New Directions in Living Well
2002
by Steven Brown
In the summer of 2001, Lillian Gonzales Brown and I traveled to Montana
to collaborate with the folks at the Rural Institute on Disabilities at
the University of Montana in Missoula. I had never been to Montana, and
Lil had never been to that part of the state. The trip had been discussed
for several years before it became reality. We got a chance to see Missoula
and some of the surrounding area, to know old friends better and to make
new ones.
We spent lots of time discussing the concept of disability culture with
a young researcher with a disability and some time dissecting the idea
of disability with the Rural Institute staff. We also had a chance to
do some sightseeing of Institute projects. Perhaps the most impressive
was a wellness program that included a facility called New Directions.
On its Web site, New Directions describes itself in this way: "In
its starkest reality, [New Directions] is a gym with fitness equipment
and rooms for conducting workshops. In its fullest reality, it is a community."
People eligible for using the gym include those with physical disabilities
who can benefit from using the equipment. The New Directions building
contains a full spectrum of exercise and weight equipment for people with
disabilities.
On our visit there we bumped into Mike Mayer, executive director of Missoula's
CIL, Summit, who was working out on the equipment. When I asked him later
if Summit had any kind of formal agreement with New Directions, he responded
no, but said that Summit and the Rural Institute have collaborated on
many projects over the years and that helped lead to the development of
New Directions. In fact, he went so far as to say, "They have always
been very focused on the IL model and have involved consumers in the design,
develop-ment and implementation of their programs. I think other research
centers could learn a lot from them in that respect."
At New Directions there is a typical array of medically-oriented staff
including a physical therapist/ exercise physiologist, personal trainer,
registered dietician and clinical psychologists. The physical therapist
meets with participants before they begin in the fitness center, helping
them decide on an appropriate therapeutic exercise program. The exercise
and weight equipment is designed specifically for people of all physical
abilities, and a personal trainer is always available to assist participants.
The dietician teaches nutrition, with participants grocery shopping,
taste testing and preparing food together. One-on-one therapy is available
on a short-term basis. Clinical psychologists and laypeople also teach
a series of workshops described in detail below. Just like any other community,
New Directions takes advantage of skills that participants can offer,
such as teaching an art class or tutoring others on the use of the Internet.
New Directions itself, while impressive partly because it is so visible
with its gym, is only one part of an entire program called Living Well
with a Disability. This program was developed by University of Montana,
Rural Institute on Disabilities (RTC Rural) researchers. After ten years
of research into lessening the significance and occurrence of secondary
conditions, the RTC Rural came to believe in the necessity of a health
promotion or wellness program for adults with physical disabilities. Secondary
conditions result when a person with a disability manifests a complication
linked to their impairment. Secondary conditions might be psychological
or physical limitations, including conditions such as depression or pressure
sores.
Initial research reveals that those people who finish the eight-week
Living Well workshop experience a 37% reduction in limitation due to secondary
conditions and report a significant lessening of depression levels. This
beginning research has been repeated with similar results. Participating
in the Living Well program has also been related to a 10% decline in costs
for medical services and has a shown a statistically significant lessening
in the occurrence and/or significance of secondary conditions and depression.
What Does the Living Well with a Disability Program do?
The curriculum begins a process for setting and clarifying goals, as
well as teaching skills for generating, implementing and monitoring solutions.
Goal setting and problem solving become the framework for developing healthy
lifestyles and making the necessary connection between health and function.
Living Well with a Disability aims to keep quality of life issues at the
forefront by teaching skills for the following:
- Preventing health problems
- Keeping health problems under control
- Physical conditioning or fitness
- Developing and maintaining healthy relationships
- Beating the blues
- Information seeking and systems advocacy
- Goal setting
- Making healthy lifestyle changes
These skills are taught in the following workshops:
- Living Well is an eight-week, sixteen-hour workshop intended to assist
participants in building a healthier lifestyle and increasing physical
activity.
Group leaders may be laypeople, peers or professionals trained in teaching
Living Well. More people practice healthy living when our lives have meaning,
so the Living Well workshop begins with why anyone would want to be well.
Tools for achieving goals, such as problem-solving, communication techniques
and information and referral are also part of the instruction. This is
broken down into a ten chapter workbook, with chapter headings that include:
- "Setting Goals: Where Do I Want to Go and How Do I Get There?"
- "Solving Problems"
- "Healthy Communication"
- "Eating Well to Live Well"
- "Systems Advocacy."
Pain Management is a five-week workshop focusing
on skills and strategies for living well with pain.
Depression workshops teach about resources
that may be helpful in living with depression.
Nutrition is a five-week, ten-hour, workshop
that focuses on eating healthy, trying out new foods and recipes, reading
labels and shopping for groceries that match a healthier lifestyle.
Over 300 people have participated in the Living Well workshop alone.
Their comments, quoted on the New Directions brochure, demonstrate that
Living Well has changed some lives.
- "The fellowship at New Directions was the most important thing
to me. The exercise was hard, but I feel so much better when I do it.
I am very grateful just to have been in the program."
- "Coming here has been like coming home I can now walk with my
cane and have a lot more confidence in my physical abilities."
- "After participating in New Directions, I now know that I can
solve problems. I am not so overwhelmed when life just happens."
- Living Well staff also train centers for independent living and other
organizations on how to provide a program similar to New Directions
or how to model a program on New Directions. They now offer three types
of training: Web-based training, on-site training and summer/winter
institutes.
Others interested in starting similar programs can obtain information
from the following Web sites:
Web site for RTC: Rural
http://ruralinstitute.umt.edu/rtcrural
Web site for Living Well www.Livingwellweb.com
Web site for
New Directions: www.livingwellweb.com/lwpages/lwpage7.htm
or contact New Directions and Health Projects Director Craig
Ravesloot at raves@selway.umt.edu.
The Living Well staff believe that their program is replicable in other
places and that funds might be available from many local and regional
foundations. When Living Well is provided by credentialed providers (e.g.
licensed counselors), the program may be a reimbursable service for a
variety of third party payers, including Medicaid, Medicare and Vocational
Rehabilitation. The final word comes once again from a program participant,
as quoted on the Living Well Web site:
"Living Well is indeed a remarkable program...when you combine
quality leaders with the input of other disabled group members, an
improvement in lifestyle is inevitable."
Contact Information
RTC: Rural The University
of Montana Rural Institute: A Center of Excellence for
Developmental Disabilities Education, Research and Services
52 Corbin Hall
Missoula, MT 59812-7056;
(888) 268-2743 or
(406) 243-5467 V/TT or
(406) 243-2349 fax
EMAIL: gargoyle@selway.umt.edu
http://ruralinstitute.umt.edu/rtcrural
Steven Brown
Institute on Disability Culture
Center on Disability Studies
University of Hawai'i
1776 University Ave., UA4-6
Honolulu, HI 96822
SBrown8912@aol.com
http://hometown.aol.com/sbrown8912/
About the Author
Steven E. Brown is currently a Resident Scholar
at the Center on Disability Studies, University of Hawaii at Manoa. Brown,
founder, Institute on Disability Culture (IDC), earned a doctorate in
history from the University of Oklahoma. He directed an independent living
center in Oklahoma, organized numerous community coalitions, and served
as training director at the World Institute on Disability Research and
Training Center on Public Policy in Independent Living. He founded the
not-for-profit Institute on Disability Culture with his wife, Lillian
Gonzales Brown, in 1994. Since then he has become an internationally sought
speaker, trainer, and writer.
Brown's publications include dozens of articles and the books Independent
Living: Theory and Practice, which has been translated into several
languages; Investigating a Culture of Disability: Final
Report, the result of a prestigious Switzer Fellowship from the
National Institute on Disability Rehabilitation and Research of the Department
of Education, the first funding of its type for research into the field
of Disability Culture; A Celebration of Diversity:
an Annotated Bibliography about Disability Culture, Second Edition;
and Celebrating Passion, Relentlessness, and Vision:
the Manifesto Editorials. An award-winning poet, Brown has published
five books of poetry, Dragonflies in Paradise: An Activist's
Partial Poetic Autobiography; The Goddess Approaches
Fifty: Poems; Love into Forever: a Tribute to
Martyrs, Heroes, Friends, and Colleagues; Pain,
Plain--and Fancy Rappings: Poetry from the Disability Culture;
and Voyages: Life Journeys.
In recent years, Brown has conducted writing workshops and residencies
with groups of all ages, especially with middle and elementary school
students. He has written a children's biography about disability rights
pioneer Ed Roberts, distributed a monthly online newsletter and continued
to publish articles about disability culture and disability rights in
a variety of publications. He has conducted trainings throughout the United
States and Europe on a variety of disability related subjects.
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