176 Sociological Approach to Reducing Risk and Increasing Resilience Live Addiction Counselor Certi

This episode was pre-recorded as part of
a live continuing education webinar. On demand CEUs are still available for this
presentation through ALLCEUs. Register at ALLCEUs.com/CounselorToolbox. I’d like to welcome you to today’s
presentation on the sociological approach to reducing risk and building
resilience. As I was putting together This presentation it was kind of like
right in the wake of when Harvey hit. And then you know recently we’ve had the
shooting in Las Vegas, and some of the counselors, especially counselors in
training that can’t practice independently yet that are in some of my
social media groups and in my professional groups have been talking
about how frustrating it is and even some of us who are licensed but we just
can’t like up and go help the Red Cross right now about how frustrating it is
not to be able to help and how much we want to help so what I usually do
because you know I I’m generally not upwardly mobile where I can just drop
everything and go to a crisis and what I did after 9/11 was look at what things
in that situation could I positively impact and how could I do it in a way
that made sense but you know for my life because I can’t you know at that point I
for 9/11 I had an infant at home and you know other stuff so we’re going to look
at when we’re talking about addressing issues like the opiate epidemic or the
major problem of depression almost I guess anxiety almost one in four people
has anxiety issues and we’re gonna look at some of that and try to figure out
what can be done what can we do from where we are in a way that makes sense
because yes we can influence politics and advocacy and but what can we do with
small chunks of time that are beneficial to helping the cause as well as you know
could possibly help our clients that we have currently so we’ll define the
socio-ecological not model which is broth and Brenner’s model we’re going to
apply it to addiction and mental health issues and explore different variables
in this model and then discuss how this framework can be used in prevention and
treatment of co-occurring or independently occurring disorders so
we’re really going to talk about how it may
sense to conceptualize not only the development of addiction but also the
development of things like eating disorders and mood disorders in terms of
a socio ecological model and even some of the things like bipolar and and
schizophrenia can be a person can be genetically predisposed or whatever but
there could be certain environmental or factors that could you know trigger that
first psychotic episodes so we want to look at what might be going on and how
can we help prevent or treat now prevention can take the form of
three different activities if you will preventing the problem so helping people
not get depressed at all ever so starting to provide those skills and
tools when people are knee-high to a grasshopper hopefully preventing
worsening of the problem so people don’t get severely clinically depressed where
they can’t get out of bed so the early intervention services and effective you
know frontline resources and preventing associated fallout okay the person gets
to press gets clinically depressed well let’s see if we can help them avoid
losing their job because they can’t get out of bed to go to work develop
additional health problems from being depressed or developing an addiction in
order to self-medicate that depression so we’ve there are three different
methods or avenues we can take in prevention and you know we really want
to look at them all because when you’ve got somebody who’s becoming clinically
depressed you know they’re depressed you know situationally whatever something
happened and it starts to turn into something more than just a couple of
days it’s going to start having associated fallout early and you know
it’s not going to be huge they’re not going to lose a job right off they’re
not going to start having major family problems right off but they are going to
start having little hiccups because that depression causes an imbalance in their
in their environment and we know environments like to maintain
homeostasis and you know the kids are gonna be like well mom why aren’t you
getting up and doing these things and what’s going on and you know things are
going to start changing and the person will need to be able to deal with that
so the socio-ecological model explores and explains human behavior as the
interaction between the individual and for environmental systems there’s
actually a fifth one that is more of your longitudinal but we’re going to
talk about the four main ones today the micro the meso the EXO and the macro
systems the micro system involves well let’s start before that the individual
if you look at the model is sort of the bull’s eye here and the individual is
not really considered a system but it involves all of the things about the
individual including biology and personal learning that make people who
they are okay so this person exists within a micro system and that micro
system is their family peers School Church synagogue whatever and health
services things that they probably interface with on a really regular basis
work should also be on that but it’s for some reason it’s not on this diagram
anyway the meso system is the interconnection between micro systems so
how do family and peers interact I don’t know about you
thankfully my family might was very accepting of most of my peers but I know
other friends of mine who brought home peers who were not as well accepted by
their family so there was some conflict between the the family and the peers and
we know how much peer pressure and peer relationships are important in an
adolescents life so that creates conflict and consternation
how does the family interface with school how does how to Pierce how does
your peer group interact with school and do they see it
as a good thing to do do they see it as worthwhile you know etc so when we’re
talking about the micro system and the meso system we’re really talking about
things that people in interface with on a daily basis so I want you to think
about how does the meso system and you can feel free to chime in in the chat
room if you want how does the mesosystem family peer
school church you know recreational activities health services impact the
development of mental health or illness now you notice I’m trying to kind of
switch ears for health because we want to promote health and we can look at the
opposite for mental illness but you know if you have positive family peer
interactions it’s probably going to support mental health it’s probably
going to support decision making in the adolescent it’s probably going to I mean
and I’m thinking adults and adolescents here but family and friends you know if
you want to think about you know how do you get along with your significant
others peer group and do they interface well or is it kind of like oil and water
how does the how does your family interface with your work how do they
deal with how many hours you have to work whether you’re getting called in at
night or getting emails or text messages at 8 o’clock at night or you know what
are their expectations and how does that influence if there’s conflict you know
if the family doesn’t really like what’s going on at work or the fact that you
know your boss is emailing you at 8 o’clock at night then it can create
conflict within the environment which can lead to increased anxiety and
depression and yada yada yada now how does mental health or illness impact the
meso system so again thinking about how if someone is clinically depressed how
does it impact their family how does it impact their peers and if you have a
family member who has you know clinical depression or generalized anxiety how
does it impact how your family interfaces with everything else because
you know you end up having somebody or somebody’s in the family who may be
caretaking for the person who has depression or anxiety or whatever the
mental health issue is who’s not able to do the stuff that they were able to do
so the rest of the families kind of pick slack so how does that affect how they
interface you know the rest of the family members interface with school and
work you know maybe they end up showing it
more exhausted so it’s important to look at the meso system
the exo system involves links in a social setting in which the individual
does not have a direct active role so for example how would I impact my
spouse’s work and and again if I am the identified patient and I’ve got clinical
depression and I’m calling my spouse to come home because I just can’t be alone
or my spouse is late to work or unproductive because he’s always
exhausted when he gets to work because he has so much to do since I am you know
not able to do as much right now then it could negatively impact his work and and
so we want to look at how that impacts how the home environment impacts work
and how work impacts the home environment the macro system describes
the culture socioeconomic status poverty ethnicity etc so what we’re looking at
in the macro system is really the larger you know not just within your city maybe
or even closer your neighborhood we’re looking at what you see in the media
what you see on national TV your your statewide elections your national
elections your state laws and culture and and what’s being communicated if you
are a religious person what your religious culture communicates because
you know religion generally is not just in one little area it’s international or
national so what types of things does that communicate to to the person and
how does that influence the development or not development if you will of
depression anxiety or addiction so again think about how does the exo system the
social setting in which the individual doesn’t have a directive at active role
think about how much people were influenced after the elections I mean
yeah we had a role if you went out and voted you had a a role but you don’t
decide the election so once that happens how does that you know exosystem
impact you know your your emotions your other
community events employment etc and how do those things impact the family I know
you know there was a lot of consternation and concern among some of
my friends who are Jewish after the last election so their family experienced a
high ink or a great increase in anxiety development of mental health or mental
illness how does this all this stuff that’s going on in the exo system and
stuff that you don’t have direct control over how does it impact the development
of mental illness you know or mental health and we’re going to talk more
specifically in a couple of minutes and again likewise how does mental illness
or mental health impact the exo system if you have a healthy workforce if you
have healthy people that are active participating in work going to community
activities voting participating then you’re probably going to have a
healthier outcome than if you have people who are not able I mean they’re
so depressed they’re not able to even get out and participate so we want to
look at the reciprocal nature it’s not one-way the community doesn’t just
affect us you know it may affect us but then how we react affects the community
how does the attitude of the culture impact the community so if you’ve got a
culture that is accepting of certain ideologies they’re accepting of LGBTQI
they’re accepting of people who are Muslim in their religion they’re
accepting of people who are Christian and their religion they’re accepting of
you know fill in the blank if the culture is accepting of that how does
that affect the community and those people within the community who might
you know otherwise not have been accepting does it kind of pressure them
in or does it cause anxiety and consternation in in those people how
does the attitude the culture for example about
premarital sex and marriage affect the family how does it affect the
development of and again we’re thinking about anxiety depression and addiction
so how does it affect the development of stress which may lead to mood disorders
or problems and how did the community family and individuals with mental
health or mental illness impact the culture you know so we have an impact on
our culture we get together we see you know we have Generation X Generation Y
but the baby boomers they all had their own sort of or we all have our own sort
of unique cultures and things that we bring to the table and things you know
that were given to us that we said no we don’t want it thank you very much
so there is definitely a give-and-take by the individuals within within the
culture and that’s good because that means we can start small you know start
in our locale and create this positive meso system and then build from there if
you have a positive community then that’s probably going to spread think
about when a company goes and dumps fertilizer for example into a waterway
it doesn’t just stay there over time that fertilizer bleeds out and
you start having algae blooms everywhere things don’t stay I mean in our society
things don’t stay in one place for very long they tend to move they tend to
migrate so positive will migrate that’s awesome
negative can also migrate so we want to look at how can we enhance the positive
migration and keep down the negative if you will so now let’s start talking
about what can we actually do how can we operationalize all of this we realize
that if we affect the individual it’ll have a positive effect on the meso
system which can have a positive effect on the exo system yada yada yada
so great we also realize that one of the only things we really have a lot of
control over is the individual ourselves so and a lot of people come to
counseling individually score so this is where we’re going to start
so what things contribute and I start out by listing risk factors for the
development of mood disorders and addictions and then we talk about capital you know what you have in order
to you need to have in order to prevent these things and then prevention
strategies so that’s kind of how we’re going to go it’s not going to stay
depressing individuals with chronic pain are at higher risk of mood disorders or
addiction addiction because of the pain management you know drugs that are out
there and you know once they start taking payment management drugs opiates
a lot of times the brain quits producing endogenous opioids the natural
painkillers so when they first come off the body doesn’t automatically pick up
so it takes a little while for the person’s pain tolerance to build back up
which keeps some people from wanting to get off the medication among other
things but chronic pain can also be debilitating it can make people lose
some abilities that they used to have or or crush some dreams if you will you
know I think I’ve told you before I have a bad shoulder and carpal tunnel so I
can’t garden the way I used to you know I still go out and do it but I’ve got to
pay attention and only be out there for an hour too instead of spending six
hours out on the farm which is frustrating to me it was only mildly
frustrating but my grandfather when he started developing Parkinson’s couldn’t
make his miniatures anymore and he made gorgeous miniatures and I know that’s
not chronic pain but it’s kind of the same thing if you’ve got rheumatoid
arthritis he couldn’t make his miniatures and he became devastated and
became withdrawn so understanding that pain has multiple influences that can
cause depression that may trigger a grief reaction that we need to help
people address now the things I put in bold are things that we as clinicians
can easily help people prevent or and/or address so chronic pain we can help
people low self-esteem that’s a no-brainer
if people don’t feel good about themselves
and they’re looking for external validation they’re going to be at higher
risk for anxiety fear of abandonment fear of not being good enough fear of
failure and depression a sense of hopelessness and helplessness substance
use especially early substance use can cause changes in the prefrontal cortex
leading to problems with impulse control and decision-making but it can also
disrupt the balance of neuro chemicals leading to symptoms of depression and/or
anxiety so it’s important to understand that especially the earlier the
substance use starts the greater the chance that it’s going to cause some
sort of brain changes and we’ve also found that a lot of people not the
majority but there is a percentage a significant percentage of people that
when they start using early they kind of quit developing coping skills after that
they find something that works they’re like oh I like this I think I’ll use
that from now on so when we start talking about talking to people who
started drinking or smoking marijuana when they were you know 9 10 11 12 you
might see more mood issues or and or addiction issues in those people than
people who didn’t start using mood altering drugs as early a history of
abuse can contribute to the development of obviously PTSD but not everybody who
is abused develops PTSD but there can be episodes of anxiety and depression as
well as it increases the chances of the development of addiction genetic
vulnerability we know that mood disorders and addictions tend to run in
families and they’ve done studies that have shown that there is a genetic
component doesn’t mean it’s going to happen it just means you have this gene
there that could be triggered so we don’t want we want to make sure that
clients know that they are not just doomed you know they can prevent
triggering that but they need to be aware that they may be more vulnerable
in appropriate coping responses if some we’re not born with coping skills
so if somebody doesn’t know how to cope with life on life’s terms
because either because they’ve always been shielded or because they’ve never
had anybody help them maybe they they were kind of on their own from the
get-go so they learned to lash out and get angry or withdraw and get depressed
but they never really learned how to deal with stuff they’re gonna be at
higher risk of mood and addictive disorders we can help people develop
coping responses one of the things you want to look at when people are using
seemingly unhelpful behaviors is to remember to ask what is the cause of
this so we want to look at what is the root cause what is prompting this
behavior and what is the benefit of the current behaviors and I’m going to keep
reminding you of that as we go through this violence and aggression you know
again what’s the cause of the violence and aggression did people do this person
learn that’s how you cope with distress in their family of origin is it a
protective mechanism because they’ve experienced situations where that has
helped them deal with conflict before what prompts this and what’s the benefit
to it when they act out when they’re violent and aggressive what is the
benefit it gives them power it pushes people away they just enjoy hurting
people hopefully that’s the minority but we want to ask that because we can’t
figure out an alternative until we know what the function is
same thing with risk-taking and impulsivity there are certain theories
that say some people need more stimulation than others they get bored
easily so they tend to be higher risk takers and maybe more impulsive so you
want to ask is this person doing this you know I have a friend who is an
adrenaline junkie you know skydiving rock climbing you
name it he’s done it and you know more power to him I don’t see a purpose of
jumping out of a perfectly good airplane but he he thrives on that and when he
can’t get out and do those sorts of things he feels good so what is it about
this risk-taking and what kind of risk-taking is it is it risk-taking as
in holding a balloon liquor store or is it risk-taking as
in doing something like skydiving which is theoretically safe and what’s the
benefit it makes them gives them a rush makes
them feel good helps him you know escape or whatever great that’s fine
the rebellious nests you know again what is
and this is a key for it for adolescents especially but even if you’re a
supervisor working with employees if they’re being rebellious you want to
look and say what’s the point what’s the benefit to being rebellious what are
they holding on to and refusing to let go of that you want them to let go of or
what are they refusing to do that you want them to do and and what’s the
benefit to it if they are being rebellious and they’re staying like
think again adolescents staying out all night ok well what’s motivating factor
is it to get under their parents skin probably not is it to conform to peer
pressure you know oftentimes that’s maybe the case but you have to look at
the individual and say ok how can you do this in a way that helps you move
forward rejection of pro-social values if the people that espouse the
pro-social values are the people that the person rejects then they’re probably
going to reject those values so we want to look at you know if you’re rejecting
those what values are you espousing and and why are those important to you and
why are you rejecting these over here you know not saying it’s right or wrong
I’m just trying to understand where you’re coming from and you know that’s
something that we’ve got to obviously be sensitive to and and different people
are going to hold different values lack of peer refusal skills to stay out late
to get into trouble to use drugs to have early sex whatever it is those things a
lot of times indicate poor communication skills and low self-esteem need to be
accepted you know all that stuff that’s challenging during during teen and early
adolescent years those are things we can help with being bullied you know that’s
a risk factor when people are bullied they tend to get depressed and and when
they’re bullied they may they turn to substances to try to make themselves
feel better to numb the pain they make self-injure there’s a lot of
different things it might happen we can help people
develop skills to deal with being bullied since we don’t really understand
a hundred percent why people bully we need to help the victims become
survivors we need to help them have the tools to be able to deal with it and
understand why it happens without letting it hurt them early and
persistent problem behaviors that’s just so broad but again look at why is the
person child acting out an early sexual activity could be a history of sexual
abuse could be a dysfunctional family of origin and the child is trying to get
out I worked with a 14 year old whom once told me she was gonna get pregnant
as soon as she turned 15 because that’s when she could get into housing on her
own so she was intentionally going to get pregnant at 15 and there was a
reason for it she was very clear about her logic a lot of times it’s peer
pressure and acceptance but uh asking what is that what is the cause and is
this cause going to keep the person from developing healthy coping skills and
being happy is it potentially going to lead to depression peer rejection you
know that hurts so helping people figure out how to navigate peer rejection
because you’re not going to be liked by everybody academic failure we can help
with now not necessarily as clinicians but we can advocate for the person we
can help them find tutors resources etc lack of information on positive health
behaviors put it out there most of the time youth these days have a pretty good
idea of what’s healthy and what’s not they just aren’t motivated for it
they’re motivated for something else when addictive behaviors are you used to
cope with stress or unpleasant feelings like I said coping skills may fail to
develop or when they’re used to enhance self confidence such as drinking before
going to a party then they may start to develop anxiety and self-consciousness
when they don’t have a drink on board so it may start
prompting the development of some mood disorders in addition to the fact that
repeated use especially in a young brain can cause some a neurotransmitter
imbalances using addictive behaviors also to enhance other experiences ties
it to those experiences making them person more likely to use in those and
similar situations desensitizing the brains pleasure centers so what am i
what do I mean I mean if you typically drink when you are watching football
then you’re going to be more likely to drink every time you watch football it’s
just one of those things you do when you watch football if you’re one of those
people who eats when you watch TV then when you watch TV you’re more likely to
eat when you go to the movies because that’s a similar situation you’re more
likely to want to have popcorn or eat so it’s important to understand that with
addictive behaviors if you have something that produces pleasure it can
be triggered you know the person can start thinking about it in similar
situations using repeatedly can cause neuro chemical imbalances genetics you
know you can’t be born with a neurochemical imbalance not enough
serotonin too much whatever and poor health behaviors as I’ve talked about a
bunch of times not enough sleep quality sleep poor nutrition and and high stress
can also cause neuro chemical imbalances so we can educate people about some of
the things that can cause depression and anxiety so they can prevent it we can
educate parents so they can start coaching their kids from the get-go so
personal recovery capital in order to develop what we need to be happy healthy
human beings we have to have certain things to help us along the way we need
to have the things to enable us for physical health think about Maslow’s
pure hierarchy bottom level is all your health and biological needs we need to
have our physical health and that includes nutrition Slee
and you know not being in pain all the time sometimes you’re gonna feel pain
that’s being human that’s being alive but we need to have our health for the
most part we need to have financial assets to get our basic needs met you
know get that food keep clothing on our back
transportation roof over our head health insurance and access to medication and
there are two different things health insurance covers theoretically
going to the doctor and the mental health counselor etc access to
medication is not covered under a lot of insurance so remember that most
pharmaceutical companies have patient assistance programs that can help
clients access their medication if they can’t afford it because some medication
is really expensive safe housing conduce it that’s conducive to recovery and
that’s not just addictions if you’ve got somebody who is clinically depressed or
highly anxious living in a radically dysfunctional household where there’s
lots of yelling or arguing or other people who are similarly dysfunctional
it’s probably not going to prompt those positive cognitions and mindfulness and
everything that we’re trying to establish doesn’t mean they can move
unfortunately a lot of people can’t so we got to talk about how can you create
an area in your housing environment that’s safe people need to have adequate
clothing to stay warm to be able to dress for work and actually you know go
to their job and be dressed appropriately and transportation to get
their needs met most of us don’t live in a city where we can just walk but
walking I guess is a form of transportation we need to be able to
access the resources that are out there whether it be food or going to work so
we can pay our light bill or whatever it is
values awareness people need to know what’s important to them in order to
figure out what they need to do to be happy a sense of purpose helps people
keep going and we can help people with this I mean these are easy exercises
when you give them a values activity worksheet you know
what are your top five values when you look at the sense of purpose what is
your purpose in life and a lot of us don’t really know but we know what we
want it to be or we can start theorizing about what is the purpose of what I do
as a job on a day to day basis what is the purpose of this activity that I’m
doing so they can start to see some meaning in the stuff they do we can help
people develop hope and optimism and we’ve talked about that one people need
to have a perception of their past present and future they need to be able
to look over the past and it may suck or it may be great but they need to be able
to look back over it and go yep that’s it they need to be able to look at their
present and realistically assess what they’ve got and maybe what they don’t
have but realistically assess what they’ve got and look at their future and
go where do I want to go from here because you’re here and you don’t want
to stay here forever you can’t stay here forever because times gonna move on what
next so people need to be able to see but understand that they’re not
necessarily controlled by their past or stuck in the present that they have the
ability to make choices every single moment to work toward what they want for
the future education training and job skills people need to be able to make a
living that’s just the way it is you need to be able to feed yourself and put
a roof over your head so we can make referrals to job training agencies we
can make referrals to social service agencies problem-solving skills
interpersonal skills and self-esteem these are all things that we are super
skilled at teaching and we can teach these in chunks they don’t have to be
these long groups they don’t have to be big drawn-out sessions we can provide
people snippets you can provide somebody the concept of distressed tolerance and
the improve acronym in a handout and have them look at that or in an email
you know if you email your clients once each day or on your blog there are a lot
of different ways you can just get that information out there and in front of
people so I can look at it I call I tell my
clients it’s bathroom reading you know I usually give them a handout or two and I
just put it on the back of the toilet and when you’re in there you know take a
look at it if it’s useful great if not bottle it up and throw it in the in the
trashcan I’m good with that but there’s no
pressure and I’m not putting extra assignments on them I’m just providing
information about a skill and then if they want to pursue it further when they
come back to counseling we can talk about it so what can we do we can
promote positive health and wellness behaviors by educating people about why
they’re important and what to do and where to find more information you know
because some of these things like nutrition we can’t be prescriptive but
we can point people in the direction on where to get good advice and information and we can also model this you know in
our treatment plan at least in mind I try to make sure that people are putting
a print putting an emphasis on getting enough
quality sleep eating well and maybe exercising at least moving around if
they don’t want to call it exercise but taking care of themselves and getting
some relaxation and recreation in there bonding to a pro-social culture is
difficult for us to do do for people or do with people we can talk about what
are your hobbies what are things that you enjoy doing and encourage people to
try out volunteering or get involved in meetups in order to engage in activities
with other people but that’s something that they’re really going to have to do
on their own participation in extracurricular activities again kind of
the same thing we can point them in the right direction of volunteerism meetups
things through their through their church or their synagogue or their you
know whatever clubs that they’re involved in positive relationships with
adults now obviously this is more important if we’re working with children
or teenagers we want to help children and teenagers kind of see where adults
don’t really have their head that far in the ground
but we also want to help adults learn how to more effectively communicate with
teenagers because a lot of adults lecture at and I know this and you’ll
you’ll understand when you’re older and you know lots of that kind of stuff
so things that we can do to enhance relationships with adults is to educate
people about you know how to effectively communicate with with teenagers for
example who are trying to find their way and trying to assert independence and
resisting some rules how do you deal with that how do you communicate with
them in a way because a lot of parents have difficulty navigating that boundary
between friend and and parent so we can help with that
active workshops in the community workshops you can do them at churches at
libraries those are things you can do there you can put them on for like an
hour once a month it’s good if you’re it’s free but it’s good promotion for
your practice if you know you go out and do it and people come learn something
from you they’re like hey that might be helpful social competence it’s another
one of those things that we can do in little snippets we can provide tips and
tips and tools whether infographics on an Instagram page those are really
useful for a lot of teenagers they want something that’s you know in a picture
and really fast it’s a snapshot so social competence checklists are another
really good thing if you’re teaching different types of skills for
communication or how you’re supposed to use different forks I know the first
time I went to a formal dinner I was looking at all the silverware going I
have no idea what to do with this stuff the sense of well-being and
self-confidence we can help people develop this by encouraging them to
focus on what they do well we want to make sure they have future plans
well that means goal setting and since a lot of people don’t know how to goal set
they don’t goals goal set so they’re just kind of floating out there not
really looking at the future we want to help people look at the future and
figure out how they’re going to get there so they’re like wow this is
doable this is attainable this is another thing you can put work put
worksheets on your website you can do short little workshops to help people
figure out how to look at how to define or learn how to how to define a rich and
meaningful life and figure out how they’re going to define their goals and
actually achieve them knowledge about risks associated with addictive
behaviors now a lot of kids you know think back to the old dare programs I
had a lot of clients tell me that those programs only taught me how to you
safely I was like well that’s not what they were intended for but we do want to
educate youth about you know still about the risks of some of those drugs and
even with adults not just youth educate people about how dangerous or how
potentially addictive opiates for example can be after three to five days
your body has already started to build up a tolerance that’s kind of scary so
helping people understand that but also addictive behaviors like pornography a
lot of teens don’t really think about it a lot of adults don’t really think about
it until they’re stuck in it or online gambling you know those are some things
that can kind of catch people unawares because they didn’t think about since it
wasn’t a substance we typically think of addictions as substances since it’s not
a substance they didn’t think about the effect that the pleasure from those
activities was going to have on our neuro chemicals and and create a
situation where they didn’t feel okay they didn’t feel normal
they didn’t feel happy without having that in their life because their
dopamine receptors had basically been blunted individual prevention strategies
really the big summary is we want to promote attitudes beliefs and behaviors
that ultimately provide the person with healthy coping skills so whether it’s
through health class whether it’s through workshops I know at
organizations I’ve worked at before the Jaypee would come in and do periodic
workshops that’s a great way to connect with people and reduce utilization if
you do psycho-educational prevention group because an ounce of prevention is
worth a pound of cure we want to make sure that they’re aware of positive
health behaviors and how to access those resources in Gainesville I don’t know
about up here but I know in Gainesville the mall used to open at six o’clock in
the morning so people could walk inside in a safe place and you know be out of
the elements and yadda-yadda so just letting people know that that
existed was a big step because they were like well I don’t want to join a gym and
go to the mall effective interpersonal skills we want to make sure people know
how to effectively communicate set boundaries all that stuff that we talked
about this can be taught it’s nice if your local news is willing to use you to
do a you know wellness minute and I find one of the best places to do that is
either right before or right after the weather because most everybody Tunes in
for the weather I may not stick around for the animal of the day or whatever
well I always do but but I’m always tuned in for the weather so if you get
either right before or right after that you tend to get higher viewership and
reach more people and a minute gives somebody a chunk of something that they
can use today specific approaches may include education and life skills
training in schools you know is provide it to the kids have them to share it
with their parents through the media and community center or or library workshops
those are all great ways to get stuff out I encourage you if you want to get
into providing prevention and helping to helping your community helping people to
prevent getting depressed or anxious or developing other problems to look at
doing some of these things that are very time limited because you don’t want to
lose a lot of billable hours but we still want to be able to do more than
we’re doing at least that’s what a lot of a lot of us tend to feel
like the mesosystem so we’ve been talking about the individuals so far
because that’s where we can have the greatest effect the mesosystem examines
close relationships that may increase the risk of experimenting with high-risk
behaviors or developing mood disorders people’s closest circle of peers
partners and family members influences their behavior and contributes to their
range of experience if you’ve got a child that grows up in a household where
the parent or parents are clinically depressed where they’re not able to
model effective coping skills where they model cognitive distortions guess what
jr. is gonna pick up if you are in a household you know you’re in college and
you’ve got four other roommates and all of your your other roommates tend to be
negative and naysayers you’re either probably going to move or you may that
might start wearing off on you a little bit likewise if they are you know all
kinds of go-getters that can wear off on you too so you know there’s going to be
an impact risk factors peer and family reinforcement of negative or unhealthy
norms and expectations so if the your family says you know people suck they’re
always going to take advantage of you what are you going to take away from
that and is that going to contribute to you probably having difficulties with
trusting and maybe developing depression possibly so we want to look at what kind
of messages is the peer group or family sending to the individual that may
contribute to the development of mood or anxiety disorders early sexual activity
among peers could communicate that well this is the norm so everybody’s doing it
ties to deviant peers and gang involvement you know especially at that
particular group there’s a lot of pressure to conform or there’s a
negative consequences family members who don’t spend much time together and this
could be because parents work a lot this could be because everybody’s you know
involved in all kinds of other stuff but they found that
when families are disengaged the parents tend to miss out on subtle cues when
families are disengaged even if they don’t have children in the mix that
there tends to be a weakening of those bonds those supportive bonds so people
are at higher risk for development of depression and anxiety because they
don’t have that you know everybody’s behind me sort of feeling parents who
have trouble keeping track of youth can indicate that the youth may be at risk
for developing substance or more mood disorders lack of clear rules and
consequences you think about even just being at work when there’s a lack of
clear rules and consequences you don’t exactly know what you’re supposed to do
I know for me that creates doodles of anxiety I like manuals and to date
pretty much every job I’ve ever taken I’ve walked in and there hasn’t been a
manual and I’ve been like okay there must be a manual written and that’s been
my first thing now I’m kind of on the structured side so I don’t expect
everybody to be that way but most of us tend to experience a little bit of
anxiety about failure about acceptance if we don’t know what’s expected so it’s
important whether it’s a family or a job situation to make sure there’s clear
rules and consequences you know what’s expected and what’s going to happen if
you mess up or if you don’t meet this expectation there also needs to be
consistent expectations and limits you know when people especially children but
a lot of us tested our limits when we were kids and even as adults you know I
know you know going back to working in organizations I would have staff who
would test limits and see how long they could go without turning in a progress
note before I’d be knocking on their door going paperwork it’s natural for
people to kind of test limits especially with stuff they don’t want to do stuff
that’s not rewarding family conflict and abuse can cause high risk of depression
and anxiety whether adults or children I mean if there’s a
lot of conflict and chaos it’s exhausting and it can cause a lot of
dysphoric emotions and loss of employment that’s kind of
self-explanatory protective factors close family relationships so as
clinicians we can encourage people to identify who they consider their family
it may not be their blood relatives whose their family who is there for them
who can they call it 2:00 in the morning and how can they nurture those
relationships encourage people to develop relationships with peers that
are involved in pro-social activities like hiking or volunteering in the
community consistency of parenting is is important in terms of producing children
who are who are stronger healthier more resilient encouraging education and
parents that are actively involved can help prevent future depression because
they’re creating children who are able to join the workforce and have that
individual capital to prevent depression and anxiety and stuff coping with stress
in a positive way and this is a family protective factor and a peer for
protective factor why because we learn from observation so if our peers cope
with stress positively by prayer or exercise or whatever it is they do and
our family has other positive ways of coping with stress and we’re going to
have a greater venue of stuff to choose from supportive relationships with
caring adults beyond the immediate family are encouraged so we want
children to grow up being able to interact with teachers with coaches with
you know Scout leaders whomever and start seeing that people outside of the
nuclear family are trustworthy sharing and family responsibilities including
chores and decision making and that’s true for children teenagers or even
adults you know if you’re living in the same household it
really important that everybody feels like they have a say in what’s happening
and and participates in the upkeep of the family environment and family
members are nurturing and support each other and this is one where I tend to
stop and I do a love languages little mini class to help people remember that
we don’t always experience nurturance in the same way so understanding one
another’s love languages is really important to being able to nurture in a
way that’s meaningful to that other person peer and family interventions are
designed to identify norms goals and expectations in the family foster family
problem-solving skills so there’s not just one person always fixing it develop
structure and consistency within the family unit promote healthy
relationships and engage peers and family of choice in the recovery process
so if somebody’s already depressed we need to be able to hopefully engage
everybody that’s involved in this person’s immediate environment in
helping them move towards recovery and you know preferably not dragging them
back down so we want to engage them and make sure that people have supportive
others school and work risk factors lack of clear expectations both academic or
performance wise and behavioral lack of commitment or sense of belonging at
school or at work if you just kind of go and you feel like a number you punch in
punch out that may not make you feel really appreciated which can contribute
to depression and you know just bad feelings high numbers of students
failing academically at school at work this translates to high amounts of
turnover if you never know who’s going to get laid off it increases stress and
anxiety and parents and community members that are not actively involved
in keeping kids in school and helping make sure that the workforce workforce
is strong but we want to make sure that people have access to how
when it’s needed we want to make sure that people have access to tutoring in
school if they need it to prevent failing from school they have access to
transportation to get to work now those are things those are meta concepts that
are more on the community level but it’s important that as a community member you
know we look at different things that we may be able to participate in advocacy
and say you know it’s really important to get a bus system going I live out
about 30 miles east of Nashville and it’s really important that we have the
the train that goes from from my city out to into Nashville so people have
access to more jobs so that was important for us to get past the City
Commission protective factors school and work positive attitudes gotta find a
reason why you’re doing this you know and sometimes it’s hard to find a reason
for algebra but we need to help kids find a reason for that we need to help
adults find a reason for why they’re going to work why are they doing what
they’re doing regular attendance shows you know it is associated with higher
mood less less risk of mood or addictive disorders because you’re able to get up
and do it and interface with people and get that social support hopefully from
your colleagues high expectations are communicated effectively goal setting
and positive social development are encouraged you know whether it’s at work
or at school there are goals there are things you’ve got to accomplish there
are performance objectives but we also want to encourage morale and positive
social bonding whatever the setting having a positive instructional climate
again whether at work or at school I know we learn things when we’re on the
job we learn things and I don’t want people to feel like they’re having
difficulty like they’re stupid I want people to feel like anything that we
teach them as a challenge and something that may be beneficial down the road
leadership and decision-making opportunities are really important again
for students or employees to prevent burnout and to keep morale up reduce
anxiety and increase a sense of personal empower
and connection active involvement for everybody is fostered and the school or
organization is responsive to the student’s needs making sure that in
school in the case of school they have access to tutoring resources it’s a safe
environment for them to be in and the children that are going to that school
have enough food in their bellies you know they can’t learn if they’re
hungry all the time workplace is a little bit different but we still need
to be responsive to people’s needs in terms of you know family requirements
whether they need to if they’re going back to school
shifting schedules a little bit we need to try to work with people instead of
being completely rigid and it’s my way or the highway when possible in order to
promote the best mental health characteristics of settings in which
relationships occur are often associated with development of mood disorders and
addictive behaviors so we want to look at the characteristics of schools are
they safe are they positive environments are they cheering squads or are they
places where people know they’re gonna go and get thrown under the bus
same thing with workplaces you know when you walk into a place you get a most of
us get a sense and you’re either like oh this is a cool place to work or oh I
can’t wait til I can get out of here you know we really want to go towards the
other end and neighborhoods when you go into a neighborhood – people take care
of their environment do they or do they have trash strewn all over their lawn
all of these things communicate how people feel about their environment and
generally how they feel about themselves and whether they have the energy to take
care of stuff or they just feel completely disenfranchised and don’t
care anymore community risk factors no sense of
connection to the community neighborhood disorganization rapid changes high
unemployment a lack of strong social institutions lack of monitoring youths
activities imbalanced media portrayals of safety health and appropriate
behavior misleading advertising and alcohol or drugs readily available
a lot of stuff we do we’re not going to be able to effect on the community level
so much but we’re gonna hit them real quick we want to improve the climate
process and policies within community school and workplace to make it safe and
promote positive health behaviors prevention strategies are designed to
reduce social isolation reduce an address stigma increase awareness of
local recovery models you know who’s out there that has recovered and can serve
as a role model improve economic and housing opportunities so people have a
house a safe roof over their head and they can you know earn money and feel
good about themselves increasing the accuracy and improving the positivity of
media messages and increasing physical and financial ability availability of
recovery so like I said I leave live in a little town so it’s nice that we have
a community mental health center here so people don’t have to rely on going into
Nashville but also making sure that services are financially available
whether you have a free clinic once a month or you know make sure you’ll you
take Medicaid but there’s still a lot of people who have no insurance so where do
they go the socio-ecological model identifies
how the end the individual impacts and is impacted by not only his own
characteristics but also those of family peers community and culture prevention
takes the form of preventing the problem preventing worsening of the problem and
preventing associated fallout like I said as clinicians a lot of what we’re
going to do is target the individual providing them resiliency skills to deal
with some of this adversity that might be around them and to help them sort
through some of those media messages and go yeah
that’s not even true you know if I drink this vodka I’m not suddenly going to
have 14 supermodels hanging on me or whatever it is that’s being communicated
so encouraging people to be informed and and wylie consumers any change in the
system will have an effect on other parts of this system so if it’s a
positive change is probably going to have positive changes negative has
negative changes addressing addictive and mood disorder behaviors requires a
multi-pronged approach we need to look at the individual and you know provide
provide as many skills as possible there because that’s where we’re going to have
a lot of our impact especially in prevention but we also need need to
realize that this person resides within a family you know whether they live
alone which sometimes is less problematic or they live in a household
with other people we need to make sure that where they lay their head at night
where they spend their non-working hours feel safe and is conducive to recovery
where they work or go to school also needs to feel safe and be conducive to
recovery and that’s part of the community so we need to kind of look at
these areas and if they aren’t safe or they don’t feel safe or aren’t conducive
to recovery we need to help people how figure out how they can fix that or
address it like I said they may not be able to move so what can you do to set
some boundaries to create as much safety as you can how can you do this and there
are a lot of different techniques that I’m sure you already have that you used
to help people but it’s important again not to just focus on the individual
because they don’t live in a bubble we need to look at everything alright are
there any questions now we have or I have added a Wednesday
class so you don’t obviously don’t have to come but if you have an unlimited
membership same time same station Wednesday so Tuesday Wednesday and
Thursday we have a class from 12 p.m. CST 1 p.m. est 2 for an hour all righty I will talk to y’all maybe
tomorrow maybe on Thursday have a great day if you enjoy this podcast please like
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