Best Practices: Wellness Self-Management: An Adaptation of the Illness Management and Recovery Program in New York State

Abstract

Wellness Self-Management (WSM) is a recovery-oriented, curriculum-based, and educationally focused practice designed to assist adults with serious mental health problems to make informed decisions and take action to manage symptoms effectively and improve their quality of life. WSM is an adaptation of the Illness Management and Recovery (IMR) model, a nationally recognized best practice for adults with serious mental health problems. WSM uses comprehensive personal workbooks for group facilitators and consumers and employs a structured and easy-to-implement group facilitation framework. Currently, more than 100 adult mental health agencies are implementing WSM, representing a broad array of program types, clinical conditions, and cultural populations. The authors describe the development, key features, delivery, adoption and sustaining of WSM

Illness Management and Recovery: A Review of the Literature

“…These studies included results from the NIEBP project (21–25) and thorough descriptions of IMR implementation efforts at a psychiatric rehabilitation center (26), a state psychiatric hospital (27), and community mental health centers in the United States and Israel (28). Others focused on the adaptation of the IMR model, either for use in a novel setting or for a novel purpose (29–31) or for overcoming perceived barriers to implementation (32,33). Finally, several studies examined staff perceptions of IMR training (34–36).…”

“…Another adaptation of IMR, Wellness Self-Management (WSM), departs from traditional IMR in three key ways (32). Most significant, consumers receiving WSM do not set long-term recovery goals.…”

“…Although it provides structure, the IMR curriculum allows a fair degree of flexibility of pace and usage of techniques, providing guidelines—rather than prescriptions—for suggested activities during sessions and as homework. Some IMR modifications, including WMR and WSM, have increased the prescriptive nature of the curriculum, introducing substantially briefer time frames for program completion (32,33). Some have added topics to the curriculum, including an increased emphasis on medications (33), general medical health (31,32), and anger management (29).…”

“…Implementation support was generally very robust and spanned domains of implementation. Implementation across studies generally included some form of external facilitation, including academic detailing (26,27,39) or technical assistance (17,19,21,32,33). In New York, a learning collaborative served many of the same functions as a state technical assistance center but was funded in part by financial commitments from participating agencies (32).…”

“…Many implementation efforts began with a pilot group, generally the most willing and enthusiastic clinicians, and expanded to additional programs and clinicians (26,27,32,40). Because IMR is a manualized program, clinicians must be willing to adapt to a more structured intervention (26).…”