(a hop international program) · 2019-03-21 · up to me –tourette and associated challenges...

(A HOP International Program)

▪ Statewide collaborative think tank to identify, implement, and evaluate evidence based practices

▪ Majority speak from experience of stigma and recovery

▪ Insight, resources, and support for stigma reduction

WI Initiative for Stigma Elimination

What Is Stigma?

Where does it come from?

StigmaDefinition

▪ Stereotype-ideas

▪ Prejudice-beliefs

▪ Discrimination-actions

Types

▪ Internalized Stigma

▪ Public

▪ Structural

ALL OPPRESSIONIS CONNECTED

Now we know what works. . .

▪ Protest▪ Education▪ Contact

Stigma Change Processes

Up to Me – Tourette and Associated Challenges

▪ Small group program for youth (8th-college) who have faced Tourette and Associated challenges and the daily decisions about what to say and to whom

▪ 5 one-hour lessons with additional booster (or seven 45 min sessions)

▪ Based on the international, evidence-based adult program of the same name

▪ Framework for key conversations

Our Goal

“…to consider what the costs and benefits are of disclosing (talking about) one’s experiences with

[Tourette and Associated challenges] to some people. We also seek to discuss strategies for

disclosing most effectively should you decide to do so.”

WISE and Patrick Corrigan, PhD(Wisconsin Initiative for Stigma Elimination)

Sue McKenzie, Director WISESarah Reed, PhD, Up to Me Program Lead

▪ CBP research — youth, parent & educator attitudes about youth disclosure

(Published in the Journal of Public Mental Health)

▪ Collaborative design process — youth drove program design decisions

▪ Pilot with four groups — urban, rural and suburban

The Development Process:

▪ Revision of the Up to Me-HS program workbook and

facilitator manual

▪ Pat Corrigan conducting randomized control trial in

urban, suburban and rural high schools

▪ I haven’t talked because adults haven’t asked

▪ I didn’t want to burden parents/adults

▪ I focus on lessening my friends’ pain, since I cannot alter my own

▪ Sexual orientation disclosure is separate from disclosing my mental health challenges

Anecdotal from Pilots

Research Trial OutcomesIncreased

▪ Self-efficacy around disclosure

▪ Help-seeking

▪ Empowerment

Decreased

▪ Self-stigma

▪ Depression (females in particular)

Reactions from Students in Research1. “Finally someone was looking at us as able to listen and share. Up to Me created

an open space for this.” being normal, not just as kids with problems.”

2. “Life and school are way too busy for us to be

3. “I didn’t feel ashamed about sharing what I’ve been through. It was a good experience for sharing what I’ve accomplished in getting through my problems.”

4. “I know all kinds of kids have mental disorders like mine, but I didn’t really think about it until I heard their stories.”

5. “Up to Me helped me tell my story in a way that helps me more than hurts me.”

6. “I feel like I’m learning more at school because I finally got my story out.”

7. “Taught me that while I shouldn’t always care about what others think about me I should always care about what I think of me.”

8. “Since Up to Me, I’m now starting to do more school activities.”

Dissemination

▪ Master trainers are training Up to Me High School program facilitators across the state. 500 trained to date.

▪ Partnered with Nicolas Rüsch for randomized control trial in a treatment setting in Germany. Showed greater outcomes than with adults.

▪ Work with you to coordinate local trainings.

▪ Youth

▪ Young Adults

▪ Parents of Children with mental health challenges

▪ Mental Health Challenges

▪ LGBTQI

▪ Survivors of teen dating violence

▪ Suicide attempt survivors

Adaptations

Setting the Tone

▪ At the beginning, start with names and any other introductory information to share with the group

▪ Begin with an ice breaker to help people learn names

▪ Point out the overall purpose of the Up to Me program

▪ Be sure to go over the definitions(Appendix A)

▪ Confidentiality what is said in this room stays in the room

▪ Everyone’s opinion counts

▪ We respect each other

Have the students brainstorm what these look like – how do they know they are being followed

Establish Group Guidelines

▪ Always review the guidelines

▪ Always provide an opportunity to introduce themselves with a piece of information about themselves (something they are proud of, favorite food, something exciting they are looking forward to)

Before Each Session Begins

The Story I Tell Myself

Helpful and hurtful self beliefs

What are some helpful beliefs that Maggie and Darryl hold

about themselves?

What were some hurtful self beliefs you heard from Maggie and Darryl?

Your Self Talk Puzzle

Disclosure Choices

There are Pros and Cons of Disclosing

Five Points to Remember about Disclosure Decisions

1. Don’t dismiss any pro or con no matter how “silly” it may seem.

2. Your decision depends on the setting.

3. You decision can be yes, no, or decide later.

4. Know your reason or goal for disclosing.

5. Prepare yourself for expected and unexpected reactions.

GETASSISTANCE

OR???

My Pros and Cons Worksheetfor Disclosing Tourette and Associated Challenges and Recovery

Setting: _____________________ To Whom: _________________________Don’t censor any ideas. Write them all down. Put a star (*) next to pros and cons you think are especially important.

Given these pros and cons:❑ I have decided TO disclose my Tourette and

Associated challenges in this setting.❑ I have decided NOT TO disclose my Tourette

and Associated challenges in this setting.❑ I have decided to POSTPONE my decision to

disclose in this setting.

What is your REASON/GOAL for disclosing?

What do you expect will happen after disclosing?

What social media do you use most?

Pros and Cons for you to use it as a means of disclosure?

Social Media: Setting for Disclosure

Choices and Settings for Disclosure

Disclosure Decisions

To whom might you disclose?

Who is a good person to disclose to?

Testing a Person for Disclosure

Emotional Reactions

Who seems like a good person for you to disclose to?

If you disclosed to them, and they unexpectedly gave you a hurtful reaction, what would an effective response be to them?

HelpfulUnderstandingCaring SupportSincere interest

Assistance

HurtfulDisrespect

DenialPunishment

Fear/AvoidanceBlame

Teacher

Grandparent

Older sibling

One of your best friends

Employer

Classmate

1. What you had hoped would happen — your reason for disclosure

2. What you saw in that person that led you to believe that they would be able to respond in a helpful manner.

TIP! Share two things:

▪ Opportunity to share some of your story if you choose

▪ Use the story guide in the “Notes Pages”

▪ Be sure to include some of your strengths and accomplishments as you develop your story – 50%

▪ You will be given approximately 5 minutes to share

Preparing for Lesson Four

▪ This is for you to practice – the group will give no critical feedback

▪ Story examples can be found at rogersinhealth.org

▪ No one has to participate, but all are welcome

Telling your Story to Others

Video Stories

Grenesha Riley Val

Rosa Charles

▪ Despite my challenges and sometimes because of them, I have many strengths and have some achievements that I am proud of.

▪ Hi, my name is _________________ and I deal/live with _____________________________.

▪ Here are a few things about me and my childhood.

▪ My Tourette or Associated Challenges started when I was about ____________ years old.

These challenges did not go away quickly.

▪ This is how I found what works for me.

▪ What works (has worked) for me includes:

▪ Along the way, I have experienced some unhelpful responses to my mental health challenges.

A Guide to Setting Up a Story

1. I, like all people with Tourette or Associated Challenges, live, go to class and study just like you.

2. So, please treat me like anyone else. Do not treat me differently based on any unfair stereotypes.

Moving Forward

Peer:

Adult:

List sources of support you know of and learn about today:

Safe Person Decal

SafePerson.org

1. Acknowledge that reaching out for support is a strength.

2. Listen and react non-judgmentally.

3. Respond in a calm and reassuring manner.

4. Reflect back the feelings, strengths, and ideas I hear when listening.

5. Ask how I can be helpful and respond as I am able.

6. Do what I can to connect to other supports if asked.

7. Maintain confidentiality and communicate if exceptions exist.

The Safe Person Decal Seven Promises

By displaying this decal for youth and adults to see, I promise to:

To order free decals or to learn how to put the promises into action, go to safeperson.org.

1. Seek out people with lived experience, listen to stories

2. Reinforce & support their resilience.

3. Consider the story you can tell.

4. Use disclosure framework in your own life.

5. Order decals from safeperson.org

6. Bring the conversation to your community – work, civic, faith, schools

What YOU Can Do Today

To request resources and/or facilitator training, email: WISE@wisewisconsin.org

Thanks for the work you do!