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Transcript + Welcome to the Open Sky Webinar We will begin at 6 pm- see you soon!

Slide 1

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Welcome to the Open Sky
Webinar
We will begin at 6 pm- see you soon!


Slide 2

Stages of Change:
Understanding Your
Loved One’s Process in
Wilderness Therapy

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Presented by Dr. Paul Case, PsyD
Open Sky’s Assistant Clinical Director
Clinical Psychologist
Clinical Therapist, Team D


Slide 3

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Agenda


Introduction to the Transtheoretical Stages of Change Model



The Stages: Pre-contemplation, Contemplation, Preparation,
Action, Maintenance, Relapse



The Stages in wilderness therapy



Supporting loved ones in change outside of wilderness


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+ Transtheoretical Stages of Change Model


Developed at the University of Rhode Island in 1977 by James
Prochaska



Based on analysis and use of different theories of
psychotherapy, hence the “transtheoretical”



This is one measure Open Sky uses in our outcome research
with both adolescents and young adults. Our research shows
all students leave Open Sky with a stronger readiness to
change their problem behaviors.


Slide 5

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The Stages: Pre-contemplation


Entry Point to the change process



Individual doesn’t see that there is a problem to be changed, it
is beyond their awareness



Often it is the people closest to the
pre-contemplator who have the
greatest awareness that something
needs to change



“I don’t have a problem”
not a big deal”
don’t understand what the issue is”

“It’s
“I


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Contemplation


Individual begins to consider the possibility of change



This stage can be rather long lasting and is characterized by
ambivalence



May attempt to reduce the frequency of the behavior or make
resolutions to address it at a future moment



Individuals in the contemplation stage may act out in
increasingly problematic ways



“Maybe I do have a problem”
“Maybe there is something I can work on”
“Maybe this has something to do with me”


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Preparation


Individual has reached a point where they want to make a
change



Committing to getting treatment, researching



Demonstrate an openness to help and support from others



Problem behavior is still exhibited,
addressing it is actively pursued



“I can’t go on like this”
“What do I need to do?”
“I need help”

but


Slide 8

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Action!


Commit to a plan and actively engage in that plan



Sometimes action is externally motived; the individual is
required to engage in treatment as part of their probation



The hope is that the motivation to change becomes internal



Internal motivation produces more sustained motivation to
change and to sustain that change over time.



“I’m checking myself into rehab”
“I commit to attending 90 AA meetings in 90 days”
“I am going to Open Sky”


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Maintenance


Realistic plan for relapse prevention



The change is not yet part of the individual’s internal way of
being in the world and is vulnerable



If returning from treatment, much support
is required to re-enter the “real world”



“I’’ve got a plan”
“I need support”


Slide 10

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Relapse


Generally part of the process



Does not negate gains made



Re-enforces importance of support and maintenance



Important to minimize shame while maximizing responsibility



“I slipped”
“If I relapse, what’s the point?”
“This doesn’t work; I’m a bad person”


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Enter

Permanent
Exit
Relapse

PreContemplation

Contemplation
Maintenance

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Preparation

ACTION

ACTION


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Stages in Wilderness Therapy


Pre-contemplation: This stage often takes place at home,
unless an adolescent student comes in with still no awareness
of the challenges they are facing.



Contemplation: With Young Adults, this
is often experienced at home, leading
the individual to Open Sky. With
adolescents and sometimes young
adults, just being at Open Sky opens
space for students to begin
contemplating., i.e.: “If I am at Open
Sky, there must be something to look at”.

an

a


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Stages in Wilderness Therapy


Preparation: This stage can be characterized by an individual’s
commitment to coming to Open Sky or choosing to go to a next
phase of treatment. Once in wilderness, we see preparation
when a student begins to actively engage in therapy and
positive relationship with their field guides and peers.



Action: Coming to Open Sky for many (especially young adults)
is a strong action. Once here, students in the action stage are
diligently involved with their treatment plan and utilize the Open
Sky treatment resources to the fullest.


Slide 14

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Stages in Wilderness Therapy


Maintenance: This often involves developing an aftercare
treatment plan, which can include everything from a therapeutic
boarding school to a supportive living environment to home
therapy.



Relapse: For some students, we see relapse happen even
while they are at Open Sky: a student struggling with
dishonesty or manipulation can exhibit these behaviors while in
the field. For others, relapse may be tied to a substance or
other stimulus available only away from Open Sky.


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Supporting Loved Ones In
Change Outside of
Wilderness
Educating and understanding where your loved one
is in the cycle can help normalize what they are
experiencing.
It’s important to remember that the stages of change
can be cyclical and it may take many revolutions
before an individual is able to leave the problem
behavior behind.

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Support is needed in all the stages!


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Thank you for
participating!
Dr. Paul Case
[email protected]
970.382.8181

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