Transcript presentation

Supported Education and
Psychiatric Disabilities
By DeAnne Lonnquist,
Karen Hughes, and Lauren Miller
Agenda
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What is a psychiatric disability?
What is supported education?
Classroom Challenges
Instructional Strategies
What is a psychiatric disability?
A psychiatric disability is a medical condition that disrupts a person's thinking,
feeling, mood, ability to relate to others and daily functioning. They often
result in a diminished capacity for coping with the ordinary demands of life.
Serious psychiatric disabilities include major depression, schizophrenia,
bipolar disorder, posttraumatic stress disorder (PTSD) and borderline
personality disorder. The good news about mental illness is that recovery is
possible.
Psychiatric disabilities can affect persons of any age, race, religion or income.
Psychiatric disabilities are not the result of personal weakness, lack of
character or poor upbringing. Psychiatric disabilities are treatable. Most
people diagnosed with a serious psychiatric disability can experience relief
from their symptoms by actively participating in an individual treatment
plan.
NAMI, 2014
General Statics on Mental Health in
the United States
One in four adults approximately 61.5 million Americans have or will
experience some form of a psychiatric disability in a given year.
About 13.6 million Americans live with chronic psychiatric
disabilities i.e. Schizophrenia, Bipolar, Depression, Anxiety, and
PTSD.
Research indicates that with support individuals with psychiatric
disabilities are able to improve and enhance professional and
personal behaviors and return to work or school.
Supported Education allows individuals to trade the identity of mental
patient for that of student and productive employee.
Schizophrenia
Schizophrenia is a brain disorder that is
characterized by delusions, hallucinations,
disorganized behavior and speech. These
symptoms can cause disruptions in an
individual’s ability to learn.
Positive symptoms
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Hearing voices (audio hallucinations)
Visual hallucinations
Active delusions (Do not buy into them)
Thought disorders (disorganized thinking)
Movement disorders (repetitive motions and
catatonia)
Negative symptoms
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Isolative behaviors
Guarded or extremely private
Blunted affect
Lack of pleasure
Lack of interaction
Schizophrenia is not to be confused
with…
• Dissociative Identity Disorder (“split
personalities”)
• Many people make this mistake
• Schizophrenia is not a learning disorder, but it
can greatly affect the person’s ability to focus
and absorb the material
Mood Disorder
Mood disorders are associated with mood
swings ranging from extreme highs i.e. high
energy, inability to maintain focus and/or
concentrate and extreme lows i.e. feelings of
despair, lack of motivation, inability to focus
and/or concentrate. Mood disorders include
Major Depression, Bipolar Disorder
Mood Disorders
• Associated with extreme moods:
• High mood, which can lead to irritability and
inability to maintain focus
– Mania
– Hypomania
Mood disorders, continued
• Low mood, which decreases member interest
and motivation:
Depression
Cyclothymia (milder form of Bipolar Disorder)
• When Schizophrenia and a mood disorder
occur concurrently, it is called Schizoaffective
disorder.
Anxiety Disorders
Anxiety disorders are defined as the inability to
control feelings of anxiety or excessive
worrying. Anxiety Disorders interfere with the
ability to focus and concentrate. Anxiety
Disorders include Post Traumatic Stress
Disorder and Obsessive Compulsive Disorder.
Anxiety Disorders
• These disorders are under an umbrella in
which symptoms cause the person extreme
anxiety (to the point of physical discomfort
and pain), as well as obsessive behaviors:
• Agoraphobia
• Generalized Anxiety Disorder
• Obsessive Compulsive Disorder
Well Known People With A Psychiatric
Disability
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Professor John Nash, who won the Nobel Prize for mathematics in 1994.
Lionel Aldridge: Played for the Green Bay Packers in the 1960's, suffered from
schizophrenia.
Charles Dickens: author of A Christmas Carol, suffered from depression.
Leo Tolstoy: Author of War and Peace, Tolstoy told of his own mental illness in My
Confession.
Gaetano Donizetti, Singer suffered from bipolar disorder.
Kay Redfield Jamison, clinical psychologist and Professor of Psychiatry at the Johns
Hopkins University School of Medicine, who profiled her own bipolar disorder in
her 1995 memoir An Unquiet Mind and argued for a connection between bipolar
disorder and artistic creativity in her 1993 book, Touched with Fire.
Margot Kidder, actress— self-described: "I have been well and free of the
symptoms that are called manic-depression for almost five years, and have been
working steadily and leading a happy and productive life since then."
Exercise
• We will now show you an exercise that will allow you to
experience what it feels like to hear voices – both positive
and negative. People who suffer from Schizophrenia often
report hearing voices throughout the day, every day.
Exercise: There will be 4 Participants in each group. Each
participant will have a role, which are teacher, learner,
positive voice, and negative voice. The teacher will explain a
lesson of “reading a passage from a book.” The “voices” will
start talking in the learner’s ears, one saying positive things
and the other saying negative things. A discussion will follow.
Supported Education
“Supported Education is a recovery-oriented practice that aids
individuals with psychiatric disabilities who want to begin or
return to school to complete their educational goals
(Mowbray, et al., 2005).”
Bellamy, 2010
Supported Education is defined as enabling individuals to
accomplish his or her educational goals that may have been
interrupted due to experiencing behavioral health symptoms
as a result of having a psychiatric disability.
SAMHSA, 2012
Classroom Challenges
Whether a person is suffering from anxiety, depression, or other
disorders, he or she may bring to the classroom the following
kinds of challenges to learning:
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Difficulty Maintaining Attention
Fatigue/Lack of Initiative and Motivation
Increased Anxiety
Behavioral outbursts or impulses
Instructional Strategies
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Build rapport
Comfort agreements
Introduce material slowly
Use interest to build lessons
Focus on strengths
Utilize learning styles
Encouragement
Constructive feedback
Difficulty Maintaining Attention
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Communicate that you are glad to see the person and acknowledge his or her goals.
Take things one step at a time.
Offer lessons that are at or just above the learner’s current level of achievement.
Help learners measure incremental progress, so they have visible evidence of their
accomplishments.
5. Encourage follow through on assignments, yet be flexible on deadlines.
6. In the learning environment, help the learner identify sensible learning goals.
7. Provide frequent, positive progress feedback to encourage sustained effort and
counteract discouragement.
8. Use humor.
9. Focus on the student as a person. Foster an environment of tolerance and
understanding.
10. As appropriate, find out what the person enjoys or has enjoyed in the past or what
they’re good at.
11. Take breaks as needed.
12. Modify seating arrangements.
13. Minimize visual and auditory distractions. For example use a trifold board or allow the
student to wear headphones.
14. Ask the person what works at home.
Fatigue/Lack of Initiative and Motivation
1. Encourage the student to focus on one subject at a time.
2. Find out what inspires the person (don’t give up easily). Relate the response
to one or more of the student’s learning goals.
3. Develop a realistic plan for achieving the student’s goals. Break it down into
small increments so the student can see results at each step.
4. Discuss the best time to study for homework.
5. Find another student to pair up with the low-energy student when possible.
6. Look for ways to reward the student and increase hopefulness.
7. Help students recognize and acknowledge positive contributions and
performance.
8. Keep a record of the student’s accomplishments so you can show it to him or
her occasionally.
9. Ask the person what works at home.
Increased Anxiety
1. Try to establish a feeling of safety and acceptance in the learning
environment.
2. Provide a consistent, predictable routine as much as possible.
3. Allow the learner to take breaks as needed, including taking a walk or doing a
breathing exercise.
4. Offer lessons that are at or just above the learner’s current level of
achievement.
5. Break assignments into manageable pieces.
6. Help learners measure incremental progress, so they have visible evidence of
their accomplishments.
7. In the learning environment, help the student identify realistic learning goals.
Behavioral outbursts or impulses
1. Rapport helps.
2. Don’t placate, realize the root of the
behavior.
3. If needed, let the member take a break.
4. Take the time to listen to what they are
saying.
5. Shorten sessions, if needed.
Accommodations
An accommodation is an adjustment in a
classroom environment, or task, or
requirement, that allows a person with a
disability to participate equally with others.
Karen Unger, 1998
Accommodations/Helpful Tips
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Quiet place for tests
Extended time for tests
Tests individually processed
Extended time for assignments
Alternative way to complete assignments
Books on tape
Seating modifications
Changes in courses of study
Wide range of adaptive technology
Incompletes rather than failures if the student needs a medical withdrawal
Karen Unger, 1998
Tutors’ experiences of working with
individuals with Psychiatric disabilities
L:
Sometimes, I forget that on top of age, they deal with all
sorts of cognitive barriers i.e. hearing voices and impaired
memories. I tailor my classes (for instance, make personal
references for them) so that they will easily remember the
concept I’m trying to teach. You would be surprised at how
using them as an example helps them to focus on learning.
D: Sometimes my learners have difficulty with concentrating
and staying on task. It can be frustrating. But when one of the
learners answers a question correctly, or completes an
assignment, it is worth all the frustrations I have experienced!
Resources
Substance Abuse and Mental Health Services Administration
www.samhsa.gov
National Alliance of Mental Illness
www.nami.org
National Institute of Mental Health (NIMH)
Information and handouts on various topics
www.nimh.nih.gov
National Mental Health Association
www.nmha.org
References
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental
disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
Bellamy, Chyrell. (2010). Recovery to Practice. Retrieved from
http://www.samhsa.gov/RecoveryToPractice/Resources/rtp_enewsletter/enewsletter_f
inal_10_29_10.html
Substance Abuse and Mental Health Services Administration. (2012). Supported Education
Evidence-Based Practices (EBP) Kit Retrieved from
http://store.samhsa.gov/product/Supported-Education-Evidence-Based-Practices-EBPKit/SMA11-4654CD-ROM
National Alliance of Mental Illness. (2014). What is Mental Illness? Retrieved on February
28, 2014, from http://www.nami.org/Template.cfm?Section=By_Illness
Unger, Karen. (1998). Handbook On Supported Education: Providing Services For Student
With Psychiatric Disabilities. Baltimore, Maryland. Paul H. Brooks Publishing Co.