Phases of Care
At The Recovery House our treatment and rehabilitation plan is based on the following steps:
1. Referral from a Consulting Psychiatrist with a confirmed diagnosis and prescription for treatment, psychological assessment if any, and record of hospitalization
2. Clinical interviews with client and family, history taking and mental health assessment
3. If client is a suitable fit for the residential or day program, then: Development of a treatment, rehabilitation and transition plan in consultation with the client and their family
4. If a client is not yet ready or a structured program of rehabilitation therapies, referral to Consulting Psychiatrist for clinical management of symptoms
5. Continuous monitoring and review of progress towards recovery goals
6. Transition and discharge with structured follow up to reduce chances of relapse.
Once the treatment has been formulated and a client is accepted into the care of TRH, we work towards healing through rehabilitation at pace that is best suited to the needs of each individual client. This typically occurs in phases, during each of which treatment and rehabilitation are being delivered simultaneously.
The psychiatric rehabilitation process consists of three phases – a) assessment, b) planning and c) implementation. Each phase involves the person, the person’s chosen support system and service provider in designing the development of wanted and needed skills and supports relevant to the person’s background:
a) A functional or goal-based individualized assessment includes the completion of an evaluation of social and environmental supports and an evaluation of strengths and unmet needs in areas of psychosocial functioning as they relate to the person’s goals and priorities consistent with the person’s culture.
b) Planning includes developing a participant-specific rehabilitation plan which establishes goals and objectives and plans for skill and support development. The plan development process involves both staff and participant (if he/she chooses) involvement using methods appropriate to the psychiatric rehabilitation program model. The plan and updates must include progress reviews that demonstrate shared staff and client responsibility for evaluation progress in goal areas.
c) In site-based programs, the implementation of services may take place individually or in groups. The following are examples of appropriate services which should be addressed consistently with the person’s goals:
1. Psycho-education: Mental health education regarding self-management of symptoms, medication and side effects.
2. Health education: Education regarding optimal physical health.
3. Assessing rehabilitation preferences: Determining with the person his or her personal perspectives and preferences regarding participation in the psychiatric rehabilitation process.
4. Setting rehabilitation goals. This is the process by which the person chooses desired rehabilitation goal(s).
5. Functional Assessment: Determining with the person the specific skills and supports or resources the person needs and prefers to develop, achieve and maintain rehabilitation goal(s)
6. Skills Teaching and Development: Providing persons with needed and desired skills to develop, achieve and maintain rehabilitation goals. Teaching methods may be direct or indirect. Examples of areas for skill teaching/development include:
a. Solving problems
b. Maintaining the living environment
c. Managing resources
d. Using public transportation
e. Planning menus and preparing food
f. Skills for self-care
g. Skills for socializing
h. Skills for budgeting
i. Communication and interpersonal skills
j. Pre-vocational and vocational supports.
d) The psychiatric rehabilitation program may also provide the following services:
1. Vocational activities or training such as job development, placement and coaching that prepare an individual for a specific job.
2. Educational services or programs that prepare persons for a particular trade.
The final phase of rehabilitation involves helping residents accept the gains they have achieved in their functioning and recovery, as well as get acquainted with how far they have come. Clients, depending upon their recovery, are stepped down from residential into the day program, or from the day program into the outpatient program. Some clients move into apartments to live with a caretaker, while others return to live with family.