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Crestwood Behavioral Health


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An Innovative Neurobehavioral Rehabilitation Approach

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National Award Recognizing Dr. Gordon Muir Giles’ Innovative Neurobehavioral Rehabilitation Approach at Crestwood.

Crestwood Behavioral Health’s own Dr. Gordon Muir Giles, Director of Neurobehavioral Services at Crestwood Treatment Center in Fremont and Idylwood Care Center, was awarded the most prestigious honor related to clinical practice in the occupational therapy profession, the Eleanor Clarke Slagle Lectureship Award. This award was made in recognition of his “innovating the clinical practice of cognitive neurorehabilitation” through his groundbreaking work with clients who have severe neurological impair- ments.

Dr. Giles was presented with the Eleanor Clarke Slagle Lectureship Award by the Ameri- can Occupational Therapy Association (AOTA) at its 2017 Annual Conference and Centennial Celebration on April 1st in Philadelphia. The Eleanor Clark Slagle Lecture- ship Award was named after a pioneer of the occupational therapy profession, and recog-nizes achievements in research, education, and clinical practice that make substantial and lasting contributions to the occupational therapy profession’s body of knowledge.

This award recognizes Dr. Giles’ efforts to improve the lives of Crestwood’s clients through innovative clinical practices, including his relational neurobehavioral approach to neurorehabilitation. This non-aversive method, which has been described as “relentless kindness,” assists clients with severe behavioral and emotional problems by empowering them through person-centered care and building positive relationships with them, rather than relying on confrontation, seclusion, or restraints. Dr. Giles uses this compassionate approach to treat clients whose neurological impairments have caused many of them to fail in other treatment settings due to difficult-to-manage behaviors. An example of this compassionate approach is being used with a client at Crestwood Treatment Center, Fremont who has had post-severe Trauma Brain Injury for 23 years. This client believes that he is a billionaire and that people are stealing his money. He would joke to the staff that they are stealing from him and if they would joke back, he would become very upset. To help deescalate this behavior, the staff now meet with him daily to review any areas of concern, assist him with solving any perceived problems, review his finances with him weekly and have him sign-off on any expenditures. Additionally, the staff responds to any of his questions about money by stating that taking money from him is unlawful and that if they did steal from him, they would go to jail. This increased focus on interpersonal factors and therapeutic relationships has made an amazing difference in this client’s life by helping to reduce his anxiety, stress, and negative attributional bias.

“This is the greatest honor of my professional life,” said Dr. Giles, who has written books and articles on the subject of neurorehabilitation. “It will absolutely raise the profile of our work at Crestwood and our innovative approaches to the practice of neurobehavioral rehabilitation.”

Karen Scott, Program Director at Crestwood Treatment Center, Fremont said, “The positive impact Dr. Giles has made with both his clients and colleagues is immeasurable. He is a tireless advocate for persons with neurobehavioral differences.”

As part of winning the Slagle Award, Dr. Giles will deliver an AOTA lecture in 2018 that will discuss how best to meet the needs of clients with neurobehavioral disability in a changing healthcare environment.

Contributed by:
Karen Scott, Program Director Crestwood Treatment Center, Fremont


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The Lessons of Change

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At Crestwood Center San Jose MHRC, they have been going through major changes, both physically and programmatically. The campus has undergone major reconstructive surgery, and now has a beautiful design similar to our other Crestwood programs. The design changes have brought about a more homelike environment and their clients are enjoying new areas, such as two living rooms, a comfort room, a serenity room, a group room, a library, and a den. Walls have been painted in soothing colors, lovely decor has been placed throughout the building, and new, stylish flooring has been installed.

San Jose Dining Room

Crestwood San Jose’s new design of their dining room also includes a living space that clients can also use for Xbox Connect games, karaoke, and entertainment when eating their meals.

On the program side, a mindful effort has been made to not only embrace the Crestwood Values (Family, Commitment, Compassion, Enthusiasm, Collaboration, Character, and Flexibility), but to also actively practice them in the staff’s daily activities. They have also incorporated a more comprehensive program schedule, opened up the patio area, and expanded their outing and pass policy. With these efforts, they continue to maintain the important focus on recovery, program success, and preparedness for community re-entry for their clients.

During this remodel and program changes, the staff learned some important lessons, such as any major change starts with the Administrator and Department Heads, and then it needs to be embraced by the entire team. “The change process may be challenging for some, even if it is perceived as positive or good, because it means saying goodbye to what we are familiar and comfortable with,” said Angele Suarez, the MHRC’s Program Director. Campus Administrator, Michael Bargagliotti, added, “It is human nature to be drawn to comfort and security, regardless of the outcome, because it is something that is known and we know what to expect. The change process introduces an insecurity and emotional instability that can cause people to react with resistance, fear or anger.”

To help with managing the challenges of change, the staff at Crestwood Center San Jose found that implementing a few key measures such as maintaining an open mind, being optimistic, asking questions and helping others with the changes, made a huge difference in how everyone dealt with what was happening around them.

“By maintaining an open mind, even though we may not always agree with the changes being implemented, we can actively listen and analyze the information, and then we can form an honest and genuine opinion about the changes. We might even surprise ourselves on how much we like the ideas,” said Angele.

The staff found that by being optimistic, even though people might be currently unhappy with the changes, can be helpful since negativity usually comes from a fear of the unknown. By not being able to predict the future, a good strategy is to then focus on the present moment with a positive attitude, which can create an optimistic outlook towards the future.

The staff also encouraged everyone to ask a lot of questions because it is important for each person to not only be notified of the changes that are occurring, but to also understand the reason behind the changes. Asking questions provides everyone with the needed information to make informed choices.

“And we found that one of the best ways to help ourselves with change is to focus on helping others with change. Helping others takes the focus off ourselves, allowing us to connect with our peers, and we can then become a part of the change process through positive interactions,” said Angele.

“At Crestwood, we know that we will always be part of innovative recovery practices and leadership. The best part of innovative change is that you end up creating a culture that is not only open to the concept, but takes on that personality. At Crestwood Center San Jose, as we continually work towards providing the best recovery program for our clients, going through change will allow us to continue our evolution, and never stop searching for our better self,” said Michael.

Change is inevitable in life and usually out of our control; however, how we respond to the change is completely in our control. How will you choose to change and how will you choose to respond? It is all up to you.

Contributed by:
Angele Suarez, Crestwood Center San Jose MHRC, Program Director,
Michael Bargagliotti, Crestwood Center San Jose, Campus Administrator


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Empowering Peer Support

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Last November, Humboldt County Department of Human and Health Services, through a grant from California Office of Statewide Health, Planning and Development (OSHPD) hosted a 10-day Peer Support Specialist Certification training that was led by Recovery Innovations (RI) to train 10 mental health staff and volunteers in the Eureka area. A lucky member of our Crestwood Eureka campus, Rebecca, a Peer Support Specialist through Dreamcatchers Empowerment Network, was invited to attend. This training is designed to enhance the peer support skills of participants, while empowering them to be more self-directed and competent in providing recovery and resilience services to clients.

“The Peer Support Specialist Certification training turned out to be one of the most interesting classes I have ever taken. I was excited to be included in the two-week course, which opened new doors for me to learn how I could partner and relate to people seeking services,” said Rebecca.

It has been a year since Rebecca began working as a Peer Support Specialist at Crestwood Eureka, and she is grateful for the conceptual framework and the set of skills which this training gives to her job. “I felt empowered to learn these things in the company of other peer support and mental health workers, who have been working to combat stigma and provide support within the county mental health system,” said Rebecca. “I have learned to better understand my role in the comprehensive health facility that I work in. I have gained valuable resources to guide me, to set my own goals, and to provide meaningful direction for my work.

Peer Support in Eureka

Rebecca (left) and Kelli Jack, Director of Hope Center in Eureka (right), proudly displaying their certificates from the Peer Support Specialist Certification Training.

This Peer Support Specialist Certification training provided a wealth of a wealth of information and skills to participants. Rebecca reported that the train- ing was relevant not only to her, but to anyone doing mental health work. She said, “The concept of helping people find their own strengths to make decisions leading to recovery is a powerful idea and is useful at any level of the mental health community.”

Contributed by:
Rebecca, Peer Support Specialist, Dreamcatchers Empowerment Network, Crestwood Eureka Campus


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The Importance of Peer Providers in the Workforce

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There was a time when a person receiving behavioral health services was simply looked on as a client. They were identified as the targeted person or the recipient of services. They generally looked to specialists to understand and treat their symptoms, their discomfort or disease. They were dependent on the system to take care of them. There was no reciprocity, no mutuality and no equality. Often there was no actual relationship, no trust, no compassion and sadly, there was no hope.

There was a time when a person receiving behavioral health services was simply looked on as a client. They were identified as the targeted person or the recipient of services. They generally looked to specialists to understand and treat their symptoms, their discomfort or disease. They were dependent on the system to take care of them. There was no reciprocity, no mutuality and no equality. Often there was no actual relationship, no trust, no compassion and sadly, there was no hope.

But today the good news is this view in behavioral health services is changing for the better. And at Crestwood, you can see the changes we have embraced in the behavioral health services we provide that are filled with hope, compassion, integrity and love. One important way we do this is to have services at Crestwood be directed by peer providers, who are people who have been clients or who choose to self-identify as a person with lived experience. Crestwood actively recruits staff with this type of lived experience and this perspective, and we refer to it as the peer experience. We also pride ourselves in employing peer providers at all levels of our organization, including at our corporate executive level, all leadership levels, as well as in the direct care areas of our organization.

The Human Resources practice of recruiting, hiring and employing people with lived experience is based on the mounting research that has led peer-provided services to be identified as an Evidence-Based Practice and one of the highest factors to eliminating coercive treatment. At Crestwood, we have found that by having peers in all levels of employment, the use of restraint and seclusion has dropped by more than 92% in the past 8 years.

Peers, whether an RN with lived experience, a Vice President who has family member dealing with mental health issues or a bookkeeper who has been hospitalized for depression, all bring the gift of empathy and understanding to our clients that other staff may not be able to provide. Our programs have become richer and more effective and most importantly, there is hope, meaningful engagement, empowerment and strong, well-defined career paths with opportunities for growth reaching to the highest levels of Crestwood leadership. This practice is the true essence of integration and meaningful roles.

Peer Providers enrich our programs for our clients on a daily basis that benefit everyone and provide a supportive and understanding resource that only they can offer. When our clients know that a staff member, who is there to help and support them, has also been through similar issues in their life, they know they are not alone and that they too can succeed in their recovery.

Contributed by:

Patricia Blum, PhD Executive Vice President