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Post Traumatic Growth Symposuim
2018
Beyond Triple Threat- CIS
LouiseA. Stanger Ed.D, LCSW, CDWF, CIP
About Dr. Louise Stanger
• Clinician-Educator
• Interventionist
• Author-Falling Up A Memoir
of Renewal- Amazon
• The Clin...
How Did You Arrive Today
Objectives
Identify, Describe How Clients and Families Come to your Practice
Identify , Describe and DiscussAddiction, Men...
Objectives
• Identify, Describe and
Demonstrate CIS
• Define & Describe & Identify
how shame, trauma,
addiction, mental & p...
Demonstrate CIS -Case Studies
Clinical & Reverse Interventions
Create Possibility
SubstanceAbuse-
Mental Health-Depression/
Anxiety
Chronic Pain-Physical Maladies
Digital and other Process
Disorders
Relat...
ASAM March, 2011
A Primary Chronic Disease of
the brain reward, motivation,
memory and related circusy
Dysfunction leads t...
Chronic Pain
133 million People Experience Chronic
Pain
1 in 5 globally
153 Billion was spent on adolescent chronic
pain
6...
Mental Health Issues
Anxiety
Depression
Narcissism
PTSD
Bi-Polar
Personality
Psychosis
Phobias
Trauma
Definitions of Trauma
Overwhelming experiencing that
cannot be integrated and elicit
animal defensive mechanisms and
dysreg...
Trauma is objective
What happened ( My
father killed himself, My
baby dies of SIDS, I was
date raped , humiliated etc
Trauma is subjective :
How do I perceive the situation ?
Relationship to early child-
hood experiences -and
Alcoholism
Adv...
Trauma
What do your Clients Say about
Trauma ????
Verbal abuse
Physical abuse
Witnessing a tragedy
Not being told about something...
Getting Emotionally Hooked
When I Experience X
I Feel- Body Sensation
I Think -Whats my go-to
thought process
Behavior-Wha...
Folks Are More Then Their Trauma
Questions about life role
Your place in life
Coupled with a sense of loss
Perhaps we have...
Shame
Shame is that intensely painful
feeling of believing we are
flawed and therefore
unworthy of love and
belonging.
I am...
Guilt
Have you ever stolen
anything ?
Had guilty thoughts ?
Have you ever lied?
Made up a confabulation?
Humiliation
The Act of Making
Someone Inferior or
Foolish
Loss and Grieving
Loss -Something of Value is
gone
Grief = Total response to an
emotional experience related to
loss
Breav...
Addiction -Attachment Disorder
Values are lost as we attach to substances and other unhealthy behaviors
My Philosophy Of Treatment
Sheldon Kopp.
Existential
Strength Based
Gift of the Buddah
Sheldon Kopp
The therapist can interpret, advise, provide the emotional
acceptance and support that futures personal growt...
Sara Lawrence-Lightfoot
Philosophy
Strength based-it begins by looking for what is good and healthy
and assumes the expression of goodness will al...
Brene Brown
Invitation is to
Wholehearted living
Strength based
Cultivates Curiosity
Owning Your Story
( Falling down and Rising
UP)
T...
Family Mapping Is the Way In
Story is our way home
“We are the authors of our own
lives
We write our own daring endings
We...
Take Aways
Strength based
Collaborative
Realistic
Inclusive
Looking for Goodness
Listening to Strangers
Client Centered
Qualitative I...
Invitations to Change
To Articulate Your Philosophy
–LouiseA. Stanger
An Intervention is an invitation to seek
and accept care
Collective Intervention Strategies
Louise Stanger Ed.D, LCSW, CDWF, CIP
Why CIS?
• Collective - In that to be successful there must be a
team of Families, Friend, Collegues, Associates,
business...
• Strength Based
• Solution Focused
• People are Teachable
• Change is Possible
• The Present is Important
• We can rise t...
Theoretical Underpinnings
Salvador Minuchin
Virginia Satir. TFT
Bowen , Family Systems
Bowlby,Attachment
Monica McGoldrick...
Theoretical Strategies
• Motivational Interviewing
• Cognitive Behavioral
• Acceptance & Commitment
• Values Clarification
...
Counseling Skills Used
•Listening- Empathy
•Genuine
•Unconditional Positive Regard
•Concreteness
•Reflecting- Echoing Key w...
Collaborator
“I am the mirror who reflects back their pain, their fears their
voices. I am the inquirer who asks difficult qu...
Interventions Include a Village of
Potential Change Agents
Participants are experts
Value Driven
Solution Focused
Evidence...
Accountability Teams
Sad-Disgusted
Boundary less
Loving -Worried
Frustrated-Shocked
Embarrassed- Shamed
Terrified-Controlli...
Families are taught
• The nature of substance
abuse process and mental
health disorders. If
appropriate about chronic
pain...
Dr. Louise Stanger
“An Intervention requires Crucial
Conversations”
War of The Roses
Case Study
Clinical & Reverse
Interventions
Clinical Intervention
Reverse Intervention
Interventions Include a Village of
Potential Change Agents
Participants are experts
Value Driven
Solution Focused
Evidence...
Clinician Interventionsist
Must Be able to :
• Develop a Team
• Do a Family Map that engages everyone
• Do a Retrospective...
Beliefs an individual or
group makes about
what constitutes proper
behavior
Standard of Conduct
Make sure you know
Collective
Perspectives
Bringing Folks
Together
For The
Common Good
Basic Anatomy
• Intervention Agreement &
Initiative
• Education, Information
Gathering & Assessment
• Implement , Review, ...
Start where your Client is !
Family Mapping
A Way into Story
Folks have unconsciously
colluded with the problem
Dr. Louise Stanger
“A Successful Intervention has the Potential To
Transform not just the Identified Client but the
Entire ...
The Conversation will take you many places
Open ended
Conversations will be non-linear
Always Start
With
Identified Love One
Qualitative Questions
Tell Me about ………..
Tell me about your Family..
Tell me about your
children, family,
Grandparents etc
20
The Wounded Hearts
Secrets & Lies
I LO
Substance Abuse
Legal
Jack
Learning disability
SallySusie
Laura John
MikeJim Sr ...
Meet Sally
Mental Health- Sucicidality- Disordered Eating -Substance Abuse
About Sally
• Mother -Father South American, Jewish
descent
• Father Hx of Depression
• Family has 4 children- Sally is th...
Family Mapping Started
after first placement
Meet Jack and his family
54 yo old retired executive lives
with 29 yo son
Two previous treatment episodes
3 children 19, 2...
Families Readiness to Change
In 2 months 3 out of 5 family members were ready to
change
In 7 months 3 out of 5 family memb...
Meet Maddi
10 operations - 6 treatment centers
First major accident age 14
Family History of SA , MH and Molestation
Pain Body, SexualAssault Trainer
For past 9 years ha...
Maddi gains trust with primary clinician
Maddi gains trust with exercises
Maddi Starts to talk to therapist
Family is conf...
Accepted to premed
Meet Erik
20 years old
Only son of high wealth
family 92 sisters)
Legal issues
SubstanceAbuse
Anxiety & Depression
ADHD
Eriks Family
Sisters-Bullying and
Depression
Mom -Family History of SA
Mom in Recovery
Dad Family History of SA
and then M...
Erik’s mom
My brother died at age 38 he had HIV
Be Curious
We can all 

Fall Up!
Contact Dr.Louise
DrStanger@allaboutInterventions.co
m
www.allaboutinterventions.com
619-507-1699
Learn To Thrive
Falling ...
Resources
Brown, Brene- Rising Strong . Speiegel & Grau International 2015 NYC NY
Brown, Brene, DaringGreatly. Gothom Book...
Resources
Kopp, Sheldon- If You Meet The Buddah on the Road , Kill Him,
1982. Penguin House Random House, NY, NY
Stanger, ...
Resources
Stanger www.allaboutinterventions.com
Systemic Model www.systemicintervention.com
Arise www.linkingsystems.com
J...
Resources
storti-www.stortimodel.com
Mintz www.reallifeis
Tap 35
www.motivational interviewing.org
Post Traumatic Growth Symposium
Post Traumatic Growth Symposium
Post Traumatic Growth Symposium
Post Traumatic Growth Symposium
Post Traumatic Growth Symposium
Post Traumatic Growth Symposium
Post Traumatic Growth Symposium
Post Traumatic Growth Symposium
Post Traumatic Growth Symposium
Post Traumatic Growth Symposium
Post Traumatic Growth Symposium
Post Traumatic Growth Symposium
Post Traumatic Growth Symposium
Post Traumatic Growth Symposium
Post Traumatic Growth Symposium
Post Traumatic Growth Symposium
Post Traumatic Growth Symposium
Post Traumatic Growth Symposium
Post Traumatic Growth Symposium
Post Traumatic Growth Symposium
Post Traumatic Growth Symposium
Post Traumatic Growth Symposium
Post Traumatic Growth Symposium
Post Traumatic Growth Symposium
Post Traumatic Growth Symposium
Post Traumatic Growth Symposium
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Post Traumatic Growth Symposium

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OBJECTIVES
- Identify, Describe How Clients and Families Come to your
Practice
- Identify , Describe and Discuss Addiction, Mental Health ,
Chronic Pain and Process Disorders
-Identify how Trauma, Shame ,Guilt, Humiliation, Embarrassment , Grief and Loss Effect Ones Story about Themselves
-Identify how we as clinicians, behavioral health care professionals identify our clients

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Post Traumatic Growth Symposium

  1. 1. Post Traumatic Growth Symposuim 2018
  2. 2. Beyond Triple Threat- CIS LouiseA. Stanger Ed.D, LCSW, CDWF, CIP
  3. 3. About Dr. Louise Stanger • Clinician-Educator • Interventionist • Author-Falling Up A Memoir of Renewal- Amazon • The Clinicians Guide to Addiction Interventions-In press Routhledge • Widow, Wife, Mother, Grandmother • Soul Cycler adventurer
  4. 4. How Did You Arrive Today
  5. 5. Objectives Identify, Describe How Clients and Families Come to your Practice Identify , Describe and DiscussAddiction, Mental Heath , Chronic Pain and Process Disorders Identify how Trauma, Shame ,Guilt, Humiliation, Embarrassment , Grief and Loss Effect Ones Story about Themselves Identify how we as clinicians, behavioral health care professionals identify our clients
  6. 6. Objectives • Identify, Describe and Demonstrate CIS • Define & Describe & Identify how shame, trauma, addiction, mental & physical health effect families • Demonstrate the power of family mapping & science of portraiture in CIS • Share invitational vocabulary
  7. 7. Demonstrate CIS -Case Studies Clinical & Reverse Interventions
  8. 8. Create Possibility
  9. 9. SubstanceAbuse- Mental Health-Depression/ Anxiety Chronic Pain-Physical Maladies Digital and other Process Disorders Relationship failures -Legal But-how do our clients arrive?
  10. 10. ASAM March, 2011 A Primary Chronic Disease of the brain reward, motivation, memory and related circusy Dysfunction leads to Biological, psychological, social and spiritual manifestations Individual pathologically pursing reward or relief thru substances
  11. 11. Chronic Pain 133 million People Experience Chronic Pain 1 in 5 globally 153 Billion was spent on adolescent chronic pain 65% of all people experience chronic pain once in their life 75 % of all heron users started with a prescription 155 people die daily
  12. 12. Mental Health Issues Anxiety Depression Narcissism PTSD Bi-Polar Personality Psychosis Phobias
  13. 13. Trauma
  14. 14. 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
  15. 15. Trauma is objective What happened ( My father killed himself, My baby dies of SIDS, I was date raped , humiliated etc
  16. 16. 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
  17. 17. Trauma
  18. 18. What do your Clients Say about Trauma ???? Verbal abuse Physical abuse Witnessing a tragedy Not being told about something Accidents Divorce Death
  19. 19. Getting Emotionally Hooked When I Experience X I Feel- Body Sensation I Think -Whats my go-to thought process Behavior-What do I do?
  20. 20. Folks Are More Then Their Trauma Questions about life role Your place in life Coupled with a sense of loss Perhaps we have lost a core part of ourselves Sometimes we become still and quiet
  21. 21. 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
  22. 22. Guilt Have you ever stolen anything ? Had guilty thoughts ? Have you ever lied? Made up a confabulation?
  23. 23. Humiliation The Act of Making Someone Inferior or Foolish
  24. 24. 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
  25. 25. Addiction -Attachment Disorder Values are lost as we attach to substances and other unhealthy behaviors
  26. 26. My Philosophy Of Treatment Sheldon Kopp. Existential Strength Based Gift of the Buddah
  27. 27. Sheldon Kopp The therapist can interpret, advise, provide the emotional acceptance and support that futures personal growth , and above all can listen…actively and purposefully, responding with the instrument of his trade, that is with his personal vulnerability of his own tumbling self. This listening is that which facilitates the patients telling of his tale that can set him free.”
  28. 28. Sara Lawrence-Lightfoot
  29. 29. Philosophy Strength based-it begins by looking for what is good and healthy and assumes the expression of goodness will always be laced with imperfections. Collaborative qualitative inquiry- The researcher becomes part of the conversation -Become witness to the conversation The Context -where the interview takes place becomes part of the portrait -Human experience is framed shaped by the setting. Discovering the tension between life, loss and liberation.
  30. 30. Brene Brown
  31. 31. Invitation is to Wholehearted living Strength based Cultivates Curiosity Owning Your Story ( Falling down and Rising UP) To look at our SFD and Confabulations
  32. 32. Family Mapping Is the Way In Story is our way home “We are the authors of our own lives We write our own daring endings We craft love from heartbreak Compassion from shame Grace from disappointment Courage from failure Showing Up is our Power
  33. 33. Take Aways
  34. 34. Strength based Collaborative Realistic Inclusive Looking for Goodness Listening to Strangers Client Centered Qualitative Inquiry- Open Ended Questions
  35. 35. Invitations to Change
  36. 36. To Articulate Your Philosophy
  37. 37. –LouiseA. Stanger An Intervention is an invitation to seek and accept care
  38. 38. Collective Intervention Strategies Louise Stanger Ed.D, LCSW, CDWF, CIP
  39. 39. Why CIS? • Collective - In that to be successful there must be a team of Families, Friend, Collegues, Associates, business partners , managers or co-workers assembled to bring about change • Intervention- In that we seek to move (i.e/ motivate a person to a place of change) • Strategy, in that nothing is set in stone ; we may adapt the process as needed
  40. 40. • Strength Based • Solution Focused • People are Teachable • Change is Possible • The Present is Important • We can rise to our best possible self Philosophical Underpinnings
  41. 41. Theoretical Underpinnings Salvador Minuchin Virginia Satir. TFT Bowen , Family Systems Bowlby,Attachment Monica McGoldrick- Family Systems Therapy
  42. 42. Theoretical Strategies • Motivational Interviewing • Cognitive Behavioral • Acceptance & Commitment • Values Clarification • Solution Focused • 12 Step or other Self help • Mindfulness • Breathing
  43. 43. Counseling Skills Used •Listening- Empathy •Genuine •Unconditional Positive Regard •Concreteness •Reflecting- Echoing Key words •Body Language •Open Ended Questions •Paraphrasing- Summarizing •Counselor Self Disclosure •To Do Not Harm
  44. 44. Collaborator “I am the mirror who reflects back their pain, their fears their voices. I am the inquirer who asks difficult questions, who searches for evidence and patterns. I am the companion on the journey bringing my own story to the encounter, making possible an interpretive collaboration, I am the audience who listens , laughs , weeps an applauds. I am the spider women spinning their tales.. I am the therapist who offers cathaersis support and challenge… I am also the stage manager coordinating the intersection of three plays- the story teller, the narrator and the readers inviting your voice to the drama” Sara Lawrence Lightfoot
  45. 45. 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
  46. 46. Accountability Teams Sad-Disgusted Boundary less Loving -Worried Frustrated-Shocked Embarrassed- Shamed Terrified-Controlling At Wits End
  47. 47. Families are taught • The nature of substance abuse process and mental health disorders. If appropriate about chronic pain syndrome or other medical legal problems • The way an intervention is conducted • The active and instrumental part they have in moving someone to change
  48. 48. Dr. Louise Stanger “An Intervention requires Crucial Conversations”
  49. 49. War of The Roses Case Study
  50. 50. Clinical & Reverse Interventions
  51. 51. Clinical Intervention
  52. 52. Reverse Intervention
  53. 53. 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
  54. 54. Clinician Interventionsist Must Be able to : • Develop a Team • Do a Family Map that engages everyone • Do a Retrospective -bio-psycho-social • Develop case strategy • Create Treatment Plan & Placement • Case Management • Follow with Aftercare • Facilitate Family Engagement in the healing process • Have Concierge Capabilities • ETHICS are Paramount
  55. 55. Beliefs an individual or group makes about what constitutes proper behavior Standard of Conduct Make sure you know
  56. 56. Collective Perspectives Bringing Folks Together For The Common Good
  57. 57. Basic Anatomy • Intervention Agreement & Initiative • Education, Information Gathering & Assessment • Implement , Review, Followup
  58. 58. Start where your Client is !
  59. 59. Family Mapping A Way into Story
  60. 60. Folks have unconsciously colluded with the problem
  61. 61. Dr. Louise Stanger “A Successful Intervention has the Potential To Transform not just the Identified Client but the Entire Family”
  62. 62. The Conversation will take you many places Open ended
  63. 63. Conversations will be non-linear
  64. 64. Always Start With Identified Love One
  65. 65. Qualitative Questions Tell Me about ……….. Tell me about your Family.. Tell me about your children, family, Grandparents etc
  66. 66. 20 The Wounded Hearts Secrets & Lies I LO Substance Abuse Legal Jack Learning disability SallySusie Laura John MikeJim Sr Mary Jack Susan Jena Jim Anxiety & depression Medical Bullying Work RAGE Religiosity Perfectionism - everythinglooks good Secrets T T T TT T T T T= Trauma = Money Issues Sample Family Map 18 = Affair Sally T died age 38 1614
  67. 67. Meet Sally Mental Health- Sucicidality- Disordered Eating -Substance Abuse
  68. 68. About Sally • Mother -Father South American, Jewish descent • Father Hx of Depression • Family has 4 children- Sally is the Subsequent child of an infant death - Brother died of brain tumor at 9 months, older brother age 5 dx with autism- PTS • Bullying, Isolation , No Friends • Trauma Riding , at School Sexual Assault • 4 Suicide Attempts-Disorded Eating- • Pills & Marijuana • No Formal Inpatient Treatment
  69. 69. Family Mapping Started after first placement
  70. 70. Meet Jack and his family 54 yo old retired executive lives with 29 yo son Two previous treatment episodes 3 children 19, 22, 29 Wife in process of divorce Being asked to leave treatment center as wrong placement Had to get him fromA -B
  71. 71. Families Readiness to Change In 2 months 3 out of 5 family members were ready to change In 7 months 3 out of 5 family members had engaged in treatment which lasted more then 60 days. 1 family member went for a 2 week intensive, 2 Private therapists 1 family member refused treatment
  72. 72. Meet Maddi 10 operations - 6 treatment centers
  73. 73. First major accident age 14 Family History of SA , MH and Molestation Pain Body, SexualAssault Trainer For past 9 years has been in and out of treatment centers Walking on crutches or not walking at all
  74. 74. Maddi gains trust with primary clinician Maddi gains trust with exercises Maddi Starts to talk to therapist Family is confronted with their substance abuse and their need to detach Maddi experiences a difference in family Maddi experiences a Community IntegrationApproach Maddi could be your next client
  75. 75. Accepted to premed
  76. 76. Meet Erik 20 years old Only son of high wealth family 92 sisters) Legal issues SubstanceAbuse Anxiety & Depression ADHD
  77. 77. Eriks Family Sisters-Bullying and Depression Mom -Family History of SA Mom in Recovery Dad Family History of SA and then Mom said I have something to share …………..
  78. 78. Erik’s mom My brother died at age 38 he had HIV
  79. 79. Be Curious
  80. 80. We can all 
 Fall Up!
  81. 81. Contact Dr.Louise DrStanger@allaboutInterventions.co m www.allaboutinterventions.com 619-507-1699 Learn To Thrive Falling Up-Amazon The Definitive GuideAddiction Interventions-Collective Strategies- Stanger & Weber .In Press Routhledge
  82. 82. 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
  83. 83. 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 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
  84. 84. 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
  85. 85. Resources storti-www.stortimodel.com Mintz www.reallifeis Tap 35 www.motivational interviewing.org

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