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Getting Started with the Let’s get real Learning Modules Published in September 2009 by Te Pou o Te Whakaaro Nui The National Centre of Mental Health Research, Information and Workforce Development. PO Box 108-244, Symonds Street, Auckland, New Zealand.

ISBN 978-1-877537-27-1

Web www.tepou.co.nz/letsgetreal Email [email protected]

2 Getting started Learning module – electronic version Contents

Introduction...... 4 The development of the seven Real Skills...... 5 Let’s get real: Real Skills...... 5 Let’s get real: the learning modules...... 6 Let’s get real: values and attitudes...... 7 The Let’s get real values and attitudes are as follows...... 7 How to use the learning modules...... 8 Assessment...... 8 Structure...... 9 Summary of key themes of the learning modules...... 9 Completing the learning modules...... 13 Getting prepared...... 13 Working through the learning modules...... 13 Reflecting on learning and getting feedback...... 14 Getting it finished – Individual Professional Development Plan...... 15 Getting going again – Summary Action Plan...... 15 Overview - How to use the learning modules...... 16 Glossary...... 17 References...... 23 Let’s get real Self-assessment Tool...... 25 Summary Action Plan...... 42 My Action Plan: how will I do this?...... 42

This document has been formatted to work on electronically. Type your answers into the areas indicated with grey shading. The answer areas will grow to accommodate the length of your answer. Print versions are available if you would rather handwrite your answers, see www.tepou.co.nz/letsgetreal to download a print version.

3 Introduction Ko te pae tawhiti whaia kia tata; ko te pae tata, whakamaua kia tina. Pursue distant goals so that they become accessible, those goals that are close, grasp them and hold securely.

This Getting Started learning module must be read in conjunction with the Let’s get real Overview which can be accessed from the Te Pou website, www.tepou.co.nz.

Let’s get real is a key action from Tauawhitia te Wero – Embracing the Challenge: National mental health and addiction workforce development plan 2006–2009 (Ministry of Health, 2005).

Let’s get real is a framework that describes the essential knowledge, skills and attitudes required to deliver effective mental health and addiction treatment services in New Zealand.

Let’s get real aims to:

 strengthen shared understandings – everyone, including service users, their families and whānau, support workers, regulated professionals, managers, funders and planners, people working in district health boards, and people working in non-government organisations, will understand the shared work that each person is engaged in

 affirm best practice – appropriate knowledge, skills and attitudes will be better recognised and valued by services through human resources, performance management and professional development processes

 complement the Health Practitioners Competence Assurance Act 2003 – the Let’s get real framework brings together the essential knowledge, skills and attitudes required of all professions working in mental health and addiction, and complements the different competency frameworks developed by each of the registered professions whose members work in mental health or addiction treatment services

 improve transferability – other services around New Zealand will be able to recognise and value workers’ knowledge, skills and attitudes

 enhance effective workforce development – all mental health and addiction workforce development activities, including education and training, human resource strategies, organisational development, and research and evaluation, will link back to the Let’s get real framework

 increase accountability – by documenting the essential knowledge, skills and attitudes needed for the job, we can demonstrate evidence against them to be more accountable to service users.

4 Getting started Learning module – electronic version The development of the seven Real Skills The development of the seven Real Skills contained within Let’s get real drew on all of the current and emerging frameworks for mental health and addiction treatment services. This includes:

 the recovery competencies for mental health workers

 the competencies developed for professionals who are regulated by the Health Practitioners Competence Assurance Act 2003

 Te Ao Maramatanga standards of practice for mental health nursing (2004)

 mental health frameworks for particular professional groups

 the practitioner competencies for alcohol and drug workers (Alcohol and Drug Treatment Advisory Workforce Development Advisory Group, 2001)

 the Midland Common Capabilities Project.

In addition, Te Rau Matatini (the Aotearoa Māori Mental Health Workforce Development organisation) and Matua Raki (the National Addiction Treatment Workforce Development Programme) drew on their involvement in, and knowledge of, developing Māori dual competency frameworks to develop what was initially known as the focusing on Māori Real Skill and is now called the Working with Māori Real Skill.

Let’s get real: Real Skills The seven Real Skills describe the essential knowledge, skills and attitudes required to deliver effective mental health and addiction treatment services in New Zealand.

The seven Real Skills 1. Working with service users – every person working in a mental health and addiction treatment service utilises strategies to engage meaningfully and work in partnership with service users, and focuses on service users’ strengths to support recovery.

2. Working with Māori – every person working in a mental health and addiction treatment service contributes to whānau ora for Māori.

3. Working with families/whānau – every person working in a mental health and addiction treatment service encourages and supports families/whānau to participate in the recovery of service users and ensures that families/whānau, including the children of service users, have access to information, education and support.

4. Working within communities – every person working in a mental health and addiction treatment service recognises that service users and their families/whānau are part of a wider community.

5. Challenging stigma and discrimination – every person working in a mental health and addiction treatment service uses strategies to challenge stigma and discrimination, and provides and promotes a valued place for service users.

5 6. Law, policy and practice – every person working in a mental health and addiction treatment service implements legislation, regulations, standards, codes and policies relevant to their role in a way that supports service users and their families/whānau.

7. Professional and personal development – every person working in a mental health and addiction treatment service actively reflects on their work and practice and works in ways that enhance the team to support the recovery of service users. The seven Real Skills apply to everyone working in mental health and addiction treatment services, whether administrative staff, psychiatrists, support workers or team leaders. It is important to read across all of the Real Skills and understand the interrelationships and connections between them.

Real Skills: levels Each of the Real Skills has a broad definition and three levels: essential, practitioner and leader.

 Essential – this level is expected to be reached by all staff within mental health and addiction services.

 Practitioner – this level is for practitioners and clinicians who have worked within a service for at least two years. Everyone in this level is expected to have achieved competencies within the essential level.

 Leader – includes people in management or clinical leadership roles. Everyone in this level is expected to have achieved competencies within the essential level. Some may also have met the practitioner competencies in recognition that they have maintained (or still exercise) a clinical role.

The levels have been structured to recognise the differing requirements of different roles at the various times that a person may enter the workforce. The levels can be cumulative (in other words, a person could aim to progress from essential to practitioner, and then to leader), but they can also be used in other ways.

For each level of each Real Skill, there is a defined set of performance indicators. The performance indicators outline what a person must demonstrate, in order to show they have achieved that particular Real Skill at the designated level.

Let’s get real: the learning modules Let’s get real and the demonstration of the seven Real Skills are driven by the need for service users to experience staff as respectful, compassionate, recovery focused and skilled. Ongoing training, workforce development and support are the means to achieving this outcome.

6 Getting started Learning module – electronic version The learning modules are a self-directed learning resource that sits alongside the Let’s get real enablers, which include:

 Guide for Managers and Leaders

 Human Resource Tool (covering recruitment, selection, orientation, performance development, and performance management and coaching)

 Team Planning Tool.

In addition, there is the Let’s get real Real Skills Plus series, which builds on the practitioner level of the Real Skills for people working with infants, children and youth: Real Skills Plus CAMHS (The Werry Centre, 2008) and Real Skills Plus Seitapu: Working with Pacific people (Le Va, 2009).

The Education Tool supports providers of mental health and addiction education and training to integrate Let’s get real into their curriculum development, and programme and course reviews.

Let’s get real: values and attitudes Let’s get real is underpinned by essential values and attitudes that run throughout the Real Skills. These are the foundation from which Let’s get real has been built and there is a dedicated learning module about the values and attitudes for all mental health and addiction staff to complete. More details about the values and attitudes can be found in Let’s get real: Real Skills for people working in mental health and addiction (Ministry of Health, 2008). The Let’s get real values and attitudes are as follows.

Values Attitudes  Respect  Compassionate and caring  Human rights  Genuine  Service  Honest  Recovery  Non-judgemental  Communities  Open-minded  Relationships  Optimistic  Patient  Professional  Resilient  Supportive  Understanding

7 Let’s get real: the learning modules in detail

Design These self-directed learning modules have been designed to apply directly to participants’ work contexts and environments. Let’s get real can only become real when staff understand each of the seven Real Skills in the context of the work they do.

Key principles underpinning the design and development of the learning modules  Individuals and organisations in the mental health and addiction sector are committed to improving outcomes for service users through the continuous improvement of mental health and addiction services and the capabilities of staff working within these services.

 Staff in the mental health and addiction sector take an active and willing role in their learning and personal and professional development, and this is an ongoing process.

 Staff have an individual personal responsibility to maximise learning and growth through active participation, self-reflection and action.

 Individuals and organisations have a responsibility to be participants in the learning of others by working in partnerships with colleagues and peers, utilising peer review, critique, and supervision processes as appropriate,

 Learning modules are self-directed and based on adult learning concepts.

 The modules are designed to encourage critical self-reflection and personal and professional development.

 The learning activities within the modules are work-related, practical and based on the personal analysis of experience.

 Organisations will exercise their responsibility in creating supportive learning environments and processes to encourage shared learning and development for all staff.

How to use the learning modules A process to determine how to best use the learning modules in your organisation is provided on page 16.

Assessment The Let’s get real framework assists services to develop competency-based workforce development programmes. However, these self-directed learning modules do not include performance-based assessment, nor is there a formal assessment component attached to these learning modules.

8 Getting started Learning module – electronic version Structure The learning modules are a package comprising:

 Getting Started

 Values and Attitudes

 three modules for each of the seven Real Skills - a separate module for essential, practitioner and leader levels of each Real Skill.

The Getting Started and Values and Attitudes learning modules should be completed by all staff.

Performance indicators for each level are presented at the beginning of each learning module. This is followed by an overview, and then more detailed information about the topic area.

All of the learning modules identify the main national strategy and policy documents that relate to the mental health and addiction sector, and contain a reference and recommended reading section to inform further investigation.

As preparation for completing each of the learning modules, participants should source any additional documents that may be specific to their area of work (for example, older adult, adult, specialist, child and youth, addiction) and familiarise themselves with the key messages.

The learning modules generally follow a standard outline. At times, they direct participants to additional resources that are either unique to their organisation or easily found in the public domain. This is followed by a variety of activities, linked to the performance indicators, which have been purposefully designed to encourage participants to reflect on their learning, and the way they work with service users, families/whānau, Māori and the wider community.

Summary of key themes of the learning modules The following table summarises the key themes addressed in each of the learning modules. The themes, which are expressed in the table as both behaviours and as ideas/concepts, are directly related to the performance indicators for each of the different levels of each of the seven Real Skills.

9 Values and attitudes Exploring and articulating personal values in relation to the work that you do. Developing an understanding of the shared values and attitudes that exist in the mental health and addiction sector. Recognising and understanding the various impacts that our values and attitudes can have on service user experiences. Real Essential level Practitioner level Leader level Skill  Engaging people and  Recovery in practice:  Operating with integrity building strong working holistically and modelling a relationships  Therapeutic recovery focus.  Building empathy relationships, working  Reflecting on strategies  Understanding recovery collaboratively, planning, and approaches to  Recognising strengths and monitoring and review overcome challenge: understanding the whole  Application of knowledge:  responsiveness to person  definitions and service users’ needs  Person-centred planning categories of mental  best practice

s illness and addiction r  Addressing disparities in principles e s Māori health and well-  assessment and  cultural safety of u intervention e being service users and c i processes, concepts employees

v  Key aspects of mental r of risk e illness and wellness  trauma-informed s  psychiatric systems h t i pharmacology and  effective w

effects

g communication n

i  evidence-informed k r therapies and o

W interventions  physical health and mental health  trauma-informed care

 The importance of te reo  Metaphorical language  Providing resource Māori  Communicating and support  Māori relationships engaging tangata whaiora  Communicating and  Unique Māori and whānau engaging with the perspectives of health  Unique Māori community and health service perspectives of health  Unique Māori delivery and health service perspectives of health delivery and health service i  The importance and r

o unique nature of wairua  Rangatiratanga – tangata delivery ā

M and Māori spiritual whaiora and whānau self-  Measuring cultural

h practices determination effectiveness t i

w  Belonging and connecting  Belonging and connecting  Māori support for your

g  Honouring and respecting  Hospitality and generosity service n i

k  Māori workforce r

o development W  Manaaki in action with tangata whaiora, staff and community

10 Getting started Learning module – electronic version Values and attitudes Exploring and articulating personal values in relation to the work that you do. Developing an understanding of the shared values and attitudes that exist in the mental health and addiction sector. Recognising and understanding the various impacts that our values and attitudes can have on service user experiences. Real Essential level Practitioner level Leader level Skill  The context of family and  Understanding policies  Developing and whānau and procedures maintaining service  Engaging with and  Managing family and systems to ensure the supporting family and whānau tensions needs of family and whānau to contribute to  Establishing, maintaining whānau are met:

u recovery  Participation and

a and enhancing

n support of family and

ā  Connecting family and relationships with h whānau to community families and whānau whānau w  / support options and  Facilitating family and Responding to the

s resources strengths and needs of

e whānau access to i

l families and whānau i  Understanding policies of community support

m involvement and resources  Leading and influencing a f

participation and the others in developing h t

i impact of these positive relationships w

with whānau, hapu, iwi g

n and communities i k r o

W  Defining and recognising  Demonstrating knowledge  Networking and n

i community of the impact of current collaborating with s h e i t  mental health and community, and health i Social inclusion and t i

w addiction policies at the and social service n

community engagement u g community level providers n

m  Māori concepts of i k

m  Ability to form effective  Community and public

r community o o c  Public health and mental working relationships health W health promotion with key support agencies  Leadership within in the community, community development including hapu and iwi

n  The impact of stigma and  Concepts related to  Operating with integrity o i discrimination stigma and in ensuring that you, t

a discrimination, including your organisation and n  Recognising personal i self-stigma, and the staff model and

m behaviours that can i r contribute to the impact of these upon demonstrate non- c s

i experience of stigma and service users, families discriminatory practices d discrimination and whānau, external and behaviour in all d

n agencies and groups aspects of your work,

a  The role of staff in internally and externally a reducing stigma and  Using strategies that

m challenge stigma and  Examining understanding

g discrimination, and i

t implementing appropriate discrimination, and of stigma and s

g strategies promote and facilitate discrimination and the n

i social inclusion impact of these g

n  Application of strategies e l l to challenge stigma and a

h discrimination, and C educate and support services and communities to minimise the impact of stigma and discrimination

11 Values and attitudes Exploring and articulating personal values in relation to the work that you do. Developing an understanding of the shared values and attitudes that exist in the mental health and addiction sector. Recognising and understanding the various impacts that our values and attitudes can have on service user experiences. Real Essential level Practitioner level Leader level Skill

 The rights and  Policy, legislative  Policy and legislative protections for service frameworks and frameworks that inform, users that exist within professional codes of guide and support the legislation conduct that inform and work of your team,  Informed consent and support practice service and organisation utilising advance  Collaborative and ethical  Contributing to

e directives to uphold decision making with legislative change and c i

t service user rights to service users policy development that c

a participate in their own impacts on mental r p

recovery health and addiction d

n  The policy context within practice a which mental health and  Creating organisational y c

i addiction services systems and a culture l

o operate in New Zealand that is grounded in p

,  Understanding policy that recovery w

a is focussed on improving L outcomes for Māori

 Understanding personal  The value of personal  Developing an strengths and professional organisational culture  Contributing to effective development that is focused on a service user driven,

t teamwork  Collaborative working

n evidence informed, e  Communication skills across disciplines

m  Management of complex collaborative vision for p  Self-care and the future o

l supervision multifaceted e  Working with staff to v  Using and contributing communication e create a healthy

d processes

to evidence-based l workplace to support a practice  Gathering and using n professional and

o quality information and s personal development r research to improve e

p  Processes and activities

systemic and service

d user outcomes that support research n

a and evaluation

l  Participation in the

a  Using information to

n development of oneself o

i and colleagues (through assist quality planning s s feedback, supervision,  Coaching, supporting e f

o appraisal and reflective and challenging people r

P practice, and to reach their full participation in lifelong potential learning)

12 Getting started Learning module – electronic version Completing the learning modules The modules have been designed to be completed through self-directed learning. They may be adapted to other interactive learning processes. Flexibility and creativity in how the learning modules are used in any particular service setting are encouraged. It is the decision of those leading and guiding staff and services to determine the most appropriate method of their completion.

Getting prepared Before starting the learning modules, participants are asked to complete the Let’s get real self-assessment tool, which is designed to help them identify their existing competence and confidence in all of the seven Real Skills. This self-assessment provides a baseline against which participants can review their learning upon completing all of the modules. The Self- assessment Tool is located in on page 25.

It is strongly recommended that the Values and Attitudes module is completed after this Getting Started module, and that thereafter the modules should be completed in the order that they are listed in the table above (that is, working with service users, working with Māori, and so forth).

Working through the learning modules Each module is to be worked through in its entirety, from beginning to end, as it has been designed to flow from one concept to the next. To get greatest benefit from each module, it is recommended that you complete the activities in sequence (that is, as the materials are presented).

Each level (essential, practitioner and leader) of each module should take a participant between two and three hours to complete. Participants need to be able to access the internet (to research national policy and strategy documents) and to have access to hard copies of strategic and policy documents, such as organisational policies and documentation.

Although the modules have been designed as generic tools and apply to all staff working in the mental health and addiction sector, participants are encouraged to think about how the learning from the modules applies to them personally and their specific work context.

13 The learning modules can also be used in the following settings:

 as individual exercises by participants in their own time

 collectively in facilitated groups within services

 in collaborative groups across services

 by occupational groups

 in other creative ways that best fit the unique context of different working environments.

The modules are not designed to be delivered as a group training session. However, a collective or team approach to completing some of the activities is recommended, which will require preparation before individuals come together as a group. If conducted in a group setting, the session should ideally be led by an experienced trainer or facilitator. Including and involving service users, Māori and Pacific people, where relevant, as partners in facilitating these sessions is also strongly recommended.

Adults learn best when the learning has direct and practical application to their work environment. Whichever methods are used by services to complete the modules, participants are required to apply the activities to their work environments.

Reflecting on learning and getting feedback The activities within the modules are designed to encourage participants to continually reflect on their current work practices and then determine actions to improve their performance with reference to each of the seven Real Skills.

While the modules do not include a formal assessment, all participants completing the modules should have the opportunity to discuss their responses and reflections with a supervisor or line-manager.

These discussions should centre on:

 the learning that the participants have gained from completing the modules

 the changes that they will implement in their work as a result of their learning.

How changes occur will be determined by individual organisations, and may include:

 using available supervision procedures, such as:

 line-manager supervision to review progress

 professional practice or clinical supervision

 team, group or peer supervision to discuss and determine key learning for each of the modules or individual performance indicators

14 Getting started Learning module – electronic version  cultural supervision

 including achievement of learning goals in performance reviews

 seeking feedback from service users and their families/whānau.

Getting it finished – Individual Professional Development Plan At the end of every module is:

 a Learning Review Tool specific to each level of the Real Skills

 a template for creating an Individual Professional Development Plan specific to that level of the Real Skill.

These tools help participants reflect on their areas of strength and the gaps that they can address.

Getting going again – Summary Action Plan On completion of all of the modules, participants are encouraged to put together all of the individual professional development plans they have formulated for each Real Skill, prioritise these into areas for future development, and compose a Summary Action Plan. The template for the Summary Action Plan is provided on page 42 – it is not included in the learning modules themselves.

The Summary Action Plan can be used by staff to help identify their ongoing development needs, which can in turn be linked to discussions with their managers and/or professional advisors in performance development and appraisal processes.

The Summary Action Plan can also be used to inform discussion about ongoing development and career planning, as well as to identify how the organisation can support professional and personal development.

15 Overview - How to use the learning modules

Read the Let’s get real Overview

Read Getting Started

Identify your personal learning and development needs in relation to all of the Real Skills by completing the Let’s get real Self-assessment Tool (page 25)

Establish that your organisation’s approach to completing the learning modules supports your requirements

Complete learning modules

Upon completing each module, complete the learning review tool, review results, and develop an individual professional development plan for the particular level of the module

Set goals for further learning and professional development

Retain your individual professional development plan (for each of the modules) and aggregate these into the Summary Action Plan (page 42) of this Getting Started module)

16 Getting started Learning module – electronic version Glossary The following descriptions have been taken from a variety of sources, including material prepared by Klub Ngaru and from the Ministry of Health’s Let’s get real framework. The descriptions are not meant to be definitive. Further discussion, enquiry and reading about the terms is strongly recommended.

Acculturation The learning of the ideas, values, conventions and behaviour that characterise a social group.

Addiction In the context of Real Skills, addiction relates only to alcohol and other drug use and/or problem gambling. It refers to a maladaptive pattern of substance use. Substance use disorders and pathological gambling disorder are characterised by dyscontrol, tolerance, withdrawal and salience, and they are considered chronic relapsing conditions. AOD Alcohol and other drugs.

Assessment A service provider’s systematic and ongoing collection of information about a service user, used to form an understanding of the service user’s needs. A clinical assessment forms the basis for developing a diagnosis and an individualised treatment and support plan with the service user, their family or whānau, and significant others.

Aroha Love; compassion; empathy. Atua God or gods.

Blueprint 1998 Mental Health Commission document Blueprint for Mental Health Services in New Zealand: How things need to be (Mental Health Commission, 1998).

Children and young People aged 0 to 19 years, inclusive. people

Community The people living in a particular area, or people who are considered as a unit because of a common nationality, culture, occupation, belief, interest or experience. Competency The attitudes, skills, knowledge and behaviours of health practitioners and support workers that enable them to perform particular functions.

Consumer A person who experiences or has experienced mental illness and who uses or has used mental health services. Other terms often used are service user and tangata whaiora.

Co-existing problems Incorporates mental health and addiction (i.e. alcohol and other drug and problem gambling).

Culture The shared attitudes, beliefs, values, experiences and/or practices of groups in society.

Dual competencies A term developed by Te Rau Matatini to mean the best clinical practice underpinned by indigenous concepts and values of healing.

17 Dual competency is a key strategy for developing the Māori mental health and addiction workforce.

Dual diagnosis Co-existing mental health and addiction disorders (co-existing is the preferred term).

DHB District health board. District health boards are established under the New Zealand Public Health and Disability Act 2000.

Evidence-based An approach to decision-making in which the clinician uses the best practice evidence available, in consultation with the service user, to decide upon the course of action that suits the service user best.

Family Relatives, whānau, partners, values, experiences and/or practices of groups in society. Hapū Sub-tribe.

Hauora Health and well-being. In traditional kōrero, hauora was the breath or spirit of life.

Health outcome A change in an individual’s or group’s health, which is attributable to one or more interventions.

Hinengaro This is often viewed as the psychological or mental dimension of the person. In traditional kōrero, hinengaro is the deep mind or consciousness.

Hui A gathering or meeting.

Intervention Action taken to improve a situation.

Iwi Tribal group.

Kāhui tautoko Support group.

Kaimahi Worker, staff or employee.

Kaimoana Seafood.

Kaitiaki Guardian.

Karakia Prayer, incantation or blessing, including whakawātea (prayer of release), whakatau (beginning prayer), whakangāwari (calming prayer), whakamurua (prayer of forgiveness) and whakamutunga (concluding prayer).

Kaumātua Elder, or older person. Often older males are called kaumātua and older women are called kuia.

Kaupapa Māori Māori purpose or Māori principle.

18 Getting started Learning module – electronic version Kawa Protocol and etiquette.

Kīwaha Māori colloquial saying.

Kōrero Speech, speaking or narrative.

Mana Often defined as status and standing, mana is the spiritual power that may be accorded to a person or group through ancestral descent, possession of certain gifts or achievements. Personal mana can be enhanced through the collective opinion of the people.

Mana motuhake Autonomy.

Mana whenua Authority of the land.

Manaaki This is the expression of love and hospitality towards others and the act of taking care of them.

Marae Principle place of gathering, or the context in which Māori custom is practised.

Mental health A state of well-being in which the individual recognises his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community.

Mental health Actions taken for the purpose of fostering, protecting and improving promotion mental health. These can arrange from community level interventions that cultivate skills, attitudes and behaviours conducive to mental health. Mental health promotion applies to the whole population in the context of everyday life – it is not just for those who experience mental illness. Mental health and The organisations and individuals involved in mental health and addiction sector addiction, to any degree and at any level.

Mental illness Any clinically significant behavioural or psychological syndrome characterised by distressing symptoms or significant impairment affecting a person’s ability to function.

Moana Refers to the sea and lakes.

Ngahere Refers to the bush and forest.

NGO Non-government organisation.

Older person Person aged 65 years or older.

PDRP Professional development recognition programmes.

Peer support Occurs when people provide emotional or practical help to each other. It can take a number of forms, such as mentors, listening, or counselling. Peer support is also used to refer to initiatives where colleagues, members of organizations and others meet as equals to

19 give each other support on a reciprocal basis. ‘Peer’, in this case, is taken to imply that each person has no more expertise as a supporter than the other and the relationship is one of equality.

Pōwhiri The ritual of encounter and engagement.

Primary health care Essential health care based on practical, scientifically sound, culturally appropriate and socially acceptable methods. Primary health care is universally accessible to people in their communities, involves community participation, is integral to and a central function of the country’s health system, and is the first level of contact with the health system.

Rāhui The practice of prohibition.

Recovery Living well in the presence or absence of mental illness or addiction and the losses that can be associated with it.

Resilience Concepts of resilience (literally, the ability to ‘bounce back’) have been developed through years of research examining how some individuals do well in many areas of their lives despite severe challenges and/or deprivations.

Reo Language or Māori language. Traditionally, language to Māori was the lifeblood of the culture, considered as a gift from the gods.

Rongoā Traditional Māori medicine and health practice.

RPL Recognition of prior learning.

Service user A person who uses mental health services.

Support worker In mental health services, a non-clinician who works with people with mental illness.

Tangata whaiora Person seeking wellness, or a mental health service user.

Tangata whenua People belonging to the land.

Tangihanga Funeral.

Tapu Often defined as restricted or sacred, tapu is a state that provides the link between the mana of the gods and the spiritual powers of all things derived from the gods. All things have an inherent tapu. In modern times, tapu has been reframed in a protective sense to encompass secular things (for example, confidentiality, trespass). Restrictions and prohibitions protect tapu (well-being, dignity and sacredness) from violation.

Tautoko Support.

Team This word is used in a broad sense throughout Lets get real. ‘Team’ can mean the formal team of which you are a member in your own

20 Getting started Learning module – electronic version service or organisation. ‘Team’ can also mean the group of people from services and organisations with whom you work to support service users recovery which could include service users themselves, their families/whānau and significant others. Te Kōkiri Te Kōkiri: The mental health and addiction action plan 2006–2015 (Ministry of Health, 2006) sets the next steps for progressing the 10 leading challenges in Te Tāhuhu: Improving mental health.

Te Tāhuhu Te Tāhuhu: Improving mental health 2005-2015: The second mental health and addiction plan (Ministry of Health, 2005) sets the high- level strategic framework to guide the existing and future action that the government expects to be the focus of mental health and addiction policy from 2005 to 2015. Its 10 leading challenges focus on improving whānau ora, recovery and wellness for people, families, whānau and communities that are affected by mental illness and addiction.

Te reo Māori The Māori language.

Tikanga Code of conduct, method, plan or custom. The right way of doing things.

Tinana Physical dimension, or the body.

Tino rangatiratanga Self-determination.

Tohunga Healer or expert.

Trauma-informed care Care that is grounded in and directed by a through understanding of the neurological, biological, psychological and social effects of trauma on people, as well as an understanding of the prevalence of these experiences in those who receive mental health services. Trauma-informed care also recognises that mental health and addiction treatment can itself be traumatic for service users (not just those with trauma histories) and that practitioners may be affected when working with very distressed clients. The service seeks to minimise trauma for all service users and practitioners. Tuakiri tangata Persona, personality and identity. Tuakiri tangata embraces aspects of mauri, hinengaro, auahatanga, whatumanawa, tinana, wairua, pūmanawa, mana, tapu and noa.

Wairua Spiritual dimension. For many, the spiritual or inner force affects how people feel and how they respond.

Waiata Sing; chat; song. Wānanga Learning or discussion

Wellness, working For some people with addiction, working towards wellness is the towards preferred phrase to describe alcohol and other drugs models that empower service users, and encourage positive attitudes in order to increase motivation for behaviour change.

Whakamana Empower or enable.

21 Whakanoa To cleanse, purify or settle.

Whakatauki Māori proverb.

Whakawhanaunga To build relationships.

Whānau Often defined as family and birth, whānau has been proposed as a key component of Māori identity and the healing process. Whānau describes groups interconnected by kinship ties. In modern times, groups use whānau to encompass their common purpose, and they have adopted whānau values. Whānau is also used to refer to the family and extended family or group of people who are important to the service user.

Whānau ora Family health. Healthy Māori families that achieve maximum strength and well-being, both individually and collectively.

Whanaungatanga Recognises relationships. Whanaungatanga is kinship in its broadest sense and concerns itself with the process of establishing and maintaining links and relationships.

Whakawhanaungatanga Process of getting to know each other’ establishing whānau relationships; relating well to others. Whenua Land or placenta.

22 Getting started Learning module – electronic version References Alcohol and Drug Treatment Advisory Workforce Development Advisory Group. (2001). Practitioner Competencies for Alcohol and Drug Workers in Aotearoa – New Zealand. ALAC Occasional Publication: Number 13. Wellington: ALAC.

Le Va. (2009). Real Skills plus Seitapu: Working with Pacific people. Auckland: Te Pou.

Ministry of Health. (2005). Tauawhitia te Wero – Embracing the Challenge: National mental health and addiction workforce development plan 2006-2009. Wellington: Ministry of Health.

Ministry of Health. (2008). Let’s get real: Real skills for people working in mental health and addiction. Wellington: Ministry of Health.

Te Ao Maramatanga New Zealand College of Mental Health Nursing. (2004). Standards of practice for mental health nursing in New Zealand (2nd Edition). Wellington: Te Ao Maramatanga (NZCMHN) Inc.

The Werry Centre. (2008). Real Skills Plus CAMHS: A competency framework for the infant, child and youth mental health and alcohol and other drug workforce. Auckland: The Werry Centre for Child and Adolescent Mental Health Workforce Development.

23 Getting Started Self-assessment Tool and Summary Action Plan Let’s get real Self-assessment Tool This Let’s get real Self-assessment Tool should be completed before starting the learning modules.

Name: Date of completion: Place of employment: Current work role: Level to be completed: Essential (Check as appropriate) Practitioner Leader Rating: Competent (C) Needs development (ND)

WORKING WITH SERVICE USERS

Essential level Practitioner level Leader level

Performance Rating Performance Rating Performance Rating indicator (C or indicator (C or indicator (C or ND) ND) ND)

Establishes a Develops effective Develops and connection and therapeutic supports a service rapport with service relationships with that is: users as part of a service users and  responsive to thorough works flexibly with the needs of assessment process them. service users and recovery planning.  reflective of best practice  recovery focused  culturally safe  trauma informed  effective at communicatin g.

Acknowledges that tāngata whaiora and whānau may choose to communicate in te reo Māori.

Uses age Applies understanding As above. appropriate and of the different

25 WORKING WITH SERVICE USERS

culturally stages of life appropriate development. protocols and processes to work with service users.

Acknowledges the Recognises the personal, physical, varying social, social, cultural and cultural, spiritual strengths psychological, and needs of each spiritual and person, including biological the service users’ contributors to interpretation of mental illness and their own addiction. experiences.

Acknowledges the Connects the tāngata importance of whaiora and identity for Māori family/whānau with and its significance cultural support and to the recovery expertise when process and the appropriate, for achievement of example, te reo, whānau ora. karakia, kaumātua, kaupapa Māori services and practitioners.

In day-to-day work, In day-to-day work, As above. applies basic applies in-depth understanding of: knowledge or understanding of:  definitions and categories of  definitions and mental illnesses categories of and addiction mental illness and addiction  a range of therapies and  assessment and interventions intervention processes,  the effects of including but not psychiatric limited to medications on consideration of people and risk interactions of these drugs  psychiatric

26 Getting started Learning module – electronic version WORKING WITH SERVICE USERS

with others pharmacology and/or and its effects alternative  the range of remedies. evidence- informed therapies and interventions available  the impact of physical health on mental health.

Understands and Practises the As above. works to mitigate principles of trauma- the physical, social informed care. and emotional effects of trauma and abuse on people’s lives.

Works in partnership Actively works in As above. with the service partnership with user to develop a service users to plan plan for recovery for their recovery, that is service user including monitoring driven, identifies and review. strengths and needs and is solution focused.

Effectively and As above. inclusively ensures service users understand their plan for recovery and facilitates access to any other relevant information.

Includes service users in all decisions about their service and treatment, and seeks feedback.

27 WORKING WITH SERVICE USERS

Comment

AGREED LEVEL

28 Getting started Learning module – electronic version WORKING WITH MĀORI

Performance indicator Rating Performance Rating Performance Rating (C or indicator (C or indicator (C or ND) ND) ND)

Te reo Māori Understands that Promotes and provides speakers of te reo for resources that: Recognises that Māori may use tāngata whaiora may  ensure easy access metaphors to describe consider waiata, to te reo Māori their situation. karakia and te reo speakers and to Māori as contributors information to their recovery. written in both English and Māori  support staff and the service to integrate te reo Māori into their service delivery.

Uses available resources such as te reo Māori speakers and information written in both English and Māori, when appropriate.

Understands that As above. tāngata whaiora and/or their whānau may wish to nominate a person to speak on their behalf and supports the involvement of nominated speakers.

Is familiar with local Develops and Māori groups (e.g. maintains explicit mana whenua), and relationships and their roles, partnerships with local responsibilities and Māori. relationships with each other as guardians of Māori cultural knowledge and te reo Māori.

Demonstrates respect Utilises local Māori to for te reo Māori and verify the relevance tikanga. and common practice of te reo Māori and tikanga in the health

29 WORKING WITH MĀORI

setting.

Demonstrates Strategies are in place effective to ensure Māori know communication and how to access Māori- engagement that responsive services promote early service and/or have access to access for Māori. kaumātua, kaimahi Māori and cultural interventions (e.g. assessment, therapy).

Whakawhānaunga Promotes an environment that: Recognises and understands the  is conducive to different roles and effective service responsibilities within delivery processes whānau and the nature for whānau and of whānau significant others relationships with (e.g. a time and tāngata whaiora. venue for comprehensive assessment or Is aware of Māori whānau hui) methods of interaction that support  supports relationships, whakawhānaunga particularly with processes. whānau, such as asking No hea koe? (where do you come from?) and establishing tātai (links).

Understands that some tāngata whaiora may be disconnected from their whānau.

Hauora Māori Is able to incorporate Promotes and provides Māori models or for processes and Develops an perspectives of hauora practices that meet understanding of Māori in service delivery cultural requirements, models or perspectives when appropriate. such as: of hauora in service delivery.  recognition of Māori models of practice and Acknowledges that Is familiar with local healing Māori may consider resources and using traditional promotes access to

30 Getting started Learning module – electronic version WORKING WITH MĀORI

Performance indicator Rating Performance Rating Performance Rating (C or indicator (C or indicator (C or ND) ND) ND) healing processes and them to support  resource practices that support recovery choices and allocation and health and well-being. whānau ora. prioritisation to reduce Māori health inequalities Utilises interventions, with tāngata whaiora  activities that and/or their whānau, measure the that optimise cultural physical, social, effectiveness of cultural, spiritual and performance and mental aspects of service delivery health  outcomes information that indicates Māori and whānau satisfaction.

Understands that As above. tāngata whaiora and/or their whānau may utilise whenua, moana and ngahere in the support of whānau ora.

Demonstrates an Recognises and As above. understanding of the supports the principles of tino resourcefulness of rangatiratanga (self- tāngata whaiora and determination) and whānau. mana motuhake (autonomy) and actively protects service user rights.

Wairua Understands concepts Promotes and provides and perceptions of for resources that Acknowledges differing Māori spirituality and support: spiritual practices and the role and function understands that these  Māori-responsive of Māori spiritual unique perspectives interventions and practices in the contribute to the processes to meet support of tāngata support of tāngata the wairua needs whaiora and whānau whaiora and whānau of tāngata ora. ora. whaiora, whānau and staff  staff access to kaumātua and

31 WORKING WITH MĀORI

kaimahi Māori that support whānau ora.

Tuakiri tāngata Is aware of available Promotes and kaupapa Māori supports: Acknowledges the interventions, and importance of identity  interventions and supports tāngata as Māori to the services to whaiora and their recovery of tāngata emphasise cultural whānau’s choice to whaiora and the linkages and engage in Māori- process of whānau ora. whānaungatanga responsive services in practice and activities that optimise cultural  staff access to linkages and whānau wānanga and connectedness. training that enhance knowledge and understanding of tuakiri tangata and its importance to the therapeutic relationship.

Demonstrates knowledge and application of cultural safety and cultural competence in terms of working with Māori.

Manaaki Employs manaaki in Promotes and the hosting of, supports: Acknowledges the working with and significance of manaaki  awareness of support processes for to the processes of manaaki and its tāngata whaiora and engagement and significance in the whānau, including whakamana, which recovery community agencies contribute to whānau processes of and organisations.1 ora. tāngata whaiora and whānau

1 Such as partnerships with service users and whānau in developing care plans, and hosting service users and whānau with respect and dignity. 32 Getting started Learning module – electronic version WORKING WITH MĀORI

 manaaki of the community being engaged with  staff learning and professional development of manaaki in practice.

Comment

AGREED LEVEL:

33 WORKING WITH FAMILIES/ WHĀNAU

Recognises that a Develops robust service user’s service systems that: family/whānau may  ensure the extend beyond participation and traditional family support of concepts. family/whānau

Recognises that Māori  recognise and have processes that respond to the promote and support strengths and the establishment of needs of relationships through families/whānau kinship, genealogy,  ensure specific history and location. provisions to identify and Works in partnership develop with the service user to relationships with identify and include Māori. family/whānau, significant people and other networks to support recovery.

Fosters relationships with whānau, hapū, iwi and communities to support service users’ health and well- being.

Establishes connection Is able to explain to and rapport with family/whānau the family/whānau as part options for of a thorough family/whānau assessment process and interventions. recovery planning.

Works with Facilitates family/whānau in such family/whānau: a way that they feel  access to relevant heard, informed and information and supported. resources about all aspects of mental health and Shares relevant addiction information with  input into and family/whānau and inclusion in significant people service users’ while respecting the

34 Getting started Learning module – electronic version WORKING WITH FAMILIES/ WHĀNAU

Performance indicator Rating Performance Rating Performance Rating (C or indicator (C or indicator (C or ND) ND) ND) service user’s right to recovery plans privacy.  participation in effective family Works to understand meetings. family/whānau perspectives, including the dynamics within families/whānau.

Identifies those who can provide support within the community, including hapū and iwi, and connects family/whānau with them.

Comment

AGREED LEVEL

35 WORKING WITHIN COMMUNITIES

Performance indicator Rating Performance Rating Performance indicator Rating (C or indicator (C or (C or ND) ND) ND)

Understands how the Demonstrates Networks and mental health and knowledge of the collaborates with addiction system works impact of current health and social and where their service mental health and service providers and fits within it. addiction policies at community agencies to the community level. ensure services are meeting the needs of service users.

Identifies a service user’s community or communities of interest and supports the service user to develop or maintain connections.

Recognises that tāngata whaiora are supported within a wider network of structures such as hapū, iwi and Māori communities.

Demonstrates a Forms effective Actively supports and comprehensive working relationships involves communities in knowledge of with key support addressing mental community services, agencies in the health and addiction resources and community, including problems. organisations and hapū and iwi. actively supports service users to use them.

Understands and uses mental health promotion principles.

Comment

AGREED LEVEL

36 Getting started Learning module – electronic version CHALLENGING STIGMA AND DISCRIMINATION Essential level Practitioner level Leader level

Understands the Articulates positive Ensures that oneself, impact of stigma and aspects of working in the organisation and discrimination on mental health and staff model and service users, families addiction treatment demonstrate non- and whānau, services services to external discriminatory and communities. groups. practices and behaviour in all Understands and aspects of work, acknowledges the internally and impact of language in externally. relation to stigma and discrimination, and role models using language that is non- judgemental and non- discriminatory.

Recognises and Uses strategies to Educates and supports challenges stigma and reduce stigma and services and discrimination. discrimination, communities to including promoting minimise stigma and and facilitating social discrimination. inclusion. Comment

AGREED LEVEL

37 LAW, POLICY AND PRACTICE

Understands and Practice is guided by Contributes positively adheres to legislation, an understanding of to legislative change regulations, standards, the intent and and policy codes and policies implications of development that relevant to the role. legislation and policy. impact on mental health and addiction practice.

Recognises and When working with Creates organisational respects the rights of service users, systems and a culture service users and their demonstrates ethical that reflect respect families and whānau decision making. for the rights of under the Code of service users and their Health and Disability families/whānau. Services Consumers’ Rights.

Understands health policy, legislation and standards of practice that recognise the significance of te reo Māori, Māori concepts and models of practice that achieve whānau ora.

Supports and assists service users to exercise their rights. Comment

AGREED LEVEL

38 Getting started Learning module – electronic version PROFESSIONAL AND PERSONAL DEVELOPMENT

Works effectively in a Actively facilitates Leads and nurtures a team by understanding collaborative working team environment team roles and with other team that: respecting and members.  articulates a accommodating clear, service different working user-focused styles. vision for the service  provides role clarity (both individual and team)  encourages synergy within multidisciplinary groups  encourages cross- sector collaboration.

Communicates Understands and can effectively (orally, in manage complex and writing, when multifaceted listening, by other non- communication verbal means) with a processes. wide range of people.

Pronounces Māori names and words correctly, and asks when unsure.

Understands the nature Is familiar with Ensures that processes and benefits of current research and and activities are in research and evaluation in the place to guide evaluation. mental health and research and addiction treatment evaluation that foster sectors. innovation and effective outcomes- focused service delivery.

Gathers and uses Collects good quality Uses information to information to inform information and uses assist planning and decisions relevant to it in decision making, quality improvement, their role. with a focus on with a focus on better improving systemic outcomes for service and service user users.

39 PROFESSIONAL AND PERSONAL DEVELOPMENT

outcomes.

Engages with Participates in Creates a healthy colleagues to give and professional and workplace and culture receive constructive personal development that encourages and feedback. of oneself and supports the colleagues through professional feedback, supervision, development of appraisal and individuals and teams reflective practice. as well as personal development.

Understands and practises self-care.

Reflects on own Supports colleagues to Coaches, supports, practice to identify achieve goals and provides feedback and strengths and needs. meet challenges. challenges people so that they can reach Understands and their full potential. engages in supervision.

Seeks and takes up Keeps up to date with learning opportunities. changes in practice and participates in lifelong learning.

Comment

AGREED LEVEL

40 Getting started Learning module – electronic version In the following table, staff members rank each Real Skill from their strongest, to second strongest and so on, and provide reasons for these rankings.

My strongest Real Skill is:

Reason:

My second strongest Real Skill My third strongest Real Skill is: is:

Reason: Reason:

My fourth strongest Real Skill is: My fifth strongest Real Skill is: My sixth strongest Real Skill is: My seventh strongest Real Skill is:

Reason: Reason: Reason: Reason:

41 Summary Action Plan On completion of all of the learning modules, please aggregate all of your Individual Professional Development Plans and complete this Summary Action Plan.

What new knowledge, skills or understanding have I gained from studying these modules?

What gaps in my knowledge skills or understanding have been highlighted to me as a result?

What are three things I can put into practice or improve on as a result?

My Action Plan: how will I do this?

Two things I have identified that I can take personal responsibility for putting into practice or improving are:

Action Timeframe Resources Challenges

What will I do? When will I do this? What or who will I What barriers or need? resistance will I face?

42 Getting started Learning module – electronic version One thing I can advocate for and work towards putting into practice or improving is:

Three things I can take personal responsibility to work on over the next six months/year (delete the timeframe you are not using):

43 44 Getting started Learning module – electronic version