Reflective practice, leadership and congruence
by Michael Nunno, DSW, Senior Extension Associate at Cornell University’s College of Human Ecology
The power of Restoring Sanctuary is that the Sanctuary Model is grounded in basic democratic principles and values, as well as decades of established research addressing the essential organizational structures and process to produce quality outcomes in mental health services. Sandra Bloom and Brian Farragher, in this new volume, make a strong case for transforming our mental health system from dysfunction and despair to systems characterized by openness and hope.
The authors propose practical steps to achieve this goal through reflective practice, values-driven leadership, democratic principles, continuous organizational and personal learning and basic interpersonal engagement principles. For example, they argue that in order for leadership to transform an organization’s structures and processes, leadership has to have an essential connection to the daily life of the facility that is congruent with these transforming values. It is important to recognize here that although Bloom and Farragher never use this term, the search for organizational congruence in the best interests of its client population is a central theme in their strategies to transform mental health care. Congruence as Anglin (2002) describes it has three essential parts: the first is consistency in organizational values, actions, and practices over time and at all organizational levels; the second is reciprocity in mutually demonstrated interactions between all persons in the organization; and the third is a pattern of organizational actions and professional interactions that clearly demonstrate integrity and client best interest.
Congruence also demands that leadership engages in interpersonal practices that recognize trauma and pain based behavior as one of the roots of mental illness and dysfunction. These trauma and pain-sensitive interpersonal dynamics are characterized by listening and responding with respect, building commitment, rapport, and relationships between staff and clients, offering emotional and developmental support, challenging thinking and action, sharing power and decision-making, respecting personal space and time, and providing resources that discover and uncover both client and staff potential.
To read the first part of Michael Nunno’s review of Restoring Sanctuary click here.
Anglin, J. P. (2002). Pain, normality, and the struggle for congruence: Reinterpreting residential care for children and youth. Binghamton, NY: Haworth Press.
Scheduling Some ‘Me’ Time
Nechsma Alvarez is the Human Resources Assistant at ANDRUS.
Self care means doing things to support your physical, mental and emotional health and wellbeing. Reduce stress and feel more able to cope with whatever life throws at you. Self care can protect you against burnout in your work and your personal life and can also put you in the best position to feel healthy and thriving, and to get the most enjoyment out of life.
Taking time for self care can be very difficult, especially if you’re busy or spend a lot of time looking after others. However, the better you’re feeling the more able you’ll be to put your energy into work, family, or other activities in your life. So this weekend try to Schedule “You” Time.
Most of us find it hard to schedule in time for ourselves with no other obligations. If we are struggling to find time to sleep, fitting in a massage may seem impossible. The wonderful thing is that “you” time is likely to leave you more energized, more emotionally grounded, and better able to face the world and its challenges. Taking time for yourself may actually support you to power through the other tasks in your life. You may also feel more fulfilled and lively as a result. If you spend a lot of time doing for others and not engaging in self care, it’s easy to start feeling drained and for resentment to creep in.
What you do during your “you” time depends on what brings you joy and relaxation. It could be painting, watching a movie, reading a book, going to a play, or taking a hot bath. It might even be taking 5 minutes to breathe and listen to your favorite song. Whatever helps you to feel supported, refreshed, and less stressed. If you haven’t been doing much self care, it may take awhile to sort out what will bring you the most pleasure during your free time. The process of figuring that out can also be rewarding.
Whatever activities you choose for your “you” time; it may be helpful to schedule that time. Experiment with treating it with as much importance as a big meeting at work. It’s easy to push time for self care aside if you haven’t made it a priority.
Restoring Sanctuary for Mental Health Professionals
by Michael Nunno, DSW, Senior Extension Associate at Cornell University’s College of Human Ecology
The National Alliance on Mental Illness (NAMI) in their 2006 report on the status of mental health services in the fifty states suggests that state mental health systems are under tremendous strain, leaving unfulfilled the promise of quality community mental health services for our citizens. Many of the strains have their roots in state budget crises that encourage cost shifting and prefer short-term financial fixes to long-term investment in community-based services. These short-term fixes result in overburdened and inappropriate emergency room admissions and the criminalization of mental illness.
The remaining public institutions that do exist to meet the short and long term needs of our child and adult population are often insufficiently funded, inadequately staffed with poor training and supervision, inaccessible to families and communities, unsafe with dehumanizing environments that are dreary and ill-kept. Rates of aggression and counter-aggression in these facilities can be high, and result in coercive and dangerous practices that lead to staff and client injury and death. It is not uncommon for turnover in many facilities to reach 40% per year.
Sandra Bloom’s and Brian Farragher’s Restoring Sanctuary: A New Operating System for Trauma-Informed Systems of Care is a timely and an important book for mental health professionals. The authors’ basic premise is that organizations are living systems with varying degrees of both health and dysfunction. These living systems are vulnerable to the external and internal strains described above that permeate the mental health system in America. The consequence is that an organization’s leadership and staff adapt in much the same way as chronically maltreated children and adults, in that they lack trust in their own capacity for system and client change. This dysfunctional adaptation prohibits the organization from succeeding in its fundamental mission to address the basic safety, development, and therapeutic needs of its client populations.
Current organizational research in mental health and child welfare services shows that positive treatment outcomes cannot occur without positive organizational climates, and that the culture of an organization will determine to a large degree the success of that organization in meeting its mission (Glisson, Dukes, & Green, 2006; Glisson & Hemmelgarn, 1998). In this volume, Bloom and Farragher detail the characteristics and dynamics of the Sanctuary Model, first proposed by Bloom in her book Creating Sanctuary: toward the evolution of sane societies, which they believe can produce positive organizational cultures and climates through a “process of reconstitution” to reshape our mental health systems so that they are trauma-informed and trauma sensitive.
The process they describe for transforming our mental health services – one of a parallel process of recovery – demands a multi-faceted commitment: 1) to basic safety, 2) to emotional management skills, 3) to reintegrating organizational and personal functioning through grounding, 4) to open communication between all levels of an organization, 5) to redefining authority relationships in an organization, 6) to improved problem-solving, welcoming dissent, cultivating relationships, empowerment, non-violence, grief work, restoring hope, and 7) to creating environments that are trauma sensitive and trauma informed. In the authors’ words, this book becomes a guide for mental health services “to help us remember and reintegrate knowledge that has been lost from our own systems”.
Glisson, C., Dukes, D., & Green, P. (2006). The effects of the ARC organizational intervention on caseworker turnover, climate and culture in children’s service systems. Child Abuse & Neglect: An International Journal, 30(8), 845-960.
Glisson, C., & Hemmelgarn, A. (1998). The effects of organizational climate and interorganizational coordination on the quality and outcomes of children’s service systems. Child Abuse & Neglect: An International Journal, 22(5), 401-421.
Exactly What I Needed, But Least Expected…
Sarah Yanosy is the Director of the Sanctuary Institute at ANDRUS.
I was a little harried, as I always am when boarding a plane toting a shoulder bag, dragging a roller bag and balancing a cup of coffee. As I made my way to my aisle seat, I noticed the young man who would be sharing the trip in the center seat next to mine. I took one look at his face, and snapped from “harried business traveler” mode to “worried mom/assessing social worker” mode. This young, Black man looked to be in his late teens or early twenties, traveling alone, with two puffy black eyes, a scar on his cheek, a gash on one eyebrow and a matching one on his chin. I took my seat and tried to figure out how to open a conversation with him while scrolling through my mental rolodex of referrals and resources I could offer him once I figured out who had hurt him and what he would need.
When the pilot told us we were 12th in line for takeoff, and that we would be on the runway for some time, he sighed loudly. I saw my chance. “Is Tampa home or are you visiting?” I asked. He told me that he was from Clearwater and headed home. I asked what had brought him to NY, and he pointed to his two swollen eyes and said “work.” I asked what on Earth he did that resulted in his face looking like tenderized steak. He smiled and told me that he had been on HBO the night before and had won his welterweight boxing match after going 12 rounds. Turns out he is 24, and his name is Keith Thurman.
We spent the rest of the flight talking about our respective careers, his plans for expanding his role as a performer to promoter, the finances of boxing, my work with Sanctuary, ANDRUS and kids in residential care, my kids, his girlfriend’s pursuit of a career as a poet, his efforts to support her dreams, his mom’s concerns (and mine) about head injuries from sports like football and boxing, gay marriage, school bullying, the importance of mentors and of course, religion. Toward the end of the flight, he shared that although he is Christian, he also practices meditation through Tibetan Buddhism. We drifted into a conversation about our knowledge of Buddhism and its resonance with our lives. He reached under the seat, and pulled out his worn copy of The Tibetan Book of the Dead by His Holiness the Dalai Lama. “Can I read you my favorite chapter?” he asked. “I’d love that,” I said. He read softly but powerfully these words that were familiar, as I had read them years ago and still connect with their strength. We sat silently after he read and as the plane passed from clouds to Earth. I laughed at the absurdity of my assumptions. When my feet touched pavement in Tampa, I had gone from “harried business traveler” past “worried mom/assessing social worker” to “head lined up with heart, fully connected to soul and world” mode. It was exactly what I needed, but least expected when I sat down. Thanks, Keith.
We the People- A Traumatized Nation
Alexandria Connally, MS Ed, is the Assistant Principal of The Orchard School at ANDRUS.
The preamble of the United States Constitution opens with three powerful words, “We the People”. This is clearly the subject of the entire document. America prides itself on being a democracy; a land of freedom. This is a land where the people can speak openly about the government. As I look through history, I question the inclusivity of the term, “We the People”. In 1787, the 3/5 Compromise was created. It stated that slaves were considered only 3/5 of a white person and most slave owners considered slaves as property. It wasn’t until the 13th Amendment to the Constitution that Blacks in the South would be free. The 14th Amendment gave slaves citizenship and the 15th Amendment gave them the right to vote but the 15th Amendment was not sufficient, hence the need for President Johnson’s Voting Act of 1965.
Another group of individuals who were excluded from “We the People” were women who would basically have no rights until the 1970s – Women’s Rights Movement. It wasn’t until the 2012 election where 17 women (the maximum ever) were voted into the US Senate. I could spend hours debating the Homestead Act and the Battle of Wounded Knee which terminated thousands of lives of the First Americans. In 1898, America invaded Puerto Rico and like the five other territories, they do not hold any Electoral College votes. Then there was the imprisoning of Japanese-born Americans during WWII and the treatment of Muslim Americans after September 11th.
What I’ve noticed about all of these groups is that they have two identities. They are American and then they are identified by their Nationality. Do they represent America or their own culture? I’ve traveled internationally and I am always amazed by people’s thoughts around my nationality. I’ve traveled to China and the natives marveled at the color of my skin. I was treated like royalty. It was the first time in my life that I can remember being Black meant being privileged. A year or so earlier, I traveled to Rome. Most of the natives thought I was from South America. I would imagine that is because most of the darker skinned people are from Africa, the color of my skin was unfamiliar to the Italians that I met. As I began to explain that I was African-American, I saw many puzzled faces. Eventually, one man responded, “So where does your allegiance fall?” Considering that I have only been to Africa once, this was an easy question to answer. As the conversation continued, my friend began to explain to me that in their culture there were no sub-cultures. So if you were of African descent and an Italian citizen, you were considered Italian. If your skin was light or dark, if you were African, Asian or European, it didn’t matter. An individual who held citizenship in Italy was an Italian. There were no Afro-Italians, Euro-Italians, and Asian-Italians. I realized at that point that there was a clear understanding of “We the People”. It is not the job of the legislature to create laws that distribute invitations to join the exclusive group of “We the People”. It is the job of every individual citizen. How do we remedy this trauma? It begins with a conversation, an open-mind, and the understanding that our differences make us stronger.
Is Confidence Contagious?
Lorelei Atalie Vargas, MA, MPP is the Vice President for Strategic Initiatives at ANDRUS.
On a warm muggy day last Spring my eight year old daughter announced that she was ready to take the training wheels off her bicycle and learn how to ride a two wheeler. I was so excited. My 12 year old son never had the desire to learn to ride a bicycle, so this was my first opportunity as a parent to teach my child how to ride a bike. I was excited about her confidence, but I wondered, Am I really capable of teaching her? My confidence waning, I did what most parents probably do these days. I reflected on when I learned to ride my bike. I also googled “Learning to ride a bike”. Armed with my experience and research — I was ready, or at least I felt ready. We ventured out to an empty lot and within 10 minutes my daughter was riding her bicycle. Inspired by how quickly she took to it, my 12 year old son asked if he could give it a try and within 10 minutes he was riding his bike. Ice cream for everyone! My daughter’s confidence rubbed off on her brother and in less than an hour, I had two bike riders in my household. That was a proud day.
Later that summer when my nephew (also 12) came to visit I offered him what I thought was the best deal – I will teach you how to ride a bike. All I need is 30 minutes (I wanted to be conservative) of your time. “I don’t know Auntie Lorelei”. His lack of confidence didn’t deter me. After all, I was on a bike-teaching high – I taught both of my children in under a half hour. After a couple of days, my persistence won him over. He and I went out one morning to the same spot where my children learned just a few months earlier. I was brimming with confidence, but him, not so much. As I shared the same techniques I had shared with my daughter and then my son, it became clear that this was not going to be a ten minute lesson. After three hours of instruction we packed it up and went home. The silence on the ride back was deafening. I learned an important lesson from this experience. Confidence can be incredibly contagious, but no matter how much you want something for someone, unless they want it for themselves, it is unlikely to happen. Maybe next summer he’ll be interested!
Live Like a King
Alexandria Connally, MS Ed, is the Assistant Principal of The Orchard School at ANDRUS.
On January 21st American celebrated the birth of a King. On January 16, 1920, Dr. Martin Luther King, Jr. would grace the world with his presence. This great man would attend college at age 15, speak out against racist injustice and become known as the Father of the Civil Rights Movement. He would eventually give his life for his cause that he believed was right and just. In my opinion, one of the most powerful statements every uttered was “I have a dream that my four little children will one day live in a nation where they will not be judged by the color of their skin but by the content of their character.” We all know that Dr. King was committed to Non-Violence but have you ever thought about his commitment to Social Learning? The statement above insinuates that there should be a learning experience; an experience where individuals are taught about the similarities and differences of others. An experience that allows one to understand the thoughts, needs and desires of others before they think of the color of their skin, the sound of their accent or their religious practices. My commitment to Social Learning is not to make assumptions about people. What is yours?
Remembering Ed Koch
Lorelei Atalie Vargas, MA, MPP is the Vice President for Strategic Initiatives at ANDRUS.
I can’t ever remember a time when I was not fascinated by politics. Politics, politicians, political issues were the basis of most of my conversations with my father, from as far back as I can remember. In the Fall of 1979 my second grade class took a trip to City Hall, where the father of one of my classmates served as an aide to Mayor Ed Koch. I remember feeling exhilarated walking up the steps of City Hall, anxious to meet the Mayor that I had seen so often on the evening news. We toured City Hall and then were told that in fact the Mayor had not yet returned from his meeting and would not be able to meet with our class. I felt completed deflated, as if my second grade soul had wasted an entire day in anticipation that would never be 
recognized. As our class made its way out of City Hall and down the street to board our bus back to Queens, there he was – Mayor Koch. He came and greeted our class, and I pushed my way to the front to see him up close. He was tall (I was in second grade so most people appeared really tall to me) and he looked exactly the same as he did on television. I was mesmerized. He asked us if we had a chance to see City Hall and if everyone inside had been nice to us. Then I blurted out “Where were you? We thought we were meeting with you?” The Mayor turned to me, looking down at me and said “Where was I? Ahhhhhhhhhh…… I’m the Mayor of New York. I’m a busy guy.” His aide laughed as I stood there peering at him, and with that he bid us farewell and offered an invitation to come back (which despite my constant petitioning my teacher never arranged). On the trip back my mother, who was a chaperone, admonished me for being so bold. She told me that I needed to be more respectful, he was after all, the Mayor.
That night when my dad got home from work I told him about my meeting with the Mayor. He laughed when I told him that I asked the Mayor about his whereabouts. He said, “Asi se hace” – that’s how you do it! He was proud. I never saw the Mayor again, but I, like many New Yorkers, was saddened to hear of his passing this morning. He was my Mayor as I grew up in a changing New York, and the boldness of his spirit will continue to inspire me for years to come.
“Dude – we have an app for that”
Alexandria Connally, MS Ed, is the Assistant Principal of The Orchard School at ANDRUS.
Technology is an ever growing – and always rapidly changing — part of our world. In the last twenty years we have moved from tapes to CDs to mp3s. Blue ray disks have taking the place of VCR tapes, and I now have a computer on my phone. Words like “downloading”, “uploading”, “syncing” and “streaming” have been added to our dictionaries and more importantly to our everyday vocabulary. So it didn’t amaze me that at the recent Sanctuary Network conference a Safety Plan app was introduced. This app is amazing! Why? Because it combines two necessary parts of life — technology and emotional management.
Oftentimes when I make a presentation about how we use Sanctuary, people assume that safety plans are just for children. But safety plans are for everyone. They remind us of what irritates us and how to self regulate when we are triggered.
The safety plan app brings your safety plan to life. One thing I really like about it is the alarm feature. If you are on your way to a stressful meeting or event you can set an alarm to remind you to read your safety plan. The next step is choosing an item from your safety plan. For example, if you choose a song the app can immediately connect you to the music on your phone. If you choose to speak to a friend, your phone can immediately call anyone in your phone book. The last function I appreciate in the Safety Plan app is your personalized feedback loop. Once you have used an item from your safety plan, the app records that data and gives you feedback.
When you are stressed, triggered, irritated or confused, now you can just reach for your closest device and practice your safety plan. Members of the Sanctuary community can now say, “dude – we have an app for that.”
New Year’s Resolutions
Joan Bender is a Faculty Member at The Sanctuary Institute at ANDRUS.
It’s that time of year again when we say good-bye to the past year, and look forward to the excitement and newness of the year ahead. It is a time when many of us participate in the ritual of the New Year’s Resolution. As we reflect on the year that just passed, we think about all of the things that we would like to change about our lives or ourselves, and we set goals related to the changes we want to create. Often these goals involve changing our life style in some way. We commit to things like eating better, exercising, spending more time with family and friends or doing good deeds for others, just to name a few.
We start off excited about our resolutions, and share them with our family and friends. We’re eager to get them going and jump in to changing our behavior full speed ahead. But if any of you are like me, in a few short weeks, you’ll find yourself falling victim to your old ways, and before long you’ll find that you are persecuting yourself for slacking off on your resolution.
This year, I’ve decided to break that reenactment, and decided that I’m going to use some of my Sanctuary tools to help me. I’m starting by revising my Self-Care Plan. Now I have my resolution written down, and I can use my Self-Care Plan to remind me. I’ve also kept my Self-Care Plan changes simple, and in small steps. When the brain experiences too much change, too quick, it gets stressed and wants to shift back to old behaviors. I’m hoping that by making small changes, practicing them over time and adding to them periodically, I will be more successful in maintaining those changes.
I’m also using my Safety Plan to manage any stress related to changing my behavior. I’ve revised my Safety Plan as well. I’ve added positive self talk and inspirational quotes, so that it can also be an inspirational tool, when I want to give up.
“Give up?!?!” I know, sometimes it is so hard to get motivated or maybe you’re motivated, but you’re just feeling really tired and worn out. You think that no one will know that you didn’t exercise, or eat healthy or reach out to a friend today. That is, unless you have a structure in place to help support you. Social support is one of the greatest factors in successfully changing your behavior, and what better way to get social support than during Community Meeting. Enlist your friends or coworkers to help support you in your new year’s resolutions with Community Meetings. You might even want to set up a daily Community Meeting with a group of friends or coworkers specific to your new year’s resolutions and how you are all doing with them.
Happy New Year! Best wishes and much success with your resolutions. Are you using any Sanctuary tools to help you with your resolutions this year? If so, commit to social learning and share what you are doing. We’d love to hear from you.