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Friday, October 1, 2010

Outpatient mental health care in hospital settings

This is where you can read and comment on Naoise and Courtney's work

8 comments:

  1. I was wondering, for volunteers who are "graduates" from the program and now seek to help others, what kind of training is offered? I imagine that they know the program well having gone through it, but from the helping side it probably looks very different. Just wondering!

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  2. I love that "graduates" from the program become volunteers and eventually can take on greater responsibilities there. I think many times people do not give credit to their clients when they accomplish their goals. They praise them for completely such programs, but do not necessarily trust them to help others do the same. Sometimes it's hard for professionals to get over our "I'm the clinician, you're the client" mindsets. I wonder how much more beneficial this must be for clients. Not only do they meet their goals and graduate from the program, but they take ownership in it and begin to help others do the same. I wonder if studies have been done, and if so, if they show that people have a better, more long-lasting response to treatment under these kinds of circumstances.

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  3. Thank you so much for your feedback! The graduate program was one of the most impressive things about our clinic for me as well, for the same reasons you articulated. It’s a wonderful thing to tell a client they’ve accomplished their goals and particularly for chronically mentally ill patients, who struggle for acceptance and understanding so much in their daily lives. The other powerful thing is the mentoring and support they can then give back to the other clients. I have seen graduates of the program lend great empathy to current clients; as they can honestly relate to the issues those clients are going through.

    Great question Megan! The graduates are all supervised by the program director and she guides them based on their particular strengths. Work for graduates might include light paperwork, refreshing the brochures in the lobby or sitting in on groups to provide feedback and referrals for new members. There is also advocacy for the graduates to set new goals after leaving the group, based on future dreams. So in addition to their volunteer work at our clinic a graduate might pursue education or employment goals next, all with the support of our program supervisor.

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  4. Courtney, I guess your comment makes me wonder about clients, who are graduates, that do not become this role model. What happens to clients that at first appear to reach this higher level of functioning and then start to regress? What support is provided for these graduates? Is there any program in place to help protect their ego-strength in an event like this? After reading about your agency, I also related to this portion of the program a lot, because my first year placement offered a similar option to youth who "graduated" and became peer educators. Between the graduation and taking on employment through the agency, the youth had to go through intensive training for the job. In relation to Megan's question, what training is offered graduates who take on positions that allow them to get involved in groups, for example? Do social workers provide trainings around mindful language and effective communication?

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  5. I had a question about the evaluation process and more specifically the external audits implemented by the state. It sounds very extreme that if a chart is deemed 'noncompliant' that the hospital must reimburse the state for all of the client's services. I can understand that this may encourage staff members to maintain compliance with the charts. I'm curious if discrepancies are found and if there has ever been a disagreement between staff at the hospital and the state officials. It seems as though the state is in a unique position and can easily take advantage of this power. Is there any mediating source that manages the disagreements? I was also thinking that rigorous audits by the state may cause staff members to document treatment/interventions that put the hospital in a favorable light. I was curious if you saw any of this while at your placement?

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