Researchers adapt successful strengths-based mental health recovery model for adolescents

LAWRENCE — Researchers at the University of Kansas have adapted a promising adult case management practice for use with adolescents. Early results show the Strengths Model, a recovery-oriented case management practice that focuses on individual strengths, is not only having a positive effect on young people, it is helping the case managers who implement it as well.

The Strengths Model was developed by the Center for Mental Health Research and Innovation in KU’s School of Social Welfare in the 1980s and has become widely used in the field of adult mental health services. The model, which empowers individuals to focus on their strengths and set goals for recovery instead of fixating on a problem or diagnosis, had not been utilized for young people. In 2013, the School of Social Welfare’s Center for Children and Families received funding from the Kansas Department of Aging and Disability Services to adapt the model for use with adolescents with mental illness and implement it as part of a pilot study.

Amy Mendenhall, associate professor of social welfare and director of the Center for Children and Families, and Whitney Grube, project coordinator and doctoral student, began the adaptation process by working with case managers, adolescents and their families receiving services at the Johnson County Mental Health Center. Case managers helped steer the design of how the model would differ for adolescents by sharing how their processes work and how they could improve.

“This model was developed, trained, learned and implemented ‘on the ground’ on a cooperative basis with individuals in the community,” Mendenhall said. “Whitney has been working closely with case managers, service providers and families on a weekly basis to help put it in place.”

The researchers took baseline levels for youth at the center receiving services and then collected monthly outcomes to track progress. They measured school performance and attendance, socialization in school and other settings, family case manager contact and supported relationships. Initial results show the strengths model may have a clear positive effect for the youth as their social and academic performance levels especially trended upward.

Researchers said the adolescents who took part in the pilot study regularly reported satisfaction with the model as mental health treatment often does not focus on goals of interest to the young people. While the standard was to focus on a diagnosis or correcting a problem, youth in the Strengths Model were able to set their own goals, focus on their strengths and what they do well as part of recovery. Like the adult model, the newly implemented version for adolescents provides a recovery-oriented philosophy and tools to help people set meaningful life goals while drawing on personal and environmental strengths to achieve them.

“Ordinarily, the focus in mental health treatment is: ‘You have all of these bad things happening your life, or you are dealing with these symptoms, and we need to fix them,’” Mendenhall said. “The Strengths Model flips this and says, ‘What would make your life more fulfilling? What are the positive things you have going for you that will help you meet your goals?’ Then we let those things guide treatment.”

The young people are not the only ones who have responded positively to the Strengths Model. Case managers reported positive outcomes after implementing the model as well. Researchers measured their secondary traumatic stress, burnout, case satisfaction and compassion satisfaction. After six months of using the model, managers reported a decline in their burnout and stress levels while reporting increases in their compassion satisfaction.

“In social services there is a lot of turnover, and it’s largely related to burnout,” Mendenhall said. “Before we developed the model, we heard a lot of people say in the focus groups, ‘We’re not case managers, we’re crisis managers, always responding to emergencies.’ We thought if we were able to give them an actual model with tools for providing case management, then we would see benefits for the case workers as well. They would be less stressed and feel more successful in their work.”

The Strengths Model has also helped reduce stress and improve efficiency for case managers by providing a new format for staffing and meeting among colleagues. Managers have reported case meetings have changed from a time of venting frustrations to brainstorming ideas and providing support.

“The case managers have responded really well to the format, and they’ve reported the kids are excited about it, because it’s their own voice and they are setting their own goals,” Grube said.

Researchers have taken lessons from the first two years of the pilot project and used it to help the model evolve. They are now in the process of implementing it with a second case management team at Johnson County Mental Health Center and plan to add two more pilot locations in the next year. The hope is to follow a similar path to that of the adult Strengths Model. After its formation at KU it steadily was expanded as the standard approach across the state and has been implemented in other states and countries.

“The model is not just something locally unique that would only work in Kansas,” Mendenhall said. “We think it could have widespread success. We’ve also talked about how this model could be adapted for use in other youth systems like child welfare and delinquency.”