1. NYC Dept of Health & Mental Hygiene: Supported Education Training Initiative- Day X:Support Planning
Michelle G. Mullen, MS, CRC, CPRP
Brittany Stone, MS, CRC, CPRP
Department of Psychiatric Rehabilitation
June 11, 2015

2. By the end of today, you will be able to…
Discuss the key concepts of recovery
Identify the 8 Dimensions of Wellness
Develop an Academic Wellness Plan

3. Outstanding Questions, Comments, Issues
Review of Day IX
Outstanding Questions, Comments, Issues
Develop and implement a Direct Skills Teaching Plan for one of the skills associated with time/task management for someone who needs help in this area (could be in either work (ACE people) or school).

4. Work Based Learning
Develop and implement a Direct Skills Teaching Plan for one of the skills associated with time/task management for someone who needs help in this area (could be in either work (ACE people) or school).

5. Why is Wellness important?
Recovery & Wellness
Average life expectancy according to the CDC about 78yrs old. People with MI 25 years younger (56.8yrs old)
Why do you think this is? Suicide about 30-40% but cardiovascular disease (more than double), diabetes, respiratory diseases, and blood-borne infectious diseases (more than triple) account for the majority of early deaths. Metabolic syndrome which is a cluster of risk factors that increases an individual’s risk for type 2 diabetes and coronary heart disease. These risk factors include abdominal obesity (a large waist circumference), elevated triglycerides, elevated low-density cholesterol, hypertension, and elevated fasting glucose. Many people while receiving good psychiatric care receive little to no treatment for metabolic syndrome.
Swarbrick found the lack of optimal health is a powerful contributor to the disability, isolation, and the lack of community participation people with mental illness often experience.
Why is Wellness important?

6. Wellness is ...
a conscious, deliberate process that requires a person to become aware of and make choices for a more satisfying lifestyle.
Creating a lifestyle centered on wellness means continually seeking more information about how we can improve ourselves and realize our full potential in the eight dimensions outlined.
Swarbrick, 2012
In our field we look to reduce the impact of illness but also strive to enhance the quality of life. Which means promoting Wellness.

7. The 8 Dimensions of Wellness
In 2008 SAMHSA stated the 10x10 campaign later renamed the Wellness Initiative.
“There are various aspects of life where we can focus in order to achieve wellness. Some people may find that they focus on one area more than other but other people may find that they need to spend a little time working on each area in order to feel well and/or maintain their recovery. The various dimensions are very interchangeable and certain activities can really help us to develop in more than dimension at a time.

8. Dimensions of Wellness
PHYSICAL (Body)
Physical wellness can improve strength, increase energy, reduce health problems, and directly affects one’s mental and emotional status.
Healthy body maintained by:
Good nutrition
Adequate sleep
Regular exercise
Making informed & responsible health decisions

9. Dimensions of Wellness
SOCIAL (Family, Friends, Relationships)
Meaningful relationships with others within and outside of family.
Having an interest in humanity and the environment as a whole.

10. Dimensions of Wellness
INTELLECTUAL (Mind)
Ability to grow from your experiences
Cultivating new skills, using imagination & creativity
Applying what you have learned
Interacting with the world around you

11. Dimensions of Wellness
EMOTIONAL (Feeling)
Recognition of feelings, thoughts, and emotions
Coping with stress in a healthy way.
Ability to express feelings, thoughts, and emotions responsibly
Enjoying life despite occasional disappointments.

12. Dimensions of Wellness
SPIRITUAL (Purpose)
Exploring your beliefs and values.
Searching for purpose and meaning to life and its events.
Development of higher self, purpose in life, inner peace, and a connectedness to the earth, others, and a supreme being or force within the universe

13. Dimensions of Wellness
OCCUPATIONAL (Career, Skills)
Using your gifts, skills, and talents to enhance your life and others.
Having an occupation that is satisfying and rewarding.
Any activity that results in a meaningful, satisfying, rewarding, and productive use of time.

14. Dimensions of Wellness
Financial ($, debt, benefits)
Refers to the objective perceptions and subjective indicators of individuals’ personal financial status.
Objective indicators may include income, debt, savings and aspects of financial capability such as knowledge of financial products and services, planning ahead and staying on budget.
Subjective indicators may include an individuals’ perception of satisfaction with current and future financial situation

15. Dimensions of Wellness
Environmental (Communities & Places)
Includes our living, learning, and working spaces and the larger communities where we participate as citizens.
Good health can be fostered by occupying pleasant, stimulating environments that support our well-being. It can be enhanced by places & spaces that promote learning, contemplation & elicit a relaxation response.
Being able to be and feel physically safe, in safe and clean surroundings, and able to access clean air, food, and water.

16. Recovery & Wellness
What is Recovery?

17. Recovery is…
" a deeply personal, unique process of changing one’s attitudes, values, feelings, goals, skills and/or roles. It is a way of living a satisfying, hopeful, and contributing life even with limitations caused by the illness. Recovery involves the development of new meaning and purpose in one’s life as one grows beyond the catastrophic effects of mental illness.”
William Anthony (1993),
Director of the Boston Center for Psychiatric Rehabilitation

18. Key Recovery Concepts (Copeland, 1996)
Hope
Personal Responsibility
Education
Self-Advocacy
Support
See Key Concepts Handout
WRAP is a program founded on these concepts. It is…

19. What is WRAP? An evidence based strengths focused tool used to:
uncover inner resources
identify the supports
affirm inherent goodness and
create a vision for ongoing recovery
It is used by:
people who are dealing with mental health issues and other challenges and
people who want to attain a higher level of wellness

20. The Focus of WRAP
The Wellness Recovery Action Plan is based on empowerment and personal responsibility.
It encourages a focus on strengths and wellness rather than on weakness and disability.
Employment and Education can also be addressed in WRAP.
Before we begin …

21. Mary Ellen Copeland & the Creation of WRAP
Part 1
Part 2
Mary Ellen Copeland & the Creation of WRAP

22. Academic Wellness Plan
Let’s Take a look

23. The Wellness Toolbox
These are the things you do to keep yourself well, and the things that you do to help yourself feel better when you don’t feel well.
Each person’s toolbox will look different (some use an actual box and fill it with resources or reminders, others make a list)- it’s important to make this plan work for them.
What are the things that you do to keep yourself feeling well (your wellness tools)?

24. Building a Wellness Toolbox
Physical
Social
Spiritual
Environmental
Occupational
Intellectual
Financial
Emotional
When creating a toolbox think back to our 8 dimensions of wellness. Do your tools cover all dimensions?
Create chart on white board with 8 dimensions to put wellness tools into
What are the things that you do to keep yourself feeling well (your wellness tools)?
You may also want to include things that negatively impact your wellness or things to avoid.
How do they fit in the eight dimensions?

25. Small Group Exercise Work in small groups
Create your wellness toolbox based on the 8 Dimensions of Wellness
Try to identify at least 1 tool in each of the 8 Dimensions.

26. Daily Wellness Plan Made up of 3 parts:
“How I am as a student when I am well”
“I am _______ at school when I am well”
List of things to do to stay well while in school
These can be creative and may include photos, videos, recordings, art, poetry, or be as simple as bulleted points.
These should also be honest- not all students are organized and diligent so if a student etc.

27. Triggers
Triggers are external events or circumstances that, if they happen, may produce feelings or behaviors that may be very uncomfortable and/or ineffective.
By increasing awareness of triggering events a more proactive approach to coping can be utilized. This can prevent onset of more severe symptoms.
2 Parts to this sections:
Identify the trigger
Pair it with a coping skill or tool from the Wellness Toolbox
What are some triggers?

28. Early Warning Signs
Those are subtle signs that let you know you are beginning to feel worse, like being unable to focus in class or feelings of nervousness.
Using the Wellness Toolbox, identify things that could help you feel better quickly and prevent a possible difficult time. (Ask for an extension on an assignment, attend a campus based self help meeting, meet with counseling services)

29. When Things are Breaking Down or Getting Worse
In this section, list the signs that indicate a progression or worsening of symptoms and signs, like you are unable to go to class or are hearing voices.
And again, using the Wellness Toolbox and knowledge of your resources, develop a powerful action plan, identify things that you MUST do.

30. Small Group Exercise
Using the focus person narrative, the Wellness Toolbox, and the Daily Maintenance Plan provided, complete the sections Triggers, Early Warning Signs, and When Things Are Breaking Down.
When processed as a full group have a different group share each section.

31. Academic Crisis Plan In the crisis plan:
identify signs that let others know they need to take over your responsibilities
who you want to take over/support you,
updated school information (ie: professors’ names & addresses and the contact persona at ODS)
things others can do that would help & things they might choose to do that would not be helpful
Your signature and the signature of those in the plan
Proactive, advanced planning keeps the student in control even when it seems like things are out of their control.
Similar to an advanced directive
It is supposed to tell others what we want them to do to take care of us when we can’t take care of ourselves.
Many people find that this is the hardest part of WRAP and it usually takes more time to develop that all the others sections combined.

32. Post Crisis Plan
This section is to be completed as one recovers from the crisis in order to have a clearer picture of what is needed to get well and what should be done differently.
Discuss the role school played in the crisis and possible changes along with consequences of making those changes.
The student will identify when and how they will resume his/her responsibilities.

33. Additional Information and Resources:
To download free WRAP forms visit
Mary Ellen Copeland’s Web-site:
Or download the WRAP App for apple or android ($4.99):
Visit SAMHSA for a customizable power point on wellness, recovery, and the 8 Dimensions:

34. This is where we stop… Work based learning:
What were the three concepts you feel most confident in knowing?
What are the three areas that you still have questions about?
Supervisors Only- Training from 10am-1pm: Friday, June 12, 2015
Next Training from 10am-4pm: Thursday, June 18, 2015
Content from training can be found here:
Work based learning:
Working with a student or prospective student, complete at least one section of the Academic Wellness Plan or WRAP.