Brain Science and Updates From the Field

BLOOM hosts reintegration program graduation

Thursday, February 25, 2016
A group of individuals commemorated their next step of recovery and sobriety by graduating from the Community Reintegration of Offenders with Mental Illness and Substance Abuse (CROMISA) program during a ceremony at BLOOM Collaborative in February.

CROMISA is a reintegration program for people with mental illness and substance abuse problems who are incarcerated in the state system with at least one year of their sentence remaining.

Program graduates received recognition for their dedication in working with a team of professionals who provided necessary supports while keeping offenders on track.

One graduate praised his team by saying, “I was hesitant to do this at first but the team has become my family.”

Another said he learned a lot about himself from his work with his support team.

“I had isolated myself pretty well,” he said. “But through the team, I learned I didn’t have to think I was alone.”

The program brings together resources from mental health and substance abuse providers, such as the Erie County Office of Drug and Alcohol Abuse, Erie County Office of Mental Health/Mental Retardation, Gaudenzia Crossroads, Greater Erie Community Action Committee and the Probation and Parole Board of Pennsylvania.

As part of the graduation ceremony, professionals from these community partners joined staff from Stairways as well as the graduates themselves to share a meal and celebrate the occasion.

Graduates were quick to point out the commitment it takes and the satisfaction that results from having accomplished the program.

“Overall, CROMISA has been a rewarding experience,” one graduate said. “But you have to be dedicated to it. You can’t just sit back and expect benefits to be handed to you.”

Peer Specialist speaks on important issue

Monday, January 25, 2016

Certified Peer Specialists serve a vital role in Stairways Behavioral Health’s mission of recovery, providing the valuable resource of having directly experienced mental illness.

This personal understanding serves not only as an asset for Stairways’ clients but also a wealth of knowledge for clinicians and other mental health professionals to tap into.

Peer Specialist Edna Lingenfelter’s recent work is an example of just that type of resource.

Lingenfelter (left, with colleague Theresa Abbey) works with 10 different peers who struggle with various mental health issues, such as self-esteem, depression and anxiety among others. And her insight into one specific issue—self-injury— has been the particular focus of Stairways staff recently.

Lingenfelter has recently made presentations on the topic to Stairways’ Board of Directors and the Assertive Community Treatment team.

“I shared ideas with our Board and staff about the work I'm doing with clients. And as a consumer, I spoke to how I’d want to be approached,” said Lingenfelter, who said she has a history with self-injury. Lingenfelter said having the credibility as someone who understands through experience why clients cut themselves has helped her establish trust with clients.

Self-harm, specifically cutting, is a difficult subject to understand for many, and treating the behavior can be challenging for clinicians, as each case is unique, she said.

“It’s instant—I guess you would say satisfaction,” she said. “People think the people who do it are suicidal when it’s actually the people who feel like their life is out of control and this is one thing that they can control.”

In her presentations, Lingenfelter offered alternative ways of addressing clients who often hide their cutting for fear of misunderstanding. She presented practical examples of coping mechanisms that have been effective with clients she has worked with, such as applying temporary tattoos, drawing on your arm and consulting a 1-800 self-injury hotline.

Lingenfelter said she sees helping clients find the proper tools such as these as the most important part of her job.

“I want people to see they can make the change in their lives or see that they already have the skills,” she said.

Lingenfelter’s work with self-injury is just one example of how Stairways’ use of its peer specialists program helps complement not only mental health treatment, but those providing that treatment as well.

National Institute of Mental Health Releases Strategic Plan

Tuesday, March 31, 2015

The impact of mental health on the American society is often expressed through statistics which are sobering – if not staggering:

  • One in four adults will experience a mental illness in any given year
  • One in five children will experience a seriously debilitating mental disorder at some point in their life
  • Nearly two-thirds of state and federal inmates meet criteria for mental health problems in any given year
  • Suicide is the No. 4 cause of death for adults ages 18-25.
  • More people pay for care related to mental disorders than any other medical condition except for asthma – more than heart conditions and cancer combined.
  • Costs associated with serious mental illness in America exceed $300 billion per year, between direct (treatment and services) and indirect (public expenditure, lost wages and disability support).

At the same time, recent advancements in brain research and understanding about mental illness are just as dramatic, leading to more nuanced treatments and overwhelmingly improved outcomes.

At the intersection of mental health research and statistics lives the National Institute of Mental Health (NIMH), one of the 27 institutes or centers of the National Institute of Health, the nation’s medical research agency.

Charged with the mission of transforming the American landscape of mental health treatment and research, the NIMH recently issued a new five-year strategic plan for research designed to help balance urgent mental health care concerns with long-term research investments.

“A strategic plan can identify the most important problems and identify areas of traction,” said NIMH Director Thomas R. Insel, M.D., in the Institute’s March 26 release to the public. “This update of our strategic plan is a commitment to take a fresh look at our horizons so that we can refine priorities and energize our path of discovery.”

Incorporating input from more than 600 individuals, groups, organizations and national mental health councils, the new plan identifies four meta-level strategic objectives:

  1. Define the mechanisms of complex behaviors.
  2. Chart mental illness trajectories to determine when, where and how to intervene.
  3. Strive for prevention and cures.
  4. Strengthen the public health impact of NIMH-supported research.

These four objectives form a broad framework for the prioritization of the institute’s research focus – beginning with the fundamental science of the brain and behavior, and ending with public health impact.

Stay tuned as Stairways mental health professionals watch for new research trends which will help transform our friends, family and community members from statistical data points into stories of success and recovery.

The full NIMH Strategic Plan for Research is available online here: http://www.nimh.nih.gov/about/strategic-planning-reports/index.shtml

Additional NIMH mental health statistics can be found here: http://www.nimh.nih.gov/health/statistics/index.shtml

Inventive exercises help shake off effects of trauma

Monday, February 09, 2015

The word “trauma” is rooted in a Greek word meaning injury—damage to the body that triggers a natural response that regulates conditions to remain stable and constant.

Now, an inventive method of relieving the effects of trauma has shed light on the body’s natural healing abilities that are activated when releasing stress through physical exercises.

Trauma Releasing Exercises, or TRE ®, is a series of deep muscle movements that assist in ridding the body of stress, tension and trauma. The movements help people to return to a state of balance by encouraging shaking and vibrating.

Kevin Berceli, a therapist at Stairways’ Meadville Outpatient Clinic whose uncle, Dr. David Berceli developed the exercises during his work as an international trauma expert, is a certified TRE® practitioner.

Berceli is also owner of Counterpoise Solutions, LLC, which offers TRE® instruction and trauma education services.

As a way to supplement therapy, Berceli has incorporated TRE® exercises into his work with clients and has recently given demonstrations to Stairways employees and staff.

David Berceli developed TRE® after observing the responses of different traumatized communities while working primarily in Africa and the Middle East.

During mission trips, David Berceli witnessed the reaction of eight people who hailed from six different countries during a bombing in Lebanon in the 1980s, as well as observed natives during an air raid in Africa years later.

What he found among everyone subjected to a traumatic experience, though, was one shared behavior: shaking. To his discovery, many of the people presented with a trauma balled up and began rocking back and forth.

“So it wasn’t so much of a cultural response as it was a human response,” Kevin Berceli said.

The quivering response was more evident in children, it seemed, while adults, were more reserved and restrained in their reaction. To Berceli, this suggested that adults were conditioned to repress their natural response as a way to appear more confident and in control, instead of letting the body’s built-in system trigger.

“As we get older, we often suppress our natural healing response to stress and trauma,” Kevin Berceli said. “Children actually use the natural response more than adults, who deny it out of fear and shame.”

Based on the universal reactions he observed, David Berceli theorized that stress and trauma tends to cause muscles to tighten and become tense. TRE® exercises invoke a self-controlled muscular shaking process called neurogenic muscle tremors as a way to relax muscles and promote healing.

David Berceli has conducted studies and published research on the effectiveness of TRE®, which has reported particular success with veterans suffering from post-traumatic symptoms. In 2011, TRE® gained a level 3 status from the Defense Centers of Excellence, a military organization dedicated to veterans suffering psychological and traumatic brain injuries.

In using TRE® with clients, Kevin Berceli has noticed pronounced improvements in many cases.

“(TRE®) has been wildly successful,” he said. “People with some pretty severe anxiety have responded well to it and have felt calmer after taking part.

“I always give clients an option of whether to use it, but those who use the technique consistently seem to benefit from it.”

Having begun TRE a decade ago and achieved certification in 2013, Berceli said his TRE® work with Stairways has expanded to performing exercises with staff during lunch breaks. Berceli said TRE is even being incorporated into yoga classes and corporate wellness programs.

Learning TRE® from a certified teacher is a safe and effective way to reduce stress for most people, Berceli said.

“Anyone can pick up a book and do TRE® on their own, but, as we all have various exposure to stress and trauma in our lives, the safest way is to learn from a certified TRE provider,” he said.

To learn more about TRE® and trauma treatment, visit Counterpoise Solution’s at www.resetstress.com or www.traumaprevention.com.

Treatment Court offers an alternative to offenders

Thursday, December 11, 2014

At a site where they might otherwise have been sentenced to incarceration, a group of individuals were recognized for making the most of a second chance Thursday, Dec. 18.

That’s when a handful ex-defendants stood before family, friends and support staff to mark their sobriety and advance to the next stage of recovery by graduating from Erie County Treatment Court.

“It’s usually an emotional time for therapists and families who have invested a great deal in seeing them graduate,” said Autumn McLellan, Stairways Behavioral Health Forensic clinical director.

Treatment court is a court-sponsored program that offers alternative treatment options for non-violent offenders struggling with mental health and substance abuse issues in lieu of jail time.

Treatment court is a model used in place of traditional prosecution for certain offenses in courts across the country and has gained popularity in recent years. In Erie, treatment court is broken down into drug, mental health and family dependency courts, all of which are presided over by Judge William Cunningham.

In March, Erie County President Judge Ernest J. DiSantis Jr. approved a veterans’ court—a program aimed at addressing veterans with addiction and mental health problems. DiSantis assigned Judge John Garhart to head up the court, which became the 18th such program in the state and will operate independently of the other three treatment court programs.

Since its inception in 2000, Erie County treatment court has graduated well over 200 individuals and witnessed on multiple occasions the benefits of using a more supportive and therapeutic approach in place of traditional punishments.

“The courts are more receptive to working with these offenders on issues that may arise because they recognize the mental health component,” said Wayne Sharrow, supervisor of Stairways Behavioral Health’s Drug and Alcohol Clinic.

Stairways has formed a close working partnership with the county in providing mental health services to those involved in treatment court. With the help of Stairways and other providers, treatment courts generally focus on treating the problems that cause the offenders to commit crimes.

Treatment court does have certain eligibility restrictions, Sharrow noted.

“If someone can’t be monitored that would be reason not to include them in treatment court,” he said. “The same is true for if there is a victim who is not welcome to the idea in the victim impact statement.”

Individuals who have applied for and are approved for treatment court attend weekly court hearings that track their adherence to the court’s conditions. Each defendant stands before Cunningham, who evaluates their progress and orders further discipline or treatment.

Staff from Stairways, the Erie County Probation and Parole Department, the district attorney’s office, Erie Office of Children and Youth, Erie County Care Management, Erie County Office of Drug and Alcohol, the Public Defender’s office, other service providers and Cunningham meet prior to the weekly hearings to review offenders’ progress and decide on the proper course of action. Should offenders violate the conditions of their treatment-court sentences, they can be sentenced to traditional penalties, such as jail time.

Offenders are monitored by probations and are subject to random drug testing. Additionally, they must comply with the conditions set forth by the court at the weekly hearings, including those relating to work and personal matters.

“If there is a bad living situation, we try to make arrangements to get them in better situations,” McLellan said. “And if the judge says you have to leave (your current living situation), then you have to leave.”

Treatment court’s pragmatic approach to justice has yielded positive results for courts utilizing the program, as national recidivism rates for graduates are regularly lower than offenders who don’t participate.

On Dec. 18, Erie County residents who completed the program’s three requisite phases and appeared before the court for graduation were the latest group to represent the efficiency of treatment court— a means of reintegration and rehabilitation McLellan endorses.

“I’d recommend (treatment court) to anyone because the need to be held accountable is so great and treatment court offers that,” she said. 


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