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High net worth clients power, prestige, problems

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With the ongoing opioid epidemic, availability or marijuana and other drugs addiction has become a problem with no class lines. The story of pain medication following surgery leading to opioid addiction and heroin is everywhere.

As Executive Protection you may not of thought of this as part of your job description , and you are in a unique position of Influence and Trust to identify and help intervene when the persons with problems are clients and their loved ones.

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High net worth clients power, prestige, problems

  1. 1. HIGH NET WORTH CLIENTS POWER -PRESTIGE -PROBLEMS Louise A. Stanger Ed.D, LCSW, CDWF, CIP
  2. 2. A Training Especially designed for
  3. 3. MEET DR. LOUISE ➤ Clinician -Ed.D, LCSW, CDWF, CIP ➤ Expert- Author Falling Up-A Memoir of Renewal & Learn to Thrive-An Intervention Guidebook, Thrive Global, Huffington,Recovery Campus , Sober world etc. ➤ Educator-Faculty SDSU, School of Social Work, SDSU Interwork Institute,NIH_NIAA researcher, USD Director AOD ➤ Black Box Client and Advocate
  4. 4. You Have the Opportunity To Play a Key Role With the ongoing opioid epidemic, availability or marijuana and other drugs addiction has become a problem with no class lines. The story of pain medication following surgery leading to opioid addiction and heroin is everywhere. As Executive Protection you may not of thought of this as part of your job description , and you are in a unique position of Influence and Trust to identify and help intervene when the persons with problems are clients and their loved ones.
  5. 5. Who is your Client ? As Executive Protection what are your legal rights in terms of who you communicate to? Who is your client? It’s easier if you represent the family or the business entity and have the power to talk to the family or business manager Tricker if your client is the identified love one with the problem
  6. 6. “Make sure your documents put you in a position to do something”. Harry Nelson Esq. Client engagements should provide sufficient power for you to act to speak in case of a health crisis . Clients may have Trust documents include “spendthrift”provisions allowing trustees to adjust or control spending for people with spending problems and substance abuse and mental health crisis. Different states offer different degrees of latitude to put controls on funds - age 21- 25 th and in some cases beyond Think that addiction is not an age-bound disease and have management - control mechanisms beyond these dates These are discussion you may have with families and business managers etc
  7. 7. What do you do? Executive protection Event management Surveillance Security Companionship Safe Passage Safety and Security Training Interventions
  8. 8. Clients Come with… Children Wives Husbands Extra Marital Affairs Relatives-Intergenerational Wounds Employees Entourage of Folks
  9. 9. Problematic Behaviors Substance Abuse- Mental Health Chronic Pain & Process Disorders -Sex, Gambling, Spending, Shopping, Disorder Eating, Digital etc.
  10. 10. Trauma
  11. 11. Definitions of Trauma Overwhelming experiencing that cannot be integrated and elicit animal defensive mechanisms and dysregulated arousal “A stress that causes physical or emotional harm that you cannot remove yourself from” Larke Huang , Director of Health Care Equity at SAMSHA
  12. 12. Trauma is objective What happened ( My father killed himself, My baby dies of SIDS, I was date raped , humiliated etc
  13. 13. Trauma is subjective : How do I perceive the situation ? Relationship to early child- hood experiences -and Alcoholism Adverse Childhood Experience- 17,000 patients - Kaiser- effects of trauma are cumulative and one of most destructive forms is recurrent calling and humiliation
  14. 14. What do your Clients Say about Trauma ???? Verbal abuse Physical abuse Witnessing a tragedy Not being told about something Accidents Divorce Death
  15. 15. Getting Emotionally Hooked When I Experience X I Feel- Body Sensation I Think -Whats my go-to thought process Behavior-What do I do?
  16. 16. Signs of Unresolved Trauma Inability to tolerate feeling or conflicts Numbness-Movement to intense feelings or rage Depression (problems sleeping, loss of memory, anxiety, low motivation Panic, Feeling like you are having a heart attack or anxiety
  17. 17. Out of Control or Injurious Behavior Addictive behaviors (over-under eating, gambling, drinking Repeated patterns of behavior to avoid feelings( Promiscuity,Internet, sleeping) Chaos in life Self-harmful behaviors -Cutting Scratching , Burning
  18. 18. Intense Self Blame Belief that somehow they were to blame for original trauma Survivor Guilt Belief they they are not good enough They may induce other people into treating them badly
  19. 19. Stuck in Victim, Perpetrator, or Rescuer Roles Seek out Relationships withAbusive people Induce abuse from others Perceive abuse which confirms they are no good ActAggressively to others Compulsively driven to help others Acts of generosity not in accordance with what is warranted
  20. 20. Disorganized Attachment Patters Inability to tolerate ambivalence to the perpetrator Ambivalence towards trusted persons Difficulty maintaining Healthy relationships
  21. 21. Black and White Thinking Childlike, magical, paradoxical, oxymorons Collect evidence to maintain distortions Generalizations, all or nothing, discount conclusions, assuming, labeling , emotional reasoning
  22. 22. Intrusive thoughts, images, feelings and nightmares Loss of long period of times, dissociated Appears to switch personalities Trances, sleepwalking Voices too much noise in my head Confusion over personal identity or new identity
  23. 23. Suicide Ideation
  24. 24. Be On The LookOut Sudden Changes in Spending Lying- Increased Irritability Depressed or Overly anxious and Worried Legal -restraining orders, Backmail Health- Physical Maladies- Lethargy Relationship Failures Work- Not able to be on Stage ,not showing up or overly demanding School- Missing Classes
  25. 25. Watch out for Nodding Off What inside the red cup- Purple Drink on Stage Constantly going to the bathroom Screaming at Staff-Hysteria Betting Intergenerational Wounds
  26. 26. Shame Shame is that intensely painful feeling of believing we are flawed and therefore unworthy of love and belonging. I am not good enough Brene Brown
  27. 27. Guilt Have you ever stolen anything ? Had guilty thoughts ? Have you ever lied? Made up a confabulation?
  28. 28. Humiliation The Act of Making Someone Inferior or Foolish
  29. 29. Loss and Grieving Loss -Something of Value is gone Grief = Total response to an emotional experience related to loss Breavement- Subjective response by loved one Mourning -behavioral response
  30. 30. Temporary Incapacity Of Clients and their families Accidents keep happening Money keeps being missed Missed Appointments Fall asleep while talking with you-Distracted not able to keep focus Can’t take care of kids
  31. 31. Mental Health Issues Anxiety Depression Narcissism PTSD Bi-Polar Personality Psychosis Phobias
  32. 32. 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
  33. 33. Keeping The Status Quo SA. MH, CP etc . Organizing structure Unconscious and Conscious Gratification Strategies must be employed that change usual ways of relating, categorizing , and thinking
  34. 34. EMOTIONAL INTENSITY FINISH SENTENCES BAIL OUT FINANCIAL SUPPORT FOOD, CLOTHING SHELTER FEAR of FAILURE FEAR of Losing Jobs ABCD
  35. 35. Secrets Dominate
  36. 36. Confabulations
  37. 37. Phone Call For Help Your client calls you in distress or your client is obviously in distress The accountant calls you The estate attorney calls you Usually they speak with rapid fire and They want something done -NOW- Fix It You lend an ear and Stop- Pause- Breathe and Listen Quick answers are not always the best answer
  38. 38. Please Remember This is not your area of expertise
  39. 39. What does this mean in the Behavioral Health Care Field A= AGE OF FIRST USE B=BIG CHANGES C=CO-EXISTING MENTAL / BEHAVIORAL HEALTH ISSUES DNA-FAMILY HISTORY
  40. 40. Isolate and Locate the Issues
  41. 41. And You Can Be A You are You are a Resource Listen as best you can - You have a position of Trust and you can reassure the client with the problem t Isolate the concerns Who, What When, How Share that you will connect with an expert - Even if you have had first hand experience with MH or SA or Process Disorders Not all Treatment Centers are alike and one size does not fit all Before Giving out or Commenting on a Center its best to seek professional Consultation
  42. 42. –LouiseA. Stanger An Intervention is an invitation to seek and accept care
  43. 43. Professional Interventionists are Called when Families are Fearful ,Angry &Confused Attached to the Problem Cognitively and emotionally Dis-regulated Attempts have failed
  44. 44. Folks have unconsciously colluded with the problem
  45. 45. Accountability Teams Sad-Disgusted Boundary less Loving -Worried Frustrated-Shocked Embarrassed- Shamed Terrified-Controlling At Wits End
  46. 46. Interventions Include a Village of Potential Change Agents Participants are experts Value Driven Solution Focused Evidenced Based Interventionists job is to bring people together for the common good and to identify SA, MH and other issues
  47. 47. Intervention Models
  48. 48. Traditional Surprise Vern Johnson-I’ll Quit Tomorrow Frank Pickard- Family Intervention Ken Seeley- John Southworth- Intervention Show
  49. 49. Traditional Made Modern The Storti Model Est. 1973 Heart to Heart: The HonorableApproach to Motivational Intervention, 1995
  50. 50. Jeff and Debra Jay Love First ,A Families Guide to Intervention 2000 Aging &Addiction , Colleran and Jay 2010 It TakesA Family, 2014
  51. 51. Action Intervention Model Jean Campell LCSW, Dr. Jim Tracey and Bill Maher Psychodrama , sociometry and other action oriented strategies for families
  52. 52. Thought Leaders in Invitational Models Spaere & Raitner - Systemic Arise -Garret and Landau Breakfree- Lamm
  53. 53. Theoretical Underpinnings Salvador Minuchin Virginia Satir. TFT Bowen , Family Systems Bowlby,Attachment Monica McGoldrick- Family Systems Therapy
  54. 54. Interventions are an Invitational Process An 11 step process for a 12 step solution 2016
  55. 55. Start where your Client is !
  56. 56. Phase 1 : Intervention Agreement & Initiative Step 1: Engagement Step 2: Determine Key Stakeholders Step 3 Define Client Guidelines,Confidentiality
  57. 57. Phase 2 : Information Gathering, Objectives & Assessment Step 4- Family Mapping Step 5-Assess ILO and key stakeholders (Portraiture - RetrospectiveAnalysis) Step 6- Teach & Survey Accountability Teams (Triangulation of data) Step 7:Develop Measurable Action Plan
  58. 58. Phase 3 : Implement . Review & Follow Up Step 8 : Coaching , Delivering the Invitation Step 9 : Pre Intervention Meeting The Invitational Meeting Intervention Progress Review and Solution Focused Family recovery Coaching
  59. 59. Other Types of Invitational Interventions(Stanger) Clinical Interventions ( Stanger & Storti ) Reverse Interventions
  60. 60. When Choosing Good Treatment Geography is not the issue !
  61. 61. What makes Good Treatment Accreditation of Center- CARF-JACHO Staff-Credentials Ethics Emphasis of Treatment and Treatment Modalities Accommodations Auxiliary Services How Long In Business Flexibility They do what they say and say what they do
  62. 62. Types of Treatment Medical Detoxification Residential Treatment Florida Model Structured Sober Living Intensive Outpatient In-Home Treatment Plans Intensives Sober Companions Sober Coaches MOST IS MULTIFACTED
  63. 63. SPECIALITIES PROFESSIONALS SENIORS GENDER SPECIFIC -WOMAN- MEN LGBT-TRANSGENDER YOUNG ADULT-WILDERNESS - SCHOOL- DIGITAL ADDICTIONS-AFFLUENZA FAILURE TO LAUNCH GAMBLING SEX SHOPPING DiIGITAL ADDICTION-GAMING DISCORDED EATING CHRONIC RELAPSERS DUAL DIAGNOSIS -MH AND SA OR PD MENTAL HEALTH- BD, DEPRESSION, ANXIETY TRAUMA INFORMED
  64. 64. Treatment Costs Inpatient -from $ 300,000 per month-to o Average is around $45,00 a month though there is good treatment at the $15,000.00 a month range Average length of stay is 45 days Average length of all treatment types 6 months to 1 year Insurance -No Insurance Aston Abernathy COO,AVA Billing and Consulting - Can check Insurance 949-315-1818 or 949-397-2288
  65. 65. Meet Josh age 52 Embezzlement A=14 played poker and Texas hold um in high school, trips to Vegas B= Divorce pending , two sons Fractured family, C- high strung -anxiety - Possibly Manic -Cocaine - alcohol -pills DNA-, hx of religiosity , workaholism MH , holocaust three generations
  66. 66. Meet Sylvia age 69 Embezzlement A= 30 Valium from Mom B= Suicide adopted son. Divorce, two daughters, Fractured family, C- Cognition Problems / Mental Health/ SA R/O/ early dementia DNA- three sisters, hx of SA, MH three generations
  67. 67. Getting Back to the ABC’s and Failure to Launch Meet Arthur Entitled Never Had to Work College Education Enmeshed Family System
  68. 68. Meet Rob age 45 and His Divorced Mother $$$$
  69. 69. Recovery is Beautiful
  70. 70. RESOURCES Dr. Louise Stanger Ed.D, LCSW, CDWF,CIP, ,http:// www.allaboutinterventions.com, 619-507-1699 Harry Nelson JD. Nelson Hardiman -Behavioral Health Care Law- http://www:www.nelsonhardiman.com/ 310-203-2800 Dr. James Flowers, LPC -CEO Driftwood Recovery, Austin- https:// www.driftwoodrecovery.com /715-205-1493 Aston Abernathy COO,AVA Billing and Consulting - Can check Insurance 949-315-1818 or 949-397-2288 Cherylene Short Majors Ph.D- Senior Strategic Advisor, Constellation Behavioral Health 310-924-9139 http:// www.constellationbehavioralhealth.com
  71. 71. Resources Brown, Brene- Rising Strong . Speiegel & Grau International 2015 NYC NY Brown, Brene, DaringGreatly. Gothom Books 2012 Lawrence Lightfoot,Sarah & Hoffman Jessica .TheArt and Science of Portraiture. Joey Bass. 1997 LawrenceLightfoot, S. Respect , 1998. Press Books, Mass. Lawrence, Lightfoot,S. I’ve Known Rivers , Penguin Publishing. Ny 1995 Lawrence, Lightfoot, S Growing Each Other Up, University of Chicago Press. 2016
  72. 72. Resources Stanger www.allaboutinterventions.com Systemic Model www.systemicintervention.com Arise www.linkingsystems.com Jays www.lovefirst.net Lamm www.bradlamm.com Seeley www.intervention911.com Resources
  73. 73. Resources Kopp, Sheldon- If You Meet The Buddah on the Road , Kill Him, 1982. Penguin House Random House, NY, NY Stanger, Louise. Falling Up-A Memoir of Renewal 2015, WZY Press stangerttp://www.huffingtonpost.com/entry/interventions-safety-security-are-the-top- priority_us_591b5042e4b0f31b03fb9f99S Stanger,http://www.huffingtonpost.com/entry/tricksters-addiction- you_us_592f0f7ee4b0d80e3a8a329e Stanger http://www.huffingtonpost.com/entry/what-are-the-differences-between- trauma-addiction_us_58f4e7aee4b048372700da27 www.allaboutinterventions.com
  74. 74. Resources storti-www.stortimodel.com Mintz www.reallifeis Tap 35 www.motivational interviewing.org
  75. 75. ASAM Definition of Substance Abuse 3-11-2015 Addiction is a primary , chronic disease of brain reward , motivation , memory and related circusy. Dysfunction in these circuits leads to characteristic biological, psychological, social and spiritual manifestations. This is reflected in an individually pathological;;y pursuing reward and/or relief by substance abuse use and other behaviors.

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