Aftercare, not an After Thought
Secret Languages of Teens
The "Real" 411 on Marijuana
Slow and Steady...
New Year's Resolution #1: No More Resolutions!
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March 6, 2008
Aftercare, not an After Thought
It has become clear that many of us in our profession believe strongly in aftercare and supporting the whole family through the various transitions our families' experience. Vive has been asked by many professionals to bring more awareness and education to the importance of aftercare programming. In order to facilitate a discussion regarding transitions and aftercare, we will use this blog site to assist in the dialogue. We invite you to join, share your perspective, and be part of the conversation on transitions and aftercare.
The following entry builds off of a panel discussion that took place at NATSAP a few weeks ago.
"Aftercare can no longer be an after thought." Success for families increases when professionals work together to support the whole family throughout the many transitions of out-of-home placements in preparation for the final transition of returning to one's real world.
Throughout the conference there were many conversations with both panel members and the audience discussing the question, "How do we make aftercare more of a priority?" Some thoughts on this are:
* Continue talking about it with your colleagues.
* Challenge each other in conversations to look at our programming, look at our systems, and look at our business plans.
* Explore how we place value on family systems work.
* Explore how our case loads impact our ability to work with the whole family and the next program.
* Determine if our fee structures take into consideration the additional resources needed to work with the family to support healthy transitions.
* Look for ways to help families reserve some resources for aftercare, whether that is through bundling aftercare support into an educational loan on the front end of treatment, or creating foundations for families to tap into for this important next and final step in the continuum of care.
It can be a challenge to introduce a new idea and establish a new way of approaching how we do things as an industry. Communication is the agent of change. As professionals, we engage in healthy debate in order to influence positive change. So let's dialogue!
Below you will find the themes that emerged during the panel discussion. Please, share your comments.
How can Educational Consultants position aftercare so families commit to this process?
Transitions between Programs
Good communication does happen between programs but it is very hit and miss. This needs to become a "best practice" across the profession.
* For example, during the students last week at Aspiro students are allowed to see the web site of the next placement and even talk to the intake director or therapist at the new school. This seems to improve the student "buy in" to their next placement AND improves communication between programs so good information is not lost.
* When possible, a therapist will provide transportation to the next program. This decreases the anxiety for the student when they are with someone they know and it allows a face to face meeting with the new therapist to transfer the info and establish an on-going relationship.
Family Reunification
If the main goal for most families is "Reunification" then, as an industry, we must do a better job of working with complete "Family Systems".
* Major obstacles to this are:
* Logistics of spending time with the family because of distance.
* Specific focus of the program allocates all resources towards this area of expertise and treatment:
* Possible solution to consider: Collaborating with aftercare programs, whose specific area of expertise is supporting the whole family in the home environment, in order to allow for a parallel treatment process DURING and AFTER residential treatment.
The whole family needs support during any transition. Whether a student is returning home or striking out on their own, parents experience a large amount of anxiety. The more support parents receive from professionals during these transitions, the more success the young person will experience.
Aiding the development of relationship rich environments. From wilderness to aftercare it was clear; the power of our profession is our ability to create healthy relationships with students and families. There were many models represented both on the panel and in the audience, and each one established that developing healthy relationships with all key stakeholders during the transition is a key element to a success.
January 15, 2008
Secret Languages of Teens
Are you a bit freaked out by your teen's use of secret code, whether when IMing or texting? You're right if you think that this code is, in part, designed to keep you in the dark. In some cases, this secrecy is actually just a functional way for your child to establish boundaries and do their job as a teen--to seperate and create their own identity. On the other hand, if your child is involved in high risk behaviors, this secrecy can prevent you from doing your job as a parent--to provide safety for your child.
Be assured that secret languages are nothing new. Ememberay igpay atinlay? The web and phone technology, however, allow for a very powerful type of secret networking that can be hazardous for young people who are easily influenced, or who are drawn to high risk behaviors. The following link to an article by ABC News offers a balanced look at teen code, along with some practical resources for parents.
http://abcnews.go.com/GMA/AmericanFamily/story?id=2820582&page=1
January 14, 2008
The "Real" 411 on Marijuana
I have been inundated with information about "Weed" over the last decade working with teens and families. I decided to seek out facts from experts that would assist in my filtering between the true and the false. Marijuana is such an ingrained obstacle for our teens, many parents just assume they will be asked to partake and many believe experimentation is just a part of growing up. Marijuana has moved from secret citizenship to a media symbol with today's teenagers. It is mass marketed on clothing, magazines and music. There is an entire award winning, cable series based on the selling and smoking of marijuana by a suburban mom. A parent myself, I decided to share with you what I found to be the "real" 411 on marijuana.
Marijuana is the most commonly abused illicit drug in the United States and it has been around as early as 10,000 BC per newscientist.com. The main active chemical in marijuana is THC.
Marijuana is a mixture of dried leaves and flowers of Cannabis sativa, a hemp plant. There are hundreds of slang terms for this drug including "pot," "herb," "weed," "boom," "Mary Jane," "gangster," and "chronic." It is usually smoked as a cigarette (called a joint or a nail) or in a pipe or bong. In recent years, it has appeared in blunts. These are cigars that have been emptied of tobacco and re-filled with marijuana, often in combination with another drug, such as crack. Some users also mix marijuana into foods or use it to brew tea.
The short-term effect of marijuana use include: problems with memory and learning, distorted perceptions, difficulty in thinking and problem-solving, loss of coordination, increased heart rate and anxiety. Smoking five joints a week is equivalent to smoking a whole pack of cigarettes a day which leads to lung and respiratory problems, wheezing, chest cold and a bad cough.
Long-term use can increase the chances of tissue damage and lung cancer and also causes changes in the brain similar to those caused by heroin and cocaine.
Several studies have linked marijuana with poor school performance. It is harder to concentrate and retain information when a person is smoking marijuana. 60% of teenagers in drug treatment programs are there because of marijuana.
Marijuana itself does not lead a person to take other drugs; people take drugs to get rid of unwanted situations or feelings. The drug only masks the problem for a while. When the high fades the problem or unwanted situation returns, more intense. This is the reason why people turn to stronger drugs to hide from their problems.
Marijuana, under the Controlled Substances Act (CSA), is classified as having a high potential for abuse, no currently accepted medical use in treatment in the United States, and a lack of accepted safety for use of the drug or other substance under medical supervision.
Between October 2004 and January 2005, there were 1,777 Federal offenders sentenced for marijuana-related charges in U.S. Courts. Approximately 94.9% of the cases involved marijuana trafficking. Between January 2005 and September 2005, there were 4,396 Federal offenders sentenced for marijuana-related charges in U.S. Courts. Approximately 95.8% of the cases involved trafficking.
If you would like to learn more about the true facts of marijuana please log on to stopaddiction.com
I hope you find these true facts provided by Narconon as helpful as I do.
Be well,
Michael Behmer MA, MFT
Vive, Inc.
January 1, 2008
Slow and Steady...
My brother in law, Wayne, is a busy newspaperman living in Alabama on a diet consisting of a little too much barbeque, casserole, and other southern delicacies. Having lived in the South myself, I know how irresistible, and decadent, southern comfort food can be. Wayne also has a weakness for excellent wine and is the doting father of a three year old and a newborn. The result of all of these blessings is a happy man with a large belly.
Underneath his 50 extra pounds, there's a solid athlete dying to come out. Despite several remarkable attempts to overcome his circumstances and revolutionize his lifestyle, Wayne has been frustrated in his efforts to sustain change. Case in point--while we spent the week together with our respective wives' family in a cabin in Arkansas, Wayne would charge out the door for a run, coming back two hours later sweaty and grinning. The next day, he wasn't even sore. I've seen him do this before, most notably on previous Christmases in anticipation of the New Year and its opportunity--and pressure--to start anew. But despite, or maybe because of, Wayne's uncanny physical and mental ability to go from zero to sixty instantly, his efforts at change have tended to be short lived. He's supercharged and impatient. Not an unusual combination among achievers, but one that has a double edge.
We discussed Wayne's frustration and his desire to finally get, and stay, in shape. "Man, I tell you, Will, it is tough," Wayne confessed. "Every night, because of our visibility in the community, we get offers of free dinners, and it's all so good. We're so busy with the paper and the kids, that it's tough to resist these offers and equally tough to keep to a fitness plan." So he tries, all at once, to overcome his circumstances, but after a short while of two-hour runs or suddenly ascetic dieting, he's back to more familiar ways. Wayne's difficulty sustaining change is not due to weakness of discipline or lack of desire; he's just employing an approach that, given his circumstances, is not effective. Brain science has uncovered some of why our best efforts at personal transformation fail. Sudden changes of habit trigger a fight or flight response in us that is tough to conquer. So when Wayne, with great resolve, changes his physical behavior or his diet, his brain says, "whoa, fella, not so fast. I'm comfortable where I am and all this change is scaring me." The result is anxiety, which can manifest as fatigue, avoidance, and failure.
So Wayne and I are working together to construct a fitness plan that employs the Kaizen Approach (see previous blog entry) to change. The Kaizen Approach--a Japanese adaptation of W. Edwards Deming's Continuous Quality Improvement (CQI) method--approaches large changes a little at a time, employing constant micro-efforts. Kaizen has been traditionally applied to corporations seeking to improve efficiency, but has recently been applied with great success to human behavior. Constant micro steps toward change tricks the amygdala into thinking that the change you're after is no big deal, so the fight or flight anxiety response is circumvented. The result is a much easier and more sustainable path to change.
Wayne will be writing a column on his Kaizen-style progress in his newspaper, which I'll link to in this blog. So we'll get to see how well the Kaizen Approach works!
Here are a few of the building blocks we're starting with for his tortoise-styled quest for fitness:
• I had Wayne pick an ambitious, but achievable goal...a goal that makes him a little nervous to keep him inspired and motivated!
o SELECTED GOAL: Run his first marathon in April
• I had Wayne break his goal into three possible outcomes: Bronze, Silver and Gold, so that there is flexibility, not rigidity, in his ambition.
o Bronze: goal that, with solid work, is well within Wayne's reach (banning sickness or injury).
BRONZE GOAL: finish
o Silver: a solid stretch goal--something can achieve if his training is solid and his race day performance is strong.
SILVER GOAL: undetermined
o Gold: a goal that would involve his best training, the achievement of all of his training benchmarks, and his best race day performance, plus a little luck
GOLD GOAL: undetermined
• We will break Wayne's work down into daily micro-tasks...change will happen a little bit every day. My job at first will be to hold Wayne back!
• We will introduce areas of change one at a time. For now, Wayne gets to eat and drink as he normally does. We're focused right now only on introducing regular, moderate exercise. Diet can wait until exercise has become a comfortable fact of life. Too many changes at once will freak out the amygdala!
The Kaizen Approach to change has been shown to work in lots of personal areas--exercise, addictions, diet, etc.--that people often find hard to change despite (or because of) an intense desire to do so. I'll upload the articles on Wayne's progress as they are published so that you can see Kaizen in action!
December 31, 2007
New Year's Resolution #1: No More Resolutions!
Here's an article I wrote a year ago and am recycling. I'll be posting a followup to it later this week where we'll follow someone who is trying to implement a Kaizan Approach to change in his life this year. We'll see how it works!
If you have ever poured your mind, body and soul into creating and implementing New Year's resolutions, chances are good you won't be doing that again soon. New Year's resolutions are more notorious for producing frustration than personal growth; because of this, many therapists suggest alternate methods for moving to higher ground.
"My advice regarding New Year's resolutions," says Judith Brodie, a Denver, Colorado based therapist, and a parent coach, "is to not make them!" In her work at Vive!, Inc., a Boulder, Colorado-based company that helps families struggling with a troubled teen, Brodie has worked with countless parents who were desperate to make changes, but exasperated by failed attempts.
Despite Brodie's dismissive approach toward resolutions, she is a champion of process-oriented personal growth. "I'm a proponent of process," says Brodie, "of figuring out what we're ready for, what we want, what we need, and then taking small steady steps in that direction. Jumps, dives, and resolutions, in my experience, are hard for people to sustain."
Psychologist Robert Maurer, a professor in UCLA's Family Medicine Department, agrees with Brodie. "The average American makes the same New Year's resolution seven years in row before giving up," he says, "this is hardly a practical solution to us wanting to better our lives." In his new book, One Small Step Can Change Your Life, Maurer applies the Japanese corporate philosophy of Kaizen--or continuous improvement through micro changes--to therapeutic healing. Instead of creating frustration and failure by attempting immediate large-scale change, Maurer suggests easing into change. "My suggestion is to take an area of life you'd like to improve and identify an activity in that area you'd like to be doing. Engage in this activity for just one minute a day, four, five or six days per week to start."
In One Small Step Can Change Your Life, Maurer tells the story of a patient who had failed repeatedly at her attempts to stick with an exercise program. Her resistance to exercise was so great that he had her just stand on her treadmill for a minute a day where she would drink her first cup of coffee and read the paper. Before long, Maurer reports, standing led to walking a little and walking a little led to walking more and more. Small steps, Maurer contends, circumnavigate our natural, neurologically based resistance to radical change, clearing the path for a process of incremental, often life changing, improvement.
"A journey of a thousand miles begins with a single step," Maurer reminds us, "and research suggests that those steps need to be as small as possible to make the giant leaps we all want in our lives."
Drew Krafcik, a therapist for Vive! Inc., suggests that there is some preliminary work to be done before we even select these areas of incremental change. "Understanding why we choose to make a New Year's resolution is much more important than the resolution itself. If we don't fully understand why we've started something, how could we expect to understand why we might quit?" Krafcik suggests starting with a broad view of what we want to change in our lives and becoming clear about our motives, visions, and fears before engaging in the change process.
So this New Year, it might be good to stick to one resolution: "no resolutions!" Instead, come up with a New Year's vision--a broad-stroke image of what you want your life to look like over the next few years. Revisit this vision frequently or post it in a highly visible location, like over your desk, and use it as a rubric to evaluate all the small, even miniscule, decisions you make on a daily and weekly basis. Constantly ask, "is this small decision leading me toward, or away from, my vision of who I want to become?" You can also focus in on one or two specific activities that support this personal vision and fold one minute's worth of that activity into your schedule several days each week. This one minute might be the start of your own thousand mile journey as one minute becomes two minutes, then three minutes, then thirty minutes over time.
This "Kaizen" approach to change combines the benefits of small, manageable steps with the benefits of accumulated effect. By committing to small but continuous change this year, you may be able to achieve a great deal while avoiding the dicey, often discouraging, routine of New Year's resolutions.
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