Client and Provider Sing Praises of ‘Bucket Approach’

A behavioral health patient and a provider endorsed the Bucket Approach to tobacco treatment during a recent webinar about the approach for behavioral health providers.

red bucketThe webinars, which took place in December, were a primer on how to integrate tobacco treatment into standard care. It was developed by UW-CTRI Researcher Dr. Bruce Christiansen and the state’s Bureau of Prevention Treatment and Recovery (BPTR) and supported by a grant from the Wisconsin Department of Health Services. The approach acknowledges that these clinicians have limited time; meanwhile, their patients (who are coping with a mental illness and/or other addictions) typically need extra time, support, and resources in order to quit tobacco use.

The December webinars promoted the original online Bucket Approach training deployed in October 2019 in the hopes of boosting usage.

Cynthia Crouse
Cynthia Crouse

On those webinars, former smoker Cynthia Crouse (right) said the Bucket Approach worked for her to help her quit smoking—an addiction that was “more difficult to quit than any drug I’ve used. I had no idea the hold it had on me.” She began smoking and using street drugs at age 9. She quit at age 17 but returned to using after her marriage broke up. She struggled with bronchitis and pneumonia. Quitting has helped her address her depression, stress, trauma, and triggers, she said.

“I have improved my self-esteem, confidence, and health,” Crouse said.

UW-CTRI and the Wisconsin Nicotine Treatment Integration Project (WiNTiP) have promoted the Bucket Approach to Community Support Programs (CSPs) and Comprehensive Community Services Programs (CCSs) across Wisconsin. Enrollees can earn up to 8.25 Continuing Education (CE) credits from the University of Wisconsin School of Medicine and Public Health by completing the training.

Marj Thorman said it has worked for the Jefferson County CSP she manages. Out of approximately 135 clients, 70 smoke. However, thanks to the Bucket Approach, seven clients have quit smoking since last June.

“That’s huge,” said Thorman. “It makes me feel this intervention works. They felt better after quitting. The staff enthusiasm about helping people quit smoking really increased as we started to have success. That’s most motivating for all of us that work with people—is seeing those changes.”

Thorman’s program provided modest cash incentives for clients to overcome inertia to quit. That said, the clients have felt so much healthier living smoke-free that the financial part has became a secondary motivation.

Marj Thorman

“Staff feel more confident, too,” Thorman said. “We all totally believed in helping people to quit smoking and the importance of that. The Bucket Approach really gave us the tools. We so appreciate that the training was offered for free.”

To boost the reach and implementation of the Bucket Approach, Christiansen and his team offered the online webinars training for continuing educational credit. The trainings feature videos by UW-CTRI regional outreach specialists and health counselors that offer facts, treatment frameworks, and technical advice. The webinars also featured Thorman and Crouse sharing their stories.

To date, 168 CSP/CCS staff have enrolled in the training and 94 have completed it. Approximately 349 other clinicians in Wisconsin have enrolled and 499 from other states. In all, more than 1,000 people have now enrolled in the Bucket Approach online course.

“Recovery is rarely a straight line,” advised Crouse, who is now a Wisconsin certified peer specialist who helps people with critical mental illness at the Jefferson County CSP. She uses the Bucket Approach to help others. “Don’t give up on yourself or others,” she said.

“I want to recognize and thank the Bureau of Prevention Treatment and Recovery for funding these activities,” Christiansen said. “Making this a priority reflects their understanding of the devastating burden tobacco use is for people coping with a mental illness. The webinar response was gratifying and exceeded expectations.”

Thorman said most of the clients at her CSP who quit smoking started out either not wanting to quit, or just being willing to talk about it. She added, “the Bucket Approach works!”