Core 5: Establishing Recovery Goals
The Importance of Goal Setting
• One of the most important instruments in the recovery toolbox is goal setting. Goal setting is important in recovery, and it’s important in life. It is difficult to realize your goals if it is unclear what they are. “You won’t be able to measure how much progress you have made toward any goal if you cannot identify it.
Goal Setting
3 Ways Goals May be Manifested
1) Getting rid of something you have because it’s presence is keeping you from having the life you want. For example, trying to maintain a drug habit but also be a productive member of society.
2) Getting something you don’t have because it’s absence is keeping you from having the kind of life you want. For example, regaining custody of you child.
3) Identify something to work for you that would begin to symbolize the kind of life you would want. For example, starting to go to the store on your own in hopes to be more comfortable in a social setting.
Starter Questions to Help Someone Identify Goals
Q: What does a successful outcome look and feel like? A: Looks like having a job and feels like financial security
Q: What would your life look life if you achieved my goals? A: Less stressful and more fulfilling
Q: What do you ultimately want to achieve? A: Happiness
Q: What's the big picture?
A: To live a happy and productive life
Q: Where do you want to get to? How can we get there? A: Success and accomplishing goals taking baby steps first.
Q: If you could wave a magic wand and change the part of your life into what you would want it to be, what would that look like?
A: Happy relationships and less stress
Q: If you were not diagnosed with a behavioral health diagnosis what would you be doing that you cant do now?
A: Relaxing not being stressed all the time
Q: Describe what a perfect day would look like to you?
A: Work, gym, go to a home that I own in a relationship that Im happy with and everyone not fight with me all the time.
Questions To Get More Specific
Q:What areas of your life or situation are you pleased with or feel good about?
A: My relationship and my family
Q: What areas of your life are you not pleased with or don’t feel good about?
A:Career and feeling of not being good enough
Q : Are there any areas of your life you would be willing to deal with?
A: School
Steps For Accomplishing a Goal
• State in a clear and positive way what you want to accomplish • Determine why you want this• State clearly what you are going to have to change to get this • Understand your strengths
• Understand your limitations• Think of ways to care for yourself and accomplish this • Draw up a plan of action• Make a list of steps
Steps For Accomplishing a Goal
• Read and listen to advice
• Alternative plans
• Examine your goals periodically
Facts About Accomplishing Goals
Accomplishing a goal changes our current situation
Sustaining change involves changing the way we think and act
Our actions help create or sustain our current situation
Become aware of how our external environment impacts our current situation
When people have goals to guide them, they are happier and achieve more than they would without having them. It's a brain thing. Achieving a goal you've set produces dopamine, a neurotransmitter responsible for feelings of pleasure.
Dopamine activates neural circuitry that makes you eager to pursue new challenges.
Goals provide focus. With no guiding vision or plan, people tend to drift.
Goals provide a measuring stick for progress.
They bolster self-esteem.
Goals increase commitment, so you're more likely to achieve whatever you set out to conquer.
Fear
Fear is generally considered a reaction to something immediate that threatens your security or safety, such as being startled by someone suddenly jumping out at you from behind a bush. The emotion of fear is felt as a sense of dread, alerting you to the possibility that your physical self might be harmed, which in turn motivates you to protect yourself. Thus, the notion of "fight or flight" is considered a fear response and describes the behavior of various animals when they are threatened—either hanging around and fighting, or taking off in order to escape danger.
Yet it has also been recognized that animals and people have other responses to a threat: a person or animal might play dead or just "freeze" in response to being threatened; yell or scream as a fighting response rather than get physical; or, isolate as a flight response.
Fear, Anxiety and Behavioral Health
In contrast to fear, anxiety is a general state of distress that is longer lasting than fear and usually is triggered by something that is not specific, even though it produces physiological arousal, such as nervousness and apprehension (Lang et al., 2000).
Yet both fear and anxiety emotions are triggered in response to threat. Some researchers distinguish between fear and anxiety by determining whether or not avoidance behaviors are present (Sylvers et al., 2011), or if the intended outcome has to do with avoidance or escape (Lang, et al., 2000). Thus, the presence of avoidance behaviors would indicate fear, in contrast to anxiety where a person may be very much on the alert but does not avoid the situation.
Fear, PTSD and Behavioral Health
• There are times when a past fear might re-emerge, even though the present situation does not truly warrant the need to be afraid. Such is the case of post-traumatic stress disorder (PTSD), where the consequence of a prior situation where you actually were in danger is re-lived in the present when those emotional memories are triggered. Although you may intellectually know that you are safe, your brain automatically prepares you for the worst to happen—a situation that it recognizes has happened before—which speaks to the power of emotional memory. A post-traumatic response can be triggered by a situation that is similar to a past trauma, the date in which a trauma occurred, a particular thought, or by a relationship that brings up an issue that is similar to a trauma that you have previously experienced.
How Fear Can Get in the Way of Goals
• Fear of failure is the emotional, cognitive, and behavioral reaction to the negative consequences you anticipate for failing to achieve a goal. It is the intense worry, the negative thinking, and the reluctance to take action you experience, when you imagine all the horrible things that could happen if you failed to achieve a goal.
Questions to Assist an Individual in Identifying Their Fear
Q: If you were not afraid what would you be doing? A: Sticking up for myself or at least communicating why I'm unhappy.
Q: Why would you like to do this? A: I have always wanted to even when I was a kid. I feel like I could help a lot of people.
Q: What are you getting out of staying in your comfort zone?
A: Routine
Q: What is it costing you to stay in your comfort zone?
A: Stress and staying in one place not evolving.
Q: What would be the biggest benefit in moving through this fear?
A: Achieving my goals and bettering myself as a person.
Questions to Assist in Identifying and Moving Through the Feelings that Accompany and Identified Fear
Q: How does experiencing that fear make you feel? A: Anxiety and scared
Q: What are the specific emotions or physical sensations that you are experiencing? A: anxiety, scared, sad and feeling nauseated and having goosebumps.
Q: What are the thoughts that come to mind in that situation? A: Something is going to go wrong
Q:What have you learned from past experiences about how to successfully address these thoughts and feelings?
A: That they will pass and I will feel better in the long run
Dissatisfaction as an Avenue for Change
Dissatisfaction Drives Dissonance, Causing Disruptive Change to the Current State
• Martin Luther King, Mahatma Gandhi and Nelson Mandela, prime examples of common people intensely dissatisfied with the then current situations, transformed their thinking and became leaders of disruptive change.
Overcome the Ambivalence
The contemplation stage of change is filled with ambivalence. You are being pulled in two opposite directions—your wish to change and your fear of changing.
Fear about change can take many forms. Some people fear the prospect of failing. Some fear the prospect of doing something new. And some fear that the changes they make won’t be accepted by their close friends and family members. Even though you know you want or need to change a problem behavior, it is still very scary to change.
All of your fears are real, and you should take a considerable amount of time to contemplate your fears during this stage. But be careful. Your fear could overtake you, and you could become “stuck” in this stage of considering changing and never make the decision to change.
Situations That are Important in Overcoming Ambivalence About Making a Change
The greater the dissatisfaction, the more likely the person will want to make a change. It is hard to stay in a uncomfortable situation. Eventually making the change will be easier then not making the change.
The benefits of making change is what motivates a person to act. Benefits motivate. Acting on something that will improve quality of life is a motivator.
In order to see the possibilities a person needs to see that there is something they can do to start the process. Instead of looking at the end goal, break it down to what you can do right now or a baby step to not feel so overwhelmed.
There are always barriers or the change would have already happened. Knowing that barriers are there but can be overcome is important.
Questions to Assist an Individual in Exploring Their Dissatisfaction
Q: What does this keep you from doing that you would like to do? A: Be happy and successful
Q: What would you need to get started?
A: Pen and paper to fill out applications or internet access on Indeed, maybe a resume
Q: What might be getting in your way of doing this? A: Fear of failure
Q: Who would support you in doing this?
A: You, My husband, My Friends, MY family.
Q: Who would not support you in doing this? A: People that aren’t the best for me.
Combating Negative Self Talk
Definition for Negative Self Talk
• The expression of thoughts or feelings which are counter-productive and have the effect of demotivating oneself.
Negative Self Talk
Negative self-talk often does not reflect one's reality, and can paralyze people into inaction and self-absorption. A critical inner voice may be driven by the desire to protect a person from the shame of failure. Some people even credit their inner critic with pushing them to develop self-discipline, and to recognize their weaknesses before others do so that they can address them head on and push forward. Over time, though, the negativity of a critical inner voice takes an emotional toll.
Characteristics of Negative Self Talk
Everyone has negative thoughts or negative self talk. You are not alone and it is normal to have the thought. It’s what you do with it that counts.
Negative talk or Negative thoughts is not the problem. A thought is just a thought. It hasn’t been put into action and it never has to be.
The problem occurs when this talk spirals downward and we end up defining ourselves in absolute negative language. We cannot define ourselves in negative language its about getting out of the downward spiral or identifying where we are going before we end up there.
Thoughts create feelings, so we can use our feelings as a cue to recognize what we are telling ourselves. This allows us the opportunity to collect our thoughts and recognize what our emotions are telling us about our thoughts.
Thoughts and Feelings by Definition
Thought- an idea or opinion produced by thinking, or occurring suddenly in the mind, one's mind or attention, an act of considering or remembering someone or something.
Feeling- an emotional state or reaction, a belief, especially a vague or irrational one, a sensitivity to or intuitive understanding of.
Thoughts and Feelings
• Differentiating between thoughts and feelings (emotions and body sensations) is an essential skill in cognitive behavioral therapy (CBT). Thoughts are often opinions or assumptions – these are open to interpretation and modification. Feelings are often a product of our the way we are thinking about something – and are best modified through balanced thinking exercises or similar. Many clients may initially find it difficult to differentiate between the two – and may become confused by statements like “I feel stupid” which confuse an emotion and a thought.
I Think, so I Feel and I Do
•Activating event – The actual event and the client’s immediate interpretations of the event.
•Beliefs about the event – This evaluation can be rational or irrational.
•Consequences – How you feel and what you do or other thoughts
How Negative Self Talk Can Go From “Facts” to “Stories”
• What is the Activating Event? Example: My co-worker comes to work one morning, passes my desk and does not speak to or acknowledge me.
• What is your Belief about that event? Example: I believe that he/she is just being rude or is upset with me about something that happened a couple of days ago.
• What feelings do you have when you think that? Example: I feel resentful that she did not speak and I fear that she will say something negative about me to a mutual friend of ours.
• I failed my math test. I'm stupid.
• I'm late on paying my electric bill. I'm irresponsible.
• I didn’t have craft night with my kids. I'm a bad mom.
Examples of Absolute Words
• None • No
• Not
• Must • Should
• Never • All
• Always • Can’t • Every • Just
• Only
The Problem with Absolute Language
• Using these words limits our willingness to accept. They restrict our thinking, demonstrate our bias, and sometimes condemn. When others hear our usage of these words, they bristle. When we hear others use these words, we feel defeated. Absolute words display judgment.
What to Try Instead
• If you hear yourself saying, “I always show up late on Monday...I never get it right...” instead say “Next time I will arrive on time...next time I will get it right...”
• When you hear a summary comment about you, such as “I bet you are so glad to have school started so you can have more time to yourself,” avoid “No, I am now even busier going to my kids activities. They are always on the go!” try instead saying, “Yes, you’d think that would be the case. Interestingly, because of my kids’ schedule, I haven’t yet found that free time!” It’s saying the same outcome without the harshness of judgement, starting first from where the speaker was (yes/yet).
Questions to assist an individual in identifying negative self talk
Q: What are some negative thoughts or thought patterns that keep you from accomplishing some of the things you want to do?
A: I think I'm not good enough so I don’t even try. If I do try I think people are judging me.
Q: When you feel mad at yourself what have you been thinking?
A: I shouldn’t have done something or I should have.
Q: Are your thoughts facts or are you telling yourself a negative story? A: In the moment they feel like facts but really its just how I feel.
What Negative Self-Talk Should You Watch Out For?
• Self-Limiting Talk. This is when we think “I can’t tell her how I feel” or “This project is too hard to finish” or “I’m getting so fat!” This type of self-talk creates a self-fulfilling prophecy because we assume defeat by telling ourselves that we can’t handle what we are facing. Instead, practice saying something else when these thoughts occur. Say out loud, “I can tell her how I feel, and I will tell her now” or “This project has the challenges I have been looking for, and I want to finish it” or “I look great!”
What Negative Self-Talk Should You Watch Out For?
• Jumping to Conclusions. This occurs when we are in an uncomfortable situation. We begin making interpretations instead of stating the facts. We might say “I tried on my skirt and looked disgusting” or “When Betsy talked to me, I made a fool of myself” or “If I go to the gym, people will laugh at me”. When we do this, we are assuming the worst instead of looking at the facts. We can stop this! When feeling uncomfortable, state that you are uncomfortable with no assumptions about what other people are thinking. For example, “I tried on my skirt, and it didn’t fit as well as I would like” or “When Betsy talked to me, she said some very interesting things” or “If I go to the gym, I will have access to equipment that I can use to better my body.”
What Negative Self-Talk Should You Watch Out For?
• Speech Habits. Speech patterns can be automatic and unnoticeable. Once we are aware of what we are actually saying, we can change the pattern. In response to mistakes, this may sound like “What do you expect from a silly blonde?” or “I’m so stupid!” It shows up in conversations with others as a way to not look conceited. For example, someone tells us we look nice, and we respond, “Yeah, right!” We may try to be humorous, but it isn’t funny. We can stop this by simply becoming aware of how we talk and respond to others. When we catch ourselves saying negative things, we stop and say something positive instead such as, “Thank you, I feel good, too!” or “Oops, I made a mistake.”
Catch and Release
Method for recognizing negative self talk and stopping it.
• Catch yourself engaging in negative self-talk
Acknowledge that you’re doing it
Don’t beat yourself up, just tell yourself:
“These thoughts are not productive”
Now, shift your focus to something else (your breath, your footsteps, the wind on your face, the project you’re working on, etc)
Using Your Recovery Story as a Recovery Tool
Illness Story VS Recovery Story
Illness Story
Focuses on the impact of the diagnosis
Features the disabling effect of the diagnosis
Supports thinking of life as limited
Lends to a pervasive hopelessness. The belief that this sis the way life will always be.
Recovery Story
• Promotes change as being possible
• Highlights an individual’s strengths
• Features overcoming barriers
• Supports the sharing of what has worked for you in overcoming challenges and maintain your wellness
How can a Peer Supporters Story be Helpful to Individuals Receiving Services?
•Is a physical representation of change is possible.•Gives individuals hope if someone like them that have had
similar things happen can recover so can they?•Gives individuals the opportunity to identify and not feel alone.
How Can Peer Supports Recovery Stories Help Educate and Inspire Providers.
•Gives providers insight on what experiences might have worked and what didn’t work to promote more emphasis on what seemed to work and can look into ways to improve upon what didn’t work.
•Help negate burnout by letting providers see that change is possible.
How to Share Your Story
Have what you are going to say crafted before you speak. Always go in prepared.
Introduce self as person with lived experience
Remember you are not speaking for 12 step meeting
Safe sharing
Repetitive words
Allow time to practice with other peer supporters before you speak
Questions to Assist Individuals in Recovery to Guide in Telling Their Recovery Story
What were some early indications you were beginning to have difficulties?
Briefly describe yourself and your situation when you were at your worst.
What helped you move from where you were to where you are right now?
What have you overcame to get to where you are today?
What are some strengths you have developed?
What are some of the things that you do to keep you on the right path?
Introduction
Name
Who you are: “Adult Peer Support Specialist with Lived Experience”
What you do: reintroducing youth in society, model effective coping skills, SMART goals
Achievements to date
How to Share Your Experience Strength and Hope the Peer Support Way
Childhood overview
First Use or first experience or symptom of diagnosis was recognized
Last days of using, last day of dealing with your diagnosis before seeking treatment
How you were introduced to recovery or treatment
What life's like today
Addressing the audience (conclusion)
Now Let's Practice
On a piece of paper write what elements of your story you would like to discuss for the following:
Childhood Overview
First use or experience or acknowledgment of diagnosis
Last day of using or of coping without being diagnosed or seeking treatment.
How you were introduced to recovery or treatment
What life's like today
Addressing the audience (conclusion)