Transcript Document

Running MUCH Better
Treatment Groups
Fred Zackon M.Ed.
June 20 2012
© 2011 Fred Zackon Permission granted for use by BJA funded RSAT programs
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This presentation is about how groups are run from the
perspective of your program’s OPERATING SYSTEM.
So if your program …
were a computer:
Groups
Staff, facilities, building, physical things, …
would be your Hardware.
Program components—evidence-based,
traditional, institution-specific, etc., …
your Applications (“apps”).
Therapeutic culture, orientation, norms,
procedures, structural organization, etc., …
the Operating System.
© 2011 Fred Zackon Permission granted for use by BJA funded RSAT programs
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Program Applications
Operating Systems
Supports and enhances
Apps and other therapies
Impacts client/offenders directly
with specific well-defined protocols
APP-land
Groups
OS-land
Needs MUCH
more attention
This is where most of the action-research, training, etc.-- is these
days
This is what we know most about
and have most experience with
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© 2011 Fred Zackon Permission granted for use by BJA funded RSAT programs
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Let’s begin by identifying a few
Relevant First Principles
Groups
© 2011 Fred Zackon Permission granted for use by BJA funded RSAT programs
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1st Principles: RECOVERY
Recovery is a multi-dimensional
developmental learning process.
No two recoveries are identical, but for any given
population, most all include similar achievements.
© 2011 Fred
© 2011
Zackon
FredPermission
Zackon Permission
granted for
granted
use byfor
BJA
use
funded
by BJA
RSAT
funded
programs
RSAT programs
5
1st Principles: INMATES & OFFENDERS
Groups
Except for their experiences.
© 2011 Fred Zackon Permission granted for use by BJA funded RSAT programs
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1st Principles: ADULT LEARNING
It requires at least one of the following:
The practice effort is engaging.
Groups
One’s progress is evident and rewarding.
The expected pay-off is desirable.
© 2011 Fred Zackon Permission granted for use by BJA funded RSAT programs
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Something REALLY IMPORTANT about learning
that we SHOULD NOT FORGET:
Groups
Without lots of practice and reinforcement we return to
our unlearned condition. This is especially true of new
behaviors intended to replace strong habits.
© 2011 Fred Zackon Permission granted for use by BJA funded RSAT programs
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Groups are concentrated contexts for learning,
specifically social learning.
Social Learning:
The acquisition of skills, behaviors, attitudes,
and ideas that results from communicating
with, or being instructed by, or observing
other people. [per FZ]
Groups
© 2011 Fred Zackon Permission granted for use by BJA funded RSAT programs
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Four Drivers of Social Learning
Practical Guidance & Modeling
Sincere Encouragement & Approval
Groups
Role Models with Whom to Identify
Peers Sharing the Learning Experience
This is the essential stuff of effective groups.
© 2011 Fred Zackon Permission granted for use by BJA funded RSAT programs
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The 4 drivers of social learning, when appropriately
utilized, can make a group an extraordinarily rugged and
powerful recovery vehicle.
Even a small group
© 2011 Fred Zackon Permission granted for use by BJA funded RSAT programs
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Two general categories of treatment groups
CONTENT DELIVERY
PERSONAL FOCUS
Issue Presentation
Personal Issues Discussion
Concept or Information Teaching
Inter-personal Issues Discussion
Skills Training or Coaching
Groups
Community Issues Discussion
MIXED
Community Management
Twelve Step Fellowship Meetings
Content or Issue “Processing”
© 2011 Fred Zackon Permission granted for use by BJA funded RSAT programs
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Treatment Groups can
• Teach important ideas and concepts helpful for recovery
• Instruct and train in skills especially important for recovery
• Deepen learning through discussion and exchanges with peers
• Allow application of learning Groups
in order to solve problems together
• Stimulate moral reasoning and moral insight
• Provide empathy, support, and healing perspectives
• Elicit “moments of truth” and the resolve to resolve them
• Enable peer evaluation and therapeutic confrontation
• Enable deliberative group decision-making …
© 2011 Fred Zackon Permission granted for use by BJA funded RSAT programs
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… and groups can also perform House-keeping
• Get important or urgent information to everyone
Groups
• Allow for safe venting of potentially
destructive emotions
• Address issues that need urgent community attention
© 2011 Fred Zackon Permission granted for use by BJA funded RSAT programs
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What makes treatment group sessions effective?
Chance
Skill
Groups
FZ’s best estimate
Preparation
© 2011 Fred Zackon Permission granted for use by BJA funded RSAT programs
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The Counselor’s Skills Are Secondary
Groups
Even great drivers can get nowhere with a faulty
vehicle, or on confusing roads, or in bad conditions.
© 2011 Fred Zackon Permission granted for use by BJA funded RSAT programs
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Structure
& Norms
Membership
Standards
Content &
Objectives
© 2011 Fred Zackon Permission granted for use by BJA funded RSAT programs
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Membership Standards
Who’s In
Every member is in an appropriate recovery or
treatment status relative to the intended
therapeutic content.
Every member demonstrates Groups
capacity to
participate respectfully.
Every member abides by the group rules.
Every member prepares appropriately.
© 2011 Fred Zackon Permission granted for use by BJA funded RSAT programs
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Structure & Norms
How the session runs
Useful Group Rules
Listen and think.
Look for the value.
Ask for clarity.
Groups
Be prepared to participate.
Keep to the topic.
Don’t hijack the discussion.
Be respectful to all.
Don’t cross talk.
Obviously these are for group
members. And for the counselor?
Remain seated.
© 2011 Fred Zackon Permission granted for use by BJA funded RSAT programs
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Structure & Norms
How the session runs
The session has a clear beginning.
The Group’s name and purpose is stated.
Group rules are referenced.
Groups
Issues to be engaged (preferably pre-determined)
are stated.
Allotted time for each issue is stated.
Issues are engaged according to an appropriate standardized format.
Respectful, consistent methods are used to control divergent discussion.
Clear, consistent limits are maintained and time schedules are honored.
The session has a clear wrap-up and conclusion.
© 2011 Fred Zackon Permission granted for use by BJA funded RSAT programs
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Content & Objectives
What the session is about
Content is clearly relevant to members’ recoveries or needs.
Content is suited to group members’ state of recovery or treatment.
Objectives are specific.
Content is formatted similarly to Groups
all similar content.
Content builds on or reinforces prior content.
Content uses/connects tools and precepts that
are used and reinforced throughout program.
Member progress can be assessed.
Content aims to enhance abilities, not disparage persons.
© 2011 Fred Zackon Permission granted for use by BJA funded RSAT programs
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Some Specifics for Leading
Content Delivery Groups (Didactic/Instructional/Training)
• Know the content well.
• Know the content well.
(This isn’t a typo.)
• Know the content well.
(Neither is this.)
• Follow the approved format.
Groups
• Have several ways to demonstrate or explain the idea or skill.
• Have several ways to show the content’s relevance and value.
• Be ready to respond to likely questions and concerns.
• Have ways to gauge progress toward learning/skill acquisition.
• Know the source or legitimacy of any claim you make.
• Stay focused on the content, not on individuals.
© 2011 Fred Zackon Permission granted for use by BJA funded RSAT programs
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Some Specifics for Facilitating
Personal Focus Groups (addressing members’ situations)
• Be prepared to listen and learn.
• Do not presume you know a good solution before the facts are
gathered.
Groups
• Look for appropriate applications
or illustrations of learning
content.
• Focus more on how to solve the problem
than on a given solution.
• Use standard procedures and tools so that
problem-solving methods can be learned.
© 2011 Fred Zackon Permission granted for use by BJA funded RSAT programs
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Some Specifics for Facilitating
Any Inmate Group
DO
• Commend—without faked enthusiasm—constructive participation.
• Solicit some participation from every member.
• Respectfully confront violations Groups
of, or encroachments against, the
rules or norms.
• Re-orient promptly any member who strays
from the group’s topic or purpose.
• Stay as alert as possible to inmate cues
regarding their interest and attention.
• Get allies by building mutually respectful relationships with at least
two constructive members.
© 2011 Fred Zackon Permission granted for use by BJA funded RSAT programs
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Some Specifics for Facilitating
Any Inmate Group
DON’T
• Fake your knowledge or experience.
• Pace the group for the slowest learners.
• Humiliate or enable others to humiliate
a group member.
Groups
• Respond to an obviously tough personal issues with a cliché.
• Tolerate 80/20 situations (i.e., give 80% of your effort to 20% of
the group).
• Mistake authentic emotion for authentic learning.
• Mistake adaptation to the group for progress in recovery.
© 2011 Fred Zackon Permission granted for use by BJA funded RSAT programs
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1st Principles: RECOVERY
Recovery is a multi-dimensional
developmental learning process.
No two recoveries are identical, but for any given
population, most all include similar achievements.
© 2011 Fred
© 2011
Zackon
FredPermission
Zackon Permission
granted for
granted
use byfor
BJA
use
funded
by BJA
RSAT
funded
programs
RSAT programs
26
1st Principles: INMATES & OFFENDERS
Groups
Except for their experiences.
© 2011 Fred Zackon Permission granted for use by BJA funded RSAT programs
27
1st Principles: ADULT LEARNING
It requires at least one of the following:
The practice effort is engaging.
Groups
One’s progress is evident and rewarding.
The expected pay-off is desirable.
© 2011 Fred Zackon Permission granted for use by BJA funded RSAT programs
28
Four Drivers of Social Learning
Practical Guidance & Modeling
Sincere Encouragement & Approval
Groups
Role Models with Whom to Identify
Peers Sharing the Learning Experience
This is the essential stuff of effective groups.
© 2011 Fred Zackon Permission granted for use by BJA funded RSAT programs
29
Structure
& Norms
Membership
Standards
Content &
Objectives
© 2011 Fred Zackon Permission granted for use by BJA funded RSAT programs
30
Thank you for being with me today, especially if
you tried to follow along. Much more than that,
thank you for working—usually
unheralded and
Groups
underpaid, often in soul-sucking conditions—to
bring skills, knowledge, and your own humanity to
people so very deeply in need. Really, thanks.
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© 2011 Fred Zackon Permission granted for use by BJA funded RSAT programs
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Next Presentation
Partnering with Public Behavioral Health Authorities to
Build Effective Aftercare Programs
July 18, 2012 2:00-3:00 p.m. EDT
Aftercare programs are increasingly important to public mental health and behavioral health
authorities that are becoming more invested in creating partnerships that serve the needs of
the "whole" client, including those with criminal justice involvement. This includes reaching out
to service systems with which they have not historically had close ties, including
corrections. The goal of this training is to introduce participants to the goals and structure of
state systems of public behavioral health care, discuss the partnerships with corrections
agencies that have been developed, and review the kinds of aftercare programming activities
that these partnerships have produced. Aftercare program theory, research, and practice
relevant for people with mental health and substance abuse disorders will be discussed.
Presenter: Bruce Emery
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© 2011 Fred Zackon Permission granted for use by BJA funded RSAT programs
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