Of greater importance to Project GREAT is the impact of peer-led educational efforts on trainees and practitioners. Wood and Wahl14 evaluated In Our Own Voice (IOOV)—an education program geared toward improving knowledge of and attitudes about mental illness. Undergraduates were assigned to either IOOV training or a control condition (career seminar). Participants in the IOOV condition showed significant improvements in their knowledge and attitudes postintervention.
Peebles and colleagues19 evaluated the Project GREAT recovery curriculum to determine its effectiveness for instilling knowledge about recovery and fostering recovery-promoting attitudes. A team of CPSs, psychologists, and psychiatrists taught the Project GREAT curriculum to doctoral-level practitioners (psychiatrists and psychologists) and psychiatry and psychology residents in a 2-part workshop. Part 1 focused on didactic materials on recovery principles. Part 2 was presented by a panel of patients and CPSs and focused on traditional care versus recovery-oriented care. Data showed that although recovery principles were effectively taught, it was not until patients and CPSs “told their recovery stories” that provider attitudes shifted to a recovery model direction.
The recognized roles of CPSs in ongoing systems transformation efforts have been limited to supporting and educating consumers and their families about recovery, guiding consumers to community resources, advocating for consumers, and providing input in treatment team meetings.14 Our strategy is to empower CPSs—all persons with a history of mental illness—to become active participants not only in their own care but also in the training of prospective mental health providers (Table 2).
Routine exposure to recovery stories. At Project GREAT, we encourage CPSs to draw from their personal experience when working with patients and providers. Exposing mental health providers to patients who recount their own recovery stories will potentially make the providers more empathetic to persons with mental illness.20 The testimonials help change practitioners’ attitudes about a patient’s competence and ability to contribute to his or her own care and demonstrate the value of the recovery model.
The Project GREAT curriculum uses recovery stories as a means of teaching providers core recovery principles and influencing their beliefs and attitudes. CPSs describe the challenges of mental illness in their recovery stories but also underscore the individual strengths, coping resources, and supports (including providers) that contributed to successful recovery.
Routine interaction with providers outside the traditional patient role. The role of CPSs as educators in Project GREAT puts them in a context outside of the traditional patient role. CPSs co-lead recovery lectures and seminars and are involved in answering questions, educating, facilitating, and presenting role-plays. CPSs and patients interact with providers, trainees, and administrators in monthly behavioral advisory council meetings in which they engage in discussions about issues that affect the welfare of patients in mental health settings.
CPSs also participate in program team meetings in which patient care is reviewed and supervised as well as in didactic sessions in which recovery principles/perspectives are integrated within discussions of clinical diagnosis and treatment issues. By interacting in contexts that foster personal contact and decrease the power differential between providers and patients (ie, CPSs), stigma, stereotypes, and other negative attitudes that providers may have can be dispelled.14,21
Providing ongoing feedback and education for trainees. CPSs shadow residents and other trainees during intake, rounds, medication evaluation, or psychotherapy sessions. CPSs provide feedback and encouragement that underscore the importance of treating the patient with respect and dignity, promoting patient independence, focusing on the patient’s strengths, and fostering shared decision making. (Table 3 lists other ongoing Project GREAT recovery education activities.)