ROLE TRANSFORMATION

1. ROLE TRANSFORMATION Key Elements to Successfully Shifting from Being a Client to Becoming a Staff Member Presenter: Cynthia Smith, CAC/CPSS, Aiken Barnwell Mental Health Center

2. Objectives The learning objectives for CPSS’s are: • To understand the benefits seeking services from outside the mental health center • To develop a framework for setting personal and work boundaries • Developing an “Work” vocabulary • Key Components for Maintaining Your Recovery

3. History of Clients as Employees at SCDMH Hiring “clients” or self-identified employees began as an empowerment initiative to bring current or former users of mental health services to the management tables of mental health systems as planners, policy- makers, program evaluators, community educators, and service providers.

4. Two Types of Self-identified Client Employees • Client Affairs Coordinators are internal agents of change who voice the client perspective during key meetings and policy sessions. • Certified Peer Support Specialists are persons who have successfully demonstrated their own efforts at self-directed recovery and who provide recovery skill building services to clients.

5. CPSS Employment Challenge One of the toughest moves for some peer support specialists to make is the shift from the client to the provider role. staff client

6. WHY Is It A Challenge? Because staff may still look at you as a “client” and clients may see you as “staff”. They both may do this without understanding that you did or still do receive mental health services.

7. Employment – Service Policy Although there is not a SCDMH departmental policy that states you cannot work where you receive services, many centers have adopted policies that does not allow this to happen. • It is NOT a good idea to work where you receive services for several reasons.

8. Reasons for Seeking Services Elsewhere • Allows you to identify yourself as a staff member at the agency you work and be treated accordingly.

9. Reasons for Seeking Services Elsewhere 2. Allows you to keep personal and professional life separate. If you receive services where you work, your personal information is available and may be known to staff. Receiving services outside the agency allows you to keep your personal business private.

10. Reasons for Seeking Services Elsewhere • Ethics and policies become difficult to enforce and are blurred. As a client you are entitle to all services and guidelines as any other client; however, as a staff member you have to abide by the policies and procedures of all DMH staff. • This can become a gray area.

11. Reasons for Seeking Services Elsewhere • Returning to “client role” in the event employment does not work out. In the event employment does not work out the transition back to the client role can extremely difficult and awkward. • You now know private information about your peers and staff.

12. Setting Personal & Work Boundaries

13. Boundaries: Some Key Points • Your recovery expertise and experience got you where you are today. • Using them to demonstrate a broad point or recovery concept is an appropriate use of your experience.

14. Five Ways You Can Minimize Problems • Don’t bring up personal questions about your illness, symptoms or medications. • Develop a crisis plan or recovery plan. • Develop a strong support system. • Continue to use the recovery tools you learned in treatment. • Continue with your treatment if needed.

15. Boundaries & Your Job Remember you are a role model for the clients, helping them to discover recovery tools they can use to move forward in their personal recovery.

16. Boundaries for All Employees Employees should not discuss their personal problems with clients.

17. Boundaries & Clients Sharing your recovery experience does not include giving out information about your: • Medications • Personal Telephone/Cell Phone Numbers • Home Address • Personal Family Issues or Problems

18. More on Medications… Never make jokes about your medications Statements such as “ I should have doubled up on my meds today” or “ Excuse me today I forgot my medication”… may be taken seriously by staff and/or clients and can “blow-up” on you. OOPS!

19. Your Medications… NEVER use your medication or symptoms as an excuse at work. NEVER allow anyone else the opportunity to use them against either! STOP

20. Boundaries: All Employees & Clients You never have the right to give out the personal, private information of other employees including other CPSS’s. Phone Address Personal Information

21. Danger of Breaking Boundaries Seeing you as a “buddy”, can damage the therapeutic relationship because you may no longer be seen as part of the treatment team.

22. Boundaries & Supervision And Now A Word From The Supervisors

23. Boundaries & Supervision Understand That Your Supervisor Is NOT Your “Therapist.” • Supervisors have policies to follow. They are encouraged to refer employees to Employee Assistance Program for mental health issues.

24. Boundaries & Supervision • Supervisors cannot provide therapy in the supervisor role. They are available to provide direction and assistance with your job duties, provide feedback regarding your job performance, lead team meetings and handle clinical issues.

25. Boundaries & Supervision • Due to nature of the job, supervisors may not have time to address your personal issues. Many are caring people who want to see you get help and ensure you get the time you need devoted to your problems.

26. Boundaries, Supervision & Crisis Response At any time employees may need to respond to crises that may involve threats, police, verbal outbursts, and other situations which may make you feel threatened or uncomfortable. Before responding you should know & understand your limits.

27. Boundaries, Supervision & Crisis Response If you feel threatened or uncomfortable, let someone else handle the situation and leave. Staying can endanger your safety and the safety of others and there is a potential that the client’s agitation can be escalated.

28. Boundaries & Supervision All staff may to “debrief” after an incident. This is when staff can talk about the incident, how it made them feel and air concerns. This is not to therapy.

29. Developing an “Work” Vocabulary I’m Sooo Stressed! I Feel Depressed I’m Manic It’s Overwhelming! That’s One of my Triggers

30. Developing an “Work” Vocabulary I’m Sorta Overwhelmed Today If you have been a client of you have probably developed a “client vocabulary”. We get comfortable using these terms like triggers, off track, manic, and over- whelmed.

31. Developing an “Work” Vocabulary These are “symptom” words and should be used only with your personal therapist.

32. Developing an “Work” Vocabulary When you use a client “ vocabulary”, staff and other clients may respond to you as such and question your wellness. If you want to step from the client role and be treated as any other staff member you have to change your vocabulary.

33. Developing an “Work” Vocabulary When responding to codes or stress you need to be able to verbalize what you are feeling in a more appropriate manner. Instead of “Triggered” you may say..” That code was a "tuff one” to describe how it effected you. Codes can have an effect on all staff…..

34. Developing an “Work” Vocabulary Learn and use appropriate the diagnoses and symptom vocabulary to: • Aide you when diagnosis and symptoms are discussed at team meetings. • To help you more accurately describe to the treatment team problems or issues that the clients you work with may be experiencing.

35. Components for Maintaining Your Recovery

36. Danger! The “ I am all better syndrome”…

37. Your Recovery The “ I am all better syndrome” has cost more CPSS staff their jobs than most all other reasons. When moving into a staff position it can be easy to start wanting to prove you are like everyone else. In the effort to “ FIT IN” some Peer Support Specialists have stopped seeking treatment, stopped taking Medication. WRONG!!!!

38. Key Components for Maintaining Your Recovery The only way to be able to provide clients with the tools they need to move forward in recovery is to be able to effectively stay in recovery.

39. Components Not discussing your treatment & not using your symptoms as an excuse will earn you acceptance and respect by staff and clients.

40. Your Recovery Staff know that you have to be, or have been in the past, a client to get this job. Stopping Treatment Will Not Earn You the Respect of Staff or Clients.

41. Points to Remember • Seek treatment outside of your center it keeps your treatment issues separate from your work responsibilities. • Allow yourself to stay well • Do not assume that because you are a self -identified staff that other staff do not also seek treatment. We are not the only staff within DMH that may get mental health services nor are we the only staff to openly uses our treatment and recovery skills to help others.

42. Remember Mental Illness One of the greatest thing about being a CPSS is that probably for the first time you did not have to hide your diagnosis to obtain employment.

43. Recovery Keys Don’t start being ashamed about being a client now. To keep the client part of you healthy you will never need your coping skills more than you do now. Remember… Staff and clients will treat you the by the way you act today.

44. QUESTIONS What I always wanted to ask but was afraid to……..

45. Finally Remember… All self-identified employees serve as recovery role models for each client, staff, family and community member they come into contact with. The willingness to publicly disclose their mental illness and triumphs associated with recovery go a long way in dispelling the stigma of mental illness and prove that treatment works. Self-Identified Employees Are HEROS!!!

46. THANK YOU!!!ROLE TRANSFORMATION: Key Elements to Successfully Shifting from Being a Client to Becoming a Staff Member Cynthia Smith, CAC/CPSS, Aiken Barnwell Mental Health Center