Wellness Self-Management Personal Workbook

198 Pages·2008·0.87 MB·English

Personal Workbook | 
Wellness Self-Management
Personal Workbook
Developed by
The New York State Offce
of Mental Health (NYSOMH)
&
The Urban Institute for
Behavioral Health (UIBH)
Workbook Development Team
Anthony Salerno, Ph.D. (Chairperson), Co-Director,
Evidence-Based Practices Initiative, NYSOMH
Paul Margolies, Ph.D., Director of Rehabilitation Services,
Hudson River Psychiatric Center, NYSOMH
Andrew Cleek, Psy.D., Director, UIBH
© New York State Ofce of Mental Health, 2008, 2nd edition. All rights reserved.
| Wellness Self-Management
A C K NOWLEDGEMENTS
The Wellness Self-Management (WSM) Personal Caren Weingart, L.C.S.W., Clinical Supervisor,
Workbook was created as a joint efort between The Postgraduate Center for Mental Health
the New York State Ofce of Mental Health (NY-
SOMH) and the Urban Institute for Behavioral This Workbook has been piloted at ten agencies af-
Health (UIBH). fliated with UIBH and at Hudson River Psychiat-
ric Center in Poughkeepsie, New York. The Work-
The initial development of the WSM Personal book has been shaped by feedback provided by the
Workbook was made possible through the support consumers, staf and leaders of these organizations.
provided by Sharon Carpinello, R.N., Ph.D., for- Without their eforts, the Workbook could not have
mer NYSOMH Commissioner. Its continued devel- been developed.
opment, fnalization and dissemination have been
made possible by the active leadership of Michael The Workbook includes material that has been re-
Hogan, Ph.D., NYSOMH Commissioner. printed or modifed with permission from:
The Workbook Development Team is grateful for OMH Ofce of Recipient Afairs. (2005). Rec-
the eforts of Sheetal Rayancha, UIBH administra- ommendations: Infusing Recovery Principles in
tive assistant, whose help with the initial draft of the Illness Management & Recovery Resource
this Workbook was indispensable. We also give spe- Toolkit. Albany: New York State Ofce of Mental
cial thanks to Robyn Katz, former Director of the Health
Bureau of Adult Community Services, for her exten-
Ryan, S.W., Littrell, K.H., Sowers, C., & Peabody,
sive editing of the initial draft.
D.D. (2003). Solutions for Wellness (2nd ed.) (© Eli
Lilly and Company). Available at www.treatment-
Appreciation is also extended to the following indi-
team.com
viduals for their contributions:
Weiden, P.J., Scheifer, P.L., Johnson McCrary, K.
rd
Peter Beitchman, D.S.W., Executive Director, et al. (2003). Team Solutions (3 ed). (© Eli Lilly
The Bridge, Inc. and Company). Available at www.treatmentteam.
com
Peter C. Campanelli, Psy.D., President & CEO,
The Institute for Community Living, Inc. (ICL)
This Workbook also includes material reprinted or
Cathy Cave, L.C.S.W., Director of Cultural Com- modifed from sources in the public domain. These
petence, NYSOMH include:
Amy Colesante, Ofce of Recipient Afairs, NY-
Mueser, K., and Gingerich, S. (2003). Illness Man-
SOMH
agement & Recovery Implementation Resource Kit.
Rosa M. Gil, D.S.W., President & CEO, Comuni- Washington, DC: United States Department of
life, Inc. Health and Human Services, Substance Abuse
and Mental Health Services Administration.
Sharon Gold, L.C.S.W., Director of Continuing
Available at http://download.ncadi.samhsa.gov/
Day Treatment, The Bridge, Inc.
ken/pdf/toolkits/ illness/ 02.IMR_Users.pdf
Chris Keane, F.N.P., ICL
Onken, S., and Dumont, J. (2002). Mental Health
Harvey Lieberman, Ph.D., Consultant to ICL Recovery: What Helps and What Hinders? A National
Research Project for the Development of Recov-
Benjamin R. Sher, M.A., L.M.S.W., Director of
ery Facilitating System Performance Indicators.
Training, ICL
Alexandria, VA: National Technical Assistance
Tony Trahan, Ofce of Recipient Afairs, NY- Center for State Mental Health Planning.
SOMH
Personal Workbook | 
The Workbook represents an adaptation of exist- developed by Dr. William Anthony and colleagues
ing open-source reports and educational materials, at Boston University. An adaptation of the ROPES
as well as considerable new material created by the teaching technique forms the foundation for the
Workbook Development Team. Adaptations gener- format utilized in the Workbook’s lessons.
ally involved changes in language, format, sequenc-
ing of topics and organization of lessons. Further- We are grateful for the contributions of the partici-
more, the Workbook was designed to refect the pants in the Illness Management and Recovery dis-
principles of recovery, recognize the role of cultural semination project, which received support from
and religious values, highlight the connection be- NYSOMH and the Substance Abuse and Mental
tween mental and physical health and address the Health Services Administration and funds from the
challenges of providing WSM services in a group Robert Wood Johnson Foundation. Participants’
modality. work and feedback heavily infuenced the develop-
ment of this Workbook. Additionally, we appreci-
Most notably, we are indebted to the work of Kim ate the thoughtful and constructive feedback of
Mueser, Ph.D., and Susan Gingerich, M.S.W., who the members of several focus groups who reviewed
developed the comprehensive Illness Management these materials as they were developed.
and Recovery (IMR) practice and related resource
kit. The WSM Workbook incorporates many of the We also wish to acknowledge the contribution of
topic areas from the IMR resource kit. In addition, Eli Lilly and Company, which developed the Solu-
the IMR emphasis on a comprehensive curriculum tions for Wellness and Team Solutions educational
and key clinical practice competencies, such as mo- materials, disseminated through the University of
tivational, educational and cognitive behavioral ap- Medicine and Dentistry of New Jersey. Some of the
proaches, served as the conceptual foundation for material was directly incorporated into the Work-
the WSM Workbook and related training materials. book, and the development of new material was
guided by the simplicity and clarity of language of
The Workbook development team was also infu- the Lilly material.
enced by the Psychiatric Rehabilitation approach
Please note: No person or agency may reproduce, reprint or distribute
the WSM Workbook without the prior written approval of the
New York State Ofce of Mental Health. Requests for approval should
be directed to
| Wellness Self-Management
WELCOME!
Congratulations on your deision to take more control over your life!
As curent and former reipients o service, we know it take a lo o
courage and hard work to make change. Te efecs o mental illne
can make even the simplet o tasks seem very difcult and drain us
o our energy and reource. However, as you will learn in the frst
chapter, everyone can reover fom mental illne and you are in
control o your own reovery. You are the epert on yourself and no
one can tell you wat your path to reovery will look like. You will
have to deide wat works for you and wat doen’t. Your Workbook is
deigned to help you with thee deisions.
For many o us traditional treatment has been only a part o our
reovery. To ge the most out o this program, we encourage you to
develop real, authentic relationships by lisening to and learning fom
people in your group and fom ohers; to share your eperience with
your peers; to co-lead the group; to fnd a buddy and to follow through
on your Action Steps. Real life hapens outside o the clinic and your
Action Steps will help to make it real for you.
You are about to start on an adventure. What you do now will
deermine wo you will beome.
We wish you well on the journe,
The Bureau of Recipient Afairs
New York State Ofce of Mental Health
Personal Workbook | 
WELLNESS SELF-MANAGEMENT (WSM)  
PERSONAL WORKBOOK
Table of Contents
In t r o d u c t i o n
Topic 1: What Is Wellness Self-Management (WSM) and How Can It Be Helpful to You?
Lesson 01 Wellness Self-Management Program Overview . . . . . . . . . . . . . . . . . . .8
Lesson 02 WSM: Important Points . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
Topic 2: Getting the Most Out of the WSM Program
Lesson 03 What Is Your Role in the Program? . . . . . . . . . . . . . . . . . . . . . . . . . 14
Lesson 04 Understanding Positive and Negative Thinking . . . . . . . . . . . . . . . . . . 17
Lesson 05 Getting to Know Each Other . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20
Chap t e r  :  R e c o v e r y 
Topic 1: What Is Recovery?
Lesson 06 Visions of Recovery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22
Topic 2: Setting Goals Helps Recovery
Lesson 07 Exploring Your Personal Life Goals . . . . . . . . . . . . . . . . . . . . . . . . . 24
Lesson 08 Understanding Barriers that Get in the Way of Achieving Goals . . . . . . . . . 27
Lesson 09 U sing Strategies to Overcome Barriers that Get in the Way of
Achieving Goals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30
Topic 3: Understanding What Helps and What Hinders Recovery
Lesson 10 What Helps Recovery? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35
Lesson 11 What Hinders Recovery? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38
Lesson 12 Choosing Your Own Recovery Strategies. . . . . . . . . . . . . . . . . . . . . . 40
Topic 4: Your Cultural Background and the WSM Program
Lesson 13 How Your Cultural, Religious and Family Background Afects the
Decisions You Make about Mental Health Treatment . . . . . . . . . . . . . . . 44
Topic 5: Personal Strengths and Outside Resources Help Recovery
Lesson 14 Recognizing and Using Your Personal Strengths . . . . . . . . . . . . . . . . . . 48
Lesson 15 Recognizing and Using Your Cultural and Community Resources . . . . . . . . 52
Topic 6: Social, Cultural, and Community Supports Help Recovery
Lesson 16 Social Supports Help Recovery . . . . . . . . . . . . . . . . . . . . . . . . . . . 55
Lesson 17 Using Self-Help and Peer Support . . . . . . . . . . . . . . . . . . . . . . . . . 59
Lesson 18 Connecting to Your Community . . . . . . . . . . . . . . . . . . . . . . . . . . 61
Lesson 19 Meeting New People . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 64
Lesson 20 Getting Closer to People . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 66
| Wellness Self-Management
C h a p t e r  :  M e n t a l  H e a l t h  We l l n e s s  
a n d  R e l a p s e  P r e v e n t i o n
Topic 1: Practical Facts about Mental Health and Mental Illness
Lesson 21 Introduction to Practical Facts about Mental Health and Mental Illness . . . . 69
Lesson 22 Symptoms of Mental Illness—Part I . . . . . . . . . . . . . . . . . . . . . . . . 71
Lesson 23 Symptoms of Mental Illness—Part II . . . . . . . . . . . . . . . . . . . . . . . 75
Lesson 24 How Is Mental Illness Diagnosed? . . . . . . . . . . . . . . . . . . . . . . . . . 79
Lesson 25 Understanding the Causes of Mental Illness . . . . . . . . . . . . . . . . . . . . 83
Lesson 26 Coping with the Stigma of Having a Mental Illness Diagnosis . . . . . . . . . . 87
Topic 2: Coping with Stress and Symptoms
Lesson 27 What Is Stress? Why Is It Important to You? . . . . . . . . . . . . . . . . . . . 91
Lesson 28 Identifying Your Personal Signs of Stress . . . . . . . . . . . . . . . . . . . . . . 95
Lesson 29 How to Prevent Stress in the First Place . . . . . . . . . . . . . . . . . . . . . . 98
Lesson 30 Coping with Stress: What Works? What Doesn’t? . . . . . . . . . . . . . . . . 101
Lesson 31 Using a Step-by-Step Formula to Improve a Problem . . . . . . . . . . . . . . 106
Lesson 32 Thoughtfully Choosing a Mental Health Problem to Work On . . . . . . . . 109
Lesson 33 Choosing Strategies for Coping with Specifc Problems and Symptoms . . . . . 112
Lesson 34 Checking on Your Progress in the WSM Program . . . . . . . . . . . . . . . . 120
Topic 3: Making Treatment and Mental Health Services Work for You
Lesson 35 Choosing Types of Mental Health Services that Are Right for You . . . . . . . 123
Lesson 36 Practical Facts about Medication . . . . . . . . . . . . . . . . . . . . . . . . . .128
Lesson 37 Understanding Side Efects . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 132
Lesson 38 Coping with Side Efects . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 135
Lesson 39 Using Medication Efectively . . . . . . . . . . . . . . . . . . . . . . . . . . . .138
Lesson 40 Working Efectively with Your Doctor . . . . . . . . . . . . . . . . . . . . . . 142
Topic 4: R elapse Prevention: Developing and Using Your Wellness
Self-Management Plan
Lesson 41 Relapse Prevention: What Is It? Why Is It Important to You? . . . . . . . . . .145
Lesson 42 Understanding Your Personal Triggers for Relapse . . . . . . . . . . . . . . . 148
Lesson 43 Knowing Your Early Warning Signs . . . . . . . . . . . . . . . . . . . . . . . . 150
Lesson 44 Completing Your WSM Plan: Relapse Prevention . . . . . . . . . . . . . . . . .154
Lesson 45 Completing Your WSM Plan: Managing a Relapse . . . . . . . . . . . . . . . .156
Personal Workbook | 
C h a p t e r :    L i v i n g  a  H e a l t h y  L i f e s t y l e  a n d  
M e n t a l  H e a l t h  R e c o v e r y
Topic 1: What Is a Healthy Lifestyle and Why Is It Important?
Lesson 46 W hat is the Connection between a Healthy Lifestyle and Mental Health
Recovery? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .159
Topic 2: Using Physical Healthcare Services to Stay Healthy
Lesson 47 Identifying and Using Your Healthcare Resources . . . . . . . . . . . . . . . . 162
Lesson 48 Getting Help for Your Physical Health Problems . . . . . . . . . . . . . . . . 166
Lesson 49 Understanding the Most Common Serious Physical Health Problems . . . . . 169
Topic 3: Exercising: Fun, Health and Fitness
Lesson 50 Exercise and Mental Health Recovery . . . . . . . . . . . . . . . . . . . . . . .172
Topic 4: Healthy Food and Nutrition: Practical Tips
Lesson 51 Learning Healthier Eating Habits and Mental Health . . . . . . . . . . . . . . 175
Topic 5: Avoiding and Reducing Unhealthy and Dangerous Activities
Lesson 52 Understanding How Smoking, Alcohol, Drugs and Unsafe Sex
May Hurt Your Recovery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .177
Lesson 53 U nderstanding Pros and Cons: Deciding if Smoking, Alcohol,
Drugs and Unsafe Sex is a Problem . . . . . . . . . . . . . . . . . . . . . . . . .181
Lesson 54 Making a Decision to Change Unhealthy and Dangerous Activities . . . . . . 184
WSM  Wr a p - U p
Topic 1: Wellness Self-Management Plan
Lesson 55 My Wellness Self-Management Plan . . . . . . . . . . . . . . . . . . . . . . . 188
Topic 2: Review of What Has Been Learned
Lesson 56 Endings and New Beginnings . . . . . . . . . . . . . . . . . . . . . . . . . . . .191
Lesson 57 What Have I Learned? How Has It Afected My Life? . . . . . . . . . . . . . 194
Appendix A: Quality of Life Progress Checklist . . . . . . . . . . . . . . . . . . . . . . . 197
Good News
“Long-term studie have consisently found that half to two-thirds o people diagnosed
with major mental illne go on to a signifcant or complee reovery. Data show that
even in the seond or third deade, a person can still go on to a complee reovery.
I believe you can be one o the one to reover.”
Patricia Deegan, Ph.D.
Presentation: “I Don’t Think It Was My Treatment Plan That Made Me Well”:
Self-Directed Recovery and the Role of the Mental Health Professional, 2005
| Wellness Self-Management
I N T r O D u C T I O N
WELLNESS SELF-MANAGEMENT (WSM)
PROGRAM OVERVIEW
LESSON 0
I M P O RTA N T  I N F O R M AT I O N
• Wellness Self-Management (WSM) is a get that he or she is a person with goals,
program for people who have had experi- values, strengths, needs, dreams, desires
ences with mental health problems that and talents. Instead, a person may think of
have resulted in disappointments in life. him or herself as a mentally ill person frst
People who participate in this program are and foremost.
looking to improve their success and satis- • Sometimes, the mental health system may
faction in important areas of life. focus too much on a person’s mental health
• Throughout this Workbook, you will see problems and not pay enough attention to
the word RECOVERY. This word is often the person’s wants and goals.
used to mean overcoming drug and alcohol • In the WSM Program, the focus is on you
problems. In this Workbook, you will learn as a complete person frst and foremost.
that the word RECOVERY means some-
• Many of the topics in the WSM Program
thing diferent when applied to mental
are based on research fndings. These fnd-
health problems.
ings show that learning about these topics
• As human beings we are all involved in and applying what is learned can make a
managing our mental and physical well-be- diference in people’s lives.
ing. Handling stress, solving problems, get-
ting along with others, coping with disap- The eight goals of the Wellness Self-
pointments and keeping a balanced life are Management Program
part of everyone’s day-to-day challenges.
• Learning about recovery and what it can
• It’s important that we don’t spend too
mean for you
much time and energy managing our men-
tal and physical health. If we do, then there • Making the best use of your mental and
is not much time and energy left to accom- physical health services
plish goals and enjoy life. • Learning how mental health and physical
• Learning how to manage mental health wellness will help you to achieve your goals
problems frees up time and energy to pur- and support your personal recovery
sue goals and enjoy life. • Staying well by decreasing symptoms of a
• For some people, managing mental health mental health problem
problems and trying to stay healthy take up
• Learning how to manage day-to-day stress
a lot of time and energy. In fact, a person’s
and prevent relapse
mental health problems could become the
center of his or her life. A person may for- • Staying well by connecting with others.
Personal Workbook | 
• Staying well by living a healthy lifestyle Each of the 57 lessons in the Workbook is
divided into three parts:
• Recognizing and building on your cultural
values and experiences to support your
• Important Information: The frst sec-
personal recovery.
tion of each lesson introduces the topic
and the key facts for thought and discus-
Wellness Self-Management can be used in
sion.
individual or group meetings. These meetings
happen at least once a week and usually last at • Personalized Worksheet: The work-
least 30 minutes. sheet helps you think in more detail about
the information and apply it to yourself
and to your own life.
How this Workbook is organized
• Action Step: The Action Step box asks
The Workbook has 57 brief lessons that are you to write down a small step to take that
divided by topic area into three major chapters: will help you learn more about the topic
area or apply it in your own life.
• Chapter 1: Recovery
• Chapter 2: Mental Health Wellness and
Relapse Prevention
• Chapter 3: Living a Healthy Lifestyle and
Mental Health Recovery
Ve ry Important Po int !
WSM is a program that covers many diferent topics.
Some of the topics will be very important to you. You
may want to discuss these topics in greater detail than
the WSM group can ofer. Bringing these topics up in
meetings with other mental health professionals may
help you get the most out of the WSM program.
0  | Wellness Self-Management
P E r SONAL IZED WOrKSHEET:
Choos ing goa l s important fo r you
Here are the eight goals of the WSM Program. Please check the boxes next to the goals that
are important for you. It is OK to check as many goals as you like:
o Learning about recovery and what it can mean for you
o Making the best use of your mental and physical health services
o Learning how mental health and physical wellness will help you to achieve your goals
and support your personal recovery
o Staying well by decreasing symptoms of a mental health problem
o Learning how to manage day-to-day stress and prevent relapse
o Staying well by connecting with others
o Staying well by living a healthy lifestyle
o Recognizing and building on your cultural values and experiences to support your
personal recovery.
Discussion Point:
How would accomplishing any of these
goals make a diference in your life?
“Forge past misake. Forge failure.
Forge everything ecept wat you’re going to do now and do it.”
—William Durant, American philosopher