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Families: Courage - Resilience - Transformation

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OBJECTIVES:
If I were starting an adolescent treatment center what would I want to make sure adolescents and families learn?

Identify and Describe How Families Arrive at your door.

To Demonstrate the Power of Family Mapping and the Art and Science of Portraiture.

Clinical and Reverse Interventions - what are these and how to do?

Share Standard Vocabulary Families need to know Family Change Agreements - What are these - when to use?

Publicado en: Salud y medicina
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Families: Courage - Resilience - Transformation

  1. 1. Families Courage-Resilence-Transformation Sept.7, 2016
  2. 2. Meet Dr. Louise Author- Falling Up-A Memoir of Renewal & Learn To Thrive- An Intervention Guidebook Educator - Former Faculty SDSU, School of Social Work, SDSU Interwork Institute Director -All About Interventions and Past Director Alcohol and Other Drug Services USD Clinician -LCSW , CDWF -Candidate Principal Investigator Dept. of Ed & NI- NIAAA and other grants Woman-Widow- Wife-Mother-Stepmother- Grandmother - Step Grandmother
  3. 3. Objectives If I were starting an adolescent treatment center what would I want to make sure adolescents and families learn Identify and Describe How Families Arrive at your door ? To Demonstrate the Power of Family Mapping and the Art and Science of Portraiture Clinical and Reverse Interventions-what are these and how to do Share Standard Vocabulary Families need to know Family Change Agreements- What are these- when to use ?
  4. 4. How did you arrive today ? Hungry-hope they have good food Worried about Family Energized after exercise Thinking I have soon much work to do Happy Traffic was awful- Grateful I work at Paradigm
  5. 5. How Do Your Clients arrive ? Substance Abuse Mental Health Legal Issues School Problems -Bullying Relationship Failures Physical Maladies -Pain etc Sexual Identity Gambling, Gaming,Digital Intergenerational Wounds
  6. 6. What Kind Of Families do You Meet AGREEABLE ANALYSIS INVISIBLE QUESTIONER KNOW IT ALL COMPLAINER TALKER WORRIER MICO-MANAGER BOOMERRANG Emotionally intense
  7. 7. Attributes of Healthy Families McMannis PHD & MacMcMannis MSW Talking and Loving Balancing Closeness & Difference Expressing Language Accepting Difference Adapting to Change Seeing The Positive Sharing Time together Effective Problem Solving Who’s in Charge Parenting Together
  8. 8. Lets do a Family Map Salvador Minuchin Flip Chart Colored Pens for Key
  9. 9. Keeping The Status Quo SA. MH, CP etc . Organizing structure Unconscious and Consciously Gratification Strategies must be employed that change usual ways of relating, categorizing , and thinking
  10. 10. Family and Confabulations
  11. 11. ASSUMPTIONS ABOUT FAMILIES THAT SEEK OUR HELP HURTING EXPERTS MOTIVATED SEEKING SOLUTIONS WOUNDED FAMILY OF ORIGIN BEEN UNSUCCESSFUL IN SEEKING SOLUTIONS THEY MAY NOT SEE THEIR PART IN THE PROBLEM -want you to FIX LOVE ONE AUTHENTIC- VULNERABLE- COURAGEOUS
  12. 12. Lets Give Our Families No Fault Insurance
  13. 13. HAVE YOU EARNED THE RIGHT TO HEAR ANOTHER’S STORY ?
  14. 14. BRAVING - Brown Am I clear in helping client accept own boundaries ? Am I reliable ? Do I do what I say I will do? Do I hold myself accountable-Ethics, professional standards &, seek collaboration when necessary Confidentiality Nonjudgemental Am I generous in my interpretation of self and others ?
  15. 15. Listening Skills
  16. 16. History DR. RUTH R Pronounced a Disease like Heart Disease &Diabetes Describable, Predictable and Progressive If Left Untreated Fatal 1954 American Society on Alcoholism
  17. 17. Dr. Seabrook Hypersensitivity to alcohol Insatiable cravings Excited by the smallest experience “TO AVOID an attack of alcoholism one had to experience a complete and enduring abstinence”
  18. 18. Dr. Tiebot Recognized the impact of Spiritual Transformation Roadblocks -Fear of Change Fear of the Unknown Shame Anger and Rage Defiance & Defenses Impulsivity - Tramua Repetition
  19. 19. What is Addiction Addiction is a primary , chronic disease of brain reward, motivation, memory and related circuity Dysfunction in these circuits leads to characteristics biological, psychological,social, spiritual,manifestations This is reflected in an individual pathology pursing reward and/or reflex by substances and other behaviors March 2011
  20. 20. Learn Your ABCs A = Age of First Use B= Big Changes C-Co-Existing Mental Health /Behavioral Heath Issues DNA= Family History
  21. 21. Enough Buttons
  22. 22. Process Disorders SEX Porn GAMING GAMBLING DISORDERED EATING EXERCISE SHOPPING DIGITAL SOCIAL MEDIA 
 
 
 

  23. 23. What’s ya Doing? Consciously Unconsciously
  24. 24. The Adolescent Brain Brain Maturation-age 25 nIMH longitude study 1991 Lag between prefrontal cortex-and growth of limbic system when emotions originate and prefrontal that manages Limbic system explodes at puberty while it takes 10 plus years for prefrontal cortex Cerebellum Higher level Cognition
  25. 25. Other Important Concepts Part 3
  26. 26. Blaming https://www.youtube.com/watch?v=RZWf2_2L2v8
  27. 27. Where Are Your Marbles?
  28. 28. Shame Shame is the intensely painful feeling or experience of believing we are flawed and therefore unworthy of love and belonging I am Not Good Enough Brene Brown
  29. 29. Who Stole The Cookie From The Cookie Jar? The Difference between Shame is Guilt I am bad versus I did something bad
  30. 30. Humiliation The act of making someone feel inferior or foolish Someone Telling You , You aren’t Smart Enough, Good Enough …Stupid Or you have negative self talk…
  31. 31. Embarrassment Have you ever felt embarrassed?
  32. 32. Grief and Loss Loss-something of Value is gone Grief-Total response to emotional experience Bereavement- Subjective Response by loved ones Mourning-Behavioral Response
  33. 33. Whole Hearted Living
  34. 34. START WHERE YOUR CLIENT IS
  35. 35. Resilience Quotient Mayo clinic 0= Not at all Accurate 1=Somewhat Accurate 2=Moderately Accurate 3= Very Accurate 4= Extremely Accurate
  36. 36. On a Scale of 1-4 I am able to adapt to change easily I feel in control of my Life I tend to bounce back after a hardship or an illness I have close dependable relationships I remain optimistic, even if things seem hopeless I can think clearly and logically under stress I see humor in situations, even stress
  37. 37. Resiliency in Recovery The ability to overcome challenges of all kinds, trauma, tragedy, addiction, personal crisis , plain ole life problems and bounce back , stronger wiser and more personally powerful
  38. 38. Whats ok - Whats Not ok What was ok before Treatment? Whats not ok today ? What gets confusing ? Boundary Exercise
  39. 39. Self Compassion - Dr. Kristen Neff Self Kindness versus Self Judgement Common Humanity vs Shared Isolation -suffering and personal inadequacy is part of the human experience Mindfulness vs. Over Identification which leads to negativity
  40. 40. Self Compassion Exercise 1 First, think about times when a loved one feels really bad about him or herself or is really struggling in some way. How would you respond to your l oved in this situation (especially when you’re at your best)? Please write down what you typically do, what you say, and note the tone in which you typically talk to your friends. 2 Now think about times when you feel bad about yourself or are struggling. How do you typically respond to yourself in these situations? Please write down what you typically do, what you say, and note the tone in which you talk to yourself. 3 Did you notice a difference? If so, ask yourself why. What factors or fears come into play that lead you to treat yourself and others so differently? 4 Please write down how you think things might change if you responded to yourself in the same way you typically respond to a close friend when you’re suffering. Why not try treating yourself like a good friend and see what happens? close friend or loved one is struggling and feels really bad about himself
  41. 41. Interventions-Crucial Conversations Part 4
  42. 42. Intervention Teams Participants are experts Psycho-educational Value Driven Directive-Homework Evidenced Based Solution Focused
  43. 43. Intervention Models - Traditional Vern Johnson Frank Picard-Family Intervention Seeley Southworth
  44. 44. Traditional Styles Made Modern Jeff and Debra -Love First Ed Storti-Authentic Model Combine Elements of MI into traditional approaches
  45. 45. Invitational Models Systemic ( Speare & Raitner) Arise- Garret & Landau -3 Phase Lamm-4 Step Model Action -Campbell & Tracey
  46. 46. Stanger Process Phase One :Intervention Agreement and Initiative Step 1:Engagement Step2 : Determine Key stakeholders Step 3: Define Client Guidelines, Confidentiality
  47. 47. Information Gathering , Objections and Action Plan Step 4 : Identify Background - Family Map Step 5 :Assess ILO and Key Stakeholders (Retrospective Analysis and Portraiture ) Step 6 : Teach and Survey Accountability Teams Step 7: Develop Measurable Action Plans
  48. 48. Phase 3 :Implementation, Review and Follow-Up Sep 8 Coaching : Delivering the Information Step 9:Intervention Step 10 : Progress Review and Feedback Step 11: Follow Up: SFC/ Case Management
  49. 49. Invitations to Change CLINICAL REVERSE
  50. 50. Modalities USED MI- Rolling With Resistance SFT- In A Perfect World what would life look like CBT Brown- You Can Write Your Own Story Family MAPPING Parallel Processes You Can ALL FALL UP
  51. 51. Agreements
  52. 52. Lets Brain Storm Pre -Admit Upon Entry into Treatment During Treatment During Clinical Interventions After Care plan OutPatient Home Care
  53. 53. Resources The Daring WAY & Rising Strong- Brown Crucial Conversations -Patterson et al Parallel Processes- Prozatek Journey of The Heroic Parent-Reedy Motivational Interviewing- Miller & Rollnick http:www.motivationalinterviewing.org Solution Focused Therapy - Young & Berg Dr. Louise Stanger http://www.allaboutinterventions.com Are You A Helicopter or Submarine ? Sober World -, Spring 2016 Stanger
  54. 54. Resources Brene Brown-Daring Way & Rising Strong Kristen Neff- www.self-compassion.org William Martin & Phillip Hemphill- Taming Disruptive Behavior Joe Newman -Raising Lions McMannis & McMannis -Family Therapy Institute of Santa Barbara http://ftisb.org
  55. 55. Resources Stanger www.allaboutinterventions.com Systemic Model www.systemicintervention.com Arise www.likinghumansystems.com Jays- www.lovefirst.net Lamm www.bradlamm.com Seeley www.intervention911.com
  56. 56. Resources Storti www.stortimodel.com mintz-www.realifeis.com I’ll Quit Tomorrow -Vern Johnson TAP 35 Institute for Solution Focused Therapy www.solutionfocused.net
  57. 57. An Intervention Guidebook for Loved Ones and Their Families Learn Thrive:to LOUISE STANGER ED.D., L.C.S.W., BRI II, CIP
  58. 58. Families Courage-Resilence-Transformation Sept.7, 2016
  59. 59. Meet Dr. Louise Author- Falling Up-A Memoir of Renewal & Learn To Thrive- An Intervention Guidebook Educator - Former Faculty SDSU, School of Social Work, SDSU Interwork Institute Director -All About Interventions and Past Director Alcohol and Other Drug Services USD Clinician -LCSW , CDWF -Candidate Principal Investigator Dept. of Ed & NI- NIAAA and other grants Woman-Widow- Wife-Mother-Stepmother- Grandmother - Step Grandmother
  60. 60. Objectives If I were starting an adolescent treatment center what would I want to make sure adolescents and families learn Identify and Describe How Families Arrive at your door ? To Demonstrate the Power of Family Mapping and the Art and Science of Portraiture Clinical and Reverse Interventions-what are these and how to do Share Standard Vocabulary Families need to know Family Change Agreements- What are these- when to use ?
  61. 61. How did you arrive today ? Hungry-hope they have good food Worried about Family Energized after exercise Thinking I have soon much work to do Happy Traffic was awful- Grateful I work at Paradigm
  62. 62. How Do Your Clients arrive ? Substance Abuse Mental Health Legal Issues School Problems -Bullying Relationship Failures Physical Maladies -Pain etc Sexual Identity Gambling, Gaming,Digital Intergenerational Wounds
  63. 63. What Kind Of Families do You Meet AGREEABLE ANALYSIS INVISIBLE QUESTIONER KNOW IT ALL COMPLAINER TALKER WORRIER MICO-MANAGER BOOMERRANG Emotionally intense
  64. 64. Attributes of Healthy Families McMannis PHD & MacMcMannis MSW Talking and Loving Balancing Closeness & Difference Expressing Language Accepting Difference Adapting to Change Seeing The Positive Sharing Time together Effective Problem Solving Who’s in Charge Parenting Together
  65. 65. Lets do a Family Map Salvador Minuchin Flip Chart Colored Pens for Key
  66. 66. Keeping The Status Quo SA. MH, CP etc . Organizing structure Unconscious and Consciously Gratification Strategies must be employed that change usual ways of relating, categorizing , and thinking
  67. 67. Family and Confabulations
  68. 68. ASSUMPTIONS ABOUT FAMILIES THAT SEEK OUR HELP HURTING EXPERTS MOTIVATED SEEKING SOLUTIONS WOUNDED FAMILY OF ORIGIN BEEN UNSUCCESSFUL IN SEEKING SOLUTIONS THEY MAY NOT SEE THEIR PART IN THE PROBLEM -want you to FIX LOVE ONE AUTHENTIC- VULNERABLE- COURAGEOUS
  69. 69. Lets Give Our Families No Fault Insurance
  70. 70. HAVE YOU EARNED THE RIGHT TO HEAR ANOTHER’S STORY ?
  71. 71. BRAVING - Brown Am I clear in helping client accept own boundaries ? Am I reliable ? Do I do what I say I will do? Do I hold myself accountable-Ethics, professional standards &, seek collaboration when necessary Confidentiality Nonjudgemental Am I generous in my interpretation of self and others ?
  72. 72. Listening Skills
  73. 73. History DR. RUTH R Pronounced a Disease like Heart Disease &Diabetes Describable, Predictable and Progressive If Left Untreated Fatal 1954 American socity on Alcoholism
  74. 74. Dr. Seabrook Hypersensitivity to alcohol Insatiable cravings Excited by the smallest experience “TO AVOID an attack of alcoholism one had to experience a complete and enduring abstinence”
  75. 75. Dr. Tiebot Recognized the impact of Spiritual Transformation Roadblocks -Fear of Change Fear of the Unknown Shame Anger and Rage Defiance & Defenses Impulsivity - Tramua Repetition
  76. 76. What is Addiction Addiction is a primary , chronic disease of brain reward, motivation, memory and related circuity Dysfunction in these circuits leads to characteristics biological, psychological,social, spiritual,manifestations This is reflected in an individual pathology pursing reward and/or reflex by substances and other behaviors
  77. 77. Learn Your ABCs A = Age of First Use B= Big Changes C-Co-Existing Mental Health /Behavioral Heath Issues DNA= Family History
  78. 78. Enough Buttons
  79. 79. Process Disorders SEX Porn GAMING GAMBLING DISORDERED EATING EXERCISE SHOPPING DIGITAL SOCIAL MEDIA 
 
 
 

  80. 80. The Adolescent Brain Brain Maturation-age 25 nIMH longitude study 1991 Lag between prefrontal cortex-and growth of limbic system when emotions originate and prefrontal that manages Limbic system explodes at puberty while it takes 10 plus years for prefrontal cortex Cerebellum Higher level Cognition
  81. 81. Other Important Concepts Part 3
  82. 82. Blaming https://www.youtube.com/watch?v=RZWf2_2L2v8
  83. 83. Where Are Your Marbles?
  84. 84. Shame Shame is the intensely painful feeling or experience of believing we are flawed and therefore unworthy of love and belonging I am Not Good Enough Brene Brown
  85. 85. Who Stole The Cookie From The Cookie Jar? The Difference between Shame is Guilt I am bad versus I did something bad
  86. 86. Humiliation The act of making someone feel inferior or foolish Someone Telling You , You aren’t Smart Enough, Good Enough …Stupid Or you have negative self talk…
  87. 87. Embarrassment Have you ever felt embarrassed?
  88. 88. Grief and Loss Loss-something of Value is gone Grief-Total response to emotional experience Bereavement- Subjective Response by loved ones Mourning-Behavioral Response
  89. 89. Whole Hearted Living
  90. 90. START WHERE YOUR CLIENT IS
  91. 91. Resilience Quotient Mayo clinic 0= Not at all Accurate 1=Somewhat Accurate 2=Moderately Accurate 3= Very Accurate 4= Extremely Accurate
  92. 92. On a Scale of 1-4 I am able to adapt to change easily I feel in control of my Life I tend to bounce back after a hardship or an illness I have close dependable relationships I remain optimistic, even if things seem hopeless I can think clearly and logically under stress I see humor in situations, even stress
  93. 93. Resiliency in Recovery The ability to overcome challenges of all kinds, trauma, tragedy, addiction, personal crisis , plain ole life problems and bounce back , stronger wiser and more personally powerful
  94. 94. Whats ok - Whats Not ok What was ok before Treatment? Whats not ok today ? What gets confusing ? Boundary Exercise
  95. 95. Self Compassion - Dr. Kristen Neff Self Kindness versus Self Judgement Common Humanity vs Shared Isolation -suffering and personal inadequacy is part of the human experience Mindfulness vs. Over Identification which leads to negativity
  96. 96. Self Compassion Exercise 1 First, think about times when a loved one feels really bad about him or herself or is really struggling in some way. How would you respond to your l oved in this situation (especially when you’re at your best)? Please write down what you typically do, what you say, and note the tone in which you typically talk to your friends. 2 Now think about times when you feel bad about yourself or are struggling. How do you typically respond to yourself in these situations? Please write down what you typically do, what you say, and note the tone in which you talk to yourself. 3 Did you notice a difference? If so, ask yourself why. What factors or fears come into play that lead you to treat yourself and others so differently? 4 Please write down how you think things might change if you responded to yourself in the same way you typically respond to a close friend when you’re suffering. Why not try treating yourself like a good friend and see what happens? close friend or loved one is struggling and feels really bad about himself
  97. 97. Interventions-Crucial Conversations Part 4
  98. 98. Intervention Teams Participants are experts Psycho-educational Value Driven Directive-Homework Evidenced Based Solution Focused
  99. 99. Intervention Models - Traditional Vern Johnson Frank Picard-Family Intervention Seeley Southworth
  100. 100. Traditional Styles Made Modern Jeff and Debra -Love First Ed Storti-Authentic Model Combine Elements of MI into traditional approaches
  101. 101. Invitational Models Systemic ( Speare & Raitner) Arise- Garret & Landau -3 Phase Lamm-4 Step Model Action -Campbell & Tracey
  102. 102. Stanger Process Phase One :Intervention Agreement and Initiative Step 1:Engagement Step2 : Determine Key stakeholders Step 3: Define Client Guidelines, Confidentiality
  103. 103. Information Gathering , Objections and Action Plan Step 4 : Identify Background - Family Map Step 5 :Assess ILO and Key Stakeholders (Retrospective Analysis and Portraiture ) Step 6 : Teach and Survey Accountability Teams Step 7: Develop Measurable Action Plans
  104. 104. Phase 3 :Implementation, Review and Follow-Up Sep 8 Coaching : Delivering the Information Step 9:Intervention Step 10 : Progress Review and Feedback Step 11: Follow Up: SFC/ Case Management
  105. 105. Invitations to Change CLINICAL REVERSE
  106. 106. Modalities USED MI- Rolling With Resistance SFT- In A Perfect World what would life look like CBT Brown- You Can Write Your Own Story Family MAPPING Parallel Processes You Can ALL FALL UP
  107. 107. Agreements
  108. 108. Lets Brain Storm Pre -Admit Upon Entry into Treatment During Treatment During Clinical Interventions After Care plan OutPatient Home Care
  109. 109. Resources The Daring WAY & Rising Strong- Brown Crucial Conversations -Patterson et al Parallel Processes- Prozatek Journey of The Heroic Parent-Reedy Motivational Interviewing- Miller & Rollnick http:www.motivationalinterviewing.org Solution Focused Therapy - Young & Berg Dr. Louise Stanger http://www.allaboutinterventions.com Are You A Helicopter or Submarine ? Sober World -, Spring 2016 Stanger
  110. 110. Resources Brene Brown-Daring Way & Rising Strong Kristen Neff- www.self-compassion.org William Martin & Phillip Hemphill- Taming Disruptive Behavior Joe Newman -Raising Lions McMannis & McMannis -Family Therapy Institute of Santa Barbara http://ftisb.org
  111. 111. Resources Stanger www.allaboutinterventions.com Systemic Model www.systemicintervention.com Arise www.likinghumansystems.com Jays- www.lovefirst.net Lamm www.bradlamm.com Seeley www.intervention911.com
  112. 112. Resources Storti www.stortimodel.com mintz-www.realifeis.com I’ll Quit Tomorrow -Vern Johnson TAP 35 Institute for Solution Focused Therapy www.solutionfocused.net
  113. 113. An Intervention Guidebook for Loved Ones and Their Families Learn Thrive:to LOUISE STANGER ED.D., L.C.S.W., BRI II, CIP

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