Promoting Activity and Participation in Individuals with Serious Mental Illness

The Action Over Inertia Approach

Terry Krupa, Megan Edgelow, Shu-Ping Chen, Carol Mieras

• Publisher: Routledge
• Year: 2021
• Print ISBN: 9780367629007
• eBook ISBN: 9781000456707
• Topic: Psychology
• Subtopic: Attention-Deficit Disorder (ADD-ADHD)
• Index: Psychology

This book presents "Action Over Inertia," a recovery-orientated, strengths-based approach to address the profound disruptions in daily activities and community participation often experienced by those living with serious mental illnesses.

With a focus on supported "doing", the Action Over Inertia approach engages individuals in small activity and participation efforts as an opening to making longer term and sustained changes that offer meaning and well-being. The book helps service providers develop their own knowledge of activities and the health and well-being benefits an individual might receive from activities. It also asks them to consider the biases, assumptions, and constraints that might impact their ability to implement interventions related to activity and participation. A range of worksheets, resources, vignettes, and other tools are provided to support this practice.

The manual was developed from the knowledge and practice of occupational science and therapy, but it will be of interest to any mental health professional, peer-provider, administrator, or policy maker interested in promoting recovery for people with serious mental illness

1 Preparing to Use This Workbook

DOI: 10.4324/9781003111368-1

Initially Alex was uncertain about discussing his daily activities with Jamie. Although he experienced distress and unhappiness with his current activities, he became noticeably anxious at even the thought of making changes to his daily activity and participation patterns.

Jamie reflected on the knowledge gained about Alex that led to interpreting his activity and participation patterns as unlikely to promote health and well-being. Jamie then discussed these concerns with colleagues who also knew Alex and asked for their perspective. Jamie and other service providers agreed that Alex’s daily activity and participation patterns were largely passive, and it seemed that he spent large parts of his days without any defined or recurring activities. Overall, they expressed concern that he had few opportunities for meaningful and fulfilling social and community connections.

Jamie supported Alex in a process of self-reflection about his activity and participation patterns. Jamie introduced Alex to the worksheets, presenting them as offering a way to consider what benefits he gets (or might get) from his activities and participation. While completing the worksheets, Jamie briefly described the meaning of some of the items. For example, Alex was unsure about the meaning of ‘values’ as it related to activities, and Jamie explained that when people are involved in activities and participation that they consider important they can experience a sense of well-being. Although he was tentative and cautious, Alex’s own reflections were consistent with what Jamie observed. He agreed that his daily activities were bringing little satisfaction and offered him few opportunities to develop interests. Alex mentioned that his parents would probably like to see him involved in more activities, and participating in more things like other people his own age. Jamie shared information about the connection between activity patterns and health and well-being. Jamie also provided Alex with a bit of information about the link between problems of mental health, like his own, and activity and participation. Jamie assured Alex they would move ahead to address his patterns at a pace he was comfortable with and remain sensitive to his needs and wishes. Jamie told him, ‘You know Alex, you are the one in charge of how you live your day-to-day life, but I will try to support you to find satisfaction and meaning in what you do’.

Focused Questions:

1. 1. How familiar are you with an activity and participation-oriented intervention approach?
2. 2. Think of a time, in practice, when you were concerned about the activity and participation patterns of an individual you served? What was concerning about these patterns?
3. 3. At a recent workshop on the Action Over Inertia intervention approach, a mental health service provider reflected, ‘You know, I never really thought about what the people I see in my daily practice will do during the day, after our visit’. How does this compare to your own practice experience?

This chapter includes the following worksheets:

• Worksheet 1.1: Making appraisals about activity and ­participation patterns explicit (service provider version)
• Worksheet 1.2: Evaluating the benefits experienced through current activity and participation patterns (service provider version)
• Worksheet 1.3: My current activity and participation patterns
• Worksheet 1.4: Benefits of my current activity and participation patterns
...

Table of contents

• Cover
• Endorsements
• Half-Title
• Title
• Copyright
• Contents
• Authors and Contributors
• Foreword I
• Foreword II
• Foreword III
• Preface
• Acknowledgements
• Introduction
• 1 Preparing to Use This Workbook
• 2 Understanding Personal Activity and Participation Patterns
• 3 A First Step: Making Rapid Changes in Activity and Participation
• 4 Providing Education about Activity and Participation, Mental Illness, and Recovery
• 5 Making Longer-Term Changes
• 6 Supporting Sustained Changes in Activity and Participation Patterns
• 7 Raising the Profile of Activity and Participation in Mental Health Service Delivery
• 8 Evaluation of Activity and Participation to Inform Service Development
• Bibliography
• Appendix A: Additional Vignettes
• Appendix B: Activity Engagement Measure (AEM)
• Appendix C: Other Applications of Action Over Inertia
• Index