WHAT WE EXPECT WHAT WE GET WHAT WE GET How did we get to this…and how do we recover? NEW AND IMPROVED THEORY? OR….. SAME OLE’ THING…WITH A NEW LOOK. Ecclesiastes 1:9 Structure of Sanctuary “Given the evidence that treatments are about equally effective, that treatments WHAT DO WE KNOW ABOUT delivered in clinical settings are PSYCHOTHERAPY? AND WHAT IS THERE LEFT TO DEBATE? effective (and as effective as that BRUCE E. WAMPOLD, PH.D., provided in clinical trials), that ABPPZAC E. IMEL, PH.D. 2018 the manner in which treatments are provided are much more important than which treatment is provided, mandating particular treatments seems illogical.” “THE DEVELOPMENT OF A THERAPEUTIC RELATIONSHIP IS THE MOST ACCURATE INDICATOR OF A POSITIVE OUTCOME.” - J. ERIC GENTRY CARL ROGERS • January 1902-February 1987 • Person Centered Therapy • Unconditional Positive Regard + Congruence = Person Centered Treatment “I am not perfect…but I am enough.” PAUL D. MACLEAN • May 1913-December 2007 • Triune Brain • Three Distinct Brain Segments: Protoreptilian Paleomammalian Neomammalian “An interest in the brain requires no justification other than a curiosity to know why we are here, what we are doing here, and where we are going.” THE TRIUNE BRAIN Reptilian Brain Limbic Brain Neocortex ERIK ERIKSON • June 1902-May 1994 • Stages of Development • Development happens in stages with spectrum type “virutes” “Hope is both the earliest and the most indispensable virtue inherent in the state of being alive.” STAGES OF DEVELOPMENT • Traumatic Reenactment regresses an individual to the Infancy and Early Childhood Stages of development (Reptilian Brain) WHICH OF THESE THINGS IS NOT LIKE THE OTHER GEORGE KELLY • April 1905-March 1967 • Personal Construct Psychology • We create our existence “A person's processes are psychologically channelised by the ways in which s/he anticipates events.” PERSONAL CONSTRUCT THEORY Construct Development Expectation Construct Development Explanation Experience Expectation Construct Development Explanation Experience MURRY BOWEN • January 1913-October 1990 • Family Systems Theory • Entities do not exist in a vacuum “The differentiated person is always aware of others and the relationship system around him.” SYSTEMS THEORY SO HOW DO WE KEEP SANCTUARY FROM BEING RELEGATED TO THE PAST? “…reducing systemic violence and counteracting the destructive parallel processes that are a result of chronic and unrelenting stress in a vulnerable species.” ~ Sandra Bloom HAS ANYONE EVER TRIED TO DEESCALATE SOMEONE IN CRISIS? TREATMENT IS TRAUMATIC. TREATMENT TRUAMA PROCESS REENACTMENT HOW WE PROVIDE SERVICES: THE POWER OF THE PREPOSITION • TO – “We provide service TO veterans.” • FOR – “We provide services FOR veterans.” • WITH – a mutual working together toward an agreed-upon end. SO WHY DOES “WITH” WORK? VICTOR FRANKL • March 1905-September 1997 • Existential Analysis • Meaning-Making “Those who have a 'why' to live, can bear with almost any 'how'.” Intentional Disruption of the Reenactment Cycle Expectation Space Construct Development Explanation Experience LET’S PRACTICE… • Admission Screen – How do we demonstrate “with” during a phone screen? • What do we do with that information. • Entry into treatment facility – How do we embody “with” in our entry process? • First day/night? • How do we train our teams in WITH? “It is impossible to get where you want to go unless you have a vision of where you want to go.” ~ Sandra Bloom THANK YOU AND HAVE A GREAT EVENING.