Good afternoon, everyone, and welcome. I'm Terri Brister, the National Director of Research and Quality Assurance at NAMI, the National Alliance on Mental Illness, and also the patients and families expert for SMI Advisor. I'm pleased that you're joining us for today's SMI Advisor webinar, Positive Living, a Positive Psychology Approach to Recovery-Oriented Care for People with Schizophrenia. SMI Advisor is also known as the Clinical Support System for Serious Mental Illness, and it's an APA and SAMHSA initiative that's devoted to helping clinicians implement evidence-based care for those affected by serious mental illness. Working with experts from across the SMI clinician community, our interdisciplinary effort has been designed to help you get the answers that you need to help you care for your patients. Today's webinar has been designated for one AMA PRA Category 1 Credit for Physicians, one Continuing Education Credit for Psychologists, and one Continuing Education Credit for Social Workers. Credit for participating in today's webinar will be available until April 26th. Slides for the presentation today are available in the handouts area in the lower portion of your control box, and you can see on the screen the visualization of where to find that. Select the handouts link and click to download the PDF of the slides. We want you to feel free to submit your questions for the presenter throughout the presentation by typing them in the questions area, and it's in the lower portion of your control panel. We're going to reserve 10 to 15 minutes at the end of the presentation for an interactive Q&A. Again, you'll submit those questions, and I'll be sharing them with our presenter at the end. Next slide. Now, it's my great pleasure to introduce you to the faculty for today's webinar, Dr. Piper Meyer-Callows. Dr. Meyer-Callows received her doctoral degree in Clinical Rehabilitation Psychology from Indiana University, Purdue University in Indianapolis. She specialized in psychiatric rehabilitation and treatment for first-episode psychosis with interests in recovery, positive psychology, and psychosocial treatment for people with severe mental illness. Since 2009, Dr. Meyer-Callows has been part of the Psychosocial Development Team at the Recovery After Initial Schizophrenia Episode, or RAISE, project and has co-led the Individual Therapy Component and Individual Resiliency Training. Dr. Meyer-Callows' current research includes an evaluation of four first-episode psychosis programs in Minnesota and the National Early Psychosis Intervention Network, or EPINET. Dr. Meyer-Callows, thank you for leading today's webinar, and we look forward to the presentation. Thank you, Terri. These are just my disclosures. I'm a national and international trainer for NAVIGATE, for the NAVIGATE intervention. And these are our learning objectives today. I have some pretty broad ones, but also I'm hoping that people will be able to leave with some things that they can go back and actually try with individuals that they work with. So we'll talk a little bit about the broaden and build theory, talk a little bit about positive psychotherapy, and describe some key features and even some activities that we do in positive psychotherapy. Here's our goal. A couple of things we're going to focus on just to kind of give you a little bit of background, but then we're going to zero in and talk a little bit more about the good things activity and the gratitude letter, and talk about some next steps that you can take. So I want to start off, and I like to put this up first and talk about what is positive psychology, because there are many misconceptions oftentimes when people hear that term. And I like to put this picture up because it's a good representation of some of the assumptions that we make about what positive psychology is, thinking that it's only focused on the basics of happiness. And it's actually so much broader and so much deeper than that. And I'm hoping to kind of integrate and talk a little bit about how this relates and how it can really contribute and support treatment. So positive psychology is what we call the study of positive emotions, positive character traits, and the enabling institutions. It focuses on the strengths and building those strengths, rather than just remediating what the person is struggling with, what kinds of things that are coming up that perhaps related to their illness. All right, I will do that. And the big thing here is to focus on finding those meaningful things in someone's life. What is the meaning and the purpose? What improves their overall well-being? So that brings us to this other piece that's embedded in positive psychology. So traditionally, it's helpful to kind of walk this back a minute. And traditionally, in psychology, we come from a disease model, and this is also very much the medical model of things. We come from this perspective of what's wrong, and how can we help somebody remediate that or fix that? So it is focused much more on this idea of pathologizing. Well-being is very different than that. One of the key facets of well-being is that just because we remove the distress, we remove the symptoms or the symptoms decrease, doesn't mean that somebody is flourishing. It doesn't mean that their overall well-being is improving. And in order for that to improve, we have to pay attention to the things that contribute to well-being. And so there's a definition here that talks about health is a state of complete physical mental and social well-being, and not merely the absence of disease or infirmity. So in what way are the interventions that we do with the individuals that we work with, in what way are they contributing to well-being? This was the question that I started to ask myself when I began getting interested in positive psychology, and the idea of in what way can what we're learning in positive psychology contribute to the interventions for people with schizophrenia? So if we look at how currently treatment is oriented for persons with serious mental illness, again, it is that medical model around reducing or managing psychopathology. And evidence-based practices have in fact popped up to address many of these key issues around informed decision-making, improving role functioning around work or school, remediating skill deficits. These are all key areas that have popped up around evidence-based practices related to serious mental illness. So what's interesting here, it's not that these are not helpful because these are vitally important. We've certainly seen that they help people improve in their areas of functioning and quality of life and these kinds of things. What the question remains is, is it enough? Are we really maximizing the potential outcomes that we could see people achieve in our current state of treatments? Or is there something perhaps that's missing? So along with this idea at this time, when I was working on psychosocial interventions and specifically evidence-based psychosocial interventions, there was this topic that came up around recovery. And when I say recovery, what I'm talking about is an individualized or personalized definition of what it means to that person to get better, to get their life back on track, to get back to what is meaningful and important to them. So the question came up about how do we infuse this idea of recovery into treatment? If we're talking about practical ways to do this in interventions, what does it look like? How does it come together and what are some practical things that clinicians can do? And the secondary question is, how could the interventions that have been developed in positive psychology, how could they actually contribute to this idea of recovery? And could they help somebody expand their experience of recovery? So the idea is around positive psychology is, might that be a way to actually address well-being? If we're not necessarily focused on just symptom remission, but in this idea of growing well-being, might this be a way to really intervene more directly? Because positive psychology is associated with building strengths. So could we, in fact, by promoting strengths and finding new ways to use strengths and integrate strengths, might that be a way to promote recovery? It also focuses on ways to increase confidence and mastery that somebody might have around their illness self-management skills. So this is what prompted me to kind of look into this idea of positive psychology interventions. And here we come to what we call positive psychotherapy. And this comes from Martin Seligman's work, where we took something that they were doing originally designed for people with mild to moderate depression. We looked at the activities that were involved in this and thought, how could we apply this to people with schizophrenia? What might be the benefit if we were to transfer this over and try this with people with schizophrenia? And so positive psychotherapy is built on originally Seligman's three-factor model, which is around building positive emotions, character strengths, and meaning. What you'll see in the picture there is the new model that he calls PERMA. And it's just an expanded model of that three categories of the model, the three original factors. But it's really, these are the kinds of things that positive psychotherapy is aiming to improve, to change, to build. And so it's built on this idea of something called the broaden and build theory. And I want to take you inside this for a minute, because this theory in particular has really informed a lot of my work. And it's helpful to kind of understand what's the basis for positive psychotherapy. So it's built on this idea that positive emotions broaden a person's momentary thought action and repertoire. So I want you to think about the last time that you experienced a negative event. Think about when you were faced with something that was threatening or really distressing. And I want you to think for a minute, what did you do when it came to your thoughts and your behavior? So if you're typically like most people, what you'll find is this leads to a flight, fight, or freeze response. And a threat means that we narrow our focus to come up with the quickest, simplest way to remove that threat. Okay? So now I want you to think about the last time that you experienced something positive, a positive interaction that you've had recently, something that came up for you that brought about a strong, positive emotion. So the difference here is what's predicted by the broaden and build theory. If we think about the last time you experienced something that was positive, think about some of the examples that are listed here, where we've seen things like joy, sparking the urge to play, interest, sparking the urge to explore, contentment, sparking the urge to savor and integrating, integrate. These are what happens according to the broaden and build theory, is that it opens up that thought action repertoire and leads to all of these other positive consequences. So these include building personal and psychological resources and strengths, as well as wellbeing and functioning over the long-term. So if we think about why that might be important, it's that what we're providing by teaching people how to tap into more of these positive emotions, it can create this upward spiral, which is what this picture is showing here, that the experience of positive emotions leads to that broadening of our thought and leads to the ability to build more personal strengths and resources, which reproduces a spiral. And actually, those resources are then there. Once somebody develops them, they're there for the long-term. They're available in the face of other things that might come up for that person. So the goal here, the thought behind positive psychotherapy, is that we're tapping into the broaden and build theory by teaching people ways to experience more positive emotions, because we have activities that have clearly shown you can do that. That's where positive living comes in. So positive living is an adapted form of positive psychotherapy. It includes the original six exercises that they did, and then we added two more based on what our experience has been working with people with schizophrenia. And the two we added included something called positive service and the positive goal. The other thing that we added that was a real benefit was a mindfulness minute. We included mindfulness that was done at the beginning and the end of every group. And we did it as a way initially to teach savory. It was a real hands-on way to teach savory. What we learned from doing it was, in fact, it was much more beneficial than just that. The group itself lasted for 10 weeks, and each group met for about an hour and a half. And if you're looking at that, you know that that's longer than the traditional one hour of a group. But I will tell you, when we've done this group, that has never been an issue that's come up, that the investment, the engagement that we got for individuals working on this was that an hour and a half was not too taxing or overwhelming. And then at the end, after the group was over, we let some time go by, and then we did a booster session as well. These are the examples of the activities that we teach in positive living. So again, you notice that I mentioned there the positive goal, the mindfulness minute, and the positive service. But in addition, we teach these other activities all as ways to increase the experience of positive emotions. Here's an example of how a group session might go. It is structured. We do find that for teaching these kinds of skills, having that structure can be really helpful and important. So you'll see we have a check-in that's followed up by a goal follow-up practice and a home practice check-in because every session ends with recommendations about trying these when people leave the session. And then as you can see, it's wrapped up by a mindfulness minute as well. So in the pilot, this was a pre-post pilot, uncontrolled. We did not have a comparison group. So it was very pilot. And we did three different assessments, a baseline, a post, and a three-month follow-up. We had a relatively small dropout rate. Our attendance was really good. And in fact, it was almost 90% for completers. And at the end of the group, we were asking people what kinds of things they were taking away. And on average, people were practicing the activities around almost three days a week for about half an hour a day. And that's actually pretty good if you're talking about getting people to use what they're learning outside of the session. That's pretty good. So here are the outcomes that we focused on. You can see there the ones at the top were our primary outcomes that had the biggest changes around well-being, self-esteem, savoring, and hope. We also explored some things that we weren't sure what was going to happen because part of this was exploring in what way can we improve the things we intend to improve around well-being. But might this also have improvements in other areas of functioning? And in fact, we did find some improvements in symptoms that we didn't quite expect. So here's some of the results that we were really targeting. And you can see there the three different bars there and where people ended up at the end. Now, again, we don't have a comparison group. I do want to kind of point that out. But people seem to be improving and that improvement seems to stick over the three-month follow-up. Here's what we saw with regards to symptoms. And this is just a general symptom inventory. And we did see that in general, there was some reduction in symptoms. And again, that reduction seemed pretty steady at the follow-up assessment as well. So before I get into the cultural adaptations, what I'll say is that this was our first entree into what are the benefits of an intervention focused on increasing positive emotions, targeting well-being. And it did seem by the end, people liked it. They tolerated it. It's certainly feasible. People enjoyed it. They came. They showed up. And it presented this idea that maybe there is some true benefit that we could really explore. Maybe there are some things that can come out of this that show that we can target more than just a reduction in symptoms. So these are just some recommendations based on what our experience has been about what do we need to consider culturally? Are there some things that we should be paying attention to when we roll this out on a larger scale basis? So a couple of things when you're thinking about doing something like this is thinking about the cultures that you may be working with and what does well-being mean or look like within that cultural context? And so it may be that when somebody is pursuing meaning or purpose in their life that that can be done through the strengthening of relationships or through some sort of other innovation or even religious or spiritual kind of connection. And it's important to understand that well-being is a very individualized process and that by understanding that and thinking about that in relationship to the culture, we can better adapt and individualize the intervention. The other thing that we know, and this has been looked at across different cultures, different regions, is that positive emotions provide that buffer. And there may be ways that we can tailor the different ways that people practice how to increase those positive emotions related to that cultural context. So that's another piece to pay important attention to. So the other thing is, is that we can adapt this intervention. One of the things I'll talk about at the end is the way that we've now kind of moved this intervention forward based on what we've learned. But we can adapt it and we can do that to really adjust and meet the person based on what their different background is. So in some ways, the positive living was a group intervention and that may work really well for some people with different backgrounds, but it may not for other people. And there are ways that you can adjust that to meet people and understand where they are. The other thing that's mentioned here is the ability to integrate spirituality practices like prayer as another strategy that may lead to ways to increase positive emotions. So let me give you some examples. This is based on the original activities that we did in positive psychotherapy and some suggestions that have been made to consider culturally. So in the beginning of positive psychotherapy, there's a positive introduction that we do where a person reflects on something that is positive, that shares a bit of a story about them, which showcases the best in them. So this may be uncomfortable for some people. And so there may be ways that we can consider different ways that people might be able to share that story or share what is best about them. In addition, the second one listed there is character strengths. And it's a big part of what we do in positive psychotherapy. We do it at the very beginning because it's something that once you practice with this and you know about this related to what your strengths are, you can incorporate it in a lot of other strategies related to building positive emotions. One way to explore that consideration is increasing the ability to understand what a person's traditions or customs might also contribute to some of those strengths that they could capitalize on and could actually influence some of the other parts of their strengths and what they're working on. So those are just a few examples. There's also one there around gratitude. The key here is that when we develop interventions, what we're learning is it's important to pay attention to those cultural adaptations and to think about the people that we're serving and how do we keep those in mind when we roll out these interventions, that there clearly are some adaptations we can make that don't change the nature of the intervention. So what I wanted to do next was to actually walk you through two different examples of positive psychology exercises, just so you can see what they're about. And these are things that you could actually go back and try with individuals that you're working with. So we're going to focus on two, finding the good things in each day and the gratitude letter. Okay, so good things. So I'm going to give everybody just a minute to write down at least one good thing that has happened to you in the last 24 hours. So I'll give you just a minute. Everybody just jot that down. All right, I hope everybody's kind of got an idea, written something down. Hopefully it's not too hard. Okay. So I want you to look at what you've got written down. And I'm going to ask you, how did it make you feel? And I'm specifically interested in what positive emotion did you feel when that happened? Okay. So I'm going to go to this slide here and I'll go back in a minute. But this is our positive emotions poster. And we were really intentional in doing this because we wanted to tap in to what positive emotion came up for you when that good thing happened. So if you look at this list, take a minute, write down one or two or three different positive emotions that you felt when that good thing happened. And I'll give everybody just a minute to do that. Okay, I'm going to go up because I've got one more thing I'm going to ask you to a couple of more things actually to ask you to write. So now you've gotten your good thing written down. You've gotten it written down. How did that make you feel? And then I'm going to ask you, why do you think that good thing happened? What was it that you did? Or what role did you play to make that good thing happen? So just take a minute and think about that and write down why you think that good thing happened. And then the last thing I'm going to ask you is, have you shared those good things with anyone else in your life? And you can just write yes or no. So hopefully everybody was able to write something down. So this is called a good things card. And when we do the finding the good things in each day, we hand these out. And I do not take any credit for the card. This was my colleagues in the UK came up with this. And I borrowed it with permission. I thought this was really brilliant. So essentially, what we do is at the end of every day, we have people fill out some good things cards. That's the activity. We do it for a week that we have them fill this out. You can actually have people fill it out anytime. What's nice about using something called the good things card is that if people fill these out and keep them in a safe place, then they are actually available to them when they might want them or need them. So it's a nice way to not only track this, which is what we do as part of the finding the good things in each day, but it's a way to kind of keep and hold these good things when you might need a reminder of them. So these are the things that I just had you do. The only extra thing I had you do was to talk about whether or not you shared it with someone. But these are the things that we would ask somebody to write down. And we would also give them just like I did you this positive emotions poster. And I will mention that when we did this as a group, we actually made a big poster size of the positive emotions poster. And we hung it up in our group room so everybody could see it. And it was a thing that we referred to quite often. And it was really, really helpful to be able to kind of see this. So let me I'm going to go back to the card for a minute. And I want to walk you through why this is helpful. So first of all, writing down the good thing. When you do this, especially at the end of the day, you'll find that there's benefits to doing this. There's not only benefits in rounding out your day or wrapping up your day and writing down the good things. But there's also benefits in this becoming a routine, which is why we ask you to do this every day for a week. The second part of this is thinking about why the good things happened, right? And this is really understanding that we play a role that we ourselves are part of initiating when these good things happen. And that's an important realization, especially for some people to see that that written down over and over again. The third part is that positive emotions part. So the key here is that if you've ever tried to elicit a positive emotion from somebody, you will notice that they typically say one of two things. They either tell you it's good, or it's fine. But if you look at the poster, what you notice is there's a whole host of words that we rarely tap into that describe what was going on. And the beauty of having the positive card and all of this written down is that it's actually also tapping into a form of savoring. So when somebody writes down that good thing that happened, they experience that broaden and build theory of that upward spiral. The positive emotion happens, and it leads to opening up that thought action repertoire. And it leads to the possibility to open these discover these strengths or these opportunities to build these additional resources. It happens when you experience it. It happens when you write it down. And it happens when you read it over again. Three opportunities for that to happen again. When we write down something specific, like this positive emotion, it is like getting a direct line to that it is allowing our brains to kind of that memory to be recalled again. So that's part of the reason that we have the cards now that we use. Here's some strategies when you're doing this with individuals to really think about. It's helpful to focus on recent events and experiences. It's really helpful to use that positive emotions poster like we were talking about. It's helpful to practice this just like we did in this workshop. So in your session when you're teaching this, practice it. It's also helpful to troubleshoot what might be difficult about this. What are they worried about? The more specific they are, the better it's going to be. The more potential burst of positive emotions that they can get. And we want to normalize anything around the difficulty in kind of creating a routine around this. Anything you can do to that is going to really increase the likelihood that people will finish this or complete this kind of activity. So when you do it, it's not just about doing it. The follow-up is just as important, if not more important, than setting it up. You want to, when the person comes back, you want to listen for not only how did it go, but what happened? What changed? What did they notice after they were doing this for several days, right? Exploring, did it change anything throughout their day when they were practicing this, when they started to make this a routine at the end of the day? And you also want to identify what did they notice about the reasons why this good thing happened? Is there a pattern in this? Is there a pattern in why these kind of good things started to happen? The last couple of things here is these are opportunities to share something positive with a family member or a supportive person in their life or friend. These are opportunities for them to kind of share those nice things and what they're doing. What you also may notice by the end here is that people might actually talk a little bit about how they were looking for these good things to happen. Once you get it into a routine, you start to look for the good things to happen. And you also might notice if people are doing this at the end of the day, that they're actually sleeping a little bit better. So this is a pretty simple one. I'm hoping that that's what people are seeing, is that this is not a huge burden here. It's a pretty simple activity. And the benefits of this really can be compounded. And if this becomes a regular thing that people do, there's some added benefits over time and really tapping into those upward spirals. So the second activity that I wanted to share with you is to talk about the gratitude letter. So let's briefly talk a little bit about the benefits of gratitude. So we know that people tapping into gratitude can lead to improvements in mood. People can find that they have increased enjoyment in the activities that they do. And they actually end up, if they're expressing gratitude, they feel more positive about the relationships. So there's all kinds of these really fantastic benefits that are associated with gratitude. But what are some ways that we can really jumpstart that? And that's where the gratitude visit or gratitude letter comes in. And so what I want to encourage you is, this is not something you can necessarily do while we're in this webinar, but it is something that you could go back and actually try. So it begins by talking about thinking about someone who has done something good for you that you've never had a chance to properly think. So this is someone that you can think of that in some way really benefited your life, changed your life, contributed, maybe even helped you through something in your life. And you want to think about what did that person do for you? How much did it mean to you? And how did it affect your life? So when we do this, what we do is we break this down and help the person get started as much as we can. We want to talk through people that they could reach out to. We want to walk through what are the kinds of things that they remember about this person, how did it help them, and what would they want them to know? So we have a worksheet that we use. We help them take notes. And then the goal here for the gratitude visit is not only do you write the letter, but we encourage the person to read the letter out loud once they've written it. Now pre-COVID, we would suggest the biggest benefit comes from when you read it out loud and in person. Now we know that that doesn't really work for everyone right now. So there's certainly benefits to not only just writing the letter, which we've seen, but even reading it on the phone or over video can still have one of those opportunities to create one of those upward spirals. But when we go through this, we want to make it as easy as possible for people to go back and write that letter and deliver it. And certainly people are concerned about, is this going to be awkward? What if I say the wrong thing? What if people don't understand why I'm doing this? We work through all of those kinds of things with them so that they can be as successful as possible when they do this. Just as we did with the finding the good things in each day, we do a follow-up for the gratitude visit as well. We talk about what was it like when you wrote the letter? What details did you include? How did you make you feel? We pull up that positive emotions poster up again. And then we want to know, did you read it out loud? If yes, how was that? How did the other person react? What was that like? How did it feel expressing that gratitude? So again, just like we set it up, the follow-up is just as important as well. Now here's the thing that was really interesting. The first few times that I did this in group, we weren't sure what kind of a buy-in we were going to get. But it was really, really powerful when we would come back and we would have people who actually not only wrote the letter, but actually read it out loud. And then we actually had people who were willing to share that letter with the other group members, which was extremely powerful. So it was really nice that we did get more buy-in than I thought. It was a bit surprising, but the benefits that people got when they did this were really enormous and really positive and really powerful that we saw when people would do this. So here's the thing about the gratitude visit. It's really great as a way to jumpstart that process around gratitude. It's not always easy as a sustainable kind of routine activity you can do. So here are three ideas of ways to continue to express gratitude in day-to-day life, including counting your blessings, practicing acts of kindness, and learning different ways to help complement people. And so that's part of what we do in a follow-up is not only to do some of those initial things that I was talking about, but it's another way to kind of talk about how do we move this over from, excuse me, one act of gratitude to something that can be more routine. Now the one thing I want to kind of mention here, now that you've seen these couple of ideas, a couple of examples of different activities that we do in positive psychotherapy, the other thing that we really encourage when people are doing these activities is that you, the clinician, when you're teaching them, you actually do them with the individual. So that they are, you're doing it alongside. So if I'm doing a gratitude visit, I'm helping the person set up their gratitude visit, but then I'm also saying that I'm gonna go back and I'm gonna try a gratitude visit as well. Or if we're doing the finding the good things in each day, at the end of the day, I'm asking them to fill out some good things cards and I'm gonna fill them out too. So it's a quite a very powerful, if you've never had the opportunity to do this before, it's quite a powerful opportunity to really learn and experience this side-by-side with individuals that you're working with. And we had an amazing reaction when we did this, where the facilitators of the group were also doing the activity side-by-side with the participants. So I would just really encourage you to do that. Okay, so we just have a couple of things left and we can stop for some questions. So I just wanna kind of note that since we did positive living, we have had some new iterations that we've tried to move this along because we've seen such really helpful benefits from this approach around this idea of integrating more recovery and improving and increasing wellbeing. So since positive living, we've taken it from a group approach to an individual approach. So we know that it actually can work in both different formats. So the individual approaches that we've done include individual resiliency training, which is the individual therapy intervention and navigate for persons with first episode psychosis. And we just recently finished a trial called individual coping awareness training, which combines more formally mindfulness-based stress reduction and positive psychology interventions. And both of these were done individually. What we've learned is there are ways to integrate these resiliency and positive psychology approaches into traditional evidence-based interventions, which is what we did in IRT. What we also learned is there may be additional benefit to expanding and including mindfulness interventions along with positive psychology interventions. And in the ICAT trial, what we found, which was a surprising finding, was benefits for people around negative symptoms. So those are kind of the way that we've taken the intervention since positive living. One of the newest adaptations that we're very, very early in piloting is we're using this as a group-based intervention for caregivers. So we're applying the same principles and same activities and teaching caregivers for people with loved ones with serious mental illness and teaching these same strategies to see what benefits they might get from learning these and practicing these strategies. So just to wrap it up, I'm hoping that this gave you some ideas about how positive psychology approaches could be applied to really increase recovery-oriented care. That we successfully implemented this, it was well-tolerated, it was very feasible, and it showed a lot of promise in improving wellbeing and actually improving other areas and outcomes such as symptoms. What I would recommend is we went through a couple of ideas. If you have an opportunity, try one of these. Try one of these for yourself first. See what you notice. See what this is like for you. And then if you have an opportunity, try this with an individual that you're working with. See what this is like when you focus on something that's not related to a symptom, that is more broadly based around improving their wellbeing and increasing their experience of positive emotions. All right, so here are my references. And they're in there for people who are interested in those. And I believe, Terri, this should bring us to the Q&A. Absolutely, but if you don't mind putting your slides back up, Piper. All right. Terrific, and if you'll click to the next one, that would be great. That was a fantastic presentation. There we go, terrific. That was fantastic. And including the technical glitches, you handled those masterfully. A colleague at NAMI told me several months into the pandemic, the Zoom or whatever the platform is, give it and it take it away. But you pivoted nicely and thank you for that. We do have time for questions. So if those of you on the call would type any questions that you have into the chat, that would be great. And while you're doing that, I wanna make you all aware of something that's available to you through SMI Advisor. It's accessible from your mobile device. And it is the SMI Advisor app. And this will allow you to access resources, education, upcoming events. You can complete mental health rating scales and you can even submit questions directly to the SMI Advisor clinical expert team. And you can download the app now at smiadvisor.org slash app and you see that at the top of your screen. So I wanted to put that in front of you before we dive into the Q&A. And if you'll go to the next slide, Piper, that would be great. Terrific, so I don't see any coming in from the participants, but I have a few. I've worked in community mental health centers for years and there was so much that you talked about that I thought would have been so helpful for me to know even then. And I'm gonna clump a couple of questions together. Do people need specialized training to use the skills that you've shared, positive psychotherapy or even some of the specific things that you went over today? And if so, how could they get that training? And if they don't need specialized training, where could they go to learn more? So, I have done some training on this before and I myself, I think in learning how to adapt it and what this means and what this looks like in our populations that we work with with more serious illness and schizophrenia, it can be helpful. There are a few things that we had to adapt. So we have written about this intervention, but the manual is not out there. And I'm happy to share that with people if they reach out to me. It's something I definitely want to get out there and for people to use. But when they do get it, I do want to have some idea of how they're planning to use it and if they need any additional support in using it. There is a lot of information out there about positive psychotherapy that people can read. There is some information about how to do it. There's lots of tips and books out there. There's actually, the group that I was mentioning from the UK, this is Mike Slade's group, have written a whole book. And theirs is a little different than Positive Living, but it includes a lot of great recommendations about how to do it. And you'll notice that the Good Things cards are in there. That's where I borrowed it from. So there are some helpful books out there. I'm happy to share the manual if people want to reach out to me and do that. I do recommend either you get some additional support or training or that you at least get some specialized information when you're using it with this population. That makes perfect sense. And what I would suggest to people on the call who might be interested in getting that information is if you go to smiadvisor.org, you're able to submit a case consult and you can submit that question that you'd like more information about this. And we can then make the connection for you. So thank you for that offer. One of the questions that I had as you were presenting was the Good Things card. Are there things that were presented in the overview you just gave that will be included in your slides that people could use if they wanted to, for example, use the Good Things card and the gratitude exercise, would that be? It seems logical, but I wanted to ask. Yes, of course. Yes, absolutely. That's why I wanted to make it very practical and give people a little bit of a taste, but give you enough of a background that you could, my recommendation, as I said, try it for yourself first. See what you notice. These are exercises originally developed for just everyone. And so there's no specialty that these are specific exercises for people with schizophrenia. These are actually exercises that any of us can do. So to familiarize yourself, do pick one of these and do this for yourself. The Good Things cards, do them for a week. At the end of the day, try to write down, and we suggest up to three things to try to write down, and do that for a week. For the gratitude letter, put together a letter, write it, and then read it to that person and see what you notice. So that's my real recommendations. Absolutely try them. Try them on yourself, and then you'll get some real experience with them, and then absolutely try them with the people you work with. Terrific, and I do see two people have typed into the QA that they would like copies of the workbook, but Piper, would your suggestion still be that they, is it okay for them to contact us through SMI Advisor, or would you prefer that they connect with you personally? If they connect through SMI Advisor, that would actually, it may actually speed up the process and allow them to get that information, so I appreciate that. And the other thing is that gives you an opportunity to visit the SMI Advisor site, and you can see the other resources that are there, but just go to the site and submit a case consult. So you mentioned specifically, I know we're almost out of time, but you talked specifically about using this with people with schizophrenia, positive psychotherapy, you know, initially was for people with mood disorders, depression, but it seems like this could be helpful with a variety of people, and I heard you even mention us using it on ourselves, so I just wanted your thoughts about that. It's not really diagnosis-specific. It's not, and if you look at the breadth of research that's out there, it's really interesting. It's been applied in a lot of different formats. You'll see there's a wealth of research that they've applied these activities to young people, to actually to children, and thought about ways to incorporate in schools. There's some more research where they actually applied these activities in the military, so it's very broad. There's research where they've done this to help people around stopping smoking. I mean, so it is very, very versatile, and that's another piece of it that felt very appealing when we were thinking about this idea of how do we really tap into this idea of well-being in treatment and address it? There was a lot of appeal where this has been done in a lot of different areas, so yes, it's gonna be applied in a lot of different ways. This has just been terrific, and again, I can't thank you enough. I've heard you present in a variety of different places, and I always learn more every time I hear you, and it just reminds me how far we've come in the field from when I first entered many years ago that the concept of wellness and recovery and improved lives with people with serious mental illness is possible and it's attainable, so thank you so much, Piper, for sharing these skills with us, and I think we have more in our toolbox now. If you don't mind, if you'll continue clicking through the slides for us, and we'll get things wrapped up today, if you have follow-up questions, for example, looking for the workbook or additional questions on this topic, you can submit them to us, to the clinical experts that are now available for online consultations. Any mental health clinician can submit a question and receive a response from one of our SMI experts. Consultations are free, and they're confidential, and this was one of the biggest surprises about this technical assistance center, I have to tell you, was the availability of the real-time consults, and if you'll go to the next slide, thank you. SMI Advisor is just one of many SAMHSA initiatives that are designed to help clinicians like you implement evidence-based care. We'd encourage you to explore the resources available on the mental health, addiction, prevention TTCs, as well as the National Center of Excellence for Eating Disorders, and the Suicide Prevention Resource Center. These initiatives cover a broad range of topics from school-based mental health through the opioid epidemic. Next slide. Claiming credit for participating in today's webinars, you'll need to have met the requisite attendance threshold for your profession, and verification of attendance may take up to five minutes. You'll then be able to select Next to advance and complete the program evaluation before you claim your credit. And the final slide, we want to remind you that we sponsor, we host these webinars on a regular basis. The next one is next week on April 1st, and if you'll please join us as Jasmine Watkins presents Compassion Fatigue in Clinicians Working with Vulnerable Populations. Always a timely topic, especially during a pandemic. Again, this webinar is free. It's going to be April 1st next week from 3 to 4 p.m. Eastern time. And again, cannot thank you enough, Piper, for joining us today, for the information that you shared, and a huge thanks to all of you who joined us and stayed with us throughout the webinar. And mostly, thank you for what you do to serve people with serious mental illness and their families. Have a wonderful rest of your day. Thank you for participating in today's free course from SMI Advisor. We know that you may have additional questions on this topic, and SMI Advisor is here to help. Education is only one of the free resources that SMI Advisor offers. Let's briefly review all SMI Advisor has to offer on this topic and many others. We'll start at the SMI Advisor website and show you how you can use our free and evidence-based resources. SMI Advisor's mission is to advance the use of a person-centered approach to care that ensures people who have serious mental illness find the treatment and support they need. We offer several services specifically for clinicians. This includes access to education, consultations, and more. These services help you make evidence-based treatment decisions. Click on consult request and submit questions to our national experts on bipolar disorder, major depression, and schizophrenia. Receive guidance within one business day. It only takes two minutes to submit a question, and it is completely confidential and free to use. This service is available to all mental health clinicians, peer specialists, and mental health administrators. Ask us about psychopharmacology, recovery supports, patient and family engagement, comorbidities, and more. You can visit our online knowledge base to find hundreds of evidence-based answers and resources on serious mental illness. All content in our knowledge base is reviewed by our team of national experts from the American Psychiatric Association, Harvard, Emory, NAMI, University of Texas at Austin, and more. Browse by key topics or search for a specific keyword in the search bar. Access our free education catalog to find more than 100 free courses on topics related to serious mental illness. You can search the education catalog by topic, format, or credit type to find courses that fit your needs. SMI Advisor also offers live webinars each month that let you learn about evidence-based practices and participate in live Q&A with faculty. Check out our education catalog often to find new courses and earn continuing education credits. For individuals, families, friends, people who have questions, or people who care for someone with serious mental illness, SMI Advisor offers access to resources and answers from our national network of experts. The individuals and families section of our website contains an array of evidence-based resources on a variety of topics. This is a great place to refer individuals in your care for information about their conditions. They can choose from a list of important questions that individuals who have SMI typically ask. SMI Advisor worked with experts from the National Alliance on Mental Illness to develop these important questions and many of the resources in this section. Watch videos on important topics around SMI, such as what to know about a new diagnosis. They can also find dozens of fact sheets, infographics, and links to other important resources. To access even more evidence-based resources for individuals and families, visit our online knowledge base. All content in our knowledge base is reviewed by our team of national experts from the American Psychiatric Association, Mental Health America, National Alliance on Mental Illness, and more. Browse by key topics and select View All to uncover a list of resources on each topic. SMI Advisor offers a smartphone app that lets you access all of the same features on our website in an easy-to-use, mobile-friendly format. You can download the app for both Apple and Android devices. Submit questions. Browse courses and access clinical rating skills that you can use in your practice with individuals who have SMI. SMI Advisor also created My Mental Health Crisis Plan, a smartphone app that helps individuals in your care to create a crisis plan. The app is available on both Apple and Android devices. It helps people prepare in case of a mental health crisis. They can make their treatment preferences known and specify who should be contacted and who should make decisions on their behalf. The app even guides individuals through the process to turn their crisis plan into a psychiatric advance directive. Thank you for your interest in SMI Advisor. Access our free education, consultations, and more on smiadvisor.org at any time. Learn more at smiadvisor.org

positive psychology

recovery-oriented care

schizophrenia

positive living

positive psychotherapy

well-being

activities

gratitude letters

improved mood

relationships