counseling as storytelling - cdn.ymaws.com€¦ · counseling as storytelling rik lundgren mapl...
TRANSCRIPT
11/3/2017
1
1
Counseling as Storytelling
Rik Lundgren MAPL LADC
Or
‘Storytelling in counseling.’ Take Your Pick.
From the description:
This session is about presenting the concepts of Recovery in a
person-centered way.
Who Am I? Person in Long Term Recovery
What that means for me is… Part of the Recovery Community since…
A Long Time Ago…
LADC Licensed since 2007 Worked at all levels of treatment except… 5 Years as a Case Manager
MAPL Metropolitan State - College of Community Studies and Public Affairs
“Recovering Academic”: Navy P.E. “A” School, MCTC, U of M,
Advocate for Recovery Empower Prevention -- Make Recovery Visible – Give Recovery a Voice
Celebrate Recovery – Confront Stigma Everywhere
11/3/2017
2
Now You Know My Story We might have something in common…
What that means for me is… Part of the Recovery Community since…
A Long Time Ago…
You know some of my history Licensed since 2007 Worked at all levels of treatment except… 5 Years as a Case Manager
You begin to make guesses about my opinions Metropolitan State - College of Community Studies and Public Affairs “Recovering Academic”: Navy P.E. “A” School, MCTC, U of M,
Some of the mystery is gone. Doubt can be questioned. Ambivalence has a chink in its armor.
My Commitments to You:
I Will Not (intentionally) steer you wrong.
All of the research is cited below.
Do my best to finish a little early.
I want some cool swag, too…
Three Assumptions:
You are all responsible, healthy practitioners
• Regular self-care, in mind, body and spirit.
Knowledgeable and informed in your area of practice. Familiar with:
• Transtheoretical Model (Stages of Change)
• Motivational Interviewing
• Relevant State and Organizational Ethics
Not interested in complexity, but don’t want to be bored.
11/3/2017
3
A Few Core Ideas Behind This Presentation:
Recovery Oriented Systems of Care Values That Underlie A ROSC:
• A Person-Centered Approach
• A Self-Directed Approach
• A Strengths Based Approach
Some (same old) Motivational Interviewing Principles: • Ambivalence about substance use (and change) is normal.
• Ambivalence can be resolved by working with your client's intrinsic motivations and values.
• The alliance between you and your client is a collaborative partnership to which you each bring important expertise.
• An empathic, supportive, yet directive, counseling style provides conditions under which change can occur.
8
Core Ideas (cont.):
There are many paths to Recovery.
• Any method is a good method, if it works.
• There is no single method that works for everyone.
Stigma
• A very real barrier to people seeking treatment.
(Most Important!) Communication can be hard.
• Different cultures, Different histories, Different Drugs
• Different plans for our future
A Few Ideas I Will Not Be Bringing To This Presentation:
All of you are in Recovery.
• Only half of the Recovery counseling workforce is in Recovery. • It’s a little higher Minnesota
The 12 Steps
• There are other paths to Recovery
But there are some stories in their book...
Everyone is comfortable telling stories
• I’m not going to ask anyone to stand up and speak.
11/3/2017
4
One More Assumption:
You are all “Allies of Recovery”.
As an Ally of Recovery, I promise to be:
• An open-minded and active listener
• Conscious of my own biases and work to adjust them
• Informed and open to learning more about life in recovery
• Aware of the environments I create and work to build a safe space for all people in recovery through my words and actions
• An amplifier for the voices of people in recovery and an advocate for the rights of people in recovery
Our First Story
This was a Demonstration.
What happened?
What did you feel?
What did you think?
11/3/2017
5
“We cannot wish old feelings away
nor do spiritual exercises for overcoming them
until we have woven a healing story
that transforms our previous life’s experience
and gives meaning to whatever pain we have endured.”
Joan Borysenko
Why Storytelling?
“You have to Dance with the one that brought you”
One more tool for the collection.
11/3/2017
6
Then What is Storytelling?
It’s not just reciting parables-
It’s teaching a different way of thinking about our lives.
The Foundation of Storytelling as a Counseling Technique:
We all have an internal dialogue, always.
We build ourselves out of that story.
It just makes sense to choose what that story is.
Why Use a Story?
All Stories Are Memories, And All Memories Are Stories. "A typical memory is really just a reactivation of connections between different parts of your brain that were active at some previous time,"
- Neuroscientist Nikolay Kukushkin
We can help them begin to write a new draft of their internal dialogue.
Why Use a Story? (cont.)
Therapeutic Motives of Storytelling
1. To direct (or redirect) a client’s attention.
2. To make or illustrate a point.
3. To set a reflective mood.
4. To help people recognize themselves.
5. To seed ideas and increase motivation.
6. To redefine a problem.
7. To decrease “resistance.”
11/3/2017
7
How to Use a Story. (cont.)
Here is what we are trying to do with a story:
Activate- Existing Memories, familiar concepts
Connect- Build the therapeutic Alliance
Illustrate- Complex or unfamiliar ideas
Expand- Add to their knowledge, experience
What Stories?
4 Kinds of Story:
1. Analogies
2. Metaphors
3. Anecdotes
4. Narratives
What Stories?
Analogies – aka Reframing
a. A similarity in some respects between things that are otherwise dissimilar: sees an analogy between viral infection and the spread of ideas.
b. A comparison based on such similarity: made an analogy between love and a fever.
A couple of words, a phrase
-“What’s in a name? That which we call a rose
By any other word would smell as sweet.”
-“Opinions are like…”
-’”worrying is as effective as trying to solve an algebra equation by chewing bubble gum”
11/3/2017
8
What Stories?
Metaphors
1. A figure of speech in which a word or phrase that ordinarily designates one thing is used to designate another, thus making an implicit comparison.
2. One thing conceived as representing another; a symbol.
Usually intended to have an emotional impact
-"All the world’s a stage, and all the men and women merely players“ (Shakespeare)
-”an honest man's pillow is his peace of mind” (John Mellencamp)
- “life is just a tire swing” (Jimmy Buffett)
What Stories?
Anecdotes
1. A short account of an interesting or humorous incident.
Very Brief
Very Concrete
Makes a point or leaches a lesson.
Can convey an abstract concept
or be used to make a point.
What Stories?
Narratives 1. A narrated account; a story. 2. The art, technique, or process of narrating. 3.
a. A presentation of real-world events that connects them in a story like way. b. An explanation or interpretation of events in accordance with a particular theory, ideology, or point of view:
Story as you are used to seeing it
Save for Lecture
Wrap a lesson in emotion
11/3/2017
9
One of the Best Storytellers in America… How many stories can you find in these 4, short paragraphs?
That is the true genius of America, a faith in simple dreams, an insistence on small miracles; that we can tuck in our children at night and know that they are fed and clothed and safe from harm; that we can say what we think, write what we think, without hearing a sudden knock on the door; that we can have an idea and start our own business without paying a bribe; that we can participate in the political process without fear of retribution; and that our votes will be counted -- or at least, most of the time.
This year, in this election, we are called to reaffirm our values and our commitments, to hold them against a hard reality and see how we are measuring up, to the legacy of our forbearers and the promise of future generations.
And fellow Americans, Democrats, Republicans, independents, I say to you, tonight, we have more work to do, for the workers I met in Galesburg, Illinois, who are losing their union jobs at the Maytag plant that's moving to Mexico, and now they're having to compete with their own children for jobs that pay 7 bucks an hour; more to do for the father I met who was losing his job and chocking back the tears wondering how he would pay $4,500 a months for the drugs his son needs without the health benefits that he counted on; more to do for the young woman in East St. Louis, and thousands more like her who have the grades, have the drive, have the will, but doesn't have the money to go to college.
Now, don't get me wrong, the people I meet in small towns and big cities and diners and office parks, they don't expect government to solve all of their problems. They know they have to work hard to get a head. And they want to.
--Barack Obama, Speech to the Democratic National Convention, July 27th, 2004
I Count 9: That is the true genius of America, a faith in simple dreams, an insistence on small miracles; that we can
tuck in our children at night and know that they are fed and clothed and safe from harm; that we can say what we think, write what we think, without hearing a sudden knock on the door; that we can have an idea and start our own business without paying a bribe; that we can participate in the political process without fear of retribution; and that our votes will be counted -- or at least, most of the time.
This year, in this election, we are called to reaffirm our values and our commitments, to hold them against a hard reality and see how we are measuring up, to the legacy of our forbearers and the promise of future generations.
And fellow Americans, Democrats, Republicans, independents, I say to you, tonight, we have more work to do, for the workers I met in Galesburg, Illinois, who are losing their union jobs at the Maytag plant that's moving to Mexico, and now they're having to compete with their own children for jobs that pay 7 bucks an hour; more to do for the father I met who was losing his job and chocking back the tears wondering how he would pay $4,500 a months for the drugs his son needs without the health benefits that he counted on; more to do for the young woman in East St. Louis, and thousands more like her who have the grades, have the drive, have the will, but doesn't have the money to go to college.
Now, don't get me wrong, the people I meet in small towns and big cities and diners and office parks, they don't expect government to solve all of their problems. They know they have to work hard to get a head. And they want to.
Why Not use a Story? Because It Isn’t True?
You actually can make this stuff up, you just shouldn’t.
B.S. Destroys Credibility
Consider Your Audience
Authenticity
Know Who You Are
Be Who You Are
11/3/2017
10
Why Not use a Story? (cont)
Bad Old Self Disclosure
Clear, consistent boundaries provide a structure and safety for many patients that is therapeutic in itself.
Reactions to changes in usual boundaries can be unpredictable, even volatile.
We need to ask whether disclosure is for the client or for ourselves.
Avoid exposing vulnerability
Get Fully Informed on Ethics and Boundaries.
When to Use a Story (Context) Human beings have been telling stories since before there were written languages. Anytime is a good time if it suits the Recoveree’s needs.
During the Assessment In Group
Be Brief! During Lecture Making Space
I use Stories to do the one thing my clients tell me they appreciate most often: Make analogies to make complicated ideas simple
How to Use a Story
Pre-contemplation
Establishing Rapport
The first conversation you have with your client shapes their mental image of you.
It's the most important interaction you will have with them.
Choose Wisely.
Building the Therapeutic Alliance
As a vehicle for Factual Information, (Maybe…)
Be Careful! Gauge receptiveness
Be Accurate! KNOW your facts and sources.
11/3/2017
11
How to Use a Story
Contemplation Identify intrinsic motivators.
Emphasize (and demonstrate) Personal Choice
Reframing
Preparation Introduce different treatment options and community resources (With permission!)
Offer expertise and advice
How to Use a Story
Action
Continue to educate clients
Prepare clients so that they know there may be some embarrassing, emotionally awkward, and uncomfortable moments
Help clients to recognize stressful situations
What Story? Your story doesn’t necessarily have to be your story.
“I had a client who…”
Your Clients
Always be Listening!
Journaling
Meetings
Addiction Memoirs
11/3/2017
12
What Story? (cont)
Recovery Narratives Project
Recovery Podcasts
Recovery Memoirs
Your Own Experience
What is Your Story?
It is in the transition from personal recovery to
social/political advocacy that recovering people
discover the connection between telling their stories
and changing the world.
-- William White
11/3/2017
13
Questions/Feedback
Rik Lundgren MAPL LADC
(651) 232-3687
References
Alcohol and Drug Abuse Division. (2013). Minnesota's Model of Care for Substance Use Disorder. Saint Paul: Minnesota Department of Human Services.
Asante, M. (2013). Buck. A Memoir. New York, New York: Spigel & Grau.
Berger, P., & Luckmann, T. (1966). The Social Construction of Reality: A Treatise in the Sociology of Knowledge. New York: Penguin Books, Ltd.
Bergner, R. (2007, March 01). Therapeutic Storytelling Revisited. American Journal of Psychotherapy, 61(2), 149-162.
Boeke, M., & Clarke, J. (2011, April). The Human and Economic Costs of Alcohol Abuse in Minnesota. Retrieved 12 01, 2016, from Minnesota Department of Health: http://www.health.state.mn.us/alcohol/alcpdf/HumanandEcono micCostofAlcoholUseinMinnesota.pdf
Borys, D. (1994, September 01). Maintaining Therapeutic boundaries: The Motive Is Therapeutic Effectiveness, not Defensive Practice. Ethics and Behavior, 4(3), 267-273.
Braiterman, K. (2015, February 02). Telling Your Recovery Story:. Retrieved from Mental Health Recovery: mentalhealthrecovery.com/info-center/telling-your-recovery- story/
Brockman, R. (2013). "Only Stories Matter: The Psychology and Neurobiology of Story. American Imago, 445-460.
11/3/2017
14
Carr, D. (2008). The Night of the Gun. A Reporter Investigates the Darkest Story of His Life, His Own. New York, New York: Simon and Schuster.
Center for Mental Health Services. (2003). Blueprint for Change: Ending Chronic Homelessness for Persons with Serious Mental Illnesses and Co-Occurring Substance Use Disorders. DHHS Pub. No. SMA-04-3870. Rockville, Maryland: Substance Abuse and Mental Health Services Administration.
Center for Substance Abuse Treatment. (1999). Enhancing Motivation for Change in Substance Abuse Treatment., Treatment improvement Protocol (TIP) Series, No. 35. Rockville, Maryland, United States: Substance Abuse and Mental Health Services Administration,.
References
Center for Substance Abuse Treatment. (2014). Improving Cultural Competence. Treatment Improvement Protocol (TIP) Series No. 59. HHS Publication No. (SMA) 14-4849. Rockville, Maryland: Substance Abuse and Mental Health Services Administration. Retrieved October 02, 2017, from https://store.samhsa.gov/shin/content//SMA14-4849/SMA14- 4849.pdf
Cooke, E. (2012, January 14). How narratives can aid memory. Retrieved from The Guardian: https://www.theguardian.com/lifeandstyle/2012/jan/15/story- lines-facts
Curtis, S. L., & Eby, L. T. (2010, August 1). Recovery at Work: The Relationship Between Social Identity and Commitment Among Substance Abuse Counselors. Journal of Substance Abuse Treatment, 39(3), 248-254. doi:10.1016/j.jsat.2010.06.006
References
Delistraty, C. C. (2014, November 02). The Psychological Comforts of Storytelling. The Atlantic Monthly.
Divinyi, J. (1995, March). Storytelling: An enjoyable and effective therapeutic tool. Contemporary Family Therapy, 17(1), 27-37. doi:10.1007/BF02249302
doukas, N., & Cullen, J. (2011, July 25). Addiction Counselors in Recovery: Perceived Barriers in the Workplace. Journal of Addiction Research & Therapy, 2(3), 112-119. doi:10.4172/2155-6105.1000112
Egley, L., Frisch, M. T., Greenlee, D., Holthausen, J., & Maroney- Ryan, J. (2017, October 31). MARRCH Organizational Ethics Codes. Retrieved from Minnesota Association of Resources for Recovery and Chemical Health: http://www.marrch.org/default.asp?page=ethics_arch_code
References
11/3/2017
15
Freed, R. (2011, November 17). The Importance of Telling Our Stories. Retrieved from The huffington Post: https://www.huffingtonpost.com/rachael-freed/legacy-telling- our-story_b_776195.html
Gibson, M. F. (2012, September 01). Opening Up: Therapist Self- Disclosure in Theory, Research, and Practice. Clinical Social Work Journal, 40, 287-296. doi:10.1007/s10615-012-0391-4
Gielen, N., Havermans, R. C., Tekelenburg, M., & Jansen, A. (2012). Prevalence of post-traumatic stress disorder among patients with substance use disorder: it is higher than clinicians think it is. European Journal of Psychotraumatology, 3(9), Special section p1-9.
Gorski, T. T., & Miller, M. (1986). Staying Sober: A Guide for Relapse Prevention. Philadelphia: Independence Press.
References
Gots, J. (2012, January 14). Your Storytelling Brain. Retrieved from Big Think: http://bigthink.com/overthinking-everything- with-jason-gots/your-storytelling-brain
Green, M. (2017). Breaking Through. Newsweek Global, 168(12), p. 24.
Hamby, S. (2013, September 03). Resilience and…..4 Benefits to Sharing Your Story. Retrieved from Psychology Today: https://www.psychologytoday.com/blog/the-web- violence/201309/resilience-and-4-benefits-sharing-your-story
Hari, J. (2015). Chasing the Scream: the First and Last Days of the War on Drugs. New York, New York: Bloomsbury.
Heath, C., & Heath, D. (2006). Made to Stick: Why Some Ideas Survive and Others Die. New York: Random House.
References
Hsu, J. (2008, August). The Secrets of Storytelling: Our Love for Telling
Tales Reveals the Workings of the Mind. Scientific American Mind, 19(4), p. 46.
Johnson, C. (1955). Harold and the Purple Crayon. New York: Harper and Brothers.
Kaufman, S. B. (2013, August 19). The Real Neuroscience of Creativity. Retrieved from Scientific American: https://blogs.scientificamerican.com/beautiful-minds/the-real- neuroscience-of-creativity/
Kautz-Sheedy, C., & Whitter, M. (2009). Guiding Principles and Elements of Recovery-Oriented Systems of Care: What Do We Know From the Research? HHS Publication No. (SMA) 09- 4439. Rockville, Maryland: Substance Abuse and Mental Health Services Administration. Retrieved October 2, 2017, from http://pfr.samhsa.gov/rosc.html
References
11/3/2017
16
Land, K. (2007, September). Storytelling as Therapy: The Motives Of A
Counselor. Business Communication Quarterly, 377-381.
LeVan, A. (2009, December 03). Seeing Is Believing: The Power of Visualization [Blog Post}. Retrieved from Psychology Today: https://www.psychologytoday.com/blog/flourish/200912/seeing -is-believing-the-power-visualization
Lloyd, C. (2013). The stigmatization of problem drug users: A narrative
literature review. Drugs: Education, Prevention and Policy , 85-95.
McAlpine, D. D. (2011). Estimating the Need for Treatment for Substance Abuse Among Adults in Minnesota. St Paul: Minnesota Department of Human Services.
References
McRae, J. (2009, December). Minnesota Department of Human Services. Retrieved November 13, 2016, from Racial-Ethnic Differences in Treatment for Substance Abuse and Dependence in Minnesota: https://www.leg.state.mn.us/docs/2010/other/100176.pdf
McRae, J. (2013). Trends in Completing Treatment for Substance Use Disorders in Minnesota 2006-2011. St Paul: Minnesota Department of Human Services.
Metaphor as an Instrument for Orchestrating Change in Counselor
Training and the Counseling Process. (2010, Spring). Journal of Counseling Development, 88(2), 182-188.
References
Minnesota Certification Board. (2015, May). Code of Ethical Conduct Drug Alcohol Addiction Counselor. Retrieved from MCBoard.org: https://www.mcboard.org/index.php/component/phocadownloa d/category/3-codes-of-ethical-conduct?download=16:code-of- ethical-conduct-for-alcohol-and-drug-counselors
Moyers, W. C. (2012). Now What? An Insider's Guide to Addiction and Recovery. Center City, Minnesota: Hazelden.
Musshoff, F., Lachenmeier, D. W., Schmidt, P., & Dettmeyer, R. (2005, January). Systematic Regional Study of Dopamine, Norsalsolinol, and (R/S)-Salsolinol Levels in Human Brain Areas of Alcoholics. Alcoholism: Clinical & Experimental Research, 29(1), 46-52. doi:10.1097/01.ALC.0000150011.81102.C2
References
11/3/2017
17
Myers, C., Tollerud, T., & Jeon, M.-H. (2012, July 13). The Power of Personal Storytelling in Counselor Education. Retrieved from VISTAS: https://www.counseling.org/docs/default- source/vistas/vistas_2012_article_19.pdf?sfvrsn=5b5ce146_1 3
Myers, R. (1996). Tetrahydroisoquinolines and Alcoholism: Where Are We Today? Alcoholism: Clinical and Experimental Research, 20, 498-500. doi:doi:10.1111/j.1530- 0277.1996.tb01081.x
Newman, T. (2016, February 17). The neuroscience of creativity. Retrieved from Medical News Today: https://www.medicalnewstoday.com/articles/306611.php
O’Kearney, R., & Perrott, K. (2006). Trauma Narratives in Posttraumatic Stress Disorder: Journal of Traumatic Stress.
References
Obama, B. (2004, July 28). Transcript: Illinois Senate Candidate Barack Obama . Retrieved October 03, 2017, from http://www.washingtonpost.com/wp-dyn/articles/A19751-2004Jul27.html
Paul, A. M. (2012, March 17). Your Brain on Fiction. New York Times.
Pomerantz, MD, J. M. (2009, October 08). Storytelling as a Psychotherapeutic Technique. Retrieved from Psychiatric Times: http://www.psychiatrictimes.com/articles/storytelling- psychotherapeutic-technique
Robert, T., & Kelly, V. (2010). Metaphor as an Instrument for Orchestrating Change in Counselor Training and the Counseling Process. Journal Of Counseling & Development, 88(2), 182-188.
References
Room, R. (2005). Stigma, social inequality and alcohol and drug use. Drug and Alcohol Review, 143 – 155.
Salmon, C., & Macey, D. (2010). Storytelling: Bewitching the modern mind. London: Verso.
Simons, I. (2010, July 21). A Therapist Should be a Good Storyteller. Retrieved from Psychology Today Blog: The Literary Mind: Simons, I. (2010, Jhttps://www.psychologytoday.com/blog/the-literary- mind/201007/therapist-should-be-good-storyteller
Slivinske, J. (2014, January 03). Everybody has a story: the role of storytelling in therapy. Retrieved October 09, 2017, from Oxford University Press Blog: https://blog.oup.com/2014/01/therapeutic-storytelling/
References
11/3/2017
18
Stephens, G. J., Silbert, L. J., & Hasson, U. (2010, July 26). Speaker–listener neural coupling underlies successful communication. Proceedings of the National Academy of Sciences, 107(32), 14425-14430. doi: 10.1073/pnas.1008662107
Stockton, N. (2017, July 17). Your Brain Doesn't Contain Memories. It Is Memories. Retrieved from Wired: https://www.wired.com/story/your-brain-is-memories/
Therapist Aid. (2016, September 09). Worksheets-What is Trauma? Retrieved from Therapist Aid: http://www.therapistaid.com/worksheets/what-is-trauma.pdf
Tomkins, D. M., & Sellers, E. M. (2001, March 20). Addiction and the brain: the role of neurotransmitters in the cause and treatment of drug dependence. . Canadian Medical Association Journal, 164(6), 817-821.
References
Waters, A., & Asbill, L. (2013, August). Reflections on Cultural Humility. Retrieved October 17, 2017, from American Psychological Association - CYF News: http://www.apa.org/pi/families/resources/newsletter/2013/08/c ultural-humility.aspx
White, W. (2011, February 15). Definition of a Recovery Oriented System of Care (ROSC). Retrieved October 15, 2017, from William White Papers: http://www.williamwhitepapers.com/pr/CSAT%20ROSC%20De finition.pdf
White, W. L. (2001). The Rhetoric of Recovery Advocacy An Essay on the Power of Language. Retrieved from William White Papers: http://www.williamwhitepapers.com/pr/2001RhetoricofRecover yAdvocacy.pdf
References
White, W. L. (2015, October). Visions of a New Recovery. Retrieved from William White Papers: http://www.williamwhitepapers.com/blog/2015/10/a-day-is- coming-visions-of-a-new-recovery-advocacy-movement.html
Widrich, L. (2016, February 01). The Science of Storytelling: What Listening to a Story Does to Our Brains. Retrieved from Buffer Social: https://blog.bufferapp.com/science-of-storytelling-why- telling-a-story-is-the-most-powerful-way-to-activate-our-brains
Zak, P. J. (2013, December 17). How Stories Change the Brain. Retrieved
October 04, 2017, from Greater Good Magazine: https://greatergood.berkeley.edu/article/item/how_stories_cha nge_brain
References
11/3/2017
19
Web Sites:
http://leanin.org/education/harnessing-the-power-of-stories/
http://recoverynarratives.org/
http://www.williamwhitepapers.com/
https://facesandvoicesofrecovery.org/
https://www.thefix.com/