Stepping Stone Peer Support and Crisis Respite Center, located in Claremont, New Hampshire, has developed and implemented a model of crisis respite that is both consumer-run and congruent with the center's philosophy of peer support and self-help. Our hope is to create an opportunity for people to learn from, and be supported in making the transition from crisis to wellness. We believe that within the context of a mutually- responsible relationship, and with the help of consumer staff’s experiential knowledge and training that those who sincerely wish to overcome their difficulties can greatly reduce the use of more restrictive hospital settings, including involuntary admissions.

The Crisis Respite Program opened November 2,1997. We offer two single bedrooms, two full and one half bathrooms, a kitchen, and a TV room. Other rooms offer space for peer support groups and creative activities. All groups, events, and activities are available to guests. Some of the current groups include nutrition skills, WRAP and Peer Support, healing meeting, recovery discussion, practicing peer support, karaoke; just to name a few. Guests are free to come and go from the center, bring and cook their own food, and can have 24-hour peer support available to them. Training for staff includes a 12-15-hour peer support skills training seminar as well as 40 additional hours in crisis skills. Crisis training includes knowledge of relational theory, creative problem solving strategies, de-escalation techniques, and extensive role playing exercises.

Eligibility rests on having completed a pre-crisis interview with a member of the respite staff and an ability to demonstrate adherence to both the center’s rules and the philosophy of peer support. The pre-crisis interview consists of both demographic information and collaborative brainstorming exercises with the goal being to develop a crisis plan. The interview will describe the expectations of the center which will not include medical supervision, and establish the ground rules staff and guests will mutually observe. The staff and guest will work together to think creatively through how the stay could be beneficial for both. Out of this exercise will come a document that will guide the guest's respite stay. Guests may stay up to seven days at one time.

Crisis, in our program, is not defined as a negative experience, but rather as an opportunity for growth; even in the midst of overwhelming situations. People describe crisis as chaotic, scary, feeling powerless, having nowhere to turn, no one to turn to, or feeling they are losing their ability to deal with their lives. In times of crisis people feel alone with anxiety; panic; anger; frustration; and deep, profound, overwhelming feelings. Our goal is to provide connections and relationships that diffuse the additional intensity of feelings, thoughts, and impulses that come from being alone as well as to offer a comfortable, nonjudgmental environment in which one might be able and is encouraged to process the stresses and explore new options. Hopefully, this will result in some fresh short-term solutions and a wider array of options for future crisis.

Our process allows and encourages development of reciprocity and mutuality between peer staff and respite guests. It is our belief that this helps to eliminate the institutionalization effect (non-mutual balance of power) that frequently results from hospitalization. Clearly, as people have an opportunity to stay connected to peers while moving through challenging thoughts, feelings, and/or impulses, the need for external intervention is diminished. Over time we believe this alternative approach to handling crises will teach people healthier attitudes about themselves and others. Further, with increased skills, people's susceptibilities to the pressures that give rise to overwhelming emotional distress can be reduced.

This program is just one of the many New Hampshire consumer initiatives and clearly an amalgamation of ideas and values of the larger consumer movement. We are funded entirely through the Bureau of Behavioral Health and work collaboratively with the State of New Hampshire to develop a new model of practice which truly reflects consumer values.

For more information about this program and how to become eligible, please call 603-543-1388.