Peer Specialists as Educators for Recovery-Based Systems Transformation
The Project GREAT Experience
By Anthony O. Ahmed, PhD, P. Alex Mabe, PhD, and Peter F. Buckley, MD |
February 7, 2012
Dr Ahmed is a Psychotic Disorders Postdoctoral Fellow in the department of psychiatry and health behavior at Georgia Health Sciences University, Augusta. He is a member of the Project GREAT team. Dr Mabe is Professor of Psychiatry at Georgia Health Sciences University. He is the leader of the Project GREAT team. Dr Buckley is Professor of Psychiatry and Dean of the Medical College of Georgia at Georgia Health Sciences University. He initiated the Project GREAT recovery-based education effort and established its vision. The Project GREAT program was selected by the American College of Psychiatrists to receive its 2012 “Award for Creativity in Psychiatric Education.” The authors report no conflicts of interest concerning the subject matter of this article.
A contemporary approach to psychoeducation
Project GREAT efforts in psychoeducation are geared toward educating providers about recovery so that they can, in turn, transform their own practices to be in concert with the recovery model. Our aim is to change practitioners’ attitudes about mental illness and recovery so that the conversations they have with patients are focused on recovery rather than on illness. In the Project GREAT approach, CPSs (and other patients) play an active role in educating practitioners, thus reinventing the role that people who have dealt with the challenge of mental illness play in psychoeducation. In their interactions with consumers, CPSs use their life experiences and recovery stories to disseminate information about recovery and teach positive coping skills. This also stands in contrast to how psychoeducation is traditionally disseminated.
Counteracting the long-held conceptions about mental illness and recovery can present a significant challenge. Residents, trainees, and mental health providers used to the traditional medical model are often reluctant to switch to the recovery model. In a survey of trainees about their perceptions of recovery, Buckley and colleagues22 determined that trainees often held traditional views consistent with the medical concept of recovery and expressed skepticism about the feasibility of the patient model in their own practice.
By being sensitive to the pragmatics of time management in psychiatric care and by fully integrating recovery training, CPS services, and recovery practice tools into the traditional structure of psychiatric training and services, we believe that Project GREAT has had success in allaying fears that recovery-based care is not feasible. There have been rare occasions when a trainee expressed concerns that the consumer movement and some aspects of the curriculum seemed “antipsychiatry.” We have endeavored to address this concern within the curriculum by underscoring the invaluable roles that providers have played in the recovery movement and the recovery journey of individuals.
The recovery model has been at the center of ongoing systems transformation to provide innovative services that are more sensitive to patient needs and that empower them to be partners with practitioners as they embark on objectives that help them reclaim a full and meaningful life beyond illness. CPSs are necessary change agents in traditional care settings, where they provide education and support for patients and their family members as well as for mental health practitioners.
CPSs have been crucial in the Project GREAT attempt to transform an academic department into a recovery model and produce psychiatrists and psychologists guided by the recovery vision. We hope that other departments will embrace a recovery-based educational curriculum and incorporate the services of CPSs in its implementation.
(See “Recovery-Based Services and Education Resources” for a brief list of available programs and materials.)
Also in this Special Report
Anthony WA. Recovery from mental illness: the guiding vision of the mental health service system in the 1990s. Psychosoc Rehabil J
Jacobson N, Curtis L. Recovery as policy in mental health services: strategies emerging from the states. Psychiatr Rehabil J
Deegan P. Recovery as a journey of the heart. Psychiatr Rehabil J
Mead S, Copeland ME. What recovery means to us: consumers’ perspectives. Community Ment Health J
Andreasen NC, Carpenter WT Jr, Kane JM, et al. Remission in schizophrenia: proposed criteria and rationale for consensus. Am J Psychiatry
Hogan MF. The President’s New Freedom Commission: recommendations to transform mental health care in America. Psychiatr Serv
Peebles SA, Mabe PA, Davidson L, et al. Recovery and systems transformation for schizophrenia. Psychiatr Clin North Am
O’Hagan M. Recovery in New Zealand: lessons for Australia? Adv Ment Health
Bellack AS. Scientific and consumer models of recovery in schizophrenia: concordance, contrasts, and implications. Schizophr Bull
Substance Abuse and Mental Health Services Administration. National Consensus Conference on Mental Health Recovery and Systems Transformation.
Rockville, MD: US Dept of Health and Human Services; 2005.
Sabin JE, Daniels N. Managed care: strengthening the consumer voice in managed care: III. The Philadelphia Consumer Satisfaction Team. Psychiatr Serv
. 2002;53:23-24, 29.
Sabin JE, Daniels N. Managed care: strengthening the consumer voice in managed care: IV. The Leadership Academy Program. Psychiatr Serv
. 2002;53:405-406, 411.
Sabin JE, Daniels N. Managed care: strengthening the consumer voice in managed care: VII. The Georgia peer specialist program. Psychiatr Serv
Wood AL, Wahl OF. Evaluating the effectiveness of a consumer-provided mental health recovery education presentation. Psychiatr Rehabil J
Solomon P. Peer support/peer provided services underlying processes, benefits, and critical ingredients. Psychiatr Rehabil J
Cook JA, Copeland ME, Corey L, et al. Developing the evidence-base for peer-led services: changes among participants following Wellness Recovery Action Planning (WRAP) education in two statewide initiatives. Psychiatr Rehabil J
Barbic S, Krupa T, Amstrong I. A randomized controlled trial of the effectiveness of a modified recovery workbook program: preliminary findings. Psychiatr Serv
Pickett SA, Diehl S, Steigman PJ, et al. Early outcomes and lessons learned from a study of the Building Recovery of Individual Dreams and Goals through Education and Support (BRIDGES) program in Tennessee. Psychiatr Rehabil J
Peebles SA, Mabe PA, Fenley G, et al. Immersing practitioners in the recovery model: an educational program evaluation. Community Ment Health J
Corrigan PW, River LP, Lundin RK, et al. Three strategies for changing attributions about severe mental illness
. Schizophr Bull
Young AS, Chinman M, Forquer SL, et al. Use of a consumer-led intervention to improve provider competencies. Psychiatr Serv
Buckley P, Bahmiller D, Kenna CA, et al. Resident education and perceptions of recovery in serious mental illness: observations and commentary. Acad Psychiatry