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• What are your general reactions to Stephanie’s personal narrative?
My initial response is angry, sad and frustrated. Her experiences are unfortunately not uncommon for the age group and for many individuals who are attempting to seek and engage in services. My favorite part of being in the field is hearing people’s stories and hearing them talk about how their experiences shape who they are in the moment we have met.
• What are your thoughts on the difference between the medical model, pathology-based approach and a person-driven, recovery-oriented approach to helping as embodied by a peer recovery support approach that Stephanie describes in her story?
As a provider it can feel incredibly suffocating at times when trying to provide good supportive care, but also needing to stay within specific guidelines/expectations as related to patient safety and overall wellbeing. I was thinking of the Columbia suicide screener which we used at my last job, the screener is incredibly subjective and at the end the “rating” provide the recommendation of treatment and as he provider if you made the clinical decision to not follow the screener it was almost punitive when finishing documentation. I understand the intention behind some of the models but the current systems are ineffective. The institutionalization of services is strongly embedded into how we are asked to practice and even many patients are strongly against utilizing peer supports as they are not “professionals” , despite having an understanding of the evidence that supports the effectiveness of peer supports.
• What are some strategies you have or would use to link consumers to peer recovery support services in your community and develop collaborative relationships with peer specialists?
In my current role we ae able to enter the community so identifying various opportunities and supporting someone as they feel comfortable to engage in new supports. Sharing the benefits can also help shift someone’s thinking and perspective. I know in a previous role I would often ask peer support groups or individuals to come in to talk about services and to share their own story as a way to make programs more accessible.
• Take a moment to reflect on the course material over the past four weeks and the new insights you have gained about wellness and recovery promotion. How do you envision bringing these new insights into your work with consumers?
I found this to be a great reminder of the importance of client driven and peer supported services. I currently work in residential treatment which can feel isolating for many of the individuals so working to continue to connect them with peer services and supports will continue to be a focus. If I ever shift back into therapy, I will continue to work to ensure clients/patients continue to drive treatment and work together to identify resources and tools that will be helpful in allowing the individual to meet their goals.1) What are your general reactions to this exercise of identifying wellness goals and taking action to achieve them?
I found this exercise to be helpful to identify what my goals are and how to move through barriers. I often use this type of exercise in practice so it was a good exercise for me to practice for myself.2) What did you discover about how your strengths, supporters, and or community resources might help you overcome barriers to taking an action step or reaching your goal?
I can be easy to focus on the barriers or negatives and this was a helpful reminder of how to access support and what that might look like. Writing things out allows for a more clear plan of action.3) What are some strategies you would employ to help consumers develop and implement their own wellness/recovery plans? I practice from strength based/recovery perspective and have used similar tools to support development of goals and steps to get there. Creating a treatment plan that does not start from recovery or does not allow the client to set the goals or pace of treatment feels disempowering and will not support someone to continue with motivation for change. During the intake process we talk through the “ideal” and then break that down into smaller goals. if someone is focused on the current challenges and unable to establish a big picture we work on day to day goals that are identified by the client.
What are your general reactions to this exercise of identifying strengths and reflecting on how a strength can help you achieve a recovery or wellness goal?
the language use feels very intentional and thoughtful. I personally found the section I picked to be challenging to answer because it is not an area I have put a lot of thought into. I was trained to use strength based language in assessment work and find creating plans from strengths vs deficits/’weakness” it allows the individual to feel empowered to make the change and encourages thinking about goals in a different perspective.
What did you discover about your own strengths that might have been previously hidden from view?
I found that I am more limited in how I spend my free time and how I structure my time than I thought, I know this is a strengths based questions but I feel like I spent a lot of time talking to other people about self care and wellness but at the end of the day I need to do better for myself. shifting the narrative to strength language: I am a great advocate for others.
How would you or have you used a strengths assessment to help consumers identify their strengths and uncover their hopes and dreams?
This is helpful to just begin a dialogue about goals and identifying small steps for change. I think anyone who has been in the ‘system’ or felt marginalized may see this as a challenge because it changes the conversation to look at what is good v the “what’s wrong with you” narrative that many often experience when seeking treatment and services. allowing someone to be thoughtful in how they may want their future to look may allow them to feel more in control of their life and the potential outcome of treatment or the ability to make change.1. What are your general reactions to the mindful writing? What were some of the personal resources, skills, and abilities you relied on to help you through a difficult experience in your life?
I attempted this with the music, at first, I found it hard to write but as I continued it became easier and more flowed o the page. For my ability to navigate challenges I relied on family, community, personal strength. I am finding it hard to answer this without disclosing a lot of personal details but I did enjoy this exercise and will need to attempt this more often to gain more comfort with it.
2. What are some of the ways the questions and or the mindful writing helped you uncover your narrative of resilience?
In this moment I found the question challenging because my mind was trying process something else with stronger emotions so I felt as though I was having to direct the writing more than intended. I was not able to get into a fully quiet space so will need to compete this again at a different time.
3. How might you apply the Narrative questions and or mindful writing in your work with others to help them uncover a neglected story of resilience in their lives?
I believe this activity can hold a lot of power for the individual completing it. As a practitioner I work to support individuals in discovering their own strengths and ability to evoke change, this activity allow for more exploration of internal processes and may bring awareness that other activities cannot.I am Julia Foster LCSW, LADC. I have worked in a variety of roles within co-occurring treatment settings for the past 12 years. In my practice I promote wellness and recovery for healthy balanced living and look forward to enhancing my knowledge with this training!
Question 1
I have noticed a pattern that when feeling stress or boredom I begin looking for snacks, even just yesterday while working on documentation I kept getting up to find something to eat and I certainly wasn’t hungry. I keep thinking of this part of the reading “unmet need and when it is an expression of addictive or risk behavior that wants to alleviate the discomfort as quickly as possible”. I wonder if using this during those moments in the office how it would benefit my time management and change my perception of the behavior. I am finishing this early in the morning as the week got away from me again but found that while doing this my “urge” was the nudge my snoring dog as it is a source of distraction but used the exercise to wait and focusing on the appreciation of something simple like my dog snoring as a sound or sign of relaxation. I notified a shift in my thinking. I often have had clients resist mindfulness in practice and have used this a lot with addiction work and will continue to do so by practicing in the office and following up to see if the skill was effective in “real time” for the client.
Question 2
I chose diffusion as that is a skill I often use in practice and often have mixed reception to it. Today I tried to use of imagery vs words and had a different experience. I find getting settled to do the activities can feel stressful and that creates some body sensations but as I move through the activities I feel better. I will continue to use mindfulness in my practice and find having more variety of skills will be helpful when working with variety of clients. I often lean into cbt as it is more comfortable and I have a core set of activities that seem to be well accepted and would like to get to the place of having mindfulness be more comfortable and “core” in practice.
Question 3
I just spoke to this a little but I think in order to be more comfortable utilizing skills in practice and teaching/guiding clients I need to be utilizing mindfulness more in my own life and routine. The balance of self care and work/life is so critical and some of the skills we reviewed are short enough that it would be easy to incorporate into a routine a few days a week even.
Thank you!Question 1
I enjoyed this as it was great with body awareness, I wonder for patients/clients if that could be triggering but at the same time feeling vulnerable can be a great vessel for change. I think this is a great one to teach and pull into sessions.
Question 2
This felt very powerful, with the stress/strain and overall anxiety we are experiencing I find I put a lot of pressure on myself and this brought up a lot of emotions for me. Our inner critic can be LOUD in times if stress and acceptance is so important to shift this. I use acceptance a lot in practice and find when someone is able to work this into daily thinking (myself included) it feels empowering and almost like a huge relief.
Question 3
With addiction work I focus a lot on mind/body awareness, working to change patterns of thinking and patterns of behaviors. Acceptance is utilized a lot in 12step work and think with the guilt/shame that often comes with recovery and patterns of substance use this can be very empowering and helpful for patients to learn and utilize.Question 1
I found this exercise relaxing, I found I was thinking too much about the activity initially but as I focused more on my body it was more enjoyable. Focusing on specific parts of the body did ultimately aid with relaxation and I felt more positive after completing. More practice will all of for more specific focus on various areas of discomfort and for use a more general coping tool.
Question 2
This was bit more challenging, I found myself getting easily distracted. I found myself thinking about various stressors and distractions in the environment more than I did with the full body activity. Touch added to the experience and made it easier to engage. I felt this was more forced and less easy to relax during this activity.
Question 3
I think both have their benefits and can see adding in as a regular tool. I find that body awareness activities can be helpful with substance use treatment and working in the body scan specifically for managing cravings. I often encourage access to nature and think of using the focus on a single object to encourage someone out for a walk to find an object to use for his activity. I think being prepared in session to practice using the skill will be helpful to identify opportunities when the person may be able to successfully use in day-to-day settings. Both of these feel very “portable” and thinking about substance abuse treatment there is so much value in providing tools that can be used at any time/place.Question 1
I found this more difficult as I have some nasal congestion, so the breathing felt unnatural. I was feeling rushed to get to the next breath as I was a bit uncomfortable, I typically enjoy breathing exercises, so this was a new experience for me. At the time I completed this exercise I did not fin it helpful/calming but know it is related to my physical health in the moment.
Question 2
What did you notice about your physical experience during the Basic Mindfulness Meditation? What did you notice about how your mind wandered? What was it like to gently shift your focus of attention from your thoughts to your breath? How would you evaluate the effectiveness of this meditation to make you more aware of the habits of your mind?
I again am doing this in a setting that is highly distractable with balancing work from home and childcare this week, so this was tricky! I did find this easier to complete but was heavily focused on my thoughts. I found this to be more helpful and relaxing/effective.
Question 3
I think personally the breath counting meditation is helpful for “in the moment” management of anxiety or just collecting thoughts/slowing down. The Basic Mindfulness meditation is great for introduction to mindfulness work. I would introduce both types to anyone willing to try and work to determine how both can be effective.Hi! I am Julia Foster, LCSW, LADC. I recently left community outpatient therapy to return to residential treatment. I am working with the Opportunity Alliance as a Clinical Coordinator. I am hoping to bring mindfulness to the milieu treatment setting but also hoping to bring more mindfulness into the staff dynamics of the program. I have been using mindfulness in my practice for years with substance use treatment and hope to continue to add to understanding and add to my own skills for my current focus of treatment.
