NAMI Provider Education – Week Two

NAMI Provider Education

Yesterday I attended the second class of NAMI’s Provider Education. Here I summarize, paraphrase, and quote the handouts from the NAMI Provider Education Course Participant Manual 2013:

THEORETICAL BASIS: Basic principles of secondary prevention/intervention in mental health care in community psychiatry as devised by Gerald Caplan, MD (1974) and Erich Lindemann, MD (1944). Community theory proposed protective interventions of crisis counseling, grief work, support networks, practical help in adaptive coping, and education.

Clinical strategies (secondary interventions) for responding to psychological trauma which both individuals with mental illness and their families experience:

  1. Recognize crushing burden of catastrophic events
  2. Quickly preserve social supports & strengthen coping skills
  3. Understand normalcy of trauma response
  4. Anticipate needs based on process of adaptation

Impact of mental illness on the family – predictable emotional reactions among family members:

  1. Stage I – Dealing with Catastrophic Event – Adaptation Model
    • Crisis/chaos/shock
    • Denial
    • Hoping against hope
    • Trauma Response: Use of denial to avoid reality & protect self from being overwhelmed
    • Families need: Support, comfort, empathy for pain & confusion, crisis intervention, prognosis, NAMI support and information
  2. Stage II – Learning to Cope – Adaptation Model
    • Anger/guilt/resentment
    • Recognition
    • Grief – chronic sorrow
    • Trauma Response: Use of anger and projection to avoid feelings of guilt
    • Families need: Vent feelings, keep hope, education, self-care, networking, skill training, letting go, co-operation from system, NAMI support groups
  3. Stage III – Moving into Advocacy – Adaptation Model
    • Understanding
    • Acceptance
    • Advocacy/Action
    • Trauma Response: Practice of advocacy as an antidote to loss. Wish to heal by helping others.
    • Families need: Activism, restoring balance in life, responsiveness from system, NAMI

Adaptive Process: through pain and grief to acceptance and hope

NAMI Provider Education Course Participant Manual 2013

Individual stages of recovery – BRIDGES Consumer Stages of Recovery – I covered the BRIDGES handout here and here when I learned about it in NAMI‘s Peer to Peer program.

  • Event 1 – Crisis: Psychosis, suicide attempt, mania, episodes of severe depression
  • Stage 1 – Recuperation: Stage of dependence. After trauma of mental illness episode ~ exhaustion of body, mind and spirit.
  • Emotions: Denial, Confusion, Depression, Humiliation, Isolation, Self-hatred, Resentment, Anger
  • Needs:
    • Safe place to rest – a lot of sleep
    • Someone to take care of me
    • To provide basic needs: Nutritious food, personal hygiene.
    • I am unable to take on even the simplest task of daily living
    • Medications (probably)
  • Event 2 – Decision: “Time to get going” – I must make it for myself. If I rush it, I may have a setback. If I resist it; I will feel bored and empty.
  • Stage 2 – Rebuilding: Rebuilding independence, ability to do things for myself. I need help to learn and practice living skills. I feel “up” when I succeed and “down” when I don’t.
  • Emotions: Hope, Grief, Discouragement, Boredom, Self-doubt, Trust, Fear, Excitement, Anxiety, Frustration with setbacks, Pride in success
  • Needs:
    • Tell my story: To have others hear my pain and despair
    • Learn about mental illness: “What is happening to me and why?”
    • Persons who believe in me: Mentor/teacher/friend
    • Getting and managing: Money, food, clothes, a good place to live
    • Learning (relearning) social skills and working skills
  • Event 3 – Awakening: “I am somebody. I have a dream!” Coming to know “the new me.” Starting to dream about who I am and who I can be. I am the Phoenix rising from the ashes.
  • Stage 3 – Recovery/Discovery: Building healthy interdependence: Starting to know, “Who I am and what I want to be, who I care about and who cares about me”
  • Emotions: Self-acceptance, Appreciation of others, Confidence, Anger at injustice, Assertiveness, Helpfulness to others
  • Needs:
    • A personal vision: A dream to strive for
    • People who appreciate me
    • Intimacy: Someone to love
    • Meaningful work: A chance to leave footprints
    • To advocate for self and others

Source: BRIDGES, Building Recovery of Individual Dreams and Goals through Education and Support, (2006)

What I’m Working On Now

NAMI Ending the Silence Program, This is My Brave, Transformed by Postpartum Depression

Last Thursday, I interviewed at NAMI Orange County to participate in two of their programs:

NAMI Ending the Silence

NAMI Ending the Silence is an in-school presentation about mental health designed for high school students. Students can learn about mental illness directly from family members and individuals living with mental illness themselves.

NAMI Provider Education

The NAMI Provider Education Program presents a penetrating, subjective view of family and consumer experiences with serious mental illness to line staff at public agencies who work directly with people with severe and persistent brain disorders.

Saturday January 31st, the next NAMI Orange County Provider Education program begins. I’m taking the course as a provider, even though I have not practiced psychotherapy since I was thirty. Perhaps I will later be trained to be a provider educator myself, if it is not too socially stimulating. Honestly, after my interview, I became hypomanic. Not sure what I can do without triggering symptoms.

Another project I am working on is finishing a 750-word piece for This is My Brave. Thank you, founder Jennifer Marshall who blogs at Bipolar Mom Life. I have writer’s block and finding it difficult to complete.

This is My Brave

This Is My Brave, a 501(c)3 non-profit organization, provides a community and platform for people living with mental illness to speak out to end the stigma associated with mental health disorders.

Transformed by Postpartum Depression

Along with many other books I want to read, I REALLY want to finish reading my good friend Walker Karraa, PhD‘s new book Transformed by Postpartum Depression: Women’s Stories of Trauma and Growth.

Transformed by PPD


I am a proud contributor to Walker Karraa, PhD‘s groundbreaking website STIGMAMA.COM. February’s theme is storytelling and fiction. Contact STIGMAMA.COM to submit your piece.

STIGMAMATM provides a nonjudgmental, supportive, creative community for women to speak their truths OUT LOUD, for with the wisdom and support of others we can unpack the stigma of mental difference in motherhood.

Life Simplified

short list

Using WordPress Reader Lists has simplified my life. There are a seemingly infinite number of excellent blogs to follow, read, like, and comment on. If you comment, I will respond. I “follow” those who follow me. Whether or not I read or comment, I do care. There are only 24 hours in a day, and I’m running out of steam. My New Year Resolution is to protect my time and energy. I am doing so now.

Now I free my time for writing original content and for living my life unplugged. I have books to read and training to attend. Starting January 31st, I will attend my local NAMI Orange County chapter Provider Education Program with the hope of becoming a Provider Educator.

We have to get our reactive dogs into dog training; actually, the humans in the family need training on how to communicate with our dogs.

Our house is a mess. Clutter surrounds us on every horizontal surface. I’m not the best house-keeper in the world, not that I ever aspired to be such. Still, I should clean the house every now and again. No doubt I should cook more often, for when I do, we eat more healthfully. (The “shoulds” are adding up here.) Luckily, we have options for healthy take-out nearby. We can get sushi, Persian salmon kabobs, grilled or ceviche fish tacos, and Indian food within a few miles. Not bad at all.

Did I mention that we have to finish painting the interior and exterior of our house and possibly heighten our fences to reduce stimulation of our territorial dogs? Oh, and I’m married to a civil engineer. Translation: he’s a consummate do-it-yourselfer. He’s handy and has accomplished a lot, including installing solid oak floors, but there is much still much to be done.

To top it all off, extended family members we love dearly fight cancer and multiple sclerosis. Oh, and just in case you didn’t read my tag line, I have bipolar disorder, and I’m a mom. No wonder I feel overwhelmed.