APNA Recovery Resilience Innovations ABCS of Resilience APNA Recovery Council Steering Committee Interactive Panel 2016 Learning Outcomes Explain the ABC S of the Chandler Resilience Model. Describe nurse patient collaborations that promote resilience. List three specific strategies to utilize when collaborating with patients on their recovery journey. The speakers have no conflict of interest. Innovate Make changes in something established. From coercive practices to building resilience Sue Brammer, PhD, RN 1
Focus on the Solution: moving from problem focus to solution approach Joining: getting to know the person in addition to the diagnosis Building: Collaborating to build skills to recover and adapt What has worked in the past? What are moments that work now? What is a future that is preferred? Extending: Creating opportunities to practice new skills and increase social support. McAllister, M. (2007). Solution focused nursing: Rethinking practice. New York, NY: Palgrave Macmillan. How the ABCS of Resilience are encouraged in Recovery Active Coping Building Strength Cognitive Awareness Social Support Chandler, G., Robert, S., & Chiodo, L. (2015). Resilience intervention for young adults with adverse childhood experiences. Journal of American Psychiatric Nursing Association, 21(6), 406 416. Active Coping Activating Your Potential Sue Brammer, PhD, RN 2
Between stimulus and response there is a space. In that space is our power to choose our response. In our response lies our growth and our freedom. Victor E. Frankl Active vs Passive Coping Strategies Active Coping Refers to the utilization of those psychological or behavioral coping efforts that are characterized by an attempt to use one's own resources to deal with a problem situation (Zeidner & Endler, 199). Passive Coping Refers to feeling helplessness to deal with the stressor. Relying on others to resolve the stressful event or situation (Zeidner & Endler, 1996). AVOIDANCE It is All About Choice Deepak Chopra. (n.d.). BrainyQuote.com. Retrieved August 20, 2016, from BrainyQuote.com Web site: http://www.brainyquote.com/quotes/quotes/d/deep akchop453986.html Developing resilience is a personal journey and a choice. The ABC S of Resilience offer multiple strategies. Avoidance may work for a while, but doesn t promote growth, evolution or expansion. Active coping does. Sue Brammer, PhD, RN 3
https://juliegeller.wordpress.com/2013/04/08/start where you are/ Examples of Active Coping Mindfulness Structured Writing Lifestyle Mindfulness Being present for what s going on in your life with acceptance. A Simple Mindfulness Practice Close your eyes and identify five sounds you hear in this moment Just watch this moment, without trying to change it at all. What is happening? What do you feel? What do you see? What do you hear? Jon Kabat Zinn http://www.inspiredliving.com/relaxation products/inner peace.htm Structured Writing Amherst Writers and Authors Method: The Five Essential Practices Today s Prompt.. What I am good at... A non hierarchial spirit is offered. Safety is a priority Confidentiality is maintained. Privacy of the writer is protected. All writing is treated as fiction. Absolutely no criticism, suggestion or question is directed toward the writer Sue Brammer, PhD, RN 4
Lifestyle http://www.metamorphicjourneys.com/open your heart workshop evening/ Pursue positivity Live to Learn Open Your Heart Take Care of Yourself Laugh Building Strength What are you good at? Strength based inquiry What has worked in the past? What works well now? How do we help our patients build on what they do well? Sue Brammer, PhD, RN 5
Cognitive Awareness Aware of automatic thinking Cognitive Awareness Becoming cognizant of automatic thinking patterns in order to be more flexible in responding The basic question to ask when a patient is reporting a distressing situation, emotion, or dysfunctional behavior is, What is going through your mind right now? (Aaron Beck, www.beckinstitute.org) How it Helps distress Experience distress Locate distress in mind/body awareness Identify the automatic thought Examine the evidence relief Choose a different thought Experience relief Sue Brammer, PhD, RN 6
Resilience is Collaborative Client Nurse Words Matter Words Actions Thoughts Habit Resiliency Includes Environment Nurse Family & Community Client Physician &Support World Sue Brammer, PhD, RN 7
Social Support The most important task for all patients is to meet the separation challenges of illness with attachment solutions. Mount, Boston and Cohen 2007: Healing connections: on moving from suffering to a sense of well being. Connections to 1) inner self, 2) OTHERS, 3) the natural world of the senses; and 4) to God or Ultimate Meaning. A movement in healthcare Whole Person Care: preparing nurses to enhance the attachment solutions of their patients to the separation challenges of illness. This involves support of a patient s healing process in which he/she grows toward a life with a greater sense of connection and meaning and a new relationship to suffering and separation. Social Support Attachment solutions Maunder and Lauder, 2001 Stress!!! SeparationC hallenge Allostatic Loading Stress Response Systems Brain Dissonance Cardiac Dissonance Imunollogic Dissonance Social support network: Education and Planning What types of support do you need and lack? (Emotional support, practical support, spiritual support, information and new points of view, good advice ) Communicating your needs to current support people Building social courage and outreach to others Create new opportunities be a joiner Be patient with yourself and others Let go of unhealthy ties and avoid negative relationships Take good care of your relationships! Sue Brammer, PhD, RN 8
References Chandler, G., Robert, S., & Chiodo, L. (2015). Resilience intervention for young adults with adverse childhood experiences. Journal of American Psychiatric Nursing Association, 21(6), 406 416. Frankl, V. (1946). Man s search for meaning. Boston, MA: Beacon Books. Kabat Zin, J. (1994). Whereever you go there you are: Mindfulness meditation in everyday life. New York, NY: Hyperion Books. Maunder, RG and Hunter, JJ. Attachment and psychosomatic medicine: development contributions to stress and disease. Psychosom. Med 2001, July Aug:63(4); 556 67. Mount, BM, Boston PH and Cohen, SR Healing connections: on moving from suffering to a sense of well being Journal of Pain Management and symptom Management, 2007April: 33(4); 372 388. Schneider, P. (2003). Writing alone and with others. New York, NY: Oxford University Press. Zeidner, M. & Endler, N. (Eds.). (1996). Handbook of coping. Hoboken, NJ: Wiley. Sue Brammer, PhD, RN 9