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April 5, 2012 Volume 3, Issue 13
Please share the Recovery to Practice (RTP) Weekly Highlights with your
colleagues, clients, friends, and family!

To access RTP's Weekly Highlights, quarterly e-newsletters, Webinar recordings,
and PowerPoint presentations,
please visit http://www.dsgonline.com/rtp/resources.html.

The second quarterly Webinar for 2012, "Understanding and Building on Culture and Spirituality in
Recovery-Oriented Practice," was held April 4, 2012. Download the slides and handout.

Reciprocal Supervision:
How Peer Specialists and Their Supervisors Can Work Together for Lasting Recovery
by M. C. Violet Taylor
Reciprocal Supervision is a term I coined to describe the egalitarian relationship I have with my supervisor. She is the Assistant Chief Nursing Executive in a locked mental health institute and I am a Regional Peer Bridger—the consumer on staff. We work in an acute care setting, where the spectrum of mental health issues, cultures, languages, abilities, and lifestyles is as varied among consumers as it is among coworkers. Our State has not been as progressive as it has been diverse. Peer Support Specialists are still a rarity, and we are the signal of changes to come.

There is a true understanding of the concept "unconditional high regard" in the working relationships I've developed with my supervisors at the hospital. We have incorporated key elements of the Wellness Recovery Action Plan (WRAP) in our relationships, emphasizing Hope, Personal Responsibility, Education, Self-Advocacy, and Support to benefit everyone—especially the consumers we serve.

Peer Support Specialists take a different approach to mental health and recovery. Relationships are based on trust, and we emphasize the strengths a consumer has already developed or has the capacity to develop. Among peers, reciprocity and discretion are implicit. You might say we work "from the heart out," with an appreciation for the preciousness of each other's humanity. It goes without saying that we all strive to support and understand one another.

For these reasons, Peer Support Specialists can be seen as disruptive in workplaces where change is necessary.[1] My focus is to help people return to work and their communities and, most importantly, begin the recovery process. Cleaning a consumer's home to ease his return from the hospital, waiting in the car during a peer's job interview, shopping with someone for work clothes and supplies these are just a few of the tasks we perform, all the while gently encouraging peers to determine what assistance is needed for their recovery. Recovery is always a work in progress. We're constantly changing together.

Each of my four supervisors has been a Recovery Champion. Along with peer leader Lisa Goodwin, the clinical staff have guided me with creativity and patience. Change has taken place at our organization and I believe healthy, strong relationships are part of the reason our consumers are so successful.

My first supervisor was Chief Nursing Executive Amy Rushton, RN. Looking back, I realize she was the driving force behind my work and recovery-oriented care at the hospital. Melissa Preston, Director of Social Work, was my supervisor the following year. She emphasized efficiency and customer service skills. Today I am supervised by Lauren Davis, ACNE, who has allowed me to write about and promote our success. These are women of vision, creativity, and strength.

Over the years, I have learned lessons from my supervisors that I still use today:

Ask the Consumer
When you're not sure about what a person has in mind, ask. Start a dialogue—it will show consumers you support their health, life, and dreams. If they don't know where to begin, help them create a list of viable options.

Give Your Supervisors What They Need to Help You!
At times, staff will question your work. My supervisor attends meetings where she's grilled about my decisions. Because we keep the lines of communication open, she can help me handle difficult staff and administrative hurdles. When my decisions are based on health, safety, and common sense, they can be easily explained to anyone.

Make Opportunities for People to Shine
As a one-peer department, I needed help facilitating groups. When consumers at the hospital heard about peer-led groups, they were anxious. "They can't be in a room alone together!" was the assumption. I responded that people need to be part of a support group where they can speak honestly, without fear of documentation or another diagnosis. My supervisor suggested each peer group leader work with an assistant, so someone would always remain in the room. We started with five peer-led groups and when consumers requested more, we obliged. I now co-lead about 14 groups each week, with help from consumers. Our groups are so effective, we host two at local drop-in centers.

Take Time to Speak Out
Consumers and I are usually responsible for presenting at local conferences. It was difficult to speak publicly at first, but my peers and supervisors brought me along. Allow your Peer Support Specialists to attend local and national conferences. If possible, let them bring consumers.

Guidelines I Use to "Manage My Supervisor"
  • Honesty. If I have a problem, I go straight to my supervisor. She has worked in hospitals for a long time and helps me resolve issues quickly.
  • Maintain role model transparency with supervisors, consumers, and staff—say what you do and do what you say.
  • Respect your supervisor's time. (Have you ever seen a mental health services provider who actually had enough staff?)
  • Take time off if you're not feeling well. Use your WRAP to catch early signs of illness.
  • Clinicians sometimes teeter on the edge of burnout. Handle as much as you comfortably can on your own and always be kind to consumers. Remember: we are not here to "do" for our peers, only to provide support.
  • Tell supervisors about new resources in the community (events, classes, etc.). Bring them information on trends and changes in technology, scholarship offerings, and conferences.
  • Let your supervisor know when she's doing well, and how her work has helped people. Note the changes you've made together.
  • When you're stuck, ask for help! Some clinicians, especially Recovery Champions, have been waiting for the chance to try something new.
  • Peer Support Specialists have two jobs: to serve consumers in ways that promote recovery, and inform their supervisors about what does and doesn't work inside the system. Don't expect solutions to magically appear. It takes time before great changes can be made.
As Peer Support Specialists working in an organization, we cannot create an atmosphere of "us" and "them." A string pulled in two directions is destined to break. Instead, show your organization you are all bound together by the sturdy, mutual, and heartfelt desire to help others overcome mental illness. There is no greater goal.

1. Patricia Deegan. 2011. Peer Staff as Disruptive Innovators—PDA Blog. Patricia Deegan and CommonGround–PDA. Retrieved from http://www.patdeegan.com/blog/posts/peer-staff-disruptive-innovators.

Violet Taylor is a Regional Peer Bridger in Falls Church, Virginia. Contact her at Violet.Taylor@dbhds.virginia.gov.

SAMHSA Updates Working Definition of Recovery
After launching several public feedback forums where stakeholders and members of the behavioral health community could provide comments, SAMHSA published its working definition of recovery. The recently revised definition recognizes there are many different pathways to recovery, and emphasizes hope as a catalyst for healing:

Recovery from mental and/or substance use disorders: A process of change through which individuals improve their health and wellness, live a self-directed life, and strive to reach their full potential.

Read more.

April Is Stress Awareness Month
How Do You Manage Stress?
Register Now Stress is the emotional and physical strain caused by our response to pressures at home, at work, and in everyday life. Everyone reacts to stressful situations differently. What causes one person anxiety may have little or no effect on another.

In small doses, stress can actually be a good thing. It helps us get motivated for the day, meet deadlines, and perform when the stakes are high. Although stress is a normal physical response, too much can wreak havoc on our health. When the body and brain sense danger—whether real or perceived—our defenses kick into high gear. A series of chemical reactions generates extra energy: blood sugar levels rise, the heart races, and blood pressure spikes. This response is the body's way of protecting itself.

Resilience is the best defense against stress. The ability to cope with adversity and adapt to change hinges on our flexibility and acceptance. Simple practices can help manage anxiety and tension—controlled breathing, exercise, and spiritual regimens, for example. When more attention is necessary, a mental health professional can provide one-on-one support.

For information about stress management, see SAMHSA's resources.

Register Now Recovery Resource
Performance Measures Target SMI
Seven new care management measures for schizophrenia and bipolar disorder have been proposed for the 2013 Medicaid Healthcare Effectiveness Data and Information Set (HEDIS). The measures address quality care for people with serious mental illnesses (SMI), especially those at greater risk of negative outcomes due to gaps in treatment, lack of medication adherence, and poor preventive care.

Proposed measures for SMI were based on 2011 studies conducted by the National Committee for Quality Assurance and Mathematica Policy Research. About 10 percent of the data set's Medicaid population had schizophrenia; another three percent had bipolar disorder.

See the 2012 HEDIS measures.

The RTP Resource Center Wants to Hear From
Recovery-Oriented Practitioners!
We invite practitioners to submit personal stories that describe how they became involved in
recovery-oriented work and how it has changed the way they practice.
The RTP Resource Center Wants to Hear From You, Too!
We invite you to submit personal stories that describe recovery experiences. To submit stories or other recovery resources, please contact Cheryl Tutt, MSW, at 877.584.8535,
or email or email recoverytopractice@dsgonline.com. All stories are reviewed by Carrie Nathans, RTP Editor.

We welcome your views, comments, suggestions, and inquiries.
For more information on this topic or any other recovery topic,
please contact the RTP Resource Center at
877.584.8535, or email recoverytopractice@dsgonline.com.


The views, opinions, and content of this Weekly Highlight are those of the authors, and do not necessarily reflect
the views, opinions, or policies of SAMHSA or the U.S. Department of Health and Human Services.