Recovery-Oriented Cognitive Therapy (CT-R)
Open Sky Community Services has been working with researchers at the University of Pennsylvania to implement CT-R. Early results indicate that individuals are more engaged in outside activities, are making more connections with the community, report feeling motivated to achieve goals, symptoms are reduced and staff feel more confident in their ability to positively inspire recovery. Stefanie Gregware, Director of Clinical Services and Andrea Wolloff, Director of Cognitive Behavior Therapy (CBT)have been leading this effort at Open Sky Community Services.
CT-R was developed for individuals who may be challenging to engage due to low motivation and energy, and for whom other treatment techniques and strategies are not sufficient. Individuals experiencing major mental illness can be tough to reach and connect with.
This treatment teaches staff strategic ways to build connections with individuals in order to help them move towards recovery. Individuals are treated as equals and staff learn how to engage and connect constantly. When individuals feel they are heard and are less isolated, they are less likely to become agitated. Research has shown that CT-R reduces symptoms of psychosis, isolation, inpatient stays and aggression. It has also been shown to improve staff attitudes towards individuals served and job satisfaction.
CT-R provides staff with knowledge and tools needed to elicit individual strengths and capacities to collaborate in goal development. It allows staff to really explore the meaning of goals, rather than focusing on symptoms (for example, instead of the goal of “I want to be less depressed," staff look to find out what would be good about this? What would the person have?). This allows for individuals to have more meaningful goals that they feel passionate about and for more motivation and excitement to work towards recovery.
CT-R also teaches staff how to engage strategically with individuals to build momentum towards achieving goals. Staff learn the skills of how to keep individuals moving towards goals that they are passionate about. This includes learning how to break goals down into workable steps.
In addition, CT-R teaches staff teams how to use a conceptualization of each individual to remove obstacles to recovery in the milieu setting. The staff are taught how to find meaning in obstacles to a person’s recovery. Staff provide structured opportunities to help them build successes and mastery in line with goals.
Finally, CT-R promotes effective interventions to change beliefs and promote long term change and progress towards recovery. Staff are taught some basics of cognitive therapy to help individuals cope with delusions, hallucinations, and other symptoms when these symptoms are interfering with recovery. Evidence in literature and in practice has shown that when individuals are engaged and connected with others and in activities that they enjoy, symptoms such as delusions, isolation, hallucinations, etc. are dramatically decreased.