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.
“Doing things for people is taking the easy way.”
- Co-Creation Participant, Rochester MN.
“We have a lot to learn from each other in co-creation. I learn so much listening to the people I work with, it offers me more than education. The current system denies people their respect/who they are.”
- Co-Creation Participant, Duluth MN
For various reasons, some people who experience mental health conditions can have their choices limited. The person can lose decision-making over major aspects of their lives. Community-based mental health workers may struggle to understand how to support person and family-centered practices in these types of situations. This lesson is meant to help professionals apply the core attributes of person and family-centered practices within this context.
After completing this lesson, you will be able:
The vast majority of people who receive mental health services will do so voluntarily. Most will have no problematic contact with the police or courts. However, some people will experience restrictions. In these situations, they still benefit from, and in some case are entitled to, person or family-centered practices.
Directions: Click each item to learn more.
The core attributes of these approaches do not disappear when a person has limits on decision-making and choice. Some of the core attributes include:
People in mandated services will come from all different walks of life. Some may have never had much trouble until the occurrence of their mental health condition. They may have loving, well-resourced families and stable homes to return to. Even so, the experience of the mental health crisis and commitment may have seriously disrupted their understanding of themselves and their lives. Others may have spent a significant parts of their lives on the streets, not cared for, in jail, or in other types of institutions. They may have very little to draw from in terms of making decisions for themselves. As a result, people may not be able to articulate dreams. They may not easily trust professionals. They may assume professionals will make decisions for them. Even understanding the smallest thing about the person’s goals, dreams or hopes in these circumstances might be difficult.
Other challenges in these circumstances include that people and families are likely to have many more professionals involved than typical. This can include multiple types of case managers or social workers. It may also include parole offers, therapists, chemical health professionals, peer supporters, and surrogate decision-makers. They may have strained family relationships or no family and therefore less support for recovery. Finally, it’s important to remember the effect of trauma. People who experience trauma can be triggered by situations that create feelings of being out of control. They do better when they have a sense of control in situations. Providers of mandated services will want to be careful to consider how trauma may be triggered by overly controlling environments. Boundaries and rules can be helpful. However, people need to feel they are respected. They need to be heard regardless of why they are receiving services.
There are different points in the mental health continuum where mandated services may be considered. These are complicated and at times controversial issues. Mental health professionals should understand them. They should help the person and family members understand them. Connecting people to education and advocacy support as needed can be helpful. It’s also important to know that people often cannot get services until they are under commitment. It’s important to advocate as necessary for resources in communities that can be engaged early and without mandated services.
Directions: Click each item to learn more.
The principles and focus of person and family-centered practices do not change when person has limits. It’s still important to learn about what matters to the person in a holistic way. This includes goals, strengths, and preferences. It’s important to maximize the person’s ability to make the choices they can. It’s important to think about relationships and allow for the dignity of risk.
Professionals who are most successful at working in person and family-centered ways with people under mandates services recognize and do the following:
People have a right to make bad choices as well as good ones. People cannot integrate back into community without learning to manage risk. Professionals should not support a person in breaking the law or in any action that is likely to seriously and immediately lead to harm for themselves or others. That said, there are other circumstances that may be risky but are part of recovery as well. For example, a person who wants freedom in the community, though they have struggled with substance use in the past. Risk is part of life. People must learn to manage these risks as best they can.
In situations where professionals are concerned, it’s important to work with the person and the full team proactivity. Clarify roles, responsibilities, and boundaries. Helping the person consider the risks. Have them look at potential outcomes of choices and identify how they will manage risks. If opportunities are given, it is up to the person to do their best. The consequences will be felt by them if they make bad choices. These situations require compassion and the ability to be fair. They require professionals to work with due diligence to support the person in understanding the risk. It requires clarity on roles and boundaries and support from your organization and supervisor and other professionals. However, dignity of risk is part of supporting people with these complex needs.
People under mandates often have struggled very seriously and maybe for a long time. They may have missed out on many typical life experiences. They may not have much experience with making choices for themselves. They may have developed some unhelpful strategies over time. It takes time to change these things. It’s important to consider small steps that help people develop their ability to make good choices.
Directions: Click on each of the voice clips to learn more about challenges and successes. These are small steps. How do these reflect person and family-centered practices?
It’s important to recognize this work requires good communication and a willingness to collaborate. This collaboration may go beyond just the person. It may include many other professionals, family and community members. Being transparent and proactive goes a long way. The person should be informed about everything. Other professionals may need to sign off. Documentation of decisions makes it clear what has been decided and who is involved. Take a minute to review some statements related to these approaches, before going on to the lesson review.
Directions: This is a Fill in the blank exercise. Click a “word” to select it, and then click a “sentence” to try and get a successful match. Keep trying until you successfully match each word.
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: