Showcasing: Strengths Model implementation in Community Mental Health Services in South Western Sydney Local Health District
South Western Sydney
South Western Sydney Local Health District
Living Well domain
Putting people first
The Strengths Model is a person-centred, recovery-oriented approach to care coordination that consists of three evidence-based practices including strengths assessment, recovery goal planning and group supervision. The practices are used in combination to foster self-determination and personal goal attainment for people with lived experience of a mental health issue.
Clinicians work with people and those in caring roles to develop and implement an action plan that assists in the achievement of unique and personal goals.
The project started in South Western Sydney Local Health District in June 2016.
NSW Mental Health Coordinating Council provided seed funding for scoping. The South Western Sydney Local Health District (SWSLHD) Mental Health Executive has approved ongoing funding in recognition of the long-term nature of the required culture and practice change efforts. The budget provides for a 0.6 FTE project manager and four two-day workshops each year.
The SWSLHD Mental Health Executive identified the implementation of the Strengths Model as a key strategic action to support the aims of the National Framework for Recovery-Oriented Mental Health Services.
Within the framework, the practice domain of ‘supporting personal recovery’ identifies three practitioner capabilities:
- Promoting autonomy and self-determination
- Focusing on strengths and personal responsibility
- Collaborative relationships and reflective practice.
The Strengths Model project objectives are to:
- ensure that mental health practitioners understand the principles of recovery-oriented practice and are able to engage with people with lived experience of a mental health issue and carers to develop recovery-oriented care plans
- ensure that all people receiving community mental health services are supported to develop a strengths assessment and recovery plan
- identify and address contextual factors that inhibit or enable the implementation of the strengths model in community mental health services.
A staff training, and supervision program enables the integration of strengths model principles and practices into clinical treatment. Training facilitators include the project manager, a senior clinician who regularly uses the strengths model and a person in a caring role who has experienced the impact of the strengths model on her son’s recovery. The project manager also provides individual coaching and supervision as well as group supervision to assist staff to embed the Strengths Model into their practice.
United States research has shown that the Strengths Model is an effective approach to community-based care coordination, associated with a reduction in relapse and hospital admission rates, and improved psychosocial outcomes. Further research is underway in Australia and internationally.
The Strengths Model philosophy views all people as having a range of strengths and capabilities, for example, knowledge, skills, life experiences, supportive relationships, resources and goals, which can be drawn on to support recovery.
- People with lived experience have co-designed the project including:
- The Strengths Model Steering Committee, responsible for governance of the implementation program, includes people with lived experience and peer worker representatives
- The training program is co-facilitated by a trainer with lived experience of caring for a family member with a mental health issue
- People with lived experience will be involved in evaluation through focus groups and individual interviews.
By June 2019, 230 staff had completed the two-day training workshop.
The program manager is completing a doctoral level research project to evaluate program impact on both clinicians and people with lived experience. Although formal evaluation has not started, mental health staff consistently report that participants are satisfied and engage in the process of assessing their strengths and developing care plans. People with lived experience are more motivated and positive when practitioners change the focus of the assessment and care planning process. The quality of the therapeutic alliance is enhanced.
Case studies prepared by staff implementing the model have shown:
- improved practitioner understanding and empathy towards people with lived experience
- greater awareness and commitment to the principles of person-centered care
- increased belief in the capacity of people with lived experience of a mental health issue for personal growth and recovery
- greater participation and engagement of people with lived experience in care planning
- increased levels of practitioner hope and optimism regarding recovery.
The Strengths Model program has been primarily focused on training and supporting staff to adopt a person-centred approach to care planning and recovery.
The SWSLHD needs to address the system-level changes to support implementation and transform mental health services. Work to integrate the Strengths Assessment template into the electronic medical record is in process, as are policy and procedural changes.
The current focus is on community mental health services. However, the District plans to introduce strengths-based practice in inpatient mental health settings as a necessary part of implementation.
Australian Government Department of Health. (2013). A National framework for recovery-oriented mental health services: guide for practitioners and providers. Retrieved from https://www1.health.gov.au/internet/main/publishing.nsf/Content/mental-p...
The Strengths Model: A Recovery-Oriented Approach to Mental Health Services, 3rd edn, Charles A. Rapp and Richard J. Goscha, New York, Oxford University Press, 2012