Franklin Recovery PROS
Jessica Oppenheimer, Director
As practitioners, we know how engagement in our PROS program can produce outcomes. Engagement can lower hospitalization rates, increase successful discharges, and have a dramatic impact on health. In fact Holt- Lunstad, Smith, & Layton (2010) studied over 300,000 individuals and found that the “influence of social relationships on the risk of death are comparable with well-established risk factors for mortality such as smoking and alcohol consumption and exceed the influence of other risk factors such as physical inactivity and obesity” (p.14). The study showed that the impact of strong social relationships determined a 50% increased likelihood of survival. With that understanding, the staff at Franklin PROS wanted to ensure that we were fostering social relationships from the moment a new client walked into the building. By increasing the chance that a member would enjoy his or her first day, we felt this would allow individuals to focus energy on healing. We therefore created a volunteer peer mentor program to welcome and orient new individuals to PROS.
The basis for the peer mentor program was two-fold. One part was the opportunity to have greater engagement with our new members. The second part was to give our existing clients a chance to practice interview skills, social skills, develop relationships, and gain experience in what could possibly lead to a paid position as a peer. On staff, we have a paid part-time peer advocate who interviewed and trained interested candidates. The training includes an explanation for the volunteer peer mentor program, reviewing the checklist for peer mentors, appropriate questions to ask a new mentee, traits that are needed for positions of leadership, and behavior expectations while in program. To provide continued support, our part-time peer advocate facilitates a weekly mentorship community living exploration class that peers attend to gain knowledge about community resources that they can also share with their mentees. The volunteer peer mentors also received training in trauma-informed care in order to provide our incoming clients with the most safe, empowered, and trustworthy environment.
By using our volunteer peer mentors,we find that clients are more likely to remain in the program and get acquainted faster. Peer mentors can direct clients around the building and explain basic program guidelines. One client who had been admitted into the program for a few months but was having difficulty making it in on a regular basis started attending every scheduled session after being linked with a volunteer mentor. That linkage with the peer also inspired the client to start talking to other PROS members and even start applying to jobs! Two months later, she was sitting at her first interview. One of our volunteer peer mentors had this to say when sharing her experience as a peer in the program: “I love it! It feels great to be able to help somebody. Being a peer mentor has helped me to understand what it truly means to help others. The best part about the role is seeing my peer’s expressions when I reach out to them. Many peers have difficulty asking for help so, I can be that helping hand. Being a peer mentor has also assisted me in my recovery. I’ve been able to go back to school, be less self-centered and my mental health symptoms have decreased. I would suggest to others to be a peer mentor, it would help build themselves and help them through recovery.”
Our volunteer peer mentors have shared how empowered they feel by the mentor program and the social relationships they have developed. These same relationships that Holt-Lunstad et al. (2010) found to determine health and survival are providing our clients with an advantage. They have experienced increased self-esteem, confidence, and contribution to others. The peer mentors have become more committed to their own recovery as they are now setting the example for others. We use the peer program as an intervention for participants who frequent the hospital or want to make progress on a social goal. Mentors have the opportunity to include their experience on a resume and utilize skills that demonstrate growth in a number of rehabilitation goal domains. The benefits have been plentiful and the connections that have developed will outlast every PROS stay. All of this is due to the social relationships created through the volunteer peer mentorship program.
References and Resources:
Holt-Lunstad, J., Smith, T., & Layton, J. B. (2010). Social Relationships and Mortality Risk: A Meta-analytic Review [Abstract]. Pmed, 1-20. Retrieved from http://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1000316
Lake Shore Mentorship – Learning Community Resources Curriculum – Click HERE
Lake Shore Peer Mentor Duty Checklist – Click HERE
Lake Shore Trauma Informed Care Presentation – Click HERE
NYAPRS is please to highlight the work of Lake Shore Franklin Recovery PROS. Jessica Oppenheimer, the Director, and her team have worked to create a peer mentorships program designed to engage people quickly and foster strong social relationships. As always, if you have any questions regarding their program or would like to request resources used in creating these protocols, please reach out to Jessica directly. Her email is JOppenheimer@lake-shore.org
Jane DeSouza, Director
The Role of Consumers in contributing to the success of the SVW PROS Program!
As the Saint Vincent’s Westchester PROS program has developed, types of roles for people to contribute to the PROS program and feel responsible and empowered for their own recovery progress have also been evolving. Since the campus is not close to any business or recreation area, people need activities to keep them occupied between their scheduled groups/individual sessions. The PROS Planning group, working collaboratively with the Program Director, takes a significant responsibility in creating the activities. The following activities are currently or in the past been organized by program participants: seasonal sports, morning walks, sewing, Wii Games, arts and crafts, current events, and calendar art. Activity groups run by participants that are more along the lines of peer support include: Family Support, Drama, CBT, Hopes/Dreams/Aspirations, Positively Positive, Bullying and Mental Health, Wellness Self-Management, Economic Self-Sufficiency and AA Principles. To build/practice skills and confidence there are volunteer opportunities available in the Recreation Center, Library, Computer Center, Café and Clothes Loft.
To celebrate September Recovery Month, we have an annual Recovery Recognition Ceremony followed by lunch and this past year, we added a carnival. The major part of the work to make this annual event meaningful and a real success is done in the PROS Planning. This event is always attended by a large number of people and we get feedback that it is a truly inspiring event letting the community know that recovery is possible.
I have attached the PROS Planning group protocol, Hopes/Dreams/Aspirations protocol and curriculum, both created by Peer Specialists. The Bullying and Mental Health curriculum I have attached was created by a participant.
Opportunities for Consumers to contribute to the SVW PROS Program:
- Program participants lead an activity or volunteer in one of the activity areas if it is part of their recovery plan.
- Non program individuals can become Hospital Volunteers and lead a group for which they have particular skill or interest.
- Peer Specialist interns can work in a variety of areas based on their interest level: reception desk, lead a group, work in the recreation center or clothes loft or café or computer center.
- Paid Employees: 1) Activity Leader and Receptionist. Monitor and lead leisure activities in the recreation center. Receptionist responsibilities include ensuring that all participants sign in and out, remind participants about MD appointments or any other daily information, and welcome people to the program then direct them to the appropriate office. 2) Certified Peer Specialist: provides engagement services, plans and supervises special events, brings in community speakers, supervises volunteers and/or particular work areas.
Jane DeSouza, Program Director
Curricula that support their work is:
- St. Vincents PROS Planning Protocol
- St. Vincent’s PROS Group Protocol for Hopes, Dreams & Aspirations
- St. Vincent’s PROS Black Ribbon Campaign
NYAPRS is please to highlight the work of St. Vincent’s Westchester PROS. Jane DeSouza, the Director, and her team have worked to build up activities created by and for program participants. They have provided protocols for: Hopes, Dreams, Aspirations, Planning Activity, and a Black Ribbon Campaign. As always, if you have any questions regarding their program or would like to request resources used in creating these protocols, please reach out to Jane DeSouza directly. Her email is email@example.com
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.
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