Linda Swann, M EdNAMI North Carolina

August 30, 2010

Erratic? Accusatory? Uncooperative? Inflexible? Argumentative? Problematic? Highly emotional? ....

“Fight or flight” mode Culture of honor Pushes my “buttons” Makes it hard to think straight Patience and empathy are at a premium

What is goal of DTC?

What is the goal of the client?

Discuss how to keep goal and objectives “real.”

In small groups, list your (professional) expectations of the Drug Treatment Court (DTC) process:

In small groups, list what expectations of the process may be held by the client:

Is client Hypersensitive to environment or

emotions? Over-reacting to what’s going on? Struggling to stay in control (anxious)? Unable to calm down and refocus? Angry at system, self, or circumstances? Poorly motivated to succeed?

Be confused Be highly emotional Taken by surprise Have had a rough evening Be used to no one believing him/her Overwhelmed Feel totally alone Feel intimidated by professionals in

room Not feel safe

Feel very much alone Be accustomed abandonment at some

pivotal point Expect no one to listen Have difficulty trusting others Be hyper-vigilant, always expecting

danger, or at least, poor outcomes for self

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When feelings are intense… thinking is impaired!!

Concrete, very black and white, thinking

Unable to form reasonable generalizations of process or situation

Rationalizing why goals cannot be reached

Disastrous thinking

Mental filter - Accentuating the negative and discount the positive

Overgeneralization – one event seen as pattern of failure

Mind reading – assuming others are thinking badly of you

Fortune Telling – Predicting that things will turn out badly.

Magnification – Smallest mistake is projected into worst possible outcome.

Labeling and Mislabeling - Generalizing – “I am stupid.” “I am a loser.”

Personalizing– “If anything goes wrong, it must be my fault.”

Learned helplessness – “Nothing ever works for me anyway, so why try?”

Be prepared

Non-judgmental approach

Help client identify what he/she needsWhat is the problem?What do you need from me?

Respond to some “kernel of truth”

Demonstrate a genuine interest

Reflective listeningAcknowledge client’s lived experience, their

realityDirect your response to what he/she must

be feeling (It must be difficult to ….)Communicate that you understandDo not correct or “disconfirm” other’s

viewpoint until you have reflected his/her perception or feelings.

Your focus is on emotional content Airport metaphor

“I” Statements used properly can helpMaintain your self-controlDe-escalate an emotional situationPut onus back onto the client.

Pause if necessary. Walk away if it’s best.

Back-up planBe upfront about process

Tell them what you need. Repeat calmly as needed.

Focus on strengthsBegin with recognizing what client does/has

done wellHelp client to remain goal-orientedBreak tasks into smaller parts if necessaryPraise effortRemember, client and DTC want same

positive outcome “Reframing”

Can a perceived negative be reframed into a positive?

System of Care modelStrength-based, family-friendlyBroad array of services and supportsTreatment Team meetings = heart of

processWraparound approach, front-line service

providersCommunity-based; multi-agency

Be patronizing or condescending Offer unsolicited advice Solve their problems for them Act like they are behaving

inappropriately

Be prepared Seek supervision, input from others De-brief your supervisor

Look for “lessons” Become the observer Work to reorient the system

Chapter one: I walk down the street and there’s a big hole. I don’t see it and fall into it. It’s dark and hopeless and it takes me a long time to find my way out. It’s not my fault!

Chapter two: repeat Chapter three: I walk down a street. There’s a

big hole. I can see it, but I still fall in. It becomes a habit. But I keep my eyes open and get out immediately. It’s my fault.

Chapter four: I walk down a street. There’s a big hole. And I walk around it.

Chapter five: I walk down a different street. Portia Nelson, “Autobiography in Five Short Chapters”