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Crestwood Behavioral Health


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Celebrating Goodbyes

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Imagine a group of people sitting in a circle coming together for a unified purpose, to celebrate the graduation of one of their own. The graduating peer excitedly sits in the middle of the group, with a huge smile on their face, because their day has finally come; they’ve made it to graduation! A beautiful rock has been painted and tailored specifically for that person. The rock is passed around the circle into the hands of all those in attendance, as they share their memories and best wishes for the graduate. Within that rock all the good thoughts are wrapped up into it and then given to the graduate.

At Crestwood Chula Vista, they started a tradition to honor their graduates. When faced with their first successful graduation in December 2015, they wanted to start a special and unique tradition, so they gathered together the people they serve and asked how they would like to celebrate their graduation. Many of them offered insightful and valuable input and all these great ideas were then considered by the community. When all was said and done, the most popular idea for a graduation ceremony came from one of their dearest residents, who has since graduated, to start a goodbye group with a “good memories” rock. The good memories rock, which is decorated according to the desire of its future owner, is passed around from person to person in a circle that surrounds the person who will soon be leaving the campus. Each person who holds the rock is then asked to speak, sharing kind words, dear memories and warm wishes to the graduate. And so, the tradition for their peer goodbye group was created and continues to this day.

For the last goodbye, right before the graduate is completely discharged, they go through what is called their “High-Five Goodbye.” Clients and staff line the sides of the hallway leading to the exit with extended hands and then whistle, cheer and chant the graduate’s name. The graduate walks down the hallway, usually with a huge smile, and receives high-fives, and sometimes hugs. Some cry, some laugh, and some shout. The one thing they all have in common is their excitement to move onto the next chapter of their lives and recovery; they’ve made it!

This tradition has carried over to not just client graduations, but also when their staff move on from Crestwood or are promoted to other campuses. Wanda Anderson, Service Coordinator at Crestwood Chula Vista, said, “Goodbye groups provide closure for staff and the people we serve and are a wonderful opportunity to give honor to those who so deserve it. We love our special tradition and if your campus does not have a tradition to honor your graduates, we hope that this may inspire you to start one of your own.”

Submitted by:
Wanda Anderson, Service Coordinator and Shanel Stec, Activity Coordinator,
Crestwood Chula Vista

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The Power of Meaningful Roles

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Crestwood Behavioral Health’s whole person approach to healing, wellness, recovery and resiliency includes a focus on enhancing or developing a meaningful role in one’s daily life. As psychiatrist and Holocaust survivor, Viktor Frankl, observed, “Life is never made unbearable by circumstances, but only by lack of meaning and purpose.” Research in positive psychology has found that a meaningful role can lead to a positive attitude, increased happiness, sense of belonging, sense of purpose, increased self-worth and promotes self-accountability.

At Crestwood we embrace the need for meaningful roles and it is one of our four Pillars of Recovery that also includes Hope, Empowerment, and Spirituality. It is defined as positive identities within the places we live, learn, work and socialize, which creates a sense of purpose and value. Crestwood’s healing and resiliency-building campuses promote this in many ways. The people we serve contribute daily to our campuses, including co-creating schedules of activities, participating in the functions of the day and educating staff, either through co-presenting at staff education meetings or participating in change of shifts.

Meaningful roles also come from those we are in a relationship with. Our clients are recognized and valued for their relationships as a roommate, parent, child and community member. As a community member, our clients contribute in positive ways such as volunteering at local homeless shelters or animal rescue groups. Clients often also take on the role of teacher or mentor as they come together to support their fellow residents in their healing. Our Crestwood campuses also provide opportunities for meaningful roles through shared group activities such as art shows and sporting events like the Crestwood Olympics, where more than seven campuses get together for fun and friendly competition.

At Crestwood, opportunities for meaningful roles for our clients do not stop at their discharge. Clients are supported in their recovery and wellness journey by being given the chance to come back and contribute through sharing their personal experiences of recovery at our campuses, volunteering in our communities or continuing with a job they achieved through Dreamcatchers Empowerment Network. Patty Blum, Crestwood Executive Vice President, says, “Supporting and encouraging meaningful roles at our campuses helps to provide our clients with a connection to their values, ethics and higher selves. All of these responsibilities -great or small- give their daily existence purpose, and as such, become their meaningful roles.”

Contributed by:
Cindy Mataraso, Director of Operations
Crestwood Sacramento Home Office


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The Healing Power of Drumming

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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.

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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
and
Nancy Soncrant, Campus Administrator, Crestwood American River


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Choosing Recovery

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Recovery is a choice; a person has to choose to be willing to work on their own recovery and actively participate in determining what recovery means to them. Not only is recovery a choice, it is an ongoing choice that is deeply personal and one that a person has to keep choosing every day, even though it may be difficult at times.

At Crestwood Center at Napa Valley when a client is not ready to begin their journey of recovery, we let them know that we are here to help them when they decide they are ready. We are able to offer compassion, support and empathy in a non-judgmental manner. We offer a variety of opportunities they can participate in that will hopefully make their choice for recovery easier such as WRAP, DBT, working for Dreamcatchers Empowerment Network, art therapy, and various addiction-based recovery groups. Independent studies are also available for those not comfortable in groups.

Once one of our clients makes the decision to begin their journey of recovery, it then becomes an ongoing choice, a new habit and a new way of life for them. Eventually, choosing recovery for them becomes easier. Recovery may be difficult for so many reasons such as facing uncomfortable thoughts, doing things they may not want to do, and even things they may believe are unnecessary. Sometimes the process of recovery includes not having much power or control over one’s own life for a time. So we try to provide our clients with tools, skills and plans they can use to gain empowerment and independence. Sometimes the realization of having to make the choice of recovery for the rest of their lives can be overwhelming, but we always remind them to take it one day at a time.  We encourage them by letting them know that when recovery does become a habit, it stops being so daunting.

The work we do at Crestwood Center at Napa Valley can be frustrating at times because we cannot force a client to work on their recovery, as much as we want it for them. But more often than not, our work is very rewarding when we can help a client with their recovery. We can never give up hope and instead we can hold the hope for the hopeless and support their decisions. We can continue to help others discover their own path on the road to recovery by offering counseling, encouragement, our life experiences and our strengths. Our goal is to let our clients know that recovery is a choice that is worth making, so that they can maximize their life and achieve a sense of balance and fulfillment.

Contributed by:
Cheri Tugmon
Service Coordinator
Crestwood Center at Napa Valley


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Supporting Recovery with WRAP

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At Crestwood Bakersfield, Wellness Recovery Action Plan (WRAP) is an important part of the healing and recovery process for their clients. Their motto and goal is to stay well by playing and focusing on their key recovery concepts, which include hope, personal responsibility, education, self-advocacy and support.  WRAP is used to learn to uncover each person’s own wellness tools and put them into action on a daily basis. Many of the WRAP activities they have incorporated into their classes are team building activities, which help others learn how to work as a team, increase problem solving skills and improve communication.

“Our goal is to incorporate more fun, interactive and competitive activities into our WRAP trainings.  Just recently I developed a WRAP Trivia/Crestwood Family Feud game which has been helpful in understanding why WRAP is such a vital part of our lives,” said Linda Johnson, Director of Recreation Therapy.

Another creative way Crestwood Bakersfield is presenting WRAP in their programs is by having individuals team up into pairs, with the assignment to create and design a WRAP community in which people would enjoy living.  This exercise is not only a lot of fun for the clients, but it also brings communication, group understanding and decision making skills in to play.

“Since so many of us enjoy being in a peaceful setting, we have also incorporated a beach theme into our WRAP classes this summer, with ocean sounds, beach sand, sea shells, candles, lounge chairs and many other soothing items which seem to help ease the pressure of daily life,” explained Linda.

Crestwood Bakersfield continues to find wonderful ways to support clients in their recovery through innovative WRAP activities and they love to say, “We are playing. What are you doing to stay well?”

Contributed by:
Linda Johnson
Director of Recreation Therapy
Crestwood Bakersfield


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Collaboration Changes Lives

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It’s unusual to observe collaboration as it is happening. It is far more common to celebrate the success of collaboration after its culminated.  Crestwood’s collaboration with San Diego Health Care Hospital system and San Diego County Behavioral Health Services has provided an incredible opportunity to observe it in real time with measurable milestones and outcomes.

This collaboration story began in 1992 when a case manager from San Diego County was seeking a placement for a very challenging client and a Crestwood facility in northern California was willing to take a chance. Later that case manager’s program manager got a chance to visit this client at the Crestwood Facility in northern California. What she saw there that day left a very positive impression that she remembered for many years to come. This was the first collaboration between Crestwood and San Diego County and set the stage for future events. Fast forward to 2013 when that very astute and dedicated program manager, Anna La Rocca Palid, LCSW, who is now a leader as a Behavioral Health Program Coordinator in San Diego County Behavioral Health Services, contacted Crestwood about the need in San Diego County for secured behavioral healthcare services. The county had grown tremendously and there were more challenging people to serve and insufficient programs to serve them. They needed a provider to work with the community and them to serve at least 40 clients requiring intensive, secured, recovery-based services. The county also wanted a provider who thinks outside the box, has creative individualized employment programs, recovery services and focuses on integrated alternative tools for clients and they chose Crestwood to be that provider.

Crestwood and San Diego County Behavioral Health Services began devising a plan to address the county’s needs. Crestwood found a beautiful site for a 42-bed Mental Health Rehabilitation Center (MHRC) on a hospital campus in San Diego and created the first of two programs – Crestwood San Diego. Crestwood San Diego opened in June 2014 and quickly filled up with 42 clients. Before long, there was a flow of individuals successfully reintegrating into the community and new admissions moving into the program. The hospitals in the area felt a sense of relief and the new services served their purpose with helping many clients with their recovery.

Soon Crestwood San Diego was full and the San Diego County behavioral healthcare system again felt the pressure of impacted Emergency Departments, long waiting lists at the psychiatric hospitals and a bottleneck in the mental health system. So they looked among themselves to find a possible location for a 40-bed MHRC. Paradise Valley Hospital found a location that would work. Crestwood and Paradise Valley Hospital started discussions about creating a 40-bed MHRC on this site. Dimitrios Alexiou, FACHE, President and CEO of The Hospital Association of San Diego and Imperial Counties and San Diego County Behavioral Health Services worked very closely together to successfully garner support from the San Diego County Board of Supervisors and the community to commit to the 40-bed MHRC in Chula Vista. Crestwood and Paradise Valley Hospital invested significantly in an extensive refurbishing project to create a beautiful, homelike, welcoming recovery-based MHRC known as Crestwood Chula Vista. Crestwood Chula Vista opened in July 2015 and is Crestwood’s ninth MHRC in California.

Collaboration is working with others to do a task and to achieve shared goals. The wonderful collaboration of these groups created an environment that enabled San Diego County Behavioral Health Services to provide beds to some of the clients in greatest need for these services, helping them with their recovery and easing stress in the community and local hospital emergency rooms. It is clear to see that through collaboration we can make a difference.

Contributed by: Patty Blum, PhD
Crestwood Vice President


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Building Resiliency in the Treatment of Trauma

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Resiliency is the ability to recover readily from illness, depression, adversity, or the like, and is one of the cornerstones to health and recovery for individuals and communities. Trauma is an emotional and psychological result of extraordinarily stressful events that shatter a person’s sense of security, making them feel helpless and vulnerable in a dangerous world. The necessity to treat and heal trauma has never been more evident than in today’s environment and culture. In recovery services, treating, mitigating and preventing trauma is a primary expectation for us at Crestwood. It is the starting point for most people as they embark on their recovery paths. The ability to restore and build resiliency through a variety of trauma-informed techniques, including engagement, resourcing, spirituality and somatic work is the basis for this integrated trauma-approach to services.

The research in neuroscience provides a foundation for the understanding that neuroplasticity and neurogenesis enables the brain to reprogram and develop new pathways for survival and growth. This has led to an understanding that we can expand the resiliency skills, thus enabling people to be less vulnerable to re-trauma, prevent trauma and heal existing trauma.  The premise is that if you teach a person to identify and access their resilient innate abilities, aptitudes or inner wellness tools, the individual can practice using these tools as a means to heal and prevent trauma. These tools are skill-based and use a wide-range of evidence-based practices, promising practices and spiritual practices as the building blocks. The practices are integrated and enable the staff at Crestwood to walk with our clients, support and stand behind our clients and guide our clients when needed.  The skills and practices are based on the premise that you meet the client exactly where they currently are.  This methodology creates a client- centered and culturally-sensitive service model.

Recovery services now have shifted from patterns that created ongoing dependency for clients, to interventions that support resiliency, self-reliance, and prevention. This trauma-informed model of building resiliency enables our clients to become more empowered, more independent of the mental health system, and more intimately connected to their communities. As Crestwood programs seek to build resiliency in our clients, communities benefit from mitigating the trauma from occurring in the first place, reducing the likelihood of diagnosed conditions recurring, and build resiliency through the community.

Trauma-informed care approaches have been the basis of the resiliency skills building. At Crestwood we utilize these trauma-informed care approaches along with culturally-sensitive multidisciplinary approaches and integrating spiritual practices by utilizing evidence-based practices including Wellness Recovery Action Plan (WRAP), Dialectical Behavior Therapy (DBT), and Peer Providers to provide a rich source for mitigating and healing the impact of trauma for our clients.  In our Crestwood programs we will continue to work with and support our clients with developing resiliency skills to create a strong foundation from which they can build from and use in their recovery.

Contributed by: Patty Blum, PhD
Crestwood Vice President