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Families
Courage-Resilence-Transformation
Sept.7, 2016
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
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 ?
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 Quo
SA. 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 ?
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 ?
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 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
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 Disorders
SEX
Porn
GAMING
GAMBLING
DISORDERED EATING
EXERCISE
SHOPPING
DIGITAL
SOCIAL MEDIA 







What’s ya Doing?
Consciously
Unconsciously
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
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 Loss
Loss-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 Process
Phase 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
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
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
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
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
An Intervention Guidebook
for Loved Ones and Their Families
Learn
Thrive:to
LOUISE STANGER
ED.D., L.C.S.W., BRI II, CIP
Families
Courage-Resilence-Transformation
Sept.7, 2016
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
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 ?
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 Quo
SA. 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 ?
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 ?
Listening Skills
History
DR. RUTH R
Pronounced a Disease like Heart Disease
&Diabetes
Describable, Predictable and Progressive
If Left Untreated Fatal
1954 American socity 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 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
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 Disorders
SEX
Porn
GAMING
GAMBLING
DISORDERED EATING
EXERCISE
SHOPPING
DIGITAL
SOCIAL MEDIA 







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
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 Loss
Loss-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 Process
Phase 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
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
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
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
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
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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Families: Courage - Resilience - Transformation

  • 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. 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.
  • 5. 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
  • 6. 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
  • 7. What Kind Of Families do You Meet AGREEABLE ANALYSIS INVISIBLE QUESTIONER KNOW IT ALL COMPLAINER TALKER WORRIER MICO-MANAGER BOOMERRANG Emotionally intense
  • 8.
  • 9.
  • 10.
  • 11. 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
  • 12.
  • 13. Lets do a Family Map Salvador Minuchin Flip Chart Colored Pens for Key
  • 14.
  • 15. 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
  • 17. 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
  • 18. Lets Give Our Families No Fault Insurance
  • 19. HAVE YOU EARNED THE RIGHT TO HEAR ANOTHER’S STORY ?
  • 20.
  • 21. 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 ?
  • 23.
  • 24.
  • 25.
  • 26. History DR. RUTH R Pronounced a Disease like Heart Disease &Diabetes Describable, Predictable and Progressive If Left Untreated Fatal 1954 American Society on Alcoholism
  • 27. 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”
  • 28. 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
  • 29. 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
  • 30.
  • 31. Learn Your ABCs A = Age of First Use B= Big Changes C-Co-Existing Mental Health /Behavioral Heath Issues DNA= Family History
  • 35. 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
  • 36.
  • 37.
  • 38.
  • 42. 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
  • 43. Who Stole The Cookie From The Cookie Jar? The Difference between Shame is Guilt I am bad versus I did something bad
  • 44. 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…
  • 45. Embarrassment Have you ever felt embarrassed?
  • 46. Grief and Loss Loss-something of Value is gone Grief-Total response to emotional experience Bereavement- Subjective Response by loved ones Mourning-Behavioral Response
  • 47.
  • 48.
  • 50. START WHERE YOUR CLIENT IS
  • 51. Resilience Quotient Mayo clinic 0= Not at all Accurate 1=Somewhat Accurate 2=Moderately Accurate 3= Very Accurate 4= Extremely Accurate
  • 52. 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
  • 53. 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
  • 54. Whats ok - Whats Not ok What was ok before Treatment? Whats not ok today ? What gets confusing ? Boundary Exercise
  • 55.
  • 56.
  • 57. 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
  • 58.
  • 59. 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
  • 61. Intervention Teams Participants are experts Psycho-educational Value Driven Directive-Homework Evidenced Based Solution Focused
  • 62. Intervention Models - Traditional Vern Johnson Frank Picard-Family Intervention Seeley Southworth
  • 63. Traditional Styles Made Modern Jeff and Debra -Love First Ed Storti-Authentic Model Combine Elements of MI into traditional approaches
  • 64. Invitational Models Systemic ( Speare & Raitner) Arise- Garret & Landau -3 Phase Lamm-4 Step Model Action -Campbell & Tracey
  • 65. Stanger Process Phase One :Intervention Agreement and Initiative Step 1:Engagement Step2 : Determine Key stakeholders Step 3: Define Client Guidelines, Confidentiality
  • 66. 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
  • 67. 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
  • 69.
  • 70. 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
  • 71.
  • 73. Lets Brain Storm Pre -Admit Upon Entry into Treatment During Treatment During Clinical Interventions After Care plan OutPatient Home Care
  • 74.
  • 75.
  • 76. 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
  • 77. 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
  • 78. 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
  • 79. 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
  • 80. An Intervention Guidebook for Loved Ones and Their Families Learn Thrive:to LOUISE STANGER ED.D., L.C.S.W., BRI II, CIP
  • 82. 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
  • 83. 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 ?
  • 84.
  • 85. 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
  • 86. 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
  • 87. What Kind Of Families do You Meet AGREEABLE ANALYSIS INVISIBLE QUESTIONER KNOW IT ALL COMPLAINER TALKER WORRIER MICO-MANAGER BOOMERRANG Emotionally intense
  • 88.
  • 89.
  • 90.
  • 91. 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
  • 92.
  • 93. Lets do a Family Map Salvador Minuchin Flip Chart Colored Pens for Key
  • 94.
  • 95. 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
  • 97. 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
  • 98. Lets Give Our Families No Fault Insurance
  • 99. HAVE YOU EARNED THE RIGHT TO HEAR ANOTHER’S STORY ?
  • 100.
  • 101. 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 ?
  • 103.
  • 104.
  • 105.
  • 106. History DR. RUTH R Pronounced a Disease like Heart Disease &Diabetes Describable, Predictable and Progressive If Left Untreated Fatal 1954 American socity on Alcoholism
  • 107. 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”
  • 108. 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
  • 109. 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
  • 110.
  • 111. Learn Your ABCs A = Age of First Use B= Big Changes C-Co-Existing Mental Health /Behavioral Heath Issues DNA= Family History
  • 114. 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
  • 115.
  • 116.
  • 117.
  • 121. 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
  • 122. Who Stole The Cookie From The Cookie Jar? The Difference between Shame is Guilt I am bad versus I did something bad
  • 123. 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…
  • 124. Embarrassment Have you ever felt embarrassed?
  • 125. Grief and Loss Loss-something of Value is gone Grief-Total response to emotional experience Bereavement- Subjective Response by loved ones Mourning-Behavioral Response
  • 126.
  • 127.
  • 128.
  • 130. START WHERE YOUR CLIENT IS
  • 131. Resilience Quotient Mayo clinic 0= Not at all Accurate 1=Somewhat Accurate 2=Moderately Accurate 3= Very Accurate 4= Extremely Accurate
  • 132. 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
  • 133. 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
  • 134. Whats ok - Whats Not ok What was ok before Treatment? Whats not ok today ? What gets confusing ? Boundary Exercise
  • 135.
  • 136.
  • 137. 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
  • 138.
  • 139. 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
  • 141. Intervention Teams Participants are experts Psycho-educational Value Driven Directive-Homework Evidenced Based Solution Focused
  • 142. Intervention Models - Traditional Vern Johnson Frank Picard-Family Intervention Seeley Southworth
  • 143. Traditional Styles Made Modern Jeff and Debra -Love First Ed Storti-Authentic Model Combine Elements of MI into traditional approaches
  • 144. Invitational Models Systemic ( Speare & Raitner) Arise- Garret & Landau -3 Phase Lamm-4 Step Model Action -Campbell & Tracey
  • 145. Stanger Process Phase One :Intervention Agreement and Initiative Step 1:Engagement Step2 : Determine Key stakeholders Step 3: Define Client Guidelines, Confidentiality
  • 146. 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
  • 147. 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
  • 149.
  • 150. 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
  • 151.
  • 153. Lets Brain Storm Pre -Admit Upon Entry into Treatment During Treatment During Clinical Interventions After Care plan OutPatient Home Care
  • 154.
  • 155.
  • 156. 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
  • 157. 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
  • 158. 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
  • 159. 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
  • 160. An Intervention Guidebook for Loved Ones and Their Families Learn Thrive:to LOUISE STANGER ED.D., L.C.S.W., BRI II, CIP