E1142Mental Health6 Recovery oriented services and relationships6.2 Delivering service is a recovery-oriented framework6.2.3 Preparing, implementing and reviewing a plan forrecoveryPart of the assessment process should be a discussion with consumers about their interest andreadiness to prepare and initiate their plan for recovery. As all steps of this process should beundertaken in collaboration, it is important to make sure that consumers are motivated and readyto be involved with this piece of work. Ideally, it is the consumer who should drive this processwith the worker offering guidance and support where needed. Should the person not be ready tostart this process, workers should be responsive and offer different options for support. It isalso important that consumers can go through this process at their own pace and be able to take“time out” when wanted and needed. Individual Treatment Plans (ITPs) were discussed in earlierstages of this course and it might be worth re-visiting some of the previous learning to set thescene for the following exploration.What do good care and support planning look like?I am trusted to write my own care and support plan – with whatever help I needMy care and support plan is about the whole of my life, not just about my assessed needs ormoneyI am encouraged and supported to think creatively about ways to achieve my outcomesIf I need help to plan, I can choose who supports me through the process and to put the plan intopracticePeople who support me to plan have a flexible, open, honest, positive, solution-focused attitudeI can involve friends and family if I choose| Topic – 2 / 19© Open Colleges Pty Ltd, 2020.I have all the information I need to plan when I need it and in an accessible way, includingsignposting to what is available locallyI am supported to take risks and know it is OK to make mistakes and change my mindThe process from assessment through to review is transparent and clear. I know what to expectand when to expect it, and people do what they say they doMy review is person-centred, focused on me and my life, my outcomes and what is working andnot working – not just the money. Through my review I can contribute my views to improving thesystem as wellAdapted from:Helen Sanderson Associates[http://www.helensandersonassociates.co.uk/health-social-care/long-term-conditions/personalised-care-support-planning/]: National Co-production Advisory Group for Think Act Local Personal and Coalition for Collaborative CareITPs are often known by different names, such as ‘case management plans’, ‘individual serviceplans’, ‘individual support plans’, ‘individual recovery plans’, ‘person- centred plans’, ‘client-centred| Topic – 3 / 19© Open Colleges Pty Ltd, 2020.plans’, ‘personal wellbeing plans’, ‘risk management plans’, ‘crisis plans’, ‘relapse prevention plans’,‘self-management plans’ etc.Whereas all of these plans claim to have consumer interests at heart, there has been criticismabout the fact that ITPs are often more reflective of the needs and requirements of the service,rather than those of the consumer (Glover & Roennfeldt, 2013). This of course stands in directcontrast to the requirement of recovery-oriented practice where ITPs should reflect the choices,preferences, values, needs and goals of a specific consumer. Whereas ITPs often come in fairlystandardized templates provided by the organisation, this format might not meet the needs andpreferences of consumers.Putting together a service plan and a personal plan can be an effective way of managing anypotential conflict between service requirements and the true needs of the consumer. Serviceplans outline and guide the service delivery process and make sure that “everyone is on the samepage in terms of their understanding of the nature and direction of the support being provided”(Glover & Roennfeldt, 2013, p. 4). Service plans might also include information on supportarrangement, including plans to transition beyond the service and timelines for any service actionsagreed in the plan.The personal plan should be of a more holistic nature and be inclusive of different areas of theperson’s life. They should be seen as being the property of the consumer and reflect their “theiraspirations, dreams and interests”. Personal plans should of course still include goals but itshould be entirely up to the consumer to decide what is reflected in this plan and which goals takepriority.Workers should also support consumers in developing strategies to achieve goals which can beof a personal nature but can also include service aspects, such as referral to other services andsources of support. These strategies should be developed with a full awareness of possible risksand barriers which might get in the way of the desired outcomes.Strategies in themselves can carry risk. For example, if a consumer decides that they want toOne way of putting consumers at the heart of the process is to offer them thedevelopment two different plans to achieve better clarity about the purpose of planning.Glover & Roennfeldt, 2013 “| Topic – 4 / 19© Open Colleges Pty Ltd, 2020.change or stop their medication or move into a more independent form of living. In this case, it isimportant for professionals to apply the ethics of ‘Dignity of risk’. Workers should aim to provide asafe space where risks and barriers can be explored in an honest way, encouraging theconsumer to direct this process. The role of workers should be simply to facilitate this process,including access to information, resources and education about opportunities and service optionsrelevant to the person’s aspirations.| Topic – 5 / 19© Open Colleges Pty Ltd, 2020.Activity 42594Whose plan is it anyway?[https://www.mymentalhealth.org.au/content/Document/Whose%20plan%20is%20it%20anyway.pdf]Thisresource[http://aplacetobelong.org.au/wordpress/wp-content/uploads/2013/11/Whose-Plan-is-it-Anyway.pdf]was developed by the Queensland Alliance for Mental Health and offers and excellent overviewof what it means to plan for recovery in a self-directed way.HintsHaving clarity about the needs of service might allow more space for the needs of the consumer.ACTIVITY 42594 TYPE Resource| Topic – 6 / 19© Open Colleges Pty Ltd, 2020.SCENARIO Whose plan is it anyway? This exploration should also include discussion about strategies and/or other people who canassist in responding to these challenges. These people could be from a professional backgroundbut also from the personal circle of support around the consumer, and it is of course entirely upto the person who else they choose to involve in their recovery process and the roles they wantthem to play. As already mentioned, it is essential that workers act with an awareness of thecrucial role that other relationships can play in the recovery of a person and which contributioneach member of the care network makes. This also means that it is in the best interest ofworkers and consumers that support professionals establish rapport and build an effectiveworking relationship with relevant members of the care network.Working with the circle of care to facilitate support and training is essential, whether the worker isable to complete this task as part of their own work or need to make a referral to other serviceproviders. This will allow the care network to resource the consumer in the best possible way andhopefully support the person to move beyond challenges and barriers in their recovery.Once the recovery plan(s) has (have) been compiled, it is important to look at the implementationand reviews of the plan. The plan should include tasks and activities for both the worker and theconsumer, and it is important to complete these actions in a timely manner. Implementation andreview need to go hand in hand, as regular review of the plan with the person will show therelevance and effectiveness of the plan as well as allow for the identification of opportunities forimproved empowerment and better processes. The implementation and review cycle shouldideally continue until all the outcomes and have been achieved and no further support is required,but this is not always possible.Families, carers and friends are invaluable resources in the lives of consumers, andworkers should identify any information and support needs the significant others in theperson’s life might have. “A lot can happen in the lives of consumers, as they embark on their journey to recovery,and there might be rapid changes in needs and even aspirations.“| Topic – 7 / 19© Open Colleges Pty Ltd, 2020.Recovery plans need to be a “living document” and allow for changes, including to the goals andtransition strategies. Workers need to be able to identify new directions and areas for change inthe recovery plans, including potential amendments.[https://res.cloudinary.com/opencolleges/image/upload/v1462516756/x3ikeipfxk12tbzufeeo.jpg]Potentially, the most powerful way of providing this ‘space for change’ is to openly and fully invitefeedback from the consumer regarding the effectiveness and relevance of their plan as well astheir satisfaction with the services and support provided. This feedback can be gathered in avariety of ways, including suggestion boxes, consumer reviews and consultation groups. However,as long as the working relationship is intact and solid, consumers should also be open to simplyhaving a frank conversation with their worker where they can openly voice any concern or issuesthey are facing.At the same time, it is also important to highlight any achievements and celebrate the positivechanges and movement towards recovery. There are many key milestones in the recoveryprocess which allow for celebration of achievements. Many consumers might however not beable to identify achievement which means that workers need to be able to set the framework for | Topic – 8 / 19© Open Colleges Pty Ltd, 2020.this process. Milestones are usually very individual to the person and can include a variety ofachievements and events, including staying on medication, reducing or stopping AOD use, nothaving admissions to psychiatric hospital etc. The best course of action is to work with consumersto identify what their key milestones are and to use the achievement of key milestones to gatherfeedback about the progress in implementing the recovery plan overall.Whereas working collaboratively with consumers to identify key milestones is the best approachwithin the framework of recovery-oriented practice, there are also more formal frameworks forworkers to use if this is appropriate.Adams and Grieder (2005) use the word ‘recovery’ to provide ideas for potential milestones inthe recovery process. Whereas this model provides some linearity regarding the achievement ofmilestones, the authors also highlight that people might journey through this process in differentways. This means that the model has to be adopted with some flexibility, as is the case with anystage model in the human services arena.Activity 44554In this model, RECOVERY stands for:Recognise| Topic – 9 / 19© Open Colleges Pty Ltd, 2020.Recognising inner distress but might not be able to identify what it is – beginning awareness.ExamineExamining inner distress with other people – accepting help.| Topic – 10 / 19© Open Colleges Pty Ltd, 2020.ChooseChoosing to believe that there is hope.| Topic – 11 / 19© Open Colleges Pty Ltd, 2020.OvercomeOvercoming symptoms and examining life circumstances.VolunteerVoluntarily taking action toards recovery.| Topic – 12 / 19© Open Colleges Pty Ltd, 2020.EnjoyEnjoy the benefits of recovery and actively participate in support.| Topic – 13 / 19© Open Colleges Pty Ltd, 2020.Responsibility for recoveryTaking ownership.YesYes to helping others.ACTIVITY 44554 TYPE HtmlSCENARIO In this model, RECOVERY stands for: Some consumers might find this model helpful, especially if they are experiencing difficulty innaming key milestones themselves. It is then up to the worker to decide whether they want tointroduce this model or suggest other aspects instead. This process might be easier if workershave adhered to the principles of strengths-based practice and offered feedback about theirperception of strengths and achievement all throughout the process of supporting the consumer.Many people living with mental illness can find it hard to see their own strengths, ability andachievement, often as a result of stigmatization and deficit-oriented service delivery. This makes it| Topic – 14 / 19© Open Colleges Pty Ltd, 2020.even more important for workers to fully embrace strength-base and recovery-orientation, as thiscan have a positive impact on the person and their well-being, thus aiding them along towardstheir journey to recovery.Source: Adams & Grieder,2005, p. 205Gathering feedback can also greatly enhance reflective practice which is also important tomention at this stage. Reflective practice is defined as “any instance where an individual thinkscritically about an action, thought, or experience. This thinking then enables the increase of theirself-awareness and professional competence” (Hampe, 2014, p.1) In the context of recoveryorientation, reflective practice should be implemented at all times, especially to identifyopportunities to further incorporate the values and practices of the recovery-oriented frameworkinto service delivery.Generally speaking, there are two different types of reflection available to professionals.‘Reflection in action’ is the ability to think what we are doing while we are doing it. ‘Reflection onaction’ on the other hand is the reflection after an event or action, and it is usually a moreconscious and documented process. (Williams & Burden, 1997)There are different tools that can support reflection on action, including the use of a reflectivejournal or working with the support of a supervisor or peers and using creative means such asart. Reflective practice should allow workers to identify areas of growth as well as bring to lightunconscious dynamics such as unmanaged power struggles or short-comings in the relationship.Reflective practice also means to look at constant improvement and to come up with an actionplan to improve professional standards. Gibb’s Model of Reflection shows the process ofreflection as movement through six different stages and it highlights the complexity of reflectiveaction. The last stage of the cycle is to come up with an action plan to achieve change, and it couldbe very seamless to use this stage in conjunction with planning for changes in the recovery plan.Gibbs 1988| Topic – 15 / 19© Open Colleges Pty Ltd, 2020.| Topic – 16 / 19© Open Colleges Pty Ltd, 2020.Activity 42609Reflective practiceThis resource shows you how to apply theGibbs Model of Reflection[http://www.cumbria.ac.uk/public/liss/documents/skillsatcumbria/reflectivecyclegibbs.pdf]to daily practice.HintsReflection is the basis for professional and personal growth.ACTIVITY 42609 TYPE ResourceSCENARIO Reflective practice Amy’s mental health recovery storyWatch Amy tell her story about living with mental illness and working towards recovery.| Topic – 17 / 19© Open Colleges Pty Ltd, 2020.[https://youtube.com/watch?v=e-S5-yS3uTM]Note: Listen out for how stigma impacted on Amy’s sense of well-being.Activity 42612Amy’s reocveryWatch the video above and answer the following questions:What strengths can you see in Amy?How has her experience of mental illness impacted on her sense of self?What are Amy’s aspirations for recovery?What are the some of the key milestones you can see in Amy’s recovery?HintsIt is always important to seek support. Workers have a right to be adequately supported in theirwork.1 2 3 4| Topic – 18 / 19© Open Colleges Pty Ltd, 2020.ACTIVITY 42612 TYPE ContributeSCENARIO Amy’s reocvery| Topic – 19 / 19© Open Colleges Pty Ltd, 2020.
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