What You Need to Know about State Peer Specialist Certification in California -submitted by Sharon Kuehn, CAMHPRO-PEERS Project Advisor to the Working Well Together TA Center
California trails 31 states in the US where peer specialists are an essential service component in the public behavioral health system. The goal of having peer specialists State certified with consistent standards for training, recognized as valuable and legitimate members of the provider community, and able to bill for their unique services is long overdue.
Here are some things you may not already (but need to) know about peer support:
1. Peer support is effective and cost-effective. Recovery outcomes are greatly improved when peer support specialists are available to provide nonjudgmental connection, mutuality, and a friendly listening ear to persons seeking support. Multiple studies have shown the effectiveness of peer support. According to a study by Mowbray & Tan (1993), studies of consumer-run drop-in centers show high satisfaction and increased quality of life, enhanced social support and problem-solving. Further, Klein, Cnaan, & Whitecraft (1998) found that in a study of one-to-one peer support program for persons with co-occurring mental health and substance use challenges, participants had fewer crisis events and hospitalizations, improved social functioning, greater reduction in substance use, and improvements in quality of life compared to a non-matched comparison group.
And it turns out peer specialist services are cost-effective, too. According to Larry Davidson (2012), the state of Georgia saw a 55% reduction in costs in mental health care for those who utilized peer support services, corresponding to a $2.5 million savings per year on average. Locally, peer mentors have produced mad-love Returns on Investment of up to and over 400%!
2. Recovery takes place in relationships. According to Wikipedia, a “common aspect of recovery is said to be the presence of others who believe in the person's potential to recover, and who stand by them. While traditional mental health professionals can offer a particular limited kind of relationship and help foster hope, relationships with friends, family and the community are said to often be of wider and longer-term importance. Others who have experienced similar difficulties, who may be on a journey of recovery, can be of particular importance. Those who share the same values and outlooks more generally (not just in the area of mental health) may also be particularly important. It is said that one-way relationships based on being helped can actually be devaluing, and that reciprocal relationships and mutual support networks can be of more value to self-esteem and recovery. “
3. Recovery is self-determined and, like empowerment, comes from inside of a person. It is not caused by interventions, as much as by creating spaciousness around the person to increase their ability to envision change. It is supported by the presence of caring, connected, non-judgmental peers who add the critical element of recovery relationships, or people who “believe in me.”
4. Now is the time. Healthcare reform is here. The Triple Aim requires healthcare, under the Affordable Care Act, to provide “better services, better outcomes, lower costs.” We can demonstrate the value of peer specialists by paying livable wages and still achieve tremendous cost savings in each county by increasing the use of peer support specialists.
Given the clearly positive outcomes, it may seem hard to believe that legislators haven’t rushed to implement the certification. The challenge is that mental health services in California are not centralized.
The challenge of implementing a new program or legislation statewide in a county-based system so decentralized, is that it can take quite some time. It has taken years so far to build the current momentum; and stakeholder input, education and advocacy efforts are still taking place. (See the Working Well Together (WWT) Draft Recommendations for State Peer Specialist Certification below)
And while the hurdles can sometimes be discouraging, there is encouraging news! There is still time for your voice to be heard. Everyone’s voice can be a voice for peer support if each and every person can speak up. WWT hosts monthly stakeholder web calls to hear input as we negotiate a process of dialogues with each of the involved state health agencies. The advocacy groups want to make sure that when peer specialist certification is implemented, it’s done well, with a consistent focus on peer values and leadership in every step of the process.
5. You can add your voice to the growing demand for a statewide structure to promote effective peer-provided recovery services in California. Our state must invest in the implementation of a certifying body to guide the practice of peer support so that we can fully harness the power of peers. [WWT Peer Certification Stakeholder Web Calls will be held on Wednesdays, 12-1 pm, on January 15 and 29, February 19, March 19, April 16, and May 21, 2014. Look for a posting of the webinar registration links here soon]
OSHPD and the Planning Council need to hear from you: Add another ‘0’ to the budget for Consumer and Family Employment. Match the language in the values statement with the budget actions in the 5 Year WET Plan. There is no reason that funding for peer certification should not be at the level it demands and every reason to fully support peer certification.
WWT Draft Final Stakeholder Recommendations regarding Certification of Peer Support Specialists (June, 2013)
Develop a statewide certification for Peer Support Specialists, to include:
• Adult Peer Support Specialists
• Young Adult Peer Support Specialists
• Older Adult Peer Support Specialists
• Family Peer Support Specialists (Adult Services)
• Parent Peer Support Specialists (Child/Family Services)
1.1 Require Peer Support Specialists to practice within the adopted Peer Support Specialist Code of Ethics.
1.1.1 Seek final approval of Peer Support Code of Ethics by the Governing Board of Working Well Together. (See Appendix 1 for Draft Values and Ethics)
1.2 Develop or adopt standardized content for a state-wide curriculum for training Peer Support Specialists. (See Appendix 2 for Curriculum Content Crosswalk)
1.3 Require a total of 80 hours of training for Peer Support Specialist Certification.
1.3.1 55-hour core curriculum of general peer support education that all peer support specialists will receive as part of the required hours towards certification.
1.3.2 25-hours of specialized curriculum specific to each Peer Support Specialist category.
1.4 Require an additional 25 hours of training to become certified in a specialty area such as forensics, co-occurring services, whole health and youth in foster care.
1.5 Require six months full-time equivalent experience in providing peer support services.
1.5.1 This experience can be acquired through employment, volunteer work or as part of an internship experience.
1.6 Require 15 hours of CEU’s per year in subject matter relevant to Peer Support Services to maintain certification.
1.7 Require re-certification every three years.
1.8 Allow a grandfathering-in process in lieu of training.
1.8.1 Require one year of full-time equivalent employment in Peer Support Services.
1.8.2 Require three letters of recommendation. One letter must be from a supervisor. The other letters may come from co-workers or people served.
1.9 Require an exam to demonstrate competency.
1.9.1 Provide test-taking accommodations as needed.
1.9.2 Provide the exam in multiple languages and assure cultural competency of exam.
Identify or create a single certifying body that is peer-operated and/or partner with an existing peer-operated entity with capacity for granting certification.
Include Peer Support as a service and Peer Support Specialist as a provider type within a new State Plan Amendment.
3.1 Seek adoption of the definitions of Peer Support Specialist providers and Peer Support services by the Governing Board of Working Well Together for use within the State Plan Amendment. (See Appendix 3 for Draft Definitions)
3.2 Maintain the ability for people with lived experience to provide services as “other qualified provider” within their scope of practice, including but not limited to rehabilitation services, collateral and targeted case management.
3.2 Acknowledge that there are important and non-billable services that Peer Support Specialists can and do provide.
Include in the State Plan the ability to grant site certification for peer-operated agencies to provide billable Peer Support Services.
4.1 Allow for peer-operated agencies to provide other services billable under “other qualified provider” within their scope of practice, including but not limited to rehabilitation services, collateral and targeted case management.
Address the concern that current practice of documentation for billing may not be aligned with the values and principles of Peer Support and a wellness, recovery and resiliency orientation.
5.1 Engage with partners such as Department of Health Care Services and the California Mental Health Director’s Association in order to develop an action plan to advocate for the use of CMS-approved recovery/resiliency-oriented language in documentation.
Investigate the options for broadening the definition of “service recipient” to include parents and family members of minors receiving services so that Peer Support Services can be accessed more easily.
Convene a working group consisting of Working Well Together, the Mental Health Directors, the Office of Statewide Healthcare Planning and Development (OSHPD) and the Department of Health Care Services to develop buy-in and policies that will create consistency of practice regarding Peer Support Services across the state.
Develop standards and oversight for the provider/entity that provides training of Peer Support Specialists.
8.1 Allow for multiple qualified training entities.
8.2 Training organizations must demonstrate infrastructure capacity that will allow for peer trainers.
8.3 Training must be provided by either individuals with lived experience or by a team that includes individuals with lived experience.
Establish qualifications for who may supervise Peer Support Specialists.
9.1 Engage with the Mental Health Directors to develop a policy that outlines key qualifications necessary for the supervision of Peer Support Specialists.
9.2 Preferred supervisors are those individuals with lived experience and expertise in peer support.
9.3 Due to capacity issues, supervisors may include qualified people who receive specific training on the role, values and philosophy of peer support.
9.4 Recognize and define the specific qualities and skills within supervision that are required for the supervision of Peer Support Specialists. These skills should align with the values and philosophy of peer support.
Develop a plan to provide extensive and expansive training on the values, philosophy and efficacy of peer support to mental health administration and staff.
Develop a plan to ensure that welcoming environments are created that embrace the use of multi-disciplinary teams that can incorporate Peer Support Specialists fully onto mental health teams.
Develop a policy statement that recognizes and defines the unique service components of peer support as separate and distinct from other disciplines and services in order to maintain the integrity of peer support services.
Develop a policy statement and plan that supports the professional development of Peer Support Specialists that allows the practitioner to maintain and hone his/her professional values, ethics and principles.
Develop a plan for funding the development of certification.
14.1 Work with the Office of Statewide Healthcare Planning and Development to utilize
state-wide monies from the MHSA Workforce, Education and Training fund.
14.2 Investigate other potential funding sources.
14.3 Develop recommendations for funding of components of certification such as financial assistance with training, exam and certification fees.
Seek representation on committees and workgroups that are addressing civil service barriers to the employment of Peer Support Specialists.
Work with Mental Health Directors to seek agreement on a desired workforce minimum of Peer Support Specialists within each county to more fully actualize the intent of the MHSA.
Develop state-wide models that can inform county leadership on the development of career ladders for Peer Support Specialists that begin with non-certified Peer Support Specialists and creates pathways into management and leadership positions.
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My long-term goal as the Empowerment Coordinator with PEERS has been to inspire hope and contribute to the resiliency and wellbeing of individuals who have lived experience with mental health challenges. Fortunately, with support and guidance from Sharon Kuehn, PEERS Program Manager of the Social Inclusion Program, I have successfully developed strength-based trainings that explore people’s talents, skills, interests, social connections, and environment.
Likewise, Sharon’s encouragement and belief in me has also allowed me to authentically connect with members of the community, inform and affirm that overall health is not the absence of disease, illness or stress; but the presence of mind, body and soul. This concept really became evident to me when Sharon invited me to learn more about Capacitar.
Capacitar means to empower, to encourage, to bring each and others to life. I have to be honest. Initially, I was taken aback by this new age state of consciousness thinking. Based on my past experiences, I was reluctant to embrace this new social movement that was multi-focused and multi-faceted. The notion that a group of people could flourish towards a specific goal of bringing peace and healing to communities plagued by trauma with compassion and wisdom seemed very foreign to me. I could not grasp the mission of a program, which is to foster personal healing while also activating global transformation.
However, to my surprise, I became enticed by Capacitar. In May of 2013, I began my journey learning about this holistic healing practice. The four-part training series included Tai-Chi movements, meditation, acupuncture protocols, chakra theory, polarity simple massage, and breathing to promote holistic healing of body, mind, and spirit. These practices integrated spirituality and body wisdom with a research-based focus.
By and large, Capacitar is an international network that is operational all over the world. To date, Capacitar is in over 35 countries in the Americas, Africa, Europe, the Middle East and Asia.
In fact, the spirit and core values of Capacitar is to teach simple practices of healing, community building and self- development to awaken the human family to accept each other as our own source of strength and wisdom. In turn, we as a Race, the Human Race can heal injustice, work for peace and transform ourselves, our families and communities.
As a result of my walking into unfamiliar ground, I not only learned about Capacitar, I have embodied it and am able to incorporate it into the community for which PEERS serves. In turn, we are supporting transformation, solidarity, understanding, and reconciliation to mental health consumers, veterans, and immigrants at the Peace and Wellness Garden in Oakland.
Every Friday, from 3pm to 4:30pm, both Sharon and I facilitate the practices of Capacitar at Hacienda Peralta Park at 2465 34th Avenue, Oakland, Ca. 94601
This weekly healing method and walk in solidarity, allows people to truly step into their greatness and embrace that we are each perfect, whole, and complete just the way we are.
For more information:
The Capacitar Prayer
“We join with the Earth
And with each other
With our ancestors and
All beings of the future
To bring new life to the land
To recreate the human
To provide justice and peace
To remember our children
To remember who we are.
We join together as many and diverse expressions
Of one loving Mystery
For the healing of the Earth
And the renewal of all Life.”
I'm not sure I have ever laughed so hard in a mental health workshop, particularly one on something as heavy as maintaining healthy relationships.
But Michele Bibby, peer specialist and a consumer for nearly three decades, effortlessly blended good-natured humor with practical self-reflection in the session "How to Maintain Healthy Relationships When Coping with Mental Health Distress." A native of Texas, Bibby shared lessons drawn from her own life experiences with friends, doctors, supporters, parents, siblings, kids, and a husband.
While there was much one could take away from Bibby's tales, I left with the following six lessons:
1. Don't pretend or hide your struggles. You don't need to share all your personal business with someone you just met, but do be honest when entering a substantive and trusting relationship of any sort, whether platonic, romantic, or even professional.
Michele told us that she took this advice to heart after hearing about a dear friend's experience coming out as a lesbian at work. She asked her friend what possibly could have motivated her to do such a thing, assuming the disclosure would cause assumptions, rumors, and a lack of support.
Her friend replied, "I did it because I wanted to take my power back. I didn't want anyone was whispering or speculating. I wanted them to know who I am."
When you hide your struggles, you can't be authentic. Behaviors will come and go, and your partner/friend/supporter will wonder what's going on. Besides, it takes enough energy just to get out of bed and join the world; don't make it harder by draining your battieries to cover up your condition.
2. Be ready and willing to apologize. Anyone who has struggled with a mental health issue (or life) has had moments where they weren't at their best. But just because you may have been in an altered state, struggling, or happened to forget what you did or said to another person is no reason to shed responsibility.
"If you did it, said it, or cause hurt or harm, it was real to the other person," Michele said. "If I did it or said it and caused harm to someone else, whether I was experiencing psychosis or whatever, I have to deal with the fact that I said it. You can't un-ring a bell."
People make mistakes. We say and do hurtful things in a moment of less-than-clear judgment. When it happens, own your role, swallow your pride, and make right by the person you wronged. It’s much less painful to admit a mistake than lose a valuable friend.
3. Educate yourself on triggers. Self-awareness goes a long way, folks. Study patterns of what makes you upset or causes you to get into an altered state. If you need a list, make one.
"If you are mentally off center, work really hard to get centered," Michele said.
By keeping tabs on yourself, you will be better able to manage and protect your relationships.
4. Don't lose your sense of humor. Life can be challenging enough. Throw in mental health challenges and it can sometimes be downright unbearable. It's ok to laugh at absurdities and ridiculous behavior sometimes. It doesn't mean you don’t care or that you are turning your back on the person with that behavior. It's ok to find humor in what they say or do. Being too serious and always taking on other people's distress is a sure road to burnout and could lead to serious psychological stresses of your own.
5. Don't be afraid to cut people off. This is the flip slide of #2.
If you damage your relationship with what Michele calls a "3 a.m. friend," you should work hard to mend fences and apologize for your role in the strife.
"A 3 a.m. friend is someone you can call in the middle of the night with a problem and they will be there for you, no questions asked," said Michele.
They can be a person you may not have spoken with for awhile because lives go in different directions, but will be there in a heartbeat if something is wrong. These friends are practically like family and are worth fighting for.
However, not every friend is like this. In fact, some friends shouldn’t be called friends in the first place; they should be referred to as acquaintances. If you've apologized or tried to make things work with an acquaintance or casual friend and they are not willing to come to terms, it might be time to let that relationship go.
"You should be in a relationship with family or friends who understand recovery, understand the challenges, support your recovery, are receptive to hearing what type of support you would like to receive, and are receptive to learning thing sthey do or say that are not helpful to you," Michele said.
So if you are working hard for a real friendship with someone whose company you enjoy when you happen to cross paths but isn't really there for you or putting in equal effort, spend your time elsewhere. Also, it goes without saying that any "friend" who is abusive, unsupportive, judgmental, or harmful to your recovery in any way needs to be removed from your life.
6. Let go. Forgive others and forgive yourself. One of the greatest barriers to happiness and wellness is resentment and a lack of forgiveness, or what Michele calls "unforgiveness."
"Some people harbor that negative spirit and hold on to what someone did to them 10 years ago," Michele said. "Nobody has time for that. You need to move on."
Forgiveness does not mean reigniting an abusive or harmful relationship, but it does mean accepting what happened to you and letting go of bitterness. By ridding yourself of that tightly held resentment, you will find you have more energy to focus on things you love — such as hobbies, work, friends, and family — as opposed to damaging things that can't be undone.
And most importantly, don't be afraid to forgive yourself. We're human. We screw up occasionally. If you've done everything in your power to make things right, that's the best you can do. You can't change what has already happened, so take it as a lesson for how to do things differently in the future.
I had the pleasure of meeting a super cool person on Saturday.
Mai Vang, LCSW, is a therapist for Sutter/Yuba County Mental Health Services in California. And she is a very big reason that the Hmong people in that county are beginning to receive effective and culturally responsive mental health treatment.
In the workshop "Traditional Healer's Project Model: Fighting Stigma in Hmong Communities," Mai kicked things off with an explanation of who the Hmong people actually are, as confusion is common in the Western world.
Who are the Hmong?
The Hmong, Mai says, are a distinct group of people, meaning they have their own language and culture. While the Laotian and Mien are close neighbors, they are not the same as the Hmong. There are approximately 250,000 Hmong in the U.S., with 91,224 of those in California, according to the 2010 U.S. Census. The Hmong living in the U.S. are refugees from Southeast Asia, which means they crossed an ocean to flee danger, not because they actually wanted to leave their homeland.
Understanding from where the Hmong come and why they moved is essential to providing effective treatment, according to Mai.
"History provides a blueprint of how to navigate the world," Mai said. "Many Hmong people are refugees from Laos, a displaced group who came to America not by choice but to escape persecution. If you come to America in pursuit of dream, you are more likely to acculturate than being in a country you don’t care for and still harboring a desire to return home some day."
Another challenge in having the Hmong engage in services, says Mai, is that Western and Eastern concepts of wellness are often worlds apart from one another.
"What the Hmong define as wellness is not necessarily what Westerners define as wellness," Mai said. "A lot of what we are trained in [Western medical practices] just does not fit.”
While not all Hmong follow traditional healing practices, many do. In traditional thinking, there is no distinction between physical health, mental health, or spiritual health.
"It's all one," Mai said. "You're either healthy or you’re not. If you're not, you go see your traditional healer."
Traditional healers include a variety of roles, including shamen, herbalists, witch doctors, masseuses, and midwives.
Mental health beliefs
It is a common belief in the traditional Hmong community that aches, pains, depression, and other serious mental illnesses are caused by lost souls. One's soul may be lost in various ways, including sudden fright, fear, too much grief, being captured by an evil spirit, or an unhappy soul trying to achieve peace. These can be caused both by natural causes, such as environment and aging, and spiritual causes, such as evil or ancestral spirits causing illness when offended.
To diagnose such an ill, an individual would typically see a shaman, who looks for where the soul has gone and chooses a remedy to treat the problem. Traditional treatments for both psychosomatic and physical ailments include cupping, spooning, punching, or coining on the neck, shoulder, back, chest, and forearms, which often result in unusual physical marks.
"There is no concept of mental health (in the Hmong community)," Mai said. "The only understanding the Hmong have of mental health is that it is for crazy people, that those conditions are genetic, and you should stay away from and not marry into that person’s immediate or extended family because the clan might be crazy, too."
It's also a common Hmong practice, Mai says, to not disclose too much information to mental health professionals for fear of being locked up with the other "crazies," in the words of the Hmong.
"People are afraid of mental health professionals, even if they are from the same culture," Mai said.
And while they believe some psychotropic medication might be a good thing, they also believe that too much will make one even crazier, so they avoid high dosages. Interestingly, Mai noted, many of the Hmong people have been categorized by clinicians as non-compliant because of the providers' lack of recognition that certain medical recommendations conflict with traditional beliefs.
There is also a widespread belief within the Hmong community that young people shouldn’t need to use mental health services because they are still young and should be free of stress and/or xiam hlwb, a term used to describe brain damage, poor memory and concentration, and memory loss). It is thought that one should not get those conditions – which can only be caused by life experiences – until old age. Parents also worry that their children will never be able to have a good job if they receive mental health services.
And just to make things more complicated, Mai says, mental heath facilities are referred to either as tsev nyuaj siab (the depression house), tsev vwm (the crazy house), or tsev xiam hlwb (the brain-damaged house).
Understandably, who would want to experience or be seen at such a place?
"We are trying to reframe and use more positive terms and reduce stigma, such as 'healthy house,'" Mai said. "A lot of times when using more positive terminology, people understand [the house] as something different."
The Hmong Outreach Center
To better serve the needs of the Hmong, Sutter-Yuba Mental Health created the Hmong Outreach Center to provide outreach services and culturally and linguistically competent mental health services to the local Hmong population.
In developing the center, the county had five main goals:
- Eliminate the stigma around mental health through a facility and name change.
- Employ bilingual and bicultural staff.
- Place the facility in a location in close proximity to the majority of the population.
- Give flexible hours to bridge different concepts of time and way of being. The Hmong people are used to showing up within a couple hours of the scheduled appointment. Have staff work with community members for a few months until they acclimate to the local culture and keep appointment times.
- Offer culturally responsive services. Ask the Hmong what they want, such as cultural activities. Offer what is familiar to the Hmong, such as Hmong poetry.
Creating a natural and safe space is often the first step in providing healing, according to Mai.
"When you can create an environment that is natural to them, a lot of stories and healing come out naturally," Mai said. "Once you develop something that works for them and is meaningful for them, they will tell the whole community and people will come."
After lots of community dialogue, the center now has groups 5 days a week and has developed a good reputation in the community.
The Traditional Healers Project
To complement the outreach center, Sutter-Yuba Mental Health launched the Traditional Healers Project, which seeks to train traditional Hmong healers to recognize signs and symptoms of mental illness.
"One of the fundamental questions is how do we get people from point A (the traditional healers) to point B (mental health providers)," Mai said. "And how to we get them to engage?"
A key step in finding the answer, according to Mai, is investing time in meeting and creating dialogue with people at every step of the are process. Some meetings have included a Traditional Healers focus group, meetings with Sutter-Yuba admin and psychiatrists, and hospital staff.
As a result, steps have already been taken to train care providers on both sides of the aisle: traditional healers are being trained on symptom identification, while psychiatrists are being trained in Hmong culture and traditional healing practices.
And while it hasn't yet been finalized, Mai is spearheading efforts to allow for the merging of both traditional and medical healing practices, such as allowing traditional healers to interact with patients in hospitals if needed.
In the meantime, Mai is continuing to lead initiatives that build on Hmong cultural strengths as a way of reducing stigma. Some of those priorities include increasing activities that are familiar to the Hmong at the Hmong Center, expand the community garden, and bringing the community together to build traditional Hmong huts in the garden to promote wellness and familiarize new people to the Center.
In a mere 90 minutes, I discovered more than I ever knew about the Hmong community.
And another thing I learned?
I want to be like Mai when I grow up.
When the Willard Psychiatric Center in New York closed its doors in 1995, an interesting discovery was made. Four hundred suitcases were found from the late 19th to mid-20th century in an abandoned attic. PEERS had the honor of being part of the exhibit “The Changing Face of What is Normal” at the Exploratorium in San Francisco, where we were able to see the suitcases and personal belongings firsthand from Willard. Darby Penney, a senior research associate with Advocates for Human Potential, presented on the lives of some of the patients whose suitcases were discovered.
Length of Stay: 47 years
Madeline was a well-to-do French woman coming of age in the Jazz Era. Her family was financially connected and she traveled to New York for work and play. She was stunning and frequented many extravagant parties. She worked at a bank and taught French literature. Then the Depression hit, and Madeline found herself homeless and cut off from her connected family. She was referred to the Emergency Work Bureau where she disclosed that she could read minds.
She was voluntarily admitted to Bellevue Hospital, but she was under the belief that she was going to be part of a study on psychic abilities. She was transferred to Willard, where she would stay for 47 years. Madeline never accepted that she belonged in a hospital and was very adamant that she be released. She wrote to her lawyer, but the letters were never sent.
Instead, she was placed on antipsychotic drugs and developed tardive dyskinesia (TD), a disorder resulting in involuntary repetitive body movements (i.e. grimacing, tongue movements, and lip smacking) and she was then prescribed “attitude therapy” to get her to stop making facial grimaces.
Length of stay: 24 years
Dmytro was a prisoner of war who escaped Nazi occupation in the Ukraine only to become a prisoner of war by the Soviet Union during WWII. When he finally escaped, he met and married a Polish woman named Sophia. They moved to upstate New York, which had a booming immigrant community. Dmytro was a skilled carpenter and started building a house for his new wife. Soon Sophia became pregnant. Dymtro felt so much gratitude to be working and starting a new family, that he wrote to President Truman and sent him a wooden carving for gratitude.
Unfortunately, Sophia died in childbirth and miscarried. Dmytro was so distraught that he came to believe that he was supposed to marry Margaret Truman and attempted to visit her at the White House. He was captured by the Secret Service and eventually committed to Willard. He underwent 20 electroshock therapy treatments and wasn’t understood by the staff because of his limited English. However, he started painting daily and his work was displayed (ironically) in Washington, D.C. He gave away most of paintings and was discharged to a county home where he made murals.
What was most remarkable about this exhibit was that it focused on the people’s lives outside of the hospital. They had careers, romances, aspirations, hopes, and dreams. In fact, they seemed quite ordinary with extraordinarily bad luck. The common theme was being in the wrong place at the wrong time, and then ultimately, being forgotten.
You can see more suitcases at the http://www.suitcaseexhibit.org.
Tuesday, December 3, 2013
BART train, airplane; Austin, Texas --what do they have in common? My anxiety. It wasn’t easy shaking that uncomfortable feeling of flying to Austin, Texas but one Advil PM later, I made it Hyatt Regency Austin (piece of cake). Checked into my room and went out and enjoyed the 70+ degree sunshine.
Wednesday December 4, 2013
1. Breakfast, across from the Hyatt at the Embassy Suites.
2. Alternatives Registration at The Hyatt
There was lots of energy emanating from people who’d come from far and near to participate in the wide variety of workshops, institutes, plenary sessions, caucus sessions, arts activities, multicultural activities and other opportunities.
The Welcome Luncheon started with an opening ceremony of native dances performed by the Ameyaltonal Tejaztian Aztec Dancers. The keynote speaker was Paolo Del Vecchio, Director of the Center for Mental Health Services at SAMHSA.
I attended a variety of workshops over the past four days. I’ve learned a lot, heard stories of wisdom, strength and hope. I shared some common experiences and on Friday, December 6, 2013 Black Men Speak (BMS) presented a workshop where Brian Hill, Joe Anderson and myself told stories, to a standing-room only audience, about wellness and recovery, substance abuse, mental health, and internal and external stigma through the eyes of African-American men. We were inspired by the possibility of establishing new venues for the BMS curriculum throughout the country. But the highlight of my experience at the Alternatives Conference was attending a workshop facilitated by Deborah Louise Trueheart called “Finding Wellness and Peace and Standing on Solid Ground in a Changing World.” Debbie shared some tools and practices that assisted me in accessing a state of self-love and well-being and of peace.
I was introduced to the “Living into Wholeness Curriculum” and these 10 perspectives, that in some form or fashion, confirm my state of being:
1. Know that you are Whole, Divine, Complete – right here, right now
2. Know that despite anything that has happened to you and anything you have been told, you have innate wisdom and are connected every moment to the creative intelligence of the Universe
3. Be willing to take full responsibility (ability to respond) for your energy, your thoughts, your emotions
4. Be willing to entertain the notion that “symptoms” are old behavior patterns which can be transformed
5. Know that you bring to life that which you focus your attention upon. Focus your attention on the Good, the Holy and the Beautiful
6. Do the GABRI practice daily – grounding, aligning, breathing, releasing, infusing. Smile. Say “Thank you, Thank you, Thank you.”
7. When you notice yourself twisted up by anxiety or old patterns – STOP and use your Power Tools to Observe, Choose and Respond
8. Stand on a platform of Capable, Grounded, Certain and welcome Dignity, Respect, Grace, Peace, Joy, Ease, Compassion and Love
9. Find a circle of like minded, supportive friends who mirror and support your wholeness and your beauty
10. Appreciate Everything
Saturday, December 7, 2013
Shuttle van, airplane, BART train--what do they have in common? My anxiety. I was just so anxious to get home, but one Advil PM later-- Oakland, Calif. (piece of cake).
For 11 years, I have made my living with words.
I always kill it in Taboo and can come up with a synonym for any term at the drop of a dime.
I can give lectures on the importance and implications of language in both professional and interpersonal contexts.
But after I attended the "Using Language to Increase Resiliency" workshop with Janet Paleo and Anna Gray, I realized that I have been completely negligent — and at times incredibly destructive — when it comes to choosing words for my own internal dialogue.
The workshop opened with Janet and Anna asking audience members what language means to them. Folks in attendance enthusiastically shouted out phrases like, "shapes world," "powerful declaration," "labels and categorizes," and "make or break you."
There was a lot of energy in the room, and clearly many people who had their own (mostly disempowering) experiences with language.
After the brainstorm, both facilitators urged us to examine all disempowering words that we — and others — use when describing ourselves, and find a way of constructively altering the word without changing the circumstances around it.
For instance, one might lose a sporting match and be called a loser. While being called a loser is disempowering, being called a winner in that circumstance would be inaccurate because that person did not actually emerge victorious in the match. However, one could shift "loser" to say "one who perseveres," "tough competitor," or "resilient learner."
While I saw their point, I still remained a bit skeptical. Isn't that like saying someone who repeatedly screws things up is "special?" And in a way, isn't that even worse because everyone knows we're lying?
But then we saw the principle in action. The duo proceeded to examine two disempowering words and transform them to their empowering counterparts.
For example, take the word "can't."
A better choice?
A simple "I choose not to."
Why? The former implies there is something inherent in or fateful about the person that will always breed failure. But the latter puts the responsibility of the outcome — both successes and failures — entirely on the choices of the person.
Janet shared one real-life anecdote about a woman who said she couldn't stop smoking. After working with this person on retraining her brain around word choice, Janet informed us that not only did the woman reduce her cigarette intake considerably over the next three months, but she stopped altogether shortly thereafter.
Another example, this time acted out in real time, focused on the word "wrong."
Janet asked for a brave volunteer from the audience. A woman walked to the front of the room, at which point Janet asked her what 1+1 equals. This brave soul laughed nervously and answered, "2," at which point Janet said, "No, you're wrong."
The room, also undoubtedly confused, grew silent as the audience waited for the lesson.
Janet immediately asked the volunteer how she felt after being told she was wrong. "Embarrassed," "ashamed," and "confused" were a few adjectives that came to mind. Add in the fact that this happened in front of a room of 75 people and she didn't feel very good about herself.
(And for the sake of intellectual resolution, the answer was not 2 becuase Janet was discussing raindrops. One raindrop melded with one raindrop equals one ginormous raindrop.)
So what could one looking for an effective alternative say?
"It would be better to have said, 'That doesn't work for this problem,'" Janet said. "'Wrong' sets up defensiveness and stops communication. It causes embarrassment and shame, whereas the alternate solution invites dialogue and exploration. When we change 'wrong' to 'it doesn’t work,' people have an ability to start being empowered around whatever they're doing."
And while it's not always easy, Janet says it is most definitely worth the cognitive effort because it helps everyone.
"We certainly need to take out all that judgment and disempowering language for ourselves, but our language can actually empower other people, too," Janet said. "But it takes practice!"
Janet then shared a fascinating study about the power of language on school-age children. A group of kids was initially given a relatively easy test, with all of them doing well. After sharing the results, half of the group was revered for their intelligence, and the other half was praised for their hard work. The same kids were then given a more difficult test. The group who was praised for intelligence on the first test actually did worse than the group praised for hard work. Why? Because the latter group kept working when things got difficult, unlike the first group.
In another anecdote, Janet shared a story about a woman who had struggled with claustrophobia all her life and defined herself by that struggle. Instead of telling herself she was claustrophobic, she started advocating to herself and others that she simply had a "need for personal space."
"The next month this person went to a conference and stayed with three roommates," Janet said. "The change opened up her life so she could do anything she wanted. She even went to swim in Africa with sharks while being confined in a cage!"
And Janet didn't just speak to the power of language in other people's lives. She shared her own personal experiences regarding transformation of spirit through words.
"I always called myself an idiot but then changed to words that uplifted me," Janet said. "I stood taller. I stood with my head held up."
It was then I had a major light bulb moment.
It occurred to me that for most of my life, I have been doing myself a terrible disservice with language. And it was going to take some conscious work to fix.
I have drilled negative words like "unattractive," "unconfident," "awkward," "geeky," and "nerdy" into my brain for so long that I have created my own reality. I have internalized these words. This reality has kept me from seeking opportunities I might otherwise have pursued and has definitely made it near impossible to strike up conversation with strangers. Because why would people want to talk to me? What could I possibly have to offer? Wouldn't they just run away?
And as I delved deeply into rumination, I was brought back by Anna's voice.
"Your language shapes your reality," Anna said. "The word may mean different things to different people. If a word we know is not yielding what we want, we find other options. It doesn't matter what the word means in the dictionary. It matters what it means to you."
If who I am is who I tell myself I am, then I better start looking up new synonyms for "badass."
Alternatives conference this year was a whole new experience for me. Even though this was my third year attending, it was my first time as a lead presenter. It really got to me.
I woke up the morning of the workshop feeling nervous and anxious. I felt like I still had a million things to do to get ready, but couldn’t remember a thing that needed to be done. I realized shortly after that I already did everything and my nerves were making me feel unprepared. I went down to the workshop room during lunch to set everything up with my team, since the workshop was right afterI wanted to feel some relief knowing that everything was ready for us to just start. About 30 minutes into the set-up we were told there is a “meet and greet” with some of the presenters, so we had to leave in the middle of our preparations.
At about 1:15pm, we went back down to the workshop room to finish setting up for our presentation. I wish I could say things started off smoothly, but they didn’t. We had horrible internet connection, which was crucial for our workshop since one of our presenters was being Skyped in. Needless to say, this took up more time than we wanted to spend to fix it. But I am happy to say that it did end up working. We were finally ready to begin, I stood up in front of the group to introduce the workshop. Before I could even open my mouth to welcome everyone, I felt my heart drop into my stomach and the rush of cold blood running through my body, I thought to myself, “Oh shizzz there is no turning back now.” From then I just started talking and all my nerves started to go away. I began feeling confident about the workshop and what we had prepared.
So many may be wondering what the workshop was about, and I am happy to share. My team and I did a workshop on cultural difference as it relates to mental health, the stigmas and challenges we faced as individuals because of this, and how we used WRAP (Wellness Recovery Action Plan) to help us break down some of these challenges in our communities and families. The cultural perspective that we gave to our audience was from the view of an Afghan woman, an African-American male and two different views from two Latina women. What was great about this workshop, for me at least, is that we were able to bring in personal experiences on how it was like for us to grow up in these communities as well as give some background information and statistics about each culture. All these cultures have huge stigmas in regards to what mental health is and what it means for someone to have mental health challenges. And going out to get services is rarely, if ever, done. This is something we all would like to change by bringing more awareness, and I hope this workshop was the first step for us.
It was like the dotting of the i and the crossing of the t. It was like the exclamation point at the end of the sentence of this year as we approach its end. What a great way to transition from that which is, into that which is intended to that which will be revealed.
That was Alternatives Conference 2013 in Austin, Texas.
This was my first time attending an Alternatives conference. I have been to a lot of conferences in my life about a few different subjects/topics, but this Alternatives Conference was probably the most fun, interesting, diverse and informative. The number of workshops being offered made it difficult to choose which ones to attend because so many of the ones that were of interest to me were happening simultaneously. I sometimes found myself drifting from one workshop to another catching bits and pieces of a number of them.
I do of course have my favorites. Anything that PEERS presented is an automatic favorite among the others. The first workshop that I went to was one titled “Creating Inclusive Communities by Shining the Light Within.” The facilitators were Sharon Kuehn and Yaffa Alter. Bre Williams and I were support staff.
From before the beginning of the workshop when the room was empty except for the tables and chairs to the end of the presentation when the room was full to capacity and then some with enthusiastic workshop attendees, this workshop was driven with high energy and spirit. It was amazing to watch this process unfolding as it did. There is always the hustle and bustle of loading in, setting up, putting together and of course working out the kinks, bugs and technical difficulties that are sure to arise. The technical difficulty fairy did not disappoint us either. When things go haywire there is always an onset of panic. Well, I start to panic anyway.
When we did have a problem the staff of the Hyatt was there on the double to remedy the situation expeditiously. I was impressed and pleased at the response and the results. The end result was that the problems were solved and the entire rest of the workshop was a complete and totally awesome and memorable experience.
I don’t know, but there’s just something about the chemistry between those two facilitators, Sharon and Yaffa. The word “magic” comes to mind when I try to describe what I witness as the exchange of thoughts, words, actions and the energy between the two of them overflows with exuberance and spills out onto the rest of the people in the room. From the warm and inviting, beautifully atmospheric, and mood-setting music playing as the people were entering the room, to the heartfelt introductions and explanation of the intention of the workshop, one was drawn in and made welcome. I know that I was.
The end result was the production of at least 50 amazingly decorated individual masks, some more ornate than others, that reflected the essence and captured the spirit of the mask makers themselves who began with a blank canvas/mask.
After being allowed to express and share with the entire group what their masks and the decorations represented to the mask makers, the workshop was over but it seemed that the participants were reluctant to leave the room as once again the room filled with the soft beautiful meditative healing sounds of music. In revealing the sentiment behind each mask, the participants unveiled themselves and found it easy to continue to share with one another their thoughts and ideas about how energizing, healing and cathartic the “Creating Inclusive Communities by Shining the Light Within” workshop had been for them. I know it was for me.
On the final day of the Alternatives 2013 conference, I attended a workshop called Reclaiming Your Power by Ben Luskin, an author and brain trauma survivor who experienced a since of nirvana and holistic appreciation for the power of thought through his recovery journey. I appreciated his facilitation style as he began by allowing everyone to introduce themselves and say what they were grateful for in the moment, and then asked how it felt to express such a thing. Responses varied, but what was a constant was this idea of gratitude and appreciation, which naturally segued into his main topic of the workshop: happiness.
He used a flip chart to create a contrast between the internal and external self, and where the idea of happiness and success comes from as it relates to the external self. The message was that every single piece and part of self-acceptance comes from the internal self, and once there is practice of gratitude and appreciation for all that one has to offer, there can be nothing to inhibit the ability to accept things as they are and work with whatever tools or opportunities one is given. A more succinct way of putting it? Play the cards you were dealt after finding and accepting all the value those cards can give you. So basic, yet so complex! He explained that as a brain injury survivor, the concept of how and when people make decisions seems like it is a quick thought-to-action type of progression. But instead what he and other survivors experience is that you have to go through each and every action at once, and even those are decisions in and of themselves.
He made that point to say that once we are happy with our internal decisions, then we will be successful in work, relationships, etc. He explained that more important than what you do, which is the external self, is who you are, which is your internal self that governs all external interactions and decisions. He did an exercise to demonstrate. He had us all sit silently for about 2 minutes. He did not give instruction besides just sitting and focusing on the external feeling. What others and I found was this sense of wanting acceptance from others. We did it again with the second time focused on the internal feeling while also being conscious of our posture. What I found personally was that I wanted to close my eyes, which was not part of the instructions. Once I closed my eyes, I immediately became more comfortable and basically began to meditate. I had no thoughts or anxiety around what others were doing, how they were sitting, or what they may have been thinking about my eyes being closed. I felt so peaceful and I had no focus other than my breathing. I shared with the group that I noticed as an individual, especially one with a social phobia, that I am much more accepting of my internal self as it relates to society, than my external self.
He went on to say that self-acceptance is key to defining the internal self and the internal self is driven by characteristics and/or qualities that one exemplifies the most. The internal self is also driven by the little things we do that make us happy. These things aren’t necessarily going dancing or receiving a nice gift, but little things like making a child smile or people laugh, holding the door open for someone, or creating origami. Those little things are most important, just like those little decisions we make without consciously noticing what we are doing. He continued and compared contentment to geometry and the concept of y=mx + b and how we use three points to determine if that equation determines a line. Once determined, that line then travels through space and time continuously forever. In the same sense, if one could fine three characteristics of the self to accept and be happy with, then confidence and appreciation, would then continue through time, space, and pass any adversity, just like the line. I absolutely loved that analogy. I loved the entire workshop. There was not a big power point to go through, or studies explored or talks of systems change, but it was still very thorough and effective. The perfect end to another awesome Alternatives conference!