I would like to mention three with whom I particularly enjoyed working: Barbara Zeigler, PhD; Karen Walmsley, LCSW; and Denise Hagney, CNA.
When I served as Recovery Coordinator for the Sheridan VA Medical Center, I worked and became familiar with Megan Harvey, PhD, Recovery Coordinator at the Denver VA Medical Center. Dr. Harvey also supported the use of this workbook and helped make it available to veterans in that facility.
Susan Blaney, MSN, FPMHNP-BC, of the Cheyenne VA Medical Center, took a special interest in the workbook and successfully used it with veterans in her care.
I have had the good fortune to work under several other supervisors who supported my use of this workbook. David Schultz, MD, nominated me for a special award based on the program on which this workbook is based. Michal Wilson, MD, and Michael Hiller, MD, were also supportive of my program and made it possible for me to continue to offer a longer-term approach when resources were slim and other programs were discontinued.
I am grateful to Dr. Robert Hutzell for granting me permission to use his Life Purpose Scale in this workbook free of charge.
Well-known psychologist and recovery movement advocate Fred Frese, PhD, showed an interest in this workbook after I gave a presentation on it at the National Alliance on Mental Illness (NAMI) Wyoming Conference in May of 2014. Dr. Frese graciously provided the excellent Foreword to this workbook.
I want to thank Vanessa Hastings, my editor and collaborator on this version of the workbook. Working with her has been a pleasure, and she finds clearer ways to say things than I do. She also has demonstrated courage in sharing the details of her experience with mental illness in this workbook, which I believe greatly enhances its value to users. I would like to thank Nancy Schenck, Executive Editor of CRP, for her gentle and able assistance in polishing this workbook into its present form.
Consultant Jack McHugh’s knowledge of the publishing field has proven invaluable. Jack helped me deliver this volume to you, and I am grateful for that service.
I also want to thank my wife, Janet, who has always believed in my work and has helped me realize that this workbook is worthy of a larger audience.
Finally, I want to thank the hundreds of veterans I have had the privilege and pleasure of serving. They showed me quite clearly the power of self-acceptance to transform lives and promote recovery from mental illness. I learned as much from them as I taught them. My work with them has been the highlight of my career as a psychologist.
From Vanessa
I want to take the opportunity to thank Jackie and Ned Peterson, my aunt and uncle, for sheltering me from the storm of my early years and for always being there for me.
I also thank my husband, Adrian Chavez, and my dear friend Autum Goodspeed for sticking by my side through this difficult journey. I can’t adequately express my gratitude for their dedication, compassion, and patience.
Endless thanks to Heather McIntosh, licensed professional counselor and massage therapist. She saved my life, and she constantly reminds me to appreciate the puppy dogs and rainbows of life.
Finally, I deeply appreciate Dr. Ashear for developing this workbook and for asking me to help make it available to the public. Our association and collaboration have improved my life tremendously.
This workbook is in no way a substitute for medical and/or psychological treatment of mental disorders rendered by qualified healthcare professionals. As you use this book, please check with your healthcare providers to ensure the suggestions it offers are suited to your individual needs.
A Word about Evidence-Based Practice
Readers with clinical knowledge will no doubt recognize the incorporation into this workbook of some, if not all, of the evidence-based practices used to treat serious mental illness. The workbook utilizes Cognitive Behavioral Therapy (CBT), Acceptance and Commitment Therapy (ACT), and Illness Awareness and Management (IAM). In addition, as I facilitated groups over the years, I employed behavioral therapy principles, especially positive reinforcement and behavioral shaping. I would welcome a study that compares outcomes for groups using this workbook and outcomes for standard group therapy.
Orientation to Self-Acceptance
Not long ago, serious mental illnesses such as schizophrenia, bipolar disorder, and recurrent major depression, among others, often meant resignation to a life of institutionalization, a life devoid of any satisfaction or accomplishment. Fortunately, this prognosis of doom no longer applies.
With the rise of the recovery movement over the past thirty years, now more than ever before, hope exists for people diagnosed with serious mental illness to live full, meaningful lives. In fact, many people diagnosed with serious mental illness are leading normal lives that include career and family.
Improvements in the effectiveness of psychotropic medication contribute to this positive and optimistic outlook. In addition, newer forms of psychotherapy, including psychosocial rehabilitation approaches, such as social-skills training and illness awareness and management programs, have proven supportive of recovery. Most recently, cognitive enhancement therapies have been effective in improving ability to focus, organize, and problem-solve.
Even more important than these developments, in my opinion, is mental-health-services consumers’ expanding awareness of the possibility of personal change and growth despite the devastating impact of mental illness. Many peer-supported and self-help resources have become available to recovering individuals. The Wellness Recovery Action Plan (WRAP),1 developed by recovering consumer Mary Ellen Copeland, is but one example of such tools. The National Alliance on Mental Illness (NAMI) offers peer-led support groups for both consumers and family members of consumers to help recovering individuals help themselves.
With such a broad array of recovery resources, including self-help materials, what makes self-acceptance so important and why is this workbook necessary?
The Importance of Self-Acceptance
Loss of identity and self-esteem are among the most significant casualties people diagnosed with mental illness experience. For people diagnosed with schizophrenia, disorganized thinking and difficulty with accurately perceiving reality can interfere with maintaining a clear sense of self. Individuals diagnosed with bipolar disorder also struggle with identity: During the manic state of the disorder, the self may take on “grandiose” or superhuman proportions, but during the inevitable depressive state, feelings of guilt and inadequacy lead to feelings of worthlessness. For individuals diagnosed with recurring major depression or persistent depression, feelings of worthlessness may continually interfere with maintaining a realistic sense of self-esteem and a positive identity.
The nature of these illnesses can lead to a snowball effect in that diagnosed individuals commonly experience losses of employment and educational opportunity, as well as in relationships with family and friends and in other important areas of life. Because we often define ourselves by our vocational and social roles, when we lose these roles, we lose part of our identities, and this inevitably
