{"id":227,"date":"2020-09-13T03:23:23","date_gmt":"2020-09-13T03:23:23","guid":{"rendered":"https:\/\/swpro.org\/ahershberger\/?page_id=227"},"modified":"2020-11-08T21:50:00","modified_gmt":"2020-11-09T02:50:00","slug":"special-project","status":"publish","type":"page","link":"https:\/\/swpro.org\/ahershberger\/special-project\/","title":{"rendered":"Special Project"},"content":{"rendered":"

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Introduction<\/h1>\n

Project Title:\u00a0<\/span>Addressing Mental Health During COVID-19<\/span><\/strong><\/p>\n

The idea of this project was initiated in collaboration with my academic advisor. The sponsors associated with this project are my field supervisor and the director of the Lighthouse. <\/span>The Lighthouse is operated by Helen Ross McNabb Center and offers a peer support program. The program is designed to provide adults with a mental illness to develop social skills in a community setting while receiving support from each other and therefore receiving higher levels of care and personal development. The duration of my project took place over the course of a two-month period. Participants were McNabb Center group home residents who have been diagnosed with mental illness. Because of COVID-19, attendance at the Lighthouse was limited and significantly impacted. Participants in the community settings outside of McNabb Center group homes were no longer allowed to attend the Lighthouse. During my field practice, I conducted a Survey<\/a> that allowed me to gather data to assess current activities delivered at The Lighthouse and the need for other activities to be integrated into a curriculum focused on the recovery of mental illness. Since attendance and participation in activities decreased, I created and implemented a curriculum focused on recovering from mental illness.\u00a0<\/span><\/span><\/p>\n

Addressing the Issue and why it matters.<\/h2>\n

The Issue\u00a0<\/span><\/strong><\/p>\n

The social issues being addressed are decreased attendance and a lack of participation in Lighthouse activities’ regular participants. Interacting with peers and feeling supported, especially during COVID-19, is paramount in preventing suicide, preventing substance use, and other destructive behaviors related to a mental health diagnosis. Due to social distancing and many organizations being closed during the Pandemic, being connected and feeling supported by others has been challenging. Being connected and feeling supported is a key component in managing mental health symptoms (Colorado Department of Education, 2020).\u00a0<\/span><\/p>\n

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Significance, Implications, and People Affected<\/strong><\/span><\/p>\n

This year has had record-breaking impacts on millions of Americans nationwide.\u00a0<\/span>The\u00a0COVID-19<\/abbr> Pandemic brought many changes to how we live our lives and, along with it, uneasiness and uncertainty, altered daily routines, and social isolation. We now may worry about getting sick, how long the pandemic will last, and what the future will bring. Information overload, rumors, and misinformation can make your life feel out of control and make it unclear what to do.<\/span><\/p>\n

During the\u00a0COVID-19<\/abbr> Pandemic, persons may experience stress, anxiety, fear, sadness, and loneliness. Mental health disorders, including anxiety and depression, can worsen (Mayo Clinic, 2020). In addition to the fear of contracting the Coronavirus are significant changes to our daily lives as our movements are restricted in support of efforts to contain and slow down the virus’s spread. This is especially true for members in community group home settings, where they are no longer to go on outings to Wal-Mart, the zoo, or other fun-filled activities that they were able to do before COVID-19. At the beginning of COVID-19, the Lighthouse closed to all participants for three-months.<\/span> Before COVID-19, attendance ranged anywhere from 20-60 people participating in daily activities six days per week to limiting the number of participants to no more than eight, having only two groups per day, one in the morning and the other in the afternoon, to decreasing activities to four-five days per week. Another significant contribution to the community group home members impacted by COVID-19 was that the Lighthouse would have cookouts for holidays and hot meals each Thursday and serve tea daily. This has now been reduced to the Lighthouse director preparing a meal the day before a holiday and delivering it to each group home the next day. The hot meals are now sacked lunches prepared the day before, and only canned sodas are being offered at the end of the group activities for members to take home.\u00a0 The issue is significant in that the peer support center is designed to offer supportive services to help participants learn social skills, provide them with the opportunity for peer interactions, and serve as a means of self-care.\u00a0<\/span><\/p>\n

Design of interventions<\/span><\/h2>\n

Mission:\u00a0 To provide support through a<\/span> curriculum that focused on recovery and address mental health issues associated with COVID-19.<\/span><\/span><\/p>\n

Goals: This project’s\u00a0primary goal was to increase attendance and address gaps in services that had been lacking based on feedback from participants.\u00a0<\/span><\/span><\/p>\n

Intervention Tools:\u00a0The type of interventions used for the peer support groups at the Lighthouse I created for the curriculum were mezzo-level social work practice models. Participants attending the Lighthouse were considered household groups because they lived together in the same group home and peer groups. After all, the participants all had similar problems they were dealing with.\u00a0\u00a0<\/span><\/span><\/p>\n

Specific interventions created for use within the curriculum were designed to impact a micro-level of social work practice by teaching skills that would impact the ability to function within the group homes and the community.\u00a0<\/span><\/p>\n

The following are links to handouts and interventions that took place throughout the curriculum.<\/span><\/p>\n

Building New Habits & Habit Plan, Recognizing Feelings & Emotions and where we feel, and an Art Therapy Mask Project<\/a><\/span><\/p>\n

Decision-Making Tree, Symptoms & Recognition of Stress and Stress Management Strategies<\/a><\/span><\/p>\n

Challenging & Countering Negative Thoughts, The Cycle of Depression & Triggers and Coping Skills for Depression, and Positive Traits and About Me Sentence Completion (Self Esteem Building Exercises<\/a>)<\/span><\/p>\n

Being Responsible & the use of ‘I’ Statements, The Cycle of Anxiety & Tools to Manage Anxiety, CBT discussion of Thoughts, Feelings & Actions, and Thought Tracker<\/a><\/span><\/p>\n

Communication Skills Active Listening & Reflections,\u00a0 Suicide Warning Signs & Safety Plan,\u00a0 Anger Management & Warning Signs<\/a><\/span><\/p>\n

Social Support, Values Discussion, and Self-Care Tips and Activities<\/a><\/span><\/p>\n

Strengths Exploration<\/a><\/span><\/p>\n

Deep Breathing Exercises and Sleep Hygiene Discussion<\/a><\/span><\/p>\n

Fair Fighting Rules & Conflict Resolution Wheel<\/a>\u00a0 <\/span><\/p>\n

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Theoretical Perspectives<\/span><\/strong><\/p>\n

Systems Theory –\u00a0<\/span><\/strong>Systems theory in social work is based on the idea that behavior is influenced by various factors that work together as a system. In this project, the system I worked with was clients who reside in group homes in a peer support setting. I observed and analyzed participants within their group home setting, individual therapy settings, and peer support groups. Based on my observations and through data collection from administering surveys, I was able to work to improve behavior and welfare for constituents on a micro and mezzo level of systems. Each intervention focused on improving an individual’s ability to function within their group home setting and functioning within the community.\u00a0<\/span><\/p>\n

Psychodynamic Theory –<\/span><\/strong> This theory examines the emotional and internal forces that shape human behavior. Interventions used to examine the emotional and internal forces for participants’ behavior were conflict resolution, fair fighting skills, mindfulness, grounding techniques, exploring emotions, and feeling these emotions on our bodies, strengths exploration, and Cognitive Behavioral Theory<\/strong> and Therapy techniques. Please see examples of this theory<\/a>.<\/span><\/p>\n

Social Learning Theory – <\/span><\/strong>In this theory, one seeks to understand human behavior in how we learn from observing and interacting with others around us. In this project, I worked with adults with mental illness. These adults observed, copied, and modeled behaviors they were taught during the group sessions in which my curriculum was presented. According to the theory’s originator, Albert Bandura, the degree to which such modeling takes place depends on attention, retention, reproduction, and motivation. Participants of this project’s curriculum were able to reproduce behavioral skills taught to them during group time.<\/span><\/p>\n

Conflict Theory –\u00a0<\/span><\/strong> This theory explains that human behavior can be explained in competition between groups with unequal power. I was able to observe numerous power struggles among participants residing in the McNabb Center group homes. I utilized conflict theory by addressing asymmetrical power relationships between group members. Interventions were created and implemented to reduce tensions among different group members in their group home settings. Interventions included: Anger Management Skills, Conflict Resolution, Stress Management, and Fair Fighting Rules. <\/span>Conflict Theory intervention examples<\/a><\/p>\n

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Review of Literature<\/span><\/h4>\n

I reviewed the curriculum at the Lighthouse that was being used before implementing my curriculum. The curriculum utilized by the Lighthouse included Wellness Recovery Action Plan (WRAP), Chronic Disease Self-Management Program (CDSMP), and Diabetes Self-Management Program (DSMP).\u00a0 Participants in WRAP reported significant increases in 1) their hopefulness for their own recovery; 2) awareness of their own early warning signs of decompensation; 3) use of wellness tools in their daily routine; 4) awareness of their own symptom triggers; 5) having a crisis plan in place; 6) having a plan for dealing with symptoms; 7) having a social support system, and 8) ability to take responsibility for their own wellness (Cook et al., 2010). Given the rapid growth of this intervention in the U.S. and internationally, these results contribute to the evidence base for peer-led services (Cook et al., 2010). The study results discussed by (Fukui et al., 2014) offer promising evidence that WRAP participation positively affects psychiatric symptoms and feelings of hopefulness. CDSMP results in significant, measurable improvements in patient outcomes and quality of life (Evidence-Based Healthy Aging Program, 2020). Over time, with greater use and research, peer support services can help mental health services fulfill the promise of recovery for those with serious mental illnesses (Chinman et al., 2014). Research findings indicated that the self-management curriculum focused on recovering from mental illness works for this population and is the best curriculum available for this population. WRAP has been rigorously studied and has been proven to work well for people with all kinds of issues and circumstances, including people who have serious mental health challenges and other major life issues (Advocates for Human Potential, Inc., 2018). Topics and activities that were implemented in my curriculum were made to implement WRAP and CDSMP guidelines.<\/span><\/p>\n

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Results Achieved<\/span><\/h4>\n

The implementation of my curriculum increased attendance from 0-5 people per day to 8-18 people per day. This was a significant increase in participants. Before COVID-19, attendance was 20-60 per day. COVID-19 played a dramatic role in the decrease in attendance since the Lighthouse had been closed for three months. I conducted pre and post-tests via surveys to gauge the curriculum’s effectiveness before the creation of my curriculum and to measure the effectiveness of my special project’s curriculum. Pre-Test Survey<\/a> and Post-Test Survey<\/a><\/span><\/p>\n

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Conclusions<\/span><\/h2>\n

There were limitations in implementing the curriculum over a six-week time frame, as I had originally planned for. These limitations involved not being allowed to create a curriculum for any Thursday, Friday, and two Tuesdays per month. The director’s reasoning behind this was because on two Tuesday’s per month, they had an established Nutrition curriculum which they used, and on Thursdays, they had to play Bingo and get a sack lunch; on Friday’s they leave that day for a ‘fun’ day to either watch a movie or sing karaoke. Instead of creating six weeks of the curriculum in a row, I created activities over September and October to work around these limitations.\u00a0<\/span><\/p>\n

Another limitation was COVID-19. Due to the Pandemic, community group homes and members were not allowed to attend. This significantly limited the number of participants to McNabb Center group home residents only, and not every resident from the McNabb Center homes attended due to fears related to COVID-19.\u00a0<\/span><\/p>\n

Time was also a significant factor in the implementation of the curriculum. I was faced with completing my entire portfolio a month earlier than expected. Therefore, I had to create and implement activities by creating instructions in advance until the end of October for the current peer support staff to review during each group.\u00a0<\/span><\/p>\n

When creating the curriculum, I had to plan activities that were not too complex and understood at a lower cognitive ability level. This was due to the varying severity of cognitive functioning for each participant. Even though I created activities that I thought could be understood by the slowest member of the group, some participants still had difficulty understanding. I had to plan to explain in a way each group could understand better. Even though I was not there every day to administer the curriculum, a discussion was made between myself and the peer support staff concerning feedback received and any recommendations I might have.\u00a0<\/span><\/p>\n

My Special Project demonstrated all nine of the competencies required by the CSWE.<\/span><\/h3>\n

Competency 1: Demonstrate ethical and professional behavior.<\/span>\u00a0<\/span><\/h4>\n