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There are three parts to this study of Mental Health Recovery. They are: 1. Key recovery concepts and issues that need attention. Hope Personal responsibility Education Self-advocacy Support Getting good health care Medication management 2
2. Wellness Toolbox 3. Wellness Recovery Action Planning 4. Recovery Topics: Building self esteem Changing negative thoughts to positive ones Peer support Work related issues Dealing with trauma Suicide prevention Additional issues 3
This workshop, and the concepts, skills and strategies you learn in this workshop, are complementary to your health care treatment program. They are not a replacement for your treatment program. Never stop taking medications without careful consideration and without getting the advice of your physician and other supporters. Never abruptly stop any medication. There are protocols which must be followed for safely stopping or changing medications. 4
Hope Personal Responsibility Education Self-Advocacy Support 5
If you experience disturbing emotional symptoms and behaviors, you can get well and stay well for long periods of time. You can work toward and meet your goals. You can lead a happy and productive life. You don't need, nor will you benefit from, dire predictions about your future. Your supporters and care providers should encourage you, help you to feel better, and assist and support you in staying well. 6
8 You are the expert on yourself. You know what you need and want. It is up to you to take personal responsibility for your own wellness and your own life. Sometimes this means taking back control that you have lost in the past. Those of us who take back this control and accept this responsibility achieve the highest levels of wellness, happiness, and life satisfaction. 7
Learn all you can about yourself so you can make good decisions about your : Treatment Lifestyle Career Relationships Living space Leisure time activities And all aspects of your life. 98
You can educate yourself by: Attending workshops, lectures and support groups Reviewing educational resources (articles, books, newsletters, audio and video tapes) Checking mental health sites on the Internet Contacting mental health organizations Talking to others who have similar experiences and those who have expertise in this field 9
www.mentalhealthrecovery.com has educational articles and lists of resources and organizations that may be helpful to you. You can get free booklets on mental health recovery from the Knowledge Exchange Network at 1-800-789-2647 or www.mentallhealth.org 10
You can become an effective advocate for yourself by: Believing in yourself Knowing your rights and insisting that they are respected (see following Bill of Rights) Setting personal goals and working toward meeting them by: - Getting the facts, - Planning your strategy, - Gathering support, - Targeting your efforts. Self-advocacy means... Going for it with courage, persistence, and determination; expressing yourself clearly and calmly until you get what you need for yourself. 11
1) I have the right to ask for what I want. 2) I have the right to say no to requests or demands I can t meet. 3) I have the right to change my mind. 4) I have the right to make mistakes and not have to be perfect. 5) I have the right to follow my own values and standards. 6) I have the right to express all of my feelings, both positive and negative, in a manner that will not harm others. 7) I have the right to say no to anything when I feel I m not ready, it is unsafe, or it violates my values. 8) I have the right to determine my own priorities. Continued 12
9) I have the right not to be responsible for others behavior, actions, feelings or problems. 10) I have the right to expect honesty from others. 11) I have the right to feel angry and to express this in a responsible manner. 12) I have the right to be uniquely myself. 13) I have the right to feel scared and say I m afraid. 14) I have the right to say I don t know. 15) I have the right to make decisions based on my feelings, beliefs and values. 16) I have the right to my own reality. 17) I have the right to my own needs for personal space and time. 18) I have the right to be playful and frivolous. 19) I have the right to be healthy. 20) I have the right to be in a non-abusive environment. Continued 13
19) I have the right to make friends and be comfortable around people. 20) I have the right to change and grow. 21) I have the right to have my needs and wants respected by others. 22) I have the right to be treated with dignity and respect. 23) I have the right to grieve. 24) I have the right to a fulfilling sex life. 25) I have the right to be happy. (Adapted from the Anxiety and Phobia Workbook, Edmund J. Bourne, PhD., New Harbinger Publications, Oakland, CA, 1990.) 14
Support from family, friends and care providers is essential. Being effectively supported will help you feel better. You will benefit from having at least five good friends or supporters you can call on when you need or want: Someone to talk to Companionship To have a good time Help in figuring things out and making decisions Someone to take over for you and keep you safe when you can t do it for yourself 15
Care about you Empathize with you Affirm and validate you and your experience Accept you as you are Listen to you and share with you Advocate for you Enjoy sharing fun and interesting activities with you Can make decisions and take action for you when you can t do this for yourself Are willing to follow your predetermined plans 16
1. Become an active member of a support group. Support groups provide an opportunity to be with people who have similar problems people people who understand and can be mutually supportive. They are a wonderful place to make new and lasting friendships. They counteract social isolation. 23
2. Participate in community activities, special interest groups or church groups. The hardest part is going g the first time. Give yourself a pat on the back or some reward for getting there. If you see the same person several times, you might suggest an activity of interest to both of you. If you enjoy being with this person, and they are willing, you could get together again. It may become a friendship. Check your newspaper and listen to the radio for announcements of activities and events which interest you. 25
3. Volunteer! Find a worthy organization that needs help and lend a hand. It s an excellent way to meet new people while doing something nice for someone else and building your selfesteem. Many communities have an organization that coordinates volunteer opportunities. 26
4. Keep in touch with friends and acquaintances. Get together for fun activities like movies, walks and ball games. Make regular phone calls, send notes and cards. Help them out whenever you can. Always have a time scheduled for your next get together. 27
5. Make mutual support a high priority! Be there for others as much as they are there for you. If your supporters are not asking as much of you as you are asking of them, treat them to lunch or some other fun activity, it or do them a needed d favor. 28
Wellness Toolbox Daily Maintenance Plan Identifying Triggers and an Action Plan Identifying Early Warning Signs and an Action Plan Signs that Things Are Breaking Down and an Action Plan Crisis Planning Post Crisis Planning 2
was developed by a group of people who had been dealing with difficult feelings and behaviors for many years, people working to feel better and get on with their lives. WRAP will: 1. Help you stay as well as possible 2. Help you keep track of difficult feelings and behaviors, and develop action plans to help you feel better. 3. Tell others what to do for you when you are feeling so badly that you can t make decisions, take care of yourself and keep yourself safe. 3
You can use WRAP as a tool to help insure your success if you are planning changes in your life like: Getting a job Changing jobs Increasing your work hours Taking on more responsibilities Getting more education or training Leaving supported housing Moving Beginning or leaving an intimate relationship Working on relationship issues Having a child 4
You can also use WRAP to address other life issues like: Chronic or acute illness Addictions Breaking bad habits Losing weight Caring for an ill or elderly l family member Trying out new interests You could develop a separate WRAP to deal with each of these issues or, as you will see in the following examples, you could include these issues in one WRAP. If you want to develop a special WRAP for a particular issue, you can see an example of how that can be done in the Work Related Issues section of Recovery Topics. 5
There is only one person who can write your WRAP YOU. You, and only yyou, decide: If you want to write one How much time it takes you to do it When you want to do it What you want and don t want in it Which parts you want to do Who you want, if anyone, to help you with it How you use it Who you show it to Where you keep it Who, if anyone, has copies of your crisis plan 6
by developing a list of your Wellness Tools These are the things you do to keep yourself well, and the things you do to help yourself feel better when you don t feel well. You may have discovered them yourself or learned about them from others. Most of them are simple, safe and free. You will use these tools to develop your WRAP. 8
On the first tab in your binder, write Daily Maintenance List. Insert it in your binder, followed by several sheets of filler paper. On the first page, describe how you feel when you feel well. Do it in list form. Some words that others have used are: bright cheerful talkative outgoing boisterous energetic humorous happy dramatic athletic optimistic content reasonable competent calm introverted industrious active compulsive responsible curious quiet withdrawn reserved 11
External events or circumstances may make you feel like you are getting ill. These are normal reactions to life events but if you don t respond to them, they may actually make you feel worse. On the second tab, write Triggers and put in several sheets of binder paper.
On the page after your list of triggers, develop a plan that you feel will keep you from feeling worse if a triggering event occurs. Sample Plan: If any of my triggers come up, I will: Make sure I do everything on my daily maintenance list If work related, talk to my vocational counselor or employer Focus on tasks that are easy for me to do well Get one thing done that I know I can do well Do a reality check Continued 19
Early warning signs are internal and may be unrelated to reactions to stressful situations. They are subtle signs of change that indicate you may need to take some further action. 21
On the next page develop a plan of things to do every day until you feel better a plan you think will help you from feeling worse if you notice early warning signs. Sample Plan Do every thing on my daily maintenance plan Tell a supporter how I am feeling Peer counsel Do a focusing exercise. Do three 10-minute relaxation exercises Spend at least 1 hour involved in an activity I enjoy. Continued 24
You may begin to feel even worse very uncomfortable, like the situation is serious and even dangerous but you are still able to take some action in your own behalf. This is a very important time. It is necessary to take immediate, assertive action to prevent a crisis. 26
On the next page, write an action plan to use each day when things are breaking down. The plan now needs to be clear and directive with many things you must do and fewer choices. Sample: Call my doctor or care provider, ask for and follow their advice Arrange for at least three days off from work and any other responsibilities Talk to a supporter Continued 29
The next section of the WRAP is the crisis plan. In spite of your best planning and assertive action, you may find yourself in a crisis situation where others will need to take over responsibility for your care. You may feel as though you are totally out of control. Write your crisis plan when you are well. Your plan will instruct others about how to care for you when you are not well. It keeps you in control even when it seems like things are out of control. Others will know what to do, saving everyone time and frustration, while insuring that your needs will be met. Develop this plan slowly when you are feeling well. 31
The time when you are healing from a crisis can be very important. Although you feel ready to begin taking care of yourself again, you may still be dealing with difficult symptoms as well as the aftermath of the crisis. You may find that you start feeling worse like you are heading for another crisis. Thinking about this time before you even have a crisis, and perhaps giving it more attention when you are starting to feel better after a crisis, may help you have an easier time recovering and moving on. 48
You can begin using your Wellness ess Recovery e Action cto Plan as your guide to daily living and for responding to triggers and troubling symptoms. At first you may want to review your plan every day, following your daily main-tenance plan, and taking other action as needed. You may want to keep a copy of your Daily Maintenance Plan posted in a convenient place like on your refrigerator for easy reference. After a while you will notice that you remember your plan and only need to refer to it from time to time, unless you are having a very difficult time. You may want to revise your plan when you discover new Wellness Tools and find that some things work better for you than others. 54