* Commonality of experience irrespective of diagnosis * Trauma as an integral part of the experience of mental illness * Impact of social/cultural contexts and resulting discrimination * Relapse prevention as a tool for understanding what has happened * Awareness as a skill that can be developed
The tone and pace of this week are quite relaxed by design because, underneath the material being presented and group interactions, are the building blocks for the group cohesion that will occur in the next few weeks.
The week attempts to strike a balance between disseminating information, allowing participants maximum “space” and choice, and imposing upon the group the kind of structures necessary to foster the kind of group framework that will be required in future weeks.
* Expand upon the idea of commonality of experience by introducing factual information on the biological bases of three mental illnesses and examining their intersections
* Engage participants in thinking seriously about sleep as:
· A factor in relapse · An important area of personal investigation · A universal problem with potential practical solutions
* Assist participants in discerning how mental illness effects their thoughts and feelings and using that information to begin to understand their own illnesses with more clarity
* Introduce the idea of “and” thinking as an alternative to “either/or”
Major topics for the week are:
* Schizophrenia, Manic Depression, and Depression
* Sleep
* Dialectic Thinking
* Awareness
Certain classroom techniques are employed in order to maximize personal and group development. For example: the technique of letting participants choose how to follow along with the lecture material (attending to hand outs, attending to lecture, both) is designed not only to accommodate individual learning styles, but to emphasize in a very real way that participants have actual choices. The technique of engaging the group in reading course material aloud is designed to both accustom participants to hearing their own voices and to enhance interactivity.
* Continue to reinforce the idea of commonality by introducing factual information on the biological bases of two additional mental illnesses and examining their intersections
* Raise consciousness among participants regarding taking what control they can, with regard to preventing future relapse
* Assist participants in discerning how mental illness effects their senses and behavior and using that information to begin to understand their own illnesses with more clarity
* Challenge participants to examine their own experiences retrospectively, from a safe and supported distance mediated by the group process thus far, and prepare participants to tell their story to the whole group in the next week
Major topics for the week are:
* Depression, Obsessive Compulsive Disorder, and Panic Disorder
* Relapse prevention
* Awareness
Even though it looks like fewer major topics are being dealt with during this week, the pace of this week is just as fast as last week’s. More time is taken up with interactive exercise material this week, since one of the goals of this week is to prepare participants for next week’s story telling class.
In the first three weeks, participants gather a lot of information about themselves and the other participants in the course. In addition to the structural elements highlighted in earlier weeks, this gathering of information also serves to build group cohesion. In this week particularly, the group and dyad exercises are certainly useful for the information they contain, but they are also serving the purpose of allowing participants to “pre-voice” their stories which will be told next week.
In this week we finish the sections of the course that are primarily devoted to science, and begin to pave the way for the more psychosocial dimensions of the course.
Week Four
Storytelling
The fourth week of the course is designed to:
* Afford an opportunity for participants to be “listened into voice” * Offer participants an opportunity to incorporate new information gained through course participation into their existing stories; and to reframe their experiences if desired
* Pave the way for more emotionally challenging material in the weeks ahead by reducing the emotional load of the past
* Serve as a divider in the course: separating the “what happened” from the “what next” of the course material
* Coalesce the group
In addition to serving the important function of debriefing participants, this week is also a major transition in the course. It is the close of the first section, through which participants have gained a sense of belonging in the course -- in addition to a great deal of information.
The major topics are going to be whatever each group member brings to this week’s class. Mentors play a key role in demonstrating the sorts of validating responses that are appropriate to the occasion, as well as supportively looking for the dialectics in the stories told, but should gradually -- as the class progresses -- be taking a back seat to the group-as-a-whole.
Week Five
Language Emotions Continue Relapse Prevention Planning
The fifth week of the course is designed to:
* Assist participants in making the connection between language used to describe mental illness and internalized messages of stigma, or discrimination
* Provide basic and comprehensive information on emotions, and increase participants’ array of coping skills
* Shift the focus of relapse prevention planning from understanding what has happened to assessing the impact of what has happened
* Demystify the group experience somewhat by helping participants to place the process of the course in the context of emotional recovery from trauma, reinforcing the shift in power that began last week
Major topics for the week are:
* Language
* Emotions
* Awareness
This week has a medium pace by design, anticipating that the group will use more talk time in the exercises for the week. The topics of language and emotions are brought up deliberately and recursively in a variety of ways, in order that participants have maximum opportunities to engage with the material.
There is a lot of time devoted to relapse prevention planning in this week, since the plan comes together next week and the material of this week consists of those elements necessary to the production of a meaningful plan. The exercises in this week build upon the sense of control evoked last week in the story telling process.
* Provide information about addictions * Alert participants to risk factors * Provide information about addictions: * Familiarize participants with how 12 step recovery programs work * Introduce the idea of spirituality as a possible aspect of recovery with mentalillness * Assist participants in deciding what are the most important things they must do or must not do in order to maintain wellness, and to assign levels of risk to their main activities in life in order to complete a comprehensive relapse prevention plan
* Encourage participants to medicate those features of mental illness that have caused the most distress or are the most troublesome in their lives
* Assist participants in deciding what are the most important things they must do or must not do in order to maintain wellness, and to assign levels of risk to their main activities in life in order to complete a comprehensive relapse prevention plan
In the first hour, addictions recovery is used as the opportunity for introduction of the idea of a healthy spirituality as a viable component of recovery with mental illness.
* The second hour uses the topic of medication as the introduction to finalizing relapse prevention plans.
Participants in the first three weeks of the course were looking inside, and have gradually been led to look outside themselves in the last three weeks. In addition to having the kind of comprehensive information they need in order to complete a workable relapse prevention plan, this orientation towards outside is serving to begin the transition out of the program that they will be experiencing in the final three weeks.
Week Seven
Coping Strategies Decision Making The seventh week of the course is designed to:
* Build on a number of skills introduced earlier in the program; particularly dialectic thinking and setting priorities
* Confirm that the focus of the program has shifted to “outside” by focusing on strategies for managing in the real world
* Impart information that may be used to keep people safe in the event of hospitalization
* Empower participants by elucidating some of the power dynamics behind the scenes in provider-controlled environments
Major topics for the week are:
* Isolation * Coming Out * Staying Safe * Awareness
This week we focus on the kinds of things -- tips, techniques, ideas -- that are generally only available as a result of long term participation in mutual support. “Collective wisdom” describes the material of today’s course.
This wisdom is also the material of empowerment, which begins the transition into stage three of the model of emotional response to trauma. Participants find value in these highly pragmatic tips for dealing in the real world as much for their informational worth as for their use as the starting point for self-advocacy.
Week Eight
The eighth week of the course is designed to:
* Promote the idea of family members as potential allies in maintaining wellness and helping participants to identify some of their most common difficulties in relationships
* Assist participants in thinking realistically about what they need to maintain wellness and during times of distress, and offering suggestions for getting what they need from others in their lives
* Begin the final tangible work of the course: an advance directive for psychiatric health care decision making
Major topics for the week are:
* Relationships with family with providers
* Volition exercising personal power choosing to delegate
Many themes from previous weeks converge in this week.
This, almost final, week is focused primarily on self-in-relationship. What is not made explicit in the week’s material but exists in the exercise portions is that this week is very much about repairing what may need repair with respect to personal relationships.
The devising of an advance directive is the final product in this course, and the transition to the final task at hand is designed to keep the focus on personal power in relationships.
Week Nine
The final week of the program is designed to remain structurally consistent with the rest of the course. There is lecture, product, interactive exercise and awareness, but it is all done with an attitude of ritual; of knowing that we are doing these things together for the last time. The pace is medium, except for the closing awareness exercise -- which also serves as a closing ritual -- which should be done slowly to allow participants maximum time to experience the moment and formulate words.
The final week includes a group evaluation process during which participants are invited to report what worked and what didn’t, what stood out, what they loved and what they absolutely hated about the course.
The final product of the course -- an advance directive for psychiatric health care decision making -- can not be completed inside the class room due to the signatures required. This is by design. The advance directive that they take away from the course and that they must complete in the real world is the symbolic blanket of our continued caring about them -- and their continued caring about themselves -- that they must make work outside of the classroom.
The last part of class is reserved for an informal, wrap-up celebration.
