CLINICAL HANDBOOK OF SCHIZOPHRENIA

304 IV. PSYCHOSOCIAL TREATMENTdiagnoses; various “principles” of support and tools for recovery; medications; spirituality;and advocacy techniques. The course is currently offered in several hundred locationsthroughout the United States.A similar, widely known consumer-operated educational program, the Wellness RecoveryAction Plan (WRAP) program (Copeland, 1999), is not affiliated with NAMI.Like the NAMI associated programs, WRAP sessions are conducted by persons in recoveryfrom serious mental illnesses, but they are of shorter duration than the BRIDGES andPeer-to-Peer programs, generally lasting only a few hours for overview sessions or 2 daysfor traditional WRAP sessions. WRAP provides structured training wherein each participantdevelops his or her own plan to maintain wellness. In this plan, referred to as the“toolbox,” one is instructed on how to use the tools to identify and deal with triggers,early warning signs, and so forth.EVIDENCE OF EFFECTIVENESSRegarding the effectiveness of the advocacy aspects of self-help activities, there can be littledoubt that the activities of persons in recovery from mental illness and their family membershave had a substantial impact on the mental health system. During the past 40 years, consumersand family members have helped bring us to the point of transforming the mentalhealth system, so that it becomes consumer and family driven, and focused on recovery.Thisembodies measures to ensure that persons with mental illness are afforded humane, dignified,and increasingly effective treatment, and that consumer and/or family representativeshave input into all phases of mental health research and treatment initiatives.Another question, of course, is whether persons with mental illness are in fact benefitingfrom these self-help activities. Research in this area has been somewhat limited, butat least one major, recent research effort has addressed this question.SAMHSA’s CMHS supports the meaningful participation of mental health consumers/survivorsin all aspects of the mental health system, including the planning, design,implementation, policy formulation, and evaluation of mental health services. Campbell(2005) reported on a SAMHSA-funded, multisite study, begun in 1998, in which the wellbeingof some 1,827 adult persons in recovery who participated in three types ofconsumer-operated services was compared to that of similar subjects who received traditionalservices only. The three types of consumer-operated services were four drop-incenters, two mutual support programs, and two educational/advocacy programs. Resultsindicated significant improvement in well-being for the participants in only two of thedrop-in center programs, but no improvement for participants in the consumer-operatedservices programs compared to those in the traditional programs overall.Although this recent SAMHSA-sponsored research effort has not produced the evidencemany were hoping for with respect to the efficacy of self-help groups, consumer andfamily advocates continue to remain optimistic that self-help is of significant benefit to thepersons in recovery from serious mental illness who choose to participate in these programs.KEY POINTS• The term self-help originally referred to the activities of groups of persons with similar disorderswho organized to assist to one another in their recovery efforts.• There are many different types of self-help groups for persons with behavioral health disorders.