Sexual Presence: A Mindfulness-based Approach to Increasing Sexual Satisfaction Among Individuals with SCI Linda R. Baggett, Ph.D. Linda R. Mona, Ph.D. Elisha R. Carcieri, Ph.D.
Disclosures This continuing education activity is managed and accredited by Professional Education Services Group. Neither PESG nor any accrediting organization supports or endorses any product or service mentioned in this activity. PESG Staff and the Program Planning Committee have no financial interest to disclose. Commercial Support was not received for this activity. No financial interests or relationships to disclose.
Disclosure Linda Baggett, Ph.D. Linda Mona, Ph.D. Elisha Carcieri, Ph.D.
Learning Objectives At the conclusion of this activity, the participant will be able to: Utilize Acceptance and Commitment Therapy (ACT) tools to enhance their skills and confidence in addressing sexuality in treatment settings. Practice mindfulness to identify barriers to providing sexuality care. Identify values around comprehensive care for people with SCI. Identify actions they can commit to in order to provide sexuality-focused care that aligns with these values.
Outline Introduction Principles of ACT ACT strategies for providers working with sexuality Intimacy Wellness Plan Conclusion Questions & Comments
Starting the Sex Conversation! Why have this discussion? Reality is. Cognitive, behavioral, emotional and physical components of injury/disability can significantly affect sexual activity and intimate relationships How much do you need to know? Job duties? Ethical responsibility? Comprehensive care
Agenda Broaden existing knowledge Disability and sexuality Spinal cord injury Increase self-awareness around your values Challenge personal views and beliefs Provide new strategies and tools for conceptualization and treatment
Exercise What are your values as a healthcare provider working with individuals with SCI?
Exercise Examples: Cultural competence Understanding the patient s perspective Assisting patient rehabilitation of activities important to patient Including patient s partner
Providing Values-Consistent Care How do these values translate to treatment and rehabilitation for sexuality-related issues?
Sexuality and SCI Overview Making sexuality an essential item on the rehabilitation menu Multiple mind and body changes Both areas should be addressed including intersections Your self-assessment as a provider begins here!
Sexual Health Services: Interdisciplinary approach Sex = Pleasure.In case we forgot Physical, Psychological, and Relational Team approach: Psychology SCI PCP Surgery Social Work Therapies Provider Self-Assessment Personal beliefs related to disability Personal values related to sexuality
ACT: Acceptance & Commitment Therapy Mindfulness: Staying in the present moment Maintaining awareness of one s thoughts, feelings, and sensations Future = worry! Past = ruminating!
ACT: Acceptance & Commitment Therapy Non-judgmental attitude: It s not good or bad, it just IS
ACT: Acceptance & Commitment Therapy Commitment to action: Taking steps to act consistent with values DESPITE how we are feeling
ACT for Providers Mindfulness: Exercise
ACT for Providers Mindfulness What reactions, thoughts, and feelings am I having about this? What thoughts and feelings might get in the way of providing sexually-focused care?
ACT for Providers Mindfulness What reactions, thoughts, feelings is the patient having? Don t assume ask! Draw on skill in discussing delicate issues Be sensitive to different comfort levels and cultural factors
ACT for Providers Non-judgmental attitude Do not judge yourself for these feelings Do not judge patient for differences A note on silence Be compassionate to yourselves and the patients!
ACT for Providers Non-judgmental attitude Help patients cultivate a non-judgmental stance Body image, physical difference, and ability Balancing act
ACT for Providers Commitment to Values-Based Action Identify steps to take to act DESPITE how you may be feeling Special note about spirituality/culture
ACT for Providers Commitment to Values-Based Action Help patient identify values and identify steps to take What do they value about their sexual relationship with self and others? What actions would help patient move toward these values? Goals vs. values
Prevention!
Sexual wellness recovery action plan (Copeland, 2002) The depression workbook A system for monitoring, reducing, and eliminating uncomfortable or dangerous physical symptoms and emotional feelings Same approach can be applied to an intimacy wellness plan
Sexual wellness recovery action plan (Copeland, 2002) Daily maintenance list Triggers Early warning signs When things break down Crisis plan
Summary Practice mindfulness of thoughts, feelings, and barriers to providing sexually-focused care. Practice non-judgment attitude of self and patients. Help patients do the same. Commit to values-based action and help patients do the same!
Contact Information Linda R. Mona, Ph.D. VA Long Beach Healthcare System Linda.Mona@va.gov (562.826.8000, X 2057)
Thank you! Questions and comments