David M. Merlo MS, COTA, CPRP [email protected] 716 851-1312

OT Mental Health Education: Retooling for the Recovery Paradigm

David M. Merlo MS, COTA, CPRPwww.davidmerlo.com

[email protected] 851-1312

http://www.davidmerlo.com/

mailto:[email protected]

AOTA Statement on Recovery

• … individuals diagnosed with mental health conditions can and do recover and lead meaningful, satisfying, and productive lives.

Champagne, T., Gray, K. (2011). Occupational Therapy’s Role in Mental Health Recovery. AOTA.

10 Fundamental Components of Recovery

SAMHSA. (2006). National Consensus Statement on Mental Health Recovery.

Erie Community CollegeOccupational Therapy Assistant Program

Psychosocial Rehabilitation OT-200

People

ProcessSystem

Dave’s Top 10 List… 1. Rehabilitation versus Treatment2. Person-centered planning, shared decision-making3. Positive psychology, strength-based approaches4. Peer perspective, practitioner-peer partnership5. Supported Models: Employment | Education | Living6. Recovery, psychiatric rehabilitation approach7. Wellness, wellness self-management, WRAP8. Therapeutic communication/relationships9. Trauma-informed care10. Group process

Pratt, C., Gill, K., Barrett, N., Roberts, M. (Expected release date: Nov 2013). Psychiatric Rehabilitation, 3rd Ed. Academic Press. ISBN: 9780123870025

Specialized Knowledge and Skills in Mental Health Promotion, Prevention, and Intervention in Occupational Therapy Practice

Document reflecting competencies:

USPRA CPRP Certification Exam Blueprint

Document reflecting competencies:

2011 ACOTE Standards

Section 1: Core MH Professional Knowledge and Skills

Section 2: Specific OT Knowledge

and Skills Applied to MH

Barrows, C., Clark, C., Gupta, J., et. Al. (2010). Specialized Knowledge and Skills in Mental Health Promotion, Prevention, and Intervention in Occupational Therapy Practice. AOTA.

• 7 Domains:– Interpersonal Competencies– Professional Roles Competencies– Community Integration– Assessment, Planning, Outcomes– Interventions for Goal Achievement– Systems Competencies– Diversity and Cultural Competency

October 2007, USPRA (currently under revision). Retrieved 4/2/13. https://uspra.ipower.com/Certification/CPRP_Exam_Blueprint_2009.pdf

USPRA CPRPCertification Exam Blueprint


https://uspra.ipower.com/Certification/CPRP_Exam_Blueprint_2009.pdf


USPRA CPRPCertification Exam Blueprint

Sample Knowledge Areas• Core Principles of Psych Rehab • Strengths Model • Distinctions between medical

and rehabilitation models • Impact of mental illness on

function • Empowerment theories and

approaches • Recovery • Normalization • Cultural differences in help-

seeking behaviors

Sample Skill Areas• Preparing group activities in

which individuals can learn specific skills

• Teaching problem solving and conflict resolution

• Modeling leadership skills • Providing feedback • Reinforcing newly learned

skills and behaviors




A Few Examples…Hearing Voices Simulation

Wellness Recovery Action Plan

Passion Fair

• Hearing Voices Curriculum– Participants use headphones for listening to a specially designed

recording simulating the experience of hearing distressing voices.– Participants undertake a series of tasks including:

• social interaction in the community• a psychiatric hospital interview• cognitive testing• activities group in a “day treatment program”

– Followed by a debriefing and discussion period. – Curriculum also includes a video lecture presenting research on

voice hearers and how they manage.– www.power2u.org

Hearing Voices Simulation

http://www.power2u.org/

• Understand role of sensory system in regulating level of alertness.

• How to use sensory tools to increase/decrease level of alertness to focus on/participate in chosen activities.

Specialized Knowledge & Skills in Mental Health: Specific OT Knowledge and Skills Applied to MH

• Key elements of WRAP:– Wellness Toolbox– Daily Maintenance Plan – Identifying Triggers and an Action Plan– Identifying Early Warning Signs and an Action Plan – Identifying When Things Are Breaking Down and an Action Plan– Crisis Planning– Post Crisis Planning

• www.mentalhealthrecovery.com

Wellness Recovery Action Plan

http://www.mentalhealthrecovery.com/

WRAP as an Intervention• Support the creation and use of a wellness recovery action plan.

– Teach/support use of coping strategies.– Identify/implement healthy habits, rituals, routines. – Identify personal values, needs, and goals to enable informed

decision making.– Increase awareness of community-based resources.– Encourage self-monitoring of health concerns, managing symptoms,

recognizing/responding to acute changes. – Engage in long-term planning that leads to meeting personal recovery

goals.



• Shared decision-making process that is person-centered and client driven.



• Evaluate relationship among health, well-being, and participation in daily life activities.

• Develop occupational profile using client-centered strategies to gather information about a client’s: – occupational history and experiences– life roles– interests, needs, and concerns – strengths and limitations


• Design/implement interventions that support development of cognitive, sensory regulation, social, and communication skills requisite for role performance.

• Choose interventions that fit the values and abilities of those providing and receiving care.



• OT Intervention Approach: – Health Promotion– Prevention– Maintenance

• OT Intervention Type: – Therapeutic Use of Self– Therapeutic Use of

Occupations and Activities – Consultative process– Education process

WRAP and OT Practice Framework

Domain• OT Areas of Occupation:

– IADL (Health management and maintenance)

– Rest and Sleep, Education, Work, Play, Leisure, Social Participation, ADL

• Client Factors:– Values, Beliefs, Spirituality

• Performance Skills • Performance Patterns:

– Habits, Routines, Roles• Context and Environment• Activity Demands

Process

• Plan/conduct a community “fair” focusing on:– health and wellness– community participation– role participation– quality of life

• Using “passions” to address individual volition as a primary motivator and organizer of human occupation.

• Address occupations of:– play/leisure exploration– volunteer exploration– social participation

Passion Fair


• Facilitate resiliency, health, and wellness in the community of the individual’s choice…



• Emphasis on holism, function, participation, and partnership, is used to help support people to– develop skills– engage in activities of interest– meet individual recovery goals


• Determine how environmental supports and barriers influence participation in meaningful & productive roles in community.

• Facilitate reducing barriers.



United States Psychiatric Rehabilitation Association• Administers Certified Psychiatric Rehabilitation

Practitioner (CPRP) specialty certification• Annual Conference: June 9-12, Atlanta Georgia• Journal: Psychiatric Rehabilitation Journal

(published by American Psychological Association)• www.uspra.org

http://www.uspra.org/

CPREConsortium of Psychiatric Rehabilitation Educators• Develop, promote, and support academic

initiatives and higher education programs specific to the contemporary practice of psych rehab.

• Membership open to all MH educators (free!).• Annual Symposium: November 1-2, 2013

University of Medicine & Dentistry of NJ School of Health Related Professions (Scotch Plains, NJ)

• www.psychrehab.net

http://www.psychrehab.net/

• Order free curricular materials including:– Lesson guides– Booklets and pamphlets– DVDs– CDs

• www.SAMHSA.gov

http://www.samhsa.gov/

• Creating and disseminating recovery-oriented training materials for mental health professions.

• http://www.samhsa.gov/recoverytopractice/

http://www.samhsa.gov/recoverytopractice/

http://www.samhsa.gov/recoverytopractice/

• Increase awareness and understanding of the concept and reality of recovery. – Articles– Books– Documents and Reports– Multimedia and Websites– Training and Technical Assistance

• http://www.bu.edu/cpr/repository/index.html

http://www.bu.edu/cpr/repository/index.html

OT Mental Health Education: Retooling for the Recovery Paradigm

David M. Merlo MS, COTA, CPRPwww.davidmerlo.com

[email protected] 851-1312

http://www.davidmerlo.com/

mailto:[email protected]

David M. Merlo MS, COTA, CPRP [email protected] 716 851-1312

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