceaptitudes.Rather,theymeeteachpersonwhere theyareat,onedayata time.Providingsupportbyactively listening inanempathicmannerbuildshopeandesteem.Bydemonstratingnon-judgmentalbehavior,thepersonwiththeCRSScredentialdevelopstrustandanatmospherewherepersonscanfeelcomfortablesharing.

Advocacy: Making It Real

Juan has begun experiencing an unpleasant side effect on his current medication that inhibits his ability to concentrate and speak clearly. These abilities are important to Juan’s current work as a salesman. Juan wants to stop taking his medication, but is afraid to talk to his doctor, thinking the doctor might admit him to a hospital for refusing to take the prescribed medication. He confides in a person with the CRSS credential.

1. Recall:WhatthreestepsshouldthepersonwiththeCRSScredentialfollowtohelpJuanadvocateforhimselfandcommunicatewithhisdoctor?

2. Comprehend:Explainthesestepsinyourownwords.

3. Apply:HowmightJuanbenefitfromthisapproachtoadvocacy?

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CHAPTER 3: PROFESSIONAL RESPONSIBILITY

TEN FUNDAMENTAL CONCEPTS OF RECOVERY PleaseseeChapter5:RecoverySupport for informationon theSubstanceAbuseandMentalHealthServicesAdministration(SAMHSA)TenFundamentalConceptsofRecovery.OneofCRSSprofessionals’responsibilitiesisthepromotionoftheseconceptsthroughouttheorganization.Theserecoveryconceptsshouldbeusedtosupportindividuals’recoveryandtoshapethepracticesoforganizations.

A WELLNESS FOCUSED APPROACH TO RECOVERYIntheillnessbasedmodelofhealthcare,thefocusispredominantlyfixedonthediagnosisofanillnessand its accompanying symptoms. Treatment is targeted at reducing symptoms. A wellness-focusedapproachisstrengthbased.Itbeginswithanunderstandingofwhatapersonislikeattheirbestandwhatstrengthsandresourcestheyhavetorecovertheirwellness.Thewellnessfocusedapproachfacilitateshopeandhelpstomotivatethepersontotakeanactiveroleintherecoveryoftheirwellness.Sciencehasshownthathavinghopeplaysanintegralroleinanindividual’srecovery.

CULTURAL COMPETENCYJustaseachpersonhastheirownuniquerecoverystory,eachalsohashadauniqueculturalperspective.Culturalidentitiesinfluenceourthoughts,behaviors,andwaysoflife.Theprocessofbecomingculturallycompetentinvolvesthebuildingofrelationshipsbasedonmutualrespectandlearning.Noonepersonisexpectedtoknowthevaluesandbeliefsofeveryculture.Rather,wecommittoadeeprespectforculturaldifferencesandareeagertolearnandwillingtoacceptthattherearemanywaysofviewingtheworld(Galbraith,2000).Thisinvolvesthedevelopmentofknowledge,skillsandawarenessonthepersonwiththeCRSScredential’spart.Culturalsensitivityisvitaltorelationships,developmentofmaterialsandthecreationoforganizationalandworkplacepolicies.

ACCOUNTABILITYAccountability is about behaving responsibly toward one another and communicating openly aboutour responsibilities. Through accountability, we ensure that actions are consistent with what we asindividuals,peersandorganizationshavecommittedourselvesto.CRSSprofessionalsareaccountabletopersonsserved,organizationalleadershipandtheCRSScodeofethics.CRSSprofessionalsmayalsoholdorganizationsaccountableforactinginaccordancewiththeirvision,valuesorpolicies.Theyworkinawidevarietyofsettings,butareaccountabletoworkinginawaythatisconsistentwiththeCRSScredential’scorefunctions.

FEDERAL, STATE, EMPLOYER REGULATIONS REGARDING CONFIDENTIALITYCRSSprofessionalsmustfamiliarizethemselveswithappropriatepracticesregardingconfidentiality.Forexample,nopersonwiththeCRSScredentialmaydiscloseanindividual’sProtectedHealthInformation(PHI)withoutasignedAuthorizationforReleaseofInformationfromtheindividualortheirlegalguardian,withlimitedexceptions.Whenindoubt,CRSSprofessionalsshoulderronthesideofconfidentialityandconsultwith a supervisor or legal professional. They should acquaint themselveswith confidentialityrequirementsandpoliciesonbothindividuals’rightstoprivacyandindividuals’rightstoaccesstheirownhealthrecords.

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INDIVIDUALS’ ACCESS TO THEIR OWN MENTAL HEALTH RECORDSPersonsreceivingmentalhealthserviceshaverightstoaccesstheirownmentalhealthrecords:

•Mentalhealthconsumers,age12andabove,areentitledtoinspecttheirownrecords.•Accesstorecordscannotbedeniedorlimitedifapersonrefusesassistance.•Anyoneentitledaccesstotheirrecordsmaydisputeinformationcontainedintherecord.

CHILDREN AND YOUTH RIGHTS AND CONFIDENTIALITY Childrenandyouthbelowtheageof18whoreceivementalhealthserviceshaveuniqueandvariablerightstoconfidentialityandotherrights,includingthefollowing:

• Forchildrenundertheageof12,parentsorguardianshavetherighttoinspectandcopytheirchildren’srecords.

• Anypersonwhois12yearsofageoroldercanaskforandgetoutpatientcounselingforuptofivesessionsof45minuteseachwithoutthenotificationorconsentofhis/herparentorguardian.Thechild’stherapistorcounselorcannotnotifythechild’sparentorguardianwithoutthechild’sconsentexceptwheretheprogramdirectorbelievesittobenecessaryandthenonlyaftertheminorisinformedinwriting;

• Youthovertheageof12areentitledtoinspectandcopytheirownrecords.Helpininterpretingtherecordsshallbeprovidedfreeofchargeforyouthundertheageof18;

• ParentsorGuardiansofyouthage12to18mayinspectandcopytherecordsoftheminorconsumeriftheyouthisinformedanddoesnotobjectandthetherapistdoesnotfindthattherearecompellingreasonsfordenyingtheaccess.Iftheparentsorguardiansaredeniedaccessbyeithertheyouthorthetherapist,theparentsorguardiansmayseekacourtordergrantingaccess.

• Parentsorguardiansofyouthage12to18mayalwaysrequestandreceivethefollowinginformationconcerningtheirchild:currentphysicalandmentalcondition,diagnosis,treatmentneeds,servicesprovided,andservicesneeded,includingmedication,ifany.

• Youthwhoare16oroldermayreceiveinpatientserviceswithoutparentalnotificationorconsentforalimitedtime.Therearerightsandconfidentialityrequirementsthatareuniquetoyouthandtheirfamilies.Youthhavelimitedrightstoreceiveserviceswithoutparentalnotification,asdescribedabove.

CODE OF ETHICS FOR CRSS PROFESSIONALS

Principle 1: Legal and Moral StandardsThewelfareanddignityofpersonsservedaretobeprotectedandvaluedaboveallelse.CRSSProfessionals,inthepracticeofmentalhealthrecoverysupportservices,showrespectandregardforthelawsofthecommunitiesinwhichtheywork.Theyrecognizethatviolationsoflegalstandardsmaydamagetheirownreputationandthatoftherecoverysupportprofession.

a. Thewelfareanddignityofpersonsservedaretobeprotectedandvaluedaboveallelse.

b. CRSSProfessionalsshallnotphysicallyorverballyabusethepersonstheyserve.

c. CRSSProfessionalsshallnotabusealcohol.

d. CRSSProfessionalsshallnotfinanciallyexploitthepersonstheyserve.

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e. CRSSProfessionalsshallnotabuselegaldrugs.

f. Insomecircumstances,CRSSProfessionalsmaythemselvesuseproperlyprescribed,mood-alteringdrugsfornecessaryandappropriatemedicalreasons.Insuchcircumstances,CRSSProfessionalsshouldweightheirabilitytoserveinrecoverysupportrelationships.

g. CRSSProfessionalsshallnotpossessoruseanyillegaldrugsunderanycircumstances.

h. CRSSProfessionalswhocanlegallyprescribecontrolledsubstancesmustexerciseclinicaldiscretioninprescribingcontrolledsubstancesthataremind-alteringand/oraddictive.

Principle 2: ICB Certified CRSS Professionals/Consumer RelationshipsIn the provision of mental health recovery support services, ICB Certified CRSS Professionals shallestablishandmaintainprofessional/consumerrelationshipscharacterizedbyprofessionalism,respect,andobjectivity.

a. CRSSProfessionalsshallnotenterintorecoverysupportrelationshipswithmembersoftheirownfamily,withclosefriends,withpersonscloselyconnectedtothemorotherswhosewelfaremightbejeopardizedbysuchadualrelationship.

b. CRSSProfessionalsshallensurethatservicesareofferedinarespectfulmannerandinanappropriateenvironment.

c. CRSSProfessionalsshallnotchargeorcollectaprivatefeeorotherformofcompensationforservicestoanindividualwhoischargedforthosesameservicesthroughtheagencythatemploystheCRSS.CRSSProfessionalsshallnotengageinfeesplitting.

d. CRSSProfessionalsmustnotuseanyrelationshipwithanindividualtheyservetopromotepersonalgain,ortheprofitofanagencyorcommercialenterpriseofanykind.

e. CRSSProfessionalsshallavoidcontinuingarelationshipforpersonalgainorsatisfactionbeyondthepointwhereitisclearthattheindividualbeingservedisnolongerbenefitingfromtherelationship.

f. CRSSProfessionalsshallnotgiveorreceiveafee,commission,rebateoranyotherformofcompensationforthereferralofconsumers.

g. CRSSProfessionalsshallnotabandonorneglectconsumersandshallassistinmakingappropriatearrangementsforthecontinuationoftreatment,ifappropriate,followingtermination,ofservices.

h. IfCRSSProfessionalsdetermineaninabilitytobeofprofessionalassistancetoanindividual,theyshalleitheravoidinitiatingtherecoverysupportrelationshiporimmediatelyterminatethatrelationship.Ineitherevent,CRSSProfessionalsshallbeknowledgeableaboutreferralresourcesandsuggestappropriatealternatives.Iftheindividualdeclinesthesuggestedreferral,CRSSProfessionalsarenotobligatedtocontinuetherelationship.

i. CRSSProfessionalsshallterminatearecoverysupportrelationship,securingtheindividual’sagreementwhenpossible,whenitisreasonablyclearthattheindividualisnolongerbenefiting,whenservicesarenolongerrequired,whenservicesnolongerservetheneedsorinterestsoftheindividual,orwhentheindividualdoesnotpaythefeeschargedbytheCRSS(ortheiragency).

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j. Inpromotionalandmarketingactivitiesforservices,CRSSProfessionalsshallrespectthedignityandconfidentialityoftheindividualstheyserve.

k. CRSSProfessionalsshallnotengageinanysexualrelationship,conductorcontactwithconsumersduringthetimeoftherecoverysupportrelationshiporforatleastoneyearthereafter,oriftheconsumerorformerconsumerbecomesorremains“Emotionallydependent”ontherecoverysupportspecialist(counselor)[asdefinedunderIllinoisLawat740ILCS&140/1(a)].CRSSProfessionalsinallinstancesshallnotengageinanysexualrelationship,conductorcontactthroughmeansofanytherapeuticdeception.

Principle 3: Non DiscriminationCRSSProfessionalsmustnotdiscriminateagainstindividualsbasedonrace,religion,age,sex,disability,ethnicity,nationalancestry,sexualorientationoreconomiccondition.Principle 4: Competence TheCRSSProfessional’sresponsibilityistoprovidecompetentprofessionalservices.

a. CRSSProfessionalsshallnotofferservicesoutsidetheboundariesoftheCRSScompetencies(PerformanceDomains)unlessotherwiseeducatedandtrained,licensedorcertified.

b. CRSSProfessionalsshallnotofferservicesoutsidetheirrangeofcompetency.

Principle 5: ConfidentialityCRSSProfessionalsshallpreserve,protect,andrespecttherighttoconfidentialityofthepersonstheyserve.

a. CRSSProfessionalsshallcomplywiththefederalandstatelaws,rules,andregulationspertainingtoconfidentiality.

b. CRSSProfessionalsshallguardprofessionalconfidencesandshallrevealsuchconfidencesonlyincompliancewiththelaworonlywhenthereisaclearandimminentdangertoanindividualorsociety.

c. CRSSProfessionalsmustinformtheconsumerandobtainagreementinareaslikelytoaffecttheconsumer’sparticipation,includingtherecordingofaninterview,theuseofinterviewmaterialfortrainingpurposesandobservationofaninterviewbyanotherperson.

d. CRSSProfessionalsmustdiscusstheinformationobtainedinclinicalorconsultingrelationshipsonlyinappropriatesettingsandonlyforprofessionalpurposesclearlyconcernedwiththecase.Writtenandoralreportsmustpresentonlydatagermanetothepurposeoftheevaluationandeveryeffortmustbemadetoavoidundueinvasionofprivacy.

e. CRSSProfessionalsmustuseclinicalandothermaterialinclassroomteachingandwritingonlywhentheidentitiesofthepersonsinvolvedareadequatelydisguised.

f. ThegeneralrequirementthatCRSSProfessionalskeepinformationconfidentialdoesnotapplywhenthebestinterestsofconsumers,welfareofothers,obligationstosociety,orlegalrequirementsdemandthatconfidentialinformationberevealed.CRSSProfessionalsconsultwithotherprofessionalswhentheyareunsureofwhetheranexceptiontoconfidentialityexists.

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g. Beforeconfidentialinformationisdisclosedovertheclient’sobjectionbecauseoflegalrequirements,CRSSProfessionalsshallrequesttothecourtthatthedisclosurenotberequiredandexplainwhydisclosuresareharmfultoconsumers.Stepsaretakentolimittheextentoftheunwanteddisclosure.ACRSSshallnot,however,beobligatedtoviolateanystateorfederallaw,ortheorderofcompetentjurisdiction.

h. Whencircumstancesrequirethedisclosureofconfidentialinformation,onlyinformationthatisessentialistoberevealed.Totheextentpossible,consumersaretobeinformedbeforeconfidentialinformationisdisclosed.

i. Atthebeginningoftherecoverysupportrelationship,CRSSProfessionalsdiscusstherelevantlimitationsofconfidentialityandtheforeseeableusesofinformationgeneratedthroughsupportserviceswithpersonsserved.

j. CRSSProfessionalsshallexplainthefactthatconfidentialitycannotbeguaranteedingroupsettingsandcommunicatethatclearlytogroupmembers.

Principle 6: Inter-Professional RelationshipsCRSSProfessionalsshallestablishandmaintainprofessionalrelationshipscharacterizedbyrespectandmutualsupport.

a. CRSSProfessionalsshallestablishandmaintainprofessionalrelationshipswiththepersonstheyserve.

b. CRSSProfessionalsshallrespecttheconfidencessharedbyothercolleagues/professionalswithrespecttothepersonstheyserve.

c. CRSSProfessionalsshallnotknowinglysolicittheconsumersofothercolleagues/professionals.

d. CRSSProfessionalsshallnotknowinglywithholdinformationfromcolleagues/professionals,appropriatelyreleasedbytheconsumer,thatwouldenhancetheirtreatmenteffectiveness.

e. CRSSProfessionalsshallnotknowinglyacceptfortreatmentapersonwhoisreceivingservicesfromanotherprofessionalexceptbyagreementwiththatworkeroraftertheterminationofthecasebythatworker.

f. Whenworkinginatreatmentteamwithotherprofessionals,CRSSProfessionalswillnotabdicatetheirresponsibilitytoprotectandpromotethewelfareandbestinterestsofthepersonserved.

g. Whenworkingwithinatreatmentteam,CRSSProfessionalsshallworktosupport,notdamageorsubvert,thedecisionsmadebytheteam.

Principle 7.1: When making recommendation for positions, advancements, certification, etc., CRSS Professionals shall consider the welfare of the public and the profession above the needs of the individual concerned.

a. CRSSProfessionalsshallnotuseanotherprofessionalasareferencewithoutfirstobtainingthatperson’spermission.

b. CRSSProfessionalsshallnotleadapersontobelievethathe/shewillreceiveafavorablerecommendationwhen,infact,sucharecommendationwillnotbegiven.

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Principle 7.2: CRSS Professionals shall establish and maintain an employer/employee relationship characterized by professionalism and respect for the agency’s rules of operation.

Principle 7.3: CRSS Professionals shall strive at all times to maintain high standards in the services they offer.

a. ThemaintenanceofhighstandardsofcompetencyisaresponsibilitysharedbyallCRSSProfessionals

b. IncircumstanceswhereCRSSProfessionalsviolateethicalstandards,itistheobligationofallCRSSProfessionalswhoknowfirsthandoftheiractivitiestoattempttorectifythesituation.Ifsuchattemptsfail,CRSSProfessionalshallpromptlynotifytheICBExecutiveDirector.

Principle 7.4: CRSS Professionals respect their professional status and standing.

a. CRSSProfessionalsshallnotmisrepresenttheirqualificationsandaffiliations.

b. CRSSProfessionalsshallnotaidorabetapersonnotdulycertifiedasaCRSSProfessionalinrepresentinghimself/herselfasaCRSSProfessional,orataclassificationwhichisnottrue.

Principle 7.5: CRSS Professionals have an obligation to see that recovery support services are done by qualified, competent persons. Constructive efforts to achieve competent services, such as certification, deserve support.

a. CRSSProfessionalsshallsubmitaccurateandhonestinformationtoICBforthepurposeofobtaining,maintainingandrecommendingsomeoneforcertification.

Principle 7.6: In the conduct of research, CRSS Professionals should adhere to high standards and follow appropriate scientific procedures.

Principle 7.7: When CRSS Professionals accept the responsibility of teaching or of supervising CRSS professionals, they should discharge these responsibilities with the same regard for standards required of all other professional activities.

Principle 7.8: As authors or editors, CRSS Professionals shall adhere to high standards abiding by the traditions established in the academic arena.

a. CRSSProfessionalsmustacknowledgeanddocumentmaterialsandtechniquesused.

b. CRSSProfessionalswhoconducttraininginrecoverysupportserviceskillsortechniquesmustindicatetotheaudiencetherequisitetrainingandqualificationsrequiredtoproperlyperformtheseskillsandtechniques.

c. CRSSProfessionalsmustrecognizejointauthorshipandmajorcontributionsofaprofessionalcharactermadebyseveralpersonstoacommonproject.Theauthorwhohasmadetheprinciplecontributiontoapublicationmustbeidentifiedbybeinglistedfirst.

d. CRSSProfessionalsmustacknowledgeinfootnotesorintroductorystatementminorcontributionsofaprofessionalcharacter,extensiveclericalorsimilarassistanceandotherminorcontributions.

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e. CRSSProfessionalsmustacknowledge,throughspecificcitations,unpublished,aswellaspublished,materialthathasdirectlyinfluencedtheresearchorwriting.

f. CRSSProfessionalswhocompileandeditforpublicationthecontributionsofothersmustlistoneselfaseditor,alongwiththenamesofthoseotherswhohavecontributed.

g. CRSSProfessionalsmustdefineforselfandothersthenatureanddirectionofloyaltiesandresponsibilitiesandkeepallpartiesconcernedinformedofthesecommitments.

h. CRSSProfessionalsmustnotuseaconsumerinademonstrationroleinaworkshopsettingwheresuchparticipationwouldpotentiallyharmtheconsumer.

Principle 8: Resolving Ethical Issues

a. CRSSProfessionalsshalltakeappropriateactionwhentheypossessinformationthatraisesdoubtsastowhetheranotherCRSSprofessionalisactinginanethicalmanner.

THE SUPERVISORY RELATIONSHIPCRSS professionals and their supervisorsmustmaintain clear roles and boundaries in the workingrelationship.An individualcannotbeasupervisorandamentalhealthprovider to thesameperson.Employeesmay requestsupervisorysupportor reasonableaccommodations,butnotseekor receivetherapeuticsupportfromtheirsupervisors.Amongsupervisorsinthementalhealthfield,theremaybeaninclinationtobringone’sclinicaltrainingintothesupervisoryrelationship.Thisisevenmorelikelytohappenwhentheemployeeisaselfdisclosedpersoninrecovery.

Ifasupervisorbeginstoprovidesupportthatfeels likeit isbeyondtheboundariesofthesupervisoryrelationship,CRSSprofessionalsshouldkindlypointthisoutandclarifythatthisisnotthetypeofsupportthatisneededorfitting.Keepthefocusofsupervisiononthejob.Whatneedstobeaccomplished?Whatisthebestwaytogettheworkdone?Isanysupportneededtoperformworktasks?Aswiththesupervisoryrelationship,itisequallyimportantthatsupportiverelationshipsbetweenco-workersnotdevelopintoatherapist-clientdynamic,andthatCRSSprofessionalsdonotoverlyrelyontheirco-workersforsupport.

DOCUMENTATION ACTIVITIESAll topics inanencounter that relate to theperson’sgoalsor treatmentplanneed tobe included indocumentation. Keep in mind the saying that, “If it is not documented, it never happened.” CRSSprofessionalsareprovidingservicesthatarebillableandrecordsneedtoreflectthatappropriateserviceswereprovidedandanyandalloutcomesaredocumented.

Individualagencieshavedifferentmethodsfordocumentation.ApersonwiththeCRSScredentialmayhavetomakewrittennoteswhileinthecommunityortheymayhavealaptoporotherdevicetoenternoteson.Inallinstances,confidentialitymustbemaintained.Evenattheoffice,computerstationsneedtobeloggedoutwhennotinuse.Documentationofservicesorincidentsshouldbecompletedassoonaspossible.

DECOMPRESSION AND DE-ESCALATION TECHNIQUESWhen interactions become tense and there is friction in a relationship, the person with the CRSScredentialassesseswhatupsettingthings(triggers)canbecontrolled.Ifthespaceiscrowded,loud,ordisorganized,perhapssomethingcouldbechanged.Theycouldmovetoamorecalmingenvironmentorsetupadifferenttimetomeet.ThepersonwiththeCRSScredentialmightaskwhattheindividualwould

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findcomforting. Theybecomesensitive tohowone’s surroundingsencourageordiscourage recoveryandempowerment.Theymayactivelyinvolveindividualsindecidingonwellnesstoolstoincludeintheenvironmentwherepersonsparticipateinservices.

CRSSprofessionalsallowforflexibility.Sometimesitisnecessarytoagreetodisagree.Sometimeswhenemotionsrunhighpeoplewillraisetheirvoiceandsoundangry.Byaskingifapersonisangrywithyou,youmayhelpapersonrecognizetheirbehavior,ratherthanrespondingbymatchingtheirvolume.Ifthepersonisnotabletorefrainfromescalating,CRSSprofessionalsassesswhetherremovingthemselvesfromtheinteractionwouldhelporifadditionalsupportisneeded.

IDENTIFYING INDIVIDUALS’ RISK INDICATORS: INDIVIDUAL STRESSORS, TRIGGERS AND SIGNS OF ESCALATIONThepersonwiththeCRSScredentialcanhelpindividualstocreatetheirownWellnessRecoveryActionPlan(WRAP)orCrisisPlantoproactivelyfindwaystorespondtoavoidorrespondtostressors,triggersandsignsofescalatingsymptoms.ApersonwiththeCRSScredentialmaychoosetoshareanaspectoftheirownstoryorexperiencethathashelpedthemrecognize,avoidandrespondhealthilytostressors,whenappropriate.Bythissharingprocess,individualslearnthatitishealthytodiscussandlearnabouttheirownexperiences.Stressorsdonotnecessarilyneed to lead toescalatingsymptoms ifaplan isdevelopedtodealwiththeminhealthyways.

SUICIDE PREVENTION CONCEPTS AND TECHNIQUESSuicidepreventionbeginsby becoming comfortablewithdiscussing suicide.Discussing suicidedoesnotputtheideaintoaperson’sheadtoendtheirlife.ApersonwiththeCRSScredentialcanhelpbymaking itpossibletodiscussdepressionandoffersupport.Sometimespeopleexhibitbehaviors thatmayindicatethattheymayhavesuicidalthoughtsincludinggivingawaypossessionsordecreasesinselfcaresuchashygiene,housekeepingorappetite.Opennessandempathyarevaluabletoapersonthatisconsideringsuicide.CRSSprofessionalsshouldbecomefamiliarwiththesuicidepreventionandcrisispreventionresourcesinthecommunityaswellas:

•TheNationalSuicideHotline: 1 (800) 273-TALK (8255)•TheIllinoisCARESLineforChildren: 1 (800) 345-9049, TTY: 1 (773) 523-4504•EmergencyServices: 911

Anexampleofacrisismaybeifthepersonexpressesadesiretoendtheirlife,hasaplanonhowtheywoulddoitandthemeanstofollowthrough.Ifthissituationoccurs,letthepersonknowyourconcerns,tellthemthatyouareobligatedtogetthemhelpandthatyouwillsupportthemingettingtreatment.Ifatallpossible,apersonwiththeCRSScredentialmayaccompanythepersontothehospitalandfacilitatebybeinganadvocateandsourceofsupport.

INDICATORS OF ABUSE AND/OR NEGLECTTheStateofIllinoisOfficeoftheInspectorGeneral(OIG)andtheDepartmentofChildandFamilyServices(DCFS)havewelldefinedinstructionsonwhentoreportabuseandneglect,forexample:

• Ifyouseesomeonehittingapersonwithanobject.• Ifyouseemarksonaperson’sbodythatdonotappeartohavebeencausedbyaccident.• Ifapersontellsyouthatheorshehasbeenharmedbysomeone.• Ifapersonappearstobeundernourished,isdressedinappropriatelyfortheweather,oris

youngandhasbeenleftalone.

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It is important foreveryperson to takeabuseandneglect seriously, tobeable to recognizewhen ithappens,andtoknowwhattodonext.Incasesofabuseorneglect,call:

•DCFSHotline(Children): 1 (800) 25-ABUSE (22873), TTY: 1 (800) 358-5117•OIGHotline(Adults): 1 (800) 368-1463

IDENTIFYING AND RESPONDING APPROPRIATELY TO PERSONAL STRESSORS, TRIGGERS AND RISK INDICATORS Everypersonexperiencesstressorsinlife.Thehumanservicesfieldcanbeadifficultenvironmenttoworkinforanyone.ThepersonwiththeCRSScredentialshouldtakestepstoidentifyandrespondappropriatelytothesestressors.CRSSprofessionalsarenotrequiredtodevelopapersonalWRAP,butmayconsiderdoingsoforthemselvestohelpprepareforanddealappropriatelywithstressors.Itisalsoimportanttohaveasocialnetworkoutsidework.

Working as a person with the CRSS credential in the human services field poses both uniqueopportunitiesandpotentialstressors.TherearetimeswhenapersonwiththeCRSScredentialmaybeputinsituationsthatremindthemoftraumaticorbothersomeeventsintheirownhistory.Inaddition,whileCRSSprofessionalsareexpectedtomodelrecovery,theyarenotexpectedtobeinvincible.Infact,modelingrecoveryinvolvesrecognizingone’sstrengthsaswellastheirhealthylimits.Havingprofessionalboundariesandopencommunicationwithsupervisorsaboutappropriateworkloads,potentialneedsforaccommodations(ifnecessary)andjobsatisfactionareimportantinanyjob,includingtheworkofthepersonwiththeCRSScredential.Ifyoubringaneedorproblemtoasupervisor,itisalwaysagoodideatobepreparedwithsuggestedsolutionsoroptions.

Professional Responsibility: Making it Real

Sue calls her ex-husband George to communicate about the need for consistent rules for their children. Over the course of the conversation, George raises his voice at Sue and criticizes her parenting. Sue is upset by the conversation and begins to complain loudly in the mental health center common area, disrupting activities nearby. A person with the CRSS credential is present.

1. Recall:NametwotechniquesthepersonwiththeCRSScanusetoassistSueinde-escalating.

2. Comprehend:Explainwhatde-escalationmeansandwhyitisanimportantapproachforCRSSprofessionalstobefamiliarwith.

3. Apply: ThinkoftwootherwaysanindividualmayhaverespondedlesseffectivelytoSue,withoutde-escalationtechniques.Compareandcontrasttheprosandconsofeachapproach.

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CHAPTER 4: MENTORING

THE CONCEPT OF MENTORINGMentoring isa relationshipbetweenapersonwith theCRSScredentialandapersonparticipating inservicesthatprovidesanopportunitytomodelandsharepersonalskillsandexperiencesthatfacilitaterecovery.Mentoringrelationshipsarebuiltontrust.Thisinvolvesencouragement,constructiveguidance,openness,mutualrespectandawillingnesstolearnandshare.

ROLE MODELING BEHAVIORSApersonwiththeCRSScredentialisaprofessionalwhoisinrecoveryfromamentalillnessoracombinationofmentalillnessandsubstanceabuseandusesthatexperiencetosupportothers’recoveries.Thepersonwith the CRSS credential serves as a rolemodel of awellness focused lifestyle, effective advocacy,professionalresponsibility,mentoringandrecoverysupport.ThismeansthatthepersonwiththeCRSScredentialconsistentlyservesasanexampleofhowtoliveandworkeffectivelyintheseareas.Thepersonwith theCRSScredential isaware thatpersonsoften learnmore fromwhatapersonpractices thanwhattheysayandactsaccordingly.Theydemonstrateencouragement,constructiveguidance,openness,mutualtrust,respect,awillingnesstolearnandshare,andalifestyleconsistentwithrecovery.

SOCIAL LEARNINGSocial learning is theprocessof learningbyobservationand interaction. Insocial learning,modelingcomesbeforeothertypesofteachinginaseriesofsteps:

1) TheskillorbehaviortobetaughtisfirstmodeledbythepersonwiththeCRSScredentialfortheindividual.

2) Theskillorbehaviorisexplainedtotheindividual.3) Theindividualisgiventheopportunitytopracticeordemonstratetheskillorbehavior.4) ThepersonwiththeCRSScredentialgivestheindividualfeedbackontheirprogresstoward

achievement.

Themosteffectivesociallearningoccurswhentheprocessaboveoccursfrequentlyandconsistently.BydemonstratingawellnessfocusedlifestyleandthedomainsoftheCRSScredential,thepersonwiththeCRSScredentialhelpstocreateaculturewherepersonslearnaboutrecovery.Theycreateopportunitiesforinteractionsbetweenpersonsthatstimulatecriticalthinking.ThepersonwiththeCRSScredentialalsocreatesopportunitiesforlearningthroughrelationshipsandtimespentinthecommunity.Asarolemodel,theyfacilitategrowthbyexampleinsteadofdirectteachingmethods.Inthisway,rolemodelingandsociallearningareinterconnectedconcepts.Sociallearningiscumulative.Itgrowsovertimeandsometimesoccurssubtly,butproducestremendousprogressovertime.

SELF ADVOCACYPreviouslyweexplainedSelfAdvocacyinChapter2onAdvocacy.Itisimportant,though,toexpandonthisandconsiderthepersonwiththeCRSScredential’sroleinmentoringselfadvocacy.Asamentor,apersonwiththeCRSScredentialmayneedtomodelself-advocacyandreviewtheprocessafterwards.Therearemanyinstanceswhenpersonshavenotbeenrespectedandmayhavefeltdefeated.Somepersonsmayhavegivenuphopeandsomemayseeobstaclesasinsurmountableorasafight.Bylivingoutandsharingpersonalstoriesofself-advocacy,apersonwith theCRSScredentialcanmodelself-

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advocacyskills.Self-advocacyisaskillthatcanbelearnedthroughpracticeatdoctorvisits,applyingforemployment,relationshipsandatschool.ApersonwiththeCRSScredentialalwaysencouragespersonstoreachthenextstepinselfadvocacy.Self-advocacyisameanstoindependence,selfrespect,learningfrommistakes,andhavingsupportavailableispartoftheprocess.

LIFE SKILLSLifeskillsarethingswedoeverydaytobeabletoliveindependently.ApersonwiththeCRSScredentialhelpswhenapersonhasobstaclesintheirlifethatinhibitfulfillingdailyliving.Theyteachandmodellifeskillsfrombudgetingtopersonalhygienetoskillsusefulforcompetitiveemployment.CRSSprofessionalsprovidesupportandencouragementtoward independence.ThepersonwiththeCRSScredentialalsocreatesopportunitiesforpersonstoteachoneanotheraboutlifeskillsthroughprinciplesofadultlearning(below).

ADULT LEARNING PRINCIPLES AND TECHNIQUESEveryadulthasalargesetofvaluablelifeexperiences.Theylearnbydrawingupontheselifeexperiencesand building upon existing skills and perspectives.When CRSS professionals help individuals learn,theyarenotfixingdeficits,butassistingindividualstobuilduponthosestrengths.Theyrecognizeeachindividual’sability,notsimplytolearn,buttoteachothers.Inadultlearning,eachindividualcontributestothelearningprocess.ThepersonwiththeCRSScredentialcreatesopportunitiesforpersonstoteachoneanother.Adultlearningisallaboutshared,mutualteachingandlearning.

HEALTHY, INTERDEPENDENT RELATIONSHIPSHealthy,interdependentrelationshipsarebasedonmutualrespectandgenuineness.Inordertobetterunderstand the concept of interdependence, it helps to compare it to the ideas of dependence andindependence:

•Dependence: “Icannotdoitwithoutyou.”•Independence: “Icandoitonmyown.”•Interdependence: “Wecandoitbettertogether.”

Independentrelationships,onepersonprovidesallthesupportwhiletheotherreceives.Withindependence,onepersondoesitallwithoutsupport.Interdependentrelationshipsoccurwhentwopeopleparticipateinmutualgiveandtake.CRSSprofessionalshelppersonstobuildhealthy,interdependentsupportnetworksinthecommunity.

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ACTIVE LISTENING Active listening involves more than just hearing what a person is saying. It involves behaviors thatcommunicate to thespeaker that theyare trulybeingunderstoodor takenseriously.Active listeninginvolves:

Restating Repeateverysooftenwhatyouunderstandthepersontobecommunicating.

Encouraging Occasionallyusebrief,positiveaffirmationstokeeptheconversationgoing.

Reflecting Putthefeelingsyouperceivefromthespeakerintowords.

Giving Feedback Shareyourobservations,insights,andexperiencesinanonjudgmentalway.

Going Deeper Askquestionstodrawthepersonoutandgetdeeperandmoremeaningfulinformation,beingsensitivetotheperson’scomfortlevel.

Validation Acknowledgetheindividual’sproblems,issues,andfeelingsempathetically.

Silence Allowforcomfortablesilencestoslowdowntheexchange.Givethepersontimetothinkaswellastalk.Sometimeswhatapersonneedsmostisforsomeonetojustlistenandbefullypresent.

“I” Statements Makeitclearthatyouarespeakingfromyourperspectiveratherthandirectingthemorspeakingforthem

Source:2005NationalAgingI&RSupportCenter,Washington,DC

EMPATHETIC LISTENINGEmpathetic(orempathic)listeningislisteningformorethanspokenwords.Itinvolveslisteninginordertohearthesubstancebehindthewords,bothspokenandunspoken.Itistheprocessofconnectingwiththepersonwhoisspeakingandsensitivelyidentifyingtheemotionsandneedsexpressed.Wehaveallfelthappy,sadandangry.ApersonwiththeCRSScredentialmaysay,“Imighthavebeenangryifthathappenedtome.”Thisispartofthesharingprocess.Thisisdifferentfromsaying,“Iknowexactlyhowyoufeel.”Nooneknowsexactlyhowanotherpersonfeelsbecauseinordertoknowthatonewouldhavetohavelivedintheother’sshoes.Itisalsoimportanttodistinguishempathyfrompity.Feelingsorryforanotherpersoncancausethemtofeelresponsibleforthesupportperson’sfeelingsanddistractfromtheinteraction.Empathyisrelating,caringandvalidationofaperson’sfeelings.

DEMONSTRATING NON-JUDGMENTAL BEHAVIORAsapersonwiththeCRSScredential,itisimportanttofocusonanon-judgmentalapproachinmentoringothersintheirpersonalrecoveries.Personswithmentalhealthchallengesorsubstanceabusedisordershaveoftenfacedprejudicesordiscrimination.Theymayhaveenduredexperiencesthattheyaresensitiveaboutsharing.ThepersonwiththeCRSScredential’sresponsibilityisnottojudgepeoplebydisability,symptoms,beliefs,orbehaviors.Rather,theymeeteachpersonwheretheyareat,onedayatatime.Providingsupportbyactivelylisteninginanempathicmannerbuildshopeandesteem.Bydemonstratingnon-judgmentalbehavior,thepersonwiththeCRSScredentialdevelopstrustandanatmospherewherepersonscanfeelcomfortablesharing.

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DEMONSTRATING CONSISTENCY BY SUPPORTING PERSONS DURING ORDINARY AND EXTRAORDINARY TIMESThehereandnowispartofmeetingsomeonewheretheyareat.Byutilizingtheskillsabove,advocacy,professional responsibility, andmentoring a personwith the CRSS credential has the core functionsto provide professional competent and consistent services. Practicing personal wellness and beingabletosharewithindividualskeepsitreal.Itisimportantforthemtobeareliablepersonwhokeepsappointments,andfollowsthroughoncommitmentsto individuals. It isalso importanttodevelopanawarenessofwhenapersonneedsdifferentlevelsortypesofsupport.

PROMOTING THE USE OF ADVANCED DIRECTIVESAdvanceDirectiveswerediscussedpreviouslyinchapter2onAdvocacy.CRSSprofessionalsmayguidepersonsthroughcriticalthinkingexercisesaboutwhattheywouldincludeinanadvanceddirective.CRSSprofessionalsnevergivelegaladvice.Theyrespectthatanadvancedirectiveisonlyempoweringifthepersonwantstodeveloponeanddoessobasedontheirownpreferences.Ifapersonattemptstowriteorsteeranotherperson’sadvancedirective,thistoolcanbecomedisempowering.CRSSprofessionalsoffersupport,butfollowtheindividual’slead.CRSSprofessionalsknowhowtoreferanindividualtoEquipforEqualityorGuardianshipandAdvocacyformoreassistance(ConsumerandFamilyHandbookp.41-42).PersonsmaycalltheIllinoisMentalHealthCollaborativeat1(866)359-7953toorderahandbook.

Mentoring: Making It Real

Trevor has recently been struggling with co-occurring mental health and substance abuse challenges. He goes to one agency in the community that provides substance abuse counseling, but due to his mental illness, the agency refers him to a mental health center. At the mental health center, he is told that he needs to get his substance abuse disorder under control before they can help him cope with his depression. Trevor is frustrated and shares his feelings with a person with the CRSS credential.

1. Recall:NamethreewaysthepersonwiththeCRSScredentialcandemonstrateactivelisteningtoTrevor’sconcerns.

2. Comprehend:WritedownthreeexamplesofwhatyoumightsaytoTrevor,demonstratingactivelistening.

3. Apply:HowmightthisactivelisteningapproachleadTrevorandtheagenciestoasolutionandcontributetoTrevor’srecovery?

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CHAPTER 5: RECOVERY SUPPORT

TEN FUNDAMENTAL COMPONENTS OF RECOVERY In2005,theSubstanceAbuseandMentalHealthServicesAdministration(SAMHSA)releasedaNationalConsensusStatementwhichincludedthefollowingTenFundamentalComponentsofRecovery:

1)Mental Health Recovery:Ajourneyofhealingandtransformationenablingapersonwithamentalhealthproblemtoliveameaningfullifeinacommunityofhisorherchoicewhilestrivingtoachievehisorherfullpotential.

2)Self-Direction:Personslead,control,exercisechoiceover,anddeterminetheirownpathofrecoverybyoptimizingautonomy,independence,andcontrolofresourcestoachieveaself-determinedlife.Therecoveryprocessmustbeself-directedbytheindividual,whodefineshisorherownlifegoalsanddesignsauniquepathtowardsthosegoals.

3)Individualized and Person-Centered:Therearemanypathstorecoverybasedonanindividual’suniquestrengthsandresilienceandtheirneeds,preferences,experiences(includingtrauma),andculturalbackgroundinallofitsdiversity.Personsalsoidentifyrecoveryasajourney,endresultandaparadigmforachievingwellnessandoptimalmentalhealth.

4)Empowerment:Consumershavetheauthoritytochoosefromarangeofoptionsandtoparticipateinalldecisions—includingtheallocationofresources—thatwillaffecttheirlives,andareeducatedandsupportedinsodoing.Theyhavetheabilitytojoinwithotherconsumerstocollectivelyandeffectivelyspeak for themselvesabout their needs,wants, desires, andaspirations. Throughempowerment, anindividualgainscontrolofhisorherowndestinyandinfluencestheorganizationalandsocietalstructuresinhisorherlife.

5)Holistic:Recoveryencompassesaperson’swholelife,includingmind,body,spiritandcommunity.Recoveryembracesallaspectsoflife,includinghousing,employment,education,healthcaretreatmentand services, complementary and naturalistic services, addictions treatment, spirituality, creativity,socialnetworks,communityparticipation,andfamilysupportsasdeterminedbytheperson.Families,providers,organizations,systems,communities,andsocietyplaycrucialrolesincreatingandmaintainingopportunitiestoaccessthesesupports.

6)Non-Linear:Recoveryisnotastep-bystepprocessbutonebasedoncontinualgrowth,occasionalsetbacks,andlearningfromexperience.Recoverybeginswithaninitialstageofawarenessinwhichapersonrecognizesthatpositivechangeispossible.Thisawarenessenablestheconsumertomoveontofullyengageintheworkofrecovery.

7)Strengths-Based:Recoveryfocusesonvaluingandbuildingonthemultiplecapacities,resiliencies,talents,copingabilities,andinherentworthof individuals.Bybuildingonthesestrengths,consumersleave stymied life roles behindandengage in new life roles (e.g., partner, caregiver, friend, student,employee).Theprocessofrecoverymovesforwardthroughinteractionwithothersinsupportive,trust-basedrelationships.

8)Peer Support:Mutualsupport—includingthesharingofexperientialknowledgeandskillsandsociallearning—playsan invaluable role in recovery.Consumersencourageandengageotherconsumers inrecoveryandprovideeachotherwithasenseofbelonging,supportiverelationships,valuedroles,andcommunity.

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9)Responsibility: Consumershaveapersonal responsibility for their own self-careand journeys ofrecovery.Takingstepstowardstheirgoalsmayrequiregreatcourage.Consumersmuststrivetounderstandandgivemeaningtotheirexperiencesandidentifycopingstrategiesandhealingprocessestopromotetheirownwellness.

10)Hope:Recoveryprovidestheessentialandmotivatingmessageofabetterfuture—thatpeoplecananddoovercomethebarriersandobstaclesthatconfrontthem.Hopeisinternalized;butcanbefosteredbypeers,families,friends,providers,employersandothers.Hopeisthecatalystoftherecoveryprocess.Recoverynotonlybenefitsindividualswithdisabilitiesbyfocusingontheirabilitiestolive,work,learn,andfullyparticipateinoursociety,butalsoenrichesthetextureofAmericancommunitylife.Americareapsthebenefitsofthecontributionsindividualswithmentaldisabilitiescanmake,ultimatelybecomingastrongerandhealthiernation.

STRENGTHS BASED APPROACH TO RECOVERYIntheillnessbasedmodelofhealthcare,thefocusispredominantlyfixedonthediagnosisofanillnessand its accompanying symptoms. Treatment is targeted at reducing symptoms. A wellness-focusedapproachisstrengthbased.Itbeginswithanunderstandingofwhatapersonislikeattheirbestandwhatstrengthsandresources theyhave to recover theirwellness.Thewellness focused,orstrengthsbased,approachfacilitateshopeandhelpstomotivatethepersontotakeanactiveroleintherecoveryoftheirwellness.Sciencehasshownthathavinghopeplaysanintegralroleinanindividual’srecovery.

PROMOTING SELF DETERMINATION AND INDIVIDUAL CHOICE IN RECOVERYAs amentor and an advocate, the person with the CRSS credential supports individual choice andencouragesself-determination.Theycandiscussoptionsprovidedbytheindividualandencouragethemtoweighoptionsandsetpriorities.Thekeyistoprovidesupportandencouragementratherthandefinitiveanswers.Theindividual’sstoryistheirownpersonalrecoverystory.Theymustultimatelyhaveownershipoftheprocessforittolast.ThepersonwiththeCRSScredentialencouragestheindividualtoaccessallthequalityinformationtheyneedinordertomakegoodchoicesforthemselves.

ACTIVE AND EMPATHIC LISTENING SKILLSEachpersonhasauniquestoryandperspective.ApersonwiththeCRSScredentialneedstoreallylistento the storyandnot judge,dismiss, oradvise. Just listen.Please seeChapter4:Mentoring formoreinformationonactiveandempathiclisteningskills.

MOTIVATIONAL INTERVIEWINGApersonwiththeCRSScredentialmayuseMotivationalInterviewingtocreateapartnershipinthedecisionmakingprocess.Motivational Interviewing involvesconcreteskills thatcanbeeffective inmotivatingeffective positive changes that are empowering for the person. Essential elements of motivationalinterviewinginclude:

• Seekingtounderstandtheperson’sframeofreference,particularlyviareflectivelistening• Expressingacceptanceandaffirmation• Elicitingandselectivelyreinforcingtheindividual’sownselfmotivationalstatementsor

expressionsofproblemrecognition,concern,desireandintentiontochange,andabilitytochange

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• Monitoringtheindividual’sdegreeofreadinesstochange,andensuringthatresistanceisnotgeneratedbyjumpingaheadoftheindividual

• Affirmingtheindividual’sfreedomofchoiceandself-direction

Formoreinformation,visit:www.MotivationalInterview.org/Clinical/WhatIsMI.html

STAGES OF CHANGEThefollowinggraphicillustratesthestagesofchangewhenanindividualisconsideringanewwayofthinkingorapproachinlife,suchasrecovery.Itisimportanttoidentifywhereapersonisintheprocessinordertomeetthemwheretheyareatandhelpthemtomoveforward.Formoreinformation,visit:

www.SkillsCascade.com/Handouts/Stages%20of%20Change%20Model.rtf

STAGESOFCHANGE

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START Explore health belief and establish readiness for change.

Premature way out

Contemplation Reflect positive statements to enable person to reach a decision about change.

Active Change Give information. Provide choices for Action. Agree with target. Provide skills & support. Precontemplation

Feedback person’s views to instill awareness of problem (cognitive dissonance).

Relapse If person does not return, send further invitation. If person returns - explore difficulty with change and attitude.

Maintenance Provide appropriate follow-up, individual or group support. Consider community support network.

OPTIMAL RECOVERY Change consolidated.

STAGES OF RECOVERYBelow, you will find the five stages of recovery as defined by Appalachian Consulting Group, Inc. The person with the CRSS credential should be able to identify where a person is at in relation to the stages of change and recovery in order to meet them where they are at and provide the appropriate level of support.

There are other models for stages of recovery, particularly from co-occurring mental health and substance abuse disorders. The model above is the model that persons with the CRSS credential are expected to learn.

HELPING THE INDIVIDUAL TO DEVELOP PROBLEM SOLVING SKILLSWe all face problems and roadblocks in life. Problem solving skills are important toward empowering persons to find solutions that work for them at home, in the workplace and in the community at large. Problem solving involves independent or group thinking, rejecting misinformation and valuing good information. When supporting an individual’s problem solving process, the person with the CRSS credential may help the individual to:

• Define the goal

• Brainstorm ideas and suggestions, sometimes within an agreed upon time limit

• Combine ideas into groups

• List options in priority order

• Think of action steps and a time frame

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Appalachian Consulting Group

…shattering of one’s world, hopes and dreams.

Impact of Illness

OVERWHELMED

BY …

We both gave up.

Life is Limited

GIVEN into…

…the fragile flame of hope and courage.

Change is Possible

QUESTIONING…

...simple acts of courage

Commitment

to Change

CHALLENGING…

We rebuilt our lives…

Actions for Change

MOVING

BEYOND…

Five Stages in the Recovery Process

…The Disabling Power

Of Mental Illness:

Symptoms and Side Effects Stigma

Self-image

EXPLAIN THE TYPICAL PROCESS FOR ACCESSING MENTAL HEALTH SERVICESDHS/DMHfundedmentalhealthcentersofferawidevarietyofservices.Thebestfitofservicesisfoundwhen theperson’sgoalsandneedsare thebasis for clinical support. This takes teamwork.Personsshouldbeinformedabouttheserviceoptionsavailabletothemandhavechoiceswithintherangeofwhatismedicallyappropriate.Toaccessmentalhealthservices,anindividualmay:

•Workwiththeirmentalhealthcentertofindservicesthatfittheirneeds•Call:1 (866) 359-7953•TTY:1 (866) 880-4459•VisittheCollaborativewebsiteat:www.IllinoisMentalHealthCollaborative.com

-Clickon“For Consumers and Families.”-Clickon“Find a Mental Health Provider.”

Formoreinformation,pleaseseetheConsumerandFamilyHandbookpages21-23.YoumayobtainacopyofthehandbookbycallingtheIllinoisMentalHealthCollaborativeat1(866)359-7953.

WHEN TO REQUEST ASSISTANCE FROM OTHER PROFESSIONALS TO HELP MEET THE PERSON’S RECOVERY GOALSDifferent positions within each human services organization have different areas of expertise. It isimportanttoknowwhattypesofservicesarewithinthescopeoftheCRSSandwhicharenot.Specifically,CRSSprofessionalsproviderecoverysupport,advocacy,andmentoring.CRSSprofessionalsshouldnotgivemedicaladviceorclinicalguidanceunlesstheirrolewithintheorganizationdemandsit.PsychiatristsorSocialWorkers,forinstance,mayholdtheCRSScredentialandiftheirpositionisthatofaPsychiatristorSocialWorker,theyarefreetofunctionassuch.However,ifaperson’srolewithintheorganizationistoprovideCRSScorefunctions,thentheyshouldseekassistancefromotherprofessionalswhenserviceisneededoutsidethescopeoftheirfunctions.Examplesoftimestorequestassistancefromotherpositionsinclude:

•MentalHealthCrisis•MedicalAdvice•ClinicalSupport

Atthesametime,CRSSprofessionalsmayadvocatewiththeindividualorprovideconsultationtootherpositions.Similarly,PsychiatristsorSocialWorkersshouldconsultwithorseektheassistanceofapersonwiththeCRSScredentialwhenrecoverysupport,advocacy,ormentoringisneeded.

IDENTIFYING THE INDIVIDUAL’S STRENGTHS, RESILIENCIES AND CHALLENGES TO RECOVERYCRSSprofessionalsareuniquelyqualifiedtoempathicallyexplorestrengths,resilienciesandchallengesto recoverywithpersonsparticipating inservices.CRSSprofessionalsshouldget toknowpersonsaspersons first. They do not identify with persons or interpret persons’ behavior through the lens of adiagnosis,butthroughanunderstandingoftheindividualasacompletepersonwhohasadiagnosis.Over time,adiagnosiscanbecomeaperson’s identity,howeverCRSSprofessionals lookbeyond thelabelandhelppersonstoseethemselvesaswholepeople.

Thediagnosisandaccompanyingchallengesareoneaspectofeachperson’slife.Thesechallengesmustbeidentifiedandovercomeordealtwitheffectively,buttheyaretreatedinlightofthewholeperson,recognizingthatthepersonalsohasstrengthsandresiliencethatwillhelpthemtoliveafulfillinglifedespiteadisability.TheWellnessRecoveryActionPlan(WRAP)beginswithadescriptionoftheindividual

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at theirbest. It isoneof themosteffective tools for identifyingstrengths, resilienceandovercomingchallenges.A balancedknowledgeof the individual’s strengthsand challengesenables theCRSS tomeettheindividualwheretheyareatandprovideappropriatelevelsofsupport.

PROMOTING EMPOWERMENT THROUGH OPTIONS AND PARTICIPATING IN SHARED DECISION MAKINGOftentimes,individuals’choiceshavebeenlimitedtoultimatums.Theyhavebeenrequiredtochoosebetween the provider’s preferred option with accompanying support, and another option withoutprovidersupport.CRSSprofessionalsengageindividualsindiscoveringmoreoptionsinsuchsituationsandencourageotherproviders,whetherdoctors,employmentspecialistsorcasemanagers,toexpandoptions.

Inaddition,CRSSprofessionalsworktoassurethatindividualsareinvolvedinanydecisionintheircarethroughaprincipleknownasSharedDecisionMaking.Shareddecisionmakingengagespersonsandproviderstogetherin:

•SharedCommunication•SharedTrust•SharedExpertise•SharedAction

Shareddecisionmakingisbasedontheassumptionthattherearetwoexpertsinvolvedinthedecisionmakingprocess.Forexample inhealthcaredecisionmaking,doctorsareexperts inhowmedicationswork,whatevidencehasshowntobeeffectiveandreducingoreliminatingsideeffects.Personsareexpertsinknowingtheirownbodies,whathasworkedandnotworkedforthemintreatmentandwhattheirgoalsareinlife.Decisionsthatpersonsshouldbecomeinvolvedinwithhealthcareprofessionalsinclude:

•Goalsfortreatment•Thelevelandkindofserviceneeded•Medicationoptions•Plansforthefutureoftheirtreatment(whatmightbeneeded)•Whattheindividualanddoctor’srolesareinthesuccessofyourtreatment

Recovery Support: Making it Real

A person with the CRSS credential asks Jerome about his interest in returning to work as a part of his recovery process after many years away from the workforce. Jerome responds that he had been told that he would likely never work again due to his mental illness. “Isn’t work too stressful for persons with mental illnesses?” Jerome asks. The person with the CRSS attempts to understand where among the stages of change Jerome currently is in relation to the idea of employment in order to respond in the most supportive way.

1. Recall:Namethefivestagesofchange.

2. Comprehend:WhichstageofchangedoesJeromeseemtobeatcurrentlyrelatedtotheroleofworkinhisrecovery?

3. Apply:WhatmightthepersonwiththeCRSSdotohelpJeromeprogresstothenextstageofchange?AtwhatpointwoulditbemostappropriatetohelpJeromebeginajobsearch?

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CHAPTER 6: WELLNESS RECOVERY ACTION PLAN (WRAP)

AWRAPcanhelpyouintheprocessofrecovery,gettingwellandstayingwell,andbecomingwhoyouwant tobe. Itcanhelpyoumakeyour life thewayyouwant it tobe. Itcanalsobehelpful toyou inadaptingtoanychallengesyouhaveinyourlife.

AWRAPisaself-directedplananyonecanuseasapersonalguidetodailyliving.Itfocusesonself-help,recovery,andlong-termstability.PersonsinrecoverycreatedWRAP.

AWRAPbeginswithanindividualWellnessToolbox,filledwithsimple,safeideastohelpyoufeelgood,staywell,andevenfeelbetterwhenthegoingishard.HerearesomeideasthatothershaveputintheirWellnessToolboxes:

Family time - Scrap-booking - Walking Martial arts - Journaling - Prayer - Poetry

Quilting - Basketball - Calling a friend

Usingthesewellnesstools,aWRAPcanalsoguideyouthroughaprocessofidentifying:

• Whatyouarelikeatyourbest;

• Whatyouneedtodoeverydaytostaywell;

• Thingsthatmayupsetyou(triggers)andwhatyoucandoifthesethingshappen;

• Earlywarningsignsthatyouarenotfeelingwellandthingsyoucandotohelpyourselffeelbetter;

• Signsthatthingsaregettingworseandthingsyoucandotomakethesituationbetter;

• Signsthatyoumaybeexperiencingacrisisandthingsyoursupporterscandointhatsituation;and

• Whattodoafteracrisishasendedtohelpyourecoveryourwellness.

TheWRAP Workbook for Kidscanhelptoguidechildrenthroughthisprocessaswell.ItisimportanttonotethatWRAPisdifferentfrom“Wrap-Around,”whichisamentalhealthsystemsapproachtosupportingchildrenthatmanyfamiliesarefamiliarwith.

AllaspectsofparticipationinWRAParevoluntary.Formoreinformation,visit:

www.MentalHealthRecovery.com

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CHAPTER 7: EVIDENCE BASED PRACTICES

Evidence-BasedPractices(EBPs)arestate-of-the-arttechniquesthatresearchhasshowntobeeffective.A person working with health care professionals to follow a course of treatment based upon EBPscanexpect tomakesignificantprogress toward their treatmentgoals.EBPscombine research-basedinformation, clinical expertise, and theperson’s ownneedsand values towork toward recovery. ThefollowingEBPshavebeenidentifiedbytheSubstanceAbuseandMentalHealthServicesAdministration(SAMHSA) for the treatmentofpersonswithmental illnesses.Accordingly,SAMHSAhasdevelopedasetoftoolkitsforusebyhumanservicecenterstoimplementthesepracticesandimproveservicestoindividuals.AdditionalEBPsarebeingstudiedand thebodyof research iseverexpanding.Formoreinformationortoreviewthetoolkits,gotowww.MentalHealth.SAMHSA.gov/CMHS/CommunitySupport/Toolkits.

Assertive Community Treatment (ACT) programs employ a dynamic team approach to treatmentof persons with especially severe mental illnesses, who have experiencedmultiple hospitalizations,emergencyroomepisodes,homelessness,and,perhaps,timeinjail.Theteamsaremadeupofspecialistsincludingadoctor,nurse,socialworker,substanceabusespecialist,employmentspecialist,andapersonwiththeCRSScredential.ACTteamsmostoftenworkincommunitysettingsotherthanahumanservicecenter.Thispersonalizedtreatmentisflexibleandtailoredtoeachperson’sneeds,strengths,culture,andcommunity.ACThasbeenshowntoreduceemergencies,hospitalstays,andtheneedforanongoingrelianceonmentalhealthserviceproviders.

Illness Management and Recovery (IMR)isanEvidence-BasedPracticeinwhichpersonsmeetweeklywith human service workers to develop personal strategies for promoting wellness in the presenceofsymptomsinorderto livefuller lives.Thisservicehelpspersonsreducerelapses,copewithstress,navigatethementalhealthsystem,andusemedicationeffectively.

Integrated Dual Diagnosis Treatment (IDDT) supports the recovery process of individuals whohavebothseriousmentalillnessesandsubstanceabuseproblems.Thisserviceisprovidedbyamulti-disciplinary teamofspecially trainedmentalhealthstaffwhoprovide individualizedservicessuchascasemanagement,counseling,andeducation.TheIDDTteamalsousesotherEvidence-BasedPracticestocreateandprovideonecomprehensiveandseamlessservice.Bytakingadvantageofanapproachthatintegratesmentalhealthandsubstanceabusetreatment,manypeoplewiththesetwodisordersareabletorecoverandlivefullandmeaningfulliveswiththeirfriendsandfamilies.

Family Psychoeducation Programshelpfamiliesandfriendsofpersonsexperiencingmentalillnessesorcombinedmental illnessandsubstanceabuseunderstandhow tocopeandhelp their lovedonesrecover.Evidenceshowsthatthereisanincreasedlikelihoodofrecoverywhenapersonreceivesinformedandintegratedsupportfromfamilyandclosefriends.InthisEvidence-BasedPractice,aperson’sfamily(asdefinedbytheperson)meetswithhisorhermentalhealthprofessionalindividuallyoringroups,andlearnsaboutmentalillnessesandwaystomovetowardrecovery.

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Individual Placement and Support (IPS) programsare consistentwith researchwhich shows thatbeingeffectivelyemployedcanbeanimportantpartoftreatment.SupportiveEmploymentProgramshelpinterestedpersonsfindworkbasedontheirpreferencesandabilities.Personswhochoosetoseekemploymentreceivethesupportstheyneedforaslongastheymayneedthem.Thesesupportsmayincludehelpwith interviews,benefitsplanning,routinesandschedules,workrelationships,managingand learning from job loss,andfindingabetter jobfit.Employmentspecialistsworkona teamwithotherhumanserviceprofessionalstohelpensurethattreatmentandemploymentareusedtopromoterecovery.

Medication Algorithms combine scientific evidence and individualized attention to help personsmanagemental healthmedications. Through closemonitoring, careful documentation, andanalysis,medicalprofessionalshelppersonsmakethebestpossibledecisionsabouttheiruseofmedicationandhowitfitsintotheirrecoveryprogram.

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CHAPTER 8: INDIVIDUAL PLACEMENT AND SUPPORT (IPS) GUIDELINES

Workingisavitalaspectofrecovery.CRSSprofessionalsencourageindividuals’desiretoworkandattaintheirgoalsinlife.Returningtoworkrequiresablendofpersonalresponsibilityandsupportfromothers.IndividualPlacementandSupport(IPS)isarecoveryorientedapproachtosupportedemploymentthatisbasedonwhatevidencehasshowntobemosteffective.IPSisbasedonsevenprinciples:

• Eligibility is based on individual choice.Nooneisexcludedwhowantstoparticipate.Symptoms,historyofhospitalization,currentaddictionsissues,etc.arenotareasontoexcludepersonsfromemploymentservices.Theirmotivationtobeemployedisthekeytoaccessingemploymentservices.

• Supported employment is integrated with treatment.EmploymentSpecialistscoordinatetheindividual’semploymentplanswiththeirtreatmentteam:thecasemanager,therapist,psychiatrist,etc.

• Competitive employment is the goal.Thefocusiscommunityjobsanyonecanapplyforthatpayatleastminimumwage,includingpart-timeandfull-timejobs.

• Job search starts soon after a person expresses interest in working.Therearenorequirementsforcompletingextensivepre-employmentassessmentandtraining,orintermediateworkexperiences(likeprevocationalworkunits,transitionalemployment,orshelteredworkshops).Eachindividualwillworkwiththeiremploymentspecialisttoevaluateemploymentinterestsandabilitieswhilelookingforemploymentinthecommunity;astheyprogressthroughsubmittingapplications,participatingininterviewsandsecuringandmaintainingemployment.

• Follow-along supports are continuous.Individualizedsupportstomaintainemploymentcontinueaslongaspersonswanttheassistance.Thesesupportsareavailableforanaverageoftwelvemonths.However,themostimportantaspectoffollowalongsupportsisencouragingthedevelopmentofnaturalsupportsforemployment.Thisisaccomplishedbyworkingtogethertodeveloppeer,co-workerandfamilyand/orsignificantothersinprovidingsupportandencouragementforemploymentsuccess.

• Individual preferences are important.Choicesanddecisionsaboutworkandsupportareindividualizedbasedontheperson’sstatedpreferences,strengths,andexperiences.

• Benefits Planning is available.Individualshavetherighttoknowhowearningswillaffecttheirpublicbenefitsandhowtheycanprotectthosebenefits.

Formore informationonbenefitsplanning, contact theWork IncentiveandPlanningandAssistanceProgram:

• Call1 (800) 807-6962

• TTY1 (866) 444-8013

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CHAPTER 9: CO-OCCURRING MENTAL ILLNESS AND SUBSTANCE ABUSE (MISA)

Co-occurringdisordersaretobeexpectedinallbehavioralhealthsettings.Servicesforpersonswithco-occurringdisordersmustbeintegrated.CRSSprofessionalspromotea“nowrongdoorapproach”meaningthatnomatterwhatprogramapersonenterstoreceivetreatment,theycanbelinkedcourteouslywiththeprogramorblendofprogramsthatmeettheirtreatmentneeds.CRSSprofessionalsmodelempathy,respectandbelief in individuals’abilitiestorecover.Theyprovideperspectiveonhowthecommunitycanbea resource to individualswith co-occurringdisorders andhowpersons cangiveback to theircommunities.

Co-Occurring Disorders (COD):Thetermoftenusedtorefertoco-occurringsubstance-relatedandmentalhealthchallenges.PersonssaidtohaveCODhaveoneormoresubstance-relateddisorderaswellasoneormorementalhealthdiagnosis.TheseconditionsmayalsobereferredtoasDualDiagnosis.

Integrated Interventions:IntegratedinterventionsarespecifictreatmentstrategiesortherapeutictechniquesinwhichinterventionsforallCODdiagnosesorsymptoms(ifoneisusingabroaddefinitionofCOD)arecombinedinasinglecontactorinaseriesofcontactsovertime.Thesecanbeacuteinterventionstoestablishsafety,aswellasongoingeffortstofosterrecovery.

Whenpersonswithco-occurringmentalillnessesandsubstanceabuseareinrecovery,itisimpliedthattheyareabstinentfromthesubstancecausingimpairmentandareabletoparticipateinlifeactivitiesthataremeaningfulandfulfillingtothem.AccordingtoLowinson,recoveryfromco-occurringconditionsconsistsof:

•Gaininginformation

•Increasingself-awareness

•Developingskillsforsoberliving

•Followingaprogramofchange

PersonswiththeCRSScredentialmaygainuniqueinsightsfromthebookWRAP for People with Dual Diagnosis.Thecontentofthisbookisbasedonwhatpersonswithco-occurringdiagnoseshavefoundtobehelpfultotheirrecoveries.

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CHAPTER 10: ADDITIONAL RESOURCES

Applied Suicide Intervention Skills Training (ASIST)www.LivingWorks.net

Bodily Harm: The Breakthrough Healing Program for Self-Injurers 1998–KarenContario,WendyLaderandJenniferKingsonBloom Hyperion

Challenging Stereotypes: An Action Guide2001–JeanArnoldandNoraWeinerthSubstanceAbuseandMentalHealthServicesAdministration

Community Links: Pathways to Reconnection and Recovery – Program Implementation Manual 2006–MaryEllenCopelandandSheryMead PeachPress

“Consumer Operated Services” Toolkit2004–SystemsOperatingtoAchieveRecovery(SOAR);CommunityMentalHealth&RecoveryBoardofLicking&KnoxCounties;OhioDepartmentofMentalHealth

Dartmouth Psychiatric Research Center: Dual Diagnosis, Supported Employmentwww.Dartmouth.edu/prc

Depression and Bipolar Support Alliance (DBSA) www.DBSAlliance.org

Equip for Equalitywww.EquipforEquality.org

“Establishing a Recovery System” Toolkit2004–SystemsOperatingtoAchieveRecovery(SOAR);CommunityMentalHealth&RecoveryBoardofLicking&KnoxCounties;OhioDepartmentofMentalHealth

Free to Choose: Transforming Behavioral Health Care to Self-Direction: Report of the 2004 Consumer Direction Initiative Summit

2004-SubstanceAbuseandMentalHealthServicesAdministration,U.S.DepartmentofHealthandHumanServicesRockville,MD

Harm Reduction Guide to Coming Off Psychiatric Drugs 2007–TheIcarusProjectandFreedomCenter

Illinois Co-Occurring Center for Excellencewww.IllinoisCOCE.org

Illinois Department of Human Services www.DHS.State.IL.US

Illinois Guardianship and Advocacy Commissionwww.GAC.State.IL.US

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Managing Workplace Conflict: A Skills Training Workbook for Mental Health Consumers and Supervisors

1997–NationalResearchandTrainingCenteronPsychiatricDisability;UniversityofIllinoisatChicago

Mental Health and Development Disabilities Code [405 ILCS 5]2002-IllinoisDepartmentofHumanServices

Mental Health and Development Disabilities Confidentiality Act [740 ILCS 110]2002-IllinoisDepartmentofHumanServices

Mental Health Recovery: What Helps and What Hinders? A National Research Project for the Development of Recovery Facilitating System Performance Indicators

2002–NationalTechnicalAssistanceCenterforStateMentalHealthPlanning;NationalAssociationofStateMentalHealthProgramDirectorsAlexandria,VA

Motivational Interviewing: Preparing People to Change Addictive Behavior1991–WilliamR.MillerandStephenRollnickGuilfordPress

National Alliance on Mental Illness (NAMI) Star Center www.ConsumerStar.org

National Consumer Supporter Technical Assistance Center www.NCSTAC.org

National Empowerment Centerwww.Power2U.org

National Institutes of Health/National Institute on Drug Abusewww.NIDA.NIH.gov

National Mental Health Consumers’ Self-Help Clearinghouse www.MHSselfHelp.org

New Freedom Commission on Mental Health, Achieving the Promise: Transforming Mental Health Care in America, Final Report

2003-SubstanceAbuseandMentalHealthServicesAdministration,U.S.DepartmentofHealthandHumanServices

Rockville,MD

Panic Attacks Workbook: A Guided Program for Beating the Panic Trick 2004–DavidCarbonell UlyssesPress

Pathways to Recovery: A Strengths Recovery Self-Help Workbook 2002–PriscillaRidgway,DianeMcDiarmid,LoriDavidson,JulieBayesandOthers UniversityofKansas,SchoolofSocialWelfare,OfficeofMentalHealthResearch&Training

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Positive Partnerships: How Consumers and Non-Consumers Can Work Together as Service Providers

1998–NationalResearchandTrainingCenteronPsychiatricDisability;UniversityofIllinoisatChicago

Question Persuade Refer (QPR) Institute: Suicide Prevention

www.QPRInstitute.com

National Alliance on Mental Illness (NAMI) Star Center www.ConsumerStar.org

National Consumer Supporter Technical Assistance Center www.NCSTAC.org

Recovering from Depression: A Workbook for Teens (Revised Edition) – 2002–MaryEllenCopelandandStuartCopans PaulH.BrookesPublishingCo.

Recovery Services Development Resource Handbook www.DHS.State.IL.US/MHDD/MH/pdf/RSD%20Resource%20Handbook.pdf

Shock: The Healing Power of Electroconvulsive Therapy2006–KittyDukakisandLarryTye PenguinBooks,Ltd.

Substance Abuse and Mental Health Services Administration (SAMHSA) www.SAMHSA.gov

Substance Abuse and Mental Health Services Administration (SAMHSA): Co-Occurring Center for Excellence www.COCE.SAMHSA.gov

Transforming Mental Health Care in America. The Federal Action Agenda: First Steps - 2005–SubstanceAbuseandMentalHealthServicesAdministration,U.S.DepartmentofHealthandHumanServices

Rockville,MD

Voices of Transformation: Developing Recovery-Based Statewide Consumer/Survivor Organizations (Second Edition) 2007-NationalEmpowermentCenterandtheRecoveryConsortium Lawrence,MA

Wellness Recovery Action Plan 1997,revised2002–MaryEllenCopeland PeachPress

Wellness Recovery Action Plan & Peer Support: Personal, Group and Program Development 2004–MaryEllenCopelandandSheryMead PeachPress

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Winning Against Relapse: A Workbook of Action Plans for Recurring Health and Emotional Problems 1999–MaryEllenCopeland PeachPress

Work as a Priority: A Resource for Employing People who Have a Serious Mental Illness and who are Homeless

2003–G.Shaheen,F.Williams,andD.DennisSubstanceAbuseandMentalHealthServicesAdministration.

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