Leave a comment

The Gift collaboration


When a company turns 50 there are moments when you look back and remember the many milestones and accomplishments throughout the years. Crestwood has had many of these milestones and the one common thread throughout our 50 years of memories is our ability to join forces through collaboration and create a synergy to support those who are in need the most. This ability is based on Crestwood’s belief that the best things happen when we engage with and support each other to meet the ever-increasing mental health needs of the people of California. By sharing our resources, we believe we are stronger as a community to serve people with mental health issues. For Crestwood, we recently added a new significant milestone to our history with the opening of our newest Mental Health Rehabilitation Center (MHRC), the San Francisco Healing Center, which was made possible through an amazing collaboration effort.

Collaboration has been defined at Crestwood as the beauty of giving and receiving. It is a partnership, an alliance and a relationship. It is the space where we connect in a common purpose. The San Francisco Healing Center (SFHC) came together through a true collaboration between Crestwood and remarkable people and organizations including the late Mayor of San Francisco, Edwin Lee; the current Mayor of San Francisco, Mark Farrell; Aneeka Chaudhry, the Mayor’s Office Senior Advisor/Health Policy; Barbara Garcia, San Francisco’s Director of Public Health for the San Francisco Department of Public Health; Kelly Hiramoto, Director of Transitions for the San Francis- co Department of Public Health; Maga Jackson-Triche, UCSF Health’s Vice President of Adult Behavioral Health Services; Rita Ogden, UCSF Health’s Direc- tor-Project Manager; John Allen, President of St. Mary’s Medical Center; Lloyd Dean, President & CEO of Dignity Health; and Mark Laret, President & CEO of UCSF Health.


SFHC Ribbon Cutting_preview

Ribbon Cutting Ceremony at SFHC’s Open House (L to R) Barbara Garcia, Mayor Farrell, Lloyd Dean, London Breen, Maga Jackson-Triche and Sister Mary Kieffer


At Crestwood we believe collaboration is a value of the heart. It recognizes the ability to create synergy and requires more than a plan or an intention it requires humility. Humility allows us to recognize and identify when we make mistakes or that others may have better solutions. Humility demonstrates a strength that many organizations shy away from – the strength to learn from mistakes, allow others to take the credit and share the spotlight on support for the people we serve.

Collaboration also requires committed, intentional and active communication. At Crest- wood this communication focuses on transparency, with the intention to enable all parties to have a voice, for messages to be heard, and for respect to be present even during painful confrontations. Communication is built on a foundation of boundaries and ethics. There must be mutuality and respect for communication to be effective.

Listening is another key ingredient in collaboration. Tara Brach, a psychologist, author and teacher of meditation and emotional healing, states that listening is more than a communications skill; it is a capacity that arises from a receptive presence and awakens our awareness. As we learn to listen inwardly, we begin to understand and care more for others.

Collaboration at Crestwood has also grown through gratitude. The opportunity to sense supreme gratefulness is a key ingredient of collaboration. An example of this type of gratitude was demonstrated by St. Mary’s Medical Center offering to lease the 5th floor in their building to our SFHC, so that more mental health services will be available in the community to help this most disenfranchised population.

Our S.F. Healing Center exemplifies another characteristic of collaboration with creativity. This program grew from the belief Kelly Hiramoto had that one day we would find the right location for a recovery-oriented MHRC, rich in evidence-based and promising practices. Kelly then worked with Barbara Garcia to bring together the partnership of San Francisco, Dignity Health, St. Mary’s Medical Center, UCSF and Crestwood to grow the program.

Lastly, collaboration requires patience. Patience is defined as the ability to wait, to continue doing something despite difficulties. Collaboration takes time and there are many bumps in the road, delays and difficulties. Patience allows us to “Keep our eyes on the prize,” which is the ultimate goal. It enables us to weather the difficulties, knowing the outcome, such as the San Francisco Healing Center, will be well worth the struggle and wait.

During the past 50 years at Crestwood, we have had numerous examples of collaboration, resulting from our patience, creativity, gratitude, listening, communication and humility. Crest- wood collaborates every day, at every program and campus, to bring the highest-level of service to our clients. Today, at our San Francisco Healing Center, collaboration has made it possible to have more mental health recovery services be provided to the people in greatest need, which is a victory for all who came together to make it a reality.

Contributed by:
Patricia Blum, PhD
Crestwood Executive Vice President

Leave a comment

The Healing Power of Drumming


Drumming has been a tool used in many cultures for many things, from communication, holistic rituals, community gatherings, and healing.  People have had an intimate connection with the drum since discovering that the beat of the drum is analogous to the beat of the human heart.  As a universal, vibrational language, the drumbeat communes with the Earth and all of her creatures.

There have been numerous research studies conducted about the power of drumming and the significant effects it can have on the human spirit and body.  Drumming is now being used to help people with Alzheimer’s, children with autism, and teens with emotional dysregulation.  Large corporations have also used drumming to help employees focus attention and improve spirits.

Research further suggests that drumming can serve as a distraction from pain and grief by enabling communication between the cerebral hemispheres, using the physical transmission of rhythmic energy.  This allows one to connect with their own spirit at a deeper, more intimate level, making it easier to access feelings of insight, understanding, certainty, conviction and truth.


Drum circles provide an opportunity to connect with groups of like-minded people, including those struggling to find their own personal resonance.  Individuals may make this connection by listening and feeling the pulse of the drum, and working out their own personal rhythm in contribution.

Sound vibrations have been known to resonate through every cell in the body, freeing energy blockages that can form as a result of unexpressed feelings and emotions.  Drumming helps emphasize self-expression, which can aid in an individual’s ability to address emotional health and issues with conflict and even violence.  Participants are given the opportunity to present and receive positive feedback.  It can help us find our center and become more mindful of the present.  Playing in a drum circle can create a magical paradox of moving from the awareness of being out of one’s body to being firmly grounded in the moment.  Group drumming can complement traditional talk therapy, providing a vehicle for personal transformation, as well as community building.

Pam Akins, LMFT, a Clinical Consultant at Crestwood American River Psychiatric Health Facility, said, “Witnessing the responses of our clients to participation in a drum circle has been a personal growth experience for me.  As a clinician, I have had to give up control of the circle and allow the drummers to take what was needed and give as they were able to.  The main attraction is the drum, center of the circle and the heart of healing.  In the PHF setting, some clients are active participants, while others may be observers, but it is evident that some type of shift occurs with everyone involved, even if only momentarily.”

“The most common initial response is that the client does not know how to play a drum or keep a rhythm, but, once an attempt is made, I can see the client respond to the beat that they create, and start to become increasingly more confident.  Instruments are eagerly shared and exchanged.  The circle creates unity and a sense of community among the participants.  Playing along and sharing their hearts, helps the group become centered and calm,” explained Pam.

The experience of conducting a drum circle at a PHF, with clients who are struggling with finding wholeness, has shown Pam and the staff the powerful, amazing and positive effect that beating on a hollowed wooden circle, covered by a tightly stretched membrane, can have.

Contributed by:
Pam Akins, LMFT, Clinical Consultant, Crestwood American River PHF
Nancy Soncrant, Campus Administrator, Crestwood American River

Leave a comment

The Healing Power of Dogs


When he first stepped inside Crestwood San Diego he was thin, weak, and frightened. He had patchy hair from malnourishment and poor hygiene. He had been abused and kept in a small space when he was younger, and he was later abandoned by his first family. He had been forced to live on the streets for some time before getting taken in by the “system.” He would sometimes get aggressive with others and he clearly was traumatized by his past in ways that gave him nightmares that made him toss and turn and cry at night. His legs were weakened and arthritic from being confined when he was young, and this caused him to struggle when walking. He was nervous when he first came to Crestwood San Diego, but he was quickly embraced by both the staff and clients. His name is Gifford and he is a six-year old Chow Chow/Golden Retriever mix dog.

Gifford was adopted with another rescued older Chow Chow/Golden Retriever mix, named Enzo, from a high-kill shelter in San Bernardino by two staff members, Meghan O’Barr, a Service Coordinator at Crestwood Chula Vista and Stephen O’Barr, Director of Nursing at Crestwood San Diego.  Enzo’s first owner was a man with mental illness who ended up hospitalized for a long period of time, which then left Enzo to fend for himself on the streets, until he was picked up by the shelter.

Gifford was so scared and traumatized that he didn’t make eye contact at first, but he was ever so grateful for any petting he received. He required a lot of care, rehabilitation, and exercise before he stepped inside the facility as a therapy dog. He was shy at first, but as staff and clients opened up to him and showed him love, he quickly grew to like spending time at Crestwood San Diego and Crestwood Chula Vista. Like Gifford, Enzo had many trust issues.  He would greet people, but also kept his distance for the first month. It took patience, consistency and compassion for Enzo to get past his trust issues, just like many of our Crestwood clients.  Enzo is now the quintessential “Velcro” dog, always staying close to his family, yet with reassurance, is eager to meet new people and give them kisses.

Michael Bargagliotti, the former Administrator of both Crestwood Chula Vista and Crestwood San Diego, who is now the Administrator of the Crestwood Center San Jose campus, was highly supportive of incorporating pets as part of the therapeutic milieu.  Since September 2015, Michael opened the door to allow several staff members to bring their dogs to both facilities, including Service Coordinator, Maida Ferraes, who brings her dog Rocco; Director of Nursing Services, Fabiola Evans, who brings her dog Riley; and Service Coordinator, Jana Cook, who brings her dog Sammy Thomas. All of these dogs were rescued from shelters, have experienced their own trauma and now love their new lives as the dogs of Crestwood.

The dogs add to the feeling of a warm and homelike atmosphere that Crestwood MHRCs strive to create with a living-room milieu. They don’t just bring cuteness, fur and fun to the two programs; they have made connections with some of the clients who suffer from the worst paranoia and anxiety and who often push most people away. Studies have shown that pet therapy helps clients by lessening depression, decreasing feelings of isolation, encouraging communication, providing comfort, increasing socialization, lowering anxiety, and reducing loneliness.  Gifford recently helped a client with suspected sexual abuse to feel safe and comfortable enough so that they could start opening up to the staff. Gifford was also the mascot at the first San Diego vs Chula Vista kickball tournament, and he even makes appearances at IDT meetings so that clients can feel more comfortable in discussions that may be sometimes stressful.

One client coping with manic episodes at Crestwood Chula Vista refers to Rocco as “my boy” and their shared exuberance and energy makes them the best of friends.  Rocco has been instrumental in reducing this client’s symptoms with simple, every day dog activities, such as walks and games of fetch. Like Gifford, Rocco struggled with his relationship with other animals and underwent training with a behavioral therapist, an experience that many clients can relate to. Sammy Thomas, who one of the clients calls, “Jana’s Lamb,” is a gentle boy, who like some of our clients, suffers from a severe medical condition.  Sammy experiences seizures and takes medication daily. Jana and Meghan both use their dogs’ medication needs to help normalize medication management and this helps many of their clients realize that Sammy and Enzo are just like them.

Clients at Crestwood San Diego and Crestwood Chula Vista have watched with delight as love and care have transformed Gifford from a nervous, half-lame dog with patchy fur, into a big, friendly bear with a beautiful, thick coat. The message our clients get is that if Gifford can grow and change, then so can they.  Just as the staff is deeply satisfied by their clients’ growth and successes, the clients have taken great joy in seeing the recovery and resiliency of our Crestwood dogs and know that they are capable of recovery too. Several clients have grown very attached to the dogs and look forward to each of their visits. These amazing dogs have awakened empathy and affection in many of our clients through their unconditioned love and presence. They both share a lot of trauma and suffering in their pasts.  They also share a simple need, which is to be loved and to know that they are not alone and they can give each other that powerful, simple love that makes them both stronger and happier.  That love, togetherness, and understanding are the mainstays of recovery, and are what makes Crestwood so special.

Contributed by: Meghan O’Barr, Service Coordinator
Crestwood Chula Vista
Stephen O’Barr, Director of Nursing, Crestwood San Diego

Leave a comment

Crestwood’s Journey


I first learned about Crestwood four years ago in Boston, where I met Mertice “Gitane” Williams, Crestwood’s Vocational Wellness Educator, at a Trauma Summit hosted by the National Center for Trauma-Informed Care. My introduction to Crestwood and subsequent work with Crestwood has had a profound effect in my personal and professional life.

I train and consult on creating trauma-informed systems all over the country and in some other parts of the world. As many of you know, trauma-informed care (TIC) is about operating from a set of values consistent with trauma-informed principles. First and foremost, Crestwood values are very much aligned with the values of TIC. But more importantly, Crestwood lives and practices its values, which makes it a trauma-informed organization.

Creating trauma-informed organizations is a journey. This journey can be difficult and challenging, but rewarding. Crestwood understands this and has made a commitment to this journey for the long haul. This is what makes my journey with Crestwood unique. I have assisted many organizations in this journey and some organizations introduce TIC as a “flavor of the month”, and then later that energy fades away. But this is not the case at Crestwood. Two years after my big training for Crestwood on TIC, the DVD of that training remains mandatory viewing for their new staff orientation. Of course, I still blush when I walk into a program and get recognized from that DVD!

Trauma-informed care is about healing. There are experiences in all our lives and our clients’ lives that leave an emotional wound, and some of those are deeper than others. A very wise Native American psychologist once said that trauma is the “wound that does not bleed.” Therefore, our job is to create a system of care that ultimately helps heal these wounds. We can call it many names, but ultimately most everything we do boils down to promoting healing. Crestwood understands this concept and that is why the many initiatives that Crestwood embarks on helps people heal. For example, the development of welcoming rooms to replace intake/admission rooms is a significant move towards healing. When clients walk into a Crestwood building, their first encounter is to walk into a room that says, “We are here to make you feel safe and wanted” versus “We are here to fix you.” Practices that empower clients to manage their treatment honors clients’ self-determination. Also the preponderance of rocking and sliding chairs in the programs provides rhythmic and repetitive movements for self-soothing and building new self-regulatory pathways, which are important in a client’s healing journey.  All the environmental improvements and enhancements convey the message to your clients and staff that you provide them with a place to live and work that reflects their importance in this world. The Dreamcatchers Empowerment Network program is not just a vocational program, it is a program that helps clients rediscover and reinforce their worth in this world and that they can make a difference.

There are many big and small things that are being implemented throughout Crestwood. I urge you to view all of these as steps in the healing journey and that there is no deed too small to make an impact on healing. There is no job or function that does not contribute to this journey.  The Crestwood motto, “It’s About Growth” is founded on the understanding that it is hard to grow without healing from the past. Practicing trauma-informed approaches is akin to preparing and tilling the land to ensure growth is possible. A good gardener knows that it is important to know the nutrients that already exist in the soil in order to supplement and enhance what is already there.  This is why it is also crucial that you recognize and honor the many years you have been conducting healing practices with your clients. Your journey is in discovering and implementing healing practices that will augment the wonderful things you all are already doing.

Lastly, I thank you all for the privilege in making me a part of the Crestwood journey!

Contributed by:
Raul Almazar
Almazar Consulting & Senior Consultant to the National Center for Trauma Informed Care.

Leave a comment

The Healing Garden


Liberty Hyde Bailey, a renowned American horticulturist, botanist and cofounder of the American Society for Horticultural Science once said, “A garden requires patient labor and attention. Plants do not grow merely to satisfy ambitions or to fulfill good intentions. They thrive because someone expended effort on them.” At Crestwood Manor Modesto, their residents demonstrate exactly that philosophy with their Healing Harvest Project. The Healing Harvest Project is part of the facility’s vocational rehabilitation program, which consists of offering three types of jobs for residents – staff assistants, peer assistants, and caring for plants, animals, and the environment with the Healing Harvest Project.

The Healing Harvest Project gives residents the opportunity to put their hands in the dirt and have the ability to enjoy outdoor time, while being simultaneously productive, industrious and a contributing member to the Crestwood community. “I like being outdoors, and having the freedom,” said one resident who is working in both the vegetable and flower gardens.


The volunteer residents participate in the garden’s care and cultivate its growth, making it into a serene and beautiful place. It also gives the residents tools and skills, which they can use in the garden, as well as in their life. It has been shown that gardening is a genuine therapeutic tool for some and can help improve memory, cognitive abilities, language capabilities, socialization and problem solving skills. Furthermore, gardening can help strengthen muscles and improve coordination, balance, endurance and overall health. One resident who works in the flower garden commented, “I like to water, it’s calming and relaxing.”

The gardens are often filled with beautiful flowers and nutritious vegetables and fruits that are used throughout the facility. The head of the vocational rehabilitation department, Judi Jimenez, makes great use of the flower garden, conducting a flower arranging group when they are in bloom. Dietary Supervisor, Rene Springfield, teaches nutrition groups, and Behavior Specialist, Michael Russ, who has a Culinary Arts degree, conducts a cooking group with geriatric residents using produce from the garden. Activity and program staff also teach independent living skills, focusing on food preparation with various cultural delights being created, always with delicious results.

The benefits of the garden are not just for the residents, but for the staff as well. On occasion when things get tough and staff need a moment to relax, the garden offers a beautiful place to rejuvenate, smell the flowers and realize that this amazing garden is a product of the residents’ hard work and a reminder of the importance of what they do each day.

Contributed by:
Robert Leavy, Director of Program Education
Leslie Darouze, Program Director
Crestwood Manor Modesto

Leave a comment

Healing Trauma


Most of us have suffered some degree of trauma during our lifetime.  A glimpse at human history shows us that we live in a traumatized world.   Since trauma is not fully acknowledged as a universal experience that requires continued attention, in many cases, it perpetuates.  It is crucial to recognize our unaddressed trauma because a high degree of stress does not merely cause discomfort, it disturbs us physiologically, mentally, emotionally, and spiritually.   We begin to operate from the part of the brain directing survival instincts rather than from an integrated, whole-brain perspective.

The question of how best to heal trauma is a complex issue.   The Strategies for Trauma Awareness and Resilience (STAR) program, led by Carolyn Yoder, helps to clearly outline the causes, types, effects, obstacles, needs of trauma, as well as breaking the cycle of trauma.  “Unaddressed traumas affect not only those directly traumatized, but their families and future generations,” says Carolyn Yoder.

These are all valuable concepts to consider and/or revisit for people who work in the mental health field.  It is also beneficial for our personal healing.  The more importance that is placed on self-awareness and growth, the greater amount of internal resources can be found to handle triggering events and unresolved pain.  Our capacities expand, building a repertoire of emotionally-intelligent responses to pain rather than dissociating or denying our trauma.  Conversely, if our society were to fully recognize its trauma, we would be less likely to place labels on the already wounded.  This would not only bring more awareness toward how trauma is treated, but would instill more compassion towards the traumatized.

Breaking the cycle of trauma requires fortitude and courage.   It begins with the acknowledgement of the traumatic incident(s). The process of self-inquiry, grieving and honestly identifying fears is deeply transformative.  As Yoder states, “it unfreezes the body, mind and spirit so that we can think creatively, feel fully, and move forward again.”

Trauma healing is about transformation.  Through personal reflection, we can break our own cycles.   By creating our own personal healing practice, we move a little closer to a society that endeavors to do the same.

At Crestwood, we take a trauma-informed approach to care that includes being aware that the majority of our clients experience trauma and that the trauma then becomes the lens through which they view and experience the world.  The initial trauma-informed care training Crestwood received came through a SAMHSA grant. It has impacted the design of our programs in the environmental planning with comfort rooms, a library area and a Serenity Room.  The training included an introduction to trauma-informed care services and an overview of creating a trauma-informed care service model for our programs. We are continuing to work with trauma consultants, such as Raul Almazar, from Almazar Consulting & Senior Consultant to the National Center for Trauma