On being person-centered… … and recovery oriented Neal Adams MD MPH Director of Special Projects...
-
Upload
james-carner -
Category
Documents
-
view
226 -
download
0
Transcript of On being person-centered… … and recovery oriented Neal Adams MD MPH Director of Special Projects...
![Page 1: On being person-centered… … and recovery oriented Neal Adams MD MPH Director of Special Projects California Institute for Mental Health.](https://reader034.fdocuments.net/reader034/viewer/2022051401/56649cc45503460f9498ccf0/html5/thumbnails/1.jpg)
![Page 2: On being person-centered… … and recovery oriented Neal Adams MD MPH Director of Special Projects California Institute for Mental Health.](https://reader034.fdocuments.net/reader034/viewer/2022051401/56649cc45503460f9498ccf0/html5/thumbnails/2.jpg)
On being person-centeredOn being person-centered…………and recovery orientedand recovery oriented
Neal Adams MD MPHNeal Adams MD MPHDirector of Special ProjectsDirector of Special Projects
California Institute for Mental HealthCalifornia Institute for Mental Health
![Page 3: On being person-centered… … and recovery oriented Neal Adams MD MPH Director of Special Projects California Institute for Mental Health.](https://reader034.fdocuments.net/reader034/viewer/2022051401/56649cc45503460f9498ccf0/html5/thumbnails/3.jpg)
pleonasmpleonasm
NOUN:
1a. The use of more words than are required to express an idea; redundancy. b. An instance of pleonasm.
2. A superfluous word or phrase. ETYMOLOGY:
Late Latin pleonasmus, from Greek pleonasmos, from pleonazein, to be excessive, from ple
![Page 4: On being person-centered… … and recovery oriented Neal Adams MD MPH Director of Special Projects California Institute for Mental Health.](https://reader034.fdocuments.net/reader034/viewer/2022051401/56649cc45503460f9498ccf0/html5/thumbnails/4.jpg)
Foremost, consumers of health care for M/SU Foremost, consumers of health care for M/SU conditions face a number of obstacles to patient-conditions face a number of obstacles to patient-
centered care that generally are not encountered by centered care that generally are not encountered by consumers of general health care. consumers of general health care.
![Page 5: On being person-centered… … and recovery oriented Neal Adams MD MPH Director of Special Projects California Institute for Mental Health.](https://reader034.fdocuments.net/reader034/viewer/2022051401/56649cc45503460f9498ccf0/html5/thumbnails/5.jpg)
![Page 6: On being person-centered… … and recovery oriented Neal Adams MD MPH Director of Special Projects California Institute for Mental Health.](https://reader034.fdocuments.net/reader034/viewer/2022051401/56649cc45503460f9498ccf0/html5/thumbnails/6.jpg)
![Page 7: On being person-centered… … and recovery oriented Neal Adams MD MPH Director of Special Projects California Institute for Mental Health.](https://reader034.fdocuments.net/reader034/viewer/2022051401/56649cc45503460f9498ccf0/html5/thumbnails/7.jpg)
![Page 8: On being person-centered… … and recovery oriented Neal Adams MD MPH Director of Special Projects California Institute for Mental Health.](https://reader034.fdocuments.net/reader034/viewer/2022051401/56649cc45503460f9498ccf0/html5/thumbnails/8.jpg)
![Page 9: On being person-centered… … and recovery oriented Neal Adams MD MPH Director of Special Projects California Institute for Mental Health.](https://reader034.fdocuments.net/reader034/viewer/2022051401/56649cc45503460f9498ccf0/html5/thumbnails/9.jpg)
![Page 10: On being person-centered… … and recovery oriented Neal Adams MD MPH Director of Special Projects California Institute for Mental Health.](https://reader034.fdocuments.net/reader034/viewer/2022051401/56649cc45503460f9498ccf0/html5/thumbnails/10.jpg)
a fuzzy concept…a fuzzy concept…
everyone recognizes overall meaning different connotation for
different people core elements of concept is
clear but unclear on the periphery
difficult to operationalize in measurable elements
![Page 11: On being person-centered… … and recovery oriented Neal Adams MD MPH Director of Special Projects California Institute for Mental Health.](https://reader034.fdocuments.net/reader034/viewer/2022051401/56649cc45503460f9498ccf0/html5/thumbnails/11.jpg)
person-centeredperson-centered
there is agreement on goals tasks participation and roles
the relationship with the provider is experienced as collaborative empathic respectful trusting understanding hopeful encouraging empowering
![Page 12: On being person-centered… … and recovery oriented Neal Adams MD MPH Director of Special Projects California Institute for Mental Health.](https://reader034.fdocuments.net/reader034/viewer/2022051401/56649cc45503460f9498ccf0/html5/thumbnails/12.jpg)
carl rogerscarl rogers
congruence genuineness, honesty with
the client
empathy the ability to feel what the
client feels
respect acceptance, unconditional
positive regard
![Page 13: On being person-centered… … and recovery oriented Neal Adams MD MPH Director of Special Projects California Institute for Mental Health.](https://reader034.fdocuments.net/reader034/viewer/2022051401/56649cc45503460f9498ccf0/html5/thumbnails/13.jpg)
picker institutepicker institute
respect for person’s values information/education access to services emotional support to relieve
fear and anxiety Involvement of family and
friends continuity across settings physical and emotional
comfort coordination
![Page 14: On being person-centered… … and recovery oriented Neal Adams MD MPH Director of Special Projects California Institute for Mental Health.](https://reader034.fdocuments.net/reader034/viewer/2022051401/56649cc45503460f9498ccf0/html5/thumbnails/14.jpg)
quality
right care
right way
right time
nothing about me…nothing about me…without mewithout me
![Page 15: On being person-centered… … and recovery oriented Neal Adams MD MPH Director of Special Projects California Institute for Mental Health.](https://reader034.fdocuments.net/reader034/viewer/2022051401/56649cc45503460f9498ccf0/html5/thumbnails/15.jpg)
quality
right care
right way
right time
person-centered
care person needs
manner person desires
time person desires
nothing about me…nothing about me…without mewithout me
![Page 16: On being person-centered… … and recovery oriented Neal Adams MD MPH Director of Special Projects California Institute for Mental Health.](https://reader034.fdocuments.net/reader034/viewer/2022051401/56649cc45503460f9498ccf0/html5/thumbnails/16.jpg)
essential role essential role of treatment planningof treatment planning
key lever for systems changes at all levels making it real
opportunity to assure that individual recovery-- oriented life goals direct services
not about documentation all about the process
frequent point of failure
![Page 17: On being person-centered… … and recovery oriented Neal Adams MD MPH Director of Special Projects California Institute for Mental Health.](https://reader034.fdocuments.net/reader034/viewer/2022051401/56649cc45503460f9498ccf0/html5/thumbnails/17.jpg)
exampleexample
Goal
Stuart will receive the assistance he needs to make decisions that best meet his needs and to keep his entitlements current
Objectives Stuart will be…
1. compliant with meds
2. compliant with scheduled appointments
3. compliant with having his blood drawn
![Page 18: On being person-centered… … and recovery oriented Neal Adams MD MPH Director of Special Projects California Institute for Mental Health.](https://reader034.fdocuments.net/reader034/viewer/2022051401/56649cc45503460f9498ccf0/html5/thumbnails/18.jpg)
changing the conversationchanging the conversation
no single treatment approach or setting effective for all individuals
emphasis on program-based care easier to target specific
communities or problems significant number of clients are
channeled into available programs rather than programs that would meet their individual needs
![Page 19: On being person-centered… … and recovery oriented Neal Adams MD MPH Director of Special Projects California Institute for Mental Health.](https://reader034.fdocuments.net/reader034/viewer/2022051401/56649cc45503460f9498ccf0/html5/thumbnails/19.jpg)
![Page 20: On being person-centered… … and recovery oriented Neal Adams MD MPH Director of Special Projects California Institute for Mental Health.](https://reader034.fdocuments.net/reader034/viewer/2022051401/56649cc45503460f9498ccf0/html5/thumbnails/20.jpg)
You’re the picture of health…and by the way, I’m totally
in love with you
![Page 21: On being person-centered… … and recovery oriented Neal Adams MD MPH Director of Special Projects California Institute for Mental Health.](https://reader034.fdocuments.net/reader034/viewer/2022051401/56649cc45503460f9498ccf0/html5/thumbnails/21.jpg)
Experience of Individuals, Families and Communities
Microsystems of Care
Where care occurs
Health Care Organizations
External Environment of CarePolicy/Financing/Regulation
![Page 22: On being person-centered… … and recovery oriented Neal Adams MD MPH Director of Special Projects California Institute for Mental Health.](https://reader034.fdocuments.net/reader034/viewer/2022051401/56649cc45503460f9498ccf0/html5/thumbnails/22.jpg)
www.wellink.org.nzwww.wellink.org.nz
![Page 23: On being person-centered… … and recovery oriented Neal Adams MD MPH Director of Special Projects California Institute for Mental Health.](https://reader034.fdocuments.net/reader034/viewer/2022051401/56649cc45503460f9498ccf0/html5/thumbnails/23.jpg)
trainingtraining
pre/post degree curriculum necessary but not sufficient
move beyond didactic and be competency based
needs to be integrated with overall systems strategy for change strategy Medicaid is the “boogeyman” built into supervision and performance
expectations work flow business processes
![Page 24: On being person-centered… … and recovery oriented Neal Adams MD MPH Director of Special Projects California Institute for Mental Health.](https://reader034.fdocuments.net/reader034/viewer/2022051401/56649cc45503460f9498ccf0/html5/thumbnails/24.jpg)
Professional Context
Shapers
Consultation Level
Influences
5 dimensions
Pro
vid
er
Fa
cto
rs
Pe
rson
Fa
cto
rs
time
provider behavior
person behavior
![Page 25: On being person-centered… … and recovery oriented Neal Adams MD MPH Director of Special Projects California Institute for Mental Health.](https://reader034.fdocuments.net/reader034/viewer/2022051401/56649cc45503460f9498ccf0/html5/thumbnails/25.jpg)
model of changemodel of change
• Thoughts
• Attitudes & feelings
• Subconscious
• Dreams
• Sense of purpose
• Intention
• Behaviors
• Skills &
competencies
• Public commitments
• Purpose
• Values & norms
• Feelings--e. g. safety
& connection
• Alignment of group &
individual intentions
• Collaborative
agreements
• Budgets
• Systems
• Structures
Individual
Group
Interior Exterior
![Page 26: On being person-centered… … and recovery oriented Neal Adams MD MPH Director of Special Projects California Institute for Mental Health.](https://reader034.fdocuments.net/reader034/viewer/2022051401/56649cc45503460f9498ccf0/html5/thumbnails/26.jpg)
self directed careself directed care
person-centered planning putting necessary services and
supports in place individual budgeting
control over how the funds are spent
financial management services tracking and monitoring
budgets supports brokerage
design and management of self-directed care plans
![Page 27: On being person-centered… … and recovery oriented Neal Adams MD MPH Director of Special Projects California Institute for Mental Health.](https://reader034.fdocuments.net/reader034/viewer/2022051401/56649cc45503460f9498ccf0/html5/thumbnails/27.jpg)
burden of choiceburden of choice
need to account for stages of change pre-contemplation contemplation action maintenance
lack of informationdifficult to manage
not for everyone
![Page 28: On being person-centered… … and recovery oriented Neal Adams MD MPH Director of Special Projects California Institute for Mental Health.](https://reader034.fdocuments.net/reader034/viewer/2022051401/56649cc45503460f9498ccf0/html5/thumbnails/28.jpg)
evidence based practiceevidence based practice
almost by definition is provider and disorder centered
does not account for individual preference or choice CATIE study toolkits
move to shared decision making
![Page 29: On being person-centered… … and recovery oriented Neal Adams MD MPH Director of Special Projects California Institute for Mental Health.](https://reader034.fdocuments.net/reader034/viewer/2022051401/56649cc45503460f9498ccf0/html5/thumbnails/29.jpg)
bio-psycho-social
CO
NT
RO
L
biomedicalCONTENT
provider
person
![Page 30: On being person-centered… … and recovery oriented Neal Adams MD MPH Director of Special Projects California Institute for Mental Health.](https://reader034.fdocuments.net/reader034/viewer/2022051401/56649cc45503460f9498ccf0/html5/thumbnails/30.jpg)
outcomesoutcomes
person-centeredness challenges current thinking/practice in outcome measurement each individual becomes
their own measure of recovery outcome and success
goal attainment scaling potential “oppression” of
standard social indicators
![Page 31: On being person-centered… … and recovery oriented Neal Adams MD MPH Director of Special Projects California Institute for Mental Health.](https://reader034.fdocuments.net/reader034/viewer/2022051401/56649cc45503460f9498ccf0/html5/thumbnails/31.jpg)
cultural competencecultural competence
at the heart of person—centeredness account for heterogeneity
within and across cultures preference for
participation may varybased on culture there are
instances in which person-centered could mean provider directed
![Page 32: On being person-centered… … and recovery oriented Neal Adams MD MPH Director of Special Projects California Institute for Mental Health.](https://reader034.fdocuments.net/reader034/viewer/2022051401/56649cc45503460f9498ccf0/html5/thumbnails/32.jpg)
above all elseabove all else
……do no harmdo no harm
![Page 33: On being person-centered… … and recovery oriented Neal Adams MD MPH Director of Special Projects California Institute for Mental Health.](https://reader034.fdocuments.net/reader034/viewer/2022051401/56649cc45503460f9498ccf0/html5/thumbnails/33.jpg)
above all elseabove all else
……be person-centeredbe person-centered
![Page 34: On being person-centered… … and recovery oriented Neal Adams MD MPH Director of Special Projects California Institute for Mental Health.](https://reader034.fdocuments.net/reader034/viewer/2022051401/56649cc45503460f9498ccf0/html5/thumbnails/34.jpg)
I get up each day determined to change the I get up each day determined to change the world – and to have one hell of a good time. world – and to have one hell of a good time.
Sometimes this makes planning the day Sometimes this makes planning the day difficult.difficult.
E.B. White