Developing the Workforce

A central player in the integrated care team is the peer recovery support member. This position is especially valuable for peers seeking to gain professional experience in the health care field and will aid in the increasing professionalization of the allied health worker. Here is how I envision the Peer Recovery Support staff member(s) working within and adding to our integrated health care team.

 
The peer recovery support position (PRS) partners with the Health & Wellness Program to provide the following types of service.

• Wellness coaching. PRS partners will be able to provide wellness coaching—that is, providing one-on-one or group counseling to help patients obtain their personal health objectives. This service will complement the rich array of wellness activities planned for the Health & Wellness program, including Yoga, music and art therapy, health cooking classes and cardiovascular exercise programs.  

 

• Recovery education and support. PRS partners will lead or co-lead self-help recovery services, perhaps even based on the 12-Step model.

• Chronic Disease Self-Management Program Leadership. PRS partners will be trained to lead or co-lead 6-week-long CDSMP workshops which instruct participants on ways in which to better manage their chronic illnesses, whether they are physical or emotional in nature. The Stanford University CDSMP model will be used for this instruction.

• Marketing. PRS partners will be able to assist with development of marketing and recruitment materials, including social and print media. CHD Health & Wellness has a Facebook and main webpage that require regular updating. PRS partners with interest in this work will be invited to update the pages, provide content and assist in designing other marketing materials.  

• Medical assistance. For PRS partners with a strong interest in health care, opportunities will be made available for assisting with obtaining patients’ vital signs, scheduling patient visits, collecting personal health information and arranging for medical taxi transport to and from visits.

Integration Case Report

Introduction

This case report describes the psychiatric behavior and primary care activities of a married 46 year old female diagnosed with major depressive disorder, severe in type, without psychotic features. What is perhaps most important to glean from this case is the benefit that the integration program, including primary care and behavioral health care, has had in the recovery experience evidenced by the patient.

Case Description & Discussion

The patient began experiencing depressive symptoms and was diagnosed with MDD in 2011, shortly after experiencing a spontaneous abortion of her first and only pregnancy. The patient was hospitalized and began a course of antidepressant therapy treatment— fluoxetine hydrochloride, 20 mg/day for 38 weeks. Meantime, the patient began participating in a weekly DBT group as well as attending individual psychotherapy of the psychodynamic type.

In 2012, the patient enrolled in the integrated services program through which she now obtains her medical care. The patient weighs 165 lbs and is 5’1 inches tall. Although she is not morbidly obese, the patient has been encouraged by the PCP to eat more nutritiously, exercise more regularly and lose approximately 20 lbs. The patient has gone to check out the gym and has been thinking more about how she wants to proceed long-term. She is feeling more stable and positive, but is worried about SI returning at some point. She agrees to get rid of anything she has held on to with which to hurt herself. According to the PCP, “she seems more hopeful overall.”

Through the integrated services program, the patient began, in 2013 ,to participate in an ongoing therapeutic writing workshop. In the workshops, the patient provides supportive dialogue and orients new members to the group. Her writing is strong and descriptive. She writes mostly about hopeful things, but she did, however, present one poem about the loss of someone close to her, which could well have been veiled reference to her miscarriage.

The patient will continue with weekly psychotherapy and DBT, as well as art therapy and writing therapy. While it is impossible to say for sure what trajectory her recovery would have taken without the integrative services program, it is clear that the patient has benefitted from the therapeutic and physical health care offerings she has received in one setting.

Healing Hearts Made by Clients

Writing Retreat Poem

 

The Writer

by Phyllis St. George

 

All these years

You've resisted

Growing up.

 

Waiting for your parents

To change?

Wanting to redo

Your childhood?

 

There are no Redo's and

No Back-to-the-Future's.

 

What's done is done.

Move on.

Be a big girl.

Take some responsibility

For your life.

 

How long are you

Going to hold out?

You are missing

So much.

 

Being a grown-up

Can't be all

That hard.

By now you know

It's more than

Paying bills

On time;

Owning a house,

A car, a cat;

Going on

Vacations.

 

Just write.

Just write and eventually,

One day

You will be there, and

You won't have noticed.