MHCD Hope Study MHCD Hope Study and Initiativeand Initiative

Jay Flynn, Kristi Mock, Roy StarksJay Flynn, Kristi Mock, Roy Starks

Kate DeRoche and Antonio Olmos-GalloKate DeRoche and Antonio Olmos-Gallo

Why Hope? Why Hope? • We believe in Recovery

• People in Recovery Tell Us It’s Important

• It is one of the 10 fundamental components of recovery

• Hope is the gateway to recovery

• We wanted to try and promote greater hopefulness and therefore greater recovery

• Hope is passion for what is possible.~Soren Kierkegaard

• Hope is a waking dream.~Aristotle

• We must accept finite disappointment, but we must never lose infinite hope.~Martin Luther King, Jr.

• Once you choose hope, anything’s possible.~Christopher Reeves

What did we actually do?What did we actually do?•We invited input on how to promote hope We invited input on how to promote hope •We created a training using the input We created a training using the input •We asked each participating clinician to select two We asked each participating clinician to select two consumers who would benefit from the hope related ideasconsumers who would benefit from the hope related ideas•Clinicians used the information from the training to Clinicians used the information from the training to promote hopefulness during interactions with the promote hopefulness during interactions with the consumersconsumers•Consumers and clinicians participated in completing two Consumers and clinicians participated in completing two measurement instruments over six monthsmeasurement instruments over six months•Evaluation processEvaluation process

TrainingTraining“Elements of Hope”“Elements of Hope”

• Having obtainable goals• Positive anticipation for the future• Seeing the possibilities in life• Believing that things will improve• Ability to accept and be

comfortable with change

TrainingTraining“Characteristics of a Hopeful Person”“Characteristics of a Hopeful Person”

•Has goals and is motivatedHas goals and is motivated

•Is able to see options and possibilitiesIs able to see options and possibilities

•Is forward thinkingIs forward thinking

•Is connected to society and supportsIs connected to society and supports

•Sees him/herself as capableSees him/herself as capable

•Bounces back from adversity – is resilientBounces back from adversity – is resilient

TrainingTraining“Hopebusters”“Hopebusters”

• Pushing people to do what you want

• Focusing on the negative

• Giving up on people

• Treating the person like they need to be fixed

• Saying “no” “you can’t” “never” “impossible” “I told you so”

TrainingTraining“Imparting Hope”“Imparting Hope”

• Talking about goals and hope

• Being welcoming and friendly

• Recognizing strengths

• Validating the challenge of changing

• Giving positive feedback

• Providing on-going support

Fostering or Instilling Hope:Fostering or Instilling Hope: A Four Step Process A Four Step Process

Dr. Kenneth Minkoff, MD

#1 -Empathize with the reality of #1 -Empathize with the reality of despairdespair

• A decent and safe place to live

• A walk down the street without fear/panic

• Connection with family & friends – love & pride

• Meaningful activities

• A peaceful mind

#2 -Establish the legitimacy of the #2 -Establish the legitimacy of the need to ASK for extensive helpneed to ASK for extensive help

• It is really hard to ask for help for even little things – what must it feel like to ask for lots of help or assistance?

• “You deserve to get some help or assistance for what you need”

#3-Identify meaningful, attainable #3-Identify meaningful, attainable measures of successful progress.measures of successful progress.

• Don’t expect too much too soon

• Three strikes and you’re out doesn’t work

• The right amount of assistance for the right amount of time

• Hanging in through the hard times is even more important than the good times

#4-Emphasize a hopeful vision of #4-Emphasize a hopeful vision of pride and dignity to counter self-pride and dignity to counter self-

stigmatization.stigmatization.

• Give credit for surviving great and difficult things

• You have met and overcome challenges and you can continue to do that

• You are as good or better than everyone on this planet

Hopeful TherapyHopeful Therapy

• (Lopez et at., 2000)

• Integration of solution focused, narrative, and cognitive behavioral interventions comprised of two stages:

1. Instilling Hope

2. Increasing Hope

Hope FindingHope Finding

• Help consumers find the hope they already possess and have experience in their lives.

• Explore how consumers hope has developed, diminished or stagnated.

• Highlight consumers hopeful attitudes and accomplishments.

Hope RemindingHope Reminding

• The purposeful search for and recollection of previous successful interventions.

• Reviewing hopeful experiences.

• Reviewing and emphasizing hopeful statements.

• Searching for silver linings.

Instilling hope changes the flow of our Instilling hope changes the flow of our languagelanguage

• “…The flow is geared more towards listening than directing; more toward inspiring than controlling; more about choices and options than direction and coercion; more about recovery than stabilization. Language and attitude are keys to making this shift successful.”

William A. Anthony

The 6 Month Study PartThe 6 Month Study Part

We used the Herth Hope Index (Kay Herth)

• I have a positive outlook toward life• I have short and or long range goals• I feel all alone• I can see possibilities in the midst of difficulties• I feel scared about my future

(Four point scale answers ranging from strongly agree to strongly disagree)

The 6 Month Study PartThe 6 Month Study Part

We used MHCD’s Consumer Recovery Measures (CRM)

• I have hope for the future• I have feelings that things are going to be just

fine• Recently my life has been meaningful

Seven point scale ranging from “worse than ever to better than ever”

The 6 Month Study PartThe 6 Month Study Part

• Consumers and clinicians completed Herth Hope Index pre training and at two month intervals post training (3 times)

• Consumers completed the CRM’s at two month intervals (3 times)

• Initial data was collected on 169 clinicians and 280 consumers and analysis done using 153 consumers with appropriate data points.

The Study PartThe Study Part

Some preliminary indications:• At the pre-test phase, clinicians were more

hopeful than the consumers • At post test, consumer hopefulness had

increased in two areas: hope for the future and interconnectedness.

• Having hope about the future may be easier than being hopeful in the present.

• As hope increases, the awareness and experience of symptoms gets worse.

What Can You Do?What Can You Do?

• What are three things that you can commit to doing to increase someone’s hope when you leave this training?