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Clinical Guidelines for Developing Resiliency Module

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Clinical Guidelines for Developing Resiliency Module Clinical Guidelines for Developing Resiliency Module OVERVIEW: The Developing Resiliency Module is broken down into two sections-standard sessions and individualized sessions. The first 3 topics (How can I develop resiliency? Using Your Strengths, and Finding the Good Things Each Day) will be completed as Module #6 at the end of the Standard Modules. During Module #7 Building a Bridge to Your Goals, clinicians work collaboratively with each client to decide which of the Individualized Modules will be completed as part of ongoing treatment. The second section of the Developing Resiliency Module- Individualized Sessions (Module #14) is included as a section clients can choose to complete after the standard modules. Clients can complete Module #14 either as a stand alone Individualized Module or with single exercises integrated into the first session or two of each of the Individualized Modules. Before beginning each Individualized Module, each client should complete one Resiliency exercise from Module #14. If the client chooses not to complete any of the Individualized Modules, he or she has the option of completing any of the exercises in Module #14. Each exercise (except How Can I Develop Resiliency) is broken down into two parts. Part I provides the rationale for the exercise, gives the client a chance to practice the skill, and helps the client make a plan to use the skill before the next session. Part II is designed to follow-up with the client to determine the success of using the skill and the impact the skill had on their mood, social relationships, level of stress, etc. Goals 1. Provide information on and help client identify with the resiliency process. 2. Help the client build resiliency through using strengths and paying attention to the good things that happen. Handouts Developing Resiliency-Standard Sessions 1. Exploring Your Resilience 2. Using your Strengths Parts I and II 3. Finding the Good Things in Each Day Parts I and II Developing Resiliency-Individualized Sessions 4. Gratitude Visit Parts I and II 5. Counting Your Blessings Parts I and II 6. Savoring Parts I and II 7. Mindfulness Parts I and II 8. Active/Constructive Responding Parts I and II 9. Life Summary Parts I and II 10. Practicing Acts of Kindness Parts I and II NAVIGATE IRT Manual – Developing Resiliency – Standard Sessions – Guidelines April 1st, 2014 Page 261 SESSION STRUCTURE: Informal socializing and identification of any major problems. Review the previous session. If client has a home practice assignment, discuss/review the home practice assignment using the Home Practice Follow-up in Part II of the handout. Praise all efforts and problem-solve obstacles to completing home practice. – The questions serve to help the client become more aware of the benefits of the exercise and address any challenges the client may have encountered trying the exercise. Follow-up on goals. Set the agenda. Teach new material (or review materials from a previous session if necessary). Take advantage of opportunities to role play and practice skills. Summarize progress made in the current session. Agree on home practice to be completed before the next session. (Consider writing it down to help the client remember) GENERAL TEACHING STRATEGIES: The client has been building on his or her definition of resiliency throughout the basic modules. Review the client’s definition of recovery, thoughts about resilient qualities, and the client’s identification of resiliency in his or her narrative. The educational process should be collaborative. Do not treat the client as a student, but as someone with whom you are trying to share information and come to a common understanding. When discussing a given topic (e.g., client strengths), ask the client to give concrete examples of how he or she thinks the concept applies to their situation, which will help them to better remember and utilize the concept. Go at a comfortable pace, but do not force the material on the client. Because of possible cognitive difficulties, it may be necessary to present the information in small chunks. – Each clinical guideline provides a Suggested Agenda table of suggestions to break up the modules based on a person who is working at a slow or moderate NAVIGATE IRT Manual – Developing Resiliency – Standard Sessions – Guidelines April 1st, 2014 Page 262 pace. Other clients may be knowledgeable enough to go through the handout in one session. GENERAL INSTRUCTIONS FOR THE HANDOUTS: Home practice must be reviewed before starting a new handout. In the Developing Resiliency Module part of the educational process is done by reviewing the client’s experience. Each handout includes: sections of text, main points that are highlighted in boxes, questions, tables, and suggested home practice assignments. You can either take turns reading the text out loud or summarize the text for the client. The highlighted boxes are useful talking points and take home message for the client. It may be used to help the client to connect facts with his or her own life situation and goals. You should ask the client questions that are bolded to facilitate discussion, assess the client’s knowledge, and understand his or her perspective. The tables can be filled out together or used as a discussion tool to individualize the topic to the client’s situation. You can use one of the home practice suggestions or individualize the home practice for the client to practice the skills in a situation connected to his or her goal. ADDITIONAL RESOURCES: Because “resilience” may be a new topic for some clinicians, we have provided below additional resources on resilience-related topics: Bryant, F. B., & Veroff, J. (2007). Savoring: A new model of positive experience. Mahwah, NJ US: Lawrence Erlbaum Associates Publishers. Lyubomirsky, S. (2008). The how of happiness: A scientific approach to getting the life you want. New York: The Penguin Press. Neenan, M. (2009). Developing resilience: A cognitive-behavioural approach. New York, NY US: Routledge/Taylor & Francis Group. Seligman, M. E. P. (2002). Authentic happiness: Using the new positive psychology to realize your potential for lasting fulfillment. New York, NY US: Free Press. Seligman, M. E. P., Rashid, T., & Parks, A. C. (2006). Positive psychotherapy. American Psychologist, 61(8), 774-788. NAVIGATE IRT Manual – Developing Resiliency – Standard Sessions – Guidelines April 1st, 2014 Page 263 #1: Clinical Guidelines for “Exploring Your Resilience” OVERVIEW: This handout reviews the process of developing resiliency and introduces common features of resiliency. The handout helps the client identify personal qualities that he or she sees as resilient and reviews personal resiliency stories. Goals 1. Review a personal story of resiliency. 2. Identify important personal elements of resiliency. Handouts Exploring Your Resiliency. SUGGESTED AGENDA: Slow-Paced Medium-Paced Session 1-Reviewing a resiliency story. Session 1-Reviewing a resiliency story and identifying resilient qualities. Session 2-Identifying resilient qualities. TEACHING STRATEGIES: Review how client has built upon definition of recovery and resiliency from the Goal Setting, Psychoeducation, and Processing the Illness modules. Connect the resiliency process with making progress towards recovery and the client’s goals. Use the My Important Elements of Resiliency Table to help the client connect his or her strengths to the process of building resiliency. Discuss how client’s resilient qualities could help him or her move forward in recovery. Discuss how the client can share the information she or he has learned about building resiliency with a family member or friend. Also, help the client practice how to approach this person to ask about what resilient qualities that he or she has noticed in the client. NAVIGATE IRT Manual – Developing Resiliency – Standard Sessions – Guidelines April 1st, 2014 Page 264 TIPS FOR COMMON PROBLEMS: 1) Be prepared for client to have a difficult time identifying resilient qualities. Focus on some of the simple challenges that he or she has faced and the qualities that the client found to be the most helpful. It may be more helpful for client to think of examples from the lives of people that he or she admires or finds inspiring. Ask the client to think about the qualities that the person could have used to get through the experience. EVALUATING GAINS: After completing this handout it may be helpful to periodically assess how much knowledge the client has retained about building resilience. You can assess a client’s knowledge using the following questions: 1. What are some examples of resilient qualities? 2. What are (your) resilient qualities? THERAPEUTIC GOALS, SPECIFIC TECHNIQUES, AND PROBES FOR “EXPLORING YOUR RESILIENCE”: Therapeutic Goal Techniques & Probes Review a personal story of Practice how the client could share a story of resiliency. resiliency with a family member or supporter. Discuss how sharing this story with a family member or supporter could help that person see that recovery is possible for the client. Have the client identify his or her Review strengths identified from the Brief resilient qualities. Strengths Test Identify resilient qualities from client’s resiliency story: – “You recently talked about a time in your life when you faced a significant challenge. Which qualities helped you face this challenge?” Use the Identify Important Resilient Qualities table to help the client list his or her resilient qualities and why they were important or helpful. NAVIGATE IRT Manual – Developing Resiliency – Standard Sessions – Guidelines April 1st, 2014 Page 265 #2: Clinical Guidelines for “Using Your Strengths” OVERVIEW: This handout helps the client find new ways to use their strengths in their daily life. In Part I of the handouts, clients can learn strategies to help them use their strengths more often in different situations. In Part II (follow-up session), clients reflect on how it felt to use their strengths and make a plan to use their strengths more often in the future.
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