Teaching self-management

The Program in Occupational Therapy is committed to offering students a diverse range of education opportunities both in the classroom and out in the community. When clinical specialist Duana Russell-Thomas, OTD, OTR/L, became a certified trainer of the Chronic Disease Self-Management Program (CDSMP), the Program became able to offer that training to students. Originally developed by Stanford University researcher Kate Lorig, RN, DrPH, the CDSMP has evolved to become a widely used community resource for people living with chronic diseases.

Russell-Thomas was not familiar with the CDSMP when she took the training in 2010. “I was asked to participate as an OT [occupational therapy] interventionist in a research study on stroke rehabilitation and needed to be certified to teach the course to participants,” Russell-Thomas recalls. “I originally started running the program for that specific grant, but faculty started sending students from their laboratories to receive the training because it fit in with their research as well. The next step was to start offering the CDSMP to all students so they could receive the training and be certified to teach it themselves if they wanted to.”

The CDSMP is typically taught in communities as a six-week program with two-and-a-half-hour sessions each week. Because of students’ academic schedules, Russell-Thomas teaches the program over the course of a week with longer sessions each day. The training is designed to help people with arthritis, diabetes, heart disease, lung disease and other chronic conditions learn to take control of their health. It is something Russell-Thomas is all too familiar with, as she started experiencing chronic pain herself in her early 30s.

“At the time, I didn’t have a clear diagnosis. I just felt pain throughout my entire body. Because I was learning self-management, I started advocating for myself with providers,” Russell-Thomas shares. “Eventually, I was diagnosed with moderate levels of arthritis and sleep apnea with the symptoms of pre-diabetes. Self-management has enabled me to more effectively manage my chronic pain, and I want to empower others to do the same.”

In January, Russell-Thomas taught the course to more than 20 OT students who wanted to receive the training. Many of them were there because either they are living with a chronic condition or they have family members and loved ones who are. Lauren Lickwar, MSOT/S, MPH/S '19, took the training to help her self-manage her health and be a resource to others.

“I have a family and personal history with cancer, as well as a couple of mild health-related issues that I have to keep on top of. Everything we covered in the training was familiar to me, but the training delivered it in informative, concise and practical ways,” Lickwar says. “The course and book lay out attainable guidelines for maintaining good self-care habits for me or anyone who needs help in the covered areas. Even though we may hear it a hundred times in our lives, we need to be reminded that we each have the agency to take care of ourselves.”

Russell-Thomas sees many advantages of offering this training to students because of how it relates to the curriculum. “The concept of self-management is not new to our curricula or the profession. Core elements of the CDSMP are found in our coursework, research and practice. By receiving the formal training, students can strengthen the skills learned in our curricula and take that with them on fieldwork and into the community,” Russell-Thomas says. “Also, just being aware if the CDSMP is available in their local communities enables them to direct clients to this valuable resource free of charge.”

Caitlin Strobel, OTD/S ’18, has already used her CDSMP training to deliver the class to clients in the Program’s student-run stroke clinic. The clinic offers free services for under-resourced clients to help increase safety and independence for people following a stroke. The classes, which were also open to the public, gave Strobel the experience of leading group sessions in a structured environment.

“It was an extremely rewarding experience to deliver the CDSMP to the survivors of stroke, brain injury and cancer that we see in the clinic. What I enjoyed most was getting to know the clients on a deeper level through the sharing of difficult experiences with disease, injuries, relationships and daily life challenges,” Strobel shares. “I received a lot of positive feedback on the program content and the opportunity clients had to connect with other individuals struggling with similar challenges.”

Providng CDSMP training is just one of many experiences the Program offers. “One of the greatest strengths of our educational philosophy is we encourage all of our students to start with themselves. Before they can maximize participation in someone else’s life, they need to participate themselves,” Russell-Thomas says. “Because they receive this training and have this experience, they can use it to help their clients live healthier lives.”

Both Lickwar and Strobel see how valuable this training will be in their future practice.

“I'm in the joint degree program and will earn a Master of Public Health along with the MSOT. The CDSMP training is a good example of how both fields work together. Although the application of this workshop might be in response to the participants’ current health conditions, applying it might deter or slow progression of a disease, support an individual's self-maintenance or prevent potential co-morbid conditions. I think it is an effective and tangible model on which to base some of my future work,” Lickwar says.

“I will use this training in my OT practice as an additional resource and asset to offer to my clients in each workplace, if possible. It is portable and easy to implement, which makes it feasible to carry with me into all settings and workplaces of my future practice. The CDSMP is a valuable tool that individuals from all backgrounds can benefit from to lead healthier lives as more independent managers of their own health and well-being,” Strobel says.