Identify, Describe How Clients and Families Come to your Practice Identify, Describe and Discuss Addiction, Mental Health , Chronic P ain and Process Disorders Identify how Trauma, Shame ,Guilt, Humiliation, Embarrassment, Grief and Loss Effect Ones Story about Themselves Identify how we as clinicians, behavioral health care professionals identify our clients

1. Trauma , Invitations To Change and Family
Mapping
Louise A. Stanger Ed.D, LCSW, CDWF, CIP

2. Meet Dr. Louise
Clinician-Social Worker
Author-Blogger
Educator- Trainer
Wife, Parent, Widow
,Grandparent

6. What Is your Philosophy of
Treatment?
Take a few minutes
and write down 3 or 4
words that describes
your philosophy of
treatment.

7. Objectives
Identify, Describe How Clients and Families Come to
your Practice
Identify , Describe and Discuss Addiction, Mental Heath
, Chronic Pain and Process Disorders
Identify how Trauma, Shame ,Guilt, Humiliation,
Embarrassment , Grief and Loss Effect Ones Story
about Themselves
Identify how we as clinicians, behavioral health care
professionals identify our clients

8. Objectives
Identify , Describe Invitations to Change Inside
and Outside of The Treatment Mileu-Current
intervention Models and Practices
To develop an invitational vocabulary as we work
with clients and loved ones to share their story

9. Objectives
At the end of this workshop
Describe and discuss Portraiture as a qualitative
method of inquiry
Describe and discuss Rising Strong as a
qualitative method of inquiry
Discuss the efficacy of using qualitative methods
of inquiry while doing Family Mapping

10. Create Possibility
Aspiration that a better life is possible

12. Substance Abuse-
Addiction
Mental Health-
Depression/Anxiety
Chronic Pain-Physical
Maladies
Relationship failures -
Legal
But-how do our clients
arrive?

14. ASAM March, 2011
A Primary Chronic Disease
of the brain reward,
motivation, memory and
related circusy
Dysfunction leads to
Biological, psychological,
social and spiritual
manifestations
Individual pathologically
pursing reward or relief
thru substances

16. Chronic Pain
133 million People
Experience Chronic Pain
1 in 5 globally
65% of all people
experience chronic pain
once in their life
75 % of all heron users
started with a prescription
96 people die daily

22. Trauma

23. Definitions of
TraumaOverwhelming experiencing
that cannot be integrated
and elicit animal defensive
mechanisms and
dysregulated arousal
“A stress that causes
physical or emotional harm
that you cannot remove
yourself from”
Larke Huang , Director of
Health Care Equity at
SAMSHA

24. Trauma is objective
What happened ( My
father killed himself,
My baby dies of SIDS,
I was date raped ,
humiliated etc

25. Trauma is subjective :
How do I perceive the situation ?
Relationship to early
child- hood experiences -
and Alcoholism
Adverse Childhood
Experience- 17,000
patients -Kaiser- effects
of trauma are cumulative
and one of most
destructive forms is
recurrent calling and
humiliation

27. What do your Clients Say about
Trauma ????
Verbal abuse
Physical abuse
Witnessing a tragedy
Not being told about
something
Accidents
Divorce
Death

29. Getting Emotionally Hooked

31. Training
Evidenced Based
Graduate Education
Post Graduate
Education

33. Shame
Shame is that intensely
painful feeling of believing
we are flawed and
therefore unworthy of love
and belonging.
I am not good enough
Brene Brown

34. Guilt
Have you ever stolen
anything ?
Had guilty thoughts ?
Have you ever lied?
Made up a
confabulation?

35. Humiliation
The Act of Making
Someone Inferior or
Foolish

38. Loss and Grieving
Loss -Something of Value
is gone
Grief = Total response to
an emotional experience
related to loss
Breavement- Subjective
response by loved one
Mourning -behavioral
response

39. My Philosophy Of
Treatment

40. Sheldon Kopp
The therapist can interpret, advise, provide the
emotional acceptance and support that futures
personal growth , and above all can
listen…actively and purposefully, responding
with the instrument of his trade, that is with his
personal vulnerability of his own tumbling self.
This listening is that which facilitates the
patients telling of his tale that can set him free.”

41. Sara Lawrence-Lightfoot

42. About Sarah Lawrence Lightfoot
Prize Winning Sociologist-McArthur Award
George Leider Prize for research Harvard
27 Honorary degrees from colleges and universities-
novelists -9 award winning books
The Emily Hargrove's Endowed Chair which upon her
retirement becomes Sara Lawrence Lightfoot chair
making her the first African American in Harvard's history
to obtain that.
Full of grace and compassion

43. Philosophy
Strength based-it begins by looking for what is good
and healthy and assumes the expression of goodness
will always be laced with imperfections.
Collaborative qualitative inquiry- The researcher
becomes part of the conversation -Become witness to
the conversation
The Context -where the interview takes place
becomes part of the portrait -Human experience is
framed shaped by the setting.
Discovering the tension between life, loss and
liberation.

44. Who Am I ?
I am the mirror who reflects back their pain, their fears
their voices. I am the inquirer who asks difficult
questions, who searches for evidence and patterns. I am
the companion on the journey bringing my own story to
the encounter, making possible an interpretive
collaboration, I am the audience who listens , laughs ,
weeps an applauds. I am the spider women spinning
their tales.. I am the therapist who offers cathaersis
support and challenge… I am also the stage manager
coordinating the intersection of three plays-the story
teller, the narrator and the readers inviting your voice to
the drama”

45. Lifting The Veil of Widowhood
Tell me about yourself. Tell your
experience of being married
How you felt about your spouse
or partner
How did your spouse or partner
die ?
How if at all did your life change
after the death of your spouse (
Family, Friends, Economically,
Emotionally etc.
What would you like the world to
know about this experience

47. Raising Strong
Brene Brown

48. Invitation is to
Wholehearted living
Strength based
Cultivates Curiosity
Owning Your Story (
Falling down and
Rising UP)
To look at our SFD and
Confabulations

50. The Reckoning
Look at your Fall Down Moments
What Emotionally Hooks you -Giving Permission
to Reckon - Mindfulness as a Way in
How have I been Off loading Hurt?
Am I willing to get Curious ?

51. The Rumble
Unleashing Curiosity
Rumble with Vulnerability -uncertainty, risk and
emotional response (what does it look like, feel
like , show up etc)
Rumble with Shame ( How does shame show up
in your story (perfectionism,comparison ) SFD
Rumble with Boundaries (choosing courage over
comfort right over what is fun , generosity
Rumble with living big, anxiety, criticism

52. Rumbling With
Forgiveness
The belief you come
out the other side…
abetter person not
consumed by anger or
hatred… no longer
chained in victimhood
and dependent on the
perpetrator”

53. The Revolution
Story is our way home
“We are the authors of our
own lives
We write our own daring
endings
We craft love from heartbreak
Compassion from shame
Grace from disappointment
Courage from failure
Showing Up is our Power

54. Take Aways

55. Strength based
Collaborative
Realistic
Inclusive
Looking for Goodness
Listening to Strangers
Client Centered
Qualitative Inquiry- Open Ended Questions

56. To Articulate Your
Philosophy

57. Invitations to Change

58. –Louise A. Stanger
An Intervention is an invitation to
seek
and accept care

61. In Your Office

62. Professional Interventionists are
Called when
Families are Fearful
,Angry &Confused
Attached to the
Problem
Cognitively and
emotionally Dis-
regulated
Attempts have failed

63. Folks have unconsciously
colluded with the problem

64. Accountability
Teams
Sad-Disgusted
Boundary less
Loving -Worried
Frustrated-Shocked
Embarrassed- Shamed
Terrified-Controlling
At Wits End

65. Interventions Include a Village of
Potential Change Agents
Participants are experts
Value Driven
Solution Focused
Evidenced Based
Interventionists job is to
bring people together for
the common good and to
identify SA, MH and other
issues

66. Intervention Models

69. Traditional Surprise
Vern Johnson-I’ll Quit
Tomorrow
Frank Pickard- Family
Intervention
Ken Seeley- John
Southworth-
Intervention Show

70. Traditional Made
Modern
The Storti Model Est.
1973
Heart to Heart: The
Honorable Approach to
Motivational
Intervention, 1995

71. Jeff and Debra Jay
Love First , A Families
Guide to Intervention
2000
Aging & Addiction ,
Colleran and Jay 2010
It Takes A Family,
2014

72. Action Intervention Model
Jean Campell LCSW,
Dr. Jim Tracey and Bill
Maher
Psychodrama ,
sociometry and other
action oriented
strategies for families

74. Thought Leaders in Invitational
Models
Spaere & Raitner -
Systemic
Arise -Garret and
Landau
Breakfree- Lamm

76. Interventions are
an Invitational
Process
An 11 step process for a 12
step solution
2016

77. Theoretical
Underpinnings
Salvador Minuchin
Virginia Satir. TFT
Bowen , Family
Systems
Bowlby, Attachment
Monica McGoldrick-
Family Systems
Therapy

78. Start where your Client is
!

79. Phase 1 : Intervention Agreement &
Initiative
Step 1: Engagement
Step 2: Determine Key
Stakeholders
Step 3 Define Client
Guidelines,Confidentiality

80. Phase 2 : Information Gathering,
Objectives & Assessment
Step 4- Family Mapping
Step 5- Assess ILO and key
stakeholders (Portraiture -
Retrospective Analysis)
Step 6- Teach & Survey
Accountability Teams
(Triangulation of data)
Step 7:Develop Measurable
Action Plan

81. Phase 3 : Implement . Review &
Follow Up
Step 8 : Coaching ,
Delivering the Invitation
Step 9 :
Pre Intervention Meeting
The Invitational Meeting
Intervention
Progress Review and
Solution Focused Family
recovery Coaching

82. Other Types of Invitational
Interventions(Stanger)
Clinical Interventions ( Stanger & Storti )
Reverse Interventions

83. A Way Into Story

84. Conversations will be non-
linear

85. The Conversation will take you many
places
Open ended

88. Always Start
With

89. Qualitative
Questions
Tell Me about ………..
Tell me about your
Family..
Tell me about your
children, family,
Grandparents etc

91. Meet Christine
32 yo music executive
Opioids and disorder
eating
Mother and Father
Brother Cooper

92. What Stands out?

93. Family Mapping
Startedafter first placement

94. Meet Jack and his
family
54 yo old retired executive
lives with 29 yo son
Two previous treatment
episodes
3 children 19, 22, 29
Wife in process of divorce
Being asked to leave
treatment center as wrong
placement
Had to get him from A -B

97. Families Readiness to
Change
In 2 months 3 out of 5 family members were
ready to change
In 7 months 3 out of 5 family members had
engaged in treatment which lasted more then 60
days. 1 family member went for a 2 week
intensive,
2 Private therapists
1 family member refused treatment

99. Meet Rock
Refered by Producer
37 foster homes
legal problems
sexually assaulted
Gang leader
Chronic Relapser
Multiple marriages and children
Poet

100. Sometimes the First Story is
SFD
Great Treatment
center
CorrectFamily Map
Wrong Placement
How did I react ?

101. Rock is Raquelle

102. Rock is one of the Most
Courageous Gentleman
Walked Into His Story
Got Curious
Felt Safe to End the SFD -
Confabulations
And asked for Help
And After I got Over being
Uncomfortable, I was of
service

104. Meet Erik
20 years old
Only son of high wealth
family 92 sisters)
Legal issues
Substance Abuse
Anxiety & Depression
ADHD

107. Eriks Family
Sisters-Bullying and
Depression
Mom -Family History of
SA
Mom in Recovery
Dad Family History of
SA
and then Mom said I
have something to share
……

108. Erik’s mom
My brother died at age 38 he had HIV

110. You are Ready?

111. Take Aways
Family Mapping is a way
into story
You need about 90
minutes
Paper and Colored pens
Life is messy
Qualitative inquiry works
to illuminate

112. Be Curious

115. Wounded Hearts

116. Resources
Brown, Brene- Rising Strong . Speiegel & Grau International
2015 NYC NY
Brown, Brene, DaringGreatly. Gothom Books 2012
Lawrence Lightfoot,Sarah & Hoffman Jessica .The Art and
Science of Portraiture. Joey Bass. 1997
LawrenceLightfoot, S. Respect , 1998. Press Books, Mass.
Lawrence, Lightfoot,S. I’ve Known Rivers , Penguin Publishing.
Ny 1995
Lawrence, Lightfoot, S Growing Each Other Up, University of
Chicago Press. 2016

117. Resources
Kopp, Sheldon- If You Meet The Buddah on the Road , Kill
Him, 1982. Penguin House Random House, NY, NY
Stanger, Louise. Falling Up- A Memoir of Renewal 2015,
WZY Press
Stanger,http://www.huffingtonpost.com/entry/tricksters-
addiction-you_us_592f0f7ee4b0d80e3a8a329e
Stanger http://www.huffingtonpost.com/entry/what-are-the-
differences-between-trauma-
addiction_us_58f4e7aee4b048372700da27
www.allaboutinterventions.com

118. Resources
Stanger www.allaboutinterventions.com
Systemic Model www.systemicintervention.com
Arise www.linkingsystems.com
Jays www.lovefirst.net
Lamm www.bradlamm.com
Seeley www.intervention911.com

119. Resources
storti-www.stortimodel.com
Mintz www.reallifeis
Tap 35
www.motivational interviewing.org