Presentation for the 5th Annual Clinical Overview of the Recovery Experience (CORE) Conference, Amelia Island, FL July 17, 2017 Wellness is an integral part of the counseling profession. As such, the incorporation of client wellness into a recovery plan is vital. This education session focuses on how to integrate wellness as a part of a recovery plan and overall treatment utilizing Myers and Sweeney's (2005) Indivisible Self Wellness (IS-Wel) Model. In doing so, this offers a more holistic approach to addictions treatment and extends the recovery model beyond a mere focus on abstinence and change to include key lifestyle and personal factors that can be essential elements to sustaining recovery.

1. Integrating a
Wellness Model in
Addiction Counseling
PRESENTED BY:
DEVONA STALNAKER-SHOFNER, EDD, LPC & MELISSA CHICKERING, MLADC, LCHMC

2. Overall Workshop Objectives:
 Participants will be able to apply the use of popular wellness models
as an integrated component of a client recovery plan and
program.
 Participants will be able to assess client total wellness using specific
wellness assessment tools to give quantitative and qualitative results
to incorporate into client treatment.
 Participants will be able to design a personalized wellness plan for
clients as a part of their recovery program and overall treatment.

3. Specific Learning Objectives:
 To educate participants about wellness through an operational
definition of wellness using the IS-Wel Model (Myers & Sweeney, 2003,
2005).
 To identify factors which could negatively impact client wellness and
adversely affect recovery.
 To examine ways to complete formative and summative evaluations of
client wellness using the 5F-Wel instrument as an integrated element of
treatment and recovery.
 To facilitate participants’ development of a clinical practice model
which integrates client wellness as an element of treatment and
recovery.

4. ASAM Disclosure of Relevant Financial Relationships
Content of Activity: Educational Session
Date of Activity: July 17, 2017
Name Commercial
Interests
Relevant
Financial
Relationships:
What Was
Received
Relevant
Financial
Relationships:
For What Role
No Relevant
Financial
Relationships
with Any
Commercial
Interests
Devona
Stalnaker-
Shofner
N/A N/A N/A
Melissa
Chickering
N/A N/A N/A

5. Glossary of Terms
Commercial Interest - The ACCME defines a “commercial interest” as any
proprietary entity producing health care goods or services, with the exemption of
non-profit or government organizations and non-health care related companies.
Financial relationships -Financial relationships are those relationships in which the
individual benefits by receiving a salary, royalty, intellectual property rights,
consulting fee, honoraria, ownership interest (e.g., stocks, stock options or other
ownership interest, excluding diversified mutual funds), or other financial benefit.
Financial benefits are usually associated with roles such as employment,
management position, independent contractor (including contracted research),
consulting, speaking and teaching, membership on advisory committees or review
panels, board membership, and other activities from which remuneration is
received, or expected. ACCME considers relationships of the person involved in the
CME activity to include financial relationships of a spouse or partner.
Relevant financial relationships - ACCME focuses on financial relationships with
commercial interests in the 12-month period preceding the time that the individual
is being asked to assume a role controlling content of the CME activity. ACCME has
not set a minimal dollar amount for relationships to be significant. Inherent in any
amount is the incentive to maintain or increase the value of the relationship. The
ACCME defines “’relevant’ financial relationships” as financial relationships in any
amount occurring within the past 12 months that create a conflict of interest.
Conflict of Interest - Circumstances create a conflict of interest when an individual
has an opportunity to affect CME content about products or services of a
commercial interest with which he/she has a financial relationship.

6. Understanding Wellness
 Historically, definitions of wellness have focused on the lack of
disease to more currently a state of balanced living.
 Take a moment to think about what wellness means to you.
 Discussion: How would you define wellness?

7. Working Definition of Wellness
The working definition of wellness for this educational
session is based on Myers and Sweeney (2005).
Wellness is a way of life. Specifically, wellness is a
means of living which:
 is oriented toward optimal health and well-being;
 involves the integration of body, mind, and spirit;
 requires conscious choices to engage in healthful
behaviors;
 has a goal of helping you live your life more fully
in all areas (social, personal environmental).

8. Wellness in Addiction Counseling:
What the Research Says
 Lewis and Myers (2010, 2012) examines the impact of wellness
factors on college student drinking.
 The results indicated that students who showed increase wellness in
the areas of wellness related to coping (i.e. self-worth and stress
management) and sense of self (i.e. self-care and identity) were less
likely to engage in inappropriate substance use, misuse, or abuse.
 It is proposed that extending these findings to existing recovery
programs such that increasing one’s perceived and experienced
wellness may also translate to more sustained recovery, which is the
focus of this workshop.

9. Wellness in Addiction Counseling: Implications
for Clinical Practice (Lewis & Myers, 2010, 2012)
 Counselors may wish to explore faulty cognitive mechanisms and
determine whether substance abuse is a way to mitigate internal
strife (Lewis & Myers, 2010).
 Clients may benefit from psychoeducational programs that teach
them to recognize and manage stress in their daily lives.
 Clients could benefit from learning a variety of stress management
skills, such as relaxation skills, to better navigate daily stressors as well
as more appropriate self-communication.

10. Wellness in Addiction Counseling: Implications
for Clinical Practice (Lewis & Myers, 2010, 2012)
 Leisure activities are often used to mitigate stress; clients may benefit
from learning how to recognize and manage stress through leisure
education.
 Whereas healthy coping can confer a number of positive benefits in
one’s life, results suggest that positive coping also may serve as a
buffer against risky behaviors. Campus counselors and clinicians
may wish to incorporate coping and stress management skills
training into their treatment protocols as a way to reduce harm from
drinking.

11. Addiction as a Reaction to Stress
 Many practitioners and researchers maintain that addiction is a
maladaptive coping strategy to manage distress (emotional,
physical, psychological)
 It is also considered an adverse reaction to trauma for some
individuals
 Wellness-based counseling can work to mitigate stress in clients by
teaching them more appropriate and adaptive ways of coping.

12. Physical Responses to Stress
 Fatigue/Exhaustion
 Disturbed Sleep
 Hyper/Hypo Action
 Changes in Appetite
 Digestive Problems
 Headaches/Nausea
 Large Muscle Aches

13. Emotional Responses to Stress
 Fear
 Guilt
 Numbing
 Anxiety
 Depression
 Helplessness
 Anger
 Irritability
 Frustration

14. Behavioral Response to Stress
 Change in Activity
 Withdrawal
 Suspiciousness
 Hyper Alert
 Increased Startle
Reaction
   Sexual Activity
 Outbursts
 Psychomotor
Agitation

15. Cognitive Response to Stress
 Concentration
 Ability to Make
Decisions
 Memory Disturbed
 Amnesia/Confusion
 Problem Solving
 Disturbed Thinking
 Change in Alertness

16. The Indivisible Self Wellness Model
 Developed by Myers and Sweeney (2005)
 Wellness is “a means of living” which:
 Is oriented toward optimal health and well-being
 Involves the integration of body, mind, and spirit
 Requires conscious choices to engage in healthful behaviors
 Has a goal of helping one live life more fully in all areas
 Wellness is based on the entirety of the individual
and within the context of the environment.

17. The Indivisible Self Wellness Model

18. Readiness for Change
 Change is hard, even if it is something you desire.
 Change is a process with cognitive and behavioral aspects.
 Prochaska and Diclemente (1983) developed the Stages of
Change
 Pre-contemplation
 Contemplation
 Preparation
 Action
 Maintenance
 Termination
 Discussion Question: Based on your understanding of what
wellness is, and the stages of change paradigm, how might you
incorporate understanding wellness and change into client
care?

19. Developing a Personal Wellness
Plan
 Based data received from the initial wellness
assessment, identify 1-2 areas that a client would like
to improve or change to create a personal wellness
plan.
 Activity: Personal Wellness Plan
 Develop a personal wellness plan based on the following
criteria:
 Specific goals
 Action steps/methods to use for wellness in the identified area
 Resources (What do I have? What do I need? )
 Incentives and rewards for success
 Implementation of the wellness plan
 Available resources
 Potential barriers
 Strategies for implementation

20. Wellness in Addictions Counseling:
A Case Scenario
Ken Cameron (pseudonym) is a 35 year-old African American single,
heterosexual, cisgender male who has presented for treatment for
alcohol and cocaine abuse. He has been sober for three months. As
a part of outpatient treatment, he has volunteered to participant in a
wellness-based recovery program. He was given an initial assessment
using the Five Factor Wellness Inventory (5F-Wel). Initial scores are as
follows: Coping-65, Social-70, Essential-72, Physical-75, and Creative-
50. Based on initial scores, an individual wellness plan is developed
focusing on three areas. For this activity, please discuss what areas you
would address and why?

21. Developing a Wellness-Based
Clinical Practice Model
 Implement an wellness assessment at specific
junctures in client treatment and recovery
process.
 Facilitate the development of a personal
wellness plan for each client to be implemented
and monitored as a part of treatment
 Educate clients about signs of distress and
impairment and have a specific plan to
remediate when necessary

22. Wellness in Addiction Counseling and
Treatment: A Multiphasic Approach
 One possible approach to multiphasic clinical supervision
advocated by Witmer and Young (1996) and Noonan,
Ballinger, and Black (2007) has been adapted for use with
addictions counseling and allows for the integration of a
wellness paradigm with a developmental treatment model.
 Phase One: A pedagogical approach
 Phase Two: An andragogical approach
 Phase Three: A heutagogical approach

23. Client Wellness Adapting the Discrimination
Model (Bernard & Goodyear, 1992)
 Advocates giving attention to three practical roles:
 Counselor as “teacher”
 Counselor as “counselor”
 Counselor as “consultant”

24. Phase One: Counselor as
“Teacher”
 Employs a pedagogical approach
 Infusing wellness into addictions counseling treatment via
psychoeducation
 Incorporation of a wellness philosophy and paradigm in existing
treatment protocols
 Wellness assessments at incremental stages of development
 Development of a personal wellness plan with monitoring of that
plan in clinical treatment

25. Phase Two: Counselor as
“Counselor”
 Employs an andragogical approach with the
focus on monitoring personal wellness based on
the established wellness plan
 Exploring and processing with client potential
“blind spots” which may be indicative of or
exacerbated by impairment
 Utilizing personal counseling as a wellness
intervention as a means to address identified
impairment, trauma, or other issues which could
create further impairment or exacerbate relapse

26. Phase Three: Counselor as
“Consultant”
 Employs a heutagogical approach
 Emphasis is on facilitating wellness from a collegial perspective
 “Self-determined learning” approach as the client begins to
rely upon his/her own understanding of wellness and
successfully integrate one’s knowledge into one’s developing
capabilities to maintain wellness in recovery

27. “Although the world is full of suffering, it is
Also full of the overcoming of it” Helen Keller

28. Concluding Remarks and Summary
 Remember, wellness is about finding balance
across different dimensions.
 Change is incremental, and even small efforts
can result in major differences in wellness.
 Thank you for your participation in this workshop.
Be well!!!

29. References:
 Lewis, T. F., & Myers, J. E. (2010). Wellness factors as predictors of alcohol use among
undergraduates: Implications for prevention and intervention. Journal of College Counseling, 13,
111-125.
 Lewis, T. F., & Myers, J. E. (2012). Wellness factors decrease odds of drinking and driving among
college students. Journal of Addiction & Offender Counseling, 33, 93-106.
 Myers, J. E. & Sweeney, T. J. (2005a). The Five Factor Wellness and Habit Change Workbook.
Menlo Park, CA: Mindgarden Publishers.
 Myers, J. E. & Sweeney, T. J. (2005b). Counseling for wellness: Theory, research, and practice.
Alexandria, VA: American Counseling Association.
 Myers, J. E. & Sweeney, T. J. (2005b). Manual for the Five Factor Wellness Inventory. Menlo Park,
CA: Mindgarden Publishers.