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Crestwood Behavioral Health


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Making Connections through Music

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Music Therapy is playing an important role for clients in their recovery at Crestwood Center Sacramento. And it all starts with the drumming circle that was started by Linda Gerardy, a Registered Music Therapist and Director of Recreation, at the campus. “On our Psychiatric Health Facility (PHF) program, I use music with exercise and movement groups, guided imagery and art, and occasional lyric analysis, but my favorite is a weekly Creative Expression Drumming Group, utilizing various hand drums and hand percussion instruments,” said Linda.  “My mantra to clients is that no musical background is needed to have a successful and enjoyable experience in this group.  It is a rarity to have a client answer “No” to “Do you like music?” and the sound alone has a way of drawing in otherwise reticent clients to see what we’re up to.  The variety of instruments provided, learning their names, sounds and capabilities are intriguing, and in most cases, a source of instant success that is empowering and sustaining.”

The American Music Therapy Association defines Music Therapy as a clinical and evidence-based use of music interventions to accomplish individualized goals within a therapeutic relationship by a credentialed professional, and can help promote wellness, manage stress, alleviate pain, express feelings, enhance memory, improve communication, and promote physical rehabilitation for clients.

“The sound of a drum helps us to notice our own heartbeat, the part of us that keeps us alive and vital,” explained Linda.  Drumming in a drum circle with others can be meditative, but also energizing and invigorating depending on how it is structured.   Specific studies conducted by professionals in the fields of music therapy and mental health show us that drumming reduces anxiety, tension and stress, helps control chronic pain, boosts the immune system and releases negative feelings, blockages and emotional trauma.

“Community effects of drumming allow for an opportunity for participants to feel connected with others and gain a sense of interpersonal support.  This is especially important at our PHF program, where the tendency to isolate is evident with many clients, and the need to develop quick connections to others, who are in similar situations, is needed in order to make all of our program groups more meaningful and beneficial,” said Linda.

There are also both cultural and spiritual connections to drumming for several Native American clients who have come through the campus’ doors.  One client patiently informed Linda and her peers that in her tribe’s culture, the same people don’t both dance and drum, so her contribution to the group was to quietly dance her “shawl dance” in a circle around their drumming.  Another client thoroughly enjoyed the drumming, but felt the need to sing as well, teaching them a song in the Chippewa language, after which they were able to provide the rhythmic accompaniment for her singing.

Another positive aspect of a drumming group is the ability for clients to serve in a leadership position, a role which is often difficult to provide in an inpatient setting.  They have had clients with extensive musical backgrounds who easily and willingly take on this task, but even those without any formal music experience are usually quite successful in taking a leadership role once Linda has modeled it for them.

At Crestwood Center Sacramento, the drumming group will continue to be a wonderful outlet for clients to express themselves through music and helping them with their recovery and wellness goals.  Linda summed it up best by saying, “Music, with a drumming group as one small part, is a medium whereby we can more easily connect with ourselves and others.  It truly is a universal language where people can join together, at times free of the need for verbal communication, to be able to experience life more fully.”

Contributed by:
Linda Gerardy, RMT
Director of Recreation
Crestwood Center Sacramento


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New Programs & Innovative Spaces

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Crestwood Behavioral Health Inc. started a big growth spurt in the spring of 2014 from Solano to San Diego. That year we opened two new distinct programs, with some exciting and significant outcomes and contributions. In April 2014, we opened our sixth Psychiatric Health Facility (PHF) at our Solano campus and in June, we opened our seventh Mental Health Rehabilitation Center (MHRC) on our first campus in San Diego. These programs are very different, but serve the same type of clients at different points in their recovery. The PHF is a soft place to land for clients who need to stabilize during a time of crisis. The MHRC is a gentle, homelike space conducive for clients to transition back into the community. The commonality between both programs is that they share the best of all of the research and practices that Crestwood has used in space conversion and intentional space utilization such as the welcoming room, comfort room, serenity room, living room, dining room and library

The welcoming rooms are dedicated to the ritual of welcoming which is based on the research and information shared by Bruce Anderson of Community Activators. It also reflects the principles of Crestwood’s First Impression program. The welcoming ritual is our way of greeting the new client when they come through our doors. This initial engagement in our welcoming room is frequently one of the most important moments in treatment. The welcoming room has comfortable furniture, fruit and snacks and a quiet, peaceful environment for the client to be welcomed into our facility. The assessment process is also part of our welcoming ritual. We use a conversation approach for the assessment and we utilize the CARF-accredited Primary Assessment that is designed to be a narrative discussion with the client. This has been an effective tool in initiating the relationship with the client, setting them at ease and garnering the most accurate and authentic information.

Crestwood’s comfort rooms provide clients with a calming place to be. We designed our comfort rooms based on extensive literature review, visits to calming and comfort rooms in New York State, attendance at conferences and interviews with experts in the field.  Our comfort rooms are used as a tool to teach individuals calming techniques in order to decrease agitation and aggressive behavior. The goal for clients in using the comfort room is to develop practical skills that can be used in inpatient settings and after being discharged from care.

Our serenity rooms are based on research from a New York State grant on Positive Alternatives to Restraint and Seclusion (PARS) and serve a dual purpose. The first is to provide a space that is calming and self-regulating for clients to be in that then reduces the likelihood of coercive treatment. The secondary purpose is to honor the spiritual growth of each client by creating a sacred space designed to support them on enriching their spiritual journey. Our serenity rooms are dedicated to support the internal growth and opportunity for contemplation, meditation and introspection.

The living rooms in our programs are designed to be an environment that is specifically for the community to congregate and visit. It is based on the promising practice in the Living Room model from Recovery Innovations. The space is less clinical and is as homelike as possible. The colors are comforting and the furnishings are aesthetically pleasing.  This room can be used for community meetings and occasionally for groups and staff interactions. It is a place where people are treated with respect, have choices and feel safe.  The other elements of the Living Room model that are in place include peer providers, Wellness Recovery Action Plan (WRAP), inclusion and comfort. This model is closely aligned with the full-array of trauma-informed care approaches that we employ.

Our library space is designed to provide another indoor space to be used by and for the clients.  This space has resources including self-help books, meditation books and books for leisure. The space is light and open at all times for clients to use.

Crestwood’s dining rooms support our wellness initiative which includes healthy heart diets and exercise. This room is also used for recreation activities, movies, arts and crafts, games and therapeutic groups.

One room that we don’t have in the programs are the restraint and seclusion rooms.  Crestwood has an initiative to eliminate the use of restraint and seclusion so we have created a trend of decreased restraints and a greater understanding and awareness of the issues surrounding their use.  In 2011, Crestwood received a grant from the Substance Abuse and Mental Health Services Administration (SAMHSA) to attend the Effective Use of Peer Programs to Prevent the Use of Seclusion and Restraints Conference in Boston.  Crestwood was recognized at that training as one of the leaders nationally on reducing seclusion and restraint throughout our organization. Our level of seclusion and restraint for similar programs was one-fifth the national average according to SAMHSA consultants. Crestwood incorporates trauma-informed approaches into each program, as well as using WRAP principles and Dialectical Behavior Therapy (DBT) assumptions to create antecedent plans for clients and staff.

As a result of creating these types of innovative spaces in our programs, Crestwood has been recognized by SAMHSA for the effective use of space and the positive effect it has on each client’s outcomes. All of these spaces are designed to provide our clients with the best environment possible to support their recovery.

Contributed by: Patty Blum, PhD, Crestwood Vice President


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Providing a Beacon of Light

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Crestwood’s Psychiatric Health Facilities Providing a Beacon of Light in the Darkest Moments

There is no more significant moment than the moment when you feel the greatest despair, the moment when you cannot find any controls for your emotions and actions, the moment when you find yourself lost in the streets, homeless, hungry and frightened, the moment when you can no longer endure the life you are living. These times generally get you to the door of an ambulance, police car or crisis center. These are the crisis moments the clients who come to Crestwood’s Psychiatric Health Facilities (PHFs) find themselves in the midst of. This moment is pivotal and can be the beginning of a long and dark road of hospitalizations, or an opportunity to embark on a journey of recovery, serenity and peace.

Crestwood has become one of largest provider of PHFs in the state with programs at our American River, Bakersfield, Solano, Sacramento and San Jose campuses.  The PHFs are designed by and for individuals who are in the middle of crisis moments and need a soft place to land. The PHF environments are cozy, with soft wall paint hues of welcoming color and are decorated with carpet and home furnishings to eliminate the sterile hospital environment feel.  When a client first arrives at one of Crestwood’s PHFs they are greeted in a comfortable welcoming room and are provided with snacks and drinks.  Each client’s initial assessment occurs in this welcoming room and is conducted as a soft inquiry interview, rather than a long list of yes and no questions, which helps to calm the client and put them at ease.

Once a client has been welcomed, they are then provided with a tour of the rest of the environment. The PHFs are small programs, accommodating 10 to 16 individuals, yet each has a large, relaxing living room; dining room and kitchen; group rooms; sitting areas for just visiting; and a serenity room with chaise lounges, walls painted darker soft hues, art and music for contemplation, meditation and peace of mind. The bedrooms have homelike beds with comforters and enough space to allow freedom of movement and privacy.

The PHF programs are designed to be open, enabling clients to choose classes each day, as well as to take the time they need for individual healing rituals such as journaling, sharing stories and laughter. The evidence-based classes available to clients include Dialectical Behavior Therapy (DBT) skills, Wellness Recovery Action Plan (WRAP), and Cognitive Behavioral skills training in anger management, self- soothing, assertiveness training, medication awareness, and life-skills training. The creative arts are also provided as another recovery tool that each person can bring with them as they transition back to their home or community.

The support offered at Crestwood’s PHF programs is exceptional.  The psychiatrists are well-versed in recovery methods and a variety of recovery tools, including medication. The licensed clinical staff and nursing staff are trained in WRAP and have extensive training to avoid coercive treatment. The relationship each staff member has with each client is viewed as one of the most healing recovery tools. Another significant support that is available for clients is peers helping peers.

Clients are also provided with transition training to help prepare them to return home or to a new environment. Linkage to community-based providers is vital at this time, as well as family support and education. With the support of the PHFs’ service coordinators, each client is linked to services, understands their aftercare plan and has an idea of where to get help should another crisis arise.

So it is only with love, compassion, hope and ongoing support that the darkest moments can be transformed into the beginning of a sacred healing journey of recovery and peace.  The Crestwood PHFs provide clients who are in this time of crisis with a safe environment that is warm and welcoming and surrounded by others who have been in their shoes and who can hold hope until they are ready to hold it for themselves.

Contributed by: Patty Blum, PhD
Crestwood Vice President