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Anthony Quintiliani, Ph.D, LADC

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December 30, 2017 By Admin

Very “SAD” Facts about the Addictions Field

Very “SAD” Facts about the Addictions Field

A recent issue of the Addictions Professional presented very disturbing news about how clinicians in the field are doing.  NOT WELL! Addictions clinicians treat people with addictions but mainly people with co-occurring disorders – addictions with trauma, depression, anxiety and/or eating disorders.  Often there is also a co-occurring medical condition. This is very difficult work. People suffering from these conditions often relapse into one condition when they improve in another. Trying to attain a healthier client life in this work is no easy matter, and places huge emotional strains on families and clinicians. It is a profession of the heart.

To begin with it is so sad how poorly the American public understand addictions. I think much of this wrong opinion is based on stigma, shame, and very poor public education about addictions.  A recent Harris Poll of 2,184 adults, of which 692 were parents of children between the ages of 6 and 25, noted that 66% of the people polled thought addictions could be cured; nearly all professional groups believe it is a chronic, progressive disease/syndrome that can be managed. Recovery, of course, is quite possible; recovery, however, does not meet clinical criteria of a “cure.”  18% believed that recovery was hopeless once a person relapses after intervention. In reality, relapse is simply part of the recovery process and may indicate by its repetition how severe the addiction is (a brain-based, mind-body-spirit disorder). 55% had an opinion that a person with an addiction could not perform well at work. In reality this situation if quite variable. 42% to 47% of respondents would feel uncomfortable if a significant person (potential in-law, teacher, medical doctors) had an addiction. Well we all know how poorly informed the American public has been and still is about the realities of addictions. What is the problem here?

A recent Quality of Life survey of 650 addictions clinicians found that in 2015 71% intended to work in the field until retirement. That number was reduced in 2016, with only 68% planning to retire from their current work. In 2017 the number went down again with only 59% of current addictions professionals intending to remain in the field until they retired. That is a 12% drop in just three years. Almost 10% noted that they would most likely seek another career. Workloads have increased and salaries have not move very much. 52% of a sample of workers noted that their caseload has increased over the past two years. What about compensation? Not so good! In 2017 71% noted that their current salary DID NOT reflect their training, experience, and job requirements. 35% have quit a job in addictions work.  13%noted that their clinical supervision needed improvement or was not good at all. These numbers are dismal.

At the same time documentation requirements of state and federal government funding, as well as health insurance company funding, have increased dramatically. In my own experience I supervised clinicians working with very difficult addiction clients. Most of them had to spend about 51% of their time documenting the work they did, while only 49% of their time or less was actually working with clients.  It was common for people to go back to work on weekends to complete overdue paper/computer documentation. I often joke that to be an addictions counselor you need to fill out more paper and/or computer screens than to transport nuclear waste across state line or to buy a house.  I think this may be true!  I call this “Organic Bureaucracy,” where record keeping and management functions increase to the detriment of time with clients. Is it not the goal to help client learn skills and stabilize emotions so that they may enter recovery process? This requires TIME!

How about self-care. Surely in such a “strained” field – often called the poor sister or poor brother of health care – where demand for services outpaces staff and funding availability – self-care must be seen as important. Perhaps not! Survey data suggests that only about 1/3 of addictions counselors perceive self-care as a high priority at their place of employment. 25% note that self-care receives little or no attention.  41% note that self-care is an occasional topic in the workplace. I fear that marginal supervisors may be fearful of emphasis on self-care, perhaps suggesting that the job really cannot be done in a healthy way. Lots and lots of “burn-out.”

Let’s HOPE that somewhere up the federal bean stock somebody wakes up. In not, we may see huge shortages of qualified addictions professional. Yes there are other resources, but often far less trained and experienced in helping people work their way out of their addictions and other clinical conditions. Then what?

For more information refer to Addiction Professional (Fall, 2016), pp. 16-18, 20, 40.

Anthony R. Quintiliani, PhD., LADC

From the Eleanor R. Liebman Center for Secular Meditation in Monkton, Vermont and the Home of The Monkton SanghaChiYinYang_EleanorRLiebmanCenter

Author of Mindful Happiness  

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New Edition of Mindful Happiness in Production…Coming soon!

Filed Under: Addiction, Behavior, Featured, Therapist, Thoughts & Opinions Tagged With: ADDICTION PROFESSIONAL, ADDICTION SUPPORT STAFF, WORKING WITH ADDICTION

December 21, 2017 By Admin

More Characteristics on Happiness – Happiness #4

More Characteristics of Happiness – Happiness #4

Here I will continue my posts about the common characteristics of happiness.  Here is the list.

  1. Keep an Open Mind – Maintaining an open mind opens up doorways to interesting things in the world, some of which may help you to become happier. Also, open-mindedness reduces inner tension about holding strong negative opinions about others. Less inner tension usually implies more equanimity, thus more happiness. Bertrand Russell informed us that open-mindedness expands personal interest in the many wonders of the world. George Bernard Shaw noted that open-mindedness helps our change process, which often means more creativity and interests.  Norman Vincent Peale said happiness is based on the absence of hate and worry; open-mindedness helps here.
  2. Act on Your Purpose – Personal purpose in life is a very strong factor.  You may need inner silence to connect with your higher self and its core purpose. John Locke noted we must avoid misery and pursue happiness. Friedrich Nietzsche reminded that the “why” of our life helps us cope with almost any adversity. Ralph Waldo Emerson suggested that life’s purpose is not happiness but being compassionate, useful, and honorable. Leonardo Da Vinci equated work with purpose and purpose with work. The Buddha advised that ultimate purpose is to work toward ultimate truth.
  3. Rest and Relaxation – To be happy we need to relax, and to relax we need to be courageous regarding the demands on our time, space, and energy. The techno-craziness of the current world’s constant distractions make rest and relaxation more difficult. Sometimes, as Nathaniel Hawthorne noted, frantically seeking happiness is a no-win situation; we need to relax so it can find us. John Lennon noted that we need to shut off our mind-chatter, relax and float a while. Thich Nhat Hanh and Oprah Winfrey tell us to breathe and let go of all troubling thoughts, and emotions.
  4. The Quality of Your Thoughts – Marcus Antonius reminded us that happiness can depend upon the quality of our most private thoughts. Mahatma Gandhi said we must forgive to be happy; holding on to negative views about others does not help us. Ralph Waldo Emerson suggested that seeking spiritual inspiration improves our mind and happiness. Sometimes just being open to the wonders of the world – nature, growth, friendship, discovery, love, is helpful. Use all your senses to remain with wonder.

For more information refer to Baxter Harmon, L. (2015). Happiness a-z…New York: MJF Books, pp. 111-181.

Anthony R. Quintiliani, PhD., LADC

From the Eleanor R. Liebman Center for Secular Meditation in Monkton, Vermont and the Home of The Monkton SanghaChiYinYang_EleanorRLiebmanCenter

Author of Mindful Happiness  

Mindful Happiness cover designs.indd

New Edition of Mindful Happiness in Production…Coming soon!

Filed Under: Featured, Happiness, MIndfulness Activities, Thoughts & Opinions Tagged With: CHARACTERISTICS OF HAPPINESS, HAPPINESS, MINDFUL HAPPINESS

August 14, 2017 By Admin

Helper Burnout in Today’s Healthcare System

Helper Burnout in Today’s Healthcare System

Helper burnout is a very common problem in all healthcare services and at all levels of professional training and experience. Helpers from recovery-oriented peer counselors, state employed case managers, and licensed counselors/therapists all the way to physicians are reporting record high levels of reactive stress and compassion fatigue. Psychiatrists are worried about the possible death of their profession. Perhaps no group of helpers has more stress challenges than typical under-funded and under-staffed non-profit behavioral health care services. These are the same services that experience being swallowed up by the organic bureaucracy of state and federal busy-work as well insurance company “to-do lists.”  For many, computerized systems and the electronic health record have only made matters worse. There is no end in sight; in fact pay for performance which is a good thing now simply adds one more layer of stress-inducing work pressure for helpers.

The Mayo Clinic, Wisconsin, just completed a major research study on helper stress. Although this research emphasized medical care services, it’s findings are clearly relevant to other helpers, especially their poor-funded cousins in behavioral health systems. The research combined findings from 52 high quality studies; the final analysis was that between 30-40% of professionals experience burnout. This reality had devastating effects on the healthcare system as a whole, and all people involved in it. Here are the negative outcomes on individuals and systems:

  1. Poor client/patient care;
  2. Reduced professionalism;
  3. Ineffective self-care;
  4. Increased safety risks to all parties -healthcare errors, etc.;
  5. More depression, anxiety, and self-medication mainly by substance use by helpers;
  6. More emotional exhaustion;
  7. Greater supervisory insensitivity – caught between the financial versus human needs of the systems;
  8. More employee dissatisfaction and turnover; and,
  9. More depersonalization – client/patients dealt with as if robots.

The key recommendations to improve this disaster were: changes in personal work habits; less workaholism; reduction of specific workplace stressors; and, changes in bottom-line realities behind the organizational stress-machine.  Because so much of the stress and emotional dysregulation is caused by the workplace and not the client/patient population, it is going to be difficult to change the system. Out is all about money!

For more information refer to Yellowlees, P. M. (August 1, 2017). Interventions to Prevent and Reduce…Burnout. www.Medscape.com/viewarticle/883134…

Anthony R. Quintiliani, PhD., LADC

From the Eleanor R. Liebman Center for Secular Meditation in Monkton, VermontChiYinYang_EleanorRLiebmanCenter

Author of Mindful Happiness  

Mindful Happiness cover designs.indd

New Edition of Mindful Happiness in Production…Coming soon!

Filed Under: Featured, Healthcare Industry, MIndfulness, Self -Kindness, Self Care, Thoughts & Opinions Tagged With: HEALTHCARE INDUSTRY TRENDS, HELPER BURNOUT

July 27, 2017 By Admin

The Tao of Nature: Two Stories about Robins

 

The Tao of Nature

I have two interesting stories about nesting robins.  These stories tell of the bonds of birds and their young, and how intelligent these birds can be. The first story happened to me abut 15 years ago. The second story happened today, July 27, 2017.

Story 1

I was working in my yard when a large robin flew by my head.  I paid little attention to this at that time.  Then I noticed that the robin continued to dive-bomb towards my head but never making direct contact.  It seemed to be trying to move me away from the spot I was working in. I have no idea if this was a mother robin or a father robin, since both tend their nests and feed their young. This strange behavior continued for some time, until the robin had forced me to move within two feet of of our above-ground pool. The robin persisted by flying closer and closer to my head, to “push” me closer and closer to the pool until I reached its frame. Then I saw it. Then I realized how this intelligent bird figured out a way to get me to see its chick now having great difficulty staying afloat in the pool water. I knew I could not touch the chick, but I had to save it. So in the pool I went and netted it in an old bird nest sitting on the deck. I placed the “saved” chick in the nest on the deck just high enough to protect it from cats and allow its parents to come to its rescue.  Soon they were feeding it. In a few days the chick was gone and so were the parents. I assume it flew correctly without landing in what must have seemed to be a gigantic ocean to the very small chick. I experienced very strong feelings of gratitude at that time. Gratitude for my actions, for the chick, and for its parents. Gratitude for the beautiful and mysterious Tao of nature surrounding me in life.

Story 2

I looked out my dinning room window to see a large robin chick dangling on the edge of its nest.  This was the second time this Summer that robins had hatched chicks in the same nest on a porch rafter. It looked like the chick caught itself in some plastic string used in building the nest.  The poor bird was just dangling, struggling helplessly, hopelessly. I had to do something.  When I went out to investigate the chick began to screech out of fear, and several large robins flew by my on the porch.  I think they were simply warning me, flying very close to me simply trying to save their third chick.  I had seen three small heads pop up each time an adult delivered food to the nest. So what to do? I did not want to leave the chick to its fate, and I did not want robins pecking at my head in defense of their own.  I grabbed a flat piece of wood and a scissors; I went out to the porch, quickly cut the plastic string and caught the chick in its fall on the board. The chick landed eventually on the porch floor. It was breathing heavy, and I think its leg had been injured in the tangle. By that time several robins were harassing me; they meant business. My good deed done, I left the chick on the floor and observed several robins flying on to the porch.  When I looked out a few minutes later, the chick was gone and no adult birds were anywhere to be seen. Worried that the injured chick had fallen off the floor onto the ground below, I went out to investigate. I was unable to find the chick. Soon, however, two robins came to the porch making all kinds of noise – probably trying to communicate with the chick.  Then I noticed the adult birds very cautiously  (after quite some time of just hanging out) flying to the ground where I had been searching for the chick. I watched one robin go into the brush nearby, entering with an insect in its mouth and leaving empty-beaked.  I guess they found their chick, and were continuing to nurse it back to health. Because I cannot disturb it, I will never know if that chick made it or not.  One thing is certain, the parents were in no mood to give up; they continued to cautiously land on the ground with food.  I think it is a happy ending just like story 1.

So now I have a renewed respect for robins, one of my most favorite birds.

Anthony R. Quintiliani, PhD., LADC

From the Eleanor R. Liebman Center for Secular Meditation in Monkton, VermontChiYinYang_EleanorRLiebmanCenter

Author of Mindful Happiness  

Mindful Happiness cover designs.indd

New Edition of Mindful Happiness in Production…Coming soon!

 

Filed Under: Featured, Happiness, Inner Peace, Tao of Nature, Thoughts & Opinions Tagged With: ANTHONY QUINTILIANI, MINDFUL HAPPINESS, MINDFULNESS, NATURE, ROBINS, THE TAO OF NATURE

April 1, 2017 By Admin

The Power of Interpersonal Mindfulness

Interpersonal Mindfulness

Various forms of mindfulness-based compassion training help us to care more about the needs, happiness, and health of other people. However, direct applications of interpersonal mindfulness activates these influences into direct action on behalf of others.  Thus, if lucky, we learn to care more about others and less about ourselves.  The self-centered ego gives way to compassionate tolerance. Buddhist practices and meditations may improve our interpersonal relations, both intimate and distant.  Today our world, nation, regions, and families are locked in bitter conflict; the entitled view of “my ideas are right” holds sway and prevents any forward movement for negotiated co-existence of different ideas and people.  If we hope to save ourselves as well as our world, we MUST practice more interpersonal mindfulness. Such practices of random acts of kindness, general compassion, taking in suffering and giving out joy, tolerance, openness to differences, general gratitude and others all support  more inter-personally cooperative thoughts and behaviors. Such thoughts and behaviors will improve self, dyads, relationship, family, community, race, ethnic group, religion, state, nation, and world. The need for this shift is highly urgent! We must change our being from greed, aversion, and hate to generosity, inclusivity, and love. If not our species and our world may fail.

In some ways this conflictual existence is the outcome of our old limbic brain structures (my own survival above all else), and our aggressive greediness as a species. According to very old Buddhists writings, one thing we can do right now if practice deep, active listening. By listening more to others and their opinions, and talking less about ourselves, we may achieve an emotional balance of mutuality. Basic mutuality (we are BOTH important) may lead to more deep listening and personal reflections of what is happening right now in this present moment.  What, exactly, is it that is upsetting me? What, exactly, is it that may lead to mutual satisfaction here now?  Begin your changes by starting with yourself.  Notice what conflictual inner self-messages continue to play and re-play themselves over and over again in your own mind.  Begin by listening to your own inner conflicts, and work at listening and reflecting deeply on both sides of this dynamic. Work on a solution, even if it is not a perfect one. First practice more radical acceptance with your own inner conflicts, then gently move to outer conflicts – begin gently with significant others.  Practice, practice, practice and practice more.  There cannot be a winner! Once you feel the sensations and emotions of successful compromise, begin to practice beyond intimate circles and into your general world environments. It is all about sharing your love and acceptance of self with others, and being for the betterment of others. On this path also practice good self-care.

Practice letting go of harsh self-centered judgments and learn to appreciate both similarities and differences – even BIG differences. After all, impermanence is real – as is the time-limited life you now have. Better to work at compassion and openness NOW. Better to work on caring about others and loving people NOW. Our total interdependence causes great energetic frictions at times. Learn how to find the MIDDLE WAY and encourage others to follow that path. The subtle energies of love and the very powerful energies of hatred both have immense influence in our lives. Live for love! Live to reduce hatred and reed! Be authentically intelligent and kind-hearted in your relatively short life.

For more information refer to Musho Hamilton, D. (2017). The Zen of You and Me: A Guide to Getting Along with Just About Anyone. Boulder, CO: Shambhala Publications.

Anthony R. Quintiliani, PhD., LADC

From the Eleanor R. Liebman Center for Secular Meditation in Monkton, VermontChiYinYang_EleanorRLiebmanCenter

Author of Mindful Happiness  

Mindful Happiness cover designs.indd

New Edition of Mindful Happiness in Production…Coming soon!

Filed Under: Benefits of Mindfulness, Featured, Ideas & Practices, Leadership, Meditation, Mindful Awareness, MIndfulness, Mindfulness Training, Therapy, Thoughts & Opinions, Training Tagged With: INTERPERSONAL, MINDFULNESS, TRAINING

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Mindful Happiness Posts

Human Needs and Spiritual Experience and the Need for Supportive Rituals From the Eleanor R. Liebman Center for Secular Meditation in Monkton, Vermont Recently the Human Givens Blog in the United Kingdom presented a post about human needs.  I will paraphrase their information as well as information from other sources for Mindful Happiness.  Having such […]

A Primary Source of Unhappiness Self-medication to reduce or avoid pain and suffering is a major unhelpful habit in the United States. It is a desperate human effort to reduce pain and suffering in physical and psychological experiences. Therefore, we humans may be hard-wired for it. When we suffer and do not utilize effective wise […]

Trauma Informed Care – Avoidance Process Although more and more clinicians are learning about and using principles/practices of Trauma Informed Care, too few understand the behavioral dynamics of negative reinforcement in the avoidance of trauma-related cues (people, places, things, internal sensations, emotions and images). This post will give a very brief description of negative reinforcement […]

  The Tao of Nature I have two interesting stories about nesting robins.  These stories tell of the bonds of birds and their young, and how intelligent these birds can be. The first story happened to me abut 15 years ago. The second story happened today, July 27, 2017. Story 1 I was working in […]

Happiness Characteristics – Post #2 Below I will note a few key characteristics of experiences and attitudes associated with happiness. Do your best to experience some of these each day – as much as is possible. Here is the first list. Being Fully Alive to Experiences – Do your best to be fully involved in […]

The Lotus Sutra and Meditatin Practice The Lotus Sutra is one of the most important and sacred of Buddhist sutras. It is often considered a summary of The Buddha’s teaching, presented many years after he began to teach and share his experiences. The version considered here is the Kumarajiva translation,  as translated by B. Watson; it […]

The Great Mother of Gratitude Meditation Sit in silence and take a few very slow, very deep breaths in and out. Relax within your personal comfort with eyes opened or closed. If you prefer your eyes to be open, hold you head level and gently gaze down a few feet in front of you. Continue […]

More Psychoanalytic Gems – In an earlier post, I noted a list of Psychoanalytic Psychotherapy Gems, including a later post on D.W. Winnicott’s approaches to building a therapeutic alliance.  My general aversion to this form of therapy has more to do with its slowness and high costs than to its effectiveness. It is effective!  However, […]

Forgiveness Meditation Practice – Mindful Happiness – Dr Anthony Quintiliani Sit comfortably in a meditation posture. Allow your breath to remain natural without any intentional modification.  Allow your body to relax, and allow your mind to be open to and to expect forgiveness.  Focus attention on your heart area deep within your soul, and allow […]

Mindfulness and Concentration –  Experience Differences In this post I will explain some basic differences between mindfulness and concentration, both of which are required for effective meditation practice.  This will be the first of three posts dealing with what mindfulness and concentration are, how to experience them briefly in a body-based activity, and how to […]

Helper Self-Care is Important In the most current issue of The National Psychologist (July-August, 2019) an article linked helper effectiveness, risk management, and clinical outcomes to helper self-care. To make a long story shorter, I will simply paraphrase and re-word the suggestions.  These recommendations support YOUR emotional survival and successful risk management as a helper as […]

“i Rest” Yoga Nidra Practice (Richard Miller, Ph.D.) All regular meditation and yoga practices are capable of bringing us closer to our true self and our relationships in the world. A by-product is deep relaxation and equanimity. Richard Miller, Ph.D. (Clinical Psychologist, yogic scholar, spiritual teacher), has created a yoga nidra practice that promises to […]

Tantric Meditation on Emptiness of Self Mind training on emptiness of self requires single-pointed attention and concentration on space, empty space. Emptiness awareness in equipoise of meditation appears as the empty of space. When we practice this repeatedly with calm abiding we can attain direct experience of non-conceptual realization – true emptiness. Awareness of emptiness […]

Three Meditation Practices to Further Your Expansion Based on the ongoing “bad news” about various domestic and world events, and the knowledge that people DO NEED more compassion and self-compassion in their hectic and challenging lives, I am writing three brief meditation practices on different aspects on compassion-wisdom as noted on my site.  Hopefully, these […]

  My blog site mindfulhappiness.org has many posts on meditation, Buddhism, education, clinical practices and self-activated emotional health practices.  Perhaps you may wish to initiate a Reflective Journal practice after you do practices presented on the site.  There are many  benefits from maintaining a written journal about personal experiences and practices.  Not only does a […]

Effective Clinical Supervision Perhaps other than the mental health status of the therapist and her/his ethical clinical skills, there is no more important variable in successful clinical work than effective CLINICAL supervision.  I emphasize “clinical’ because in today’s bureaucratic systems, so much supervision tends to be about required procedures like utilization level, reporting requirements, and documentation for services […]

Personal Happiness in the Age of COVID-19 We are all in this together!  However, wealth and employment status do play important roles. RTI International and the Consortium for Implementation Science have serious concerns about the links between racial equity, social justice, and personal responses to COVID-19. Neuroscience notes that personal happiness in a brain-mind-body thing. Its […]

Improving Client/Patient Collaboration  in Treatment To improve collaboration between you and your clients/patients, simply practice the following behaviors as your norms.  See the list below, and practice, practice, practice. Present with an attitude of helpfulness and authentic caring. Empathy and authentic concern are required. Recognize the reality that clients/patients are at different levels of readiness […]

Building Emotional Resilience On a personal note, right now I am suffering.  Its April 15th and I have a terrible viral infection (sore throat, chest congestion, and fever).  I feel weak and miserable.  Perhaps all that frigid air we endured in New England this Winter also kept infectious “stuff” under control for a while. However, […]

How to be Happier in a Relatively Unhappy World In today’s fast-paced, digitized, unstable world – with it uncertainty, childish tweets from on-high, and general dissatisfaction with things as they are – how may one become a happier person. It is clear that isolation will not work; it is clear that aggressive actions in opposition […]

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