10-Exhibit D - SAMHSA Person Centered Treatment.pdf

Recovery-Oriented, Person- Centered Behavioral Treatment

Recovery-Oriented, Person-Centered Behavioral Treatment

PEP24-08-003

Recovery is a process of change through which individuals improve their health and wellness, live a self-directed life, and strive to reach their full potential. To be effective, mental health and substance use treatment and services must be based on recovery-oriented and person-centered practices. Such services have demonstrated to improve individuals' quality of life, health outcomes, and social support as well as decrease stigma. Here are tools and approaches that can help:

Informed Consent A foundational principle in all healthcare and required by medical law and ethics, informed consent involves patient agreement to treatment including the provider’s full disclosure of all pertinent information. This includes disclosure of the risks and benefits of treatments, options and choices for treatment approaches, the patient’s role in treatment, their right to refuse treatment and a clear appreciation and understanding by the patient of the facts, implications, and consequences of an action.

Person-Centered Planning Moving beyond treatment or care planning, person-centered planning is a set of collaborative approaches to assist an individual to plan their services and supports by identifying their self-defined, individualized goals. Person-centered planning is directed by the person to discover and act on what is important to their values, preferences, relationships, and other factors that respect their chosen pathways to recovery. It is driven by the individual receiving care, with whomever they choose, which may include family members, friends, advocates, or others to develop a plan based on community living and improved quality of life.

Person-Centered Approaches Informed Consent Person-Centered Planning Shared Decision Making Relationship Building Respectful Communication Trauma-Informed Least Restrictive Engagement Resilience and Strengths-Based Culturally Centered Wellness Focused and Whole Person

Care Harm Reduction Peer and Family Support Recovery-Oriented System of Care

SAMHSA Office of Recovery www.samhsa.gov https://www.samhsa.gov/find-help/recovery 1-877-SAMHSA-7 (1-877-726-4727) • 1-800-487-4889 (TDD)

SAMHSA’s mission is to lead public health and service delivery efforts that promote mental health, prevent substance misuse, and provide treatments and supports to foster recovery while ensuring equitable access and better outcomes.

https://www.samhsa.gov/find-help/recovery https://www.samhsa.gov/ https://store.samhsa.gov/product/samhsas-working-definition-recovery/pep12-recdef https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3562581/ https://pubmed.ncbi.nlm.nih.gov/32996442/ https://pubmed.ncbi.nlm.nih.gov/32996442/ https://www.sciencedirect.com/science/article/abs/pii/S0306460321001301?via%3Dihub https://www.annfammed.org/content/21/Suppl_2/S56.long https://www.samhsa.gov/spark

SAMHSA’s mission is to lead public health and service delivery efforts that promote mental health, prevent substance misuse, and provide treatments and supports to foster recovery while ensuring equitable access and better outcomes.

Shared Decision Making Shared decision-making builds on informed consent, whereby the person and provider are acknowledged for their expertise with both contributing to the medical decision-making process. In this approach, providers explain treatment options and alternatives and help the patient choose the option that best aligns with the person’s preferences as well as their unique cultural and personal beliefs. Choices are then included in the person-centered plan. Shared decision-making aids can assist the patient to work with the provider to choose the best treatment option.

Relationship Building Effective recovery-oriented and trauma-informed services and treatment are based on respectful and trusted relationships that meaningfully establish a therapeutic alliance that can lead to healing and problem solving. Developing effective relationships requires engaging with the person to understand the “story” of their journey, their strengths, values, preferences, family, and social factors.

Respectful Communication The foundation of effective working relationships is honest and trust-based communication. By their communications and actions, providers should demonstrate that they value and respect the individual being served. Jargon should be avoided as well as judgmental and authoritative approaches.

Trauma-Informed Effective care seeks to recognize and respond to trauma experienced by those being served.

Trauma is often a common precursor to mental health and substance use conditions.

Interventions such as seclusion and restraint can break trust, are often unsafe and, in fact, can re-traumatize individuals seeking help. Trauma-informed care seeks to provide a care environment that focuses on safety and trust.

Least Restrictive The L.C. vs. Olmstead U.S. Supreme Court decision stipulated that people with disabilities – including those with behavioral health conditions – have a right to a life in the community.

Recovery-oriented care promotes individuals to pursue independence and community integration. Institutional and coercive care are to be avoided whenever possible and individuals and families are provided with the services needed to live in home and community-based settings.

Engagement Engaging the person and their chosen supporters, or family into care and recovery are key for people starting and maintaining their journeys of healing. Peer and family support can assist recovery by providing hope and role models who demonstrate that recovery is possible. Peer support includes being consistently and compassionately present with and for the person and believing in their capacity for recovery. Developing respectful, trust-based relationships is critical to creating an environment in which the person can talk openly and honestly to activate recovery. Other approaches such as motivational interviewing can be helpful.

Resilience and Strengths-Based Care providers must identify and build on the strengths, skills, resources, and knowledge of the person being served and their families. This includes recognizing and valuing the resilience of people to manage and persevere in the face of major life challenges.

Culturally Centered Understanding culture is critical in promoting effective healing practices for individuals, families, and communities. Providers must practice cultural humility and learn about the history, beliefs, language, practices, and values of those they serve. Care delivery should be congruent with and build on the person’s cultural preferences.

https://www.samhsa.gov/resource/spark/using-motivational-interviewing-substance-use-disorder-treatment

Wellness Focused and Whole Person Care Recovery is holistic and integrative of the multiple options for a person’s life that promote healing and wellness. This includes a focus on the 4 pillars that support recovery: health, home, purpose, and community, as well as the 8 dimensions of wellness: emotional, physical, occupational, social, spiritual, intellectual, environmental, and financial.

Harm Reduction Care providers must meet individuals ‘where they are’ and promote practices that can assist an individual in their present situation based on their needs and preferences. This includes providing harm reduction services to help save lives such as naloxone, syringe service programs, and testing strips.

Peer and Family Support Peer and family support are essential to recovery-oriented care. Having shared lived experience:

peers and families can provide authentic mutual support, systems navigation, education, and more. Peer support specialists work with care providers (or not) to promote whole person care.

Providers should understand, recognize, and respect the roles and responsibilities of peers to work with peer provided recovery support services – such as Recovery Housing, Peer Crisis Respite programs, Drop in and Outreach Centers, Recovery Community Organizations, warm lines.

Recovery-Oriented System of Care A Recovery -Oriented Systems of Care (ROSC) is a coordinated network of community-based services and supports that is person-centered and builds on the strengths and resiliencies of individuals, families, and communities to achieve recovery and improve wellness, and quality of life for those served.

For more information, SAMHSA’s Working Definition of Recovery

SAMHSA’s Program to Advance Recovery Knowledge

Practical Guide for Implementing a Trauma-Informed Approach

Shared Decision - Making Tools https://store.samhsa.gov/product/samhsas-working-definition-recovery/pep12-recdef https://store.samhsa.gov/product/samhsas-working-definition-recovery/pep12-recdef https://www.samhsa.gov/spark https://www.samhsa.gov/resource/ebp/practical-guide-implementing-trauma-informed-approach https://www.samhsa.gov/brss-tacs/recovery-support-tools/shared-decision-making

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Recovery Oriented Care Fact Sheet SWIFT approved 9.6.24.pdf

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