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JOE MARRONE INSTITUTE FOR COMMUNITY INCLUSION MAIN OFFICE: BOSTON, MA NW OFFICE : 4517 NE 39 TH AVENUE PORTLAND, OR 972

JOE MARRONE INSTITUTE FOR COMMUNITY INCLUSION MAIN OFFICE: BOSTON, MA NW OFFICE : 4517 NE 39 TH AVENUE PORTLAND, OR 97211-8124 TEL : 503-331-0687 HOME TEL : 503-331- 0486 FAX : 509-691-9282 EMAIL: JM61947@AOL.COM. GENERAL WEB : WWW.COMMUNITYINCLUSION.ORG or

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JOE MARRONE INSTITUTE FOR COMMUNITY INCLUSION MAIN OFFICE: BOSTON, MA NW OFFICE : 4517 NE 39 TH AVENUE PORTLAND, OR 972

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  1. JOE MARRONE INSTITUTE FOR COMMUNITY INCLUSION MAIN OFFICE: BOSTON, MA NW OFFICE: 4517 NE 39TH AVENUE PORTLAND, OR 97211-8124 TEL: 503-331-0687 HOME TEL: 503-331- 0486 FAX: 509-691-9282 EMAIL: JM61947@AOL.COM GENERAL WEB: WWW.COMMUNITYINCLUSION.ORG or NCWD - ADULT: WWW.ONESTOPS.INFO

  2. VISION OF RECOVERYJOE MARRONE RECOVERY MAY BE A JOURNEY; BUT IF YOU NEVER GET ANYWHERE, IT CAN EASILY BECOME A TREADMILL.

  3. IF EVERYONE IS ALREADY DOING IT, HOW COME IT NEVER GETS DONE ???

  4. “ ALL CHANGE IS DIFFICULT –NO MATTER HOW LONG YOU PUT IT OFF. “ ------ JOE MARRONE

  5. “ Ships are safe in harbor,but that is not what ships are built for. “ ------ Anonymous

  6. I WORRY ABOUT: • DISCRIMINATION NOT STIGMA • BEHAVIOR NOT ATTITUDE • CITIZENSHIP/CIVIL RIGHTS NOT CONSUMERISM • POWER/CONTROL NOT CONSUMERISM • COMPETENCY NOT COURTESY • LOVE/RELATIONSHIPS/SEX NOT INTERVENTION/ SERVICES • JOBS/ CAREERS NOT VOCATIONAL PROGRAMMING

  7. VALUES IN WORKING WITH PEOPLE W. MI IN THE COMMUNITY • CULTURE OF CLIENT BENEFIT – LIVING, WORKING, RELATIONSHIPS • PEOPLE HAVE RIGHT TO CONTROL THEIR LIVES, THEIR TX, & KINDS OF HELP THEY RECEIVE. STAFF SHOULD INFLUENCE. • ALL PEOPLE NEED HOPE & SUPPORT • PEOPLE W. MI DO GET BETTER --- > 60% • SYMPTOMS NOT PREDICTIVE IN OTHER AREAS • PEOPLE CAN WORK, SO THEY SHOULD WORK • PEOPLE W. MI BEST SERVED IN COMMUNITY • COMMUNITY/ PEER/ FAMILY SUPPORTS + PROS

  8. IF PEOPLE CANWORK PEOPLE SHOULDWORK

  9. UNEMPLOYMENT IS BAD FOR YOU !!!

  10. Dooley, D., Fielding, J., & Levi, L. (1996). Health and unemployment. Annual Review of Public Health Kasl, S. V., Rodriguez, E., & Lasch, K. E. (1998). The impact of unemployment on health and well-being. In B. Dohrenwend, (Ed.). Adversity, Stress and Psychopathology Lennon, M. C. (1999). Work and unemployment as stressors. In A. Horwitz, & T. Scheid, (Eds.). A Handbook for the Study of Mental Health: Social Contexts, Theories and Systems

  11. Dooley, D., Catalano, R., & Hough, R. (1992). Unemployment and alcohol disorders in 1910 and 1990: Drift versus social causation. Journal of Occupational & Organizational Psych ----- increases alcohol use Linn, M. W., Sandifer, R., & Stein, S. S. (1985). Effects of unemployment on mental and physical health. American Journal of Public Health ---- increases in anxiety Dooley, D., Catalano, R., & Wilson, G. (1994). Depression and unemployment: Panel findings from the Epidemiologic Catchment Area study. American Journal of Community Psychology ----- increases in depression

  12. “ YOU NEED A LITTLE LOVE IN YOUR LIFE & FOOD IN YOUR STOMACH BEFORE YOU CAN HOLD STILL FOR SOME DAMN FOOL’S LECTURE ABOUT HOW TO BEHAVE.” BILLIE HOLIDAY

  13. MARK TWAIN " FEW THINGS ARE HARDER TO PUT UP WITH THAN THE ANNOYANCE OF A GOOD EXAMPLE"

  14. WHAT DO YOU DO TO ENCOURAGE WORK AND DISCOURAGE IDENTITY AS A SELF -- IDENTIFIED FAILURE ???

  15. HOPE AND HASSLING

  16. HELPER’S RESPONSIBILITY TO ENGAGE & MOTIVATE HOPEVS. OPTIMISM? --- PAT ON BACK VS. COMMUNICATING THAT: YOU CARE YOU UNDERSTAND YOU WILL BE THERE YOU HAVE IDEAS & HELP TO OFFER

  17. OSCAR WILDE “ TO LOVE ONESELF IS THE BEGINNING OF A LIFE LONG ROMANCE. “

  18. Stages of (Readiness for) Change • PRECONTEMPLATION • CONTEMPLATION • PREPARATION • ACTION • MAINTENANCE • TERMINATION • PROCHASKA, J.0., NORCROSS, J.C., • DICLEMENTE, C.C. (1994). CHANGING FOR GOOD. NEW YORK, N.Y.: AVON BOOKS

  19. NO MOTIVATION • FEAR OF FAILURE • NO SELF - CONFIDENCE • POOR EXPERIENCES • LOSS OF BENEFITS • LACK OF INFORMATION • LAZINESS

  20. John Galbraith “Given a choice between changing and proving that it is not necessary, most people get busy with the proof.”

  21. MOTIVATIONAL INTERVIEWING • Express empathy • Develop discrepancy • Avoid argumentation • Roll with resistance • Support self-efficacy Miller, W. & Rollnick, S. (1991).Motivational interviewing: Preparing people to change addictive behavior.

  22. MOTIVATION • VALUES • EXPECTANCY • EXPERIENCE • RESOURCES • INFORMATION • ENERGY FROM YOU

  23. WILLIAM JAMES “ MANY PEOPLE THINK THEY ARE THINKING WHEN THEY ARE MERELY REARRANGING THEIR PREJUDICES “

  24. JERRY GARCIA “ SOMEONE HAS TO DO SOMETHING AND IT’S PRETTY PATHETIC IT’S GOT TO BE ONE OF US “

  25. THOMAS EDISON “ RESULTS! WHY, I’VE GOTTEN A LOT OF RESULTS. I KNOW SEVERAL THOUSAND THINGS THAT WON’T WORK. “

  26. PRINCIPLES OF IPS MODELR. DRAKE & G. BOND • COMP. EMPLOYMENT = GOAL • RAPID JOB SEARCH • MH & REHAB INTEGRATED • TIME UNLIMITED SUPPORT • ATTENTION TO PREFERENCES • CONTINUOUS ASSESSMENT

  27. Research Based Principles of Successful Rehabilitation/ Recovey • People with SMI can be successfully engaged in competitive employment • VR services should involve employment in integrated settings at customary wages or above • People with SMI should be placed in paid jobs as quickly as possible and according to their preferred pace

  28. Research Based Principles of Successful Rehabilitation/ Recovey • Ongoing employment support services should be available as needed & desired by the person served. • Persons with SMI should be helped to find jobs matching career preferences • VR services should explicitly & proactively address financial planning & provide education/support around disability benefits & entitlements. • VR services should involve family & friends in supporting efforts to work

  29. Research Based Principles of Successful Rehabilitation/ Recovey • Vocational & MH services should be integrated & coordinated. • Vocational providers should work collaboratively w. persons w. SMI to address issues of stigma/ discrimination, & help negotiate reasonable accommodations w. employers. • VR services should be made available to all MH consumers

  30. CLEARVIEW MH EMPLOYMENTAnnual Totals (7/01/01 to 6/30/02): Referrals------------------------------- 416 Referrals received directly from PHP Mental Health Services--------------- 220 Attended Orientation------------------------ 327 Vocational Profiles Completed----------- 240 Placed in Competitive Community Employment----------------------------------- 129 Those Placed that are involved with PHP Mental Health Services----------- 99

  31. “ I’M TIRED OF PLAYING BY THE RULES. LET’S SCRATCH THEIR EYES OUT TILL THEY GIVE US FRESH TUNA.”

  32. GREEK PROVERB “ BEFORE PRACTICING VIRTUE, FIRST SECURE AN INDEPENDENT INCOME. “

  33. OLD YIDDISH PROVERB If 1 person calls you a jackass, ignore him; If a second person calls you a jackass, think about it; If a third person calls you a jackass- get a saddle.

  34. CONSUMER DRIVEN IS NOT: • JUST SAYING YES • STAFF ONLY PLACATING • AVOIDING OPINION • CONSUMER RUN

  35. CONSUMER DRIVEN IS NOT: • AVOIDING RESPONSIBILITY TO INFLUENCE • "I TOLD YOU SO" • JUST LISTENING WITHOUT HELPING

  36. Thom Hartman“ADD, An Alternate View” “I am not inattentive, you are just boring.“

  37. RITA MAE BROWN “ FOR YOU TO BE SUCCESSFUL, SACRIFICES HAVE TO BE MADE. IT’S BETTER THAT THEY ARE MADE BY OTHERS, BUT FAILING THAT, YOU’LL HAVE TO MAKE THEM YOURSELF. “

  38. RITA MAE BROWN “ IF THE WORLD WERE A LOGICAL PLACE, MEN WOULD RIDE SIDESADDLE “

  39. " There is nothing you can say in answer to a compliment. I have been complimented myself a great many times, and they always embarrass me -- I always feel they have not said enough. "Mark Twain

  40. KEY ISSUES -- TICKET TO WORK: 1] FEW TICKETS DEPOSITED 2] NATIONALLY GREAT MAJORITY OF TICKETS DEPOSITED W. VR 3] PAYMENT STRUCTURE BACKLOADED - POSSIBLE CHANGE4] HOW MUCH MOTIVATION IS THIS FOR RECIPIENTS OR PROVIDERS?5] IS AVOIDING CDR A BIG DEAL?6] SHOULD IT EXTEND TO YOUTH OR THOSE WHO HAVE NOT HAD THEIR FIRST CDR?7] SOME PROVIDER STRUCTURES CONTROVERSIAL – WI ARRANGEMENT8] FEW NEW PROVIDERS IN POOL

  41. KEY ISSUES -- WIA: 1] DISABILITY LOW ON WIA RADAR SCREEN 2] PERFORMANCE STANDARDS - EXCUSE BY WIA?3] EMPLOYER FOCUS -- EXCUSE BY WIA?4] REHAB ACT -- EXCUSE BY VR?5] VR USED AS DISABILITY SERVICE BY WIA – SECTION 188 MANDATES?6] MANY DISABILITY ENTITIES (E.G., DD/ MH) AVOID IT7] SHOULD THERE BE A SEPARATE TRANSITION STREAM?

  42. KEY ISSUES -- WIA: 8] SHOULD IN SCHOOL YOUTH MONEY BE GIVEN TO LEAS, NOT WIA?9] ROLE & STRUCTURE OF WIBS10] HOW MUCH SELF IN SELF SERVICE?11] MIDDLE CLASS SYSTEM FOR ALL? OR JUST FOR MIDDLE CLASS?12] ACCESS FOR “HIDDEN” DISABILITIES13] DISCLOSURE - DISABILITY INQUIRIES14] CORE, INTENSIVE, TRAINING SERVICE SEQUENCE15] ROLE OF TRAINING/ USE OF ITAS OVERALL – HOW BENEFIT PEOPLE WITH DISABILITIES?

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