This document outlines an 8-session group psychoeducation program to teach inmates with serious mental illness skills to manage negativity in prison. The program aims to help inmates examine how their negativity can be debilitating and develop coping skills. It is presented as a structured class format rather than traditional group therapy. The goals are to help inmates adjust to prison rather than expecting the environment to adjust to them. Each session builds on the last to cumulatively develop a positive learning experience and new skills for managing stressors, identifying strengths, making decisions, and minimizing the impact of negative situations. The program is intended to be used alongside other mental health treatments to comprehensively address negativity that stems from incarceration.
As any clinician knows, every year witnesses the introduction of new treatment models. Invariably, the developers and proponents claim superior effectivess of the approach over existing treatments. In the last decade or so, such claims, and the publication of randomized clinical trials, has enabled some to assume the designation of an "evidence-based practice" or "empirically supported treatment." Training, continuing education, funding, and policy changes follow.
As any clinician knows, every year witnesses the introduction of new treatment models. Invariably, the developers and proponents claim superior effectivess of the approach over existing treatments. In the last decade or so, such claims, and the publication of randomized clinical trials, has enabled some to assume the designation of an "evidence-based practice" or "empirically supported treatment." Training, continuing education, funding, and policy changes follow.
Amputation is the removal of a limb or part of a limb by a surgical procedure in order to save the life of a person. Amputation is a triple threat. It involves loss of function, loss of sensation, and loss of body image.
Gestalt therapyIntroductionThe history of Gestalt Th.docxbudbarber38650
Gestalt therapy
Introduction
The history of Gestalt Therapy
The beliefs on which it is based
The important contributors or practitioners of the theory
The theory of helping
The relationship between the helper and the client
Some techniques or approaches developed
The kinds of problems addressed
The populations on which the techniques are used
Multicultural issues in using these approaches
Research findings on the model or theory
Theory of Helping
Responsibility for themselves
Express
Fourfold
expression
differentiation
affirmation
choice and integration
Gestalt therapy is concerned with how a client is experiencing life at the present point in time, and will have this as the basis of the therapeutic work.
A Gestalt therapist, then, would help the client move into those feelings
(or thoughts) in a way that allows a deep immersion into those experiences and the
freedom to express what the client has previously feared to release. Once the client
has moved through the impasse and experienced and expressed what was lying
underneath, an insight usually occurs that helps the client understand what has kept
him or her stuck
Gestalt therapy is helping individuals assume responsibility for themselves rather than relying on others to make decisions for them
Gestalt therapy aims to challenge its clients to move from “environmental support” to “self-support,” in order to mobilize their own resources for dealing with the environment effectively and to make creative adjustments that permit the self to respond to environmental pressures and to inner needs.
expression clients are encouraged to tell who they are as fully as possible, even becoming aware of gestures, breathing, voice tone, and facial expressions. In order to keep them in the “now” and maintain responsibility, clients are urged to preface their expressions with the phrase, “Now I am aware. . . .”
differentiation, so that clients can differentiate among the parts of their inner conflict. They might be encouraged, for example, to exaggerate their facial expression and in so doing, they may become more aware of their “angry part.”
affirmation, occurs when the client is encouraged to identify with “all the parts” that are emerging into awareness. It is here that the Gestalt therapist will allow clients to fully express their pent-up emotions.
choice and integration, the client comes to say, “I am responsible for my frustration and resentment.” “responsibility is really response-ability, the ability to choose one’s reactions,” and it comes about only when we relinquish our defenses and allow ourselves to become aware of our true feelings and motivations. In this stage an internal integration brings a sense of peace and is a sign of a “completed gestalt.”
3
Therapist
“like an artist bringing something out which is hidden,”
-Frederick Solomon “Fritz” Perls
Helper v. Client
Helper (therapist)
Not objective or neutral
Relationship
Empathy
Respect
Challenge
a thera.
Amputation is the removal of a limb or part of a limb by a surgical procedure in order to save the life of a person. Amputation is a triple threat. It involves loss of function, loss of sensation, and loss of body image.
Gestalt therapyIntroductionThe history of Gestalt Th.docxbudbarber38650
Gestalt therapy
Introduction
The history of Gestalt Therapy
The beliefs on which it is based
The important contributors or practitioners of the theory
The theory of helping
The relationship between the helper and the client
Some techniques or approaches developed
The kinds of problems addressed
The populations on which the techniques are used
Multicultural issues in using these approaches
Research findings on the model or theory
Theory of Helping
Responsibility for themselves
Express
Fourfold
expression
differentiation
affirmation
choice and integration
Gestalt therapy is concerned with how a client is experiencing life at the present point in time, and will have this as the basis of the therapeutic work.
A Gestalt therapist, then, would help the client move into those feelings
(or thoughts) in a way that allows a deep immersion into those experiences and the
freedom to express what the client has previously feared to release. Once the client
has moved through the impasse and experienced and expressed what was lying
underneath, an insight usually occurs that helps the client understand what has kept
him or her stuck
Gestalt therapy is helping individuals assume responsibility for themselves rather than relying on others to make decisions for them
Gestalt therapy aims to challenge its clients to move from “environmental support” to “self-support,” in order to mobilize their own resources for dealing with the environment effectively and to make creative adjustments that permit the self to respond to environmental pressures and to inner needs.
expression clients are encouraged to tell who they are as fully as possible, even becoming aware of gestures, breathing, voice tone, and facial expressions. In order to keep them in the “now” and maintain responsibility, clients are urged to preface their expressions with the phrase, “Now I am aware. . . .”
differentiation, so that clients can differentiate among the parts of their inner conflict. They might be encouraged, for example, to exaggerate their facial expression and in so doing, they may become more aware of their “angry part.”
affirmation, occurs when the client is encouraged to identify with “all the parts” that are emerging into awareness. It is here that the Gestalt therapist will allow clients to fully express their pent-up emotions.
choice and integration, the client comes to say, “I am responsible for my frustration and resentment.” “responsibility is really response-ability, the ability to choose one’s reactions,” and it comes about only when we relinquish our defenses and allow ourselves to become aware of our true feelings and motivations. In this stage an internal integration brings a sense of peace and is a sign of a “completed gestalt.”
3
Therapist
“like an artist bringing something out which is hidden,”
-Frederick Solomon “Fritz” Perls
Helper v. Client
Helper (therapist)
Not objective or neutral
Relationship
Empathy
Respect
Challenge
a thera.
What is group
counseling?
Group counseling involves 4-8 students meeting
with 1-2 trained counselor(s), typically
once a week for 1.5 hours. Group members talk about a variety of
issues including exploring relationships, improving self-esteem, and
enhancing coping skills. Group members share information about
themselves and provide feedback to others while group leaders facilitate
productive communication in the group.
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
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These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
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1. Managing Negativity in Prison
Psychoeducationalgroups.com, David Barry
______________________________________________________________________________
Pulling Up:
Managing negatvitiy in Prison
What “Pulling Up” is About
This manual “Pulling Up: Managing Negativity in Prison” outlines a group
psychoeducation approach to teach inmates with a serious mental illness
skills that will help them manage their prison experience.
Negativity can come in many forms and has many expressions in prison. Almost all inmates
entering prison have a long-term history of experiencing negative messages. Their arrest,
conviction and sentencing also become negative experiences. Once in prison the “pecking order”
in the prison environment provides the individual with a serious mental illness numerous negative
messages. Individuals frequently manifest this negativity by either withdrawing into their cells or
becoming hostile and management problems.
This is an eight-session group psychoeducation program for inmates receiving mental health
services. The intent of the program is to help inmates examine how their negativity can be
debilitating and to help them develop skills that will enable them to more effectively manage their
negative emotions, thoughts and behaviors.
The overall theme of the program supports the strategy of helping inmates successfully adjust to
their prison environment rather than having them persists that the environment should adjust to
them. This re-framing of their orientation to prison is no simple tasks and this psychoeducation
program needs to be presented in concert with at least individual, if not individual and group
psychotherapy. There are three assumptions that are the foundation to and interwoven in this
manual.
A series of eight group psychoeducation sessions, using a variety of learning strategies,
with a core group of individuals is enough time to develop new skills and creative a positive
learning environment. The skills demonstrated in this manual are important and will be
helpful for individuals. And, in learning new skills they are beginning to mobilize their
strengths and taking positive action. The sessions are also structured to create a positive
learning experience. This positive learning experience can also serve as an example that
not all aspects of an individual’s life in prison need to be negative.
No single intervention in itself is going to work for all individuals. This group
psychoeducation program will be effective when used in context with other mental health
treatment interventions. In fact, many clinicians state that if there is no opportunity for
patients to talk about more personal or pressing issues they will subvert the
psychoeducation session to address their individual needs. Negativity is a consequence of
prison not a mental health condition. This program can help individuals manage that
negativity. However, once that negativity is minimized the individual will still require mental
health treatment.
The focus for change needs to be on the person not the system. Individual inmates are not
going to change the prison system. If an inmate is going to learn how to better manage the
negativity in prison, is he or she that need to change, not the prison system.
1
2. Managing Negativity in Prison
Psychoeducationalgroups.com, David Barry
______________________________________________________________________________
What is Meant by A Group Psychoeducation Approach
Group psychoeducation is an evidence based
Psychoeducation has been found to be
treatment intervention. The efficacy of group
effective in helping individuals
psychoeducation has been recognized by the
understand their mental illness…and in
Department of Health and Human Services and
the teaching of coping skills that helps
specifically SAMSHA.
decrease the severity of psychiatric
symptoms.
This manual is meant to be a “semi-structured” group
Muesser, et al “Illness Management
psychoeducation program. Each of the sessions has a
and Recovery: A Review of the
clear set of goals and learning activities. The goals
Research” Focus, Jan 2004; 2: 34 - 47.
and learning activities are reinforced in assignments
the participants are to complete between sessions.
The sessions are to be conducted much more like a class than a traditional group session.
Members of the group psychoeducation program are referred to more as participants than group
members. The person conducting the sessions is referred to as a facilitator not a group leader or
group therapist.
The sessions are developed to be sequential and cumulative. Concepts and skills learned in
Sessions 1 and 2 are helpful when learning the concepts and skills presented in Sessions 4 and 5.
The sessions are also cumulative and will help develop a positive learning experience. The
beginning sessions are general discussions about negativity and stressors in prison. The sessions
in the middle focus on how individuals manage negativity and helping them identify strengths they
have to help them manage their prison experience. The sessions at the end of the program teach
new skills to re-evaluate the stressors that confront them and develop new ways of responding to
those situations.
While there is a specific structure and sequentially developed set of exercises included in this
manual, it is also recognized that each class will be different. Different facilitators may have
additional skills and examples of exercises they want to include in their programs. And on occasion
there may be such a pressing issue in the overall prison environment that those issues will “spill
over” into the group psychoeducation session. Skilled clinicians conducting these sessions need
to incorporate their understanding of the participants needs into the overall delivery of the program.
When the clinicians have “more to bring to the table” in terms of new concepts and skills for the
participants the clinicians should assimilate the learning of those new skills and concepts into the
delivery of the program.
How the What you will review in the sessions:
Session1 “Don’t be surprised when In this beginning session participants review what
you pray for rain” the program has to offer and examine how
negativity affects individuals physically, emotionally
and behaviorally.
Session 2 “Yin and Yang” People can often get trapped at looking at the
negative aspects of many situations. This session
helps individuals explore how to look at situations
from different perspectives.
2
3. Managing Negativity in Prison
Psychoeducationalgroups.com, David Barry
______________________________________________________________________________
Session 3 “Understanding Stress” Stress plays a large role in wearing individuals down
and experiencing negative thoughts. This session
helps understand how stress impacts on people in
different ways.
Session 4 “The Weight” It is not easy to be overcome many negative
aspects of prison. In this session individuals identify
resources that can help minimize the impact
negativity has on them.
Session 5 “The Prisoner in the Stone” This session focuses on helping identify the positive
characteristics that define the cores strengths that
will help individuals survive prison.
Session 6 A “Decision Balance In this session participants learn how individuals can
Worksheet” make better decisions by more closely examining
the positive and negative consequences to their
decisions.
Session 7 “The Fly in the Ointment” At times no matter how much people try, negative
situations and statements can still confront them.
This session will provide a new skill to help minimize
the impact of negative situations.
Session 8 “Do you see what I see?” In this final session group participants take inventory
of the skills and resources they have and need to
help manage prison life.
3
4. Managing Negativity in Prison
Psychoeducationalgroups.com, David Barry
______________________________________________________________________________
PULLING UP-
OVERCOMING NEGATIVITY IN PRISON
EXERCISE: DON’T BE SURPRISED WHEN YOU PRAY FOR
RAIN
INTRODUCTION: Negativity can come in many forms and has many
expressions in prison. This introductory exercise gives participants a
chance begin thinking about how negativity can impact on people and
what are some of the ways they can minimize negativity.
GOALS- During this session individuals will have the opportunity to:
1] Compare the eight session “Pulling UP” workshop goals with their individual needs.
2] Define negativity and discuss how it can impact on the physical, social and emotional aspect of
a person’s life.
3] Evaluate their potential to become “locked into” negative thinking styles.
LIST OF MATERIALS:
1. “Pulling Up” Workshop Overview.
2. Individually cut “When it Rains” quotations.
3. The Impacts of Negativity Worksheet.
4. Negativity Checklist.
SPECIAL NOTES FOR THE FACILITATOR:
The intent of this exercise is to help participants begin to examine how negativity can
impact on individuals. This session contains:
A brief “ice breaker”
A general discussion about negativity
A self-examination focusing on the extent to which negativity impacts on the client.
Steps
Overview to Pulling-Up Workshop: Handout the “Pulling Up” Workshop Overview and provide a
brief overview of the “Pulling Up” Workshop goals and individual sessions. Reinforce that while the
topic of negativity can be depressing the intent of this session is to look at it in a more general,
objective sense. The in the program participants will learn “psychological tools’ that will help them
not just in prison but also in life outside of prison.
2] Icebreaker- “When it Rains” – There are 15 phrases on the “When it Rains” quotation sheets.
Have each of the phrases cut on individual strips of paper. Pass out different strips, with the
quotations, to the group members. Have members work in dyads.
Give each member a minute to read and think about the quotation on his strip of paper.
Ask the participants to talk for 2-3 minutes with their dyad partner about the quotation they
received and what they think it means.
4
5. Managing Negativity in Prison
Psychoeducationalgroups.com, David Barry
______________________________________________________________________________
Go “round robin style” around the room asking each of the dyads to read their quotations
and state what it means to them.
Let the other group members know they can also respond with their interpretation to the
quote.
3] Keeping members in dyads, facilitate a brief discussion of what negativity is. Use some of the
questions below to focus the discussion.
How do different people in the room define negativity?
What are the differences between responding negatively to a specific situation and being
negative in general?
What are some of the characteristics of negativity?
Why might it be easier to be negative all the time?
What are some of the costs of being negative all the time?
4] Following the brief discussion on “What is Negativity” hand out the Impacts of Negativity
Worksheet. Let the members know you are interested in seeing who can identify the most impacts
of negativity on a person.
A. Have the dyads work on completing the worksheet
B. For each of the 3 categories, ask dyads which group identified the most impacts of
negativity on:
A person’s health
A person’s interactions with others
A person’s emotional well-being
As the dyads with the most responses report out see if other dyads had additional impacts
that had not been listed by the reporting dyad.
5] Take time to reinforce the participants’ involvement in the exercises. Let them know that talking
about negativity is sometimes like dealing with that “500-pound” gorilla in the middle of the room.
6] Let participants know this is the final exercise of this session. It is a quick checklist designed to
help theme estimate the extent to which negative thinking can impact on them.
A. Hand out the Negativity Checklist
B. Give participants 15 minutes to respond to the questions and score the checklist.
C. Reinforce that participants will be asked to talk about the general impressions of the
checklist, but the decision to talk about their specific score or response to specific items it
their decision.
D. Ask participants if any of them were surprised by their ratings on the sheet.
Ask which items they though most represent them
Ask which items they could not relate to at all or did not apply to them
Summarize Session:
Review some of the ways the group members described negativity
Review the ways negativity can impact on people
Ask participants to keep their Negativity checklists so they can review the checklist at the
end of this workshop.
5
6. Managing Negativity in Prison
Psychoeducationalgroups.com, David Barry
______________________________________________________________________________
Briefly preview that in Session 2 participants will what will be helps exploring how to look at
situations from different perspectives. And maybe talking about some ways to minimize the
affects of negative messages they may receive.
Ask for questions and thank people for coming and participating.
6
7. Managing Negativity in Prison
Psychoeducationalgroups.com, David Barry
______________________________________________________________________________
Pulling Up-
Maintaining a positive attitude in prison is a large challenge. Arrest and
conviction, separation from family and friends, confinement to prison all are
difficult obstacles to cope with.
This program cannot change your arrest history, separation or confinement
conditions. However Pulling-Up can give you some tools that will help you
better manage some of the obstacles that prison life presents.
Pulling-up is an eight-session psychoeducation program to help inmates receiving mental health
services. The program examines ways of minimizing negative thoughts, feelings and emotions.
The program also teaches some life-skills on how to minimize the impacts of negative situations on
our day-to-day functioning.
What you will review in the sessions:
Session 1 “Don’t be surprised In this beginning session we review what the program
when you pray for rain” has to offer and examine how negativity affects us
physically, emotionally and behaviorally.
Session 2 “Yin and Yang” We can often get trapped at looking at the negative
aspects of many situations. This session helps explore
how to look at situations from different perspectives.
Session 3 “Understanding Stress” Stress plays a large role in wearing us down and
experiencing negative thoughts. This session will help
better understand how stress impacts on us.
Session 4 “The Weight” It is not easy to be overcome many negative aspects of
prison. In this session we will try to identify some
resources that can help minimize negativity.
Session 5 “The Prisoner in the This session will focus on helping identify the positive
Stone” characteristics that define who we are and the cores
strengths that will help survive prison.
Session 6 A “Decision Balance In this session we will study how individuals can make
Worksheet” better decisions by more closely examining the positive
and negative consequences to their decisions.
Session 7 “The Fly in the At times no matter how much we try, negative situations
Ointment” and statements can still confront us. This session will
provide some “psychological tools” to help minimize the
impact of negative situations.
Session 8 “Do you see what I In this final session we will work with other group
see?” participants to take inventory of the skills and resources
we have and need to help manage prison life.
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WHEN IT RAINS QUOTATIONS SHEET
Listed below are a series of quotations that are often
used when talking about negativity. Hand out the
individual quotations to group members. Give
participants a minute to think about the quotation and
what it means to them individually.
Ask the group members who wants to read their
quotation and discuss it’s meaning first. Let other
members know they can also add to the
interpretations of the quotations that have been read.
Victory has a hundred fathers but defeat is an orphan.
Galeazzo Ciano
If you pray for rain, don’t be surprised if you are struck by lightening.
Damien Cannon
A skeptic is a person, who when he sees the handwriting on the wall, claims it
is a forgery.
Morris Bender
What causes most people to fail is that after one failure, the stop trying.
Frank Burford
To expect defeat is nine-tenths of defeat itself.
Francis Crawford
Use the losses and failures of the past as a reason for action, not inaction.
Charles Givens
No man ever became great or good except through many and great mistakes.
William Gladstone
Notice the difference between a man who says I have failed three times and
the one who says I am a failure.
S. I. Hayakawa
The man who tries something and fails is better off than the one who tries
nothing and succeeds.
Lloyd Jones
It is better to talk about the 500-pound gorilla in the room than to try to ignore
it.
Unknown
Most people would rather be certain they're miserable, than risk being happy.
Robert Anthony
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A fault is sooner found than mended.
Ulpian Fulwell
Regret is an appalling waste of energy; you can't build on it; it's only good for
wallowing in.
Katherine Mansfield
Our greatest glory is not in ever falling, but in rising every time we fall.
Confucius
Give some people a piece of pie and the want to know where the ice cream
is.
My grandmother
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THE IMPACTS OF NEGATIVITY WORKSHEET
Following the brief discussion on “What is Negativity” hand out the
Impacts of Negativity Worksheet.
Let the members know you are interested in seeing who can identify
the most impacts of negativity on a person.
C. Give members 5 minutes to complete the worksheet
D. Ask members who identified the most impacts of negativity on:
A persons health
A persons interactions with others
A persons emotional well-being
Ways negativity can impact on a person’s health:
Ways negativity can impact on a person’s interactions with others:
Ways negativity can impact on a person’s interaction’s with others:
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NEGATIVITY CHECKLIST
We all use score sheets and checklists to help us understand how we
are doing. Being able to objectively examine how we are doing is
essential in improving our performance. This principle holds true for
great athletes as well as anyone who is trying to improve.
This section of the exercise gives participants an opportunity to evaluate
for themselves how negative thinking can impact on their well being.
It is a “self-report”, “self scoring” checklist. By self-report we mean that
you rate the items for yourself. By self-scoring we mean you can score
the inventory yourself.
Please take 15 minutes to complete the checklist.
You may be asked to discuss your overall impression of the inventory,
but the decision to talk about your specific score or response to the items is totally your decision.
Please use the scale below to rate your responses on the Negativity Checklist survey.
1 2 3 4 5
Never applies to Rarely applies to Sometimes this This often This frequently
me me happens happens to me happens to me
Score
Question
1 2 3 4 5
Think of how bad others have treated me and get bitter, angry
Not willing to look at new ideas or accept suggestions for change
Spend much of the day thinking about what is wrong with my life
When I meet someone new try to figure what they want from me
Think I can not ever get things right
Say what “I am not” rather than what “I can be”
Would rather be myself, alone, than with others
Think critically about myself
Say “yes, but” when people suggest new ideas
Do not like to think about the future
Score
Scoring:
10-15 Very optimistic
16-25 A little negative but manageable
26-40 Negativity can become problematic and is generalized
41+ Negativity is difficult, but you are responding honestly
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PULLING UP-
OVERCOMING NEGATIVITY IN PRISON
SESSION 2: YIN AND YANG
INTRODUCTION: Negativity can come in many forms and has many
expressions in prison. This introductory exercise gives participants a
chance to examine the ways individuals either experience negativity
and attempt to manage it. The key to the exercise is that individuals
gradually begin to accept that there are different ways to look at any
one situation. The Yin and Yang symbol and underlying principles of
that symbol are the foundation for this exercise. This introductory session also help provide an
overview of some of the concepts that are more deeply examined in the following sessions of this
program.
GOALS- During this session individuals will have the opportunity to:
1. Compare and contrast negative thoughts and attitudes with more positive thoughts and
attitudes.
2. Discuss how individuals can look at any one event and see both the positive and negative
aspects of that event.
LIST OF MATERIALS:
5. Individually cut, ‘Yin and Yang’ cards. For this specific exercise it is recommended to have
4, 6 or 8 cards per individual or per small work group. More variations and options for use of
the cards with various size groups are described at the end of this section.i
6. Score sheet of flip chart for keeping score.
SPECIAL NOTES FOR THE FACILITATOR:
The intent of this exercise is for participants to examine more positive approaches to their
negative beliefs and attitudes. To the extent that participants discuss and examine how
there are more positive ways of looking at a situation the exercise is successful.
When doing the exercise if a participant matches a card with another card that is not
necessarily identified as the correct response, but he can justify his answer, the participant
has succeeded and met the intent of the exercise. So give the participant the points.
BEFORE STARTING THE EXERCISE
Make sure you have the correct number of “matching pairs’ of responses for the exercise.
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Overview to Session 2:
Review what was covered in session 1.
Briefly discuss some of the impacts of stress that participants identified.
Discuss participants general responses to the Negativity Checklist
Highlight what will be covered in this session.
Looking at some ways to see both the positive and negative ways of thinking about an
event.
Steps
1. Up to 8 participants can individually play or you can participants break into 4-6 subgroups.
[You can vary the number of participants but need to pre-sort cards so there will be
matching sets and they can be evenly distributed among the participants.]
2. Deal 6 cards to each of the individuals [if using small groups then 6 to the group] from the
“Yin and Yang Deck” to the participants.
3. Describe the components of the deck to the participants.
• They are four suits of cards in the deck;
a) The Yin [black symbols] in a white circle.
b) The Yang [white symbols] in a black circle.
c) Blade-up, a triangle with the base facing up.
d) Blade down, a triangle, with the base facing down.
• There are ten [10] Yin and ten [10] Yang cards that have specific matches in the
deck. There are tow additional Yang Wild Cards that can be matched with a
corresponding Yin card.
• There are ten [10] “Blade up” and ten [10 “Blade down” playing cards with phrases.
And, two [2] “Blade Down” wild cards with out phrases.
4. Review how the participants can earn points my matching the following types of cards.
• 5 Points for matching the saying on the Yin card with the exact counterpart to the
saying on the Yang Card.
For example: The Yin Card states-“Complaining is easy and the matching Yang
card states- “Complaining rarely solves a problem”
• 5 points for developing your own match, using to a Yin with a Yang wild card. For
example The Yin card says “Complaining is easy” and your response is something
like- “Complaining is cheap but rarely gets accomplishes anything.”
• 5 Points for matching Blade up and Blade down cards. That is the saying on the
Blade up card in the exact match to the saying on the Blade down Card. For
example:
The Blade down card says- “Here I can never be a success”
The Blade up card says- “My being successful depends on what I can make
of my current situation.”
• 3, 5 or 7 points for developing your own match to the Blade up card with a Blade
down wild card.
For example: The Blade down card states-“Here I can never be a success”
The participant with the blank Blade down wild card says something like:
3 points for matching the topic “For here success is keeping out of
trouble”
5 points for a good match “Maybe I need to redefine what success is
for me here”
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7 points for words of wisdom “Success is when I feel I have done the
best I can do given my situation.”
Points can only be awarded for responses that have a matching suit. Only a Yin card can
match a Yang card, and only a Blade up can be matched to a Blade down card.
5. Review the how participants can receive new cards. [The exercise can be done with either
individuals or teams. This same procedure applies.]
• The teams will have four opportunities to pass their cards to the members other
teams.
• The teams can pass any one card they want to the team on their immediate right.
• The object of passing cards is to get either matching Yin or Yang, Blade cards or a
wild card that they can use.
• A team may decline to pass a card. In this case the team passing the card passes it
to the second team on the right.
6. At the end of four passes the members show their cards to the rest of the class and the
facilitator. The facilitator then scores the cards and lists the scores on a board. Teams will
need to justify the rational for using wild cards. And, if a team does not have what is
identified in the instructions as a correct match, but the teams their response is valid they
can present to the facilitator an appeal for points.
7. The first team to get 33 points wins.
8. If there is time remaining teams can play a second round.
Summarize:
Summarize the session by discussing how participants were able to demonstrate that
people can look at the same situation in more than one way. Discuss that how we look at
the situations can greatly influence how they can impact on us in either a negative or
positive manner.
Briefly describe Session 3: Triggering Negativity.
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Yin Yang
Life is unfair, so why even try. Life is unfair I need to try
harder.
Yin Yang
When people treat me bad I When people treat me bad, I
get bitter. try to get beyond it.
Yin Yang
If someone says something When someone says
bad about me I cannot let it something bad about me I
go. think of it is more their
problem.
Yin Yang
When I think there is too much
Most of my conversations
complaining I try to change the
end up in complaining. topic of conversation.
Yin Yang
Complaining is easy. Complaining never solves a
problem.
Yin Yang
When a problem happens I When a problem happens I
look at who is at fault. look for the solution.
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Yin Yang
This system needs to better My first challenge is to adjust
understand my needs. to this system, and then
maybe try to change it.
Yin Yang
I can often find something
When anything happens I fear
good out of almost all
for the worse.
situations.
Yin Yang
I spend much time thinking of I often think of what I can
what I could have been. become.
Yin Yang
To change my future I need to
If people give me break change myself.
things will get better.
Yang Yang
Wild Card Wild Card
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Blade Down Blade Up
He really knows how to get He is someone who is always
under my skin. trying to irritate me.
Blade Down Blade Up
I have so many problems I will I need to try to match my
never be able to break free of strengths against my problems.
this.
Blade Down Blade Up
I have really screwed up my life Things are really tough for me
and now nothing else matters. but at least I have a few friends
and my health.
Blade Down Blade Up
They say I am a convict so I Maybe to them I am a convict
might as well behave that way. but to me I am a man.
Blade Down Blade Up
They say I am a screw-up so I Let them think what they will, I
might as well act that way. still have my dignity and no one
can take that from me.
Blade Down Blade Up
He is pushing me, just waiting He really wants me to explode.
for me to explode. My keeping calm is getting to
him.
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Blade Down Blade Up
Think the worse of people, that I need to judge individual
way you are never disappointed. people by their behavior.
Blade Down Blade Up
It is his fault I hit him and am I really let him get to me, and
now in SHU. now I am the one who is paying
for it.
Blade Down Blade Up
Trusting others is for suckers. Trusting or not trusting
someone depends on their
behavior.
Blade Down Blade Up
I have tried all this @@XX! once Last time this didn’t work,
before and it did not work then maybe I can do better this time.
and will not work now.
Blade Up Blade Up
Wild Card Wild Card
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PULLING UP-
OVERCOMING NEGATIVITY IN PRISON
SESSION 3: TRIGGERING NEGATIVITY
INTRODUCTION: This session teaches participants how to begin to
understand the difference between an event and how the person
responds to that event. This session in many ways is the beginning of
that process how the can choose how to respond to what is happening
in their environments.
While the activity itself is a stress index scale this principle of “differentiating the event from the
experience of the event” is the key learning point to the session. In latter sessions {Sessions 8 and
9] this principle will be used in examining and reframing situations that normally could produce
negative emotions.
GOALS- During this session individuals will have the opportunity to:
1] Discuss events situations they may encounter and how much stress is associated with that
event.
2] Compare and contrast their reactions to stressful events with the responses of the other group
members.
3] Identify factors that influence how an individual may experience an event and explore the
“subjectivity” of individual reactions to eventssituations.
SPECIAL NOTES FOR THE FACILITATOR:
The intent of this session is for participants to begin to differentiate between events they encounter
and their reactions to those events.
Individuals each completing a stress index scale
Small groups of 4-6 completing a group stress index scale [same scale]
A review of small group scores
A discussion of factors influencing how individuals would react differently to the
events listed on the scale
A discussion of the individual’s experience of the event is what influences his
reactions.
LIST OF MATERIALS:
7. Copies of the stress index scale for each group participant.
8. An extra set of copies of the stress index scale for small group experience
9. A flip chart and pad for listing group responses
Overview to Session 3:
Review what was covered in Session 2.
Briefly discuss how the participants were able to compare and contrasts negative and
positive ways at looking at the same situations.
Highlight what will be covered in this session.
Looking at how stress can impact on us and it’s potential to increase negative thinking and
emotions.
Steps
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1] Briefly discuss with participants the history of the Holmes Ray Stress Index scale.1
2] Let participants know they are going to look at 10 potentially stressful items. On the scale they
will be asked to distribute 100 points amongst the various items based on how stressful they think
that event would be to them. For example for some people “being transferred to another prison”
might only be 5 stress points while coming up for a “parole board hearing” might be 20 stress
points. Give participants 10 minutes to individually distribute a total of 100 points between those 10
items.
3] After participants have individually rated the events on the “Stress Index Scale” they will be
asked to rate the same items as a group. [Small groups of 4-6 work best for this part of the
exercise.] The small groups will have 15 minutes to complete the group list.
SPECIAL NOTE
Participants need to reach a consensus on how much stress the average inmate
would experience if he or she had any of the events identified in the scale happen to
them.
If the small groups seem to be having problems reaching consensus have them
identify the three most stressful events and the three least stressful events. Once
this is done they can begin to distribute the values.
4] Have a flip chart prepared listing items on the Stress Index Scale with room to the right of the
items to list the small groups weighting of the events. 6] Give participants 10, 5 and 1-minute
warnings
5] Ask the small groups to report out their results and list results on the flip chart.
6] Ask participants which types of items they had difficulty reaching consensus on.
Ask what factors influenced how they rated the different items.
Review how those factors influenced the participants’ reactions to the events.
Ask participants, “If the same events do not cause the same stress for everyone…. then
what is the main factor determining how an individual experiences stress?”
7] Reinforce the concept that it is not the event that causes an individuals reactions but how the
individual experiences that event.
Summarize Session 3:
Review how different people can experience the same event in different ways.
Briefly discuss that in Session 4 participants will discuss some of the negative impacts of
prison and explore some resources that could help minimize those negative impacts.
1
Holmes and Rayhe developed the Holmes-Rayhe Stress Index Scale were workers in a crisis clinic in
Boston. After a number of years and seeing hundreds of individuals in crisis Holmes and Rayhe decided they
could quantify different events in terms of levels of stress associated with those events. The listed over 50
different types of stressors and assigned a numerical value to those events. The numerical value was
associated with the level of stress that even would have for an individual. Holmes and Rayhe would then
interview individuals using the scale and check the various stressor the incoming client would identify. From
the number of items checked, Holmes and Rayhe would then total the accumulated stress points and identify
if the individual was experiencing one of 5 levels of stress.
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Exercise: Stress Index Scale
Introduction: There are ten items listed below. You are to distribute 100 points to the total ten
items. The number of points you assign to any one item will represent how much stress that event
would have for you. For example, having your wife win $100,00 in a lottery might only be 2 stress
points while finding out she is pregnant might have 50 stress points. Some of the items might not
apply to you, such as the item about having a younger brother, still rate the item thinking that if that
item could apply to you, how would you respond. You have 10 minutes to complete this task.
Stress Points Event
Being transferred to another prison
Find out your mother is ill
Lose visiting privileges
Parole hearing
Become sick for over a month and not know why
Younger brother gets sentenced for 4 years
The inmate in the cell next you told you he is thinking about suicide
Mother wins $100,00 in lottery
You are facing a hearing for a 3 month ticket
Your 18 year old sister is pregnant
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Sample Exercise: Stress Index Scale
Introduction: There are ten items listed below. You are to distribute 100 points to the total ten
items. The number of points you assign to any one item will represent how much stress that event
would have for you. For example, having your wife win $100,00 in a lottery might only be 2 stress
points while finding out she is pregnant might have 50 stress points. Some of the items might not
apply to you, such as the item about having a younger brother, still rate the item thinking that if that
item could apply to you, how would you respond. You have 10 minutes to complete this task.
Stress Points Event
Being transferred to another prison
Find out your mother is ill
Lose visiting privileges
Parole hearing
Become sick for over a month and not know why
Younger brother gets sentenced for 4 years
The inmate in the cell next you told you he is thinking about suicide
Mother wins $100,00 in lottery
You are facing a hearing for another 3 month ticket
Your 18 year old sister is pregnant
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PULLING UP-
OVERCOMING NEGATIVITY IN PRISON
SESSION 4: THE WEIGHT
INTRODUCTION: In a highly stressful environment it is often easy to solely
focus on negative factors and disregard potential resources and
supports. This primary function of this exercise it to have participants
begin to identify and discuss potential resources.
GOALS- During this session individuals will have the opportunity to:
1] Discuss negative factors in the prison environment that can cause stress and lead to a sense of
futility.
2] Identify potential resources that can help balance some of the negative influences of prison.
3] Explore options for gaining additional supports and resources to help them in their environment.
LIST OF MATERIALS:
1] A weight worksheet for each participant.
2] The Envelop Worksheet for facilitators
SPECIAL NOTES FOR THE FACILITATOR:
The intent of this session is to have participants begin to shift their focus from looking solely at
negative factors to begin to explore some potential resources. For many inmates the only resource
they will be able to tap into is themselves. For some, there may be potential to re-unite with family
and friends, find a greater sense of spirituality or identify some other external resource.
Overview to Session 4:
Review what was covered in session 3.
Briefly review how participants discussed that they would experience
similar events in different ways. Discuss how factors like values, previous
experiences, relationships and supports all impact on how we
experience an event.
Introduce Current Session- Facilitator briefly describes how in this
session participants will examine some of negative factors in the Pri
prison environment and some of the resources they need to help
overcome the “weight” of prison life.
Steps
1] Facilitator begins this exercise by briefly discussing how scales work and weights on one side of
the scale are needed to counteract and thereby measure the weight on the opposite are of the
scale.
2] The facilitator segues this part of the discussion into how life is similar and we often need
something to give balance to our lives. It may be necessary to give a concrete example of this
need for balance.
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Example of a Story: In the movie “Cast Away” Tom Hanks is stranded alone on an Island with no
one to talk with. The isolation is beginning to really bother him until one day he finds a soccerball.
He paints a face on the soccerball, names it Wilson, and feels he has someone to talk with. Now
the character new the soccerball was not a person but used the soccerball as an object to talk to.
The point of the story is that in difficult situations we have to look hard for resources and think of
things that normally would not mean a lot as things that can have value for us.
3] Tell participants you are going to ask them to begin to think about things in prison that can be
stressful and result in negative thinking for them. Also let them know you are going to be asking
them to think about things that can potential resources for them.
4] Hand out a copy of the “The Weight Worksheet” to each participant. Ask them to first circle the
items and scores of the negative Factors on the sheet they think apply to them. Have participants
feel free to add additional negative factors [i.e. their girlfriend want to stop seeing them]. Allow
some flexibility in terms of the weighting [i.e. if an inmate thinks being in prison should have a
weighting of 75, ask the group if they think that is true for him and go with their opinion].
SCORING OPTION: Some
individuals may have difficulty
adding numbers on the Weight
50 10 Worksheet. At the end of the
materials in this session there
lbs are several pages of “weight
bars”.
The facilitator can distribute the weight bars to group participants so they can more easily score
their Weight Worksheets. The weight bars with the blackened center are for negative points and
those with the unfilled center are for positive points.
5] Ask participants to then circle and score the positive factors. As they do this you can bring a little
humor to the exercise if some participants are beginning to despair. For example you might tell an
inmate “his stubbornness” can be a positive factor, because it is a sign he has his own mind.
6] Ask participants to tally up the positive and negative factors. The facilitator will most likely need
to help many of the inmates do this task. If an inmate seems very well skilled in doing the tally tell
them to give themselves an extra positive 5 points.
7] Ask participants to read of the differences between their scores to the rest of the group. Have
them discuss some of their reactions to the various factors. Ask how they felt about the issue of
remorse being both a positive and negative factor.
8] Let participants know you are now going to see if there is some additional resources they can
use to help counter the differences between the negative and positive factors.
Read off the statement and scoring options for Envelope #1. Ask participants to add
the weight of importance that item has to their positive score. Have a brief
discussion with participants about their perceptions of that item.
Read off the statement and scoring options for Envelope #2. Ask participants to add
the weight of importance that item has to their positive score. Have a brief
discussion with participants about their perceptions of that item.
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Read off the statement and scoring options for Envelope #3. Ask participants to add
the weight of importance that item has to their positive score. Have a brief
discussion with participants about their perceptions of that item.
Read off the statement and scoring options for Envelope #4. Ask participants to add
the weight of importance that item has to their positive score. Have a brief
discussion with participants about their perceptions of that item.
9] Ask participants to take a second tally of their positive and negative factors. Ask if
there were any significant changes for any of the members.
10] Calling in the Big Guns: Facilitator should begin to end the exercise. If participants begin to
ask about the final item on the Weight Worksheet, “Calling in the Big Guns” YOU ARE MAKING
PROGRESS.
This indicates the participants are beginning to think of what can do to help themselves…
maybe they are even looking to explore new ideas.
Calling in the Big Guns is when we ask the audience for their opinions. Ask participants if
they have ideas to help other group members overcome their negativity. Let this concept
“sit’ for while with the group.
Some suggestions you can make to this section are:
1. Just being able to begin to identify positive and negative factors is a positive step.
2. It is probable that some participants’ scores increased from the first to the second part of
the exercise. And, that improvement demonstrates that there can be change.
3. Sometimes we have to learn to establish a “new normal.” That is accept where we are now
with our life rather than what we had or wanted. In accepting some of that new normal we
can begin to think of ways to improve what we now have.
Summarize Session
Discuss why it is necessary to take an honest accounting of events before your can change them.
Let participants know that he following session they will be exploring how some people get “out of
touch” with themselves while in prison. How it is often so necessary to “cover up” to protect oneself
that individuals can loose track of what has been important to them.
Ask two of the more oriented group members if they will do the report out next session on what
was covered in today’s session.
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THE WEIGHT WORKSHEET
Negative Factors Positive Factors
Weight [lbs] ConditionSituation Weight [lbs] ConditionSituation
50 Prison 20 No major mental illness
20 SMI 10 15 20 Family, friends
10 No family, friends 5 10 15 Good health
Pri
5 10 15 Enemies in prison 5 10 15 Supports in prison
5 10 15 Isolated from others 5 10 15 People to turn to when
needed
5 10 15 Feel remorse about 5 10 15 Feel remorse about
what happened what happened
5 10 15 Little to no money 5 10 15 Able to care for self
5 10 20 30 SHU Time 5 10 15 Have a spirituality
5 10 20 30 Illness 5 10 15 Can enjoy music
5 10 20 30 Facing additional 5 10 15 Can enjoy sports
charges
Other Other
5 10 15 5 10 15
5 10 15 5 10 15
0 5 10 15 20 Envelope #1
0 5 10 15 20 Envelope #2
0 5 10 15 20 Envelope #3
0 5 10 15 20 Envelope #4
Total 0 5 10 15 20 Total
Difference between Negative and Positive Factors
Difference between Negative and Positive Factors
Help Lines
Envelope 1:
Envelope 2:
Envelope 3:
Envelope 4:
Calling in the “Big Guns”
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THE ENVELOPE WORKSHEET FOR THE FACILITATOR
Envelope 1: How much does the difference between the negative and positive factors
bother you?
Add number of points for your rating:
0 5 10 15 20
Not at all No big deal A little Bothers me Really upsetting
For Facilitator: The differences between the scores can be motivating factors for participants to
begin to do something about their situation. Reinforce the concept that people often change
because they do like the way their life is going.
Envelope 2: How much more of yourself can you depend on to help?
Add number of points for your rating:
0 5 10 15 20
All tapped out Hardly anything A little Some reserve More than I realize
For Facilitator: With this item we are asking participants to begin to think of how much they are
willing to try to change their situation. We are also trying to help them feel that they need to draw
strength from themselves to help overcome negativity. For many this item might be difficult to score
but for some it could be beneficial.
Envelope 3: Intellectually, do you have ability to make some of this better?
Add number of points for your rating:
5 15 20
0 10
Trying to figure it Maybe able to Think I can figure
All tapped out A little
out do more out situation
For Facilitator: Hopefully this item is playing to the participants’ egos and will get some positive
ratings.
Envelope 4: Are there Positive factors you can develop or increase? Which ones? Why?
10
0 5 15 20
Might be
None Maybe one Possible three There are several
two
For Facilitator: Ask participants to look back on the list at the Positive Factors. Have them think are
there items in the positive factors they can make more use of. For example they might have friends
or family they have not contacted in a long time, they used to gain strength from religion and no
longer feel spirituality.
Points FactorsChangesDifferences
Difference between Negative and Positive Factors
Total from Lifelines
Remaining difference between Negative and Positive Factors
Calling in the “Big Guns”: Refer to Step 12 in session overview.
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10 10 10
10 10 10
10 10 10
10 10 10
10 10 10
10 10 10
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10 10 10
10 10 10
10 10 10
10 10 10
10 10 10
10 10 10
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PULLING UP-
OVERCOMING NEGATIVITY IN PRISON
SESSION 5: PRISONERS IN THE STONES
INTRODUCTION: The intent of this psychoeducation group session is to
help participants identify at least one positive characteristic they feel is
still part of their core person and explore ways they can more
effectively utilize that characteristic.
GOALS- During this session individuals will have the opportunity to:
1] Participants will learn identify a “positive quality” that they believe they often exhibited as a child.
2] Participants will discuss obstacles to becoming “in touch” with that positive quality.
3] Participants will explore options they have to begin to re-develop that positive quality in their day
to day lives.
LIST OF MATERIALS:
Prisoners of the Stone Worksheet
The Phoenix Rising Worksheet
SPECIAL NOTES FOR THE FACILITATOR:
Overview to Session 5:
Facilitator asks the two participants selected from last week to review Session 4: “The
Weight”. Try to reinforce their responses and wiliness to take on a group role. Also review
the key principles that it will often be up to the individuals in the group to change the level of
negativity they experience in prison.
Introduce Current Session- Facilitator briefly describes how in this session participants will
try to examine some personal characteristics they might be able to use to help minimize the
negative impacts of their prison experience.
Steps
1] The facilitator presents a brief lecture on how individuals start out in one direction but events,
situations and even their own behaviors often change how they feel about themselves and respond
to others.
2] Briefly discuss the “prisoners of the stone” story on the attached worksheet.
3] Have participants begin to think of how others, whom they had a special relationship with,
described them when they were young children.
4] Hand out the Prisoners of the Stone worksheet to each of the participants.
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5] Ask the participants to briefly fill out the questions on the worksheet. Give participants about
5-10 minutes to complete their worksheets.
6] Ask each participant to describe the quality they think is hidden in the stone that they identified.
Ask participants begin to describe these qualities begin to identify some common themes.
7] Ask each of the participants to then identify 2 or 3 events, situations or behaviors that they think
keep that special quality hidden.
8] Ask each of the participants to then discuss some ways they can help their lost quality re-
emerge.
OPTIONAL ACTIVITY:
The second activity in this session is optional. It builds on the first, but there might not be enough
time to complete the exercise and it might not useful be for all patients.
1] Hand out “The Phoenix Rising” activity sheet.
2] Ask participants to take 10 minutes to complete the worksheet.
3] Many participants will need help thinking of things they can do know to “recover” that lost quality.
This part might require some individual attention for the participants.
4] After completing the tasks ask participants what is was like to think about trying some “new-old”
behaviors. Ask if any of them want to describe the personal contract. But remind the participants
that it is their choice to talk about this part.
Summarize Session
Reinforce the positive attributes the various participants identified in themselves and maybe
identified in other group participants. Acknowledge that it is difficult to think of some ways
that they can change. Review some of the changes that the members stated they thought
they could make.
Let participants know that he following session they will be exploring some ways of making
better decisions that might help them not just in prison but also in the community.
Ask two of the more oriented group members if they will do the report out next session on
what was covered in today’s session
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Prisoners’ of the Stone: Michelangelo’s David
Michelangelo- Painter, Sculptor and Architect
(1475-1564)
When asked how he completed his sculptures Michelangelo replied, “I first
start with a big block of stone and then chip away at everything in the block
that is not the statue.”
The artist Michelangelo believed there was a work of art in every stone.
This story also translates into how people have something buried deep inside them that is their
“gift” to others. That gift is something that has grown in the person since childhood.
It is the quality that as young children, people often commented on. Statements like “he is so easy
going” or “she wants to help others so much” represent those qualities.
Often growing up events happen, situations and people change. That quality of the child that was
so special and remarkable becomes hidden.
That quality and the person in many ways become their own “prisoners.” Events, situations and
new ways of behaving cover the special qualities
1] What was the quality that people often used to
describe you as a child?
2] What are some of the events, situations and
behaviors that have hidden that special quality?
3] What are two things you can do, right now, today,
to remove some of the obstacles you have from
being in touch with that special quality?
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Phoenix Rising
The myth of Phoenix Rising is a story of hope and rebirth and is a common
story I many different cultures. The story of Phoenix tells of a mythical, bird-
like creature that is consumed by flames and rises new from the ashes.
One of the meanings associated with the Story of the Phoenix is that of redemption, or of having a
second chance. It is very much a story of a creature that was beautiful and destroyed yet was able
to come back.
In an other interpretation it represents a creature that has great vision and can see what is ahead.
1] What is the quality you identified as how people often used to
describe you as a child?
2] What would be some behaviors you would exhibit to show that
those qualities still can exist?
PERSONAL CONTRACT:
This is your contract, for yourself, in hoping to become regain a
quality that has been hidden for a long time. It is a quality that
others saw in you and you felt pride when others saw it in you.
Fill out the contract form below. It is yours to keep. You may or
may not share it with others in the group. That is your decision.
I was often known for my ________________________________________________ and felt
that that quality was important and made me feel good about myself.
Some of the behaviors I would often do to demonstrate that quality were:
1]___________________________________________________
2] __________________________________________________
3] __________________________________________________
For the next week I want to try to see what part of that quality is left and will try the following
activities to see what can be done.
1]_____________________________________________________
2] _____________________________________________________
3] _____________________________________________________
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PULLING UP-
OVERCOMING NEGATIVITY IN PRISON
SESSION 6: THE DECISION BALANCE WORKSHEET
INTRODUCTION: The key principle of this unit is that if patients have some
tools to help them change then they will feel less negative. It is doubtful
that the prison system will change for them. If they have a serious
mental illness they will have to learn how to manage their symptoms.
The one thing people can change is themselves.
The intent of this psychoeducation group session is to help participants
evaluate the positive and negative factors associated with changing their behaviors. The session
is based largely on understanding the “stages of change” and utilizes a motivational interviewing
technique. [References for background reading for both of these topics are easily accessed on the
Internet. Six sources are listed below in the Special Notes for Facilitators section of this session.]
This session works best if presented as a “life skill”. As a life skill it is a skill that can be beneficial
for all people to learn.
GOALS-
1] Participants will review the “stages of change” and relate how at different times they have made
changes in their lives.
2] Participants will describe how an individual can effectively evaluate the options to changing a
behavior by completing a “Decision-balance” worksheet.
LIST OF MATERIALS:
The Stages of Change Hand-out
The Decision Balance Worksheets [1 and 2]
SPECIAL NOTES FOR THE FACILITATOR:
For additional references on the “Stages of Change”:
TIP 35: Enhancing Motivation for Change in Substance Use Disorder Treatment,
Referenced at http://www.samhsa.gov/centers/csat2002
http://coce.samhsa.gov/cod_resources/PDF/ReadinessforChangeandManagingMultiplePro
blems.pdf
http://www.pathprogram.samhsa.gov/pdf/Motivational_Interviewing_Slides_2_11_03.pdf
For additional references on “The Decision Balance Worksheet”:
Chapter 5 in TIP 35 referenced above.
http://www.motivatehealthyhabits.com/pdfs/0TASK1page.pdf
http://www.aodgp.gov.au/internet/aodgp/publishing.nsf/Content/tobacco-7
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Overview to Session 6:
Facilitator asks the two participants selected from last week to review Session 5: “The
Prisoner in the Stone”.
o Reinforce the members’ review of the previous session and their willingness to take
on a group role.
o Review the key principles from Session 5. Frequently people have qualities that can
become lost or hidden because of their current situations. Those qualities are still
there but it might take some extra efforts to have those qualities re-emerge.
o Ask if any of the patients wants to discuss how they tried using their personal action
plans.
Introduce Current Session- Facilitator briefly describes how in this session participants will
look at how change can happen and how participants will learn how to better evaluate big
decisions in their lives.
Steps
Stages of Change:
1] The facilitator presents a brief 10 minute lecture on stage of change. Use the Stages of Change
Hand-out when presenting the material.
The Stages of Change Worksheet has examples of behaviors representing each of the
stages of change.
2] After your brief lecture break the group into smaller groups of 3-4 participants each. Ask the
groups to come up with one example of a problem behavior someone might want to change.
[These examples can range from quitting smoking, having safe sex, to deciding to take prescribed
medications.] Have the participants then list out what could be some examples of behaviors the
individual experiencing that specific behavior might demonstrate at each of the stages of change.
3] Have the small groups report each example to the larger group of participants.
Decision Balance Worksheet:
1] Deciding to change is not easy!
Discuss how the most difficult shift in going from one stage to another in the “Stages of Change” is
when an individual is going from contemplation to preparation. In this shift, the individual is
beginning to recognize some of the consequences of the problem behavior but does not fully want
to recognize the difficulties associated with the problem behaviors. Completing a “Decision
Balance Worksheet”.
2] How to objectively begin to think about changing.
Explain how the Decision balance Worksheet is a way that people who are beginning to think
about making a change can objectively evaluate the costs and benefits of the old behaviors in
comparison to changing their behaviors.
3] Hand-out the Decision Balance Worksheet 1 and review each of the cells in the table. Have
participants look at how while some of the questions at the top of each of the cells may sound the
same the questions are really different.
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4] Hand-out the Decision Balance Worksheet 2. Have participants return to same small groups of
3-4 from previous exercise. Ask the groups to review the problem behavior they identified in the
earlier exercise on Stages of Change. Have the participants then complete each of the cells in the
Decision Balance Worksheet. Ask each of the small groups to identify at least three “reasons” that
would fit in each of the cells on the worksheet.
5] Have the small groups report each example to the larger group of participants.
Summarize Session
Reinforce how making change can be difficult but also helps people become more in control
of their lives.
Discuss how this is a life skill people can use no matter what type of situation they are in.
Review some of the interesting perspectives participants had on examining change.
Ask participants to complete a “Decision Balance Worksheet” on a behavior they want to
think about changing.
Let participants know that he following session they will be exploring options they have for
changing some of their behaviors or at the very least to have some ways so problems they
encounter will not bother them as much.
Ask two of the more oriented group members if they will do the report out next session on
what was covered in today’s session
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STAGES OF CHANGE WORKSHEET
Stage Examples of Someone
Characteristics
of Change Experiencing this Stage
“Ignorance is not necessarily bliss” Example: A person is arrested for
driving while intoxicated, but
The person does not see hisher continues to drink and drive.
PRE-
behavior as a problem. Others might YOUR EXAMPLE:
CONTEMPLATION complain about the behavior or
person has gotten into bad situations
because of the behavior.
“Maybe I’ll quit tomorrow” Example: Well it happened to
Paris Hilton, maybe it could
The person begins to see the happen to me the next time.
C O N T E M P L A T I O N behavior as a problem. Might even YOUR EXAMPLE
think of changing…. but not
necessarily right away.
“ I’ll be giving up a lot if this works.” Example: My wife and I agreed
that if I need a ride home she will
The person intends to actually pick me up…. no matter what
P R E P A R A T I O N perform the new behavior, but first time.
they have to get organized and YOUR EXAMPLE
everything in order.
“The new me!” Example: “Honey, it’s me and I
am at Joe’s but do want not to
The person changes the behaviors drive home. Can you pick me
that were problematic. They up?”
ACTION implement a plan, learn new YOUR EXAMPLE:
behaviors and adapt new attitudes.
This stage lasts from 3-6 months.
“This is me!” Example: Well my wife and I just
figure this is better than getting
The new behaviors become another DUI.
M A I N T E N A N C E integrated into the way the person YOUR EXAMPLE:
behaves and thinks about
himherself.
“I should have known better” Example: Well it was a few blocks
home and I did not really have
There is great potential for relapse that much to drink.
R E L A P S E with any behavior that has been YOUR EXAMPLE:
chronic. Relapse is a set-back, but
not a sign of failure,
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D E C I S I O N B A L A N C E W O R K S H E E T [1]
Reasons to Stay the
Reasons to Change
same
WHAT ARE SOME GOOD THINGS WHAT ARE SOME “NOT-SO-GOOD” THINGS
ABOUT MY CURRENT BEHAVIOR? ABOUT MY CURRENT BEHAVIOR?
W ell dr inking and dr iv ing is Ther e m ight be s om e not- s o- good
not all t hat bad. t hings about dr ink ing whil e I
dr iv e.
I am not conf ined t o
hour s dur ing t he day I c ould get in an ac c ident
when I need t o leav e t o ev en if it is not my f ault.
go hom e.
CURRENT A t ic k et c ould c ost s m e as
I do not have t o depend m uc h as $5, 000. 00.
BEHAVIOR
on anyone els e.
I c ould loos e m y dr iv er ’s
I have a good t im e. lic ens e.
As long as I do not hur t I will not be s o par anoid ev er y
anyone it is m y t im e I dr iv e down t he s t r eet and
business. s ee a polic e c ar behind me.
WHAT ARE SOME “NOT-SO-GOOD” WHAT MIGHT BE SOME GOOD THINGS
THINGS ABOUT CHANGING MY ABOUT CHANGING MY BEHAVIOR?
BEHAVIOR?
W ell s om e good t hings about
Ther e ar e som e “ not - s o- good” c hanging my behav ior m ight be:
t hings t hat m ight happen if I
st op dr inking while I am I will elim inat e m y c hanc es
dr iving. of get t ing arr es t ed.
M y buddies wil l think I I will pr obably not dr ink out
CHANGING am a wuss. as muc h and m ay be ev en
s av e s om e m oney .
BEHAVIOR
Som eone will hav e t o
dr ive m e hom e. Hec k , I m ight ev en c ut
down dr ink ing a bit .
I wil l not be able to
f r eely go fr om one plac e My c ar won’t sm ell lik e the
t o the next . “ night bef or e” ev er y
m or ning when I get in.
Taxis ar e expens iv e.
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Reasons to Stay the
Reasons to Change
same
WHAT ARE SOME GOOD THINGS WHAT ARE SOME “NOT-SO-GOOD” THINGS
ABOUT MY CURRENT BEHAVIOR? ABOUT MY CURRENT BEHAVIOR?
CURRENT
BEHAVIOR
WHAT “NOT-SO-GOOD”
ARE SOME WHAT MIGHT BE SOME GOOD THINGS
THINGS ABO UT CHANG I NG M Y ABOUT CHANGING MY BEHAVIOR?
BEHAVIOR?
CHANGING
BEHAVIOR
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PULLING UP-
OVERCOMING NEGATIVITY IN PRISON
SESSION 7: GETTING THE FLY OUT OF
THE OINTMENT!
INTRODUCTION: This session provides participants with a very concrete
technique that will help them better understand their emotions before
they act on them. Part of the session involves learning the technique in
a very rote manner. The participants then will have the opportunity to
practice using the skill in a variety of situations.
This session works best if presented as a “life skill”. As a life skill it is a skill that can be beneficial
for all people to learn.
GOALS-
1] Participants will describe the “What, how and why, then what, how and decide” technique for
managing difficult situations.
2] Participants will apply the What, how and why, then what, how and decide” technique to a
variety of situations they might experience.
LIST OF MATERIALS:
SPECIAL NOTES FOR THE FACILITATOR:
Much of the material in this session is an adaptation of Cognitive Behavior Therapy. Some
references can easily by found on the Internet at the sites listed below.
http://en.wikipedia.org/wiki/Cognitive_behavioral_therapy
http://psychservices.psychiatryonline.org/cgi/content/full/53/10/1272
http://www.springerlink.com/content/k641p02j62135731/
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