Numerous consumer surveys, research projects, interviews and patient satisfaction studies confirm what most clinicians already know—behavioral health consumers want and need the same things the rest of us do; a balanced, rewarding and healthy life. The role of psychosocial rehabilitation therapists (PSRs) is critical to achieving these goals and aiding in the recovery process. In fact, OMH, OASAS, and NIDA report that consumers consistently rate living independently, being employed, having a social network and managing their symptoms with few side effects at the top of their purpose for seeking treatment.
At NewYork-Presbyterian Hospital- Payne Whitney Westchester, we provide comprehensive services that support and facilitate consumer goal attainment. The Psychosocial Rehabilitation Department has adapted the Center for Psychiatric Rehabilitation’s and Dr. William Anthony’s model of recovery, believing that healthy functioning is a recovery tool in and of itself, and that most consumers can assume multiple roles in their lives regardless of symptoms.
Consumers at Payne Whitney Westchester acquire necessary skills by participating in practical tasks, groups, assessments, classes, and other on-site programs. Services are provided by occupational, recreational, and creative arts therapists as well as CASACs and experienced vocational and psychological counselors.
Vocational goals are addressed through a SWE (simulated work experience,) job hunting groups and volunteer work, among other activities. Educational goals are developed through testing and other forms of assessment while consumers are assisted with applications, and counseled as they adjust to new settings. An example of the work done in vocational and educational areas can be found in the story of a young law student who was diagnosed with bipolar disorder while in school. He continued to attend classes after beginning treatment, but was frequently hospitalized and still symptomatic. He found the schoolwork too taxing and a lack of sleep contributed to his being ill. At his request we explored alternative careers he was interested in exploring and administered vocational testing and counseling. He eventually made the decision to become a paralegal and was referred to VESID (Vocational educational services for individuals with disabilities) which sponsored the training for his new career.
Exposure to a variety of leisure activities, community resources, and volunteer opportunities are also provided. Occasionally, consumers request assistance with structuring their free time or expanding their social network, both essential tools for recovery.
Cooking groups are mandated by OASAS for consumers who attend the Addiction Recovery Service. Nutritional education, healthy diet selection and weight management are all components of the PSR approach. Consumers will select a recipe and determine the cost of the ingredients, which also helps with budgeting skills. Shopping for the products in the grocery store as a group is an enjoyable social event without the use of alcohol or substances. Preparing the ingredients and cooking the meal teaches math, measurement, portion control, collaboration, hygiene, sanitation and safe food handling. Serving the food, setting the table and enjoying a meal with peers is a normalizing activity which distracts from maladaptive cravings and symptoms.
Exposure to these tasks helps them to make career choices and in some cases, consumers have then transferred these skills learned to new jobs in the Food Service industry.
Life skills such as stress and symptom management are learned through demonstration and practice utilizing many different mediums, techniques and therapies.
As we well know, improving family and significant other relationships directly benefits consumers struggling with psychiatric and substance abuse issues. When consumers identify deficits in parenting, managing households and social relationships, they are assessed and assisted in seeking helpful information.
Self-Help interventions such as those we offer for individuals struggling with substance abuse get high marks from consumers. The intergenerational intervention of “Straight up Wisdom,” which joins adult recovering substance abusers who present the negative impact drugs and alcohol have had on their lives with adolescents, is a powerful approach. The adolescents, in turn, communicate their new insights to children currently in treatment.
Programs and Services in the PSR Department at Payne Whitney Westchester are continually evaluated and refined as suggested by consumer surveys and feedback.
For further information about Psychosocial Rehabilitation and the Recovery Model, contact: the Center for Psychiatric Rehabilitation at Boston University, 940 Commonwealth Avenue West, Boston, MA 02215, (617) 353-3549; the International Association of Psychosocial rehabilitation Services, www.iaprs.org; and the US Psychiatric rehabilitation Association, www.uspra.org.