The New Age of Psycho-Social Rehabilitation

1. The New Age of Psycho-Social Rehabilitation Roadmap to Outcome-Oriented Treatment and Recovery

2. The New Age of Psycho-Social Rehabilitation Today’s Objectives: How You Can… • Meet Payer Standards • Demonstrate People Improve • Develop a PSR program that • helps people improve • enhances recovery • Maintains/Builds Revenue Streams

3. The New Age of Psycho-Social Rehabilitation What Can You Get PAID For Providing? • Services What Do You Have To Do To Get Paid? • Develop Outcomes • Delivery Services that Generate Anticipated Outcomes • Document Reached Outcomes How Do You Get People Connected? • Without People: • No Services • No Outcomes • No Payments

4. Meeting Payer Standards: Outcomes Assessment and Planning (Rule 132): • Client’s preferences relating to services and desired treatment outcomes. • Documenting goals & anticipated outcomes. Clinical Recording Keeping (Rule 132): • Discharge summary documenting the outcome of treatment and, as necessary, linkage to continued services.

5. Meeting Payer Standards: Outcomes Utilization Reviews (Rule 132): • The expected short-term and long-term outcome of each service needed by the client and • Progress made in response to treatment.

6. The New Age of Psycho-Social Rehabilitation Do You View “Recovery” as a Continuum:or Trend:

7. Developing a World Class PSR Program Starts with a Philosophy of Recovery • Trend vs. Continuum • People ARE SMART • People KNOW What ISN’T WORKING • People KNOW What They WANT • People KNOW What HELPS • People ENGAGE When TREATMENT Has Quality • People IMPROVE the QUALITY of Their Life

8. Developing a World Class PSR Program Presumptions • Staff Deserves To Be: • Compensated for Expertise and Passion • Thus – Generate Income with Services • Retention of Quality Staff • Clinically Challenge Staff – expect the best, • Pay Raises Through Increased Income • Agency Deserves To Be: • Compensated for Services Provided • Remain OPEN to Serve Community Members.

9. Developing a World Class PSR Program Assessment and Planning (from Rule 132): • Clientpreferencesrelating to services and desired treatment outcomes. Getting Client’s Preferences Means PSR MUST: • Get to Know the Person • Understand THEIR GOALS • Review Assessment Data • Bring the Person TO THE PROGRAM: Community • Develop Motivation & Hope

10. Developing a World Class PSR Program Assessment and Planning (from Rule 132): • Documenting goals & anticipatedoutcomes Means PSR MUST: • Assess the Client’s Needs (baseline) • DLA – Functional Measure • MHA – Tx History. • Connect Treatment to DLA and MHA = Prescriptive

11. DLA

12. L10 Have client Identify what they perceive as potential strengths and obstacles to their recovery? Strengths Obstacles (Check all that apply) (Check all that apply) _____ History of treatment success _____ History of treatment disappointment _____ Understanding of illness _____ Denies illness/problems or blames others _____ Has decision making skills _____ Lacks decision making skills ability _____ Good communication skills _____ Limited communication ability _____ Adequate education _____ Limited education or learning difficulties _____ Good physical health _____ Physical/medical problems _____ Ability to manage finances _____ Financial difficulties _____ Stable living conditions _____ Unstable living conditions _____ Ability to form and maintain relationships _____ Difficulty with interpersonal relationships _____ Ability to care for self/others _____ Lack of trust in others _____ Vocational skills, some work history _____ Limited vocational skills and work history _____ Transportation available _____ Lacks transportation _____ Family support _____ Lack of family support _____ Social support system present _____ Lacks friends and social outlets _____ Has confidence in treatment provider _____ Doubts their capacity to improve/be helped _____ Religious, spiritual or cultural beliefs _____ Religious, spiritual or cultural beliefs _____ Other Strengths, specify: _____ Other Obstacles, specify: MHA

13. Developing a World Class PSR Program Means PSR MUST: • Deliberately Intervene: Development of • Group: Evidenced Based, Curriculum Driven • Individual: “Supersize the Fries” Con-Current with Group • Milieu: Practice Socialization and Skills Lab. • Connect Treatment to DLA and MHA = Prescriptive

14. PSR Treatment Team Therapists and Supervisor met for a 90 day treatment review session to evaluate the client's progress toward goals identified in the client's individual treatment plan (ITP) driven by assessed needs identified in a yearly mental health assessment. The review also determined and discussed the consumer's readiness to be transitioned and connected to less supportive therapeutic services and/or community-based and socially driven support activities. Prior to this review session, the consumer completed a self-report psychometric based on the Daily Living Assessment to determine a level of functional impairment that prevents the consumer from engaging in less supportive therapeutic services and/or community-based and socially driven support activities. Staff discussed their clinical observation of the consumer while in treatment and the data collected during the completion of the self-report psychometric, which assisted the staff in determining gains or decreases in functionality over the past 90 days of treatment. In addition, staff reviewed and discussed the client's compliance percentages and their levels of engagement with the treatment measured each week using an engagement matrix and the client's overall reported progress during each session of the treatment. Recommendation: Continue PSR services. Justification: During the review session, staff came to the decision that the consumer has reached very few of the goals identified in PSR services ITP as evidenced by the completion of a self-report psychometric and observations by the staff and the client's scores in compliance, engagement and progress toward goals. The client’s progress in the past 90 day session includes: XXXXX. Anticipated continued therapeutic services: Staff observes and conceptualizes that XXXX. Client is encouraged to attend XXXX to learn XXXXX. Client is also encouraged to attend XXXX to start learning how to XXXXX. Example of Note

15. Consumers will attend Anxious No More to acquire, practice, and use in natural/community settings skills including: • Coping Skills: • Will learn cognitive restructuring techniques that allow them to be more competent of their anxiety triggers and accompanying reactions measured through client self-reports and the completion of activities and worksheets provided in the group and as evidenced by at least 75% engagement in the group. • Will learn to be in control of their anxiety by identifying at least three healthier and more effective cognitive reactions associated with anxiety-provoking events measured by the completion of activities and worksheets provided in the group and as evidenced by at least 75% engagement in the group. Problem Solving: • Will identify and respond to options about the way in which they interpret and react to anxiety-provoking events measured by the completion of activities and worksheets provided in the group and as evidenced by at least 75% engagement in the group. • Will learn to set realistic expectations related to anxiety-provoking events so that accompanying cognitive, emotional, and behavioral reactions are appropriate measured by the completion of activities and worksheets provided in the group and as evidenced by at least 75% engagement in the group.

16. What are You Attracting? • Have you wondered why you keep finding yourself in the same situations? Bad relationships, encountering “toxic” people, feelings of being out of control with the direction your life is taking? Shifting the manner in which you approach the world can be hugely empowering and give you the feeling of being more in control. We will explore, through activities and discussions, what YOU can do to feel that no matter what life throws at you, you are more powerful than you think you are! • *Family relationships, social network, coping skills, problem solving. • Coping including the following objectives: To be able to: • Identify three new ways in which the client can engage with and interact in their social, family and career/education environments measured by the client’s self-report and observation of the client in group as evidenced by 75% or higher compliance with treatment, engagement matrix average score of 50% and a score of 66% or higher on the progress toward goal measure. • Identify at least 3 personal strengths that will enable the client to resolve daily living issues and communicate effectively with others measured by the client’s self-report and observation of the client in group as evidenced by 75% or higher compliance with treatment, engagement matrix average score of 50% and a score of 66% or higher on the progress toward goal measure. • Anticipate and predict the potential outcome of a new behavioral approach to engagement with the client’s social, family and career/education environments measured by the client’s self-report and observation of the client in group as evidenced by 75% or higher compliance with treatment, engagement matrix average score of 50% and a score of 66% or higher on the progress toward goal measure. • Problem Solving including the following objectives: To be able to: • Effectively emotional regulate while communicating needs, cognitions and emotional reactions to life stressor when engaged socially with others as measured by the client’s engagement with role plays and the discussion after the roll play evidenced by 75% or higher compliance with treatment, engagement matrix average score of 50% and a score of 66% or higher on the progress toward goal measure.

17. Developing a World Class PSR Program Anticipating Outcomes Means PSR MUST: • Adapt to Changing Needs of Client • Develop Progressive, Trend-Oriented Program • Offer Services That Meet Person on Multiple Levels of Recovery. • Assist the Client in Reaching Outcomes • Motivational • Hope Inspiring • Community-Based

18. Developing a World Class PSR Program Clinical Recording Keeping: • Discharge summary documenting the outcome of treatment and, as necessary, linkage to continued services. Quarterly Conferences • Compliance, Engagement & Progress • DLA Completion and Reviewed • Face to Face Collaborative Meetings

19. Data Sheet

20. DLA

21. Developing a World Class PSR Program Utilization Reviews: • The expected short-term and long-term outcome of each service needed by the client and • Progress made in response to treatment. Conferences and ITPs • All Progress Documented in ITP • Collaborative, Strengths Based Consultations

22. DLA Items ITP

23. DLA Items ITP

24. Ecker’s PSR Program Particulars Golden Corral of Treatment • Large and Diverse Team Includes: • Staff • Interns • Clients • Multi-Leveled Treatment Program • Varying Functional Skills • Varying Skill Development Needs • Deliberate Program Design and Implementation

25. Ecker’s PSR Program Particulars 3-Tiered System to Meet Assessed Needs • Ecker Offers: • Do Drop-Inn: Social Laboratory • 2 Hour Treatment Groups - Catalog • 4 Hour Treatment Cohort - Workbook • Individual Treatment

27. Contact information: • Rick Vander Forest, Director of Recovery • rvanderforest@eckrecenter.org • 847-695-0484 x 322 • Bob Zima, MA/LCPC, PSR Supervisor • rzima@eckercenter.org • 847-695-0484 x 347