Mental Health Crisis Help
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CMH
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Cognitive Therapy |
Cognitive Therapy for older adults is a modification of the Cognitive Therapy (CT) model, also referred to as Cognitive Behavioral Therapy or CBT. CT is a short-term talk therapy that has been demonstrated in hundreds of research trials to be effective for a range of psychiatric disorders including depression, anxiety, and post-traumatic stress disorder. The main idea behind the model is that the way we perceive situations influences the way we think, feel and behave.
The adaptation of the CT model for older adults incorporates specific needs and therapeutic considerations. These may include sensory and cognitive changes, presence of caregivers, generational differences, dependency, autonomy, or chronic medical conditions. Adaptations and therapeutic considerations may involve the pace of treatment, coordination of medical needs, and the treatment setting. Life review, the role of reminiscence, meaning and change are also considerations to this model with the older adult population. AMHS staff are continuing to develop expertise in this model so that it can be made available for many more older adults experiencing severe and persistent mental illnesses. |
Co-occurring Disorder Treatment |
Co-occurring Disorder Treatment (COD) is treatment for substance abuse and mental health problems that is delivered by a team who are trained in both substance abuse and mental health. The treatment includes psychological and psychopharmacological (medications) components. It also includes and incorporates education and social networking. COD treatment is a multi-disciplinary approach, meaning there are many different types of providers involved: psychiatrists, case managers, nurses, peer support persons, etc., doing many different things, but with one focus. That focus is on the person's recovery, abstinence and wellness. Prevalence of substance use disorders is high among people who have Schizophrenia (45%) and Bipolar Disorder (55%) when compared with the general population (17%). There are more modest increases among people with Obsessive Compulsive Disorder (32%), Major Depression (27%) and Panic Disorders (22%), but the rates of co-occurring substance use accompanied by mental illness is still high. The co-occurrence of substance use and mental illness can make it hard for people to maintain employment, have healthy family relationships or recover from mental illness. This can lead to higher rates of relapse and greater cost of care. COD treatment is proven to: -Reduce arrest and incarceration -Increase abstinence -Decrease substance use and relapse -Decrease psychiatric symptoms -Increase the quality of life for participants In COD treatment, five stages of change are stressed as the person moves forward in his or her recovery: 1) Pre-contemplation, 2) Contemplation, 3) Preparation, 4) Action, and 5) maintenance. Motivational Interviewing (MI) is a technique that is used within the COD approach to treatment. MI is a type of interaction that helps people identify their goals for daily living, consider the pros and cons of behavioral choices, and then develop strategies for reaching those goals. AMHS has provided extensive training to its staff in the treatment of co-occurring disorders. Many AMHS staff possess specialty training in the treatment of substance use disorders. AMHS has made it a priority to ensure all of its programs are capable of providing high quality COD treatment services, so that such services are available to all consumers who may desire them. |
Dialectic Behavior Therapy |
Dialectic Behavior Therapy (DBT) is a form cognitive-behavioral therapy developed to help people who have extreme difficulty managing their emotions, especially those leading to self-injury and suicidal behaviors. DBT is generally intended to improve the individual's well-being and quality of life by improving his or her skills, abilities, and independence. DBT is designed to help emotional regulation difficulties such as: |
Family Psychoeducation |
Family Psychoeducation (FPE) is an evidence-based practice that gives consumers and families information about mental illnesses, helps them build social supports, and enhances problem-solving, communication, and coping skills. Family Psychoeducation builds on the family's important role in the recovery process. Research has shown that consumers and families involved in FPE often experience markedly better outcomes including reduced relapses/hospitalizations, increase in employment and reduced health issues. FPE typically takes place in a multifamily group format with facilitation by certified clinicians. AMHS has been offering FPE groups since 2008 in seven program locations. |
Peer Support Services |
AMHS continues to enhance its services by expanding the availability of Peer Support Specialist (PSS) services. In 2012, AMHS added a Recovery Specialist to coordinate and lead this effort. Twelve permanent Peer Support Specialist (PSS) positions are now available in ten AMHS locations including Charter House, PATH-Homeless, Assertive Community Treatment, Case Management Services, the Bridges Crisis Unit/Crisis Services, the Crisis Recovery Team, Mason Rural Outreach, Outreach Case Management Services and the Clinton County Counseling Center. At any given time, four to six members of Charter House are participating in a six month Transitional Employment Peer Support experience which has led to the creation of a pool of well-trained Peers who are ready when permanent PSS positions become available. PSS staff are actively involved as members of their assigned teams and have made significant contributions to AMHS and the recovery efforts of its consumers. Additionally, 14 Peer Support Specialists are available to AMHS consumers through its contract with Justice in Mental Health Services. Recovery initiatives have been at the forefront of AMHS as the Recovery Enhancing Environment (REE) survey was conducted in 2010. AMHS Peer Support Specialists are assisting AMHS leadership with dissemination of REE results to staff and consumers across AMHS with the goal of improving recovery outcomes. |
Psychosocial Clubhouse |
The “Clubhouse model” of psychosocial rehabilitation is a comprehensive and dynamic program of support and opportunities for people with severe and persistent mental illnesses. In contrast to traditional day treatment or other day program models, Clubhouse participants are called "members" (as opposed to "patients" or "clients") and restorative activities focus on their strengths and abilities, not their illness. The Clubhouse model is unique in that it is not a clinical program, per se, meaning there are few therapists on staff. Almost all clinical aspects of the program have been removed so as to focus on the strengths of the individual, rather than their illness. Additionally, participation in a clubhouse is strictly on a voluntary basis. The members and staff of a Clubhouse work side-by-side to manage all the operations of the Clubhouse, providing an opportunity for members to contribute in significant and meaningful ways; therefore, a Clubhouse is operated as a partnership between members and staff working side-by-side as colleagues. Through this environment of support, acceptance, and commitment to the potential contribution and success of each individual, Clubhouses are places where people can belong as contributing adults, rather than passing their time as patients who need to be treated. The Clubhouse Model seeks to demonstrate that people with mental illness can successfully live productive lives and work in the community, regardless of the nature or severity of their mental illness. Currently, there are over 325 clubhouses in 28 countries around the world. The AMHS Clubhouse is called Charter House. Please click this link to be directed to the Charter House website . |
Supported Employment |
Supported Employment is an approach to enhancing the work skills and abilities of a person experiencing a severe mental illness or disability. Work opportunities are sought in a variety of settings which are intended to provide support for persons with mental illness to secure and maintain paid employment in the open labor market. Supported employment is usually paid employment, in an integrated setting, with on-going support provided over the long-term. Supported employment has become so successful across the nation, that it is now commonplace to see individuals with significant disabilities successfully working in the community and enjoying their careers. The supported employment program offered through AMHS is called the Community Work Experience Program (CWEP). The CWEP Program reflects a partnership between the individual with a mental illness, the employer, co-workers in the work setting, family members, the various community agencies, and the community at large. Individuals referred to this program receive assistance in: AMHS consumers may obtain more information, or request a referral to CWEP, from their case manager. |
Trauma Informed Care |
CMHA-CEI is currently developing policies and procedures that promote an environment that is more welcoming and sensitive to the individual experiences of our consumers. One way this is being done is by creating a “Trauma-Informed Care (TIC)” environment at all levels of engagement with the consumers in our agency. Traumatic experiences can be dehumanizing, shocking or terrifying, singular or multiple compounding events over time, and often include betrayal of a trusted person or institution and a loss of safety. Trauma can result from experiences of violence…including physical, sexual and institutional abuse, neglect, intergenerational trauma, and disasters that induce powerlessness, fear, recurrent hopelessness, and a constant state of alert. Trauma impacts one’s spirituality and relationships with self, others, communities and environment, often resulting in recurring feelings of shame, guilt, rage, isolation, and disconnection. (National Center for Trauma-Informed Care). Trauma-Informed Care (as defined by the National Center for Trauma-Informed Care) is an approach to engaging people with histories of trauma that recognizes the presence of trauma symptoms and acknowledges the role that trauma has played in their lives. Trauma-Informed Care facilitates the adoption of trauma-informed environments in the delivery of a broad range of services including mental health, substance use, housing, vocational/employment support, domestic violence and victim assistance, and peer support. In all of these environments, TIC seeks to change the paradigm from one that asks, “What’s wrong with you?” to one that asks, “What has happened to you?” By adopting a Trauma-Informed Care environment, CMHA-CEI is striving to decrease the occurrence of retraumatization of the consumers we serve, as well as, to reduce the potential for staff to experience secondary trauma. Studies have shown that between 51-98% of all consumers of mental health services have experienced a traumatic event in their lifetime which supports why this is such a critical issue (to learn more see the ACE study, www.cdc.gov). Research has also shown that when trauma is addressed effectively, treatment outcomes improve, customer satisfaction increases, and staff members feel more capable and effective in addressing these underlying issues which frequently complicate treatment. Trauma-Informed treatment cares for both the consumer, as well as, service providers and instills the belief that healing is possible. |
