Sunday, July 10, 2011

Ideas from Moving Forward Conference

I have just returned from the Moving Forward in Challenging Times Conference in Austin Texas. This SAMHSA funded conference focused on Domestic Violence and Substance Abuse programs, most specifically how they could work better together so the clients would experience fewer barriers. It was sponsored by Safe Place of Austin, an organization that provides direct service, prevention, and advocacy. The conference was very inspiring, and I wanted to share some ideas I learned there.

I was inspired by the participants at this conference. They approached their work from a mission base, a deep commitment to their clients. And they were working hard to change their programs so that any person would be welcome, there were no barriers to care, no restrictions to participation. This means that however a woman shows up, drunk, using, dirty, belligerent, whatever, she is welcomed with food, sleep and talk. They had carefully redesigned their intake and assessment to be welcoming, and not designed to unearth rule outs, but instead to help them be more skillful and individualized in the help they offer. They have tried to eliminate rules and recognize that their participants are adults. Instead, they have agreements that the clients make with each other. If one is broken, they discuss it. It seemed to me that they were trying to radically work from the premise that the woman is doing the absolute best she can, and their job is to help her do whatever she wants to do next.

Many of these programs use some kind of a crisis management plan, which in my program we call ICPMP. I was impressed with an idea from one presenter, Lourdes Carrillo. Instead of asking what helps you when you are upset and framing the discussion in terms o a crisis, ask questions to get to know the person. Like, “What do you like to do? How do you relax? How do you prepare for difficult situations?” and getting very precise. If the person says she likes music, what kind of music. If she says she relaxes by sitting on the couch, are her feet up or down? Does she like to have something to eat or drink? Water? With ice or without? All these details will be then available when she does get upset- staff can invite her to sit down and bring her some ice water. I think this approach honors the strengths of the person, and acknowledges that she already has many valid strategies for managing difficulties. And, it gives us a lot to work with when life gets hard.

Another interesting point I’d never thought of was in the area of confidentiality. When we say to clients that what happens between us will never be shared with anyone else, this may remind clients of when they were abused. It may sound to them like we are saying that what happens in treatment is a secret. They have already experienced too many secrets and they have usually included danger. Ms. Carillo suggested saying this instead: “This is your story. I am privileged to hear whatever part of it you wish to tell me. It is up to you who knows your story, so I will never tell anyone else whatever you tell me. You, however, are free to talk about what happens here to anyone you want.”

There was a lot of discussion of self care at the conference, including vicarious traumatization and ways organizations traumatize their workers. I was struck by the presentation of Karen Kalergis and Sapana Donde. They spoke of going beyond coping with vicarious traumatization to creating resiliency in our work force. They listed five core elements of resiliency: self knowledge and insight; sense of hope; healthy coping; strong relationships; and personal perspective and meaning. They shared strategies for increasing each of these. I was struck by how well this integrates with both the RICH relationships and our thoughts on addressing and transforming VT.

It is always exciting to meet new people and old friends, and to be re-inspired by the dedication and commitment of others. I could have done without being stuck in Chicago’s Midway airport all night on my way home, but otherwise this conference was a worthwhile experience.

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