Recovery/Substance Abuse

Use of Practices
in a Recovery Program
Mary Ann Steffes, RN

The first group I worked with was made up of residents at a halfway house for recovering alcoholic/drug dependent women ages 18 years to 50 plus. We held four one-hour sessions with them. We began with a little grief work because two weeks prior to starting classes, a resident's four month-old daughter died of SIDS. This baby was loved and "mothered" by all the women in the house. We felt it was imperative to address grief and then incorporate this in our healing practices.

We did breath work, Tai Chi, finger holds, mandalas and a closing ritual with an "altar' of our gifts. In the Tai Chi I used words and phrases associated with recovery and also used words to describe the guilt and shame alcoholic women carry. Seventy to ninety percent of alcoholic/drug dependent women have been victims of sexual, emotional and/or physical abuse since childhood.

Our group was diverse in that some had only been at the house for days and therefore were new to recovery. Others were nearing the end of their 90-day stays. Staff also joined us. Residents and staff were very vocal about the relaxation and focusing that occurred. One resident had experienced breast cancer and its treatment. She felt strongly that the Tai Chi and breathing would be very beneficial to her continued physical healing and her recovery in addiction.

It was interesting to note the changes in appearances and attitudes as we progressed throughout the classes. Emotional barriers dissolved and gentleness and acceptance became evident.

Work with a Residential Treatment Program
Rosann Geiser, R. N., M. A., Wisconsin

A series of classes was offered to women recovering from substance abuse who resided in a local residential treatment program. The flier advertising the classes was titled Stress Management - Body, Mind and Spirit. A paragraph describing the classes stated: A series of classes is being offered for women in using natural personal power for body, mind and spirit healing It is based on the Capacitar Training Program, which teaches simple yet profound techniques of accessing the universal energy available to everyone for natural healing and stress reduction. Using these practices, the participants can create healing and unity within and among themselves and experience a transforming, nourishing and healing environment. The classes are being offered free as a service for women who have suffered trauma and abuse. Maximum benefit is obtained from consistent attendance at class and application of the practices between classes.

This group was chosen because of a personal connection with a young woman who participated in the program. Observing the issues she experienced as well as the environment in the house, it seemed these women could benefit from these practices.

The objectives for the classes were that the women would develop an understanding of body, mind and spirit integration and a basic proficiency in and commitment to the practices. Another objective was to see a faster response rate in the treatment program and reduction in relapse rates for substance abuse. This was difficult to measure because of turnover in the group and inconsistent participation in the classes. In addition statistical information about the women was not accessible either because it was not tracked or because it was confidential and not available to an outside person.

Another challenge for the classes was that attendance was optional and not made part of the program. In order to have sufficient space to perform the practices, the classes were held at a neighboring church classroom. Therefore, motivation to attend had to be high in order for the women to go out at night and participate in yet another "program". Initial interest was piqued but waned quickly. One of the counselors who experienced and understood the benefit of these practices encouraged the women to participate when she was on duty. Follow-up discussion of these challenges took place with the Program Director. She now recognizes the benefit of these practices and has requested this series of classes be offered one to two times a month during their daily group sessions at the residential facility. Planning for this is underway.

Group Work:
Six classes were held with attendance ranging from 1 to 6 people per class. A total of 10 women participated in the series of classes. The setting was a church classroom with carpeting and moveable chairs so that a comfortable environment could be created. We sat in a circle with a centerpiece of a plant and a candle. Each class started with Tai Chi. Many of the participants came because of the Tai Chi. Then a new practice was taught and previous subjects reviewed because there were new attendees. Class work included: Protection, boundaries and finger holds; Breathwork; Loving Kindness Meditation and Affirmations; Acupressure point ; Emotional Freedom Technique; Pal Dan Gum; Visualization.

Evaluation
Response during class was positive with many "ah ha" moments. The women shared moving stories of successful use of the practices between classes. "I used the boundaries during a conversation with my brother that in the past would have turned into an argument." "This program is an integral part of my sobriety." "The breathing techniques help me at work to remain calm during stressful moments." After the classes were completed a counselor from the program who attended the classes, provided exciting anecdotal information about results in the participants and her clients: "In working with a client, I found it a quick way to help her release energy, reconnect with the self and thus able to better problem solve during our session." "A client who had difficulty with staffing sessions would have someone page her out. She now visualizes her egg of light and feels safe and enclosed. This helps her stay in the situation so she doesn't have to take herself out." "S. uses the finger holds at night to get to sleep. It helps her focus on different emotions she needs to let go of." "An incarcerated woman struggles with obsessive thinking. By using the EFT, she is calmer and more tolerant of the prison experience."

Feedback from this counselor on my teaching techniques included:
The information was simplified. The center elements added a warm touch. My style was relaxed, laid back and not aggressive which was especially important for the women in the program. I was patient with those who had difficulty understanding and had an effective way of reinforcing the lessons. The evening time of the class was hard for participants at the end of their day.

Work at a Substance Abuse Services Center
Judy Sinnwell, OSF, Educator, Massage Therapist,
Dubuque, Iowa

I worked with a women's group which meets each Monday at a substance abuse services center in Dubuque, IA. The second Monday of each month I met with the participants and a counselor, teaching and practicing selected techniques of Capacitar. The number of participants ranged in number from 3 to 17 at any given session. Participants reflected: varied socioeconomic, educational levels, and ages; single women, single mothers with children, married with/without children, divorced; probation, court ordered participation, and other legal identifications; varied histories of substance abuse, other addictions and the self-empowerment issues associated with many of those dependencies.

One outcome of Capacitar training, as I understood it, was to stretch personal boundaries by moving into a population one does not at present interact with. This women's group seemed to provide that possibility. I saw the opportunity to bring skills in self-care and wellness to a population which does not, in most cases, have the financial resources to access these health resources. Also, my religious congregation has a continued four-year focus to address the issues of women and children. This again was a match: my professional skills and a population in need of such self-help skills.

In an initial meeting with the program director/counselors, we identified and agreed that the scope of the sessions would be stress reduction and wellness practices. It was also decided that my membership in a religious community would not be stated to the participants in order to keep the atmosphere clear of unnecessary psychological baggage/expectations/stereotyping that could occur around that.

The biggest challenge for me was the turn over in participants. As women moved through the program, their commitment to attend changed. Numbers varied each session, and there was no way for me to know ahead of time how many would attend, who would be first time, who would be repeats.

Format:
Following from the challenge identified above, the format of the class evolved into a repetition of basically the same practices each session. Providing a time/space for women to reduce stress and experience simple techniques for self-care became the priority of the session for me. Repetition would also increase the possibility of participants becoming familiar enough with one or more practices that she could integrate this into her day/week to some degree.

Class lasted an hour. Usually included were: tai chi or pal dan gum; jin shin finger holds; guided relaxation, safe space/mentor guide visualization; thought field therapy; self-talk/affirmations, breath work, acupressure points. Some input on mind-body-spirit-emotions connections and health was included. At the beginning of a session, participants were asked to name the feelings they had then; later they were asked to identify how they felt at the end of the session. Participants could ask questions, add information or personal experience that was relevant; there was not a lot of self-disclosure done.

Outcomes:
I would identify the following as necessary components for a program: Regular commitment of time/space/staff; whether or not this is viewed as an important on-going component of their treatment program is yet to be seen, and may be missed.

The importance of regular time, consistent structure for participants to learn and practice stress reduction and wellness techniques; repetition is significant; integration of wellness practices into various aspects of a total program, so that participants experience the possibility of practicing these as part of one's day/week. For the facilitator, a deepened personal awareness of and sensitivity to the issues women face daily who are attempting to manage family, financial, social, work, legal responsibilities and overcome addictive/other dysfunctional behaviors.

Feedback:
Though informally assessed at the end of each session, participants usually gave positive feedback, noticing that they felt more relaxed and energized. During the first seven months, participants told others in the program to come to the session, they reported missing class when it was not possible to have class one month; a substitute staff counselor at an early session reported that participants had told her about the class. More formally, a feedback instrument designed specifically for this group and what had been taught in the first five sessions was used in October and gathered the following comments: Guided relaxation…'helps sleep', 'helps thinking positively' Self-talk/affirmations…'built self-esteem' Finger holds…'keeps me calm', 'helps at work with fellow employees' Breath work…'self control at home with kids', 'keeps me calm' Pal dan gum…'wasn't as angry with people' Tai chi…'helped me relax'.

Capacitar Practices with Women in Recovery
Sigrun Columbia, R. N., Wisconsin

We decided to hold a 5-week Capacitar session for our group project, and to interest participants we advertised at various places like the hospital where I work, a women's shelter, a women's halfway house for recovering alcoholics, and at a family resource center. A large room at a center for spirituality and healing was available for our use. Fifteen women showed up: 10 of them came from a local halfway house, 3 nurses from the hospital and 2 business people. The group work was set up for 5 weeks once a week each Wednesday evening for one and one-half hours each time.

Our group was very dynamic- everyone was eager to learn new things and they enthusiastically participated in all the activities. We did Tai Chi, Pal Dan Gum, finger holds, the river of life, guided imagery, deep centered breathing, the drum massage, hand massage and the mandala. We always started with Tai Chi and ended with Pal Dan Gum.

The women enjoyed the program immensely. In the beginning I used a notebook to help me remember the different Tai Chi movements. One time I forgot my notebook and the women had great fun with suggesting the various moves! Everyone liked drawing the mandala. All the participants were completely absorbed in and focused on the activity and they enjoyed sharing their thoughts and feelings with each other afterwards. One lady stated that she felt all kinds of emotions welling up inside her as she was drawing, and she felt a lot of release of these emotions by drawing. " I'm going to do this at home," she exclaimed. She was very grateful for having had this experience. Everyone enjoyed the massages, the finger holds, but the most popular activities were Tai Chi and Pal Dan Gum. That's why we decided to always include these two practices in all of our sessions. It was always very energizing for these women to finish up with the HO HO HO shouting and the Lion's roar. It felt good to them to let all the frustrations and bottled up feelings come out. Overall, the women said that this program was very helpful to them, especially helping them cope with stressful situations. One business woman stated that she had been having terrible stress at work and centering herself and deep breathing has helped her to cope much more effectively.

Another woman said that doing these things with other women brought her so much closer to them, helping her to realize that "we really are all the same in a lot of ways and that we can help each other." A lot of the women voiced how good it felt to be in a group where they felt respected and honored, and that helped ease the emotional pain they were going through. The majority came to all the sessions and by the end of the 5 weeks we had developed a wonderful bond. At our last meeting all the women said they wished that this could continue. The hugs I received were very meaningful and touched me in a very special way.

I gained a lot of confidence by doing the 5 week Capacitar group work. On the first night I was somewhat shaky and unsure of myself and by the last meeting I felt confident and at ease and I had fun. This has been a very enriching and rewarding experience for me and for all the women that were involved.