Training Program Description: This training program is designed for professionals in the mental and chemical health community. It may also be useful to others with interested in supporting people with mental health conditions to live well. This training program supports learners in understanding the value in trends toward person and family-centered approaches in Minnesota. It provides context to this movement that is Minnesota specific and helps learners support the vision the Minnesota Olmstead Plan. The content provides both context and enhanced skills in these approaches and practices.
Directions: Please scroll down or click on the page on the menu to see additional content in the lesson.
The following lessons are included in this training program:
A Note about Language: This training program recognizes that the terms mental health professional and mental health practitioner are recognized titles have specific meaning related to scope of practice within the Minnesota mental health system. However, for the purposes of this training, the terms practitioner or professional are used interchangeably to indicate any person with professional responsibilities in the system. This includes clinical professionals such as psychiatrists. It also includes social services professionals such as case managers or peer specialists. If a specific role or scope of practice is important to content, that is made clear in content.
“Unique paths should include the opportunity to earn some money not just use up time.”
- Co-Creation group member, Mahnomen, MN
“How do we navigate a system in a family-centered way that’s designed so [siloed] and individualistic?”
- Co-creation group member-St Paul, MN
“Viewing people as broken ruins the relationship.”
- Co-creation group member-New Brighton, MN
“[Consider] how difficult it is to feel included, valued and I have power due to past experiences.”
- Co-Creation group Member-Rochester, MN
"Family maybe should be 'supports'? My 'family' is not biological.”
- Participant, American Indian Mental Health Conference, 2017.
Mental health professionals do not always consider people’s relationships and having valued social roles as part of recovery. They also rarely acknowledge that family caregiver isolation can occur. When they do get involved with families, it is usually to sort out family conflict. However, this limited approach means that the person is not supported in developing and maintaining relationships. They may miss out on participation of social roles that make life meaningful. It means that families may be excluded from recovery efforts. It often means the family may not have their own needs met. This lesson is an overview of why relationships and valued social roles are important parts of person and family-centered recovery practices. It provides strategies for working with individuals in the context of family, social roles, and other relationships.
After completing this lesson, you will be able:
Having relationships and valued social roles are important to recovery and resilience. The words “valued social roles” means that people are included in social groups that are meaningful to them. These roles should increase their social capital. Social capital is about being known and having mutuality in relationships. Views on valued social role will vary based on culture, age, and life experience.
Listen to the following voice clips. Write your responses in to the following questions. Open the PDF on the eight dimensions of wellness to complete this activity.
Person and family-centered practices are rooted in relationships, inclusion, and belonging. This aligns well with wellness and recovery models in mental health.
Directions: Relationships maps are often used in person and family-centered plans. This includes the Person-Centered Thinking training currently available in Minnesota. Review the images of relationship maps on this page. One is a map of a person who does not receive services. The other is of a person who has been in and out of services multiple times. Can you tell the difference? How?
Directions: Click on the items below to learn more about the considerations in supporting relationships and valued social roles. Which of these can you relate to? How do you address these barriers in your work.
Understanding the person’s values and desires as they relate to social roles and relationships helps define a meaningful recovery. It’s important to consider inclusion and satisfactory relationships and roles as measure of success in treatments and services. If people are not less isolated what is the point of treatment or services? Professionals may explore how and if the person wants to engage supporters in treatment plans and recovery activities. They can explain the value of educating and supporting family through recovery. This can include all members including children who are often forgotten.
It is important to be cautious not to give advice or share personal opinions about the quality of a person’s relationships. These opinions may encourage people to distance themselves from their supporters. This can lead to estrangement and a loss of supports. It could also lead the person to be less honest with the professional. If relationships are complicated, it’s a good opportunity to help people learn the skills they need to navigate them. This is part of moving toward wellness and recovery.
Comments by professionals can have a strong impact on people. They can help people feel more hopeful or less hopeful. By staying focused on the person’s goals and recognizing the importance of relationships and valued social roles, professionals can help people move forward. Try the activity below.
Directions: This is a matching exercise. Click a “statement” to select it, and then click an “answer area” to try and get a successful match. Keep trying until you successfully match each “statement”.
Mental health professionals often have a number of existing skills and approaches that help them with supporting relationships and roles. They may need to adjust how these things are applied. For example, both diagnostic and functional assessments look at social functioning and relationships. Current practices may be deficit-based or focus on stress or loss. Taking time in your assessments to find out people’s strengths and hopes can be useful to developing a recovery plan.
Motivational interviewing skills can be used to explore places where people feel ambiguous or unclear. When asking about supporters don’t confine your questions to “family”. Use more global terms and questions like: “Do you live with anyone? Do you have anyone in your life you can count on to be there for you? What does this person/people do for you?” “Are there people in your life who count in you?” This is a more culturally open way of understanding these roles. Encourage the person to ask supporters what might be helpful to them. This helps the person remember to give back support to those that are there for them.
Person-centered thinking practices (PCT) are something the state has adopted to help professionals think differently about services and supports. There are a number of approaches in that training that support problem-solving and learning for the purpose of being more person-centered. You’ve already seen the relationships map. Other skills and tools include the process of reflecting on what’s working or not in relationships and roles. This can be helpful for clarifying what is happening right now that needs to change. Another approach is called the 4+1 questions, which is a process of examining what has been done for the purpose of deciding what to do next. Another is a learning log. This can be helpful for understanding things that people may have trouble articulating in an organized way.
As people have used these approaches they have found that their roles may often include more collaboration between professionals in order to make progress. Being willing to learn and try new things can be important to person and family-centered practices.
As mentioned previously, social services has tended to be stricter in their approach to privacy and confidentiality than mainstream medical care. This is especially true in how family and close natural supporters are engaged. These practices can keep families from being able to support their family member effectively. It can leave the person without natural support that many of us have. These practices can reinforce stigma and shame around these illnesses. It can send the message that people with mental illness or substance abuse disorders are not worthy of the same types of social and family support as people with other types of illnesses.
It can sometimes be easier to think about mental health concerns around privacy by comparing them practices in physical health when people are facing serious or chronic illnesses. It’s common in physical medicine to ask people to bring a supporter with them to appointments. They may know of resources for families like support groups or education programs. In a medical emergency, family is often seen as a valuable resource. By conveying this to people receiving services, they may become less fearful of sharing their needs and acknowledging the needs of their family.
A more formal planning process can be helpful when people or their families have depleted their networks. There are a variety of person and family-centered planning processes that can be of help. Mental health professionals and practitioners should be familiar with different forms of person-centered planning. They should have information and referrals for people and families who may find this helpful. One person and family-centered planning process in that comes from the mental health field is called Wellness Recovery Action Planning (WRAP®). WRAP® can be used with individuals, families, and organizations. Planning Alternative Tomorrows with Hope (PATH) comes from the community of people with intellectual and developmental disabilities but has been use in many settings including with individuals from various walks of life. It also works for families and organizations. It helps to set a positive vision and create steps toward it. The skills learning in the Person-Centered Thinking (PCT) training in Minnesota can be applied to planning in a process called Picture of a Life (POL). You can find more information in the resources section of this training program.
Keep in mind, a formal plan belongs to the person or the family (not the professional). They are not obligated to share any part of the plan with professionals. However, whether they share them or not, these plans can be powerful for people and help them be better advocates in managing treatments and supports.
This lesson was meant to help you achieve the following learning objective:
In this lesson you learned:
This list was developed as part of a training project to help mental health professionals, practitioners, and others in the mental health community in Minnesota enhance their ability to deliver services in person and family-centered ways. The project included identifying what training and resources were already available in Minnesota and how well they might meet the needs of the mental health and behavioral health community. There was a special focus on those in Targeted Case Management roles. A standard protocol that included a review tool and at least two reviewers was used to ensure products were reviewed consistently. The following materials were reviewed and ranked as being likely to be helpful to Mental Health Targeted Case Managers or those in similar or related roles.
The Learning Community on Person-Centered Practices
TLCPCP is an organization and a global volunteer community. It focuses on supporting people who have lost or may lose positive control because of society's response to the presence of a disability or other conditions. It does so through training and development of person-centered practices. The Minnesota Department of Human Services Disability Services Division and other divisions have invested in disseminating training materials developed by TLCPCP. They have also supported development of trainers in Minnesota. The following two trainings are commonly available in the state. TLCPCP also supports other types of training. To locate trainings in Minnesota you can go to http://pct.umn.edu. Certified trainers are also listed on The Learning Community’s website. Some local trainings listed at the Minnesota site are free; others have a fee.
Person-Centered Thinking is equivalent to a full two-day training. Training is completed in groups. The terminology and strategies of this training are aligned with some state and national regulations in the area of person-centered practices. The curriculum is generic and skills are transferable to any setting including mental health settings. A wide variety of professionals could benefit from this training. This can include professionals from any scope of practice who:
The concepts and strategies in this curriculum have meaning and are useful in mental health practices. However, the examples in the core curriculum focus mostly on adults, are not all mental health related, nor always current to the context of community living. Content does not explicitly support deeper understanding of equity or diversity issues and does not use examples that represent diversity. Though there is a small portion in the new version on culture, on the whole, the curriculum does not attend to these issues. In addition, there is no specific tie in to how to use these practices to ensure family-centered practices. Trainers in this curriculum have various backgrounds. It would be important to select a training with a strong background in mental health services and supports if that is an important training need for your group.
Picture of a Life is two-day training that provides in-person learning and applying person centered thinking and planning tools to develop a person-centered description. The process is focused on helping a person envision the life they want in their community. The training include a co-trainer with support needs and others who are this person’s natural or paid supporters. Trainees get a chance to watch and participate in interviewing processes and enhance their discovery skills. Values of choice, control, direction, and shared power are modeled in the training.
The quality of the training is highly dependent on the skill and knowledge of the facilitator and the willingness of the co-training and supporters to share. Participants will likely benefit more if they attend a session where the co-trainers needs are similar to those of the populations they support. There will be no explicit connection to the mental health practices of recovery, peer support, or cultural and equity practices if the facilitator does not have these skills, knowledge, and orientations. Person-Centered Thinking (described above) is required training before attending Picture of a Life.
The Person-Centered Counseling Training Program is a blended learning model that embeds the Person-Centered Thinking skills and planning skills into online modules. The target audience for this training is counselors through the Aging and Disability Resource Centers (ADRCs) and others who are engaging in development of No Wrong Door systems. The online component is available in Minnesota via DirectCourse. For full review for this audience please see description below. For more information on the in-person day of training, contact The Learning Community for Person Centered Practices.
DirectCourse is a national online curriculum for direct support professionals and similar professionals who support people to live in their communities. It is available in Minnesota through support from the Department of Human Services. The training programs and curriculum are self-paced, competency-based, and multimedia. The following materials from DirectCourse were reviewed for the mental health community.
This online training was developed by Temple University Collaborative on Community Inclusion of Individuals with Psychiatric Disabilities. It consists of approximately 38 hours of self-paced training for community based mental health workers. The set of available courses is listed below.
The courses in the College of Recovery and Community Inclusion can be helpful to any practitioners interested in recovery-based inclusion and self-determination models. The suite of courses in CRCI doesn’t use term “person-centered” but aligns with these approaches. They cover the scope of all mental health professionals. This material can be useful to support planners in mental health in apply the Minnesota Olmstead Plan expectations in their work. These courses consider culture and evidence-based practices. Incorporation of family into support is not included substantially.
The Minnesota Department of Human Services has purchased a limited amount of seats in Minnesota that are available for free. Contact Nancy McCulloh at mccul037@umn.edu. Rates for broader access will vary based on organization size. Information can be obtained by contacting Bill Waibel at Elsevier, b.waibel@elsevier.com.
These online materials were explicitly designed for the No Wrong Door System of Long Term Services and Supports (LTSS). It considers all populations, all ages, and all methods of payment for LTSS. Person-Centered Thinking and Planning skills are a core of the training program. There is a whole course on family caregiving and other lessons on family involvement. However, content is not strictly focused on mental health.
This content would be best for disability generalists who have a portion of their potential recipients living with serious mental illnesses. Another potential target audience is staff affiliated with Certified Community Behavioral Health Clinics or Behavioral Health Homes or similar services, where clinicians and LTSS and community professionals need to have a coordinated understanding of person-centered practices across clinical and community settings. This curriculum needs to include a one-day in-person training in PCT to be considered complete as far as PCT skills. It would need a skilled training to support groups in organizing a blended learning model for above purposes. It is not ideal as core training for MH TCM because of the more broad disability focus but is rooted in recovery principles, self-determination, and culturally responsive services.
The Minnesota Department of Human Services has purchased a full contract for this curriculum in Minnesota that makes training available for free and/or with minimal administrative costs. Go to: https://mn.gov/dhs/partners-and-providers/training-conferences/directcourse/to learn more.
The Yale Program for Recovery and Health, Person Centered Approaches has a focus on research, consultation and tools in the area of person-centered approaches in mental health and co-occurring disorders.
The following resources related to authors and researchers at this program were reviewed.
Partnering for Recovery in Mental Health is a practical guide for conducting person and family-centered recovery planning with individuals with serious mental illnesses and their families. This guide represents a new clinical approach to the planning and delivery of mental health care. It emerges from the mental health recovery movement, and has been developed in the process of the efforts to transform systems of care at the local, regional, and national levels to a recovery orientation.
This is a very solid and recommended resource that looks comprehensively at person and family-centered practices in planning specific to mental health conditions and co-occurring conditions. It provides context to recovery, self-determination, cultural needs, family support, and shared power. It is a good overall resource that would be helpful to any professional working with people with serious mental illnesses and required to complete support or treatment plans, including targeted case managers.
This book is authored by Janis Tondora, Rebecca Miller, Mike Slade and Larry Davidson and was published in 2014 by Wiley-Blackwell. It is available online as an ebook or from booksellers in hard copy, for an approximate cost of $42.00.
This resource is a downloadable booklet for organizing information a person might want in a treatment or support plan. It is meant to help people organize their thoughts and information in ways that are likely to yield person-centered goals and approaches in a treatment plan.
The strengths of this resource include: It is easily downloadable from a public site. It is concrete, process-oriented, flexible and applicable to many circumstances, and written in plain language. It gives people structure and context to taking the time to identify their goals and preferences in key areas outlined in the Person-Centered Informed Choice Protocol (DHS, 01/17). It asks people to consider including people important to them in the process. It would be a great foundation for developing a person-centered plan. Professionals and practitioners for all level of practice in mental health would benefit from being familiar with this tool. Case managers, support planners, and those in similar roles would benefit the most. There is a Spanish language version available.
Limitations of this resource include: The rights information is specific to the state of Connecticut (but could be easily customized to Minnesota). It provides little context for bigger picture aspects of history and professional responsibly. While it may work with a variety of cultures and circumstances, it does not support practitioners in how to adapt for a variety of cultures and circumstance. Family and natural supporters are considered as support but not as people who may need support. Information would need more work to translate into an operational treatment plan. Literacy would be an issue with this tool if used without assistance.
Authors are Tondora, Miller, Guy and Lanteri. Published in 2009 by Yale Program for Recovery and Community Health.
This online resource is available as a .pdf document at no cost:
The Copeland Center for Wellness and Recovery promotes mental health recovery through education, training, and research based on WRAP©. (Wellness Recovery Action Plan). It is a peer run, non-profit organization that provides training, consultation, and program activities to support the wellness, recovery, community inclusion and peer support journeys of individuals. They work with the owners of WRAP© materials at Advocates for Human Potential (AHP) to ensure the fidelity and quality implementation of WRAP© Facilitation in the health care system. There are a variety of training and consultation options offered through Copeland.
Locally people can connect and take seminars through the Kaposia which is an International WRAP© Center for Excellence.
The Developing Your Own WRAP© workshops is co-facilitated by WRAP© Facilitators in a variety of formats and agendas, including 8-12 week WRAP© groups, 2-3 day workshops, retreats. Participants in these workshops will learn how to develop their WRAP© as a personalized system to achieve their own wellness goals. These workshops are for anyone and can apply to any self-directed wellness goals. WRAP© is a safe, effective wellness process that has an evidence-base for supporting mental health recovery. It is s self-directed, peer supported process that the person engages with in ways that they prefer. WRAP© is an ongoing processes of reflecting on and engaging approaches and lifestyles that support personal wellness. Processes can be used by individuals and organizations to move to a true recovery and self-determination focus in services and supports. WRAP© has proven to be an effective approach to working with children, youth, and families and caregivers to improve relationships, feel more hopeful, create support systems, learn to self-advocate, and put a greater focus on their personal overall wellness.
WRAP© must be delivered with fidelity in order to meet the evidence based criteria. This include that participation in WRAP© be completely voluntary, that at least two peer facilators who are skilled, trained, and mentored facilitate this process, materials are appropriate, and all processes align with the values and ethics of WRAP©. (To learn more about fidelity download and read the document The Way WRAP Works!.) Professional who have their own WRAPs can benefit from the process and also understand the value and power of WRAP© in supporting recovery.
WRAP© is voluntary, focused on wellness, owned by the person, and avoids clinical or medical language. It is a powerful tool for helping people reconnect with hope, personal responsibility, and personal strategies for recovery. However, it is not something professionals can have access to without a person’s permission and it is not something professionals can require of people. If people chose to complete a WRAP© on their own, it can support their ability to more clearly define many of the aspects of the PCICTP. It is something to recommend, especially to people who have lost touch with what recovery and a life worth living means to them. However, there can be no expectation that people participate unwillingly or in order to receive services.
The cost for this entry course ranges from $100-400.00 approximately. Locally, there may be a possibility for a need-based reduction in the fee or waiving of the fee.
The content of materials developed through this contract was co-created with members of Minnesota’s communities. Co-creation include structured and open-ended conversations as well as listening sessions. It also included seven structure co-creation processes conducted in different parts of the state. These sessions include professionals and people with lived experience or their families. Community members were also invited to review and edit the content of online materials (Community Reviewers). Participants were kept informed about ongoing progress through a website.
The following sessions helped to shape refined definitions and areas of focus after the initial environmental scan was complete.
There were seven (7) Co-Creation Groups (in 6 communities) Rochester, Duluth, Mahnomen, Minneapolis, St Paul (2), and New Brighton. A total of 89 people participated in these groups. Participants included a spectrum of people with a variety life experiences and backgrounds. These processes were developed to support the maximum engagement of each participant. The following people attending a co-creation session:
The authors for the online lessons were:
There were seven community reviewers recruited to review the content of online materials that were developed. These reviewer were mental health professionals and included family members of service users. The following people served in this role:
In addition Darrin Helt of the DHS Behavioral Health Division served as editor and approver.
Web development, design, and media team: