CHCMHS008 Promote And Facilitate Self Advocacy
ContentsBefore you begin viiTopic 1 Assist individuals or groups to identify their issues, rightsand preferred options 11A Apply strategic questioning to clarify advocacy issues 21B Review and provide information on self-advocacy in relation to individualor group issues 61C Assist others to clarify their own needs and rights and to determine if theirrights are being infringed or not being met 161D Work with others to evaluate and negotiate advocacy options 341E Document advocacy options 40Summary 43Learning checkpoint 1: Assist individuals or groups to identify their issues, rightsand preferred options 44Topic 2 Enable individuals to gain self-advocacy skills 492A Build a shared understanding about advocacy issues and choices available 502B Identify potential barriers and relevant strategies to overcome them 532C Collaboratively develop an individual’s self-advocacy strategy and arguments 592D Provide opportunities for practising self-advocacy 652E Identify and utilise self-advocacy resources 682F Support individuals to document the circumstances and events relevant tothe advocacy situation 71Summary 75Learning checkpoint 2: Enable individuals to gain self-advocacy skills 76Topic 3 Follow up and support individuals after self-advocacy 793A Follow up and reflect with the individual on the self-advocacy process andoutcomes, and identify strategies and next steps 803B Provide additional advocacy support to individuals to further enhance theirself-advocacy efforts 84Summary 87Learning checkpoint 3: Follow up and support individuals after self-advocacy 88Topic 4 Promote self-advocacy 914A Model aspects of self-advocacy through assertive communication skills 924B Identify and use opportunities to promote the right of individuals to selfadvocate and develop promotional material 954C Encourage a culture of self-advocacy and dignity of risk 984D Raise awareness about barriers to self-advocacy 101Summary 103Learning checkpoint 4: Promote self-advocacy 104 v
CHCMHS008 PROMOTE AND FACILITATE SELF-ADVOCACYChange questionsChange questions move from the static to the dynamic or from the present situationto a more ideal situation.Example: ‘What exactly needs to change here?’Alternative questionsAlternative questions help to identify and evaluate alternatives.Example: ‘What are the consequences of each alternative you see?’Personal inventory and support questionsThese questions identify an individual’s interests, potential contributions, andsupport required for them to act.Example: ‘What do you like to do that might be useful in bringing about thesechanges?’Personal action questionsPersonal action questions are designed to get to the specifics of what to do, when todo it, and how it should be done.Example: ‘Who do you need to talk to?’Clarify advocacy issuesAsking strategic questions of an individual or group will allow you to clarify theiradvocacy issues. Sometimes there may be a number of issues faced by a person. Ifthis is the case, ask questions that get to the root cause of the problem so you can geta clear idea of what the person’s main advocacy issue is and work to help them solvetheir own problems, one at a time.Write down the answers an individual or group gives you so you can refer back tothe information in the future, and record how you assisted them to prepare for selfadvocacy.Strategic questioning will allow you and the self-advocates to:4XXidentify the main issue; for example, what makes them angry or upsetXXclarify how the issue makes them feel; for example, angry or upsetXXidentify who is causing the problem; for example, the self-advocate or somebodyelseXXdiscover why the issues makes a person feel a certain way; for example, thattheir rights are not being metXXidentify when the issue occurs the most; for example, when the person is alone,or with othersXXidentify where the issue occurs the most; for example, in one place, or in manyplaces. ASPIRE TRAINING & CONSULTING
CHCMHS008 PROMOTE AND FACILITATE SELF-ADVOCACYBehaviouralSymptoms may include avoidance of certain situations, distress in social situationsor crowds and obsessive or compulsive behaviour, such as continuous hand-washing.Serious mental illnessThe term serious mental illness (SMI) is often used to describe more severe or chronic(longer lasting) mental disorders, such as schizophrenia and bipolar disorder.Here is an outline of some of the more serious mental disorders you may encounterworking in the mental health sector.Bipolar disorderBipolar disorder is a mood disorder that can also be classified as a psychotic disorder.It is an illness where a person experiences extreme moods; for example, veryelevated or very low and depressed. Some people may experience both extremes,while others will experience one or the other. Treatment includes medication andcommunity support programs.Examples of extreme moods include being or acting:XXhigh and excitableXXgrandiose and recklessXXhelplessXXsometimes suicidal.Borderline personality disorderPeople with borderline personality disorder (BPD) may experience distressingemotions, have difficulty relating to other people and may exhibit self-harmingbehaviour.Treatment includes a combination of psychological therapy, medication andcommunity support.Symptoms may include:XXfeelings of abandonment and insecurityXXconfusion and contradictory feelingsXXimpulsiveness and reckless behaviourXXself-harmXXpossible psychotic symptoms such as delusions.Major depressive disorderDepression is an illness that affects the way a person feels, causing low mood andpersistent feelings of sadness and helplessness. The person may also experiencephysical aches and pains and thoughts of suicide. Treatment includes medication,individual therapy and community support programs.8 ASPIRE TRAINING & CONSULTING
CHCMHS008 PROMOTE AND FACILITATE SELF-ADVOCACYThe following provides information about how self-advocacy has evolved over time,reflecting changing attitudes and approaches to assisting people with mental healthneeds to advocate for themselves.Historical changes in approaches to mental health needs1960sThe self-advocacy movement began in Sweden where people withmental health needs were supported to form and lead their ownleisure clubs.National conferences for leisure club members were held and theparticipants developed statements about how they wished to betreated.1970sThe leisure club idea spread to Britain and Canada, and the conceptof self-advocacy spread across the United States. A group from Oregonformed a self-advocacy group called People First, because they felttheir disabilities were secondary to their personhood.Psychiatric patients took on a more prominent role in self-care andbegan speaking up for their rights, needs and preferences.1980sChanges occurred in the medical area where patients wereencouraged to participate in decision-making about their own care andtreatment, and to be knowledgeable about the supports and servicesthey required.1990sParticipants attending a national conference in Nashville in 1991voted to have a national coalition of state and local organisations. By1993, there were at least 27 state-wide self-advocacy organisations.2000sPeople with mental health needs, illnesses or disorders are nowencouraged and assisted to stand up for their needs and rights, andparticipate in decisions made about their care and recovery. Mentalhealth consumers and patients are provided with legal protectionsagainst discrimination as a result of their mental health needs orillness.Values of self-advocacyThe values of self- advocacy are built on the principlesof human rights and social justice. Core values arebased on beliefs such as the following:Consumers are not defined by their mental illness ordisability.XX Consumers are supported to make their owndecisions.XX Consumers are valued as individuals.XX Consumers are valued as equals.XX12 ASPIRE TRAINING & CONSULTING
Topic 1Assist individuals or groups to identify their issues, rights and preferred optionsCompulsory patientsAn assessment order allows a psychiatrist to examine a person to decide whetherthey have a mental illness, even if they do not want to be assessed. A doctor ormental health practitioner (nurse, occupational therapist, psychologist or socialworker employed or engaged by a designated mental health service) can make anassessment order. Compulsory patients can be assessed in the community or at ahospital. Compulsory patients are still afforded human rights and are encouraged tomake or participate in decisions about their treatment.Support and self-help groupsSupport and self-help groups exist to provide information, programs, socialnetworking and support opportunities to people who share common interests orexperiences. There are numerous mental health support and self-help groups thatprovide advocacy services to the community. Some groups work together to advocatefor issues a specific cause, such as schizophrenia treatment, or the preventionof post-natal depression. The purpose of these groups is to focus on the presentand work on making changes to improve the lifestyles of the individuals’ affected.Services are confidential, welcoming to everyone, and usually free.Legal and ethical considerationsLegal frameworks are based on law and breaches carry legal penalties. Ethicalframeworks may be, but are not always, supported by law, and may not carry legalpenalties. Both are intended to support and protect the rights of people receivingservices, and to reinforce the duties and responsibilities of workers. Legal frameworksare Acts of Parliament relating to service provision, with attached regulations andservice standards. Ethical frameworks include declarations of human rights, codes ofethics, codes of practice and codes of conduct, and agency policies and procedures.Mental health legislationEach state and territory has a mental health Act that is the law governing compulsorymental health, assessment and treatment.In Victoria, the purpose of the Mental Health Act 2014 (Vic.) is to provide a legislativescheme for the assessment of people who have mental health needs and for thetreatment of those with mental illness. It appoints various tribunals and expertsincluding a chief psychiatrist. The Act outlines decision-making models to enablepeople to participate in decisions about their care that will assist in their recovery. Italso outlines safeguards to protect the rights of people with mental health needs andenhances the oversight of public mental health services through the establishment ofa mental health complaints commissioner.DiscriminationTo discriminate means to treat someone unfairly or favour others. Discrimination isnever acceptable behaviour. It is unlawful to discriminate against people on the basisof age, gender, ethnicity, disability or impairment, marital status, sexual preference,political or religious beliefs. Organisations within Australia must comply with a varietyof federal Acts, national standards, and state Acts aimed to prevent discrimination andfoster equality of opportunity. 17
Topic 1Assist individuals or groups to identify their issues, rights and preferred optionsRights and choicesMental health treatment and support should impose the least personal restriction onthe rights and choices of individuals taking account of their living situation, level ofsupport within the community and the needs of their carer(s).Sustained recoveryServices are delivered with the aim of facilitating sustained recovery.Role of carersThe role played by carers, as well as their capacity, needs and requirements, arerecognised as separate from those of the individuals with support needs.Breach of StandardsIf the standards outlined in the NSMHS are not adhered to, there are no specificconsequences for services delivering mental health services or their staff. These arerecommended Standards but not legislation (law). The mental health Acts for eachstate and territory are law and therefore have penalties in place for breaches. Each ofthe penalties will differ for each piece of legislation.Here is more information on the frameworks, accreditation programs andimplementation guidelines of the Standards.Quality, safety and performance frameworksEvery organisation offering mental health support and services is influenced by anumber of internal and external quality, safety and performance frameworks. TheNSMHS represents one component of assessment of service delivery as thereare other specific state and sector legislation, associated regulation, professionalregulation, accreditation and employment conditions, purchasing and fundingagreements, government policy, service development and accreditation. All of thesecontribute to and affect the achievement of standards.Accreditation programsOrganisations will be expected to have incorporated the standards into the relevantservice accreditation programs that monitor compliance. Compliance makes up alarge and important part of ensuring quality service delivery to people with mentalhealth needs and their families, including evaluation and feedback processes.Implementation guidelinesThere are implementation guidelines that provide more detail on the implementationof the standards into an organisation. These are available for public mental healthservices, private hospitals, non-government services and private office-based mentalhealth practices 21
Topic 1Assist individuals or groups to identify their issues, rights and preferred optionsthere is a duty to the public; for example, there is public threat or concernXX the person has consented to the disclosure.XXPolicy frameworksThe national framework for recovery-oriented mentalhealth services provides a new policy direction toimprove and enhance mental health service deliveryin Australia. It combines a range of recovery-orientedapproaches developed in each Australian state andterritory, and draws on national and internationalresearch to provide a national understanding andapproach to recovery-oriented mental health practiceand service delivery. The purpose of the framework isto improve outcomes and quality of life for people withmental health issues, illnesses and disorders.The framework was developed through an extensive consultation process involvingindividuals and organisations across Australia. The lived experience and insights ofpeople with mental health issues and their families are central to the framework. Itis designed to help mental health professionals in a range of settings to align theirpractice with recovery principles. Mental health settings include hospitals, communitymental health services and other public, private and non-government health andhuman service settings.The framework applies to all people employed in the mental health service system,regardless of role, profession, discipline, seniority or degree of contact with peopleaccessing services. It is also designed for people working in administration, policydevelopment, research, program management and service planning.Resources for practitioners, services, carers and mental health consumers to help inthe implementation of the framework are available at:XXwww.health.gov.au/mentalhealth.Rights and responsibilitiesIn every organisation, whether it is public or private, small or large, everyone has rightsand responsibilities. For example, an employer has a right to expect certain levelsand standards of performance from employees, and employees have a right to expectcertain conditions from employers. The employer is responsible for the successfuloperation of the organisation; employees must complete their work tasks to ensure theoperation runs efficiently. 25
Topic 1Assist individuals or groups to identify their issues, rights and preferred optionsViolation of rightCauseViolations withinpsychiatricinstitutionsXXThe use of illegal physicalrestraintsXXUnsafe and unhygienic livingconditionsXXInsufficient heating or coolingfacilitiesXXPeople kept in seclusion forlong periods of timeXXPeople isolated from societyand their families due todistancePeople experiencingdiscriminationand violations oftheir basic rights,inside and outsideof psychiatricinstitutionsXXStigma in society relating tomental health issuesXXDeprivation of civil rights,including the right to vote,marry, or have childrenXXLimited access toemployment, education, andshelterInappropriatedetention in prisonsXXPeople with mental illnessesor disorders are detained inprison due to a lack of mentalhealth services or facilitiesRecommendationMonitoring bodies mustbe set up to ensure thathuman rights are beingrespected in all mentalhealth facilities.People with mentalhealth needs must beafforded the same humanrights as everyone elseand be protected fromdiscrimination, especiallypeople who belong to avulnerable group.People with mentalillnesses and disordersshould be diverted awayfrom the criminal justicesystem and towards mentalhealth services.Social justice principlesSocial justice contains the notion of equality andequal opportunity in society. It may also be viewed as‘justice as fairness.’ Social justice principles target themarginalised and disadvantaged groups in society.People with mental health issues often fall into thecategory of the marginalised and disadvantaged. Socialjustice principles may include human rights, selfdetermination, access and equity, participation andempowerment.Human rightsHuman rights recognise the value of every person, regardless of background, where welive, what we look like, what we think or what we believe. Human rights are based onprinciples of equality and respect, shared across cultures, religions and philosophies.They are about being treated fairly, treating others fairly and having the ability to makegenuine choices in our daily lives. Respect for human rights underpins the valuesand principles of the mental health sector and should be applied by all workers whensupporting consumers with mental health issues. It allows all people to contribute tosociety and feel included. 29
CHCMHS008 PROMOTE AND FACILITATE SELF-ADVOCACY1DWork with others to evaluate andnegotiate advocacy optionsAs a mental health worker, you should work withindividuals and groups to evaluate and negotiatetheir advocacy options. Self-advocacy is justone form of advocacy available to mental healthconsumers. There may be other advocacy optionsthat are more appropriate for people to use inaddressing their mental health issues.A person with mental health needs may requirethe assistance of an advocate to represent theperson’s interests, needs, rights and preferencesin situations where the person:is not mentally strong enough to representthemselvesXX does not have the requisite skills and knowledgeXX does not have access to appropriate resourcesXX is not confident in self-advocacyXX does not have the mental or physical capacity to make decisions about their careand treatment without assistance.Whenever you work with mental health consumers, you must ensure that you workwithin your work role boundaries, responsibilities and limitations.XXAdvocacy functionsAdvocacy is the process of standing alongside an individual or group who isdisadvantaged, and speaking out on their behalf in a way that represents theirinterests, needs, rights and preferences. The purpose of advocacy is to bring aboutbeneficial outcomes in a way that enables each mental health consumer to retainas much control and independence as possible over how it is delivered. Advocatesprovide information and advice to people with mental health needs in order to assistthe person to take action to resolve their own concerns, or may take an active role inrepresenting the individual or group’s rights to another person or organisation.The following outlines the functions of advocacy.Functions of advocacy34XXPromoting the interests of mental health consumers to ensure government,agency, and service provider accountabilityXXMonitoring compliance with international and national obligationsXXS
2B Identify potential barriers and relevant strategies to overcome them 53 2C Collaboratively develop an individual’s self-advocacy strategy and arguments 59. 2D Provide opportunities for practising self-advocacy 65 2E Identify and utilise self-advocacy resources 68. 2F Support individuals
self-respect, self-acceptance, self-control, self-doubt, self-deception, self-confidence, self-trust, bargaining with oneself, being one's own worst enemy, and self-denial, for example, are thought to be deeply human possibilities, yet there is no clear agreement about who or what forms the terms between which these relations hold.
3.6 Sexual Shame and Self-esteem; Self-esteem expert Rosenberg (1965) defined self-esteem as an attitude towards one's self, a self-worth with levels of positive and/or negative feelings about the self. Coopersmith (1967) described self-esteem as being an appreciation of oneself and showing self-respect,
associated with higher level osf self-handicapping i n young people. Moreover, certainty of self-esteem and the trait of self-handicapping wer noe t associated with self-handicapping. Stud 6 explorey d the relationship between self-esteem and self-handicapping using domain-specific measure of self-esteems an, d task specific self-efficacy.
hypertension in clinical settings c. Promote the use of Clinical Decision-Support Systems (CDSS) d. Promote the use of Team-Based Care to Improve Blood Pressure Control e. Promote self-measured blood pressure (SMBP) monitoring with additional support f. Promote self-measured blood pressure (SMBP) monitoring used alone g.
11 The Practice of Personal Integrity 12 The Philosophy of Self-Esteem PART III EXTERNAL INFLUENCES: SELF AND . self-esteem with an examination of what self-esteem is and is not. . feeling of guilt or shame or inferiority, a clear lack of self-acceptance, self-trust, and self-love. In other words, a problem of self-esteem. .
Using This Book (For the professional, continued) Additional Factors The Teen Self-Esteem Workbook deals with many different aspects of self-esteem, including self-worth, self-responsibility, self-awareness, and assertive behavior. Self-esteem is a person’s overall evaluation of self-worth
Components of Self-Determination Self-regulation: self-monitoring, self-evaluation, self-instruction, self-management (controlling own behavior by being aware of one’s actions and providing feedback) Self-awareness: awareness of own individuality, strengths, and areas for improvement
ACCA ADVANCED DIPLOMA IN ACCOUNTING AND BUSINESS ETHICS AND PROFESSIONAL SKILLS MODULE Research and Analysis Project and Key Skills Statement ACCA DIPLOMA IN ACCOUNTING AND BUSINESS (RQF LEVEL 4) ACCA DIPLOMA IN ACCOUNTING AND BUSINESS (RQF LEVEL 4) ACCA GOVERNANCE ACCA (the Association of Chartered Certified Accountants) is the global body for professional accountants. We aim to offer .
