We have several questions ranging from the very specific to the very broad. So we're going to try to handle as many as we can. The first one, Dr. Cook, this sounds like a technical one, but you mentioned UIC Center at the beginning. What is UIC? Oh, sorry about that. UIC refers to the University of Illinois at Chicago, where I'm a professor in the Department of Psychiatry. That makes a lot of sense. The next question is kind of related. What is the, where are you on Twitter? What is the handle or name or tag that people can follow you guys on Twitter? Let me find that. Okay. It's the ampersand sign. So it's at, and then UIC Health RRTC. And I'll say that one more time. So ampersand, UIC, the word health, H-E-A-L-T-H, and then R-R-T-C, and on our Twitter feed, which we post on daily, if you go and look at it now, you'll see an advertisement for today's webinar. If you look back, you'll see tweets about the WAM research that was published recently. You'll see tweets about WAM being offered in different locations. And you'll also see tweets about the solution suite, which I hope to talk about a little bit more later on, that has, in addition to WAM, other products and interactive tools that you can use to enhance your own health and wellness, as well as help other people do the same. Got it. Question is, did participants in the study have prior experience with peer support special service days prior to becoming involved in this study? That's a really excellent question. I would say by and large, they did not. In Georgia, where, as some of you may know, there are many, many more trained peer specialists than in other states, and a number of peer-run recovery centers, people had more experience than they did in Illinois, where those things are a little less accessible. However, we find that many of the people, even if things are accessible, in our research, we find that many people don't have experiences with self-help and peer support, don't even necessarily know when they first come to a class and somebody says, I'm a certified peer specialist, they're not even sure what that means. That's why WAM includes some basic education about what peer support and self-help is, how to give it, how to receive it, how peer specialists are not clinicians, but what they add and augment to people's recovery. It's really important learning for folks, because as you can probably tell from my description of WAM, it's peer-run and very recovery-oriented and self-help oriented, it's really important that people understand what peer support is and how helpful it can be. So many folks are used to just thinking that if they show up at a health professional's office, that that's going to be enough to help them establish health and wellness. So WAM is one of the many interventions that convey something that we've really learned from decades of research now about chronic conditions, not just including mental health, but other things like diabetes and asthma. And that is that the major determiner of a person's health, especially if they have a chronic medical condition, is themselves and their ability to self-manage it. The amount of time you spend with doctors and taking medication is really a drop in the bucket compared to the everyday decisions you make about when to get up, what to eat, how much activity to engage in. So these are all messages that WAM conveys. And the evidence base is very impressive. There are, of course, many psychological treatments, there's many services like this, but the evidence is just so impressive. And this is actually an interesting question. I suppose that it comes up in most things. It says, now that we are in the COVID-19 era and what is different or if you got, if someone is, wants to offer WAM or is doing it, it sounds like transportation may not be a barrier just because people may be at home or like, what is, is there any kind of differences that happen with COVID and kind of more video visits now? What an excellent question. So WAM wasn't designed for COVID, obviously. Really nothing was. Nothing was. Right. Right. Right. But it's certainly deliverable virtually. And I know you're an expert in that, John. So I'm sure as you were listening to my presentation, you probably clued in on some of the things that would make WAM doable in a virtual way. The fact that you can do both groups and individual sessions through Zoom is very important. But the idea of using WAM specifically to help you get through COVID is something it wasn't designed for, but something it's really perfect for. So we found, for example, we just finished a survey of people who reported that they had a serious mental illness, and we found that around 20% of them said they were unable to access the healthcare that they needed. So it's really important that people be able, from their homes, to set a health goal and work on it. Now it's a little different. Working on our health goals today, we're not finding a place to walk outside necessarily, although hopefully some of us live in situations where we can take a walk with a mask on. Many of us aren't going to the gym, so forth and so on. But I think there's always opportunities to be able to come up with a weekly action plan that will still be doable with social distancing and masks when they're needed. So I think this is a perfect intervention to be learning to administer during these COVID times. And more just me listening, I'll longer pronounce it. Everything you describe, I think you guys have built WAM to be so flexible that I could see it running very well via Zoom, video visits. It really seems like you can implement in so many different ways, but there's nothing about COVID that means you couldn't run WAM, from what I can hear. Does that sound right? Yes, that's exactly right. And while it would be challenging, I know a lot of people don't have access to the technology they need for Zoom, you could even do WAM by telephone. You'd have to do some extra things. You'd have to send people things through the mail ahead of time, and it might not be as enjoyable. But just in the same way that people have done RAP through Telephone Wellness Recovery Action Plan, for example, and other interventions, which comes to shove, I think you could pull it off. Yeah. This is an interesting question, kind of related to this. I'd be interested in doing WAM. I have a site that doesn't have funds. How could I start kind of working towards WAM, or what could I be doing today? And I know you said you gave the link to the website, the price is negotiable, but for a site that just doesn't have funds or says, like, we're not there yet, what are some positive steps they can be taking towards this? So I'm going to tell you exactly how to access our center's solution suite, which will enable you to be able to use some tools that are free, that have training webinars, so you don't have to pay for those, podcasts that you can listen to to learn about the tool and how it's been used, and you can download these tools, and you can even get some technical assistance from our center, and in some cases, from the person that created the tool. Oh, wow. If we can go back a couple slides, because I don't have control of them. One more. Forward one. There we go. That's perfect. So at that link at the bottom, the www.centerforhealthandsdc.org, you'll go to our website, and at the top of the page, you'll see something that you can click on called the solution suite. So the solution suite has a number of products that I think would meet this need of, I'm not going to be able to convince people to pay for expensive training right now, but let's take a look at some similar things that we could do in the meantime to get people excited about this, perhaps to show our organization's leadership that people want to do this and that it has a positive impact. So one of the things that people can get from the solution suite is a product that was created by Peggy Swarbrick, Dr. Peggy Swarbrick, who's at a peer-run program in New Jersey called Wellness in Eight Dimensions and the Wellness Daily Plan. And this is a workbook that helps people assess their strength in each of the eight dimensions of wellness. And those dimensions include things like physical health, emotional health, financial health, occupational health, environmental health. These are all areas that contribute to people's health. So there are things that people want to work on when they're trying to improve their health and wellness. What people do in using the manual or the workbook, and they can either use this on their own or they can use it in a group, is assess their strengths in each of the eight dimensions. It's really important that they start with their strengths rather than what they don't have. Then if they're interested in setting a goal in that area, they can set that. And then they do an assessment about what they'll need in order to achieve that goal. And that's really important because a lot of people have a goal and can't achieve it but aren't aware of that because they haven't stopped to think about some of the resources they're going to need. So they then try to work toward that goal and because they're under-resourced, they don't achieve it and they think it's because of them. So it's really important to think a little bit when you're setting a goal about what resources you have and which ones you'll need to acquire. Also they spend some time thinking about something that I talked about in terms of WAM and that's getting the needed social support for goal achievement. There are instructions about creating a daily plan for wellness activities and monitoring progress toward a healthy lifestyle. So as you can see, Wellness in Eight Dimensions has many of the same features as WAM. It's like a lighter version of some of the elements. But remember it's a free manual with free training, free podcasts, and free technical assistance. It's a lot there actually. That sounds like that could keep someone busy for a while. Yes, absolutely. I just want to mention a couple other things that people might be interested in. There's a Wellness for Work manual that deals with many of the same issues but locates them within the world of work. Many people who want a job don't realize how much physical stamina is needed just to get back and forth to work as well as stamina needed on the job. What's important is healthy sleep and good nutrition. And yet we tend to not think about those things when we're trying to help people work, when we're delivering supported employment. So Physical Wellness for Work is another product that people might want to check out that's available in the solution suite. I'm going to mention one more for those of you who are creative and like to write. There's a manual called Journaling for Wellness. I don't know if you're aware of the research on journaling, but research shows that it improves a number of emotional and physical outcomes. This is a fascinating area. And again, Dr. Peggy Swarbrick created this manual on Journaling for Wellness. It's another approach that you can offer depending on the needs of the organization that you'd like to introduce these principles into, or even if you're thinking about things for yourself and think, I didn't like the eight dimensions, but this idea of journaling, that sounds really intriguing. That sounds so accessible for anyone, right, to capture your thoughts and well-being. Yes, absolutely. And especially journaling is not real clinically oriented. So it doesn't feel like a clinical chore, for example. So this is a, I think, related question. You partially answered it in this, or how would someone listening, what does the site, how do they know if they're ready to kind of take the step and kind of get training for WAM and kind of reach out and begin the formal process? Are there kind of any indicators or the opposite of a red flag, like a gold flag that says, hey, if you're ready to do it, you probably have the right peers, you have the right experience. This is the next step to do. Another great question. So one thing that I think would indicate readiness is whether your organization is delivering any other types of peer-led self-help or support. If your organization is delivering WRAP, Wellness Recovery Action Plan, which is a very, very well-known illness self-management intervention, then you're probably ready for WAM. If you have peer service deliverers who are capable of learning how to deliver a structured intervention. The whole point about fidelity is you don't take the WAM manual as an instructor and pick some parts of it but not others and decide, well, I'm going to follow some of these principles, but I think this other one doesn't make sense, so I won't follow it. So you need people who are willing to adhere to the intervention, attend the training, and persist in it until they get certified. We've talked about, you know, visiting the Solutions Suite and trying some of the materials there and seeing, you know, what you might find is we have people that really want to teach this, and we did a, you know, a run through, and it was great, but we couldn't get people interested in it. So there I think you see that you have some work that you might want to spend working with your general population on the importance of their health. So those are a few ideas about how you could determine whether or not you're ready to receive WAM training. That makes sense, and I'm going to do some rapid fire questions. There's so many, but here's one. Is that what you have there, is that the contact information to slide up now to reorder new WAM books and tools for certified WAM specialists? Also, do you have to recertify after a certain amount of time? Okay, so if we can go back one slide. We are back that slide. There we are. There we go. So the link to the National Council for Behavioral Health WAM training website will either answer those questions or tell you who to contact if you need to answer them. There is a new version of the manual available, but I don't believe that you need to be recertified in order to deliver WAM. If you've already been trained and certified, then you do want to go ahead and get a new copy of the manual and check in and see about training, but otherwise, no. Yeah, and this question is related, so I think we'll stay on this slide. What are the requirements for WAM certification? Should it only be used by licensed mental health clinicians, or could people working under a clinician in larger communities be certified as well? Okay, so anyone can be certified to deliver WAM. It is usually taught by certified peer specialists, mainly because they exist in many states. They're already trained. You know, I think what I'd say about WAM is it can be offered by a clinician, but not using clinical principles. WAM is a, as you can see, it uses things like CBT and motivational interviewing and the relaxation response, so it uses some of those principles, but it really operates from a foundation of peer support. However, you don't have to be a person with lived experience of mental illness to convey those principles and deliver WAM, so I would say if I followed those questions correctly, yes, it can be offered by clinicians who don't necessarily use clinical principles when they're delivering it. It can be offered by people acting under the supervision of clinicians, as long as those clinicians understand the principles of peer support. That makes sense, and we're getting questions after just our compliments for how many resources are on the websites up there, so that's not really a question. That's a quick compliment. And a different question I think we have, I'll quickly go. Of the evidence-based health therapies and topics, are there any that are kind of highest yield or kind of people have the best success for when they pick or if they're starting on which one to go for? Is there one that's a little bit easier, or is it very on the person? Oh boy, that's a really tough one. No, that's okay, that's okay. I will tell you one thing. I think people can use their good common sense and their knowledge of the people they're working with and read what's in the intervention and then say for themselves, I think this is what my group needs. Wellness Recovery Action Plan, WRAP, is very, very good for people who are just starting to learn that they can manage their upsetting feelings and emotions, that they can be in charge even when they're nearing crisis, there's still time to avert it, that their health is very, very important to their emotional health. But WRAP tends to focus a little bit more on the emotional side. WAM focuses much more heavily on the health side because there's specific attention to health topics and people are asked to set a health goal. WRAP is maybe a little better in helping people manage symptoms, although symptoms are never referred to that in WRAP, where WAM might be a little better at teaching people that they can take small steps toward improving their health. If they're obese, they don't have to become normal, wait to feel better and be more healthy. If they're smoking and haven't been able to stop, they need to add something to their routine and not focus so much on stopping. Unless, I would say, they're able to engage in evidence-based practice, smoking cessation, which has been shown to help people very much. But they're not going to go that full route. There are some things they can do, like becoming more physically active. If they really do do that, they will smoke less because they'll find that smoking is getting in the way of that. So I hope I've answered that question. No, that makes sense. And again, it's hard just because you've built such an amazing, flexible resource that can meet so many needs. There's always going to be flexibility in it. So I think so many questions, we weren't able to answer all of them.

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