families: courage - resilience - transformation
TRANSCRIPT
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FamiliesCourage-Resilence-Transformation
Sept.7, 2016
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Meet Dr. LouiseAuthor- 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
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ObjectivesIf 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 ?
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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
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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
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What Kind Of Families do You Meet
AGREEABLE
ANALYSIS
INVISIBLE
QUESTIONER
KNOW IT ALL
COMPLAINER
TALKER
WORRIER
MICO-MANAGER
BOOMERRANG
Emotionally intense
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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
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Lets do a Family Map Salvador Minuchin
Flip Chart
Colored Pens for Key
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Keeping The Status QuoSA. MH, CP etc . Organizing structure
Unconscious and Consciously Gratification
Strategies must be employed that change usual ways of relating, categorizing , and thinking
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Family and Confabulations
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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
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Lets Give Our Families No Fault Insurance
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HAVE YOU EARNED THE RIGHT TO HEAR ANOTHER’S STORY ?
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BRAVING - BrownAm 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 ?
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Listening Skills
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History
DR. RUTH R
Pronounced a Disease like Heart Disease &Diabetes
Describable, Predictable and Progressive
If Left Untreated Fatal
1954 American Society on Alcoholism
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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”
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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
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What is AddictionAddiction 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
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Learn Your ABCs
A = Age of First Use
B= Big Changes
C-Co-Existing Mental Health /Behavioral Heath Issues
DNA= Family History
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Enough Buttons
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Process DisordersSEX Porn
GAMING GAMBLING
DISORDERED EATING EXERCISE SHOPPING DIGITAL
SOCIAL MEDIA
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What’s ya Doing?
Consciously Unconsciously
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The Adolescent BrainBrain 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
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Other Important Concepts Part 3
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Blaming https://www.youtube.com/watch?v=RZWf2_2L2v8
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Where Are Your
Marbles?
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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
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Who Stole The Cookie From The Cookie Jar?
The Difference between Shame is Guilt
I am bad versus I did something bad
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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…
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Embarrassment
Have you ever felt embarrassed?
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Grief and LossLoss-something of Value is gone
Grief-Total response to emotional experience
Bereavement- Subjective Response by loved ones
Mourning-Behavioral Response
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Whole Hearted Living
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START WHERE YOUR CLIENT IS
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Resilience Quotient Mayo clinic
0= Not at all Accurate
1=Somewhat Accurate
2=Moderately Accurate
3= Very Accurate
4= Extremely Accurate
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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
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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
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Whats ok - Whats Not ok
What was ok before Treatment?
Whats not ok today ?
What gets confusing ?
Boundary Exercise
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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
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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
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Interventions-Crucial Conversations Part 4
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Intervention Teams Participants are experts
Psycho-educational
Value Driven
Directive-Homework
Evidenced Based
Solution Focused
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Intervention Models -Traditional
Vern Johnson
Frank Picard-Family Intervention
Seeley
Southworth
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Traditional Styles Made Modern
Jeff and Debra -Love First
Ed Storti-Authentic Model
Combine Elements of MI into traditional approaches
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Invitational Models
Systemic ( Speare & Raitner)
Arise- Garret & Landau -3 Phase
Lamm-4 Step Model
Action -Campbell & Tracey
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Stanger ProcessPhase One :Intervention Agreement
and Initiative
Step 1:Engagement
Step2 : Determine Key stakeholders
Step 3: Define Client Guidelines, Confidentiality
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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
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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
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Invitations to Change
CLINICAL REVERSE
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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
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Agreements
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Lets Brain Storm Pre -Admit
Upon Entry into Treatment
During Treatment
During Clinical Interventions
After Care plan
OutPatient
Home Care
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ResourcesThe 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
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ResourcesBrene 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
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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
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ResourcesStorti www.stortimodel.com
mintz-www.realifeis.com
I’ll Quit Tomorrow -Vern Johnson
TAP 35
Institute for Solution Focused Therapy
www.solutionfocused.net
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An Intervention Guidebookfor Loved Ones and Their Families
LearnThrive:to
LOUISE STANGERED.D., L.C.S.W., BRI II, CIP
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FamiliesCourage-Resilence-Transformation
Sept.7, 2016
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Meet Dr. LouiseAuthor- 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
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ObjectivesIf 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 ?
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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
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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
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What Kind Of Families do You Meet
AGREEABLE
ANALYSIS
INVISIBLE
QUESTIONER
KNOW IT ALL
COMPLAINER
TALKER
WORRIER
MICO-MANAGER
BOOMERRANG
Emotionally intense
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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
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Lets do a Family Map Salvador Minuchin
Flip Chart
Colored Pens for Key
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Keeping The Status QuoSA. MH, CP etc . Organizing structure
Unconscious and Consciously Gratification
Strategies must be employed that change usual ways of relating, categorizing , and thinking
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Family and Confabulations
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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
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Lets Give Our Families No Fault Insurance
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HAVE YOU EARNED THE RIGHT TO HEAR ANOTHER’S STORY ?
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BRAVING - BrownAm 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 ?
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Listening Skills
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History
DR. RUTH R
Pronounced a Disease like Heart Disease &Diabetes
Describable, Predictable and Progressive
If Left Untreated Fatal
1954 American socity on Alcoholism
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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”
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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
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What is AddictionAddiction 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
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Learn Your ABCs
A = Age of First Use
B= Big Changes
C-Co-Existing Mental Health /Behavioral Heath Issues
DNA= Family History
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Enough Buttons
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Process DisordersSEX Porn
GAMING GAMBLING
DISORDERED EATING EXERCISE SHOPPING DIGITAL
SOCIAL MEDIA
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The Adolescent BrainBrain 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
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Other Important Concepts Part 3
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Blaming https://www.youtube.com/watch?v=RZWf2_2L2v8
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Where Are Your
Marbles?
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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
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Who Stole The Cookie From The Cookie Jar?
The Difference between Shame is Guilt
I am bad versus I did something bad
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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…
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Embarrassment
Have you ever felt embarrassed?
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Grief and LossLoss-something of Value is gone
Grief-Total response to emotional experience
Bereavement- Subjective Response by loved ones
Mourning-Behavioral Response
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Whole Hearted Living
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START WHERE YOUR CLIENT IS
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Resilience Quotient Mayo clinic
0= Not at all Accurate
1=Somewhat Accurate
2=Moderately Accurate
3= Very Accurate
4= Extremely Accurate
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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
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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
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Whats ok - Whats Not ok
What was ok before Treatment?
Whats not ok today ?
What gets confusing ?
Boundary Exercise
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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
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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
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Interventions-Crucial Conversations Part 4
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Intervention Teams Participants are experts
Psycho-educational
Value Driven
Directive-Homework
Evidenced Based
Solution Focused
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Intervention Models -Traditional
Vern Johnson
Frank Picard-Family Intervention
Seeley
Southworth
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Traditional Styles Made Modern
Jeff and Debra -Love First
Ed Storti-Authentic Model
Combine Elements of MI into traditional approaches
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Invitational Models
Systemic ( Speare & Raitner)
Arise- Garret & Landau -3 Phase
Lamm-4 Step Model
Action -Campbell & Tracey
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Stanger ProcessPhase One :Intervention Agreement
and Initiative
Step 1:Engagement
Step2 : Determine Key stakeholders
Step 3: Define Client Guidelines, Confidentiality
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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
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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
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Invitations to Change
CLINICAL REVERSE
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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
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Agreements
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Lets Brain Storm Pre -Admit
Upon Entry into Treatment
During Treatment
During Clinical Interventions
After Care plan
OutPatient
Home Care
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ResourcesThe 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
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ResourcesBrene 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
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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
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ResourcesStorti www.stortimodel.com
mintz-www.realifeis.com
I’ll Quit Tomorrow -Vern Johnson
TAP 35
Institute for Solution Focused Therapy
www.solutionfocused.net
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An Intervention Guidebookfor Loved Ones and Their Families
LearnThrive:to
LOUISE STANGERED.D., L.C.S.W., BRI II, CIP