Weaving Wellness into

Your Therapeutic

Practice

Kelly Phillips-Henry, Psy.D

AspenPointe Health Services

We must think bigger than just

providing behavioral healthcare

Teaching our Clients to

Understand the Links

Mind and body can not be separated

Stress impacts all aspects of our lives – especially physical

Stress is a causal factor in at least 60% of all medical illnesses

Stress reduces the immune’s system ability to function and fight off illness

If mind-body links are clear, why don’t most people practice good wellness care?

Helping Clients Understand

Quadrant II Priority (Covey, 1989)

Self-Care Integration and Balance

Thirty Days to a Habit

Start with building knowledge

Begin skill building in client expressed areas

Exposure to new experiences in moderate amounts with positive experiences builds desire

Set weekly targets and build off positive experiences

Next Steps in Session

Identify areas of balance/imbalance early in assessment

Set wellness/balance goals in treatment plan

Make appropriate referrals to support goals

Check in each session on these goals to emphasize importance of goals

Celebrate small successes!

Visualizing Total Wellness

Meditation/Tai Chi/Yoga*EMDR*Cognitive Behavioral Therapy *Dialectical

Behavior Therapy*Mindfulness Based Stress Reduction*The Relaxation

Response*Exercise*Laughter*Biofeedback *Tai

Chi*hypnosis*EMDR*Massage*Exercise* Autogenic Training* Exercise*

Art Therapy*Music Therapy*Guided Visualization*

Nutrition*Yoga*Progressive Relaxation* Journaling* Imagery *Pain

Management

A HEALTHY MIND IN A HEALTHY

BODYMichele Willingham

Community Reach Center

Mind/Body practices increase the mind’s capacity to

affect health and bodily function. Research shows they

decrease mental health symptoms and chronic diseases.

A Healthy Lifestyle will improve health and quality of life.

But Not for us….. Our death rate

is accelerating.

A study, conducted by the National Association of State Mental Health Program Directors and the Medical Directors Council noted that suicide and injuries

cause up to 40 percent of excess deaths among the mentally ill, while,

60 percent of premature deaths of people with schizophrenia “are due to medical conditions such as cardiovascular, pulmonary and infectious disease.”

People with mental illness also face additional risk factors of obesity and tobacco usage that could be modified or eliminated, the study said.

The problem is that people with serious mental illness tend to be low on the socioeconomic totem pole and often don't get the best available health care. Frequently, their own doctors pay little heed to their patients' physical health. "Medical doctors think, 'Well, they're crazy,' so they don't take their concerns seriously," says Wendy Brennan, executive director of the National Alliance on Mental Illness (NAMI) in New York City. "Their very real physical symptoms are often dismissed."

Read more: http://www.time.com/time/health/article/0,8599,1863220,00.html#ixzz109KNS7D3

CHRONIC STRESS

Stress is closely associated with hypertension, heart

disease, stroke, arthritis, gastro-intestinal disorders, and other

health problems. According to The American Academy of

Family Physicians, two-thirds of office visits to family doctors

are for stress related symptoms.

Chronic Stress can cause anger or rage, fear or

terror, fragmented and distorted thinking, emotional

liability, memory loss, anxiety, and depression.

STRESS MANAGEMENT IS A VITAL WELLNESS SKILL That

can HELP the MENTALLY ILL overcome these acute and

chronic stress issues.

How Stress Management HELPS

Mind-Body interventions promote healing

Effect positive changes in brain activity

Improve emotional processing

Enhance immune functioning

EVEN BETTER….

Improved rate of recovering from many diseases

Improved circulation and stamina

Management of chronic pain

AND most of all…..

Reduce anxiety, fear and depression

greater mental clarity and peace of mind

experience of INSIGHTS relating to

one’s social, psychological,

and PHYSICAL WELLBEING.

READY TO GET STARTED?

SCALING STRESS

Wellness Interactive Interventions with Scaling

HOW IS YOUR STRESS?

HOW IMPORTANT IS IT TO YOU TO REDUCE STRESS?

WHAT ARE YOU DOING TO REDUCE STRESS?

HOW CONFIDENT ARE YOU IN YOUR ABILITY?

Add it to the Treatment Plan

George will use 3-6 Stress Management/ Wellness

skills daily.

Walking for 10-20 minutes,

Eating fruits/veggies/whole grains,

Tai Chi Breathing,

Laugher and Joy in life every day in every way

Alls Well that Ends Well

Let’s Relax- Like the Kitties!

10 Tips to Help Clients Stop

Smoking

Stephanie Allred, PhD

Axis Health System

Targeting smoking to promote

wellness

Recent research on health disparities

found the average life expectancy of

someone with a significant mental illness

to be as much as 25 years shorter.

Americans with mental illness are nicotine

dependent at rates two to three times

higher than the general population.

1. Create a smoke free

environment

Use “Positively No Smoking” campaigns in

your organization

Is smoking allowed in your residential unit?

Do employees have support and incentives to

stop smoking?

Are there visible signs and messages that no

smoking is allowed, and about the supports

that are available to consumers?

2. Be aware of myths and work to

overcome them.

“Smoking is the least of my client’s

problems.”

“My client needs to overcome other

addictions first.”

“This is not a good time to work on

smoking.”

From a client, “I was told that smoking

would help me with my illness.”

3. Know the Stages of Change

Prochaska & DiClementePre-contemplation

Contemplation

Preparation

Action

Maintenance

Relapse

4. Bring it up, often

Make sure clients are getting consistent messages from case managers, therapists, medical staff. Even administrative staff have a role in enforcing “PNS” and referring to resources.

Ask every consumer at every visit.

Use non-judgmental and open ended questioning, match to client’s stage of change. What concerns do you have about smoking?

Have you ever tried to quit?

Have you ever thought about cutting down?

What are other changes you have made that were difficult?

How do you think your smoking will impact your health in the next 5 to 10 years?

If you decided to quit, how confident are you that you would be successful?

What are some advantages of not smoking?

5. Connect to a range of resources

Colorado quit line: 1.800.Quit.Now

Coaching, groups, or kits offered through

local health department.

“The Easy Way to Stop Smoking” by Allen

Carr.

6. Offer nicotine replacement

therapies, target short term use

Buproprion

Nicotine gum

Nicotine lozenge

Nicotine inhaler

Nicotine patch

7. Use interventions that work

Motivational Interviewing: Elicit change talk, work with ambivalence within stage of change model, increase self-efficacy, develop discrepancies between smoking behavior and values.

Behavioral interventions: Make list of activities that smoking is not associated with.

Distress Tolerance: Increasing ability to tolerate negative emotions (DBT “crisis survival strategies”)

Social Support

8. Incorporate into existing groups

and programs

Acute Treatment Unit

Group therapy

Empowerment Center and Peer Support

Activities

Medication check ups

Coordinate care with client’s PCP

9. Identify and build skills to

improve coping

Assertiveness

Stress management and Relaxation

https://members.kaiserpermanente.org/redirects/listen/

Mindfulness

Exercise

Assist Clients in developing a WRAP (wellness, recovery action plan).

10. Celebrate and reinforce moves

toward change

Provide encouragement when clients acknowledge they want to quit

Reflect sense of confidence in clients’ ability to succeed when they set a quit date.

Celebrate quit anniversaries in groups.

Acknowledge clients who stay quit through difficult times.

Congratulate employees who have quit.

Wellness Strategies with

Chronic Pain Clients

Kathy Baur, Ph.D.

Jefferson Center for Mental

Health

Objectives

Assessing pain levels

Understanding how to apply Gate Control

Theory

Tool kit for working with chronic pain

Assessing Chronic Pain

Rating for understanding

Creating common language

Providing yardstick for

improvement

Types of Scales

Numeric

Semantic Differential

Verbal

Numeric Rating Scale

George

Chronic Low Back Pain

Contributing factors:

Weight gain secondary to

meds

Increase sedentary lifestyle

Repeated injury – poor body

mechanics

Smoker

Poor nutrition

George’s Ratings

Pain Ratings 0 – 10 scale

Average: 5

Highest: 12

Lowest: 3

Describes Pain

Stabbing

Burning

Sharp

Gate Control Theory

Physical

EmotionalCognitive

Behavioral Strategies

Relaxation Strategies

Diaphragmatic breathing

Body Scanning

Relaxation Response

Autogenics

Physical Exercise

Pacing

Modify Your Environment

Modify Activities

Cognitive Strategies

Acceptance

Skillful versus Unskillful responses

Watching our thoughts

Awareness of our stories

Choice based on values not pain

Emotional Strategies

Stress Management

Treating Depression and Anxiety

Dealing with Anger

Serenity Prayer

George’s Program

Exercise

Clearance from PCP

Walking program with core strengthening

Pacing to increase activity levels

ACT strategies to increase willingness and

flexibility

Antidepressants and working Depression

Cure protocol