Robert Franco, Sr. Vice President for PROS
Alexandra Webb, Assistant Director
Who we are: Founded in 1972, SPOP was one of the first agencies in the U.S. entirely dedicated meeting the mental health needs of community-dwelling older adults. It is the region’s only agency dedicated exclusively to behavioral health care for older adults and is distinguished by its commitment to increasing access to treatment.
SPOP’s core programs include a clinic, which offers home visits to disabled clients and appointments at satellite sites throughout Manhattan, and New York State’s only PROS/Personalized Recovery Oriented Services program entirely for age 55 and older. Other programs include free Bereavement Support for adults of all ages, Information & Referral services, and Training & Education in the field.
PROS: The program began October 2013. The current census is 70 adults, and 85 percent of the participant population is between the ages of 65 and 85.
At SPOP, the basic concepts of goals and life role domains were refined and adjusted to meet the particular needs of older adults – for instance, in addition to traditional employment goals, SPOP participants may set goals for volunteer work or babysitting grandchildren, and socialization goals often focus on reconnecting to and building relationships with adult children or grandchildren or becoming involved in a Senior Center or faith-based community.
The PROS staff is comprised of social workers, a psychiatrist, nurse, creative arts therapists, recovery counselors and rehabilitation counselors. Each participant is assigned a recovery counselor and also has the option of seeing the staff psychiatrist for medication management or symptom monitoring. The majority of work is done in the 85 groups that are offered each week, many in Spanish. Specialized groups include Navigating the Medical System, Understanding My Medication, Building Balance, Exploring Life Role Goals for Seniors, and Spirituality. The program is open Monday-Friday 9:00-3:30 and includes two meals and a healthy snack each day.
Over the past year, PROS participants have achieved a success rate of 74 percent in making progress toward their goals. Several participants have transitioned to a lower level of support, such as therapy through the SPOP clinic or enrollment at a traditional senior center. The program has also resulted in decreased demand on the hospital system, as participants are directed to their regular physicians for routine care or to urgent care centers for minor emergences. Last year the overall rate for psychiatric hospitalizations was 2.0 percent (based on the percentage of program days in the hospital).
This group cycle, we launched a new group created by Alexandra Webb (Allie), Assistant Director and one of their clinicians, Anahi Galante, LMSW. Anahi has experience in hospice/ palliative care, and recognized that the risk of falls and the fear-of-falling cycle is of significant importance in the older population and could be a great addition to their menu of group services. Using information gathered from an EBP called ‘A Matter of Balance’, they created ‘Building Balance’, a 12 week group to reduce vulnerability to falls and increase activity by improving balance and mobility. This is a BLST service. Additionally, SPOP re-tooled the Medication Education and Symptom Management group and created ‘Understanding My Medication’ in English twice a week, and Spanish once a week. This curriculum was created by Allie and one of the bilingual LMSW’s, Ashley Zayas, who facilitates the group in Spanish.
Additionally, there is a BLST group called ‘Navigating the Medical System’. This group is focused on assisting participants in communicating with providers, creating and maintaining a personal health record for emergencies, selecting a health care proxy and creating a living will (if they choose to), understanding the basics of managed care, obtaining medical records, etc.
These groups are good examples of the work done at SPOP to support older people to achieve wellness and independence.
SPOP has provided the following curricula they use to guide their work:
If you have any questions regarding the program described here or the curricula they provided, please contact the program directly. You will find the links to their email addresses above.
November 2016 PROS Provider of the Month
Lindsay Morrison, PROS Director
Five years ago when I interviewed for the job as RN for Gateway PROS, I was impressed with and attracted to the evidence of a holistic philosophy embedded in the Gateway PROS program which was in its infancy at the time. The recognition that recovery and rehabilitation involves the body, mind and spirit and planning services that address individuals’ wellness as a whole has continued to be an important part of the culture at this program. I was asked to share some of the classes that I as the PROS RN teach and other ways this culture is supported as we provide services to our students in recovery from serious mental illness.
When students are oriented to the program and begin to consider which PROS services best meet their needs and hopes for wellness, this holistic message is clearly communicated to students. Students are encouraged to discuss their physical health needs and concerns. They are encouraged to make connections with their primary care providers. If they are not currently enrolled with a primary care provider, they will be offered assistance with setting up an appointment with a PCP. Use of tobacco is assessed and students are advised about benefits of quitting and health risks of smoking. We are currently instituting a monthly “ask and advise” protocol concerning tobacco use which is incorporated into the monthly summary. Healthy lifestyle changes are addressed as powerful sources of strength and improved self-esteem and are integrated into all Wellness Self- Management classes whether the focus is coping with depression, anxiety, understanding emotions, managing grief and loss or managing trauma. WSM classes provide information that help students understand the mind-body connection so they can begin to utilize a variety of skills that assist them to reduce stress and manage anxiety effectively. Because integration of physical and mental health is systemic in our curriculum, students learn that finding balance and caring for their whole selves is the way to recovery.
This program also provides some specific classes that provide support and information about physical wellness such as learning about nutrition, physical activity and mindfulness practices. Students who smoke may join the ongoing class “Tobacco and You” which is held every week to explore their thoughts about quitting and learn something about tobacco dependence in a non- judgmental and encouraging environment. They will learn how people plan to quit and techniques that increase success in quitting even before they are in the “contemplative stage” about quitting. Because so many of our students are dealing with Diabetes, a chronic disease requiring a high level of management, we provide an ongoing weekly class for students with Diabetes. This class combines information to help students understand the principles of Diabetes management and offers emotional support and understanding of the demands of Diabetes management.
I have included lesson plans and resources we have been using for a few of these classes and hope they are useful for others who are working on PROS curriculum.
Sally Anderson, RN