Rev Laura Mancuso M S CRCCPRP Dolores Subia
Rev. Laura Mancuso M. S. , CRC/CPRP Dolores Subia Big. Foot, Ph. D. Gladys Christian, CPSS Implementing Recovery-Oriented Practices April 4, 2012
April 4, 2012 Rev. Laura L. Mancuso, M. S. , CRC/CPRP Interfaith Chaplain Dolores Subia Big. Foot, Ph. D. Director, Indian Country Child Trauma Center and Project Making Medicine, University of Oklahoma Health Sciences Center Gladys Christian, CPSS President, National Association of Peer Specialists Senior Certified Peer Support Specialist Trainer Certified Wellness Recovery Action Plan Facilitator Center. Point Human Services (LME/MCO) Moderated by Larry Davidson, Ph. D. Project Director, Recovery to Practice (RTP) Development Services Group (DSG), Inc.
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3– 3: 05 p. m. Welcome Wilma Townsend SAMHSA/CMHS 3: 05– 3: 10 p. m. Introductions & Overview Larry Davidson, Ph. D. DSG, Inc. 3: 10– 3: 25 p. m. Rev. Laura L. Mancuso, M. S. , Culturally Sensitive Spiritual Assessment in a Recovery-Oriented CRC/CPRP Mental Health Service Setting 3: 25– 3: 40 p. m. In the Circle Way: Teachings of the Spirit 3: 40– 3: 55 p. m. Gladys Christian, CPSS Understanding and Building on Culture and Spirituality in Recovery. Oriented Practice 3: 55– 4: 30 p. m. Discussion Dolores Subia Big. Foot, Ph. D. Participants & Presenters
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Rev. Laura L. Mancuso, M. S. , CRC/CPRP Interfaith Chaplain Santa Barbara, California
Image: Horizon and sky “For me, becoming ‘mentally ill’ was always a spiritual crisis, and finding a spiritual model of recovery was a question of life or death. ” —Sally Clay, The Wounded Prophet, 1987
First National Mental Health Consumer/Survivor Summit, 1999 Four Values Most Important to Recovery �Hope �Spirituality �Responsibility �Empowerment Source: The First National Summit of Mental Health Consumers and Survivors. 1999. Report from the Recovery Plank. Philadelphia, Pa. : National Mental Health Consumers’ Self-Help Clearinghouse. www. mhselfhelp. org
California Mental Health & Spirituality Initiative Survey of Individuals Receiving Mental Health Services & Their Families � Documented the needs, experiences, and preferences of more than 2, 600 consumers and family members � 79 percent said spirituality was important to their mental health � 74 percent wanted their mental health-care providers to discuss spiritual concerns with them upon request Image: Mental Health and Spirituality Initiative logo Source: David Lukoff & Laura L. Mancuso. 2010. Survey of Individuals Receiving Mental Health Services & Their Families. Sacramento, Calif. : California Mental Health & Spirituality Initiative.
California Mental Health & Spirituality Initiative Survey of California County Behavioral Health Directors � 53 of 59 counties participated � 98 percent agreed or strongly agreed that “spirituality is an important element of multicultural competence for mental health providers” Image: Mental Health and Spirituality Initiative logo Source: Laura L. Mancuso & David Lukoff. 2010. Survey of California County Behavioral Health Directors Regarding Spirituality. Sacramento, Calif. : California Mental Health & Spirituality Initiative.
California Mental Health & Spirituality Initiative Values Statement “Spirituality is a core component of cultural competency — the public/private mental health system in California recognizes that cultural competency, including the ability to understand different worldviews, is necessary for effective practice. Spirituality represents a core value within many ethnic and cultural communities and is often considered a primary resource. Faith-based organizations are a vital source of community leadership for individuals, families, and neighborhoods. Therefore, spirituality can be regarded as an essential connector for ethnic and cultural communities and for understanding wellness, intervention, and recovery. ” Image: Mental Health and Spirituality Initiative logo
X “Do you go to church? ” X “What is your religious affiliation? ” Image: Sunlight behind dark clouds
Joint Commission: The Source, February 2005 “Spirituality can be defined as a complex and multidimensional part of the human experience — our inner belief system. It helps individuals search for the meaning and purpose of life, and it helps them experience hope, love, inner peace, comfort, and support. ” Image: Blades of grass emerging from soil
“Religion refers to a belief system to which an individual adheres. Religion involves particular rituals and practices — the externals of our belief system. Many people find spirituality through religion; however, some people find spirituality through communing with nature, music, the arts, quest for scientific truth, or a set of values and principles. ” Image: Religious and spiritual symbols from around the world
“Not everyone is religious, nor is religion a requirement for spirituality. Within a spiritual assessment, it is important to determine if a patient has a religious affiliation; however, that is not the sole purpose of the assessment. A person may not practice religion, but may still have spiritual needs that should be met. Any assessment process should identify those spiritual needs, in whatever form they take. ” Source: Joint Commission on Accreditation of Healthcare Organizations. 2005. “Evaluating Your Spiritual Assessment Process. ” The Source, 3(2), 6− 7.
Spiritual Practices Are Diverse … � chanting � participating in spirituality support groups � creating shrines � participating in a sweat lodge (temazcal) � dancing � participating in Talking Circles � drawing mandalas � praying � drumming � Qigong � journal writing � � making crafts reading sacred texts or spiritual self-help books � meditation � � mindfulness training receiving healing advice from a medicine man (curandero) or medicine woman (curandera) � participating in 12 -step groups � singing � participating in bible study groups � spending time in nature � participating in prayer vigils � t’ai chi � participating in religious services � volunteering to serve the community � participating in rituals and ceremonies � yoga Source: Adapted from the Survey of Individuals Receiving Mental Health Services & Their Families Regarding Spirituality by the California Mental Health & Spirituality Initiative, 2009.
F. I. C. A. Spiritual History, Dr. Christina Pulchalski, George Washington Institute on Spirituality & Health F – Faith and Belief � Do you consider yourself spiritual or religious? � Do you have spiritual beliefs that help you cope with stress? � What gives your life meaning? I – Importance & Influence � What importance does your faith or beliefs have in our life? � How do they influence you in how you take care of yourself?
F. I. C. A. Spiritual History, Dr. Christina Pulchalski, George Washington Institute on Spirituality & Health C – Community � Are you part of a spiritual or religious community? � Is this of support to you and how? � Is there a group of people you really love or who are important to you? A – Address in Care � How would you like me to address these issues in your health care? Source: Christina Pulchalski, M. D. , George Washington Institute on Spirituality & Health, www. gwish. org
H. O. P. E. Questions, Drs. Gowri Anandarajah & Ellen Hight, Brown University School of Medicine H – Sources of Hope, Meaning, Comfort, Strength, Peace, Love, and Connection � What do you hold onto during difficult times? � What sustains you and keeps you going? O – Organized Religion � Do you consider yourself part of an organized religion? � Are you part of a religious or spiritual community? � What aspects of your religion are helpful or not so helpful to you?
H. O. P. E. Questions, Drs. Gowri Anandarajah & Ellen Hight, Brown University School of Medicine P – Personal Spirituality/Questions � Do you have personal spiritual beliefs that are independent of organized religion? � Do you believe in God? � What kind of relationship do you have with God? � What aspects of your spirituality or spiritual practices are most helpful to you personally?
H. O. P. E. Questions, Drs. Gowri Anandarajah & Ellen Hight, Brown University School of Medicine E – Effects on Medical Care � Has your current situation affected your ability to do things that usually help you spiritually (or affected your relationship with God)? � Is there anything I can do to help you access the resources that usually help you? � Would it be helpful to speak with a community spiritual leader? Source: Gowri Anandarajah & Ellen Hight. 2001. “Spirituality and Medical Practice: Using the H. O. P. E. Questions as a Practical Tool for Spiritual Assessment. ” American Family Physician, 63(1).
Beyond Only “Clergy” to … � Community elders � Chaplains � Spiritual directors � Pastoral counselors � Parish nurses � Lay religious leaders � Culturally based healers � Other spiritual care providers of diverse religious, spiritual, and cultural backgrounds, including humanistic non-religious leaders Source: Christina Pulchalski et al. 2009. "Improving the Quality of Spiritual Care as a Dimension of Palliative Care: The Report of the Consensus Conference. " Journal of Palliative Medicine, 12(10), 885 – 904.
Pictorial Assessment Methods Dr. David R. Hodge, Arizona State University Image: Pictorial map for spiritual assessment Source: David R. Hodge. 2005. “Spiritual Lifemaps: A Client-Centered, Pictorial Instrument for Spiritual Assessment, Planning, and Intervention. ” Social Work, 50(1), 77– 87.
How Can You Bring PRESENCE? � Begin by working on yourself. What are your personal strengths and weaknesses related to spirituality and religion? What wounds have you suffered? What healing still needs to occur? What are your personal biases and triggers? � Use the spiritual assessment questions for personal reflection. Explore your own spiritual journey through co-counseling, journal writing, and sessions with spiritual mentors and/or therapists as needed. � Get clear on how far you are willing and able to go in discussing spirituality and religion with the people you serve. What would lead you to refer the individual/family to a specialist, or remove yourself from the situation? � Approach spiritual assessments with an eye toward finding strengths and an attitude of curiosity.
San Mateo County Behavioral Health & Recovery Services Spirituality Initiative Postcard Image: Front of the San Mateo County Behavioral Health and Recovery Services Spirituality Initiative postcard
San Mateo County Behavioral Health & Recovery Services Spirituality Initiative Postcard Image: Back of the San Mateo County Behavioral Health and Recovery Services Spirituality Initiative postcard Source: San Mateo County Behavioral Health & Recovery Services, Spirituality Initiative, www. smchealth. org/spirituality, or Jairo Wilches, Consumer Liaison: 650 -573 -2890
Presentation References Sally Clay, Zangmo Blue Thundercloud: http: //sallyclay. net National Mental Health Consumers Self-Help Clearinghouse: www. mhselfhelp. org California Mental Health & Spirituality Initiative: www. mhspirit. org Joint Commission (formerly Joint Commission on Accreditation of Healthcare Organizations): www. jointcommission. org George Washington Institute for Spirituality & Health: www. GWish. org David R. Hodge, Ph. D. , School of Social Work, Arizona State University: http: //ssw. asu. edu/filelib/faculty-profiles/david-hodge *Also see the related handout available at www. dsgonline. com/rtp/resources. html.
Closing … Image: Clouds and mist surround mountains at sunrise
Contact Information Rev. Laura L. Mancuso, M. S. , CRC/CPRP Interfaith Chaplain Santa Barbara, California mancuso@west. net www. personalchaplain. com
Dolores Subia Big. Foot, Ph. D. Director, Indian Country Child Trauma Center University of Oklahoma Health Sciences Center Oklahoma City, Oklahoma Image: Indian Country Child Trauma Center logo
Cheyenne Creation Story Every Tribe has a creation story that tells of their origin, how they came to be, and which helpful behaviors led them forward. Many tribal Web sites have posted creation stories sharing the wisdom of their history, important teachings, or other understandings about life. One creation story of the Cheyenne is the name given to recognize and help individuals be grounded in knowing who they are, where they came from, why they are here, who their relatives are, who came before them, and who will come after them. I beg the pardon of the Cheyenne people if my words do not convey the full significance of naming. Naming allows a person to participate in a ceremony of belonging, recognition, connectedness, identity, history, gratitude, grounding, and hopefulness. Giving a name requires knowing where that name came from, who carried the name before, the meaning of the name, where and who gave it, the expectation of the name, and when and where it will be used (whether in daily conversation, in ceremony, or in other sacred ways). Even the place and timing of the name giving can be important in sharing the story of the new identity and way of viewing the world. It can be the unfolding of a new life—a new creation story for that person. In each passing day, that person can share his story with others and gain strength in knowing many are there to support his new life.
Therapeutic Indigenous Practices Society/Clans/Bands Ceremonies Extended Family Honoring Naming Ceremonies Vision Seeking Listening/ Watching/Doing Storytelling Therapeutic or Healing Sweat Lodge Humor/Teasing Talking Circle Offerings/Gifts Smudging Drumming Meditation Singing Dancing Big. Foot, 2005
Medicine Wheel Teachings The Medicine Wheel was also part of the Sacred Hoop and Sacred Circle. From its teachings come the direction for guidance and understanding. The Medicine Wheel is divided into four parts to represent the four parts of man: physical, mental, emotional, and spiritual. The Medicine Wheel gives mankind an understanding of good medicine and bad medicine. Teachings of the Four Directions also come from the Medicine Wheel. Wisdom, knowledge, and learning come from using the Sacred Directions for guidance and understanding (White Crow, 1986). The Four Directions are for understanding—they are messengers.
Big Horn Medicine Wheel Image: Bighorn Medicine Wheel Source: Ancient Observatories Timeless Knowledge, http: //solar-center. stanford. edu/AO/bighorn. html
Teachings of the Medicine Wheel Big. Foot, 2005
It Starts With Me In Recovery I Can … � Greet myself by my name each new dawn � Feed myself daily with food and laughter � Tell myself a story of hope each day � Pray for myself and others each day Image: Indian Country Child Trauma Center logo Image: Teepees on a field beneath rainbow © Indian Country Child Trauma Center, University of Oklahoma Health Sciences Center (405) 271 -8858, www. icctc. org
In the Circle Way: Teachings of the Spirit � Know that you are Sacred � Know that you are Honored � Know that you are Prayed For � Know that Others made offerings on your behalf � Know that you are Not Alone � Know that you were Known before you came to this place � Know that you have Choices � Know that you have a Name � Know that many know your Name � Know that when you reach, you are also reaching toward
In the Circle Way: Teachings of the Spirit These are the gifts I leave you. … What gifts are you taking?
Resources � Prayers of Our Ancestors (page 26) http: //www. okcic. com/gallery/Horizons_winter_2011. pdf � National Child Traumatic Stress Network www. nctsn. org � First Nations Behavioral Health Association http: //www. fnbha. org � Indian Country Child Trauma Center www. icctc. org � White Bison www. whitebison. org � Wellness Conferences www. nationalwellness. org � Wellbriety www. pacific. edu/Academics/Professional-and-Continuing-Education/Programs/Certificate. Programs/Native-American-Wellbriety-Certificate-Program/Wellbriety-Instructors. html
Contact Information Dolores Subia Big. Foot, Ph. D. Director, Indian Country Child Trauma Center University of Oklahoma Health Sciences Center Oklahoma City, Oklahoma
Gladys De. Vonne Christian, CPSS President, National Association of Peer Specialists Senior Certified Peer Support Specialist, Peer Support Specialist Trainer, Certified Wellness Recovery Action Plan Facilitator Center. Point Human Services (LME/MCO)
Purpose and Objectives � The purpose of this presentation is to share my personal recovery story and inspire others to live a meaningful and productive life. � The objective is to present a framework for personal steps towards whole health and wellness.
Oh, Happy Day! � Topic 1: The “Will” to Recover Diagnosed with posttraumatic stress disorder with major depression � Topic 2: How Culture and Spirituality Framed My World A culture of love, support, value, and opportunities for growth � Topic 3: Faith Makes All Things Possible Striving for excellence
Image: People form circle around globe
Gladys De. Vonne Christian President, National Association of Peer Specialists Center. Point Human Services (LME/MCO) gladys@naops. org www. naops. org (336) 725 -6800 x 220
Q&A, Discussion, and Summary To ask a question, click on the Q/A tab and type your question in the window that opens, or press *1 for the operator, who will take your question in the order in which it is received. Larry Davidson, Ph. D. Project Director, Recovery to Practice DSG, Inc. ldavidson@dsgonline. com Image: Photo of Larry Davidson, Ph. D. Thanks for joining our Webinar today!
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