LifeRing Training in Sacramento Nov. 21

Following up on the well-reviewed Sept. 19 LifeRing training in Oakland, I'll be co-presenting a new LifeRing training for treatment professionals in Sacramento on Saturday, Nov. 21.  This'll be in part a replay of the Sept. 19 presentation in Oakland, and in part an entirely new and exciting event, with the addition of my co-presenter, Dr. B.J. Davis of Strategies for Change.  Dr. Davis is, of course, the author of the new DVD, What is Recovery?  A Quality of Life Analysis (available from LifeRing Press), and a frequent and dynamic presenter at professional conferences.  Here's an online flyer with the information about the event.  As in Oakland, there'll be 6 (six) CEUs available for treatment professionals.  Even better than Oakland, which cost $10, this event is FREE.  LifeRing convenors and other participants are, of course, invited to sit in.

Full house for CAADAC LifeRing Training

The turnout of treatment professionals for my full day LifeRing training yesterday surpassed expectations.  More than 25 people squeezed into the conference room next to the Service Center in Oakland.  Some had come from as far as Sacramento for the six-hour session.  All except three, who were LifeRing convenors, were working in the addiction treatment field.

Peg Miller, a Vice-President of CAADAC and responsible for organizing trainings in CAADAC Region 4, which includes the Bay Area, organized the event, handled logistics, and awarded people their certificates of completion at the end.  LifeRing CFO Robert Stump organized coffee and pastries in the morning and helped set up the room. Service Center volunteer Lou A. assisted with room setup the previous day.

The program took six hours, not counting an hour for lunch.  During five of those hours, I presented a slide show of exactly 200 slides. Here's my outline:

LifeRing
An Introduction for Addiction Professionals
By Martin Nicolaus MA JD
CAADAC Region 4 Training
Sept. 19, 2009

Objectives

• To understand basic facts about LifeRing
• To get how LifeRing works
• To pick up tools that can be used with clients
• To facilitate client involvement with LifeRing

Hour 1: Basic facts about LifeRing

• What is LifeRing?
• Where is LifeRing?
• Who goes to LifeRing?
• How is LifeRing organized?

Hour 2: The Three-S Philosophy

• Sobriety
• Secularity
• Self-Help

Hour 3: How LifeRing Works

• Empower Your Sober Self: A short overview
• In more depth:

o The Divided Self
o Horizontal Synergy
o Confrontation v. Support Strategies

Hour 4: The LifeRing Meeting Format

• Circle seating
• “How was your week?”
• Crosstalk
• Limits
• Aim: Living Room atmosphere
• Closing ritual: Round of applause
• Peer leadership
• Signup sheet -- basket

Hour 5: How people build Personal Recovery Programs (PRP)

Two Pathways to PRP
Through the “How Was Your Week” Meeting Format
“Random access”
Through the Recovery by Choice workbook
• Nine Domains (Work Areas)
• My Decision
o The A-S T-chart
• Domain 1: My Body
• Domain 4: My People
• Relapse Chapter
• Pulling the PRP Together
Result: Diversity of Programs
Pros and Cons of PRP

Closing Thoughts

• LifeRing is a Strength-Based Approach
• The Aim of LifeRing is Choice

o We need more pathways
o Choice should not be controversial

What can providers do?
Choice is good program policy
More choices = more recoveries

For more information:

• www.lifering.org – LifeRing, the organization
• www.lifering.com – LifeRing Press e-commerce store
• LifeRing Service Center, 1440 Broadway, Ste. 312, Oakland 94612
• service@lifering.org
• 1-800-811-4142

P.S.  Today, Monday, Peg Miller kindly sent me the program evaluations (feedback sheets) filled out by participants at the end of the program.  Namely:

WORKSHOP EVALUATION (scale is 0-below satisfactory to 5-above satisfactory)

Your overall rating of subject matter:
•    20 5's
•    2 4's
Your overall rating of the trainer:
•    17 5's
•    5 4's
Your overall rating of the materials'handouts:
•    15 5's
•    4 4's
•    1 2
•    1 0 with comment (needed handouts--powerpoint printouts)
•    1 not marked--"handouts" circled followed by comment:  "sparse  hard to follow"
Your overall rating of the training/workshop: 
•    16 5's
•    6 4's
Your overall rating of the fees:
•    18 5's
•    3 4's
•    1 not marked and with comment:  "two days I went to training in NAPA... cost $75...$10 is nice"

Comments on this page:

Very good TR...affordable in very hard times
Educational, motivational in terms of realizing the need for choice.
Helped solidify what I had gleaned from the web site and publications
It was great!!!
Uncomfortable room
Enjoyed this training...learned a lot
Very interesting!
Excellent presentation   Very worthwhile
I am glad that I had a chance to learn more about the organization.
Most important point missed...we refer less to LR with clients because there are few, and we teach clients to stay connected to others, to stay sober.
I was surprised by how much I learned today.
Difficult to sit in these chairs in small room
Lots of good info... Some areas/topics were too lengthy--redundant.  Good program--Glad to see it growing in availability.

POST TEST INFO:

What did you learn today from Martin A. Nicolaus about LifeRing?

•    Three-S Recovery Philosophy; Strength-Based Sober Self Empowerment engine is positive practice of reinforcement; abstinence only is foundational; Personal Recovery Plans are highly individualized through support mtgs plus workbook; able to combine with variety of the models
•    Choise is best...many different paths
•    LifeRing is truly secular; LifeRing offers a choice other than faith based or 12 step; LifeRing emphasizes empowerment and positive reinforcement of the individual
•    A lot.  Ways I can improve the program I work for by LifeRing tech and beliefs.
•    Many interesting things, among others personal recovery plan, that I found very powerful tool in recovery.
•    The S & A model for recovery and how it works through reinforcement.  That all "personalities" are equally capable to become addicted.
•    It is focused on building on strengths of the individual--provides a choice--Personal Recovery Plan.
•    Lots--the choice factor; the love--feeding the S; forgive me--I'm way too tired and burnt to say more, but I got so much out of it.
•    Philosophy and history of LifeRing.  I am a convenor.
•    How to get treatment programs to mention LifeRing as a group option.
•    That it mirrors my thinking about Treatment Approaches.
•    We have another option
•    Focus on individual treatment.
•    The client is instrumental in his own recovery if given the opportunity.
•    Secular spirituality--support sober self.
•    There is an alternative approach to group support other than NA/AA.
•    Friend.
•    Lots!  I knew nothing of LifeRing.
•    The PRP program.
•    Philosophy...mtg structure.
•    It gives clients more of a choice.

How will you incorporate this information into your practice as a drug and alcohol counselor personally and in the agency you work in?

•    Philosophy and concepts (client choice, strength based, flexible treatment and support options);  Skills--workbook exercises--alt. HWYW support mtg formats.
•    Continue with MET, RET  use LifeRing principles in class, educate staff, talk with LifeRing meetings as Option more.
•    By A--facilitating myself with the visual and cognitive tools and use them in 1 on 1 sessions and groups; B--suggest to agency to use LifeRing possibily in continuing care program.
•    Investigating L.R. for and in my own recovery.  The applying LR to the program.
•    I will use the point that the patient takes responsibility for his own recovery more than I did before.  I would share todays experience with coworkers.
•    The strengthening of each individual will be the focus.  And shifting the focus from flaws to what they are capable of and what they find works for them.
•    Help clients and staff understand the nature of building up the sober self through the interchange bewteen people--focusing on here and now
•    I bought the work book--I'm sure I'll use it next week!
•    My meetings will have an enriched meaning due to the workshop today.
•    Refer
•    I will introduce the information about LifeRing to my director.
•    Gives me encouragement to do more research on the subject.
•    Already do--offer as a choice of support group.
•    I hope to start a group for teens.
•    Present client with choices...give basic info about LifeRing.
•    Working more with clients to focus on a personal service plan.
•    Plan to discuss implementation of LifeRing on the approval by my Program Director.
•    Consider choice.
•    LifeRing used to do presentations at NCADA...can do again.
•    Not in field.
•    I am a convenor.

How can you contribute this material to your fellow counselors?

•    Educate and consult re: LifeRing as resource; inputs to program policy and planning; follow ups to stay current on related research
•    In community meeting; 1 on 1 discuss content
•    Familiarizing myself with the materials and sharing them at staff mtgs.
•    Word of mouth.  Introducing things from work book into our program.
•    Through LifeRing Website.
•    Case conferencing, loaning my materials and discussing the information.
•    Not sure yet.
•    I will discuss the information with other convenors ASAP (any who were not present)
•    Talk about it
•    Sharing interaction.  Communicating presentation ideas.
•    Tell them to check it out.
•    Already do.
•    Do presentation.
•    Share information, go to LifeRing meeting, go to web site; present it in Case Conference.
•    Staff Meeting.
•    Discuss this training with them.
•    Shared information.

To your clients?

•    Client info and materials re: LifeRing; use workbook exercises--ind, and group; Encourage ? families LifeRing
•    Will use stuff from workbooks; agian, refer as much to LR as AA
•    Sharing the ideas learned; by continually recognizing the sober person living inside my clients
•    Introducing things from workbook into our program--word of mouth.
•    Refer them to the closest meeting place and website.
•    The strengthening of each individual will be the focus.  And shifting the focus from flaws to what they are csapable of and what they find works for them.
•    Plan to start a LifeRing group and turn it over to a group member eventually.
•    Pamphlets of where meetings are and the workbook.
•    NA
•    None yet.
•    Continue letting them know there is no one road or treatment towards recovery.
•    Give them another option.
•    Give them choice at intake.
•    Do a presentation.
•    Incorporate LifeRing materials to practice.
•    One on one sessions.
•    Paroles/State prison
•    Consider choice.
•    Shared info.

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P.S. 9/28/09:  I've posted the PowerPoint at http://www.unhooked.com/trxpro/CAADAC workshop.ppt -- just the slides, no sound track.  When I get time I hope to create a sound track and make a Flash video (or a series of them) based on this presentation. -- MN

Another door opens by a crack

A few weeks ago, as I reported elsewhere, I was invited to speak about LifeRing at Mountain Vista Farm, one of the oldest rural inpatient treatment programs in California. Mountain Vista's reputation is that of a citadel of the 12-step approach. Yet there was genuine interest in hearing about the LifeRing approach, and my presentation appeared to resonate with quite a few of the counselors in attendance.

Now comes an invitation to speak about LifeRing at another well-known bastion of the 12-step approach, the Henry Ohloff program in San Francisco. I will be addressing staff at the outpatient center on June 2. Like Mountain Vista, this program is not ready to host a LifeRing meeting, and it may be quite a while before the treatment protocol opens up to the reality that there are many roads to recovery. But meanwhile, there are staff members in these tradition-bound programs who have their eyes and ears open for new developments that may help some of their clients.

This is certainly a welcome sign. If I ask why it is occurring, the answer is that patients/clients are driving it. In at least 80 per cent of the cases where we are contacted by a treatment professional and asked for more information about LifeRing, a patient or client was the driver. A patient or client introduced the professional to LifeRing literature or the LifeRing web presence, or informed the professional that he/she was attending LifeRing and that it was helping.

And even when an individual patient or client is not directly the driver, in the sense that he or she located LifeRing and put LifeRing on the professional's radar screen, it is still patients/clients who drive the process passively, by voting with their feet when the professionals only offer an approach that does not work for them. A treatment program that only offers the 12 steps and nothing else is going to experience, sooner or later, the reality that 80 per cent of newcomers to AA walk away within 30 days (and 95 per cent within a year).

While few treatment programs retain a patient as long as a full 30 days -- the average stay at one nominally 28-day program I know is around 10 days -- the client resistance to 12-step may well show up from Day One of treatment. If the program has nothing else to offer, it's going to lose clients earlier than if it offered choices. Monomodal treatment translates into high patient turnover. You don't need to be a rocket scientist to figure it out.

And so, the wheels turn, and sooner or later a call goes out to LifeRing, or another alternative approach. Quite a few LifeRing convenors now have had the experience of explaining LifeRing before audiences in treatment programs. To be sure, it's far too early to proclaim a tsunami, but if we compare the interest in LifeRing from treatment programs ten years ago and now, we're almost in a new era. Ten years ago, most minds were closed and we couldn't get in the door. Today, we're frequently in the embarassing situation of getting requests from a program director to start a meeting, and not having a convenor to take the room. It's a problem, but it's a better problem to have.

"One More Arrow In the Quiver"

Report on a presentation to staff and patients of a 12-Step treatment facility

By Marty N.

This morning (1/27/00) Marjorie J and I presented the LifeRing approach to a "doctor's hour" meeting of patients and some staff at the Merritt-Peralta Institute (MPI) in Oakland. The MPI is a unit in Oakland’s privately owned Summit mega-hospital located on Pill Hill in midtown. About 30 persons were present, seated around a long table in the board room. The MPI has a reputation for being a hard-core traditional 12-Step treatment facility. Knowledgeable sources have described it without malice as a Step-Nazi citadel. It is one of the largest inpatient facilities and is, after Kaiser, one of the largest outpatient programs in the S.F. Bay Area.

In the reception area on the fifth floor there is a placard containing the 12 Steps in red letters about 2 inches high; this is framed behind glass in a wood case about three feet by four feet. The frame is bolted to the wall with ¼” thick carriage bolts. You can’t miss it. The literature rack is filled with AA and NA schedules in messy profusion. There is an MPI alumni newsletter that contains nothing but 12-Step homilies.

How, you may ask, did we get invited to present our program to this staff? The bottom line answer is: patient demand. The medical director of the facility told us that they were constantly encountering patients who did not want to have anything to do with the 12-Step program, and he, the director, did not know where to send them or what to do with them. So, if you are ever a patient in a treatment facility and you have problems with the 12-Step approach, be sure to register your concerns. You may not see immediate changes, but the cumulative impact of your pressure over a period of time may eventually create an opening for change, as in this case. There are individual treatment professionals in every facility I have had contact with who, like this physician, are driven by a desire to help the patient, over and above any personal 12-step affiliations, and who realize from daily professional experience that the 12-Step approach just does not cut it for a number of their patients. Patient demand is driving these professionals to look for alternatives. Patient demand combined with staff professionalism is what got us invited to this citadel of traditionalism. As far as I know, we are the first and only non-Step group to ever be invited there.

Our host told us before we began that he did not want to polarize the issue into Us v. Them, and did not want to have the session turn into a debate. He wanted us to be seen as a complement and an adjunct to their traditional program, one more arrow in the quiver, not as a rival or a competitor. This is a situation with which everyone who advocates for a secular alternative has to deal. It’s all a lot of fun to polemicize with faceless dodecamaniacs on the Internet, but when you’re talking to a staff meeting and your objective is to win approval to hold a meeting on the premises, the word is: be positive. Our experience in talking to the Kaiser groups in Oakland over the past three years came in very useful here.

In this case, I began by telling about my own recovery. I said that I had 7 years 3 months and 25 days clean and sober, all of it in SOS/LSR, and had never attended any 12-Step meeting. I described LSR/SOS as a supportive, tool-rich environment where people are encouraged to build their own recovery programs, taking what they need for their individual recovery. Then, by way of example, I outlined my own personal 1-2-3 program (do something every day, go to meetings, use the Sobriety Priority as a decision-making tool) along the lines I’ve written in my story in the Handbook. The audience members could see nothing objectionable in this approach, which is in its secular way quite traditional, and it seemed to reassure them at the outset that we were sound.

Then, I explained the concept of the drunk self and the sober self at war in the user/abuser. By drawing cartoon heads on the whiteboard, I was able to show the small, weak, sober self becoming empowered by interaction and support via the meetings, and becoming dominant within the person. This is a plausible, intuitively correct model of recovery, presented in an entirely positive way without polemics. Only later will some in the audience realize that this simple and sensible recovery model requires no Higher Powers. Like Occam's razor, it has no need of the God hypothesis. I concluded with a few words of gratitude toward the LSR/SOS program for being there for me to get sober in, and with appreciation for my new sober life.

Marjorie then took the floor and told very movingly of finding SOS/LSR on the Internet, and how the sosmail list helped her pull herself out of drinking and isolation and helped her get sober, and how participating in LifeRing positively changed the quality of her life.

We then took questions. The first question was to describe what goes on at an LSR meeting. I read the opening statement for our SF Bay meetings out of the Handbook, and briefly described the check-in format and the topic format, emphasizing our use of crosstalk, and our practice of closing meetings with a round of applause.

I don’t remember all the questions in detail, but one of the next ones was about crosstalk. I said that we felt the process of drunks talking with drunks was central to making the sober place inside us stronger (pointing to the whiteboard and the diagram I had drawn), and for that reason we encouraged crosstalk and allowed it in either all or part of each of our meetings. Marjorie pointed out that sometimes we asked a person whether they wanted crosstalk to their share, so that a person could be protected if they felt crosstalk would threaten them. This set the questioner (a person who introduced himself saying “I’m Joe (or whatever name) and I’m an alcoholic”) grumbling to himself but without a comeback. (You need to know that AA, even though it has made an icon out of “drunks talking to drunks” does not allow crosstalk in its meetings.)

Another question was, “do you have mentors or sponsors?” I said that if a newcomer in our group felt attracted to another person’s recovery program and wanted to learn from them in particular, they were free and encouraged to approach that person and form a closer relationship with them. But we had never formalized these relationships. The reason is partly historical. When AA began, meetings were underground and you had to be invited; the person who brought you was your “sponsor.” But today meetings are publicly announced, so there isn’t any need for this role, really. Besides, I said, formalizing the relationship scares us; sponsors have a lot of power, but there isn’t any exam, or any standards, or licensing board, and that worries us; so we’ve kept mentoring strictly informal. The questioner did not pursue this and seemed satisfied.

One person wanted to know the history. I told briefly of how the founder got sober in AA in 1978 but then felt he had to start on a new foundation, and began SSG, and so on. Another questioner (another one who began “I’m Joe and I’m an alcoholic”) took off on this and asked a very interesting question that I had never heard before. He said, what was it the founder could not handle in AA? What was the thing that made him finally decide to leave?

I said the thing that gave the founder cold sweats and finally made him leave AA was the thought “what if God wants me to drink?” He realized in that case he would have to tell God to go to hell. And when he thought about the implications of that, he realized he had to start a program that was not God-based, but was based on the Sobriety Priority. The questioner took this answer very seriously and did not argue with it.

Someone asked whether we were just for atheists and agnostics. I explained that we were not atheist/agnostic but secular, meaning that people of all faiths and none were welcome, and that neither religion nor anti-religion were business that came up in the meetings. I said that people with very definite religious beliefs felt comfortable in our group because our process did not require them to amend the beliefs they came in with.

The same questioner who had asked about the founder then volunteered that he had attended a couple of our meetings and found that, as far as religion goes, in our program “you get to keep what you have.” I think this is a very good expression.

Another questioner asked, skeptically, “is this some kind of experimental program? Have there been any studies done as to whether it works or not?” I answered that as to studies, there was the 1996 study by Connors and Dermen, a copy of which was included in the presentation packet we put together and handed out. Admittedly, I said, this was not a comparative study with a control group, which was the only way to really find out anything scientifically. But then, scientific studies with control groups had never been done for AA or NA either, except in rare instances and with mixed results. If anyone in this room would like to study our group in a scientific way, I said, I’m sure we would be glad to cooperate; please to talk to me afterward. As for being “experimental,” I said we gladly copped to that, we were still learning and developing and trying things out, and I hoped that we would always be listening and learning and developing, and that if we ever got to the point where we thought we had the final answer on how to get you, you, and you, and everyone in the world sober, we would become obnoxious. (I had sense enough to stop there and take another question.)

A questioner wanted to know about our history locally and our name change, and where did we have meetings. I dealt with the name change very briefly: we got involved in litigation with another group that claimed rights to the name and we lost and the court made us change our name. End of story. As to history, I pointed out that our first local meeting was on March 17, 1988, and this meeting was still going, and in fact Marjorie was the current secretary of it. At this time, we have meetings in the area seven days a week, and you can do “seven in seven” in our organization. This made a strong impression on the group. I pointed out we had meetings at the Kaiser in Oakland, at Kaiser in San Francisco, at Kaiser in Richmond and at Kaiser in San Rafael, as well as at Herrick Hospital in Berkeley. This also seemed to impress, as Kaiser is the biggest chemical dependency outpatient program around here, the implication being that if Kaiser hosted our meetings, we must be OK. Also, I said, at Kaiser Oakland on Saturday morning, the patients have to attend a support group between the hours of 10 and 11, and Kaiser has AA and NA and LifeRing going side by side during this hour, patients’ choice. Several heads nodded approvingly at this concept.

When they ran out of questions, our host thanked us and again said, as he had earlier in introducing us, that he frequently had patients who resisted the 12-Step programs and he did not know what to do with them. He felt that an alternative group would be a useful addition to the program, “one more arrow in the quiver.” That seemed to express a consensus. They gave us a good hand. What happened next was completely unexpected to us. The whole group, patients and staff, linked hands and recited the Serenity Prayer, followed by some kind of rah-rah chant along the lines of “keep coming back, it works if you work it,” like at an AA meeting. We took it in stride.

Several patients and staffers talked with us afterward to express interest and support. The physician who was our host said he was pleased with the way it turned out. He joked that he hoped he still had a job after hosting our talk. He looked relaxed and upbeat. He introduced us to the program coordinator, a younger man, and the two of them agreed in our presence that we should have an evening LifeRing meeting at the facility. They would consult their calendar and get back to me. With cordial shaking of hands and thank-yous, we parted.

We left 15 copies of the Professionals’ Packet and a bundle of meeting schedules. One of the staffers said he would personally see that the schedules got into their literature rack. I will follow up about the meeting. I have been looking for a way to get a meeting at this facility for more than three years. From time to time people who have gone through their program manage to find us, and it’s always the same story: 12-Steps rammed down one’s throat, many patients not happy, looking for an alternative. Hopefully they’ll have one soon.

Credit our member B. for providing a key information link to make this happen. A little before Thanksgiving B. had a major relapse, and managed in one weekend to check himself into, and get thrown out of, both the Herrick crisis unit and the MPI unit. When he sobered up and told the story at a meeting, he happened to mention that he saw the same physician, Dr. C., at both places. That was how I learned that the Dr. C whom I already knew from the Wednesday morning Herrick meeting was also on staff at MPI. I had had no idea. The very next day I buttonholed Dr. C at Herrick and asked him whether we could start a meeting at MPI. I nagged him by phone and by letter over the holidays. Last week finally came the invitation, on five days' notice. We were ready.

###

P.S. I got the call today (ten days later) that we are invited back for a second presentation, this time to staff only, on 2/24. -- MN.

Edited 3/3/00 MN.