A values-driven organization identifies its values through a process of self-examination.  This involves identifying the organizational purpose, the needs of the customer, assessing all strengths, deficits, and opportunities, as well as threats to the organization’s mission. It also entails taking an extensive and comprehensive 360 degree look at the entire organization, in other words, a non-compromising organizational soul-searching. At Crestwood Behavioral Health, Inc. this self-examination involves a view of our organization, our communities, and our purpose which stems from four different perspectives. The first view we examine is from the perspective of the organizational leadership which consists of our Board of Directors, Chief Executive Officer, Chief Financial Officer, executive leadership, program administrators and campus leadership.  Next we include our front line staff, mid-management staff and program supervisory staff.  This provides perspectives from all viewpoints in Crestwood. The next vantage point that is vital to gaining the company’s full perspective is the client and family support system stakeholder group. This involves creating a safe space for our clients and their family voices to be heard.  The client and family are the primary voices to be listened to and it may take time, support and compassion to enable this perspective to be fully shared. At Crestwood we see this as the responsibility of the organizational leadership. One way we do this is to employ people with lived experience and have family members at the executive, management and front-line staff level job positions. The next perspective that we include is from our county partners, customers, and the communities we provide services to. This perspective enables us to understand the needs of the community and provides the opportunity to develop and enhance meaningful relationships with our partners so we can better understand and anticipate the needs of the communities we work with. Crestwood has developed its mission and values from gathering all of these different perspectives. Crestwood’s mission is to create a partnership with clients, employees, families, business associates and the community in caring for individuals of all ages affected by mental health issues. Together, we invest our energy to enhance the quality of life, social integration, community support and empowerment of mental health clients.  Crestwood promotes wellness and recovery by providing quality and cost-effective programs in a socially responsible manner, and works with families and communities to reduce the stigma associated with mental illness. The values that were developed from this framework are simple and come from the heart. Crestwood’s values are family, compassion, enthusiasm, flexibility, character and commitment. It is through these values that Crestwood views all aspects of our operations. These values reflect the strength and vulnerability of Crestwood, with a focus on trauma-informed approaches with love and gratitude for the people and communities we serve and the staff and partners we work with. Crestwood views all decisions, strategies, goals and objectives, and benchmarks for success based on these values.  Our organization is driven to achieve objectives and goals relying on the courage and strength to maintain the highest level of integrity, while honoring these shared values. Having this values-driven perspective has allowed us to grow as partners in services with other community-based organizations such as Recovery Innovations, Turning Point and Dreamcatchers Empowerment Network. The understanding and recognition that our county and community partners provide the foundation for our services, enables Crestwood to develop community specific services, with the values of the community intertwined with Crestwood’s values. The opening of our MHRC programs in San Diego and Chula Vista are an excellent example of involving all of these perspectives.  Crestwood worked very closely with the county and community leaders to identify the needs.  The community-based providers and hospitals helped Crestwood to find the right locations for the programs. The recruitment of employees was focused on hiring people with lived experience and allowing them to provide a strong client voice, as well having family members involved at all levels of service. We worked to include the voices of Crestwood San Diego’s and Crestwood Chula Vista’s leadership teams so that they could participate in all elements of program development, making it strong and reflecting all of Crestwood’s mission and values. By being a values-driven organization and continuing to take a full 360 degree look at ourselves and our services, Crestwood will continue to grow and provide the best care possible for our clients and the communities we serve.

At Crestwood Chula Vista, they offer several types of fitness and movement activities for their clients, from Yoga to Zumba, to strength training, to dodgeball and kickball. “A journey of a thousand miles begins with a single step.” - Confucius Unfortunately, they found that only a small percentage of their clients were participating in these activities and at the same time were also still struggling with their desire to be healthy and to maintain their weight. “I’m too overweight to exercise” and “I don’t have the energy to work out” were common explanations as to why they were not participating in activities. This presented the staff with a challenge. They asked themselves what activity can just about anyone do, what activity will they want to do and what would be something that would also benefit both their physical and emotional health? The answer was right in front of them. Every client was doing it every day – walking! It was right about this time that the City of San Diego advertised the Parks Fit San Diego 2016 Challenge, which is to walk 30 miles in 60 days. Clients and staff were excited to become involved in the 30-mile challenge and it was a way for them to celebrate every step they would take. But as their clients thought about it, they decided that 30 miles in sixty days was not enough and they would instead do 30 miles in 30 days. So the staff purchased pedometers for everyone participating and off they went. The challenge began on June 18 with a 1-Mile Fun Run.  After that, they went on walks in the community, took nature hikes, and joined 5k events. Each and every day, clients could be seen walking the halls and the patio at the facility with pedometers in hand. They pounded the pavement in their neighborhood, trampled the grass at Balboa Park, explored the trails of the Living Coast Discovery Center, and even kicked up some sand at Imperial Beach. The results of the challenge were tremendous! One of their clients walked 215 miles! She reported her miles to the staff proudly every morning. One day she joked, “I didn’t do so well yesterday, I only went 20 miles.” Other clients were motivated to keep up and the race was on!  Four clients logged more than four hundred miles and together, as a group, they walked more than 500 miles! “Beyond the miles they racked up, we were seeing firsthand what we have all read in the research studies, that walking and exercise promotes good health, reduces anxiety, increases self-esteem, and boosts mood,” said Shanel Stec, Recreation Assistant.  Clients also made healthier food choices. One client lost 20 pounds and another client lost three pounds.  They set goals for themselves and tracked their progress faithfully. They worked together as a team, challenging each other to keep up and they joined other groups. They were out in the community, they were out in nature, and best of all, they were having fun. The challenge ended on August 13 with the Parks Fit San Diego 5k finale. However, this finale is not the end for them walking, even more clients and staff have signed up for a new challenge that begins soon.  Shanel said, “We are excited to lace up our shoes and walk together, not as clients and staff, but as companions on our journey toward health and wellness.” Contributed by: Shanel Stec Recreation Assistant Crestwood Chula Vista

There was a time when a person receiving behavioral health services was simply looked on as a client.  They were identified as the targeted person or the recipient of services. They generally looked to specialists to understand and treat their symptoms, their discomfort or disease. They were dependent on the system to take care of them. There was no reciprocity, no mutuality and no equality. Often there was no actual relationship, no trust, no compassion and sadly, there was no hope. There was a time when a person receiving behavioral health services was simply looked on as a client. They were identified as the targeted person or the recipient of services. They generally looked to specialists to understand and treat their symptoms, their discomfort or disease. They were dependent on the system to take care of them. There was no reciprocity, no mutuality and no equality. Often there was no actual relationship, no trust, no compassion and sadly, there was no hope. But today the good news is this view in behavioral health services is changing for the better. And at Crestwood, you can see the changes we have embraced in the behavioral health services we provide that are filled with hope, compassion, integrity and love. One important way we do this is to have services at Crestwood be directed by peer providers, who are people who have been clients or who choose to self-identify as a person with lived experience. Crestwood actively recruits staff with this type of lived experience and this perspective, and we refer to it as the peer experience. We also pride ourselves in employing peer providers at all levels of our organization, including at our corporate executive level, all leadership levels, as well as in the direct care areas of our organization. The Human Resources practice of recruiting, hiring and employing people with lived experience is based on the mounting research that has led peer-provided services to be identified as an Evidence-Based Practice and one of the highest factors to eliminating coercive treatment. At Crestwood, we have found that by having peers in all levels of employment, the use of restraint and seclusion has dropped by more than 92% in the past 8 years. Our programs have become richer and more effective and most importantly, there is hope. Peers, whether an RN with lived experience, a Vice President who has family member dealing with mental health issues or a bookkeeper who has been hospitalized for depression, all bring the gift of empathy and understanding to our clients that other staff may not be able to provide. Our programs have become richer and more effective and most importantly, there is hope, meaningful engagement, empowerment and strong, well-defined career paths with opportunities for growth reaching to the highest levels of Crestwood leadership. This practice is the true essence of integration and meaningful roles. Peer Providers enrich our programs for our clients on a daily basis that benefit everyone and provide a supportive and understanding resource that only they can offer. When our clients know that a staff member, who is there to help and support them, has also been through similar issues in their life, they know they are not alone and that they too can succeed in their recovery. Contributed by: Patricia Blum, PhD Executive Vice President

Last November, Humboldt County Department of Human and Health Services, through a grant from California Office of Statewide Health, Planning and Development (OSHPD) hosted a 10-day Peer Support Specialist Certification training that was led by Recovery Innovations (RI) to train 10 mental health staff and volunteers in the Eureka area. A lucky member of our Crestwood Eureka campus, Rebecca, a Peer Support Specialist through Dreamcatchers Empowerment Network, was invited to attend. This training is designed to enhance the peer support skills of participants, while empowering them to be more self-directed and competent in providing recovery and resilience services to clients. “The Peer Support Specialist Certification training turned out to be one of the most interesting classes I have ever taken. I was excited to be included in the two-week course, which opened new doors for me to learn how I could partner and relate to people seeking services.” It has been a year since Rebecca began working as a Peer Support Specialist at Crestwood Eureka, and she is grateful for the conceptual framework and the set of skills which this training gives to her job. “I felt empowered to learn these things in the company of other peer support and mental health workers, who have been working to combat stigma and provide support within the county mental health system,” said Rebecca. “I have learned to better understand my role in the comprehensive health facility that I work in. I have gained valuable resources to guide me, to set my own goals, and to provide meaningful direction for my work. This Peer Support Specialist Certification training provided a wealth of a wealth of information and skills to participants. Rebecca reported that the train- ing was relevant not only to her, but to anyone doing mental health work. She said, “The concept of helping people find their own strengths to make decisions leading to recovery is a powerful idea and is useful at any level of the mental health community.” Contributed by: Rebecca, Peer Support Specialist, Dreamcatchers Empowerment Network, Crestwood Eureka Campus

At Crestwood Center San Jose MHRC, they have been going through major changes, both physically and programmatically. The campus has undergone major reconstructive surgery, and now has a beautiful design similar to our other Crestwood programs. The design changes have brought about a more homelike environment and their clients are enjoying new areas, such as two living rooms, a comfort room, a serenity room, a group room, a library, and a den. Walls have been painted in soothing colors, lovely decor has been placed throughout the building, and new, stylish flooring has been installed. On the program side, a mindful effort has been made to not only embrace the Crestwood Values (Family, Commitment, Compassion, Enthusiasm, Collaboration, Character, and Flexibility), but to also actively practice them in the staff’s daily activities. They have also incorporated a more comprehensive program schedule, opened up the patio area, and expanded their outing and pass policy. With these efforts, they continue to maintain the important focus on recovery, program success, and preparedness for community re-entry for their clients. During this remodel and program changes, the staff learned some important lessons, such as any major change starts with the Administrator and Department Heads, and then it needs to be embraced by the entire team. “The change process may be challenging for some, even if it is perceived as positive or good, because it means saying goodbye to what we are familiar and comfortable with,” said Angele Suarez, the MHRC’s Program Director. Campus Administrator, Michael Bargagliotti, added, “It is human nature to be drawn to comfort and security, regardless of the outcome, because it is something that is known and we know what to expect. The change process introduces an insecurity and emotional instability that can cause people to react with resistance, fear or anger.” To help with managing the challenges of change, the staff at Crestwood Center San Jose found that implementing a few key measures such as maintaining an open mind, being optimistic, asking questions and helping others with the changes, made a huge difference in how everyone dealt with what was happening around them. “By maintaining an open mind, even though we may not always agree with the changes being implemented, we can actively listen and analyze the information, and then we can form an honest and genuine opinion about the changes. We might even surprise ourselves on how much we like the ideas,” said Angele. The staff found that by being optimistic, even though people might be currently unhappy with the changes, can be helpful since negativity usually comes from a fear of the unknown. By not being able to predict the future, a good strategy is to then focus on the present moment with a positive attitude, which can create an optimistic outlook towards the future. The staff also encouraged everyone to ask a lot of questions because it is important for each person to not only be notified of the changes that are occurring, but to also understand the reason behind the changes. Asking questions provides everyone with the needed information to make informed choices. “And we found that one of the best ways to help ourselves with change is to focus on helping others with change. Helping others takes the focus off ourselves, allowing us to connect with our peers, and we can then become a part of the change process through positive interactions,” said Angele. “At Crestwood, we know that we will always be part of innovative recovery practices and leadership. The best part of innovative change is that you end up creating a culture that is not only open to the concept, but takes on that personality. At Crestwood Center San Jose, as we continually work towards providing the best recovery program for our clients, going through change will allow us to continue our evolution, and never stop searching for our better self,” said Michael. Change is inevitable in life and usually out of our control; however, how we respond to the change is completely in our control. How will you choose to change and how will you choose to respond? It is all up to you. Contributed by: Angele Suarez, Crestwood Center San Jose MHRC, Program Director, Michael Bargagliotti, Crestwood Center San Jose, Campus Administrator

The Crestwood Nutrition and Wellness Initiative was started in May of 2013 under the direction of Margaret McDonald, Crestwood’s Director of Nutritional and Wellness Services.  One of the initiative’s first goals was to provide Crestwood facilities with new menus and recipes based on government guidelines and the latest nutrition research, using whole foods, rather than processed foods. In many of our Mental Health Recovery Centers (MHRCs), we have been able to greatly reduce or eliminate therapeutic diet orders because this diet is appropriate for the vast majority of our clients, including those with diabetes, high blood pressure, and high cholesterol.  The diet is appropriate for diabetics because we keep each meal within a certain range of carbohydrates, and we offer very few concentrated sweets.  We do most of our baking with whole wheat flour and serve real sugar in small portions. The diet is appropriate for those with high blood pressure and high cholesterol because we limit saturated fat by serving red meat only once a week and serving low-fat dairy products.  We also use very little added salt, and few processed or canned goods. Dietary Directors have reported that the costs have been about the same or a bit lower than the old diet. We offer two fish meals per week, three vegetarian meals per week, and limit red meat to one meal a week. Other meals provide lean proteins such as turkey and chicken.  The diet is high in fiber with lots of whole grains, beans, lentils, and fresh fruits and vegetables.  We include many plant sources of healthy fats such as oils, trans fat free margarines, nuts, and seeds.  Whenever possible, we avoid products with trans fats, high fructose corn syrup, and artificial colorings and sweeteners, and we make as much as possible from scratch.  We also offer meals from a variety of cultural backgrounds in order to appeal to our diverse client population. We have been monitoring client weights, lipid profiles, and HGBA1Cs (a measure of blood sugar levels over time).  In the facilities that have implemented our menus, we have seen a gradual weight loss in some of our overweight and obese clients, and an improvement in lipid profiles and a lowering of HGBA1Cs in some clients.  Dr. Zhongshu Yang, M.D., PhD from the University of California, Davis was so impressed with the change in weights and lab results at Crestwood Sacramento Center, that she applied for a grant to do a research project on our diet. She and a graduate student, Jennifer Papac B.S., recently presented a poster on our diet at UC Davis Medical School, titled “Crestwood Nutrition and Wellness Initiative in Long-Term Psychiatric Patients.”  They concluded that after implementing the diet, there was a reduction in the percentage of obese patients and an increase in the percentage of patients in the overweight and normal weight ranges. They also concluded that patients lost a significant amount of weight over the time period looked at, and that they showed a significant decrease in Body Mass Index (BMI) over that time period. Lastly, we have received positive feedback from Dietary Directors, kitchen staff, and the clients themselves.  Dietary Directors’ comments include, “There was some resistance at first from clients and staff, but they gradually accepted the changes and are getting excited about eating healthy”, “We are starting to see healthy weight loss and an overall change in clients’ attitudes toward making healthier choices”,  and “Clients are enjoying the meals and we are getting positive feedback.”  Clients also have their opinions about the new diet changes and made comments such as, “It’s like restaurant food”, “I feel better and it’s only been a week”, “I feel good, not so heavy”, and “I feel like I have more energy.” Going forward, Margaret plans to develop more nutrition and exercise-related groups, for clients, as well as health related in-services for staff.  Overall, Crestwood’s ultimate goal is to continue to improve the health and wellness of both our clients and staff through educating and serving them nutritious and delicious food that will make a difference in their recovery and lives.  In the words of Hippocrates, “Our food should be our medicine and our medicine should be our food.”

National Award Recognizing Dr. Gordon Muir Giles’ Innovative Neurobehavioral Rehabilitation Approach at Crestwood. Crestwood Behavioral Health’s own Dr. Gordon Muir Giles, Director of Neurobehavioral Services at Crestwood Treatment Center in Fremont and Idylwood Care Center, was awarded the most prestigious honor related to clinical practice in the occupational therapy profession, the Eleanor Clarke Slagle Lectureship Award . This award was made in recognition of his “innovating the clinical practice of cognitive neurorehabilitation” through his groundbreaking work with clients who have severe neurological impair- ments. Dr. Giles was presented with the Eleanor Clarke Slagle Lectureship Award by the Ameri- can Occupational Therapy Association (AOTA) at its 2017 Annual Conference and Centennial Celebration on April 1st in Philadelphia. The Eleanor Clark Slagle Lecture- ship Award was named after a pioneer of the occupational therapy profession, and recog-nizes achievements in research, education, and clinical practice that make substantial and lasting contributions to the occupational therapy profession’s body of knowledge. This award recognizes Dr. Giles’ efforts to improve the lives of Crestwood’s clients through innovative clinical practices, including his relational neurobehavioral approach to neurorehabilitation. This non-aversive method, which has been described as “relentless kindness,” assists clients with severe behavioral and emotional problems by empowering them through person-centered care and building positive relationships with them, rather than relying on confrontation, seclusion, or restraints. Dr. Giles uses this compassionate approach to treat clients whose neurological impairments have caused many of them to fail in other treatment settings due to difficult-to-manage behaviors. An example of this compassionate approach is being used with a client at Crestwood Treatment Center, Fremont who has had post-severe Trauma Brain Injury for 23 years. This client believes that he is a billionaire and that people are stealing his money. He would joke to the staff that they are stealing from him and if they would joke back, he would become very upset. To help deescalate this behavior, the staff now meet with him daily to review any areas of concern, assist him with solving any perceived problems, review his finances with him weekly and have him sign-off on any expenditures. Additionally, the staff responds to any of his questions about money by stating that taking money from him is unlawful and that if they did steal from him, they would go to jail. This increased focus on interpersonal factors and therapeutic relationships has made an amazing difference in this client’s life by helping to reduce his anxiety, stress, and negative attributional bias. Karen Scott, Program Director at Crestwood Treatment Center, Fremont said, “The positive impact Dr. Giles has made with both his clients and colleagues is immeasurable. He is a tireless advocate for persons with neurobehavioral differences.” As part of winning the Slagle Award, Dr. Giles will deliver an AOTA lecture in 2018 that will discuss how best to meet the needs of clients with neurobehavioral disability in a changing healthcare environment. Contributed by: Karen Scott, Program Director Crestwood Treatment Center, Fremont

In life we only get one chance for a few things – one of them is a first impression, so it’s vital we prepare ourselves to give an authentic and genuine one. In doing so, we share ourselves with others in the way we wish to be understood.  First impressions can be our calling card and they can be the one element or the one interaction that connects two people deeply. At Crestwood Behavioral Health, we believe in the value of the first impression so we strive to make it the most authentic and positive one possible.  We create the opportunity to meet the person, whether it’s a client, a coworker, a family member or visitor, exactly where they are at. We have drawn from a course created in the hospitality industry called First Impressions to teach the skills needed to make this welcoming and warm first impression.  We included it in the curriculum lessons from Dialectical Behavior Therapy (DBT), the 12-Step Program, Core Gifts, Trauma-Informed Care and Wellness Recovery Action Plan (WRAP). The course framework focuses on the principles of commitment, leadership, attitude, service and support. The principle of commitment in the First Impressions course emphasizes how to do our very best each day, to make a difference in someone else’s life and by doing so, we then make a difference in our own lives. We commit ourselves to the Crestwood values of family, to holding ourselves with integrity, to compassionately doing our work, to being flexible and forthright, and to have a sense of humor and positive attitude about the serious and challenging moments that frequently occur in our day. The leadership principle in the course focuses on leading by example. No matter what position you hold in life or at Crestwood, we are certain that we all have an opportunity and responsibility to lead. In life we are all leaders and we must demonstrate our values each day so that we create a sense of positive peer pressure, creating a culture of caring behavior by “paying it forward.” Attitude is addressed in the course as being reflected in our actions. We promote healthy productive behavior through building skills to increase the self-esteem and sense of value of our clients and staff. We create an environment where skills are taught and practiced to enhance the lives of our clients, families and ourselves, whether it’s DBT, Trauma-Informed Care approaches or WRAP. This culture of learning creates a positive sense of self which turns into positive performance at Crestwood. The service principle in the First Impressions course focuses on the work we do and so much more. It is being committed to come to work on time and making each moment count. It is having a smile. It is consistently meeting the needs of those around us with healthy boundaries, dignity and compassion. And finally the principle of support is addressed on how it holds the first impression and the ongoing relationship together. Support of others starts with self-care. In Trauma-Informed Care approaches we say “put your mask on first, before you can help someone else”, so if you are not healthy and supported, then you cannot provide care and support to others.  Support includes anticipating the needs of co-workers, as well as clients. It is creating a healthy environment where we feel cared for and appreciated. This leads to our sense of pride in the work we do and the people we are. The First Impressions class at Crestwood teaches each of these values and allows our staff to spend time together sharing their thoughts and developing the rapport to truly emanate team work. The opportunity is always there for a positive first impression and at Crestwood we seize the moment to do so.

The proposed Fallbrook Healing Center will be a secure Mental Health Rehabilitation Center (MHRC) in the former Fallbrook Hospital and will serve 100 clients. It is built on a foundation of Crestwood Behavioral Health’s 49 years of providing mental health recovery and wellness services throughout California. Crestwood will purchase the site (which has been closed since December 2014), secure the facility, improve it for appropriate use, and open the new center in 2018. Mental health issues such as depression, bi-polar and suicide affect one out of every five families in our country, and this facility will provide much-needed help for many in this and surrounding communities. We know that there are many questions about the new facility and its relationship with the Fallbrook community. We are committed to becoming a community asset and being responsive to your questions and concerns. To learn more about the Fallbrook Healing Center please download the documents below: Fallbrook-Proposed-Factsheet Fallbrook-Presentation-May-2017 Fallbrook-Presentation-July-2017 Fallbrook-Jobs  Crestwood-Testimonials

The Crestwood Wellness and Recovery Center in Redding has incorporated an additional and powerful therapeutic tool in their dynamic recovery program known as Motivational Interviewing.  Motivational Interviewing is a person-centered therapeutic approach using a process that is infused with collaboration and personal choices and honors the person’s autonomy and self-direction. There are five principles to Motivational Interviewing, which includes developing empathy to elicit engagement; identifying discrepancy between where the person is not and where they want to be; avoiding conflict while passively rolling along with any perceived resistance; avoiding the development of counter positions between client and staff; and supporting the client’s belief in their own abilities to build self-worth. John Dalton, the facility’s Wellness and Recovery Director, explained, “Almost instantly after beginning the use of Motivational Interviewing, I noticed the clients being less resistive and more communicative.  We were able to elicit new information from each of the clients and there was the development of enhanced therapeutic relationships as clients and staff worked together toward each client’s self-identified goal.” Many of the clients involved with the Motivational Interviewing therapy stated that they felt in greater control of their own recovery, and that the staff working with them truly heard what they had been trying to say to others for years. The facility staff who have utilized the Motivational Interviewing technique also identified that it creates a collaborative conversation that leads to tremendous growth, empowerment, and healing.  By using the client’s own goals, beliefs, abilities, and reasoning, clients were less likely to resist the process of making positive changes in their lives.  The key to the therapy is the process of asking, listening, and informing the client in a reflective manner what was said during the conversation.  This interactive role between the clients and staff, which is grounded in the understanding of the importance of the clients’ perceptions and desires, has led to multiple success stories. One of their clients said, “I never knew that I possessed the ability to change my life in such a profound way.  My Service Coordinator helped me to hear my own voice, and then cheered me on as I began to make the changes in my life that I wanted to change.” Motivational Interviewing is just one of many tools that can be used in the recovery journey.  Yet, for many, it is that unique inner voice that once identified, heard, and acknowledged, can then be nourished, cultivated, and supported to help clients make self-empowered changes toward health and stability.

Most of us have suffered some degree of trauma during our lifetime.  A glimpse at human history shows us that we live in a traumatized world.   Since trauma is not fully acknowledged as a universal experience that requires continued attention, in many cases, it perpetuates.  It is crucial to recognize our unaddressed trauma because a high degree of stress does not merely cause discomfort, it disturbs us physiologically, mentally, emotionally, and spiritually.   We begin to operate from the part of the brain directing survival instincts rather than from an integrated, whole-brain perspective. The question of how best to heal trauma is a complex issue.   The Strategies for Trauma Awareness and Resilience (STAR) program, led by Carolyn Yoder, helps to clearly outline the causes, types, effects, obstacles, needs of trauma, as well as breaking the cycle of trauma.  “Unaddressed traumas affect not only those directly traumatized, but their families and future generations,” says Carolyn Yoder. These are all valuable concepts to consider and/or revisit for people who work in the mental health field.  It is also beneficial for our personal healing.  The more importance that is placed on self-awareness and growth, the greater amount of internal resources can be found to handle triggering events and unresolved pain.  Our capacities expand, building a repertoire of emotionally-intelligent responses to pain rather than dissociating or denying our trauma.  Conversely, if our society were to fully recognize its trauma, we would be less likely to place labels on the already wounded.  This would not only bring more awareness toward how trauma is treated, but would instill more compassion towards the traumatized. Breaking the cycle of trauma requires fortitude and courage.   It begins with the acknowledgement of the traumatic incident(s). The process of self-inquiry, grieving and honestly identifying fears is deeply transformative.  As Yoder states, “it unfreezes the body, mind and spirit so that we can think creatively, feel fully, and move forward again.” Trauma healing is about transformation.  Through personal reflection, we can break our own cycles.   By creating our own personal healing practice, we move a little closer to a society that endeavors to do the same. At Crestwood, we take a trauma-informed approach to care that includes being aware that the majority of our clients experience trauma and that the trauma then becomes the lens through which they view and experience the world.  The initial trauma-informed care training Crestwood received came through a SAMHSA grant. It has impacted the design of our programs in the environmental planning with comfort rooms, a library area and a Serenity Room.  The training included an introduction to trauma-informed care services and an overview of creating a trauma-informed care service model for our programs. We are continuing to work with trauma consultants, such as Raul Almazar, from Almazar Consulting & Senior Consultant to the National Center for Trauma

Crestwood Behavioral Health’s whole person approach to healing, wellness, recovery and resiliency includes a focus on enhancing or developing a meaningful role in one’s daily life. As psychiatrist and Holocaust survivor, Viktor Frankl, observed, “Life is never made unbearable by circumstances, but only by lack of meaning and purpose.” Research in positive psychology has found that a meaningful role can lead to a positive attitude, increased happiness, sense of belonging, sense of purpose, increased self-worth and promotes self-accountability. At Crestwood we embrace the need for meaningful roles and it is one of our four Pillars of Recovery that also includes Hope, Empowerment, and Spirituality. It is defined as positive identities within the places we live, learn, work and socialize, which creates a sense of purpose and value. Crestwood’s healing and resiliency-building campuses promote this in many ways. The people we serve contribute daily to our campuses, including co-creating schedules of activities, participating in the functions of the day and educating staff, either through co-presenting at staff education meetings or participating in change of shifts. Meaningful roles also come from those we are in a relationship with. Our clients are recognized and valued for their relationships as a roommate, parent, child and community member. As a community member, our clients contribute in positive ways such as volunteering at local homeless shelters or animal rescue groups. Clients often also take on the role of teacher or mentor as they come together to support their fellow residents in their healing. Our Crestwood campuses also provide opportunities for meaningful roles through shared group activities such as art shows and sporting events like the Crestwood Olympics, where more than seven campuses get together for fun and friendly competition. At Crestwood, opportunities for meaningful roles for our clients do not stop at their discharge. Clients are supported in their recovery and wellness journey by being given the chance to come back and contribute through sharing their personal experiences of recovery at our campuses, volunteering in our communities or continuing with a job they achieved through Dreamcatchers Empowerment Network. Patty Blum, Crestwood Executive Vice President, says, “Supporting and encouraging meaningful roles at our campuses helps to provide our clients with a connection to their values, ethics and higher selves. All of these responsibilities -great or small- give their daily existence purpose, and as such, become their meaningful roles.” Contributed by: Cindy Mataraso, Director of Operations Crestwood Sacramento Home Office