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Anthony Quintiliani, Ph.D, LADC

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October 27, 2019 By Admin

Crisis Resilience Skills

Crisis Resilience Skills  – Mindful Happiness

Below I will list various interventions that have proven effective in reducing the level of personal crisis. The sources for many of these skills came from Burns (1980), Ellis (1995), Seligman (1988), Linehan (1993, 2015)), Hayes (2018), and Thich Nhat Hanh (various publications). The skills noted are for immediate application in crisis and/or post-crisis practice. Due to space limitations, I will not explain details; rather I will list skills with minimum directions. If interested in improving your clinical capacities to deal with crises, you can look up the details on your own. It is a growth process. It is always a good idea to have a clear and practical crisis response plan.

  1. Move to cognition as soon as possible – get out of body reactions and take over the thought process related to the situation. Practice Tara Brach’s RAIN skills (recognize, accept, investigate, and relate to non-self), complete a pros and cons grid (good and not-so-good things about staying the same versus making small changes – CT, MI, CBT). Also distant or distract yourself quickly. Distraction is not to be used in physically dangerous situations.
  2. Practice mindfulness core skills. Begin relaxation breath with deep, slow breathing (polyvagal impediments may exist especially if poorly treated trauma is a reality), use positive imagery, meditate, do yoga, pray, pay attention to non-crisis variables, and live within the realities impermanence.
  3. Practice self-soothing. Remember or engage in positive images, sounds, touch, smells, and tastes. Carry your favorite self-calming scent with you. Rub your hands hard and long until hot, then place them on your face and absorb the healing warmth.
  4. DBT-like skills are highly effective. Use “wide-mind” skills. Try ACCEPTS. Engage in alternative activities, contribute to others, compare downwardly with others, engage in opposite emotion, push away unhelpful thoughts and move away from the situation, engage in productive thinking about what to do now without emotional dysregulation, and improve your sensations. Although not part of DBT, you may wish to practice progressing counting (distractive); say to yourself or outloud consecutive numbers and imagine them in your mind’s eye. Continue to count until the emotional reactivity has reduced.
  5. Practice mindful movement. Do yoga, tai chi, qi gong in more vigorous modes until you notice that your body has experienced a reduction in emotional reactivity. Regular meditation practice is, perhaps, your best option here.  Do vigorous exercise.
  6. Do your best to reduce a “victim” self-image. Work on fear-based reactions and combat hopelessness and helplessness tendencies. Use your older, experienced self’s wisdom.
  7. If in therapy, be certain to process the crisis experience. If your therapist is competent, she/he will include such skills development as part of your treatment.
  8. Hope this quick review has been helpful to you.

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: ANTHONY QUINTILIANI, Crisis Resilience Skills, Featured, MIndfulness, Nhat Hanh Thich, Resilience, Self Care, Trauma Tagged With: CRISIS SKILLS, RESILIENCE, SKILLS, TRAINING

August 22, 2019 By Admin

Using Creativity in Clinical Supervision

Using Creativity in Clinical Supervision

Effective clinical supervision is a combination of hearable direction about clinical practice, gentle-direct leadership, clinical “Know-How,” evidence-based skills, complex psychodynamics, and the willingness to work with others on their developmental processes. There are risks involved. I have provided clinical supervision and consultation to other clinicians for 43 years without a legal or ethical issue. I do not think you should allow your creative spirit to run wild; there are many very serious ethical and legal implications in supervision.  These are not benign; most states hold clinical supervisors 100% accountable for the actions of their supervisees, whether those actions were known and recommended by the supervisor or not.

Here we will look at the work of Leonardo DaVinci, the genius in art, science, engineering, and humanities. He saw art as science and science as art – most clinicians recognize these combinations in their own clinical work. I will simply note a list of documented attitudes, values and behaviors that DaVinci mastered. Here is the list. Courage may be needed to move off your comfort-path.

 

  1. Practice intense curiosity and deep awareness about the specific details of your work. As you do this apply a sense of wonder about your observations and  different possible perspectives you encounter. Multiple realities of perspectives do exist. There may not be one absolutely correct response.
  2. Observe! Observe! Observe! Notice how your supervisees do their work, and how their idiosyncratic personalities and attitudes influence that work and your supervision. Be certain to pay close attention to the facts of reality, but better to procrastinate a bit before making big decisions. Be sure you have all the correct facts. You may need to test your hypothesis.
  3. Use your personal imagination more, and visualize the situations that cause you the greatest concerns. Remember: Do No Harm! In some situations it may actually be ok to use day dreaming and helpful fantasy for new perspectives for problem solving.
  4. Be sure to keep written lists of all the things you need to do. Also, write in your own “supervision development journal” about new things you learn and lessons you wish you already knew. Review selected parts of that journal with your own supervisor.
  5. It pays to be a little obsessive when dealing with supervisees and the welfare of their clients. Your growth also depends upon being a bit obsessive with learning new clinical processes and evidence-based interventions. However, remain creative and highly responsible in your role. Document everything you do in your role.
  6. For more see Isaacson, W. (2017). Leonardo DaVinci…New York: Simon & Schuster.

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: ANTHONY QUINTILIANI, Clinical Practice, Clinical Supervison, Clinicians, Commentary, Featured, Learning, Training Tagged With: CLINICAL SUPERVISION, CLINICAL TRAINING, CREATIVITY, MINDFUL HAPPINESS, TRAINING

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

March 30, 2017 By Admin

Helping Therapists Work with Diversity

Help For Therapists: Working with Diversity

Clinical interventions, especially strongly evidence-based interventions, impact clients via new skills and practices in mind-body clinical realities. No matter how good (or “good enough” ) a clinical intervention is it requires a highly positive, active therapeutic relationship. As ample research suggests, a strong and positive therapeutic relationship in therapy enhances client trust and courage – thus expanding their experimenting with new ways of being, thinking, and doing. A huge problem is establishing such a therapeutic relationship is the inability of some therapist to bond with diverse people – people not exactly like the therapist. Below I will present information from clinical  and social psychology about
what general variables/differences to be most mindful about.  This information will be noted in three categories: Universals; Group Differences; and, Individual Self-Development (within groups). If therapists practice paying more attention to some of these basic realities in their clients, the expectation is that their therapeutic relationship/alliance will improve along with their clinical outcomes.

UNIVERSALS: Here is the listing – Similar Life Experiences/History, Biological Similarities, Social Similarities, Psychological Similarities, Emotional Similarities, Self-Awareness Valences, Use of Symbols, Use of Art, Compassion and Aggression, Love and Hate, and, Differences in the Above. Noticing, being mindful of, and using these realities in therapy should improve alliance and clinical outcomes.

GROUP DIFFERENCES AND SIMILARITIES: Here is the listing – Gender, SES, Age, Geography, Race, Ethnicity, Culture, Abilities, Disabilities, Religion, Marital Realities, Sexual Orientation, Urban/Rural, Education, Environmental Exposure (good/bad), etc. Again, therapists who are highly mindful of these realities will do their best to integrate them into their work with clients.  Good work here will improve the alliance and clinical outcomes.

INDIVIDUAL SELF-DEVELOPMENT: Here is the list – Genetic Transfer, Modeling Transfer, Familial Transfer, and All Non-Shared Experiences in Life. Therapist who make it a norm to differentiate carefully between individuals in therapy – and who actively use these differences in their work – will most likely experience stronger emotional ties/alliances and better clinical outcomes.

If you have not been fully conscious of using such differences and similarities in working with your clients, you may want to select a few variables and begin.  Begin NOW!

For more information refer to Pomerantz, A. M. (2017). Clinical Psychology: Science, Practice, and Culture. Los Angeles, CA: SAGE Publications, pp. 69-93. See also the DSM-V emphasis on culture and diversity in treatment.

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: Activities, Diversity, Featured, Leadership, Therapist, Therapy Tagged With: DIVERSITY, MINDFULNESS, THERAPISTS, TRAINING

November 29, 2016 By Admin

Basics of Mindfulness-Based Stress Reduction

Basics of Mindfulness-Based Stress Reduction

reducestress-mindfulhappinessMindfulness-Based Stress Reduction is, perhaps, one of the major contributions to evidence-based mindfulness therapies. Jon Kabat-Zinn’s development of this model of intervention was both timely and exquisite.  In clinical care of psychological
and physical problems, these skills and practices are of utmost importance for improving (according to the most recent meta-analytic reviews in 2014 and 2016)
depression, anxiety/stress, chronic pain and emotional regulation – so important in various addictions and improvement in physical illnesses. Below I will list the most basic components to the MBSR model of practice.

These include:

  1. Clear understandings of mindfulness in theory and in everyday life;
  2. Mindfulness and mind-body interactions;
  3. Selected breathing practices;
  4. Mindfulness meditation;mindfulhappiness_stress-reduction
  5. Mindfulness walking;
  6. Haha yoga practices;
  7. Body scan practices;
  8. Extensive home practice of skills;
  9. Mindful eating practices (may be included);
  10. Loving kindness meditation (may be included);
  11. Compassion and self-compassion practices (may be included);
  12. Modifications of RAIN (recognize, allow, investigate, dis-identify) may be included;
  13. Cognitive aspects of the mindfulness-based path to practice (especially mindfulness-based cognitive therapy) may be included; and,
  14. Spiritual experience in the mindfulness-based path may be included, especially in more advanced Buddhist path practices.

Research has consistently supported MBSR (as noted above) for improved outcomes in various physical and psychological problems. Once people become involved in regular home practice (or group practice with a sangha), improvement are generally maintained. You may want to search for “MBSR research support.” I will not document the numerous studies here. The single most important variable in success is regular daily practice of core skills (mindfulness, meditation, yoga, etc.). Ideally, such practice would range from at least 20 minutes to an hour each day.

For more information refer to Kabat-Zinn, J. (1990, 2009). Full Catastrophe Living: Using the Wisdom of Your Body and Mind to Face Stress, Pain, and Illness. New York: Delta Trade Paperbacks. See also Kabat-Zinn, J. (2005). Coming to Our Senses: Healing Ourselves and the World Through Mindfulness.  New York: Hyperion.

By 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 in Production…Coming soon!

Filed Under: Activities, ANTHONY QUINTILIANI, Breathing, Featured, Meditation, MIndfulness, Stress Reduction Tagged With: JON KABOT ZINN, MINDFULNESS, STRESS REDUCTION, TRAINING

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