Illness Management and Recovery

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Acknowledgements

This presentation is based on the work of Dr. Kim Mueser and Susan Gingerich, co-authors of the Illness Management and Recovery Toolkit;

The Illness Management and Recovery Practitioners Workbook, US Department of Human Services;

“Philosophy of Rehabilitation” by Al Condeluci Ph.D

and Marty McMurrow, MS, CBIS Training Manual

And the training and mentoring offered by Anastasia Cyptar, Quality Assurance Director for People Incorporated

Overview Importance of understanding the

entire person

Traditional goals of brain injury rehabilitation

How an Illness Management and Recovery Program works

Review of Educational Modules of IMR

Implications for future practice

Recovery from brain injury involves healing the entire person

PhysicallySociallyVocationallyEmotionallyCognitively Spiritually

IMR works with the psychosocial components of brain injury

Anxiety and Depression

Substance Abuse that predates or is a consequence of brain injury

Ongoing mental health symptoms that are a consequence of brain injury

Goals of Brain Injury Rehabilitation

Independence – this contrasts with dependence, focuses on people accomplishing tasks by and for themselves

Interdependence – This paradigm focuses on importance of partnerships between individuals that benefit both parties

(Condeluci 1991)

Independence and Interdependence

INDEPENDENCE INTERDEPENDENCE

Goals of Brain Injury Rehabilitation

Integration – this contrasts with segregation, it involves participation in society, but can focus on bringing the behavior and appearance of people with disabilities more in line with community norms

Inclusion – the inclusion of all people into the community; society creates supports that fit the person; includes curb cuts

Integration and Inclusion

INTEGRATION INCLUSION

Goals of Brain Injury Rehabilitation

Self Determination – the practice of individuals with disabilities making important decisions in their lives

Productivity – the value of work or study in peoples lives and receiving appropriate wages for that work

Self Determination and Productivity

SELF DETERMINATION PRODUCTIVITY

Recovery for Individuals with Mental Illness

Recovery is both a process and an outcome of learning to have a meaningful life

Recovery involves having hope, expectations, respect, well-being, and confidence

Background of IMR Practice

Illness Management and Recovery is one of the six evidence based practices used in mental health rehabilitation today

The concepts in IMR are based on the results of extensive research on effective psychosocial rehabilitation techniques and programs

Components of Illness Management and Recovery

Programs Psychoeducation

Medication education

Illness relapse prevention

Coping skills training

Social skills training

Illness Management and Recovery Educational Process

Individual sessions or small groups

Standard format for all sessions

Homework based on recovery goals

Motivational interviewing, behavioral shaping, positive reinforcement

Repetition for better learning

How do individuals succeed in growing their vision of recovery into a new reality?

IMR Recovery Skills Summary

Learning to cope with stress

Building Social Support

Developing a Relapse Prevention Plan

Using Medication Effectively

Learning to cope with mental health symptoms

Getting needs met in the mental health system

Creating a Vision of Life in Recovery

When choosing a recovery goal IMR participants are asked

What do you want your world to look like?

Setting Recovery Goals

Recovery goals can be any size from“I want a cat” or “I want to run a business”

Respect each person’s priorities

Make the vision real – use all senses

Create a visible image of what recovery means by making a drawing or in putting it in writing

UnderstandingSigns and Symptoms of Mental Illness

Understanding Mental Illness

Offering a message of hope and recovery to all individuals with mental illness

Basic Facts on Depression, Bipolar Disorder, Schizophrenia

Identifying personal beliefs about mental illness

Challenging stigma and misconceptions about mental illness

Stress Vulnerability Model of Mental Illness

Stress Vulnerability Model

Both stress and biology contribute to the symptoms of mental illness

How stress can affect the symptoms of mental illness

Strategies for reducing biological vulnerability to relapse of mental illness symptoms

Building Social Support

Building Social Support

Self assessment of level of social support and personal desire for change

Opportunities for finding support

Training in initiating connections and maintaining friendships

Recovery Approaches to Drug and Alcohol Use

Drug and Alcohol Use

Why people use controlled substances – social needs, symptom management

Self Assessment – what substances people use and what function it has in their lives

Pros and Cons – concept of harm reduction

Personal decision and resources for change

Reducing relapses and mental health hospitalizations

Avoiding Symptom Relapse

“Mental Illness is for many a chronic, relapsing and remitting condition”

Education about triggers and warning signs

Self assessment and personal relapse prevention plan

Personal recovery choices and resources for change

Using Medication Effectively

Using Medications Effectively

Self assessment of beliefs about medication

Personal experiences with medication

Education about types of medications

Pros and cons of using medication

Personal medication plan

Strategies for taking medication consistently

Managing Stress

Understanding Stress

Understanding the signs and symptoms of stress and relationship of stress to mental health symptoms

Self assessment of level of stress

Education about the sources of short and long term stress

Personal stress management strategies

Coping with ongoing symptoms or problems

Coping with Problems and Persistent Symptoms

Skill training on solving problems

Self Assessment of ongoing mental health symptoms

Skill training using problem solving to manage ongoing mental health symptoms or behaviors

Living a Life in Recovery requires

KnowledgeCoping skillsEffective medical careSocial SupportLife with Hope

Final Thoughts on Facilitating Recovery

Illness Management and Recovery practices provide a useful addition to rehabilitation strategies for the mental health components of brain injury

Adding Recovery to the basic values of brain injury rehabilitation will bring more hope and meaning to the lives of people we serve