When I first met Mrs. Vest, she appeared to be very sad and physically weak. Her husband was present during most of our in-home visits. Initially, I felt awkwardness between us. I shared with both Mr. and Mrs. Vest my story of challenge and they responded that they never heard of a person actually recovering from severe depression and addiction. I shared with Mrs. Vest that “recovery is possible”. That statement brought tears to her eye and she said that “she had never heard that statement” and never expected it could occur in her life.

Mrs. Vest seems to gain a lot from hearing about my early stages in recovery. She seems to understand the idea of recovery as a possibility. I encourage her that no one can do it alone. When we discuss the Intensive Outpatient Program (IOP) program as a chance to talk with others who will support her stability, she immediately expresses interest. Mrs. Vest is becoming more aware of her inner strengths.

Initially it was difficult to have Ms. Gonza agree to an in-home visit. We had a number of telephone conversations. She was patient and interested in what I was describing to her. We exchanged things that have happened to each of us as a result of having a “diagnosis”. Ms. Gonza referred to her illness frequently. I mentioned to her that she is not her diagnosis but is still Ms. Gonza, who is a successful retired teacher whose life has meaning and purpose. Despite our immediate connection she still would not agree to an in-home visit. Ms. Gonza shared that she had a home health provider that she is very satisfied with and could not see how meeting with me would be beneficial. However, she said she really enjoyed talking to me. I told her I would like to continue to follow up with her and she agreed to that.

One day, I called and she was excited to hear from me. Ms. Gonza said that she had lost her home health provider and would like to meet with me. I reminded her that the value of working with me would be different from that of a provider.

When I met Ms. Gonza in person again, we made an extraordinary connection. We shared a lot of mutually lived experiences. She loves to hear my recovery stories. Ms. Gonza says that she just cannot see herself recovering from a depression so sudden that it led her to a suicide attempt. The whole thing has left her very confused. We talk a lot about how she does not have to do it alone. This is a new concept for her since she has been so isolated for the last two years. Now, with this situation (as she refers to her suicide attempt), she cannot imagine how this would encourage friendships. We have an agreement that if she begins to think about suicide, that she will either call me immediately or the crisis line. So far that is exactly when she has done, is call me. Now that we have been working together for about eight weeks, she continues to call me frequently, but less and less often to talk about suicidal thoughts.

Ms. Douglas is a very vulnerable woman. She is devoted to her husband in spite of his verbal abuse and negative attitude towards her. Ms Douglas is so committed to her marriage that she normally prepares meals ahead of time and freezes them when she is anticipating a hospitalization.

On our first meeting, she was not shy at all. She asked permission to show me her most recent self- inflicted cuts on her forearms. Then she said see how angry “he” makes me. Our work together has primarily consisted of my listening and her talking. I have really enjoyed and learned a lot about her — as a woman in search of recovery.

She began her recovery journey as a patient in psychiatric hospitals. It was there that she learned about her illness, developed meaningful relationships and discovered her artistic interests. In a short time, Ms. Douglas has discovered that she can receive the same things from her community that made retuning to the hospital so attractive. After only one week of Intensive Outpatient Program (IOP) at DebLin, she was able to meet the contract we had developed for her where she was not to go to the hospital for one week. Within that time, she was to see if the things that she wanted out of a hospitalization could be obtained in the community. I had been sharing with her that this was a real possibility.

I have very high hopes that Ms. Douglas will become a Peer Specialist. She has been sharing her recovery story with new friends that she made at IOP and sees that she is already giving “peer support”.

When Ms. Size and I first met, she was socially isolated and living in a one room apartment that was substandard in terms of lighting and furniture. We made an instant connection through our love for our cats. Ms. Size is usually very fearful. Her neighbors often avoided her. Maybe this was due to her unusual mannerisms that they didn’t understand. Her landlord spoke to her harshly and could be mean. Her symptoms were so bothersome at times that she would take her cat and get under her bed or in the bathtub to make herself feel safe. Ms. Size would frequently call me during these moments of intense distress and we would talk, often avoiding another hospitalization.

Ms. Size has worked very hard to continue living in the community. With Peer Support, she transitioned to a structured boarding home that has a day program and will soon start an intensive outpatient program. Ms. Size has an increased interest in others and is more hopeful for the future. We use humor frequently as a way to alleviate the significant symptoms she experiences.

Ms. Size’s family relationships have improved so much that she recently moved out of the boarding home and is residing with her son and his wife. She experiences the value of being a part of her family. Although Ms. Size is unable to have her emotional support cat with her, she has developed a support network in the community. Before, she had always seen the hospital and the nurses there as her only allies. Now she has people in the community that she can count on for comfort and support.

Mrs. Dawn is very dependent on her husband. She no longer responds to medications only and she has had electric shock treatments (ECT) routinely for greater than five years. She has become helpless in any decision making and on our initial meeting was non verbal. She is a frail older lady with no self confidence.

With self disclosure and patient listening, Mrs. Dawn was able to identify her own goal. She was very aware that she no longer was able to care for their home and she wanted help to do heavy cleaning and laundry. I felt that the Dawn’s needed an individual who would share their religious beliefs and make a strong connection with Mr. Dawn. Mr. Dawn is a loving husband who is worried, sad and tired. I suggested that they contact their church for in-home care referrals. They were able to identify a wonderful catholic lady that works for them part time. The nontraditional avenue to link them together was helpful to both Ms. Dawn (for the services) her husband (cost effective) and the in-home provider (needed the extra income and helpful work to a couple in need).

Mrs. Dawn had a history of enjoying baking. Together we baked chocolate chip cookies. This was a wonderful opportunity to talk together while completing a task she loved to do. Also for the first time, I had time alone to talk with her. Mr. Dawn learned to trust my visits and now uses some of that time to do some of his own in-home projects.

When alone with Mrs. Dawn, she talked of her Diabetes and the complications she has at times — fatigue, light headedness and foot numbness/dull pain. Her physical therapist had recommended a home program for exercise to relieve circulation problems in her feet. Together, we established a calendar for daily activities that included her doctor’s appointments, exercise and relaxation. I also taught her relaxation response techniques which she continues to do daily.

Mrs. Dawn experiences what she calls “panic attacks”. When they are particularly difficult, she will call me or ask that I schedule to come over. I come visit her and with supportive listening or just sitting quietly with her, I become a part of her stability solution and have helped limit her hospital stays.

From the very beginning of our visits together, Mr. Bus has been eager to begin his recovery process. After I self disclosed a history of substance abuse, he said that he learned a lot and gained a sense that if I could do it, then he could find purpose.

He’s had many deaths in his family in the last two years. He felt alone and hopeless, but was relieved to hear of my ongoing goal for sobriety. As a result of my openness, he disclosed his discomfort with himself and his sexuality. He responded to encouragement and support. Mr. Bus shared some of his past accomplishments and how he would like to use them to serve others in the future. He is an expert in the Classics. One of his several hobbies is to read and listen to Opera. Mr. Bus attends his Synagogue weekly. He also visits the neighborhood library where he hopes to offer tutoring. The Whole Health Peer Specialty program has assisted Mr. Bus to look beyond loss, to remember his strengths and to aid in future planning and hope.

Mr. West’s initial contact phone conversation was challenging in that this gentleman lives daily with severe pain. He was often negative in perspective and irritable in attitude. Mr. West permitted me to briefly introduce myself and the Whole Health Peer program. When I asked him if I could come to see him in person he barked back “if you can do something about my pain, come on over”. I reminded him that I am not a doctor or a nurse, but I would commit to work hard with him to find ways to improve his pain.

During our visit, I asked Mr. West to describe to me what life was like with such severe pain in his leg. He described himself as hopeless and often felt that there was no purpose for living. He wondered if he could ever walk again.

I discovered that beneath Mr. West’s gruff presentation, he had a wonderful sense of humor. We have a motto that we share and talk about often “We will never give up”!

Through Whole Health Peer strategies and support Mr. West developed a willingness to talk about his condition and schedule appointments with specialty physicians. After careful consideration, Mr. West elected to have leg surgery. He is recovering and has realistic hopes of walking again.

With renewed hope and a less self centered focus, Mr. West began to share with me his successful career as a skilled auto mechanic. He is enthusiastic about some day becoming a mentor for high school students learning auto mechanics. Mr. West is choosing life and wants to share his talents with others. He has developed relationships with neighbors and has a network of friends who enjoy sitting on the porch talking every evening.

DebLin Health Concepts is an organization that offers mental health services in both traditional and non-traditional settings. Their goal is to give consumers the power to realize their highest level of functioning in the least restrictive setting.

The case studies represent the actual experiences of Peer Support Specialists and recount several encounters with program participants. The names of all participants have been altered to mask participant identity.

We hope you will find these case studies enlightening, hopeful and an affirmation of the power of Peer Support. We also encourage you to leave comments or questions and to check back as we post new case studies.

Sometimes a crisis happens, even with everyone’s best intentions. A WRAP “Crisis Plan” is created in advance for supporters to coordinate so that the person in crisis can concentrate on healing and wellness while other details of their lives are being taken care of. The Crisis Plan includes lists of signs that others need to take over; lists of doctors, medications, allergies; contact information for supporters; places that are preferred if hospitalization becomes necessary; predetermined alternatives to hospitalization; places and treatments to avoid – among other useful information. No one wants to have a crisis, but it is great to be able to have excellent plans in place in advance.

The time after a crisis is very important. People need time to readjust gradually to their lives. The “Post Crisis Plan” has a schedule for resuming activities, ways that supporters can help, and opportunities to learn from the crisis – a gentle way of getting back into the swing of life.

WRAP is simple, friendly, and empowering. People from all walks of life can benefit from using it. Each person’s WRAP is different, and is completely flexible to suit the ever changing nature of their lives.

To learn more about WRAP, there is the Wellness Recovery Action Plan book and the recently published WRAP Plus, which has a more comprehensive look at WRAP. Visit www.mentalhealthrecovery.com and explore the bookstore to get information on many books, CDs, and DVDs. Please feel free to email me at carol@mentalhealthrecovery.com with any questions or comments. Thank you.