The Center of Excellence for Children’s Behavioral Health at GHPC are the statewide trainers for the rollout of the Recovery-oriented Cognitive Therapy model.
She gets 30 minutes. Thirty minutes to juggle medications, to deal with food insecurity and homelessness, and to try to improve the life of a patient with a chronic, severe psychotic disorder.
“It is pretty impossible to feel like we accomplished something in 30 minutes. You feel powerless, like you have nothing to offer your patients,” recounts Britnay Ferguson, an adult outpatient physician assistant for psychiatry at Grady Health System in Atlanta.
Ferguson is not alone. Burnout and frustration are common among mental health care providers.
“I had patients that were in and out of the hospital, they didn’t have any personally meaningful activities. If you asked them what is going well in their life, they would say nothing,” Ferguson says. “Now, they are home, working, volunteering, or in a basketball league. I am seeing all of this positive change.”
What changed? Ferguson credits these breakthroughs to her training in Recovery-oriented Cognitive Therapy (CT-R).
Georgia Is a Leader
CT-R, developed by Aaron T. Beck, M.D., and Paul Grant, Ph.D., at the Beck Institute, is a treatment model for individuals with severe mental illness that focuses on understanding what motivates each individual and helping each patient achieve their personal aspirations.
Unlike other models that focus on therapeutic goals, like day-to-day functioning, CT-R focuses on activating patients based on their interests (music, playing ball, etc.); understanding not just their behaviors, but their beliefs about themselves and the world around them (outward aggression may stem from the belief they can’t connect with people); and helping them achieve the life they want through skills development, strengthening positive beliefs about themselves, and drawing learnings from positive experiences.
The state of Georgia has become a national leader in the use of CT-R. It is the first to fully implement the model statewide through the Georgia Department of Behavioral Health and Developmental Disabilities (DBHDD) provider network.
“We were in the early phases of implementation of the Americans with Disabilities Act settlement agreement with the U.S. Department of Justice — moving patients that we could out of state institutions and into the community. But the community was not ready,” recalls Monica Johnson, the director for the Division of Behavioral Health at DBHDD. “Having a workforce does not just mean finding more people. You have to train people to be comfortable and feel competent that they can treat these individuals, so that they won’t run away from their job.”
Since 2015, GHPC’s Center of Excellence for Children’s Behavioral Health has partnered with DBHDD to train more than 230 community-based mental health professionals providing care to youth and adults with severe mental illness in a variety of treatment settings.
“There are stories of patients that had been in the hospital for 10 years that hardly spoke, mostly in a disassociated state, and once they started incorporating some of the strategies from CT-R, this person just started to come alive,” says Johnson. “The bottom line for CT-R is that everybody has something that they want to do. It is about bringing out that person that is still in there behind the psychosis. If I stopped working in this field today, this will have been one of my top five most amazing things that I got to experience.”
Implementation of the CT-R model in the state is not only transforming patients’ lives, but improving the professional lives of therapists, too.
“CT-R increased my confidence as a provider,” says Ferguson. “I feel very effective, and I could not say that before this training.” ●●