Families: Courage - Resilience - Transformation

FamiliesCourage-Resilence-Transformation

Sept.7, 2016

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

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 ?

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

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

What Kind Of Families do You Meet

AGREEABLE

ANALYSIS

INVISIBLE

QUESTIONER

KNOW IT ALL

COMPLAINER

TALKER

WORRIER

MICO-MANAGER

BOOMERRANG

Emotionally intense

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

Lets do a Family Map Salvador Minuchin

Flip Chart

Colored Pens for Key

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

Family and Confabulations

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

Lets Give Our Families No Fault Insurance

HAVE YOU EARNED THE RIGHT TO HEAR ANOTHER’S STORY ?

https://www.youtube.com/watch?v=1Evwgu369Jw

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 ?

Listening Skills

History

DR. RUTH R

Pronounced a Disease like Heart Disease &Diabetes

Describable, Predictable and Progressive

If Left Untreated Fatal

1954 American Society on Alcoholism

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”

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

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

Learn Your ABCs

A = Age of First Use

B= Big Changes

C-Co-Existing Mental Health /Behavioral Heath Issues

DNA= Family History

Enough Buttons

Process DisordersSEX Porn

GAMING GAMBLING

DISORDERED EATING EXERCISE SHOPPING DIGITAL

SOCIAL MEDIA

What’s ya Doing?

Consciously Unconsciously

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

Other Important Concepts Part 3

Blaming https://www.youtube.com/watch?v=RZWf2_2L2v8

Where Are Your

Marbles?

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

Who Stole The Cookie From The Cookie Jar?

The Difference between Shame is Guilt

I am bad versus I did something bad

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…

Embarrassment

Have you ever felt embarrassed?

Grief and LossLoss-something of Value is gone

Grief-Total response to emotional experience

Bereavement- Subjective Response by loved ones

Mourning-Behavioral Response

Whole Hearted Living

START WHERE YOUR CLIENT IS

Resilience Quotient Mayo clinic

0= Not at all Accurate

1=Somewhat Accurate

2=Moderately Accurate

3= Very Accurate

4= Extremely Accurate

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

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

Whats ok - Whats Not ok

What was ok before Treatment?

Whats not ok today ?

What gets confusing ?

Boundary Exercise

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

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

Interventions-Crucial Conversations Part 4

Intervention Teams Participants are experts

Psycho-educational

Value Driven

Directive-Homework

Evidenced Based

Solution Focused

Intervention Models -Traditional

Vern Johnson

Frank Picard-Family Intervention

Seeley

Southworth

Traditional Styles Made Modern

Jeff and Debra -Love First

Ed Storti-Authentic Model

Combine Elements of MI into traditional approaches

Invitational Models

Systemic ( Speare & Raitner)

Arise- Garret & Landau -3 Phase

Lamm-4 Step Model

Action -Campbell & Tracey

Stanger ProcessPhase One :Intervention Agreement

and Initiative

Step 1:Engagement

Step2 : Determine Key stakeholders

Step 3: Define Client Guidelines, Confidentiality

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

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

Invitations to Change

CLINICAL REVERSE

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

Agreements

Lets Brain Storm Pre -Admit

Upon Entry into Treatment

During Treatment

During Clinical Interventions

After Care plan

OutPatient

Home Care

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

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

http://www.self-compassion.org

http://ftisb.org

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

ResourcesStorti www.stortimodel.com

mintz-www.realifeis.com

I’ll Quit Tomorrow -Vern Johnson

TAP 35

Institute for Solution Focused Therapy

www.solutionfocused.net

http://www.stortimodel.com

http://mintz-www.realifeis.com

http://www.solutionfocused.net

An Intervention Guidebookfor Loved Ones and Their Families

LearnThrive:to

LOUISE STANGERED.D., L.C.S.W., BRI II, CIP