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Outcomes of the Wellness Management Recovery Program in Ohio

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Outcomes of the Wellness Management Recovery Program in Ohio

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    1. Outcomes of the Wellness Management & Recovery Program in Ohio Presentation Prepared by the WMR CCOE: Kelly Wesp, MS, Wesley Bullock, PhD, Deborah Wilcox, PhD, Mary Kay Smith, MD, Stephanie Rich, LSW, and Gregg Pieples, BA

    2. Measuring WMR Requires us to examine both content and process

    3. Evaluation and Outcomes: “Highlights” WMR Client Self-Rating Scale – content-focused measure includes: Knowledge Increase Better Coping with Symptoms Use of Wellness Planning Progress towards Personal Goals Ohio Consumer Outcomes System-Adult Consumer Form – includes: Empowerment Quality of Life (+ financial status) Symptom Distress

    4. Evaluation and Outcomes: Measures (cont.) Mental Health Recovery Measure – a consumer derived recovery measure that includes: Getting Unstuck, Self-Empowerment, Learning & Self-Redefinition, Basic Functioning, Well-Being, New Potentials, Advocacy, & Spirituality WMR Social Support Questionnaire (added after Year 1) that includes: Quantity of Social Support (number of people you can turn to for support in your social network) Quality of Social Support (how satisfied are you with the quality of support you receive from the people in your support network?)

    5. WMR Research Design Ongoing Open Clinical Trial / Longitudinal Design Caveat = No Random Assignment to Groups No Comparison to other active treatment programs Pre, Post, and 6-month Follow-up assessment Current Sample Sizes (as of 9/15/08) N = 603 with Pre-WMR Data N = 268 with Pre & Post-WMR Data N = 72 with Pre, Post, & Follow-up Data Multiple WMR groups run per site Over 50 persons have gone through WMR more than one time (current outcomes look only at 1st time through).

    6. WMR Research Design (continued) Analysis of Data Nomothetic: Analyze group average changes pre-WMR, post-WMR, and 6 month follow-up Idiographic: Analyze individual results for reliable change (improvement / deterioration) Qualitative: Open-ended questions and individual interviews to uncover commonly expressed themes of the change process related to WMR participation

    7. Demographic Data (N = 268) Gender: 42% Male; 58% Female Ages 18-72: Mean=44.8 years (SD=11.1) Ethnicity: 67.2% European-American 24.3% African-American 1.1% Asian .7% Hispanic/Latino 1.9% Native-American/Pacific Islander 4.8% Missing or “Other” (e.g., Race: ”for the cure”) Are you in treatment because you want to be? 86.6% Yes 10.4% No 3.0% Missing

    8. Demographic Data (N = 268) Employment Status 39% Disabled 38% Unemployed 8% Employed Part-time 2% Sheltered Employ. 6% Retired 2% Homemaker 1% Employed Full Time 1% Student 3% Missing data Marital Status 50% Never Married 26% Divorced 6% Separated 9% Married 3% Widowed 3% Living with Partner 3% Missing data

    9. Summary of Results for All Measures from Pre to Post-WMR A “busy table” but it tells the tale. Note the consistency in average group gains across the variety of recovery oriented outcomes. Note effect sizes are generally in the small to medium range.

    11. WMR Self-Report Scale: Item Level Analysis helps reveal where Changes are occurring: 70% of overall gain on the curriculum-focused WMR Self-Report Scale were due to significant changes on 10 of the 20 items (p < .001) Item# (Mean Gain Pre - Post) Item Content 2. (.74) Knowledge Increase (of symptoms; treatment; coping strategies; medications) 19. (.63) Use of a Wellness Plan 8. (.50) Use of Relapse Reduction planning 1. (.48) Progress towards personal goals 17. (.43) Making healthy life-style choices

    12. WMR Self-Report Scale: Item Level Analysis of Changes (continued) Item# (Mean Gain Pre - Post) Item Content 11. (.36) Coping better with mental & emotional illness day-to-day 12. (.34) Involvement with self-help activities 20. (.28) Recovery philosophy integrated into your life 3. (.26) Involvement of family & friends in my mental health treatment 7. (.23) Symptoms interfering less with daily functioning

    13. Individualized Results: Reliable Change Scores on the MHRM Threshold for Reliable Change (p<.05) on the MHRM is a gain/loss of 15 points (3/4 SD). Threshold for Moderate (“Meaningful”) Change (p<.20) is 10 points (1/2 SD).

    15. Do the Significant Overall Gains Last Over Time? 3-6 month Follow-up Results for the WMR Client Self-Rating Scale and the MHRM

    19. Beyond the Numbers Looking at the Qualitative Outcomes Responses to Written Open-Ended Questions Responses to Individual Interviews What Themes Emerged?

    20. How has participating in the WMR program helped you in your recovery? Wide diversity of responses => unique recovery journey, even when participating in the same program The Alpha and the Omega summary In the Beginning => Fear, Isolation, Doubt, Inhibition, and Feeling Stuck In the End => Growth, Learning, Renewed Energy, Socialization, Overcoming Prejudice and Stigma

    21. Qualitative Post-WMR Themes 4 Primary Themes I. GREATER COMPETENCY: Participants learned specific information, skills and techniques that could be applied to their daily life. Seeking and Finding Answers => Gaining Knowledge Concrete and Experiential Learning => Gained New Perspectives Becoming more assertive, less passive => “Finding a voice” Empowerment

    22. Qualitative Post-WMR Themes (continued) II. GREATER SELF-AWARENESS: Participants gained self-insight and self-knowledge, including a deeper appreciation of themselves and their own recovery efforts Redefining “self” (Person vs. Illness) Recognition of Self-Worth Acceptance of Self Greater sense of autonomous self Self-Confidence Seeing Self as an Advocate

    23. Qualitative Post-WMR Themes (continued) III. SOCIAL CONFIDENCE: Participants gained from the group discussions Active and Passive learning Role models for recovery Recovery benefits of having support from others – “not the only one.” WMR provided opportunities to be a helper to others. IV. GAINING NEW PERSPECTIVES / CLARITY: Participants gained perspective on recovery process Clarified their own recovery goals Recognized healthier life choices (“new potentials”). Promotion of hopefulness Decreased shame regarding mental illness.

    24. Qualitative Post-WMR Themes What part or aspect of WMR did you like best? N = 210 meaning units (from N=154 respondents) Two Major Themes and Two Minor Themes GROUP DYNAMICS / CAMARADERIE (process) (43%) Participants greatly valued the opportunity to engage in lively discussions, do role plays / practice in group, and receive feedback and support from peers and WMR group facilitators. LEARNING (content combined with process) (34%) WMR topics (Recovery; Goal Setting; Coping Skills; Wellness; Mental Illness Facts; Medications) combined with individual activation to use this information to “do the work” of recovery. WMR MATERIALS (content) (10%) Participants liked the WMR materials used (handouts, cartoons, pamphlets) and the relevance and user-friendliness of the materials. Some specifically liked the homework (2%)! GESTALT (10%) “Liked it all.” No specific factor cited.

    25. Contact Us Visit our website: www.wmrohio.org Email: Kelly Wesp, Program Coordinator kwesp@wmrohio.org

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