Dr. Jayashree Nimmagadda, FHR Board Member, reflects on the creation of the PrismModel

Contributed By:  Edward Allard, Communications Representative

I recently had the privilege of speaking about the creation of the PRISMMODEL with Jayashree Nimmagadda, Ph.D., Professor and Director of the Case Management Certification Program at the Rhode Island College School of Social Work, and a ten-year member of Fellowship Health Resources’ Board of Directors. Dr. Nimmagadda (or Dr. Jay, as she allows me to call her), played a key leadership role in the development of Fellowship Health Resources’ PRISMMODEL for the Effective Treatment of Serious and Persistent Mental Illness, a model five years in the making.

PRISM, an acronym representing the core constructs of the treatment approach used by Fellowship Health Resources’ (FHR) staff members working with consumers in the field, stands for Person-centered, Respectful, Individualized, Strengths-based, and Mission-driven. The history of the model’s inception, as shared by Dr. Jay, is interesting, and for me, somewhat flattering. To my surprise, Dr. Jay revealed that I had accidentally sparked the research effort with a question I asked during a Board retreat in 2004, when I was serving as a FHR Board member. I simply asked, “What is the approach Fellowship really uses when working with a consumer?” Dr. Jay and the people of Fellowship took it from there. The Board transformed the question into a strategic priority, and President/CEO Joe Dziobek asked Dr. Jay to lead the project. Initially, Dr. Jay thought, “This would be a small thing, a little survey, and a paper at the end, nothing big.” However, due to the enthusiasm the effort inspired, it took on a life of its own and grew into a major undertaking. The process resulted in a coherent and well-executed model of treatment for people with serious and persistent mental illness, rooted in our organization’s belief in the power of an individual to prevail, in time, over the worst of circumstances. As the Fellowship Health Resources’ mission statement states, “We invest in the individual and never lose hope in the potential for personal growth and recovery of each person we serve.”

Identifying the organization’s clinical approach; i.e., the PRISMMODEL, was a feat of qualitative research, supported with data gathered from twelve agency-wide employee focus groups. Trained facilitators developed model-appropriate case studies to direct and guide focus group discussion. The conversations were audio-recorded, and an independent transcriptionist converted the recordings into a 340-page document. Group members gleaned recurring themes from this document, and Dr. Jay, with the help of research assistants, coded the results. The use of a second independent coder ensured reliability with the coding process. After preliminary examination, the data was analyzed using Atlas.ti scientific software, to produce quantifiable data.

The identification process led Fellowship Health Resources to base its clinical approach on two primary requirements. The approach asserts that successful treatment must occur within a (1) strengths-based and (2) person-centered framework. The fundamental organizational belief that clinical treatment is also mission-driven, respectful and individualized, as well as the qualitative data garnered by the focus groups, supports this assertion.

The project generated the in-house publication of three training modules addressing the topics of Engagement, Assessment, and Treatment Planning. Dr. Nimmagadda, M.S.W., Ph.D., L.I.C.S.W., with assistance from Christine Meglio, M.A., C.A.G.S., led the following FHR staff members in authoring and editing the manuals: Kristen Guilfoyle, B.A., Susan Buck, L.S.W.c., M.H.R.T./C., Margaret Carroll, B.A., Pamela Daisey, M.S., N.C.C., L.P.C.M.H., Elizabeth Folcarelli, M.S., Lyanne Trumbull, L.C.S.W., and Christopher McInnis, M.S.W., L.C.S.W.

As for the future of Fellowship Health Resources and the PRISMMODEL, Dr. Jay expressed this hope: “We’d like to see the PRISMMODEL get NREP (National Registry of Evidence-based Practices) certification. That would be a real feather in the cap.” NREP certification would identify the PRISMMODEL as a scientifically supported Evidence-based Practice, entered into the federal government’s registry of such practices. This acknowledgement would open the door to a number of opportunities for our agency with SAMHSA (Substance Abuse and Mental Health Services Administration), a NREP certifier. It would also be a source of pride for the employees involved, who all worked so hard to bring the PRISMMODEL to fruition.