2. Meeting the Challenge of Challenging Customers Mary Jadwisiak (360) 687-7954 mjadwisiak@msn.com

3. Acknowledgments Judy Cantor, MSW, MHP, GMHS Columbia River Mental Health Services University of Illinois at Chicago Center on Mental Health Services Research & Policy Lisa A. Razzano, Ph.D. & Carol A. Peterson, M.Ed

4. Outline Customer Engagement Behavior vs. symptom management Self Determination Whose Problem Is It? Self care & Burn out Getting the Right Help at the Right Time Positive team members

5. Part One Customer Engagement

6. Signs There Might Be Problem Missed appointments with you or employers Lots of reasons why nothing will work Loss of enthusiasm Constantly changing direction Others?

7. Is This a Behavior or a Symptom? How do you know when the behavior is caused by the illness? ASK Directly and honestly

8. Really? Ask? You can’t provide appropriate services until you have all the information you need to: make the proper placement provide the necessary accommodations Dealing directly and respectfully with the issues signals you’re hopeful and approachable.

9. Sample Questions How do you learn? What helps you to learn and remember new information or a new task? Does being around people bother you? What helps you cope with your symptoms? Headphones, talking to others, walking, etc.

10. Common Medicine Side Effects Blurred Vision Dry mouth Diarrhea Restlessness Difficulty getting up in the morning Hand Tremors Flat Affect (no expression) Nervous, constant movement Sensitive to the sun Fatigue

11. Things You Don’t Expect Learned Dependence Mixed signals from the professionals in their life (The Jerry Springer Syndrome) Fear of Recovery Loss of identity Personal responsibility Loss of benefits

12. Get More Information Get basic information on various mental illnesses. National Alliance for the Mentally Ill  www.nami.org www.nami.org Google it. But remember “A little learning is a dangerous thing!” You’re not a mental health professional and you don’t play one on TV!

13. Self Determination It’s not my plan, if I didn’t write it. It’s not my plan, if I can’t change it. It’s not my plan, if I have to be talked into it. It’s not my plan, if I don’t like it.

14. Self Determination- A Brave New World Contrary to what the doctors told them Contrary to the expectations of those around them Self Stigma

15. Things I learned upon diagnosis You’ll never get well You’ll never work again You’ll have to quit school You’ll take medicine the rest of your life Avoid all stressful activity Don’t expect any meaningful relationships

16. How That Made Made Me Feel Like *@#! Hopeless Ashamed Alone Sad Depressed Worthless Discouraged

17. Not Just A Job An entirely new personal identify Facing a future they never thought possible All new habits and routines All new fears Is it any wonder we have a few false starts?

18. Part Two Whose Problem Is It?

19. The Emotional Experience for People Who Provide Care to Challenging Customers You may feel: Overwhelmed Dread at continuing to provide care Anger at co- workers, customers or supervisor You may also feel Depression Confusion at the need to provide care Preoccupation with the client BURNOUT

20. Effects of Burnout on the Team Staff splitting “cracks” in a team can show Bending or breaking “tried and true rules” or policies Neglect of one individual Overly focused on one customer to the exclusion of others’ needs Abuse of one individual Strong desire to discharge or transfer individual

21. Maybe It’s Time to Take a Break When your work begins to lose its appeal, it’s time for a change or to have your duties changed.

22. What Should I Do? Go to a class on Burnout prevention & recovery. Until then – check out these platitudes: Look at what’s negotiable Prioritize and delegate Think positively Laugh – choose how you respond

23. More Platitudes Monitor your stress level What is your body telling you? Are you self medicating? Develop a strong support system, not a griping system. Life Long Learning What is your overall goal in life? Get at it!

24. Still More Platitudes Find ways to decompress Pace yourself for the long run Maintain a healthy work/life balance Learn to become unavailable for short periods of time. It’s OK to say “No”,

25. Last One L.E.A.R.N. To Maintain A Healthy Work-Life Balance  Laugh  Exercise  Attitude  Relax  Nutrition

26. Part Three Getting the Right Help at the Right Time

27. When All Else Fails: Go back to the plan. Is it still their plan? Review it with the customer Confirm their agreement and direction Does the plan need revising? If it’s working, it need revising. If it isn’t working, it need revising

28. Who’s On the Team? Is there a team? Does the client like team members? Are the team members still relevant? Why are they there? Whose idea was it that they join? Are there natural supports?

29. Maybe It’s Time to Call in the Calvary There usually isn’t one Experts are good, if you can Find one Afford one Actually implement their recommendations

30. Find the Real Experts Trust the customer to lead you Trust yourself and your team mates Trust your local resources Trust your ability to take risks

31. What Else Is There? Patience Persistence Hope Commitment And, of course, the class on burn-out prevention!