My Tool Box
Interview with Dr. Deborah Radcliffe-Branch, Director of My Tool Box
What is My Tool Box? Who was it made for?
Being diagnosed with a chronic illness such as cancer, heart disease, asthma or diabetes can turn your world upside down. The pain and decreased independence caused by these kinds of illness can make patients feel depressed and isolated. My Tool Box is a six-week program offered free of charge at the MUHC which assists patients and their loved o nes in managing the day-to-day challenges of living with a chronic condition. This evidence-based program designed at Stanford University, is led by trained and certified volunteers who themselves suffer from chronic diseases. The program is designed to teach people the skills they need to live well with chronic health conditions such diabetes, heart disease, asthma, arthritis, cancer, MS, muscular dystrophy, stroke, hypertension, and chronic pain. These enjoyable, practical and interactive workshops emphasize coping strategies and practical skills.
Why and when was this program started? Where did the idea come from?
This CDSMP program was developed at Stanford University over 20 years ago. The idea of implementing the program in Quebec was the brainchild of a patient of the Neuro, the Neuro’s patients committee and the “Friends of the Neuro”, (all volunteers) and was supported by hospital staff. The Montreal Neurological Hospital and Institute formally initiated the project and received funding from an MUHC innovation bursary, as well as from the patients' committee. The Stanford license was acquired and we introduced the program in 2006 as a pilot project. On the heels of the pilot’s tremendous success, in 2007 the McGill University Health center and the Montreal Neurological Hospital and Institute awarded further funding for 3 years. To accommodate rapid growth, additional funding was secured from a private foundation.
Why did you decide to be part of this program?
I was initially brought on board to implement, evaluate and coordinate the pilot project. With post secondary degrees in psychology and educational psychology, it was a good fit. I have been implementing and evaluating supportive and educational interventions for patients for over 15 years. Directing this program was a wonderful opportunity for me, it doesn’t get much better than helping people living with chronic illnesses learn how to help themselves.
How successful is My Tool Box?
My Tool Box is enormously successful in many ways. A recent statistical analysis on 306 participants who completed the workshops found statistically significant differences from pre to 6 months post course in the following measures-
Improvements in: coping with and ability to manage symptoms, communication with physicians, ability to manage the disease, general health, depression, physical abilities, energy, fatigue, health distress, pain severity, illness intrusiveness as well as reductions in mental-health care visits, emergency room visits and overnight hospitalizations. There is also a social component which we have not yet evaluated formally, participants frequently remain in contact once the course is complete, we have been told that feelings of isolation are reduced and supportive friendships are created.
How can MS patients benefit from My Tool Box?
MS patients make up about 24% of the course participants and to-date we have had over 1000 people register for the program. Managing MS can be challenging, good self-management skills can really make a difference in quality of life and functionality. Benefits include those listed above including improved communication with physicians, and reductions in pain, fatigue, health distress, depression, and illness intrusiveness. Improvements have also been seen in participants' ability to cope with, and manage their disease and its symptoms.
Why do you think it is important for patients to be part of this program?
Many people with chronic health conditions fail to receive the necessary support because the Canadian healthcare system is better set up to manage acute, rather than chronic conditions. My Tool Box is an evidence-based resource that can help the estimated 9 million people in Canada who suffer from a chronic health condition. Workshops are highly participative, and involve volunteers who themselves have chronic conditions. Mutual support and success help build the participants’ confidence in their ability to manage their health and maintain active and fulfilling lives.
What is a typical workshop like?
A typical workshop is a group of 8-14 people living with various chronic conditions, with the common goal of improving their health and quality of life. Workshops are facilitated by two trained and certified volunteers living with a chronic illness themselves. The workshops are structured and problem based, so there is quite a bit of participation required - it can get lively at times. Most participants really enjoy the non-judgemental learning environment and the camaraderie in workshops. Over 6 weeks, participants learn and practice the following self-management skills:
- Managing symptoms
- Techniques for reducing stress
- Dealing with difficult emotions such as fear, anger, frustration, and depression
- Establishing good exercise and nutrition routines for maintaining and improving strength
- Learning and practicing relaxation techniques
- Optimally managing medication use
- Communicating effectively with your health care team and loved ones
- Managing pain and fatigue
- How to evaluate treatment options
- Goal setting and problem solving
What goals do you have for My Tool Box in the future?
Future goals include securing sustainable funding and growing the program to reach more people. We have already begun the chronic pain specific program and have completed a 3 component program for people with spinal cord injuries.
To find out more: http://mytoolbox.mcgill.ca/