Section 3: Applying Recovery to Daily Challenges

Applying Recovery to Daily Challenges is a whole variety of writings applying my understanding of recovery to challenges in my daily work.  In my view, for a model to be useful, it should be able to lead us to successful approaches to challenges we didn’t anticipate when we put together the model.  The recovery model hasn’t let me down yet.  You get the most papers on issues that focus on what I worked on, most notably substance abuse, homelessness, and psychiatrists.

 

 

Service Delivery

Transforming Staff/Client Relationships – 1994

A set of definitions of the elements of Village based services, contrasting them with traditional services

 

Mark’s Goal Setting Ideas – 2000

Concrete guidelines for case managers helping people set goals and grow

Recovery Based Service Coordination – 2006

Applying “client-driven” without turning over the asylum to the inmates.  Making plans depending on their stage of recovery.  Also “value driven and consumer centered” as a guide to decision making. 

Ask Your Doctor about Recovery – 2007

An advocacy guide and schema for more recovery based relationships with psychiatrists and other mental health professionals 

This Facility is Psychosis Accessible – 2008

A list of practical ways to make the value of “psychosis accessibility” a reality 

14 Things you can do to Rebuild your life – 2010

A list of practical things that people can do to help themselves to recover and rebuild their lives

Confidentiality, Integrated Services, and Recovery – 2011

An effort to rethink confidentiality to a create “Recovery Based HIPPA Training”

Four Levels of Recovery Practice – 2009

A checklist description of four transformed levels of practice – recovery enhanced practice, recovery based practice, community integration, and community development inspired by four levels of leadership skills – direction, support, linkage, and networking

What is Recovery Based Practice? – Outline – 2010

A list of concrete practices that are recovery based for staff who say “I’m already doing recovery.”

Taking Strengths Seriously – 2011

An analysis of four different perspectives of strengths-based work - social determinants of health, protective factors, self-efficacy, and building resilience by finding strengths in struggles

Substance Abuse

Working towards Services for all Substance Abusing Mentally Ill People – 1994

My version of the NIMH four stages- engagement, persuasion, active treatment, and relapse prevention as a practical guide to dual diagnosis services

Creating a Dual Diagnosis Treatment Culture – 2004

Dealing with the emotional issues underlying our difficulties working with substance abusing people

Integrating Mental Health and Substance Abuse Treatment within a Recovery Framework – 2006

A vision of the possibilities of the implications of a truly integrated approach to dual diagnosis

Integrating Mental Health and Substance Abuse Treatment within a Recovery Framework – 2006

A vision of the possibilities of the implications of a truly integrated approach to dual diagnosis

Families

Friends with Families - 1997

Some musings on the difficulties working with families and an approach based on being “replacement peers” instead of “replacement families”

Advice for Families – 2009

An e-mail from a friend asking for help for parents of someone recently diagnosed with paranoid schizophrenia led to this response  

Suicide

Challenging the Suicide Status Quo – 1999

A bold rethinking of suicide prevention from a person centered, subjective point of view worth considering given the Village’s remarkably low suicide rate.

Homelessness

Forming Treatment Relationships – Reach Out and Touch Someone - 2001

A set of six practical techniques for engaging people

American Refugees:  The Village as Ellis Island - 2002

Reconceptualizing homeless people as “refugees in their own country” and our services as refugee services including practical implications

Who are the Mentally Ill Homeless? - 2003

My reflections on the “actual” diagnoses of mentally ill homeless people and the serious limitations of DSM for this group of people 

Dr. Mark’s Ten Myths of Homeless Mental Illness – 2004

A very controversial article challenging the prevailing view that homeless mental illness is the result of deinstitutionalization when so many people were so impaired early in childhood

Give Me a Home – 2004

An overview of recovery-based housing from vision to principles to practices

Psychiatrists and Medications

Psychiatrists

Let’s Include Psychiatrists – 1993

A brief list of six ways to include psychiatrists  

Training Psychosocial Rehabilitation Psychiatrists – 1997

A discussion of psychosocial rehabilitation, not as an adjunct to medical treatment, but as an entire reframing of medical treatment including the nature of the therapeutic relationship, techniques, and desired outcomes  

Medication Collaboration Strategies – 1998

A short list of my twelve instructions for psychiatrists 

Psychiatrists’ Recovery Curriculum – 2003

Suggestions for key competencies for recovery-based psychiatrists including engagement, assessment, treatment, and outcomes

Dr. Mark’s Guidelines for Psychiatrist Teamwork – 2009

A practical description of the psychiatrists’ job at the Village to guide case managers’ collaboration

Thoughtful Psychopharmacology – 2005

A short article I use as a handout to show how much more there is to successful prescribing than there seems to be - for non-psychiatrists or students

Can I Recover and Stop My Medications? – 2009

A lengthy reply to a psychiatrist who was upset that we had posted a link to the National Empowerment Center because it said that many people with schizophrenia could recover and stop their medications, “Not the message DMH should be sending to anyone.”

Collaborative Psychiatry – 2012

A brief outline of all the levels on which a good psychiatrist collaborates as part of helping people recover

A More Comprehensive Approach to Ethical and Effective Prescribing – 2013

A four-pronged approach – individualization, recovery, trauma informed, and toxicity informed to prescribing, in part responding to the challenge of Robert Whittaker’s “Mad in America”

Psychiatrists Can Make Personal Recovery-Based Changes - 2013

A review of some personal practice changes individual psychiatrists can make to be more recovery- based

Do I Enjoy Prescribing Meds?- 2014

Even with the corruption of big pharm, our ongoing overreliance on meds, and the toxicity involved there are still gratifying positive usages for psychiatric medications

Employment

Interested in Working? - 2013

A practical guide for engaging people in employment efforts

Transitional Aged Youth

Transitional Aged Youth

Diagnosis and Transitional Aged Youth – 2007

A discussion of the common diagnostic clusters that are messily combined in our TAY program

First Year Lessons from our Transitional Age Youth Academy – 2007

A frank discussion of the difficulties in working with TAY, and the hope

Rolling into TAY - 2007

Practical details of engaging TAY

Trauma

Responding to the Demands of Trauma – 2013

A set of questions challenging whether we’re emotionally strong and prepared enough to help people who have experienced severe traumas.

Ten Life Lessons in Becoming an Effective Trauma Therapist - 2013

          A set of approaches to meet the personal challenges and transformations needed to effectively work with trauma, from the same trauma keynote presentation as the previous article.

Physical Health

Promoting Health and Mental Health – An Integrated Vision - 2013 

A schema for promoting health within a mental health setting including practical goals

Top 10 Strategies from the World of Recovery and Serious Mental Illness That Should be Used in Medical

and Behavioral Health Homes – 2013

A comprehensive article describing how a number of practices developed within the world of mental health recovery are badly needed in the medical system, especially in ObamaCare “health homes”

Lessons for Person-Centered Diabetes Services from Mental Health – 2015

A redesign of the diabetes treatment system using the person-centered structure of the Milestones of Recovery Scale (MORS) based on risk, engagement, and skills and supports.

Violence and Jail Diversion 

Violence and Jail Diversion

Murders are Frightening in Mental Health Too - 2012

Long version of an L.A. Times editorial written after the Aurora, Colorado shootings

An Anti-Violence Mental Health Plan - 2014

A five stage public advocacy agenda to attempt to deal with violence prevention, mental illness, and social isolation collaboratively as a community.

Are We Safe and Secure? - 2014

A list of various strategies staff can use to feel safe and secure for proactive discussions instead of waiting for a frightening incident to occur to talk about it

Focusing on Forensics and Achieving Deincarceration - 2012

Lengthy discussion of the various levels of mental health and forensic interaction including practice implications based on notes from a conference hosted by Elyn Saks at USC

Recommendations for Mental Health, Substance Abuse, and Housing Jail Diversion Programs for Los Angeles County – 2015

A lengthy article applying the perspectives of person-centered recovery to our forensic system, which is increasingly looking to community services to replace them, including a 3 level triage of people (Involuntary , excluded from society, Actively supported in the community, and Unengaged, living in the community) 

Important Considerations for Implementing Assisted Outpatient Treatment: A Collaborative Advocacy Agenda - 2014

Lengthy discussion of serious concerns around “the devil is in the details” of implementing AOT

Paperwork 

Adult Initial Assessments - 2013

A practical guide for doing initial assessments – interview, filling out form, and making chart diagnosis

Psychiatric Disability Determinations: Adapting to Inconvenient Truths – 2011

This is a guide written to help people evaluate disability to help with Social Security disability  application forms that was developed with SAMHSA as part of a training for Social Security disability hearing officers

Ready to move on – 2015

This is a systematized set of criteria for determining which people are prepared to move on form the intensive services in Full Service Partnerships (or ACT teams) to more independent levels of service.

Recovery Based Treatment Plans Checklist - 2019

This Checklist was created to be a comprehensive recovery treatment plan chart document that would replace the standard illness treatment plan forms we use now. 

Creating a Psychosis Formulation:  Describing the Journey You’re On - 2021

This article was excerpted from my psychosis guidebook I wrote after I left the Village.  It’s a handout for creating psychosis formulations using my Psychosis Triangle and journeys.

Strengthening Staff

Understanding Burnout and Protecting Ourselves - 2011 

This article describes how to protecting staff from burnout by embracing our emotions and recovery principles instead of by betraying them.
 

Staff Dealing with Client Deaths and Other Tragedies - 2013

Intellectual, emotional, and spiritual strategies to help staff rebuild after tragedies

Research 

 

Should the CATIE Study be a Wake-Up Call? - 2005 and Still Not Happy with CATIE - 2006

A full version of a letter published in the Psychiatric Services about the high profile CATIE study of antipsychotic medications wondering what went wrong and a follow-up letter

What Would Recovery Oriented Research and Publishing Look Like? - 2010 

A description of what could be changed about research so it would support recovery-based clinicians and our work.

International Mental Health

A Personal Worldwide Perspective of Psychiatric Rehabilitation – 2000

An article about what I learned visiting 23 mental health programs in 12 different countries on a 4 ½ month long world wide trip with my family

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