APNA Recovery Resilience Innovations ABCS of Resilience APNA - PDF document

APNA 30th Annual Conference Session 2053: October 20, 2016 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 speaker have no conflict of interest. Innovate • “Make changes in something established.” • From coercive practices to building resilience Chandler 1

APNA 30th Annual Conference Session 2053: October 20, 2016 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 Chandler 2

APNA 30th Annual Conference Session 2053: October 20, 2016 “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 Passive Coping • Refers to the utilization • Refers to feeling of those psychological or helplessness to deal with behavioral coping efforts the stressor. that are characterized by • Relying on others to an attempt to use one's resolve the stressful own resources to deal event or situation with a problem situation (Zeidner & Endler, 1996). (Zeidner & Endler, 199). • AVOIDANCE It is All About Choice • 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. Deepak Chopra. (n.d.). BrainyQuote.com. Retrieved • Active coping does. August 20, 2016, from BrainyQuote.com Web site: http://www.brainyquote.com/quotes/quotes/d/deep akchop453986.html Chandler 3

APNA 30th Annual Conference Session 2053: October 20, 2016 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  A non ‐ hierarchial spirit is offered. Today’s  Safety is a priority Prompt…..  Confidentiality is maintained.  Privacy of the writer is protected. “ What I at I am am good at...” good at...”  All writing is treated as “ fiction.  Absolutely no criticism, suggestion or question is directed toward the writer Chandler 4

APNA 30th Annual Conference Session 2053: October 20, 2016 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? Chandler 5

APNA 30th Annual Conference Session 2053: October 20, 2016 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 • Experience distress • Locate distress in mind/body distress • Identify the automatic thought • Examine the evidence awareness • Choose a different thought • Experience relief relief Chandler 6

APNA 30th Annual Conference Session 2053: October 20, 2016 Resilience is Collaborative Client Nurse Words Matter Words Actions Thoughts Habit Resiliency Includes Environment Nurse Physician Client Family & Community &Support World Chandler 7

APNA 30th Annual Conference Session 2053: October 20, 2016 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 Allostatic Loading Stress!!! SeparationC hallenge Stress Response Systems Brain Imunollogic Dissonance Cardiac Dissonance 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! Chandler 8

APNA 30th Annual Conference Session 2053: October 20, 2016 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. Chandler 9