Changes to First Step…

4/15/18

First Step Treatment Center blog

It has been awhile since I blogged.  I have busy making some changes at First Step that I want to share with those who come by this website for a visit. Since the last blog entry, I have been making changes that come from a shift in therapeutic approach that has been going on in my practice for some time.

I have received formal training, and instituted at my office an approach to helping clients called Acceptance and Commitment Therapy (ACT) developed by Steven C. Hayes, Ph.D.  This is a fascinating approach that looks at psychological distress as being the effort expended to avoid negative thoughts and feelings.  This is called Psychological Inflexibility.

“Acceptance and commitment therapy has been shown to be effective in helping those with anxiety, depression, substance abuse and stress. According to NREPP, ACT also helps to reduce symptoms of depressive disorders and the intensity of certain anxiety disorders like OCD, relieve distressing symptoms associated with psychotic episodes (such as delusions and hallucinations), and improve general mental health.”

Some thoughts about ACT.   ACT leads to a lifestyle… ACT guides you to a way of living that changes how you “live with thoughts and feelings without fighting them… A way of living in the moment, and according to values”.   ACT is not a cure, but rather, a way of going through life in a more fulfilled way.

I began formally using ACT with clients this past September, 2017.  Since that time, I have seen significantly more positive change taking place in the lives of individuals I am working with.  Here is an example, from a post on the First Step facebook page:

Another ACT metaphor that is often used is the “passengers on the bus”. A great metaphor for understanding how we go through life collecting “passengers”, thoughts, feelings, experiences, that fill our metaphorical bus. As we drive through life, we often get feedback, both positive and negative, from these “passengers”. This can lead to difficulty in living life as we are often hassled by these passengers. But as we learn to live with the negative passengers, listen more to the “wise” passengers, we can make our decisions based on our values, instead of the negative noise coming from the negative “passengers”. Clients we work with often cite this metaphor as a significant moment in their therapy… Discovering that life with the passengers can be meaningful and fulfilling.

We have also started a DUII treatment program at First Step.  This took some time to develop, but will serve clients in Newberg, greater Yamhill County, parts of Washington County and other areas.  We will use ACT along with standard DUII information to aid individuals toward making healthy changes leading to fulfillment.

There must be a better way!

11 August, 2017

There must be a better way!

I have been contemplating this blog entry for awhile now.  The title was inspired by the growing frustration I have been experiencing as a professional doing both mental health and addictions work pondering how to best engage clients and help them make healthy changes.  Without getting bogged down in the core tenets of various theories, let me freestocks-org-126848simply say that I have come to see some underlying assumptions that I believe are simply getting in the way, and keeping the individuals we see from reaching their fullest potential.

This summer, and going into the fall, I have and will be studying and training in a therapeutic approach called (ACT), Acceptance Commitment Therapy.  This approach is actually a shift from the theories known as CBT and DBT.  This is a challenging approach that helps individuals see that part of the very problem with anxiety, depression, PTSD, substance abuse, and other problems, are rooted in the effort one puts forth to avoid, push away, suppress or medicate painful thoughts and feelings. This therapeutic process aids the individual toward learning to manage without control, and make peace with these feelings and thoughts, rather than continue to fight with them.  This approach uses various homework and in session experiential exercises, and engages individuals on a deeper level, and has been show by the research to be very effective with the issues identified above. I have already begun using some of the techniques with clients and the results are quite promising and exciting.

Now some thoughts about substance abuse counseling!

Addictions programs have always followed a similar model and set standardized immediate expectations for individuals coming in to treatment.  The curriculum often includes information about how drugs harm your brain and body, effects of drug use on your life, what is addiction, progression, disease concept…. The list goes on!  What I have found is that we spend a significant amount of time telling clients things they could learn at home doing a google search, and the information typically has no impact on whether or not they continue using.  Individuals who are abusing drugs are well aware that what they are doing can and usually does have negative consequences.  Not that a certain amount of education in this area is not helpful, interesting and appropriate… But relying on education about drugs to have any sort of impact on their decisions about use will be fruitless.

I have also begun to wonder about the immediate expectation that drug counselors have regarding continued use by their clients.  Individual (Sally) comes to therapy because she drinks every weekend.. There is this expectation, especially if she is in the legal system, that she will quit drinking while she is in treatment… But if Sally could quit drinking so quickly, would she need treatment? Isn’t this a little like having a depressed individual come to therapy for help with depression… But being required to not be depressed while they are in the therapy process?  “You can come to therapy Sally, but if you drank this week, I’m telling your PO!!”… This is often a significant frustration for clients who come to treatment as they enter a program with more fear and anxiety because they are being expected to immediately do what they have been unable to do on their own… Creating a real paradox.  So my approach is to focus more on the underlying processes that are contributing to the ongoing use, while still addressing the continued use in a manner that seeks to avoid punishment and supports changes.

There is much more I would love to say, but this blog entry is long enough.  I will conclude by inviting anyone reading this blog to come on this journey of increased acceptance, commitment to change, and finding lasting serenity in the midst of an often painful world.

Identity change..

Identity change..

Thank you for visiting the First Step website and blog.  Some of you may know that I recently obtained my License as a Professional Counselor, making me a Dual Diagnosis qualified therapist working with both mental health and substance abuse.  Although, over the last 20 years of clinical practice, rarely have I treated an individual with substance abuse issues that did not have co occurring mental health diagnosis.

I had an individual I am working with make a statement that really got me thinking.  This individual stated that “people really need to know about this place, and what you do”.  What makes the work I do special and unique among the many other providers of mental health and substance abuse treatment that are out there?  Most Therapists are not the best “self promoters”.  We go through years of training and education to help people, not self promote.  Most of what we do takheidi-sandstrom-120382es place out of the public eye, and done in a setting where confidentiality and privacy are key to people feeling comfortable working through the painful emotions that brought them to the office to begin with.  But the point was taken, and so here goes…. Some “self promotion”…

What is First Step really about?

First Step was founded on the basic principle of promoting healthy changes in attitude, thinking and behavior which in turn lead to a better life.  All of us, at some point in our lives, will encounter circumstances that leave an impact on how we think, what we believe, and the end result is often substance abuse, depression, anxiety, or other painful emotions and coping skills.  First Step seeks to help people work through the damage and find healing on a deeper level through raising awareness, and supporting change.  This often comes from exploring core beliefs, changing automatic thoughts and unhealthy behaviors.

How we do this?

People have many different views and ideas about therapy.  The process can take many forms.  Sometimes individual therapy, group, family, or couples work.  Often, I hear comments such as “what can change just by sitting there and talking”.  The answer is simple.. Sometimes nothing, but sometimes a lot.  I have long believed that so often what helps people the most is having their feelings and thoughts validated, and being heard.  Validating feelings and thoughts does not mean you necessarily agree, but rather, it is acknowledging that what the individual is experiencing is indeed real for them, and is important.  Much healing can come from the therapeutic process through which individuals have their painful experiences and emotions validated.  Validation says “yes, you are important, and what you have experienced matters”.  The therapeutic process also includes helping individuals explore new ways of thinking about their experiences, shifting perspectives, and learning new ways to look and respond to life.

Where is First Step going?

Being a Christian, this question is not really mine to answer.  Recent events and opportunities have led me to believe that God is taking the therapy I offer in a significantly new direction.  Providing a broader range of services to include those with mental health conditions such as depression, anxiety, PTSD, as well as substance use disorders with make that work we do more complete in serving the community.  There are so many out there that struggle day to day with emotional pain that needs a place to heal.  It is my hope that we will be able be of service.

I hope this blog post answers the spirit of the comment that inspired this entry today.  People need to know who we are, and what we are about.  We are a dual diagnosis facility that seeks to serve those experiencing emotional pain and need a place to heal.

By Rodney D. Robbins MA, LPC, CADC III

Times Change… Do people?

Times Change… Do people?

I heard this line on an old comedy from the 70’s once… “Times change.. People don’t”.. At the time, I believed it. Now? Well, I am not so sure.

It seems that the values I once believed were constant are shifting in our culture over the last 5 or so years in a direction that should be concerning.  The cultural attitudes toward drug use and mental health continue to barriers to people recognizing and accessing help.

What I have seen in my own practice, as well as other established treatment centers, is a problematic trend in several areas.

  1. Mental health conditions are often viewed as a weakness, thus, most people who are depressed, anxious, have trauma or other conditions, do not seek help.
  2. Substance abuse is not recognized as being a problem until it has progressed to such a pronounced level that treatment is significantly more difficult. The pervasive mindset that the problem needs to progress to the point of hitting bottom is the same as waiting until cancer is stage 4 before initiating treatment.
  3. Use among teens is becoming more accepted and viewed as normal despite the medical evidence that clearly shows the negative impact on the developing brain and body.
  4. There are so many distractions that fitting therapy into an already hectic schedule requires a significant amount of effort and commitment.
  5. Shifting attitudes and beliefs about seeking help are resulting in fewer people accessing available resources.

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All of these, and I am sure many more, have become a significant barrier to people seeking and accessing help.  In the past, doing the “right thing” for yourself and family was the priority.  Is it today? Or perhaps figuring out what the “right thing” to do is the problem? With so many conflicting voices coming from social media and all the other distractions, finding the “right thing” to do can be a daunting task.

I guess I wrote this blog entry today to simply ask the question.. What is the right thing to do about substance abuse and mental health problems? Help is available.  Maybe doing the “right thing” means overcoming these distractions and getting the help that is available.

Just a thought for the day..

The Hidden Agenda

12 April 2017

The Hidden Agenda

As I sipped morning coffee, preparing to start today, I was doing some reading about treatment centthomas-martinsen-2443ers and what individuals seeking help want to know before they make that first move to get an evaluation and start the process.  What came to mind came from a message at church I heard in Colorado when I was a soldier stationed there in the 80’s.  The message was called “The Hidden Agenda”.

I don’t remember the entirety of the message, but the central point was that very often people approach life with a variety of hidden agenda’s that are kept secret for a variety of reasons.  Now that we are in the internet age, the hidden agenda’s are not so very hidden.  When you click on a website and are inundated with ads, the “agenda” is pretty clear.  In our consumer culture, there are so many competing voices trying to sell you something… Anything…

Treatment centers offering therapy can appear in some ways no different.  Agencies attempt to market their “product” to consumers as any other business selling a product will do.  Just do a google search looking for a Therapist to treat whatever condition, and you will be flooded with results, all describing their approach and outcomes in a variety of ways.  This whole process can seem very overwhelming to someone who is already in distress and just wanting to find someone to talk to.  For some, the process is so overwhelming that they simply do not seek help at all.  For others, they see counseling centers as just “wanting to get money”.

All of this led me to consider my own approach to doing outreach and “marketing” if you will, and look at what people really want to know when they are considering getting therapy.  Certainly factors such as cost, approach to therapy, outcomes and types of counseling are important.  But ultimately, don’t most people really want to know the “end game”?  Don’t they want to know just what the goal of the treating therapist is?  I know for me, the “agenda” is to help people learn more about themselves, their core beliefs and unhealthy thinking processes, along with how to change them.  My agenda is to help people find hope and healing in the midst of what can be a very stressful and chaotic daily life.  When it comes down to it, I do have an “agenda” that is not so very hidden.

Boundaries of Hope!

Boundaries of Hope!canstockphoto1684056

Recently, I began to make plans to launch a group for individuals who have someone they care about dealing with the drug abuse.  This will be a therapeutic group similar to Alanon, which is very respectable and helpful.  The process of the group will go deeper.  Providing both education and therapeutic support to aid individuals work through the powerful emotions that accompany having a loved one abusing substances.

The time has come!  I am grateful to a Health Psychology class at my Alumni George Fox University.  The class was tasked with helping me come up with a name for this group, and they did exceedingly well!  The name Boundaries of Hope was chosen!

Boundaries are a powerful part of the healing process.  Being able to set and hold consistent boundaries is very difficult with those using mood altering chemicals.  But doing so is a key to keeping yourself healthy.

Hope is often deferred when dealing with the drug abuse of another.  The constant feeling of “maybe this time they will change” is dashed by the next use! This process creates significant distress and leaves the individual feeling hopeless.

As you can see, the name fits the agenda!

If you are interested in being a part of this group, please call our office at (503)538-7647 and schedule an initial evaluation to be considered for enrollment.

I apologize that it has been awhile…

5 April 2017

I apologize that it has been awhile since I last posted to the blog.  I had a medical event in February that was quite serious, but am doing much better now.  March seemed to go by much faster than anticipated.

I am now in my 20th year post graduate school providing therapy to clients.  Over those 20 years, I have spent my time doing primarily addiction work, with the addition of mental health issues that are almost always contributing factors.  Recently, I obtained my License as a Professional Counselor, which now qualifies me to do both mental health and addiction counseling, and bill insurance.

As I embark on this new direction, some thoughts came to mind that I want to share with the visitors to this blog.

I am excited to be expanding my clinical work to focus on some new areas.  Issues such as depression, anxiety, PTSD and grief/loss are of particular interest.  There are so many out there suffering with these conditions that never seek help.  My particular approach looks at what life events from childhood to the present have contributed to negative thought processes and core beliefs that lead to these troublesome problems such as those listed above.  This is not an easy process, and there really are no “quick fixes” when it comes to changing how we think.  I had a client recently compare changing your thinking to rewiring your house.  This is not so far off from the truth!

Thank you for visiting this blog, and I look forward to this new direction providing mental health services.