Learn to identify and describe Collective Intervention Strategies and how they can be utilized in your practice.

1. Collective Intervention Strategies for
Medical Professionals
2019

2. CIS - Especially Designed For Physicians

4. About Dr. Louise Stanger
• Clinician-Educator
• Interventionist
• Falling Up A Memoir of
Renewal- Amazon
• The Clinicians Guide to
Addiction Interventions-
Ruthledge 2018
• Widow, Wife, Mother,
Grandmother
• Soul Cycler- Adventurer

5. How did you arrive ?
Mindful: or Mindfull

6. Objectives
• Identify, Describe and
Introduce CIS
• Define & Describe & Identify
how shame, trauma, addiction,
mental & physical health effect
families
• Demonstrate the power of
family mapping & science of
portraiture in CIS
• Share invitational vocabulary

7. Demonstrate CIS -Case Studies
Clinical & Reverse Interventions
In Medical Settings and Elsewhere

8. Create Possibility
Aspiration that a better life is possible

9. Substance Abuse-
Addiction
Mental Health-
Depression/Anxiety
Chronic Pain-Physical
Maladies
Relationship failures -
Legal
But-how do our clients
arrive?

10. Problematic
Behaviors
Substance Abuse-
Mental Health
Chronic Pain
&
Codependency
&
Process Disorders -Sex, Gambling,Work,
Debiting, Spending, Shopping ,Religiosity,
Disordered Eating, Digital etc.

12. ASAM March, 2011
A Primary Chronic Disease
of the brain reward,
motivation, memory and
related circusy
Dysfunction leads to
Biological, psychological,
social and spiritual
manifestations
Individual pathologically
pursing reward or relief
thru substances

13. Chronic Pain
133 million People Experience
Chronic Pain
1 in 5 globally (more women then
men )
65% of all people experience
chronic pain once in their life
75 % of all heroin users started with
a prescription
Annual cost of $365 billion , $154
For young people
151 people die daily (CDC)

16. Mental Health Issues
Anxiety
Depression
Narcissism
PTSD
Bi-Polar
Personality
Psychosis
Phobias

18. Shame

21. Trauma

22. Definitions of
TraumaOverwhelming experiencing
that cannot be integrated
and elicit animal defensive
mechanisms and
dysregulated arousal
“A stress that causes
physical or emotional harm
that you cannot remove
yourself from”
Larke Huang , Director of
Health Care Equity at
SAMSHA

23. Trauma is objective
What happened ( I was
date raped , humiliated
, I fell of a ladder, had
a concussion, was in a
terrible accident etc

24. Trauma is subjective :
How do I perceive the situation ?
Relationship to early
child- hood experiences -
and Alcoholism
Adverse Childhood
Experience- 17,000
patients -Kaiser- effects
of trauma are cumulative
and one of most
destructive forms is
recurrent calling and
humiliation

25. What do your Clients Say about
Trauma ????
Verbal abuse
Physical abuse
Witnessing a tragedy
Not being told about
something
Accidents
Divorce
Death

27. Addiction -Attachment Disorder
Values are lost as we attach to substances and other unhealthy behaviors

28. Dr. Louise A. Stanger
“An Intervention is an invitation to
seek
and accept care “

31. Professional Interventionists are
Called when
Families are Fearful
,Angry &Confused
Attached to the
Problem
Cognitively and
emotionally Dis-
regulated
Attempts have failed

32. Collective Intervention Strategies
Louise Stanger Ed.D, LCSW, CDWF, CIP

33. Why CIS?
• Collective - In that to be successful there must be a team
of Families, Friend, Collegues, Associates, business
partners , managers or co-workers assembled to bring
about change
• Intervention- In that we seek to move (i.e/ motivate a
person to a place of change)
• Strategy, in that nothing is set in stone ; we may adapt
the process as needed

34. • Strength Based
• Solution Focused
• People are Teachable
• Change is Possible
• The Present is Important
• We can rise to our best
possible self
Philosophical Underpinnings

35. Theoretical
Underpinnings
Salvador Minuchin
Virginia Satir. TFT
Bowen , Family
Systems
Bowlby, Attachment
Monica McGoldrick-
Family Systems
Therapy

37. Theoretical Strategies
• Motivational Interviewing
• Cognitive Behavioral
• Acceptance & Commitment
• Values Clarification
• Solution Focused
• 12 Step or other Self help
• Mindfulness
• Breathing

38. Counseling Skills Used
• Listening- Empathy
• Genuine
• Unconditional Positive Regard
• Concreteness
• Reflecting- Echoing Key words
• Body Language
• Open Ended Questions
• Paraphrasing- Summarizing
• Counselor Self Disclosure
• To Do Not Harm

39. Collaborator
I am the mirror who reflects back their pain, their fears
their voices. I am the inquirer who asks difficult
questions, who searches for evidence and patterns. I am
the companion on the journey bringing my own story to
the encounter, making possible an interpretive
collaboration, I am the audience who listens , laughs ,
weeps an applauds. I am the spider women spinning
their tales.. I am the therapist who offers cathaersis
support and challenge… I am also the stage manager
coordinating the intersection of three plays-the story
teller, the narrator and the readers inviting your voice to
the drama” Sara Lawrence Lightfoot

40. Interventions Include a Village of
Potential Change Agents
Participants are experts
Value Driven
Solution Focused
Evidenced Based
Interventionists job is to
bring people together for
the common good and to
identify SA, MH and other
issues

41. Families are taught
• The nature of substance abuse
process and mental health
disorders. If appropriate about
chronic pain syndrome or other
medical legal problems
• The way an intervention is
conducted
• The active and instrumental
part they have in moving
someone to change

42. Clinician Interventionsist
Must Be able to :
• Develop a Team
• Do a Family Map that engages everyone
• Do a Retrospective -bio-psycho-social
• Develop case strategy
• Create Treatment Plan & Placement
• Case Management
• Follow with Aftercare
• Facilitate Family Engagement in the healing
process
• Have Concierge Capabilities
• ETHICS are Paramount

44. Dr. Louise Stanger
“An Intervention requires Crucial Conversations”

45. Collective
Perspectives
Bringing Folks
Together
For The
Common Good

46. Intervention Teams
What are your Protocols ?

47. Clinical & Reverse
Interventions

48. Hospital Interventions
• The ER
• Short Term Motivational
Interviewing
• Referral Team

49. Interventions in Your Office
• Mother comes in Worried
about her daughter
• Daughter comes in worried
about her mother
• Another Physican comes in
worried about his/her
colleague

51. Chronic Pain Patients

53. Reverse Intervention

54. Clinical Intervention

55. Family Mapping
A Way into Story

57. Dr. Louise Stanger
“A Successful Intervention has the Potential To
Transform not just the Identified Client but the
Entire Family”

61. Meet Ricardo
Prostrate Cancer
Depression
Anxiety
Heavy drinker, smoker,some , pills and meth
Once successful know works graveyard shift
at Amazon
Kasier Patient

62. Meet Sylvia-62
Hoarder- Depression- Substance Misuse
• A-Valium from Mom
• B= Suicide adopted son, two
daughters, Husband had
affairs
• Stole money from dying
mother, collects, collects,
collects little trinkets
• C-Cognition Problems,
MH/SA/RO Early Dementia

63. Meet Sally

64. Chronic Pain

65. 100 Million- One in Ten
Americans - 1.5 Billion
Globally

66. Concussions
Facial pain
Neck Pain
Accidents -Driving, Texting
Exercising, Weekend
Warrior Tasks
Hips, Knees , Shoulders

67. Low back pain
Osteoarthritis
Rheumatoid Arthritis
Migraines
Fibromyalgia
Pelvic Pain
Carpel Tunnel Syndrome

68. Common Types of Chronic
Pain
• 28% Low Back Pain
• 15% Migrane or Headache
• 15 % Neck Pain
• 4 % Facial Pain
• #1 Cause of long term
disability

69. Impact of Chronic Pain on
Families
• Person with Pain
• - Pain that does not show
• -Fluctuating Activity Levels
• -Isolation in home and income
• -Unpredictable Mood Swing
• Doubt about reality of Pain
• Loss of friends, job, productivity
• Loss of plans , hope for the future
• Family Members
• -Inability to see or feel pain
• Increased responsibility for
maintaining home and income
• Loss of personal support
system
• Emotional Outbursts of person
with pain’Added Daily stress
• Loss of plans and hope for the
future

70. Who would of ever thought
Canoeing

71. Meet Maddi
10 operations - 6 treatment centers

72. First major accident age 14
Family History of SA , MH and
Molestation
Pain Body, Sexual Assault Trainer
For past 9 years has been in and out of
treatment centers
Walking on crutches or not walking at all

73. Maddi gains trust with primary clinician
Maddi gains trust with exercises
Maddi Starts to talk to therapist
Family is confronted with their substance
abuse and their need to detach
Maddi experiences a difference in family
Maddi experiences a Community Integration
Approach
Maddi could be your next client

74. Accepted to premed

75. Meet Helen - 62 y.o
FemaleHip replacement
Knee replacement’
Shoulder
Constant pain-anxiety
Cancer survivor
Tried to commit suicide
Angry Husband & Family
Addicted

76. IN THE
BEGINNING
Not able to take breaths -
use of Heart Math
Self Esteem was missing
Smile was gone
Only memories of what
once was

77. I Have Lost
Relationships
Money
Self Esteem
Ability to Walk
Smile

78. Strategies
15 day detox- Pain still 20% due to
Hyperalgesia
Education
Cognitive Behavioral Therapy
Mindfulness
Mediation
Yoga etc - Canoeing- walking
Peer Support

79. Strategies
15 day detox- Pain still 20% due to
Hyperalgesia
Education
Cognitive Behavioral Therapy
Mindfulness
Mediation
Yoga etc - Canoeing- walking
Peer Support

82. Collective Intervention
Strategy
In Medical Settings

83. To Contact Dr. Louise
Stanger
619-507-1699, www.allaboutinterventions.com
drstanger@allaboutinterventions.com

84. Resources
Stanger, L & Weber, L. 2018. The Definitive Guide to Addiction Interventions-
Collective Strategies . NY . Routhledge.
Stanger, L. 2016. Falling Up-A memoir of Renewal. Ca. WZY Press. available
on Amazon
Stanger, L 2016. Learn to Thrive : An Intervention Guidebook (available at
www.allaboutinterventions.com)
Stanger, L & Roger P. 2016-present Huffington Post, Thrive Global, The Sober
World, Renew, Recovery View, DB Resources, Counselor Magazine etc.
Stanger, L .& Flowers, J. 2016-present. Huffington Post, Thrive Global,The
Sober World.
Stanger, L & Holsomback, J. 2016-present. Huffington Post, Thrive Global, The
Sober World.
Stanger, L. WWW.AllaboutInterventions.com

85. Resources
Brown, Brene- Rising Strong . Speiegel & Grau International
2015 NYC NY
Brown, Brene, DaringGreatly. Gothom Books 2012
Lawrence Lightfoot,Sarah & Hoffman Jessica .The Art and
Science of Portraiture. Joey Bass. 1997
LawrenceLightfoot, S. Respect , 1998. Press Books, Mass.
Lawrence, Lightfoot,S. I’ve Known Rivers , Penguin Publishing.
Ny 1995
Lawrence, Lightfoot, S Growing Each Other Up, University of
Chicago Press. 2016

86. Resources
Kopp, Sheldon- If You Meet The Buddah on the Road , Kill
Him, 1982. Penguin House Random House, NY, NY
Stanger, Louise. Falling Up- A Memoir of Renewal 2015,
WZY Press
Stanger,http://www.huffingtonpost.com/entry/tricksters-
addiction-you_us_592f0f7ee4b0d80e3a8a329e
Stanger http://www.huffingtonpost.com/entry/what-are-the-
differences-between-trauma-
addiction_us_58f4e7aee4b048372700da27
www.allaboutinterventions.com

87. Resources
Stanger articles https://www.allaboutinterventions.com/pain-
management-and-opioid-
addiction/http://www.huffingtonpost.com/entry/
Stanger, Porter, Flowers Huffington Post-Trauma and
Addiction http://www.huffingtonpost.com/entry/trauma-
addiction-whats-the-
difference_us_58d14912e4b0e0d348b347f3
Flowers Articles,https://www.thriveglobal.com/authors/3611-
james-s-flowers-phd-lpc-s-and-angela-harris-msw-candidate
Stanger,https://www.allaboutinterventions.com/current-
news/

88. Resources
Stanger www.allaboutinterventions.com
Systemic Model www.systemicintervention.com
Arise www.linkingsystems.com
Jays www.lovefirst.net
Lamm www.bradlamm.com
Seeley www.intervention911.com

89. Resources
Stanger www.allaboutinterventions.com
Systemic Model www.systemicintervention.com
Arise www.linkingsystems.com
Jays www.lovefirst.net
Lamm www.bradlamm.com
Seeley www.intervention911.com

90. Resources
storti-www.stortimodel.com
Mintz www.reallifeis
Tap 35
www.motivational interviewing.org

91. Resources- Chronic Pain
R, L. Nahim, Estimates of pain prevalence and severity in adults,
2012, “j Pain, vol.16, no 8 pp789-80
A. May, “Structural Brain Imaging. A Window into Chronic Pain", The
Neuroscientist,vol17,No 2,pp.2019-220, 2011
Napadow& R.E. Harris ,”what has functional connectivity and
chemical neuroimaging in fibromyalgia taught us about the
mechanisms and management of centralized pain ? Arthritis Research
and Therapy .vol 16
Ingemanson, Morgan PHD , “Chronic Pain Lives in the Brin, April 17,
2017 Vox Brain Map http://evoxbrainmap.com/chronic-pain-lives-
brain/

92. Resources-Chronic Pain
Nahin, R. ,Boineau, R, Partap. S. K.,
Stussman, Weber, N.D. Evidence -Based
Evaluation of Complementary Health
Approaches for Pain Management in the
Inited States , Sept. 2016
Why Goldilocks is my Rehab Heroine
https://meduim.com/cheryllee-98816/why-
goldilocks-is-my-rehab-heroine

93. Resources-Chronic Pain
Driftwood Recovery https://www.driftwoodrecovery.com
http://www.nbcnews.com/nightly-news/video/louisville-kentucky-
sees-spike-in-heroin-overdoses-876423747884
Achenbach, Joel.The Washington Post, Dec.23, 2016. An opioid
epidemic is what happens when only treated with pills.
Gebelhoff, R. The opioid epidemic can turn into a pandemic if we
are not careful. The Washington Post .Feb. 9, 2017
https://www.washingtonpost.com/news/in-
theory/wp/2017/02/09/the-opioid-epidemic-could-turn-into-a-
pandemic-if-were-not-careful/?utm_term=.d7f5c8218e3c

94. ResourcesTrauma-
Addiction-Chronic PainStanger articles https://www.allaboutinterventions.com/pain-
management-and-opioid-
addiction/http://www.huffingtonpost.com/entry/
Stanger, Porter, Flowers Huffington Post-Trauma and
Addiction http://www.huffingtonpost.com/entry/trauma-
addiction-whats-the-
difference_us_58d14912e4b0e0d348b347f3
Flowers Articles,https://www.thriveglobal.com/authors/3611-
james-s-flowers-phd-lpc-s-and-angela-harris-msw-candidate
Stanger,https://www.allaboutinterventions.com/current-
news/

96. Brief History Lesson
• Surprise
• Invitational
• Action
Intervention “Models”

97. Traditional Surprise
Vern Johnson-I’ll Quit
Tomorrow
Frank Pickard- Family
Intervention
Ken Seeley-Face It Fix
It John Southworth-
Intervention Show

98. Traditional Made
Modern
The Storti Model Est.
1973
Heart to Heart: The
Honorable Approach to
Motivational
Intervention, 1995

99. Jeff and Debra Jay
Love First , A Families
Guide to Intervention
2000
Aging & Addiction ,
Colleran and Jay 2010
It Takes A Family,
2014

100. Action Intervention Model
Jean Campell LCSW,
Dr. Jim Tracey and Bill
Maher
Psychodrama ,
sociometry and other
action oriented
strategies for families

102. Thought Leaders in Invitational
Models
Spaere & Raitner -
Systemic
Arise -Garret and
Landau
Breakfree- Lamm

104. Interventions are
an Invitational
Process
An 11 step process for a 12 step
solution
Stanger
2016
on line
www.allaboutinterventions.com