Men s Healing: Working With Men. Stephen R. Andrew LCSW LADC 25 Middle Street Portland, Maine USA

Transcription

1 Mes Healing: Working With Men Stephen R. Andrew LCSW LADC 25 Middle Street Portland, Maine USA

2 Biography Stephen R. Andrew, LCSW, LADC, CCS, CGP Consultant, Trainer, Author & Therapist... Chief Energizing Officer of Health Education & Training Institute (HETI) and member of MINT (Motivational Interviewing Network of Trainers) since He has been a substance abuse counselor in a public school system, and the Executive Director of an adolescent prevention/treatment agency. He is the co-founder of the Mes Resource Center of Southern Maine whose mission is to support boys, men and fathers and oppose violence. Stephen maintains a compassion-focused private practice in Portland, Maine and facilitates mes, co-ed, couples and caregivers groups. He is the co-author of the book: Game Plan: A Mas Guide to Achieving Emotional Fitness with 2 friends. Stephen lives with his sweet wife, Hilary, and is the proud father of fifteen year-old Sebastian, in Portland, Maine USA.

3 Guidelines for the Training Ask lots of questions.. Attitudes: What the Heck!! Jump into the experience.. Make Mistakes, OOPS! Confidentiality, make the training your experience Please resist the fixing impulse

4 Male-Specific Treatment Facts about men. What are men taught? What do we ask of men in treatment? How to effect change in men. Why alternative therapies work with men.

5 Facts About Men (USA) Majority of children abused, neglected, and murdered are boys (Kipnis, 1999) Most of the children in foster-care, shelters, and juvenile institutions are boys (Kipnis, 1999) 80% of student suspensions, expulsions, grade failures, special education referrals, school violence casualties, and all other assault victims are boys (Gurian, 2007)

6 More Facts About Men (USA) 70% of all suicides are men (CDC, 06) 70% of all addicts/alcoholics are men (Powell, 03) 80% of the homeless are boys/men. (NAEH, )06) 80% of homicide victims are men (US DoJ, 03) 93% of prisoners are men (US DoJ, 03) 99% of executed prisoners are men (US DoJ, 03)

7 UK STATS Age of the Alcoholics is increasing. the increase 55 to 75 years Men 2X greater chance to die from alcohol related... Men are 3X more likely to drug dependent. Scotland and the North West they have highest rates of alcoholism... almost 2X.. Attitude of Men in health care makes it difficult for the primary health care provider to intervene. 7

8 POWER & CONTROL TO LOVE AND TO BE LOVED CAPABLE CONNECTION every person male or female

9 Tell us about the significant men in your life? (father, mentors, uncles, teachers..)

10 What are men taught? That they are expendable. That they shouldt express emotions. That they must succeed at all costs.

11 What are men taught? That only women can be depended on for emotional needs. That they need sex and should know how to please their mate. That fatherhood is not as important as motherhood. That they must always appear strong and confident.

12 Empathy Accurate understanding of the other s world as seen from their inside. Accurate understanding of one s cultural messages as seen by the man...

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14 Definition of Listening Focusing all of one s purpose, attention, and energy on understanding what the mas message means to the them.. Focus: What is the man is saying? Focus: what does the man MEAN? Can you hear the messages..?

15 Presence...LISTEN well... Undivided Attention Listen with your soft eyes, ears and your heart.. Acceptance Wicked lot of Delight Silence...

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17 The Male Brai

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21 Out of the box protect, provide & perform Be vulnerable Being in our shame Act like a man Be strong Perform Take risks, believe Armor plated Lonely Be judged A threat to others Isolative Provider Trust no-one Succeed Aggressive all emotions are unacceptable except anger Share emotions Accept the ideas of others

22 MOTIVATIONAL INTERVIEWING one thing that works with men... DEFINITION: Motivational interviewing is a client-centered, evidence-based, goal-oriented method for enhancing intrinsic motivation to change by exploring and resolving ambivalence with the individual. SPIRIT: Collaboration; autonomy; respect; evocation; compassion...

23 A client-centered, goal oriented intervention focused on resolving ambivalence in the direction of change not a series of techniques but a way of being with me (Information on MI adapted from Motivational Interviewing. Miller and Rollnick, 1991)

24 Compassion When we listen to a man with an open heart, soft eyes, hearing what they mean and seeing all this from their competent world view, a reflection of the training compassion will be the connection...

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26 Care as usual.. o o Ask lots of questions Give a solution.. An idea on how they can improve their life Tell the participant how to change o Gently warn..point out the risk for them Emphasize how important it is for them to make the change o o Create an action plan Get a commitment Tell the person to do it!

27 Intention To create and amplify ambivalence between present behavior and broader dreams, wishes. How? Create cognitive dissonance between where one is and where one wants to be. Meet men where they dream

28 Cognitive Dissonance

29 What did create our understanding of men? Male change agent (e.g., supervisor, teacher, coach, counselor, clergyperson) who had a major influence List behaviors and values... What are the strengths of the gender?

30 The Spirit of our work with Men UNDERLYING ASSUMPTIONS " Acceptance...feeling heard and believed " Autonomy/Choice... Power and Control " Less is better.. " Elicit versus Impart " HOPE...Michelangelo Belief " Ambivalence is normal " understanding of the norms of being male " All judgment is violence... Non - judgmental " Change talk.. Empower " Righting reflex... holding our right position...

31 Engagement Skills :OARS O: open-ended questions A: affirm, notice the strengths of men, see the motivation in what they do hear their values R: reflection, use empathy, simple and complex, 2 to 1 reflections to questions S: summarize (transitions, beginnings, endings)

32 Open Questions: Open the door, encourage the man to talk, elaborate.. Do not invite a short answer Leave broad latitude for how to respond

33 Affirmations Emphasize strengths Notice and appreciate a positive action Be genuine Express positive regard and caring Strengthen therapeutic alliance...

34 Affirmations Include: Commenting positively on an attribute: You re a strong person, a real survivor. A statement of appreciation: I appreciate your openness and honesty today. Catch the person doing something right: Thanks for coming in today! A compliment: I like the way you said that. An expression of hope, caring, or support: I hope this weekend goes well for you!

35 Empathic Reflection Accurate Empathic Reflection is the key to this work. The best motivational advice we can give you is to listen carefully. They will tell you what has worked and what hasn t worked for men. What moved them forward and shifted them backward. Whenever you are in doubt about what to do, listen reflectly. (Miller & Rollnick, 1991)

36 Levels of Reflection 1. Simple Repeating, rephrasing; staying close to the content... works with aggression 2. Amplified & Double sided Paraphrasing, double-sided; testing the meaning/what s going on below the surface... empathy 3. Affective (Feelings) Emphasizing the emotional aspect of communication; deepest form

37 Summarizing Special form of reflective listening Ensures clear communication Use at transitions in conversation Be concise Reflect ambivalence Accentuate change theory

38 TRAPS TO AVOID Question-Answer Trap Trap of Taking Sides Expert Trap (I know, you dot) Labeling Trap Premature Focus Trap Blaming Trap

39 Tell me, what as a man is it that you are willing to do in relationship to women & children? or as a woman what do you want from the men in your life in relationship?

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44 Built upon a Support Group Community and/or 12 Step Foundation

45 Summary Specific male issues require specific focus. Motivational approach breaks down typical dominant/submissive barriers. Therapeutic alliance is critical for relationship building and trust. Holistic approach addresses whole issue. Integrated therapies open the male heart. Go slowly with a mas emotional life...

46 Thank you! One thing you liked... One thing you learned... One thing you relearned... One thing you are willing to try...

47 References Ackerman, Robert J. (1993). Silent Sons: A Book For and About Men. Fireside Andrew, Stephen. (1993) Courageous Men (audiotape). Spritwind Tape Series, Andrew, Stephen. (1994) Anger: Rage or Passion? (audiotape). Spiritwind Tape Series. Capacchione, Lucia, Ph.D. (1991). Recovery of Your Inner Child. Fireside: Simon and Schuster. Carnes, Patrick. (1992) Out of the Shadows: Understanding Sexual Addiction. Hazelden Covington, Stephanie, Ph.D. (1994) A Womas Way Through the Twelve Steps. Hazelden. David, D. & Brannon, R. (1976). The Male Sex Role: Our culture's blueprint of manhood, and what it's done for us lately. Addison- Wesley Publishing Company. Andrew,S. Lyme, A. Powell, D. (2012) Game Plan: A Mas Guide to Achieving Emotional Fitness.Central Recovery Press.

48 References cont d Duncan, Hubble and Miller, (1999). The Heart and Soul of Change: What Works in Therapy. APA, Washington. Goldberg, Herb, Ph.D. (1976). The Hazards of Being Male: Surviving the Myth of Masculine Privilege. Wellness Institute Inc. Greenberg, S. (1979). Right from the Start: A Guide to Nonsexist Child-Rearing.. Boston: Houghton Mifflin. Gurian, Michael.(2005) The Minds of Boys: Saving Our Sons from Falling Behind in School and Life. John Wiley, New York Hoffman, N. & Harrison, P. (1991). The Chemical Abuse Treatment Outcome Registry (CATOR). Hazelden. Keen, Sam, Ph.D. (1991). Fire in the Belly: On Being a Man. Bantam Books. Kindlom, Dan, Ph.D. & Thompson, Michael, Ph.D. (1999). Raising Cain: Protecting the Emotional Life of Boys. Ballentine Books. Kipnis, Aaron, Ph.D. (1999). Angry Young Men. Jossey-Boss Publishers, Kivel, Paul (1992). Mes Work: How to Stop the Violence that Tears Our Lives Apart, Hazelden.

49 References cont d Kivel, Paul (1999). Boys Will Be Men: Raising Our Sons for Courage, Care, and Community. New Society Publishers. Lee, John. (1993). Facing the Fire: Experiencing and Expressing Anger Appropriately. Bantum Books. Lyme, A., Powell, D., and Andrew, S. (2012) Game Plan: A Mas Guide to Achieving Emotional Fitness, Central Recovery Publishing. Miller, William, Ph.D. & Rollnick, Stephen, Ph.D. (2012). Motivational Interviewing: Preparing People for Change. 3rd ed. The Guilford Press. Pollack, William Ph.D. (1999). Real Boys: Rescuing Our Sons from the Myths of Boyhood. Random House Real, Terrence. (1997). I Dot Want to Talk About It. Scribner SAMHSA. (1996) Schneider, Burt, (1992). The Cocaine Sex Connection: Understanding Our Sexual Acting Out. Hazelden US Dept. of Justice, (2004). Stephen Andrew