Understanding Mental Health Recovery

Recovery means being able to have a sense of meaning and belonging, as well as security, despite the fact that some of the symptoms of mental illness don’t go away or don’t always stay away.

 Recovery starts by making the choice to discover what helps you feel better, think clearly and relate to others.It often includes taking medication, talking about your problems, sleeping regularly, eating moderately and exercising. We all face challenges at different times, and any of  these problems can be our most immediate concern. It might be medical coverage,  housing, food, employment, incarceration…or anything else. Whatever it is; a problem is a problem.

According to the federal Substance Abuse and Mental Health Administration (SAMHSA), recovery is a process of change through which individuals improve their health and wellness, live a self-directed life, and strive to reach their full potential.

William Anthony has defined it as, “…develop(ing)…new meaning and purpose in…life as one grows beyond the catastrophic effects of mental illness.”

Recovery is not about the lack of symptoms, but instead recovery is about finding ways to live a meaningful life despite having symptoms.

Recovery, according to Mary Ellen Copeland, in her Wellness Recovery Action Plan (WRAP)—has five elements:


            Personal Responsibility


            Self Advocacy


A WRAP includes a plan for each of the following:

Wellness Tools. Things I can do or might do to feel better.

Daily Maintenance Plan. Things I need to do to stay well (including weekly, monthly or one time).

Triggers. Events or circumstances that may make me feel uncomfortable.

Early Warning Signs. Changes in my thoughts, attitudes or behaviors.

When Things are Breaking Down: I’m still able to manage my daily activities but need extra support.

Crisis. I’m unable to handle daily activities and need others to take responsibility for my care.

A WRAP includes making a list of the people you can call if you need to talk or would like more support.

There are at least 14 paths to recovery, and no doubt, many more. Dr. Mark Ragins’ Paths to Recovery include:

Talk to other people instead of isolating.

Actually feel feelings and emotions instead of deadening, medicating or avoiding them, or getting high.

Learn some emotional coping skills.

Learn to “use” medications instead of just “taking” medications.

Engage (or re-engage) in activities that make you more fun and interesting.

Take responsibility for your own life and make some changes in yourself.

Go to work even when you’re not feeling well.

Do things outside of being a mental patient and outside the mental health system.

Improve physical health and wellness.

Love other people—family, partners, kids.

Work on acceptance and forgiveness instead of blaming and vengeance.

Give back by helping others

Find meaning and blessings in suffering and reconnect with God and spirituality.

Once you start traveling down your road to recovery, you might want to write your recovery story. It can help you and others stay on course. These stories often begin with a description of the way it was, what happened to bring you to the point of making a decision to change, and what it is like now.

“It is the greatest secret of our modern world that inside the people we label as psychiatric cases live ordinary people with the same feelings, hopes and dreams as everyone else. It can take a great deal of patience and care to discover who we really are and help us connect to society, so that we can live decent lives. The history of civilization has always been to bring the “others” who we treat unfairly or unjustly into our sense of community, so we are all one community of equals with rights and meaningful roles to play. The last frontier of our evolution as a society may be to understand and find a place for people laboring under psychiatric difficulties. Some of these difficulties can be avoided if we protect people from trauma. And what can’t be avoided, we need to learn to accept and love, despite the differences we present to the world.”

Brian Youngberg / Seattle 02/17/12 permission to use with attribution.

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Getting Better from Mental Illness

You can get better from mental illness. You can have a life worth living. First, medications can bring symptoms down to where they are tolerable. You can further lessen your symptoms by learning lifestyle skills. And you can learn to tolerate what can’t be reduced further. Hoping for a better future is realistic.

Recovery is not really about the lack of symptoms, but instead recovery is about finding ways to live a meaningful life despite having symptoms.

The “consumer movement” is the name for people who have mental illness and are involved in making treatment better and reforming the system. We are working to de-stigmatize mental illness, so it is seen in the same light as other medical conditions. The consumer movement is making  great contributions to advances in treatment. They are fond of saying that, ” ‘Normal’ is only a setting on a dryer.” What this means is that you don’t have to feel ashamed that you have mental illness. It does not mean that it’s OK to be messed up or at odds with society. And it’s not OK to disengage from society and imagine that the problems you face aren’t problems after all. Our vision should be to recover
and not to simply exist. People can and do recover to a remarkable extent.

Some meds take effect very quickly, within hours or days. Others build up in your bloodstream over weeks or longer. All medications have direct effects, but indirectly they may also help you make more or less of your own natural brain chemicals, so you stabilize. This stability can take a long time to become fully complete, so give your medications time to work. That also means giving your prescriber lots of time to adjust your meds. Be patient and hopeful. Medications often have other effects than the ones which are desirable. These side effects can sometimes be more tolerable using a lower dose. They also sometimes lessen as time goes by. Or we just get used to them as a trade-off for the benefit which we grow to see as most important for your lives.

Always ask if a change of meds might help. If you don’t speak up, your prescriber won’t think about making changes.

Your lifestyle and attitude are as important as your medications in dealing with what you face, whether it is schizophrenia, bipolar disorder, depression, Post Traumatic Stress Disorder or brain trauma, to name a few. Or you may have a combination of more than one of these conditions. At times you likely have depression, anxiety or difficulty concentrating and remembering etc. You also are likely to feel fear, shame, hopelessness, helplessness or feel suicidal. Treatment including your own efforts to get well can make these feelings go away, at least most of the time. Never give up trying new ways to get better!

If you use alcohol or street drugs, you may never really get better, at least until you stop. But, mental health treatment will help stabilize you, even if you do continue to use. Get alcohol/drug treatment and cooperate. Figure out a way to like going to Alcoholics Anonymous and absorb AA’s teachings, which is easier for some people than others.

The main battle for better mental health is often waged over sleep. If you’re sleeping on a regular schedule, then all your symptoms will likely improve. As long as you can’t sleep well, everything will be the same or worse. See the article on sleep for help with this.

Generally, besides sleep, the paths to reduce your symptoms and lead a better life include one or more of the following:

Follow a daily schedule to increase your physical health. This includes some exercise, even if it’s only walking. Eat healthy instead of junk food. Reduce or stop smoking. If you have medical problems, see a doctor ( if you can) and follow his or her treatment plan. Brush and floss your teeth twice a day, and, if you can, see a dentist. There is a saying, “Only floss the teeth you want to keep”, and it is true.

Don’t isolate but drag yourself up and out. Make sure you keep your appointments. Follow a routine each day and have one for every day of the week. Gracefully carry yourself from place to place and a better state of mind, moment by moment. Stay in a meditative state of mind, banishing your negative thoughts and feelings (and actions), and your life will improve. We think, we feel, we act, and then we act what we think, we feel what we act, and we think what we feel. All the theories about human behavior and brain chemicals are only that –theories–which have rapidly been rolled over repeatedly for a generation. Do they have all the answers yet? They admit that they don’t. What doesn’t change is the benefits from thinking and feeling positive and doing constructive things. You will feel better and people will like you more.

Recovery happens much more easily and meaningfully when you are in healthy relationships. This can mean things as simple as smiling and being pleasant to the grocery clerk or things as serious as romantic relationships –and everything in between. Make friends or at least friendly acquaintances. Remember that to have a friend, you have to be a friend.

Not all people with mental illness exhibit the next trait I bring up, but we are generally known for it, which is that we do not get along with others. To a certain extent, this difficulty with other people could almost be one of the definitions of mental illness. In order to recover more, you may need to learn how to get along with everybody. Go to groups, read books, listen to positive songs, choose some movies which are upbeat. Talk about it, and seek out people who do get along.  In Alcoholics Anonymous we have a saying, “Go with the Winners”. It means to seek out people and spend time with people who are in recovery—these will be individuals and groups who get along with other people. Destructive relationships or interactions are a major cause of stress and increased symptoms. Avoid conflict.

Discover how you can understand yourself and others in your own unique spiritual way. To do this learn how others have found morals and values, inspiration and meaning. Life without values is drudgery. Get a better life by finding meaning –perhaps you can find a way that your suffering can give you insight on how to help others.

Do everything you can to look nice and be clean. You will get an entirely different response from society this way, because to a certain extent, the “stigma” or discrimination against the mentally ill is an aversion to people who are poor and dirty. Don’t look poor and dirty if you can help it, and the world will treat you differently. You will feel better about yourself.

Volunteer or work. You will respect yourself more and so will the world.

Create a home of order and beauty, no matter how simple or sparse –even if you only carry it in your backpack or just in your back pocket. Try to recreate and save your memories of the past, your pictures, your diplomas or whatever–maybe it’s a certificate of successful completion of parole. Save these pieces of your life, if you can. Carry the paper records of your life and also scan them electronically and put them on a computer CD, which is waterproof. So often, we lose our past, which contains real accomplishments. Try to hang onto the parts of your past life which you cherish.

We have a past, but we also have a future. Often our past is burdened with trauma, abuse, shame, failure, rejection, fear, pain–even terror or horror. Get treatment for going through these events, but don’t dwell on the past. Come to terms with it but don’t let it control your future. Learn to live a life of peace and joy. An important part of this might be to find someone who will listen without shock or judgment. Maybe you can be that friend who listens to someone else, or you can listen to each other. Just listen,  people do not want advice, just a friendly ear to tell their story to.

Recovery often takes years, but you can start feeling dramatic effects right away. And even while you may continue to be disabled from working, you can live with dignity, respect and joy. You can have a real life, have fun, love and learn, despite your symptoms or your poverty (which often comes along with having mental illness).

Plan for a future which will be better. Dream of the day we will be treated with respect and not contempt by our society. Make moves which will bring about a better world for the mentally ill. Become involved with society and help it to change so we can all live in a better place.

Here are the 13 paths to recovery from mental illness of Dr. Ragin

Dr. Mark Ragins has years of on-hands experience helping people go into recovery. He is part of The Village inLos Angeles, which serves the homeless and others seeking help. The best way to go into recovery from mental illness is not to simply take your medicine and do what you’re told. People recovery with medication, but they need to do something more. He recommends that people start down at least one of the 13 paths he has found have worked for others. These paths can lead into each other, until the person is using many of them and many more which they find on their own.

Edited with the help of Silvia S. 10/29/11

The 13 Paths to Recovery of Dr. Mark Ragins:

  1. Talk to other people instead of isolating.
  2. Actually feel feelings and emotions instead
    of deadening them, medicating them, avoiding them, or getting high.
  3. Learn some emotional coping skills.
  4. Learn to “use” medications instead of just
    “taking” medications.
  5. Engage (or re-engage) in activities that
    make you more fun and interesting.
  6. Take responsibility for your own life and
    make some changes in yourself.
  7. Go to work even when you’re not feeling well.
  8. Do things outside of being a mental patient
    and outside the mental health system.
  9. Improve physical health and wellness.
  10. Love other people—family, partners, kids.
  11. Work on acceptance and forgiveness instead
    of blaming and vengeance.
  12. Give back by helping others
  13. Find meaning and blessings in suffering and
    reconnect with God and spirituality.

Mark Ragins, MD, Medical Director for the
MHA Village Integrated Service Agency, Mental Health America of Greater Los

You can view Dr. Ragins writings online or
order it at MHAVillage.org

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Print Out a Flyer “There’s Always a Way to Get Medications”

Ways to get medications if you’ve left an old provider, never had one in the first place –There’s always a way to get medicatiions whether you have medical coverage or not.

If You Can’t Get or Lose Prescription Coverage,keep a list of all medicines and their dosages!

To obtain a new provider or source of medications, take one of the steps below

[1] If you lost Medicaid coverage but still have Medicare, you need to find a providerwho will take your Medicare as payment for services and write you prescriptions AND either A. pay your Medicare Part D premium to a qualified plan, OR B. meet a state DSHS Medicaid Spendown OR C. qualify for a Healthcare for Worker’s with Disabilities (HWD) with the Department of Social and Health Services (DSHS).

[ A] Medicare Part D premiums vary and have complicated rules—Call the State Health Insurance Benefit Advisors (SHIBA) volunteers at 1-800-562-6900. SHIBA will provide you with answers on how Medicare clients can obtain medication. Have a complete list of all your medications and dosages both for regular medical and for mental health medications. Or [B] Do a Medicaid Spend Down. Go to your local state DSHS (welfare) office and apply (you can also apply online). Or [C] Get Healthcare for Workers with Disabilities (HWD) which is an inexpensive Medicaid Buy-In. Make a regular DSHS Application for Benefits –it is best to apply online. HWD is one of the options in the application. After you have made an application, if you have questions, callHWD at ___________ and leave your name, social security number, telephone number and mailing address. If they send you an application, fill it out and mail it in. You must be employed at least one hour a month (this may be increased and for SSDIers past the end of their Extended Period of Eligibiliy, it is 10 hours a week) – O if you have income from a steady source of self employment in services or sales, you may qualify.

[I2]If you have Medicare and also have Medicaid, follow the instructions below for those with Medicaid.

[3] If you have Medicaid, you have medical insurance and full prescription coverage. Contact the DSHS or CSO or Welfare office and ask what provider you can go to and get prescriptions written and filled—or go to urgent care at a publically funded hospital and ask for meds with your Medicaid.

[4] If you have Disablity Lifeline (DLX or the old GLX), ADATSA or are in another program, like housing, street outreach, prison re-entry, or drug or mental health court, or if the DSHS, CSO or welfare office said “you get a check” or you get “medical” use your Provider One card (get a new one from DSHS if necessary) and ask the welfare office what to go to and get prescriptions written and filled.

[5] If You Have No Insurance:

[a] Always go back to the DSHS ( CSO or welfare) office and ask for help even if you were turned down in the past. If that doesn’t work, then try one of the following: [b] Call 211 and ask for a Community Health Clinic (which may go by some other name). They will always help you, and they should be able to get you your medicationsfree from the manufacturer. –or at low cost. Or [c] Ifyou can get someone to write your prescription, go directly to the manufacturers web site and find the form to download and print for free meds. Fill out that form and take it to whoever might agree to write your meds. Or [d] A doctor, nurse, physician’s assistant medical office or clinic where went in the past may write prescriptions for you or give you free “samples” (given to them by factory representatives)

If Nothing Else Works, and you are out of meds and your symptoms are returning, call the crisis line at 1-866-427-4747 or go to a local hospital (in the Seattle area, Harborview Urgent Care at 9th and Jefferson). (TheresAlwaysAWayToGetMeds.doc/mentalrecovery.wordpress.com) 

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The Office of Consumer Partnership and A New Coalition

Build a Consensus of Community Organizations to Present to Government Agencies

How many times have we heard that for community organizations, to be effective, must build a consensus, so the government has only a single option to comply with citizen demands? But how do you build this conensus? One important point is to agree to reach a consensus and in the next meeting or communication to the government, all stick to that demand or stay quiet.

What follows is a description of what was a particularly successful meeting with a government agency which occurred at a very difficult time for its budgets and policies. It can be an example of how to move forward in such difficult times.

On September 30th, 2011, I had the opportunity to attend a meeting facilitated by Mary Jadiwisiak, of Mental Health Advocacy Training and Consulting (MATAC). The meeting had been called to bring more direction to the Office of Consumer Partnerships (OCP). The name of this office is “partnership” and we are the other partner, the mental health recovery movement. We have discovered and developed the tools so people can recovery over the last 25 years—we did not do this alone–but no one else believed we are capable of going into recovery, so it was up to us. And we want to continue to influence the treatment field and government policy.

We are adults in mental heatlh recovery, which is one of the groups with which the OCP works. The other groups are youth and their families, youth in transition, people in recovery from addictions and those with co-occurring disorders, as well as the elder population. (People in hospitals and some group homes, as well as those in jails and prisons are part of other government departments—however the recovery movement crosses all these boundries and includes people with chemical dependency issues and, of course, our own families—families of people with mental illness).

David Dickerson, the Director of the Department of Behavioral Health Recovery (DBHR) decided to establish an advisory committee to the Office of Consumer Partnerships, drawing from our ranks. He will also bring in members of the communty to represent the families of youth, parents of adults with mental illness, and people with chemical dependency and COD issues. Our meeting also resulted in a consensus decision to form a new coalition of adult consumers, which will address issues beyond the Office of Consumer Partnership.

Out of this meeting the participants forged this new coalition of organizations and individuals, including the Regionally Emplowered Communities of Accessability and Hope (REACH) and Mental Health Action (MHA), each of which have been funded by SAMHSA to establish networks and for REACH to establish more Consumer Recovery Centers (like Consumer Voices Are Born (CVAB), in Vancouver). Also participating were the state-wide consumer social networking site, Northwest Seeds of Change, based at the Capitol Clubhouse, Ombuds, consumer hospital representatives, members of the Regional Organizing Initiative, and people who are active in the NAMI consumer movement. Representatives from Optum Health were present, which has the mental health component of the DBHR contract for Pierce County and contracts with Recovery Innovations.

Minutes and a complete list of participants is available from MATAC.

In the afternoon, the group was joined by David Dickerson, Director of the Department of Behavioral Health Recovery and his staff, including individuals who had been assigned to work in the Office of Consumer Partnerships. This example of how community coalitions can work with government agencies begins with the morning session in which the group worked through the ideas which became the basis of a set of demands to the state agency.

Mary Jadwisiak began by saying that she wanted us come to a consensus– and immediately began unfolding four easil-sized sheets of paper with the rules and values which she wanted us to agree to, so we could achieve this. Throughout, she made humor of the fact that the shortcuts to the process she was taking were directions from her and not (at least yet) anything which we had greed to.

Group Agreements

1. All ideas matter

2. Stick to the process

3. Set aside perfection

4. Principles before personalities

5. Come to a consensus and then support it (or stay quiet)

6. Recovery principles should guide, including respect, responsibility and self reliance

7. Allow fluidity of language– don’t quibble over words or how something is said

Consensus Decision Making

1. General agreement

2. A judgment arrived at by most of those concerned

3. Group solidarity (at least for the time period of the presentation of the demand or whatever time period is agreed upon and accepted)

Let’s Examine our Assumptions– Why Are We Here?

For instance, for myself, I answered, that I talk to people every day who rarely are appreciated for their accomplishments or feelings or listened to about the traumas they have been through, and mental illness recovery is about these things as much as its is about medication or achieving normal roles and functioning.

Mary Jadwisiak put up a page for connected ideas – a parking lot for ideas outside the topic today.

On this Parking Lot she put down things like:

There should be a contract term requiring mental health clinics to have consumer councils, otherwise we will never make organizational progress in marketing recovery principles into the clinic system.

Do to the budget problems, the system needs us nor more than ever as volunteers.

What is the definition of a “consumer” – Washington is the only state which includes a family member of an adult consumer as a consumer.

The discussion began with Jill saying that we have to take ownership of the issue of how the Office of Consumer Partnership carries out recovery and the existing Strategic Plan. We need to hold individuals accountable.

Stephanie: Let’s get outside grants [and I made a mental note that we should do our own fundraising, like the Minglethon].

John: There should be an advisory committee to the Office of Consumer Affairs (an idea later approved by Director Dickerson).

Cindy: No one communicates to us in Eastern Washington.

[In answer to the question of whether the state supports recovery, the slogan that, “They need our experiences of Recovery to guide their policies of care” was later repeated by the Director]

Helen: We are involved in areas beyond the jurisdiction of the Department of Behavioral Health Recovery and so she should have our advisory committee attached to the Assistant Director of the Department of Social and Health Services [which would then include our people in youth, youth in tansition and institutions]

Michael: Self-Determination is the key issue [which was later adopted as the key issue by the meeting]

It was noted that Stephanie Lane, who was present, was successful, during her tenure as the director of the Offcie of Consumer Partnership, in starting supported employment within that office, which spread to the DSHS and the whole state government (?).

Brad Berry, the Director of Consumer Voices Are Born and REACH then faciliated the following items:

1. What is the best configuration and structure of the Office of Consumer Partnership?

2. What role and work should they do?

3. How will they interact with other elements of government and outside organizations?

[Perhaps we should have a weekly e-mail of a post which floats on top of the Northwest Seeds of Change home page. This email would be our New Coalition’s short weekly message on what is happening politically in Washington State]

John: The advisory committee members should each hold local committee meetings in their regions.

Stephanie Lane asked who hadn’t spoken.

Brad Barry presented his detailed agenda of items for consideration (to be inserted later from Mary Jadwisiak’s notes or Brad’s email attaching this agenda).

Jill: House (or is it Senate?) bill 2654 providing for consumer operated services needs to be moved forward both regarding funding and allowing Medicaid funding to be used outside the confines of Communtiy Mental Health Clinics. [Is this the bill which provided for consumers to be required to work within the confines of Communtiy Mental Health Clinics while “family members” were not required to do so –or was this later amended? If not amended, a legal challenge is very possible and would be so embarrassing to the “families” and DSHS, so that this might be resolved. – Unfortunately Disability Rights Washington has no contract to provide an opinion and should not do so –an independent professional should be consulted]

[Otherwise regarding Peer Serv ices, the can be accomplished as follows:

1. Working for Community Mental Health Clinics

2. Consumer-driven programs embedded within clinics.

3. Consumer Recovery Centers (or Clubhouses), respite centers etc. free from the current restrictions on funding only to clinics.

4. Clinics run by consumer professionals. ]

Issue: Should one or more positions within the Office of Consumer Partnerships be exempt/management positions outside the union contract and outside civil service? (This meeting was called because those rules under the Reduction of Force Terms (RFT) forced David Dickerson to accept as Director of the Office of Consumer Affairs a “family” consumer DSHS employ who is not part of the consumer movement—not even a member of NAMI ).

Steph: The Office of Consumer Partnership needs a budget [something David Dickerson later promises to pursue and put as as Requests for Proposals to local groups].

At this point David Dickerson and his staff joined us.

A report on that interaction and the resulting agreements etc. will be posted when Mary Jadwisiak posts her minutes.

Brian Youngberg, Seattle Sept. 31, 2011 for MentalRecovery.wordpress.com

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Train Others To Be Trainers

You’ll use what you learned in kindergarten all your life, but when you’re teaching adults, you’ll need to use Adult Learning Skills. Some of these skills are illustrated below.  For instance, tell people what you are going to teach them, teach it and finally demonstrate how it works in a practical way.

8 Principals for Conducting Sessions for Adult Participants

  • Focus on “real world” problems.
  • Emphasize how the learning can be applied.
  • Relate the learning to the goals of the participant.
  • Allow debate and the challenging of ideas.
  • Listen to and respect the opinions of participants.
  • Encourage participants to be resources to the trainers and to one another.
  • Treat participants like adults. (shocking!)

Recovery Story

For this and almost every other training for mental health peers, you should start out by telling your own Recovery Story. Make it short but with some raw depths of sorrow, a dramatic turning point and finish with what volunteering or working as a peer specialist does to enrich your own life. As you tell your story, you’re modeling something short and to the point, which the people you’re training can use in a variety of situations. Recovery Stories can be used to train others, help others or explain Recovery to the normals.

Ask each person to introduce themselves and how we might all remember their name. Then each person should tell his or her own Recovery Story. If any of them start rambling or getting away from recovery–especially if they start telling an “Illness Story”–interrupt them — don’t jump in while they are talking about trauma or triumph– but look for a pause. By interupting them, you’re modeling how they themselves can interrupt someone to help keep Recovery Stories stay on track.

You’re teaching the use of  the formula “What it was like. What happened. And What it’s like now.” Sharing stories is therapeutic, but remember you’re also training them.  Keep in mind, better trained peers means providing better services and helping more people. You’re teaching them to model short, sorrow-to-recovery testimonials. This short Recovery Story is the kind of thing which works best in groups. The long versions of people’s stories can be part of one-on-one sessions.

Next focus on the message of the training which you are conducting.  For instance, “How to be a better Peer Counselor”. To introduce your theme, first ask them why they have come to the training. Point out there are no right or wrong answers.

Theme of the Training and the Method or Gimmick You’ll Use

So first you’ll  ask people, “Why are you here?” Once you’ve heard all their answers, tell them that you are going to teach them (insert your theme here–we’ll use Becoming a Better Peer Specialist).

Next, you introduce the method or gimmick you re going to use to train them. In this case, we’ll illustrate the “Solving the Puzzle” method.

So when they’ve finished answering the “Why They Are Here Question”… say, “I’m going to teach you how to be a better Peer Specialist. We need to solve puzzle of how we can do that.

Use the Method or Gimmick –in this case the “Solving the Puzzle”

Introduce the puzzle theme: Ask each of them to take a few pieces of a jig-saw puzzle from a bowl (use interesting, over-sized jig-saw puzzle pieces).

Ask each one to say one good thing about him or herself for each piece they took from the bowl. (You’ll see how this puzzle/confidence building will be used with them later in the main part of “Solving the Puzzle”.

Teaching the Basic Theme in No More than Four Bullet Points or Numbered Steps

Now use four bullet points (or numbered steps) or less to teach your basic material. At each step ask for examples from the audiences’ own experiences. Intersperse your own examples. For instance, if you are talking about “How To Be A Better Peer Specialist”, you might say, “When someone doesn’t show up at the Consumer Recovery Center, call  that person that day or the next and ask how they’re doing or leave a message. And as long as they don’t show up, call and deliver that message every day until they either show up or ask you to stop calling.

(This would be a good time to tell the story about the new peer specialist who was told by his supervisor to call people on the clubhouse’s list of members who weren’t coming in. The next day the new peer specialist said he’d called everyone, so the supervisor told him to call everyone who hadn’t showed up. Another day went by and the peer specialist asked if he’d called enough, and the supervisor told him to keep calling until everyone showed up. So the peer specialist didn’t ask any more but just kept calling. One person he would call but all he got was an answering machine, so he kept leaving a message that the person was missed and he should come in tomorrow.

Then one day, someone new to the peer specialist came into the clubhouse, so the peer specialist greeted him at the door. The new arrival said, yeah, he was glad he’d come in. He said, “Someone from the clubhouse called me every day for the last year and left a message. I didn’t know how I would have made it except for those calls. They were the only person I talked to the whole time.”

What Do You Do Once You Get The Person To Come To The Clubhouse?

The numbered points for this example might be:

  1. Take the time to talk with him or her or just  hang around, until you feel both of you are comfortable with each other (this may take 5 minutes or 5 years).
  2. Ask them to tell their story, if they are comfortable to share it–this may come out all at once or in little pieces. Their life story, or their past, though is different than their Recovery Story. Their Recovery Story is something which they may not even have started thinking about.
  3. Find something you can share with them every day — maybe you can start following their sports team in a column  in the paper.  Or if they’re interested in dinosaurs, collect them from Goodwill–whatever it is that interests them, take an interest in.
  4. Share some aspect of how you overcame an obstacle which is similar to an obstacle they face.  Ask them if they think that might help. If they say “no”, ask them what might.

Pulling the Theme, the Method and a Practical Plan Together

Move on to the conclusion of the training when they are going to incorporate everything into a concrete plan for how they will better interact with their friends, their peers or the normals.

For team exercises, pass out an easel-sized pieces of paper to each team. Ask each team to give itself a name.  (If you’re training people to act and implement what they’re learning individually, pass out big, oversized sheets to each person.)

Give out  markers, glitter glue, etc. (Did I mention this should/could be a “Flower Power” recovery style program with children’s and adult’s silly toys– and don’t forget the spray can of silly string!).

Solve the Puzzle of How We Can Be Better ______ (in this case Be Better Peer Specialists)

They are going to solve the puzzle of what is missing so they can be better ________. They are going to leave the training with new skills and concrete plans to use them.

Ask them to draw a big puzzle piece and write inside it what is missing from them achieving their goals. Once they have all written what is missing, have do a read around. As they say out loud their missing pieces, write them down.

Once everyone has had a chance to speak out loud what they are missing, ask each person or group to return to their puzzle and write in solutions.

Once everyone has had a chance to write in solutions or solve the puzzle, ask each team or person to read their “solution to the puzzle” out loud. Write these solutions on a fresh piece of paper. If a solution isn’t strength-based, immediately re-phrase it as a strength-based solution and write it down.

Ask the group as a whole to each come up with solutions to other people’s puzzles and write these additional solutions down.

Sort out all the puzzles and solutions, so they are together. Tell them you are going to email all this to everyone. (Do this no later than the next day. Include a link to the blog or Facebook page where you’ve posted all the puzzles and solutions)

Thank them for coming and tell them they have been a great group. Give them the blog address, your email address and your phone number, if you’re going to continue to be working with this group of people.

Thanks to Stephanie Kay Lane of Helping Other People Excel (HOPE)/Capitol Clubhouse/Northwest Seeds of Change and a great friend for inspiring this blog.

From our Mental Health Action leadership training September 20th, 2011 at the Palisades Retreat Center in Federal Way Washington, co-mentored by Helen Nilon, Mental Health Action’s Executive Director.

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Recovery Art

Our Employment and Volunteer Tree and the Recovery Book  means that we have a chance to tell people about recovery and ask them if their art work etc. was related or could be related to their recovery.

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The Thirteen Paths of Recovery of Dr. Ragin

Dr. Mark Ragins has years of on-hands experience helping people go into recovery. He is part of The Village inLos Angeles, which serves the homeless and others seeking help. The best way to go into recovery from mental illness is not to simply take your medicine and do what you’re told. People recovery with medication, but they need to do something more. He recommends that people start down at least one of the 13 paths he has found have worked for others. These paths can lead into each other, until the person is using many of them and many more which they find on their own.


The 13 Paths to Recovery


  1. Talk to other people instead of isolating.
  2. Actually feel feelings and emotions instead of deadening them, medicating them, avoiding them, or getting high.
  3. Learn some emotional coping skills.
  4. Learn to “use” medications instead of just “taking” medications.
  5. Engage (or re-engage) in activities that make you more fun and interesting
  6. Take responsibility for your own life and make some changes in yourself.
  7. Go to work even when you’re not feeling well.
  8. Do things outside of being a mental patient and outside the mental health system.
  9. Improve physical health and wellness.
  10. Love other people—family, partners, kids.
  11. Work on acceptance and forgiveness instead of blaming and vengeance
  12. Give back by helping others
  13. Find meaning and blessings in suffering and reconnect with God and spirituality.


Mark Ragins, MD, Medical Director for the MHA Village Integrated Service Agency, Mental Health Americaof Greater Los Angeles www.mhavillage.org margins@mhala.org


You can view Dr. Ragins writings online or order it at MHAVillage.org

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