1. Strength-Based Approaches Mark M. Lowis, LMSW MML Consulting, LLC

2. Transition? From What?To What? Institutional Memory Goal is to Maintain Stability in within the System What the Agency Offers Prescribing/telling Compliance Based Monitoring compliance Deficit Based Targeted Treatment Goal is to Exit the System through Amelioration Individualized Issues Assistive Interventions Collaborative Guiding Incremental change Recovery based

3. Institutional Memory Historical Approach to Treatment in which the need is to protect the public by: Identify Persons with Mental Illness based upon dangerous, aberrant or abhorrent behavior Remove from Mainstream Place in institution Stabilize Symptoms Maintained forever (for their own good) – State Facility – Forensic Center – Jail

4. Old Muscle MECHANICPHYSICIANPROBATION OFFICER Diagnose Fix Diagnose Prescribe Prescribe Behavior Monitoring Compliance Dosing with Reality (warn) Violate PARENTCOMMANDERJAILER Prescribe Behavior Confront Resistance Entice/Warn/Emotional blackmail Consequences to motivate Change Give OrdersConfinement Monitor Compliance Dominate COACHTHERAPISTPOLICE OFFICER Directs Rates performance Bench Identify Dysfunction Advise Confront Resistance Violation Citation Detain/Arrest

5. New Muscle MECHANICPHYSICIANPROBATION OFFICER Quality Warrantee Support Customer Service Respects Autonomy Empathic Explains Reassure Emphasize Choice and control Monitor Orders of Probation Focus on Offender’s reason for change Assists in finding ways to be successful PARENTCOMMANDERJAILER Clarify Expectations Teach Skills Coach Performance Emphasize Choice and Control Support Change Motivation Train Motivate Focus on Skills Promote Observe Respond COACHTHERAPISTPOLICE OFFICER Train Motivate Focus on Strengths Assist in increasing strengths Assist in attaining goals Respect Autonomy Emphasize choice and control Empathy Assist Focus on strengths Protect Deter

6. Deficit-Based Approaches Prescriptive Treatment is “taking over” or “rescuing” Interprets Client behaviors as pejorative Approach shifts from client to practitioner Labels and sub-labels are used to describe clients Client’s ways are backward, unsophisticated, incorrect Interventions are seen as necessary for client’s own Good Effort to address practitioner emotional states over client needs Confronting is seen as an intervention based on authority of the practitioner over the client

7. Deficit-Based (Institutional Memory) Prescribed Goals and Objectives Encounters are cumulative and general Time frames are subjective Consumer must accept expert advise Consumer must match expectations of system Confront Resistance – Guardianship – Consequences – More Restrictive – Seclusion and Restraint – Behavior Management Committee

8. Absent From Deficit-Based Autonomy = Self Governance Right of Choice and Control Lifestyle Choices Medication Choices Relationships Hygiene Income Activities

9. I See You As A Person Who…

10. Strength Based The individual has the right to dignity and respect from the practitioner(s) and every person whom they encounter at the agency (Mutuality)

11. Strength Based Its not looking for their strengths. Its knowing that they are there Honors autonomy Emphasizes choice and control What assistance are they seeking What do they already understand How do they see us working with them

12. Strength-Based Approaches Strong Emphasis on Joining and Engaging (Alliance) Treatment focuses on Amelioration of issues targeted by the individual Behaviors are understood from the Client’s perspective Approach shifts from practitioner to the client’s goal Focus shifts from “should(s)” to client’s motivation Focus is on what the client is able to do Interventions are collaborative and assistive strategies meant to aid in achieving goals and objectives The client and practitioner are “Mutually” involved

13. Strength-Based Bio-Psycho-Social A.Fred enjoys reading, music and watching sports on TV B.Fred has been able to maintain himself with few resources despite his paranoia C.Fred has a driver’s license D.Fred values his independence and wants to manage his own medication E.Fred is open and verbal F.Fred needs to have more activities outside his home

14. I See You As A Person Who…

15. Strength-Based Techniques Reframing – The other way – An other way – Deeper Recognition Understanding Resistance – What makes sense? – How do we work on that? – Flexible learning/Socratic

16. Making Sense Out of Resistance

17. Strength-Based Methods Motivational Interviewing Solution Focused Cognitive Behavioral Therapy Gentle Teaching Positive Psychology Targeted Case Management Multi-Systemic Family Psycho-Education Etc.

18. Video Describe Jim Clinically Describe Jim as a Person

19. Case Work Lets develop a case Write a Strength-Based Goal with Good agreement and interventions that are assistive and collaborative Interview this person

20. Thank You