IIPR Award Vote Now! – Institute for Inpatient Psychiatric Rehabilitation

Nominations have come in from across the country and now you get to decide which of the three program finalists is the IIPR Award winner for 2024.

The winner should be the program that best exemplifies the goals, values, and principles of inpatient Psychiatric Rehabilitation.

Click the red button at the bottom of the page to cast your ballot.

Voting will remain open until 12/31/24

Finalist #1

Title: The Bleyzer Program

Submitted by: Tyson Keller
Location: Moccasin Bend Mental Health Institute, Tennessee

Program Description: The name of the program we are nominating is the Bleyzer Program. The Bleyzer program functions as a specialized program at Moccasin Bend Mental Health Institute (MBMHI). MBMHI is one of four Regional Mental Health Institutes in the Tennessee operated by TN Department of Mental Health and Substance Abuse Services. This program was named for Dr. Gedaly Bleyzer, a former MBMHI psychiatrist who defected from Russia to the United States due to religious and political persecution. Dr. Bleyzer, once a prominent cardiothoracic surgeon in his homeland, took up psychiatry upon coming to the United States and practiced at MBMHI until his passing in 1995. He was a beloved, well-respected, and devoted clinician so much so that one of the properties at MBMHI is named in his honor.

Goals of the Program: The program was designed to serve patients who have been in the clinical inpatient setting for anextended period of time and is designed to prepare them for discharge and community reintegration.The goal of the program is to help patients build or develop their functional skills that will help them in their transition back into the community. These functional skills deficits can create barriers to discharge readiness and community placement for our patients.

Abstract: The Bleyzer program exemplifies the goals, values, and principles of psychiatric rehabilitation by providing a program of recovery that helps individuals gain or refine independent living skills, confidence and self-esteem, work toward individual goals and obtain the tools needed in the community upon discharge. This is achieved through a “community living” approach. The patients work together to complete chores, plan and prepare meals including shopping in the community. The mission of the program is to “Blaze new trails back into the community through facilitation and practice of vocation, support, and knowledge of recovery”. I believe the Bleyzer Program should win the IIPR Award because we have seen the positive impact of our program on the patients it serves. We have seen 36 patients complete this program. Three patients have returned to the hospital giving us a 92% success rate. Those three individuals returned for a medication adjustment or need for new placement and length of stay was less than one month.

In 2020, a 27-year-old patient was admitted who suffered from severe and debilitating social anxiety and depression with overwhelming feelings of worthlessness and suicidal ideations. She had decompensated to the point she began having trouble managing the basic tasks of daily living. She was withdrawn and would decline to engage with others and avoid eye contact. After completing the program, she was soon ready for discharge. Upon discharge she continued to apply and develop the skills she learned in Bleyzer. She returned to Chattanooga on a mission to continue “BLEYZING” through life. When asked, what impact The Bleyzer Program had on her she replied, “Bleyzer helped me to find and see myself as more than a person with a mental illness, and it taught me how to believe in myself and that I could have a real life”.

Finalist #2

Title: Social Learning Program

Submitted by: Manfredo Flores Cruz, PsyD
Location: Fulton State Hospital, Missouri

Program Description: The Social Learning Program (SLP) at Fulton State Hospital is designed to teach and support individuals with severe and persistent mental illness to assist them in overcoming difficulties and facilitate the process of recovery. The SLP was designed by Dr. Gordon Paul and his colleagues in the 1960s and 70s with the overarching goal of serving individuals residing within inpatient psychiatric settings who were unable to be discharged during the de-institutionalization movement (Paul & Lentz, 1977). This program was designed to serve individuals who were highly institutionalized and experiencing significant impairments as a result of their mental illness. Currently, the SLP serves adults primarily diagnosed with schizophrenia or schizoaffective disorder in a forensic inpatient setting. Additionally, the program serves the senior population at Fulton State Hospital, providing evidence-based treatment for older adults.

Goals of the Program: The mission of the Social Learning Program at Fulton State Hospital is to provide comprehensive psychosocial rehabilitation and recovery-oriented services. The purpose of the program is to teach and support adults with severe and persistent mental illness to assist them in overcoming difficulties and facilitate the process of recovery. The goals of the SLP are to assist residents in developing skills so that they can correct any problem behaviors that may have brought them to the hospital, may be keeping them in the hospital, or may hasten their return. These problem behaviors can typically be broken down into six areas: 1) excesses in bizarre, unusual, and aggressive behaviors; 2) deficits in self-care skills; 3) deficits in interpersonal skills; 4) deficits in instrumental role performance; 5) difficulty in planning for the future; and 6) lack of understanding about personal triggers that may lead to psychiatric relapse. Interventions in the program are designed to target all six of these areas and the program strives to incorporate evidence-based practices in all aspects of treatment. Measurable outcomes of the program’s mission and purpose include the ability to safely live and function in a less restrictive setting, reliable performance of activities of daily living, improved social and occupational functioning, and a higher perceived quality of life while respecting residents’ autonomy and self-determination. The program consists of a comprehensive, integrated network of skills training techniques and supports based on learning theory, individually tailored to resident needs. Most evidence-based individual and group interventions can be incorporated to meet the individual needs and functioning of program residents.

Abstract: The Social Learning Program (SLP) has exemplified the Goals, Values, and Principles of Psychiatric Rehabilitation since its inception. The SLP is the longest running program at Fulton State Hospital, running continuously since 1988. Its implementation represents the first widespread, comprehensive utilization of Social Learning principles for the treatment of severe mental illnesses (Menditto, et al., 2022). Since its beginning, the SLP has focused on providing evidence-based treatments for individuals with severe mental illnesses to aid in their process of recovery. The program’s goals are closely aligned with Psychiatric Rehabilitation, as it espouses the same goals of recovery, community integration, and quality of life. One of SLP’sprincipal values is that “people with a mental illness can and do learn.” This guiding principle enables the SLP to instill hope and provide an environment dedicated to respect and empowerment of the people we serve. Additionally, the SLP is a “program without walls,” meaning the therapeutic value of every interaction is emphasized,regardless of when or where the interaction occurs. The SLP provides opportunities to engage meaningfully with a wide variety of treatment providers who take into consideration the client’s individual needs, cultural background, and recovery goals in every interaction.

Fulton State Hospital prides itself in its pursuit of evidence-based practices and thus has collected extensive data on the SLP. Research conducted in the SLP between 1988 and 2019 highlights the effectiveness of this treatment. Out of 288 clients treated by the SLP between these years, 248 clients successfully discharged from maximum security (Menditto, et al., 2022). Furthermore, when compared to other programs, between 2010 and 2019, only 3 out of 90 (3.3%) SLP clients were readmitted to maximum security following discharge. In comparison, 32 out of 225 (14.2%) of clients discharged by other programs were readmitted to maximum security (Menditto, et al., 2022).

Finalist #3

Title: Recovery and Self-Motivation Program (RSM)

Submitted by: Kayla Collier, Psy.D
Location: Fulton State Hospital, Missouri

Program Description: The Recovery and Self-Motivation (RSM) program is intended to assist clients with primary psychotic disorders such as schizophrenia or major mood disorders who may also have primary or secondary personality disorders. Common diagnoses on the program include schizophrenia, schizoaffective disorder, bipolar disorder, and antisocial personality disorder. Clients often have complex presentations with multiple diagnoses, significant histories of trauma, and overt behaviors of aggression.

Goals of the Program: RSM is a psychiatric rehabilitation program whose staff and consumers seek to provide a nurturing and safe environment that more adequately fosters recovery. The program is oriented toward functional-contextualism and the empirically-supported theory that humans behave the way they do within a specific environment because of the purpose it serves for them. Subsequently, RSM staff are constantly working to employ empirically-supported treatments and interventions through individual, group, and milieu-wide strategies, to create a more nurturing environment that fosters recovery through prosocial cooperation and social connection.RSM adopts a person-centered approach to better identify specific needs, rather than simply reducing our clients to a diagnosis, to better tailor individual interventions for treatment. We utilize recovery models (e.g. Illness Management & Recovery and Wellness Recovery Action Planning) that teach illness self-management and empower clients to be proactive authors of their own recovery. We further work to support clients through a range of Cognitive-Behavioral interventions (e.g. individual incentives, contingency management, behavioral contracting, Dialectical Behavior Therapy, Michael’s Game, etc.) to influence prosocial cooperation and recovery-related actions. These efforts help our clients develop insight into their symptoms of mental illness and overall wellbeing, engage in safe behaviors, interact prosocially, increase their knowledge of helpful coping skills, and develop future cope-ahead plans to help ensure their success in a less restrictive setting.

Abstract:Historically, RSM provided treatment in a milieu that focused on rules and consequences, gave clients minimal empowerment in their own treatment, and focused on areas of development rather than strengths. This was not found to be effective in treatment, nor helpful to our clients when looking at their overall well being, and consequently, the program was completely revamped in 2019. Institutional settings are inherently unnatural and have often been shown to have negative effects on people already prone to mental health problems and antisocial behavior. For instance, both clients and staff often reinforce and reward antisocial and maladaptive behaviors with an inordinate amount of attention. Furthermore, a common reaction from staff is to punish clients in an attempt to suppress those behaviors. In turn, clients become resentful. This often creates a never-ending cycle of discipline and negative consequences. The problem is that punishment does not teach new, more skillful behaviors that allow people to be more adaptive. Therefore, the primary recovery-oriented principle and value of the RSM program is to create a more nurturing environment. We are committed to creating an environment that differentially reinforces recovery-related behaviors and prosocial cooperation, while attempting to limit situations where less adaptive behaviors are rewarded.

To address community integration, RSM works to teach, promote, and richly reinforce prosocial behaviors, skills, and recovery-based activities that foster cooperation with others. This assist clients with learning to get their needs met without infringing on the needs or rights of others. A key piece includes ensuring this is modeled through individual interactions amongst not only staff and clients, but also staff interactions with each other. Through these efforts, RSM has successfully reduced rates of seclusion and restraint episodes, injuries to both clients and staff, and improved engagement in treatment; allowing clients to make meaningful gains in treatment goals.

CLICK HERE TO VOTE!