JOE MARRONE

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• JOE MARRONE
• INSTITUTE FOR COMMUNITY INCLUSION
• MAIN OFFICE BOSTON, MA
• NW OFFICE
• 4517 NE 39TH AVENUE
• PORTLAND, OR 97211-8124
• TEL [phone]
• HOME TEL [phone]
• FAX [phone]
• EMAIL JM61947_at_AOL.COM

• GENERAL WEB WWW.COMMUNITYINCLUSION.ORG or
• NCWD - ADULT WWW.ONESTOPS.INFO

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VISION OF RECOVERYJOE MARRONE

• RECOVERY MAY BE A JOURNEY
• BUT IF YOU NEVER GET ANYWHERE,
• IT CAN EASILY BECOME A TREADMILL.

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• IF EVERYONE IS ALREADY DOING IT,
• HOW COME IT NEVER GETS DONE ???

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ALL CHANGE IS DIFFICULT NO MATTER HOW LONG YOU
PUT IT OFF.

• ------ JOE MARRONE

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Ships are safe in harbor,but that is not what
ships are built for.

• ------ Anonymous

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I WORRY ABOUT

• DISCRIMINATION NOT STIGMA
• BEHAVIOR NOT ATTITUDE
• CITIZENSHIP/CIVIL RIGHTS NOT CONSUMERISM
• POWER/CONTROL NOT CONSUMERISM
• COMPETENCY NOT COURTESY
• LOVE/RELATIONSHIPS/SEX NOT INTERVENTION/ SERVICES
• JOBS/ CAREERS NOT VOCATIONAL PROGRAMMING

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VALUES IN WORKING WITH PEOPLE W. MI IN THE
COMMUNITY

• CULTURE OF CLIENT BENEFIT
  LIVING, WORKING, RELATIONSHIPS
• PEOPLE HAVE RIGHT TO CONTROL THEIR LIVES, THEIR
  TX, KINDS OF HELP THEY RECEIVE. STAFF SHOULD
  INFLUENCE.
• ALL PEOPLE NEED HOPE SUPPORT
• PEOPLE W. MI DO GET BETTER --- gt 60
• SYMPTOMS NOT PREDICTIVE IN OTHER AREAS
• PEOPLE CAN WORK, SO THEY SHOULD WORK
• PEOPLE W. MI BEST SERVED IN COMMUNITY
• COMMUNITY/ PEER/ FAMILY SUPPORTS PROS

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• IF PEOPLE
• CAN WORK
• PEOPLE
• SHOULD WORK

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UNEMPLOYMENT IS BAD FOR YOU !!!
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Dooley, D., Fielding, J., Levi, L. (1996).
Health and unemployment. Annual Review of
Public Health
Kasl, S. V., Rodriguez, E., Lasch, K. E.
(1998). The impact of unemployment on health and
well-being. In B. Dohrenwend, (Ed.).
Adversity, Stress and Psychopathology
Lennon, M. C. (1999). Work and unemployment
as stressors. In A. Horwitz, T. Scheid,
(Eds.). A Handbook for the Study of Mental
Health Social Contexts, Theories and Systems
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Dooley, D., Catalano, R., Hough, R.
(1992). Unemployment and alcohol disorders in
1910 and 1990 Drift versus social causation.
Journal of Occupational Organizational Psych
----- increases alcohol use Linn, M. W.,
Sandifer, R., Stein, S. S. (1985). Effects of
unemployment on mental and physical health.
American Journal of Public Health ---- increases
in anxiety Dooley, D., Catalano, R., Wilson,
G. (1994). Depression and unemployment Panel
findings from the Epidemiologic Catchment Area
study. American Journal of Community Psychology
----- increases in depression
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• YOU NEED A LITTLE LOVE IN YOUR LIFE FOOD IN
  YOUR STOMACH BEFORE YOU CAN HOLD STILL FOR SOME
  DAMN FOOLS LECTURE ABOUT HOW TO BEHAVE.
• BILLIE HOLIDAY

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MARK TWAIN

• " FEW THINGS ARE
• HARDER TO PUT UP WITH
• THAN THE ANNOYANCE
• OF
• A GOOD EXAMPLE"

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• WHAT DO YOU DO TO ENCOURAGE WORK AND DISCOURAGE
  IDENTITY AS A SELF -- IDENTIFIED FAILURE ???

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• HOPE
• AND
• HASSLING

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HELPERS RESPONSIBILITY TO ENGAGE MOTIVATE

• HOPE VS. OPTIMISM? ---
• PAT ON BACK VS.
• COMMUNICATING THAT YOU
  CARE
• YOU UNDERSTAND
• YOU WILL BE THERE
• YOU HAVE IDEAS HELP TO OFFER

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OSCAR WILDE

• TO LOVE ONESELF IS THE BEGINNING OF A LIFE LONG
  ROMANCE.

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Stages of (Readiness for) Change

• PRECONTEMPLATION
• CONTEMPLATION
• PREPARATION
• ACTION
• MAINTENANCE
• TERMINATION
• PROCHASKA, J.0., NORCROSS, J.C.,
• DICLEMENTE, C.C. (1994). CHANGING FOR GOOD. NEW
  YORK, N.Y. AVON BOOKS

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NO MOTIVATION

• FEAR OF FAILURE
• NO SELF - CONFIDENCE
• POOR EXPERIENCES
• LOSS OF BENEFITS
• LACK OF INFORMATION
• LAZINESS

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John Galbraith

• Given a choice between changing and proving that
  it is not necessary,
• most people get busy with the proof.

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MOTIVATIONAL INTERVIEWING

• Express empathy
• Develop discrepancy
• Avoid argumentation
• Roll with resistance
• Support self-efficacy

Miller, W. Rollnick, S. (1991).
Motivational interviewing Preparing
people to change addictive behavior.
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MOTIVATION

• VALUES
• EXPECTANCY
• EXPERIENCE
• RESOURCES
• INFORMATION
• ENERGY FROM YOU

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WILLIAM JAMES

• MANY PEOPLE THINK THEY ARE THINKING WHEN THEY
  ARE MERELY REARRANGING THEIR PREJUDICES

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JERRY GARCIA

• SOMEONE HAS TO DO SOMETHING AND ITS PRETTY
  PATHETIC ITS GOT TO BE ONE OF US

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THOMAS EDISON

• RESULTS!
• WHY, IVE GOTTEN A LOT OF RESULTS.
• I KNOW SEVERAL THOUSAND THINGS THAT WONT WORK.

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PRINCIPLES OF IPS MODELR. DRAKE G. BOND

• COMP. EMPLOYMENT GOAL
• RAPID JOB SEARCH
• MH REHAB INTEGRATED
• TIME UNLIMITED SUPPORT
• ATTENTION TO PREFERENCES
• CONTINUOUS ASSESSMENT

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Research Based Principles of Successful
Rehabilitation/ Recovey

• People with SMI can be successfully engaged in
  competitive employment
• VR services should involve employment in
  integrated settings at customary wages or above
• People with SMI should be placed in paid jobs as
  quickly as possible and according to their
  preferred pace

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Research Based Principles of Successful
Rehabilitation/ Recovey

• Ongoing employment support services should be
  available as needed desired by the person
  served.
• Persons with SMI should be helped to find jobs
  matching career preferences
• VR services should explicitly proactively
  address financial planning provide
  education/support around disability benefits
  entitlements.
• VR services should involve family friends in
  supporting efforts to work

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Research Based Principles of Successful
Rehabilitation/ Recovey

• Vocational MH services should be integrated
  coordinated.
• Vocational providers should work collaboratively
  w. persons w. SMI to address issues of stigma/
  discrimination, help negotiate reasonable
  accommodations w. employers.
• VR services should be made available to all MH
  consumers

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CLEARVIEW MH EMPLOYMENTAnnual Totals (7/01/01 to
6/30/02)
Referrals------------------------------- 416 Re
ferrals received directly from PHP Mental Health
Services--------------- 220 Attended
Orientation------------------------ 327 Vocational
Profiles Completed----------- 240 Placed in
Competitive Community Employment------------------
----------------- 129 Those Placed that are
involved with PHP Mental Health
Services----------- 99
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IM TIRED OF PLAYING BY THE RULES. LETS
SCRATCH THEIR EYES OUT TILL THEY GIVE US
FRESH TUNA.
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GREEK PROVERB
BEFORE PRACTICING VIRTUE, FIRST SECURE AN
INDEPENDENT INCOME.
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OLD YIDDISH PROVERB

• If 1 person calls you a jackass, ignore him
• If a second person calls you a jackass, think
  about it
• If a third person calls you a jackass- get a
  saddle.

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CONSUMER DRIVEN IS NOT

• JUST SAYING YES
• STAFF ONLY PLACATING
• AVOIDING OPINION
• CONSUMER RUN

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CONSUMER DRIVEN IS NOT

• AVOIDING RESPONSIBILITY TO INFLUENCE
• "I TOLD YOU SO"
• JUST LISTENING WITHOUT HELPING

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Thom HartmanADD, An Alternate View

• I am not inattentive,
• you are just boring.

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RITA MAE BROWN

• FOR YOU TO BE SUCCESSFUL, SACRIFICES HAVE TO BE
  MADE.
• ITS BETTER THAT THEY ARE MADE BY OTHERS, BUT
  FAILING THAT,
• YOULL HAVE TO MAKE THEM YOURSELF.

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RITA MAE BROWN

• IF THE WORLD WERE A LOGICAL PLACE,
• MEN WOULD RIDE
• SIDESADDLE

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" There is nothing you can say in answer to a
compliment. I have been
complimented myself a great many times, and they
always embarrass me -- I always feel they have
not said enough. "Mark Twain
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1 FEW TICKETS DEPOSITED 2 NATIONALLY GREAT
MAJORITY OF TICKETS DEPOSITED W. VR 3 PAYMENT
STRUCTURE BACKLOADED - POSSIBLE CHANGE4 HOW
MUCH MOTIVATION IS THIS FOR RECIPIENTS OR
PROVIDERS?5 IS AVOIDING CDR A BIG DEAL?6
SHOULD IT EXTEND TO YOUTH OR THOSE WHO HAVE NOT
HAD THEIR FIRST CDR?7 SOME PROVIDER STRUCTURES
CONTROVERSIAL WI ARRANGEMENT8 FEW NEW
PROVIDERS IN POOL
KEY ISSUES -- TICKET TO WORK

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1 DISABILITY LOW ON WIA RADAR SCREEN 2
PERFORMANCE STANDARDS - EXCUSE BY
WIA?3 EMPLOYER FOCUS -- EXCUSE BY WIA?4 REHAB
ACT -- EXCUSE BY VR?5 VR USED AS DISABILITY
SERVICE BY WIA SECTION 188 MANDATES?6 MANY
DISABILITY ENTITIES (E.G.,
DD/ MH) AVOID IT7 SHOULD THERE BE A SEPARATE
TRANSITION STREAM?
KEY ISSUES -- WIA

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8 SHOULD IN SCHOOL YOUTH MONEY BE GIVEN TO LEAS,
NOT WIA?9 ROLE STRUCTURE OF WIBS10 HOW
MUCH SELF IN SELF SERVICE?11 MIDDLE CLASS
SYSTEM FOR ALL? OR JUST FOR MIDDLE CLASS?12
ACCESS FOR HIDDEN DISABILITIES13 DISCLOSURE -
DISABILITY INQUIRIES14 CORE, INTENSIVE,
TRAINING SERVICE SEQUENCE15 ROLE OF TRAINING/
USE OF ITAS OVERALL HOW BENEFIT PEOPLE WITH
DISABILITIES?
KEY ISSUES -- WIA