PMP Risk Management as Applied to Behavioral Health

This is a blogpost detailing the use of PMP risk management techniques to help manage mental health disease symptoms:

During the last 20 years or so, I have been applying risk management techniques learned as a Project Management Professional to help manage risks associated with my mental health and mental illness characteristics.  What I learned as a technical skill as a project manager to manage risks can be applied to illness management as a person with bipolar illness.  Typically in risk management, the project manager identifies with the team all the risks associated with the particular project in hand.  After recounting the risks, the team goes through the process of assigning probability of occurrence and level of impact associated with each risk to the project.  After the severity and likelihood of the risk is captured, the team then works to develop mitigation strategies for each risk and to indicate whether mitigation strategies are sufficient to address each risk recorded. 

How can this be helpful to a person with mental illness?  The idea of risk management is characterizing the probability and impact of the risk and then creating risk mitigation strategies.  This same scenario can be applied to managing risks associated with bipolar illness.  This risk management may take place with the patient’s care team including the prescribing doctor and the therapist.  For example, say I have extreme anxiety about leaving my home and have an Obsessive Compulsive Disorder-type set of checking routines I do to mitigate this anxiety.  The risk would be the anxiety condition and the mitigation would be the checking routine.  This is a largely effective strategy for managing this form of anxiety unless the OCD ritual becomes ever-present and ever-pervasive.  In this instance with the OCD mitigation it might be said that the risk mitigation strategy is becoming non-mitigating.  It may be time to revisit that risk or anxiety and re-evaluate what an effective new mitigation strategy might look like.  This might include self-talk about the probability of the risk occurring based on the prior number of years the risk has been managed and self-talk about the impact if ever the risk or anxiety has manifested itself in an actual real event during the course of tracking the risk.

All in all, assigning probability and impact to behavioral health management risks helps set priorities for what is a big risk to manage versus what is a smaller risk to manage.  Key is the development of effective risk-management mitigation strategies to use to address the risks.  Also key is the reassessment of risk mitigation strategies when the risk mitigation is no longer effective.  At that time, new measures of risk mitigation need to be developed and put into place.

All in all, risk management learned through the Project Management Professional lens can prove helpful in the management of unwanted behaviors associated with bipolar illness.  Different risks can be catalogued and associated with different mitigation strategies.  When these mitigation strategies no longer are viable, new mitigation techniques are developed and applied.   

What tools – either from your professional life or not – do you use to help mitigate your illness symptoms?

3 thoughts on “PMP Risk Management as Applied to Behavioral Health

  1. Is the anxiety condition actually the risk, though? Or is it a factor that’s leading to the overestimation of risks of particular outcomes? And does the checking routine actually reduce the risk of specific outcomes, or does it provide temporary emotional relief that ends up reinforcing the overestimation of risk? From a cognitive behavioural therapy perspective, framing anxiety as a risk and checking as a mitigator would most likely be anxiety-reinforcing.

    Let’s say that anxiety brain says there’s an 80% probability of bad outcome X happening, although the actual probability of outcome X occurring is 5%. Checking routines typically don’t reduce the actual probability of outcome X (for example, they wouldn’t reduce it from 5% to 1%), but they do provide a temporary reduction in anxiety, which then reinforces the perception that the risk of outcome X is 80% rather than 5%.

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    1. I see where you are going with this. Checking behavior is not a true mitigation strategy though it does offer temporary relief from anxiety symptoms. A much more effective mitigation strategy is self-talk. The idea being to look back over the history of anxiety and acknowledge that the “bad outcome” has occurred in the past no percent of the time and therefore has little to no “real” impact on health. So the checking behavior is a false mitigation technique, while the self-talk can be fairly successful and meaningful. Does that make sense to you?

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      1. That absolutely makes sense. Self-talk would help with more accurately assessing the level of risk, which would put you in a better position to decide what other measures may or may not be necessary.

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