Auto Draft 132021 Resolution: Fail Well

Most of us fail at keeping resolutions, not to mention other goals.  So, why not try a different approach?

Let’s learn how to be more skillful at … Being ready to fail … and … Doing it well … in order to have the life we most want!

Summary

Most of us fail at keeping resolutions, not to mention other goals.  So, why not try a different approach?

Let’s learn how to be more skillful at … Being ready to fail … and … Doing it well … in order to have the life we most want!

Overview

Life is full of setbacks (aka failures). We don’t stick to diets, exercise, or sleep regimens. We lose jobs, miss opportunities, rupture our relationships and repeat self-defeating behavior.  So, this isn’t just about New Years … it’s about the rest of our lives.

Growing up among generations of depression, anxiety, suicides, divorces, alcoholism, and more, I certainly didn’t learn how to deal well with my own (plentiful) failures. Regardless of our early experiences, science has taught us ways that that we can learn how to fail well – to succeed more often.

So, here’s what I know that works – via science (CBT and positive psychology), backed up by the school of hard knocks. Let’s use a relatively universal example, just to illustrate a 5-Step process.

I want to lose weight. I set one tiny goal: Don’t eat chocolate this week. Of course, I end up eating a bunch of chocolate. Once I realize I broke my diet, I now think that the day is shot for ‘good behavior’ so I may as well eat whatever the hell I want and I do. Right afterwards, I’m really angry with myself but I vow I’ll start anew tomorrow. The next day I knowingly overeat, I’m fixated on my failures, and I’m overwhelmed with self-berating, guilt, shame, and demoralizing conclusions like, “I never stick to anything”. Bottom line, welcome to my well-worn diet rabbit hole.

1.  Setbacks & Autopilot

Start with the premise that we all make mistakes (i.e., have setbacks) which often trigger a self-defeating default reaction – a bundle of negative thoughts, feelings, and behaviors (i.e., our Autopilot). We’re all hardwired to act in ways we regret. Since our setbacks and autopilots are fully expectable (predictable), we can intentionally build up skills to be ready for the next time and decide to react differently.

So now, next time you’re feeling stressed, expect Setbacks and Autopilot. Intentionally decide to watch your experiences – like an objective reporter calling it as you see it, moment by moment.

Mindfully, I notice and name the process … “Oh, here’s my diet rabbit hole.”

Mindfully, I dispassionately study it … “Now I notice that I’m feeling overwhelmed and struggling with all the negativity … Now I notice I’m having the thought … I’m an idiot for having that chocolate … Now I notice I’m having a feeling of anger – between a 5 and a 7 out of 10 … Now I notice the urge to eat more … Now I notice I’m reaching for a sweet …  Now I notice I’m feeling guilty (an 8 out of 10) that I know I’m eating a sweet and still do it anyway …

2.  The Growth Mindset

2021 Resolution: Fail Well 1Begin with the premise that when we’re more rational, we’d CHOOSE to take the science-based stance that reframes mistakes (setbacks) as challenges that we can overcome by studying the elements of the system to see what conditions trigger or maintain them. And, as long as we keep persisting, we can figure out work-arounds to most challenges.

Dr. Dweck suggests that if we practice choosing the Growth Mindset, we can learn to approach challenges with an attitude of curiosity, reminding ourselves of the power of YET.  I may not have mastered this challenge … YET … but, I’ll get there if I keep asking questions about how it happened, problem-solve, and learn new ways.

Mindfully, I note … “This is a good opportunity to figure out what the conditions were that triggered the mistake this time. I did see one chain reaction (i.e., an  interpersonal situation) right before I ate the first chocolate. My friend offered one to me … I told her I was really trying not to eat chocolate … Then, she insisted I just try one … I noticed that in that moment … I didn’t have the right words to say ‘no’ without sounding really frustrated with her … So, I ate.  

I can set a new goal to try to reduce that trigger in the future … I’m not there YET … I need to learn a skill – how to say “no” more effectively – without hurting someone. This is an interesting challenge … I will find a Youtube video or a book that teaches me how to do it.  If I keep at it, I can figure it out to become more skillful.” 

3.  The De-motivating 3 P’s

Dr. Seligman would suggest that we be ready to catch ourselves in Personal, Pervasive, and Permanent thoughts – the most demoralizing and demotivating style of thinking.  According to his ‘learned optimism’ research, people who prompt themselves to reframe with alternative, more useful, thoughts actually perform much better.

2021 Resolution: Fail Well

4.  The Motivating 3 W’s

To build confidence, pay MORE attention to the details of what you did to contribute to ‘What Went Well’ (3 W’s) this past week. It can strengthen the new neural pathways formed by your new behaviors to build habits. Schedule (20 minutes a week) savoring the 3 W’s.  It usually is a positive experience.

Just fill in the blanks of … Yes … And … Jot it down in a journal. If it sounds too self-indulgent, you might think of it as notes for the book you’ll write to help others or even to leave to your children, so they can learn your wisdom.

YES … I fell back into Autopilot (ate 5 chocolates, etc)
AND … Then I chose to learn to do better … using

  • Skills:  Mindfulness to identify what I could change, (2) Reframing 3 P’s, (3) Practice Growth Mindset, (4) Problem-solving, (5) Goal setting to learn how to ‘say no’
  • Strengths:  Honesty, Open-Mindedness
  • Supports:  New book, Asserting Yourself
  • Values:  Living a healthy lifestyle, with self compassion (i.e., eat well, move more, stress less, love more)
  • Beliefs:  To err is human; to forgive [and learn to do better next time] divine; I can expect autopilot and then choose a Growth Mindset; I can expect the 3 P’s and reframe; Simple, not easy

5.  Mantra: Simple, Not Easy

Don’t forget self-compassion! Many of us never even try to reach for our dreams. After all, it’s human nature to avoid the failure-related negative feelings – the fears, helplessness, hopelessness, guilt, shame and loss of esteem or confidence.  That’s why AA has a mantra: Simple, not easy. 

Yes, it’s simple to know:

(1) Normalize failure as an expectable, temporary setback
(2) Neutralize obstacles as inevitable bumps in the road to problem-solve
(3) Savor your new choices … to build confidence for the next bump in the road.

It was only after I explored what was MOST important to me (clarified the values I’m passionate about) – to discover how I wanted to be in the world (in work, play, love), that I became more ‘gritty’ – and felt empowered to persevere through the stressful times.

So, it’s OK to make (even big) mistakes. To err is human; to forgive (and learn to do better) divine. The more time we commit to the life we really want, expect setbacks, and keep learning to do better, the less time we’ll waste on blaming ourselves and others, procrastinating, getting stuck in a demoralized rabbit hole, or even avoiding our dreams altogether. Still …. simple, not easy!

Twenty years from now you will be more disappointed by the things that you didn’t do than by the ones you did do, so throw off the bowlines, sail away from safe harbor, catch the trade winds in your sails. Explore, dream, discover.                                                                                  Mark Twain

References

 

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Auto Draft 12Thanks-Giving for well-being

Particularly on this Covid Thanksgiving, I’m thankful (and hopeful) for the increasing spread of positive health & well-being for all.

I’m sharing my 2 top favorites – Psychologist Seligman and Cardiologist Ornish. Each in their own compelling way explains how their extraordinary mind-body scientific contributions can help us to be and age well.

Summary

Particularly on this Covid Thanksgiving, I’m thankful (and hopeful) for the increasing spread of positive health & well-being for all.

I’m sharing my 2 top favorites – Psychologist Seligman and Cardiologist Ornish. Each in their own compelling way explains how their extraordinary mind-body scientific contributions can help us to be and age well.

A New Health Framework

Thanks to U Penn Professor Seligman (and colleagues), the new field of positive health and well-being is flourishing.  This new 8-domain definition of ‘health’ began with Total Force Fitness in 2010 and is spreading to civilians.

Here Dr. Seligman presents in his typically fascinating way, how ‘PERMA’ and your ‘explanatory style’ relate to resilience – in the face of physical illness as well as anxiety or depression.

Dr. Seligman: The Hope Circuit

HINT:  You can increase the speed by clicking the gear icon, that shows once you’ve begun the video. The Q & A are interesting too!

Dr. Ornish: Lifestyle Medicine

Cardiologist Dean Ornish MD developed, tested, and has now spread the only program that is proven to REVERSE the progression of heart disease. It’s comprehensive care (covered by insurance)… not just diet and exercise. Some of the personal stories of program graduates are so inspiring.

But wait there’s more … Dr. Ornish (one of the best speakers I’ve heard) explains 40 years of research that shows his program not only reverses other diseases (like cancers), but it even slows down aging …

 

For more recent Ornish talks (2020), watch a video by Dr. Bill Frist interview Dr. Ornish about his latest book. Also,  Dr. Ornish presents another in-depth slide presentation in April, 2020.

Positive Physical Health

Search an extensive database of articles on Positive (Physical) Health – by health assets or health outcomes – such as:

  • Cardiac health
  • Aging
  • Diabetes
  • Cancer
  • Negative Emotions
  • Ikigai
  • Curiosity

For more about physical health and “Positive Relationships,” here’s an update on the amazing 80-year Harvard study or listen to Dr. Waldinger below.

Positive Health Projects

The research projects of Positive (Physical) Health, the study of strengths that contribute to good health and protect against illness, include:

  • The Positive Cardiovascular Project
  • Physical Activity Project
  • Measurement of Flourishing
  • World Well-Being Project
  • Adolescent Positive Health Project

 

Positive Mental Health

The U Penn Positive Psychology Center provides a treasure trove of videos, spotlighting the foremost thought leaders in the areas of:

  • Well-being
  • Grit
  • Compassion
  • Fostering a Sense of Purpose
  • Happiness
  • Transcendence (religion)
  • Growth Mindset
  • Gratitude
  • Love
  • Self-control (willpower)
  • Character Strengths
  • Hope
  • Kindness
  • Adolescence
  • Aging well
  • Flow
  • Creativity

Measure Your Strengths

It’s free … Find out about your own … Character Strengths … Attachment Style … Grittyness, and other health ‘assets’ at U Penn’s Authentic Happiness Questionnaire Center.  You’ll find reliable and valid measures of:

  • Emotion
  • Engagement
  • Flourishing
  • Life Satisfaction
  • Meaning 

Resilience Skill Training

Learn (online) from the U Penn faculty member who trained the Army to be more resilient.  The course, “Resilience Skills in a Time of Uncertainty” may be free on Coursera.

Hoping for more 'Positive Health'

 

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Auto Draft 10Crystalize your core values

Values are the best motivators, according to Acceptance & Commitment Therapy research.  So, it’s a good idea to assess your values periodically, to know how to motivate yourself to reach your most important goals.

Summary

Values are the best motivators, according to Acceptance & Commitment Therapy research.  So, it’s a good idea to assess your values periodically, to know how to motivate yourself to reach your most important goals.

Assess your values

It doesn’t take long to do.  I’ve taken this  … http://www.lifevaluesinventory.org … Step 1 – 5 myself (to clarify/prioritize values) and found it quite useful.  The Life Values Inventory is free and it’s part of a research study. Your ‘data’ is kept private for you online for you to return to. The only way your data is used is without your name attached to it.

This process can help you to crystalize your values … so that you can better prioritize your goals!
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Auto Draft 9The Wake Up Call for Women & Sleep

The NIH sponsored a fantastic 2-day Research Conference in October 2018 where thought leaders shared their latest research on SLEEP and WOMEN’S HEALTH. It’s a wakeup call about the importance of sleep for the health of women.

Dr. Dinges shared his top 12 reasons to have consistent, restorative sleep. Many other panelists showcased a decade of federally-funded research advances in understanding health risks, societal burden, and treatment options associated with sleep deficiency and sleep disorders in women and families.

You can watch the 2-day event in its entirety  -  if you missed it!

Summary

The NIH sponsored a fantastic 2-day Research Conference in October 2018 where thought leaders shared their latest research on SLEEP and WOMEN’S HEALTH. It’s a wakeup call about the importance of sleep for the health of women.

Dr. Dinges shared his top 12 reasons to have consistent, restorative sleep. Many other panelists showcased a decade of federally-funded research advances in understanding health risks, societal burden, and treatment options associated with sleep deficiency and sleep disorders in women and families.

You can watch the 2-day event in its entirety  –  if you missed it!

Conference overview

This conference summarized current research establishing the national burden of sleep deficiency, gender-specific health risks (insomnia, CVD, dementias, metabolic disorders), and the findings from an array of initiatives examining the role of sleep deficiency in health and SES disparities of women across the lifespan. The objectives were to:

The Wake Up Call for Women & Sleep1) Highlight federally funded research advances

2) Stimulate translation of significant recent research advances through public presentations

3) Identify critical gaps/barriers to implementation.

Watch the conference!

You can watch the entire conference here … DAY ONE  … and … DAY TWO

The Speakers

 

Monika Haack, Ph.D.

Ruth Benca, M.D., Ph.D.

Gina Poe, Ph.D.

Natalie Shaw, MD, MMSc 

Hadine Joffe, MD, MSc 

 

Nancy Schmieder Redeker, PhD, RN, FAHA, FAAN

Tiffany M. Powell-Wiley, M.D., M.P.H., FAHA

Shobhan Gaddameedhi 

Jason C Ong, Ph.D. 

Suzanne M. Bertisch, MD, MPH 

Vanessa Leone, Ph.D. 

Kenneth P. Wright Jr., Ph.D. 

 

Esra Tasali, M.D. 

Mary Carskadon, Ph.D.

Fiona Baker, Ph.D. 

David Dinges, Ph.D. 

Chandra Jackson, Ph.D., M.S.

Alberto Ramos,  M.D. 

Norman Ruby, Ph.D.

Agenda

Day One

8:15 ….  Keynote
8:40 …  Sleep and Circadian Rhythms
9:05 …  Sleep and the Health of Women
9:30 …  Sleep and Transitional Periods Across the Lifespan
10:40 .. Sleep and Health Disparities
1:05 …  Wake Up Call (from Stakeholders)
2:05 …  Alcohol Consumption & Sleep
3:05 …  Gender/Sex-related Differences in Neurological & Mental Health Disorders

Day Two

8:15 …  Keynote
8:35 …  Cardiovascular Health in Women
9:45 …  Complementary Approaches to Sleep Disturbances
10:45 ..  Gender/Sex Differences in Glucose Metabolism
1:30 ….  Women Service Members and Veterans 
2;30 …   Circadian Rhythms, Sleep, & Cancer

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Managing Chronic Pain with CBTManaging Chronic Pain with CBT

Chronic Pain affects 100 million people and it's the most common symptom that drives people to a visit to their doctor. However, too few are informed how beneficial Cognitive Behavioral Therapy for Chronic Pain (CBT-CP) can be.

I recently gave the following presentation about the benefits of CBT, what's involved in the CBT treatment protocol, as well as numerous online resources - many of which are free to the public.

Summary

I recently gave the following presentation about the benefits of CBT, what’s involved in the CBT treatment protocol, as well as numerous online resources – many of which are free to the public.

Presentation

Use the bottom arrow to click through the slides.

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If Birds can do it, why can't weCan we compete together?

Birds fight together to survive. Isn't it time for healthcare professionals to stand up for science together to prevent the harm of hype?

We hope to make it easy and fun for healthcare learners to train interprofessionally, by providing an open, curated, non-profit network of knowledge sharing Hubs. Educators - anywhere - could train their learners to compete to 'share & spread what works and where to find it' ... to have the most impact - together, via shared service-learning.  Anybody game?

 

Summary

We hope to make it easy and fun for healthcare learners to train interprofessionally, by providing an open, curated, non-profit network of knowledge sharing Hubs. Educators – anywhere – could train their learners to compete to ‘share & spread what works and where to find it’ … to have the most impact – together, via shared service-learning.  Anybody game?

 

Most don’t share

Can we compete together? 4At a recent conference, when Popular author Mitch Prinstein suggested we all just tweet once, some did.  But let’s face it, even though we’re outraged at the misinformation online, most in healthcare don’t share what we know with the public.

 Mayo shares … Why not us?

Can we collaborate to compete? 2

Mayo Clinic Social Media Residency
Nov 12-17, 2018

Years ago, at a Mayo Social Media Residency I learned that many in healthcare avoid social media due to fears of catastrophized risks. Fact is, Mayo Clinic experts say it’s vital to share and their lawyers say there’s virtually no liability risk, if we don’t ‘share’ anything we wouldn’t say out loud in an elevator.

As an antidote to fears, we offer ‘exposure-safe’ Health Hubs. A leading pioneer in Health Communication, our advisor has piloted Hubs for his 2017 conference as well as in his courses that added service-learning projects targeting one shared aim.

Question:
Are educators ready to add a shared service-learning project to their courses – to offer hands-on social media training across silos (suggested by our Curriculum) … for a little healthy competition?

Can we compete to have impact?

To change norms, health communicators say we must make it EASY, FUN, & POPULAR. We can make Hubs EASY for any healthcare educator to train learners anywhere to share with the public, to comment on and curate others posts, and to spread the content to more social platforms. We can make it FUN for individual learners (or classes, programs, hospitals) to compete to have an impact.

Can we compete together?Educators … will you make ‘sharing’ POPULAR?
Could your learners, for credit, share with the public what they learn in your course on a Health Hub – CBTInsomnia, Health Communication, Addictions, Neuroscience and others?

Would you offer a service-learning opportunity to enter a shared social media challenge to:

Can we compete together? 5

 

  • Share:  Create a blog post or enhance others posts on a Hub topic  (see examples)
  • Spread:  Interprofessionally disseminate content (e.g., Tweet-to-compete for more impact in the intercollegiate competition)
  • Measure impact:  Display social media metrics on a leaderboard to spotlight the top influencers (learners, classes, programs, hospitals).

Bottom Line

I look forward to a day when healthcare educators collaborate to add a shared service learning project to courses so learners can practice clinical prevention and population health media skills … to fight the hype together.

Can we compete together? 2


Share & Spread
… ‘what works and where to find it’ to the public on curated Hubs

Compete for the most impact  (see March Madness for Total Fitness Health Comm pilots)

Continuously Improve … learn best practices for sharing together (dissemination & implementation; social scholarship)

 

For more, contact Meredith Cary.

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Auto Draft 8Reading about … Mental Models

Take a look at this unusual infographic that suggests how 'mental models' help highly successful people to make better decisions.

Recent Reading

Auto Draft 8

Copyright Michael Simmons Medium.com

I just wanted to quickly share an INFOGRAPHIC I recently came upon by Michael Simmons. I’m finding the idea of ‘Mental Models’ to be fascinating.

 

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IOCDF 2018:  The BEST conference ... EVERAn amazing OCD conference – for all!

The IOCDF 2018 Conference was the MOST ... Inclusive, Welcoming, Engaging, Supportive, Vibrant, Well-Promoted and integrated among researchers, clinicians, and consumers ... I've seen in 30 years.

No other conference I've attended has been so effective at demonstrating evidence based practices - right on site!

By the way ... the International OCD Foundation (IOCDF) is offering research grants for $500,000 ... in comparison to ... $50,000 in the past.

Here are 6 reasons that made this a spectacular conference ... for consumers and their loved ones, researchers, and clinicians alike...

Summary

No other conference I’ve attended has been so effective at demonstrating evidence based practices – right on site!

By the way … the International OCD Foundation (IOCDF) is offering research grants for $500,000 … in comparison to … $50,000 in the past.

Here are 6 reasons that made this a spectacular conference … for consumers and their loved ones, researchers, and clinicians alike…

1.  Inclusive

Foundation staff estimate that there’s a 1/3 split between researchers, clinicians, and consumers/loved ones. They estimated that there were 1975 attendees at the conference.

…  I’ve attended so many conferences …

  • American Psychological Association (APA: Health Psychology, Media Psychology)
  • Association for Prevention Teaching & Research (APTR)
  • American Pain Association (APA)
  • American College of Lifestyle Medicine (ACLM)
  • Society of Behavioral Medicine (SBM)
  • Institute for Healthcare Improvement National Forum (IHI)
  • Association for Behavioral and Cognitive Therapy (ABCT)
  • American Telemedicine Association (ATA)
  • mHealth Summit
  • Sleep Summit

No other conference has been so effective at bringing together … researchers, clinicians, and consumers … to actually DEMONSTRATE evidence based practices – right on site!

Researchers

Top OCD researchers presented their science to an audience of other scientists for a full day before the conference, including a poster session at the end of the day.

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They also presented in seminars, lectures, and poster sessions – throughout the conference.  There were several tailored tracks for:  Everyone, Living with OCD, Parents & Families, Young Adults, Hoarding, Therapists, Research-to-Clinical Practice, BDD, OCD & Substance Use.  As well, one research group was recruiting study participants at an Exhibit Hall booth.

 

Clinicians

Clinicians also presented in workshops and seminars – including at extensive programs for kids, middle schoolers, teens, and adults.  Clinics, Hospitals, and Practices promoted their services in the program book as well as in the Exhibit Hall.

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Also, clinicians led Support Groups at the end of each day. as well as other experiential ERP evening activities for consumers – of all ages (e.g., ERP Boot Camp) .

Consumers

Documentarians presented their documentary (Unstuck). Foundation Awards were presented to consumers as well as for research and service. A ‘Hero Award’ went to the founder of a weekly podcast, The OCD Stories, in which Stuart Ralph shares his own stories, interviews others with OCD as well as experts in the field.

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2.  Welcoming

There were tons of friendly ‘Ambassadors’ available, answering any question and helping to navigate to sessions. It seemed like there was always a helping hand no matter where you turned. The Foundation deploys volunteers well … not just at the annual conference, but for advocating, fundraising, etc.

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3.   Engaging

This conference was for all ages!  There was even a ‘Keynote Alternative for Youth’ that featured a special prize for the winner of a IOCDF’s Got Talent competition.  The Keynote (Dr. Drew Pinsky) spoke to ‘Everyone’ about moving away from stigma into empowerment and advocacy. There was an Open Mic Night, with 3 to 5 minute creative storytelling performers expressing about OCD experiences … not to mention the 18th Annual Road to Recovery Tour hosted by clincians.

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4.   Supportive

In the evenings, clinicians led support groups for you-name-it issue related to OCD (Young Adults, Body-Focused Repetitive Behaviors, Married Life, PANDAS/PANS, Substance Use, Relationship OCD, Violent and Sexual Obsessions, Scrupulosity, Diversity (color-based), Self-Injury, Health Anxiety, Postpartum, Emotional Contamination, Family & Caregivers of BDD, Contamination, Harm, BDD, Parents, Autism Spectrum, Eating Disorders, Skin Picking, Pedophilia, Sexual Orientation).

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5.   Vibrant

It’s pretty darn amazing … to convene all in one place  … so much support and healing … mainly using science-based strategies  …  a rabbi at the social … a Japanese child hunting OCD monsters … storytelling via a digital outlet … and so many more …

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6 ways to build a spectacular conference

6.   Well-Promoted

A videographer who has OCD put together the main promotional IOCDF video (below). And other consumer members (‘Ambassadors’) tend to promote the conference with blog posts, Twitter, Instagram, Facebook, and other social media.

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Morgan

 

More random tweets from #OCDcon

More about the International OCD Foundation

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Change your job!Change your job!

For anyone who doesn’t like their job (90% of us!) … please listen and take note of the 5 important concepts shared by Dr. Lopez, a leading positive psychology researcher.

Summary

For anyone who doesn’t like their job (90% of us!) … please listen and take note of the 5 important concepts shared by Dr. Lopez, a leading positive psychology researcher.

How to change your job

The best things you can do to make your life better is to … change your job … here’s how …

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Videos for 'wind down' time 1Videos for ‘wind down’ time

If you’re having trouble turning your mind off at bedtime … have a set of YouTube videos ready to watch … to gently remind yourself to focus on neutral, relaxing stimuli.

Summary

If you’re having trouble turning your mind off at bedtime … have a set of YouTube videos ready to watch … to gently remind yourself to focus on neutral, relaxing stimuli.

Try a Video

 

 

 

 

 

https://www.youtube.com/watch?v=pxqIlaVBoH0

 

Relaxing Music

 

 

Ocean Tide and Music

 

 

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Lessons from Teaching at a Simulation CenterLessons from Teaching at a Simulation Center

I directed year-long Clinical Skills I & II  at 'America's Medical School' in Medical & Clinical Psychology.  We trained both military & civilian learners in one of the most advanced medical Simulation Centers

Gold Standard Clinical Training

These courses used the best methods, materials, and measures to train in the most essential assessment, therapy, and supervision core competencies:

  • Actors, with diverse demographics, were coached to portray patients
  • Empirically validated treatment and supervision manuals
  • Empirically validated measures of therapeutic relationship and skills
  • Up to 14 45-minute sessions with 4 patients having multiple co-occurring conditions
  • Complex therapeutic and ethical (military & civilian-related) challenges
  • 360’ feedback from actors, peers, teaching assistants, & post-doc’s
  • Seasoned clinical faculty supervisors (military & civilian)
  • Specific self assessment ratings using minute-by-minute video review

The National Training Director invited us to the flagship Army Psychology Internship (Tripler in Hawaii) to train his faculty and other internships across the country how to adapt our methods & measures to their training.

The Council of University Directors of Clinical Psychology (CUDCP) invited us to their 2011 annual meeting, to showcase our training model – having seen our poster at the 2010 Association of Behavioral & Cognitive Therapies (ABCT) conference.

Introduction

Lessons from Teaching at a Simulation Center 3It was great fun to work with talented actors. We wrote weekly stories for the 4 different ‘Simulated Patients’ they portrayed. We choreographed & coached the actors for each weekly encounter.  Each session was like an episode out of a soap opera – produced by a simulation center crew behind the scenes who provided ‘moulage’ (e.g., dumping whiskey all over actors who were portraying a substance use disorder episode).

Each student met with 2 ‘patients’ per year during my tenure (2004 – 2010). They had up to 14 encounters each year per patient. They met with their patients (i.e., Howard, Denise, Seth, & Candace) – back to back for 45 minute-long sessions.

The following week, each class (I and II) met to share feedback about those sessions as well as to plan for the next treatment session. At one point, we had a crew of 2 faculty members, 2 post docs, and 2 teaching assistants who were supervising up to 12 graduate students.

At times, it seemed like there was a cast of thousands. These courses could not have worked without the many years of dedicated teams of  Faculty, Fellows, & TA’s who made directing Clinical Skills richly rewarding. The 2010 crew is pictured below, beginning with Associate Professor Holloway.

Screen Shot 2016-01-01 at 5.42.01 PM

 

 

 

 

 

Videotaped Sessions

Lessons from Teaching at a Simulation Center 1

Each session was captured, minute-to-minute, in online videos.  Supervisors and students would show clips of their videos at group supervision sessions – to help illustrate specific clinical dilemmas or questions.

  • Students self-assessed their sessions.
  • Supervisors assessed the sessions.
  • Simulated Patients assessed the session.

 

 

Validated Assessments

At the end of each weekly encounter, each Simulated Patient gave constructive written feedback to their therapist (student), about what was helpful (or not) – using validated forms.

Calpas

As well, supervisors and students used validated instruments to assess over 20 dimensions of clinical skill during each session. Supervisors rotated, so that each student had the benefit of feedback from several perspectives.

CTAS

Validated Training Protocols

Lessons from Teaching at a Simulation Center 2

We taught therapy skills using validated manualized treatment protocols for Depression, PTSD, Chronic Pain & Fatigue, Readiness for Change (Smoking Cessation), insomnia, anger management, ADHD, anxiety.

And we taught clinical supervision skills using validated supervision training materials. For instance, with motivational interviewing, students in groups of three would rotate their roles: one playing the therapist, one playing the patient, and one playing the supervisor. The supervisor would use MIA-STEP rating tools to give feedback to the supervisee.  Faculty would then give feedback to the supervisor trainee.

 

Meet the Simpatients

Characters portrayed people with medical illnesses (e.g., cardiac, chronic pain, diabetes), psychiatric disorders (e.g., PTSD, Depression, ADHD, Substance Use), and lifestyle issues (e.g., weight management, smoking cessation). As if that wasn’t enough, these people were finding themselves in many crises (e.g., relationship issues and divorce, cardiac rehab, demotion and employment clashes with supervisors, lack of family support) that would pose ethical and other dilemmas for therapists.

Howard

Howard2Initially, Howard came in feeling pretty well. He just had some chest pain. So his primary care doc referred him for help with stopping smoking and diet and exercise management. Well, before we knew it, he had the feared heart attack. When he returned to us he was in cardiac rehab and much more ‘ready to change’ his lifestyle habits. Still, he did have quite a bit of impatience and hostility, which would flare up rather often.

But, shortly after his heart attack, Howard began having huge anxiety attacks. Not just any old anxiety. That near death incident triggered a flood of all those horrific memories from an IED attack he barely survived, before retiring from the Army last year.

Screen Shot 2016-01-01 at 2.25.05 PMAnd, he was always torn about how close he wanted to get … now that his ex-wife came back into the picture. We’ll let you imagine … did he get back together with her … was he able to quit smoking … did his anxiety get better?

Over 14 sessions, a crew of Howard’s were trained & coached weekly in how to portray certain challenges related to Post Traumatic Stress Disorder, Type A hostility, diet & exercise behavior change, and interpersonal conflicts.

 

 

Denise

DeniseTest2Denise was not only depressed, she was very angry with her doctor for dumping her on a psychologist. She had really bad physical pain. And, she believed that he just didn’t want to listen to her complaints anymore. She thought her doctor was clueless and there was no hope in sight.

Meanwhile, she was so fatigued, she had to cut back her work hours, she couldn’t make plans with people and so she was getting more isolated, she couldn’t sing in the choir anymore, she couldn’t even focus on reading. All she knew was she used to be (at least strive to be) the perfect wife and mom – maybe a little too much people pleasing. Now, they had to take care of her and she felt like a huge burden on her family. In her fifties, she felt like she was in her eighties.

Screen Shot 2016-01-01 at 3.30.27 PMIn fact, she did have a lot of complaints … and wondered herself how one person could have so many things wrong with her. She had a real headache .. a real stomach ache … real pain in her joints, that seemed to move around her body  … and she seemed to get sicker and sicker.

Each time her doctor prescribed a new drug, it made her feel even worse. She couldn’t stay asleep and she couldn’t remember things that were obvious to her before. Her only guilty pleasure left was smoking … she wasn’t going to give that up!  Over 14 sessions, the crew of Denise’s were coached in how to portray a military wife with pain and sleep problems associated with fibromyalgia (Chronic Multisymptom Illness), depression, & low readiness to change (i.e., smoking).

 Seth

PMRThis one was active duty in the Navy (building jets) and wasn’t coming for help – willingly. He didn’t think that his coming in late to work or fighting was such a big deal. But, his Commanding Officer threatened him. If he didn’t go to the ‘shrink’ to ‘get better’ he’d mandate that Seth seek treatment – a far more serious situation.

Even though he’d already been demoted once for getting into fights, Seth was still in denial – about a lot. It was never his fault – whatever the problem was.  He knew he wasn’t like his father, the violent alcoholic. He didn’t drink like his father and he didn’t beat up on his kids. It wasn’t his fault that he didn’t feel well in the morning to get to work on time.

Screen Shot 2016-01-01 at 3.05.24 PMIn his mind, he deserved to drink to forget. After all, he was the victim here. He was the one who lost his wife and 2 kids in a car accident seven years ago. He just drank to numb out the loneliness and heartache. In his mind, anybody would. What else was left for him to do?

The crew of Seth’s got doused with bourbon a few times. And, they were coached in Substance Abuse, ADHD, complicated bereavement, suicide, readiness to change … and can you tell … anger issues!

Candace

CandaceCandace was struggling with the break-up of her marriage. Her husband was acting very differently from returning from war, actually several deployments. He finally did break it off – to fall in love with a woman with children. Candace couldn’t have children. Most of her therapy was dealing with a severe depression.

Also, her primary coping mechanism was to work long hours and not take adequate care of herself. That didn’t work out too well. Twice, she ended up hospitalized – last time in a diabetic coma. It’s complicated. Candace had diabetes from a very young age. Her mother literally hovered over her day and night, checking her blood sugar.

Screen Shot 2016-01-01 at 3.22.41 PMSo, Candace unfortunately learned to become too dependent on her mother – and then her husband – for basic self-care. Consequently, as an adult, she struggles with ambivalence about self-care of her diet, exercise, and diabetes self-management skills – but has no idea why.

Candace’s were prepped in how to portray a Major Depression, dependency issues, and medically non-compliant behavior related to Diabetes self-care.

 

 

Conclusion

Although these courses used the best methods, materials, and resources, they were prohibitively expensive to maintain and ultimately they were discontinued for that reason!  First they were cut from 2 years down to 1 year. But, ultimately after many (fun) years, they were completely discontinued.

In my opinion, however, in clinical psychology training I think it’s essential to use simulated training before students work with actual patients. There are ways to reduce the cost of this training significantly, while keeping the core experience in tact. Unfortunately, we lost the opportunity to test that out.

Rest in Peace Clinical Skills I & II … those of us who were involved over the 6 years I was there really appreciated the chance to train in such a unique way.

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Why Can’t We ALL Learn to be Totally Fit? 2What are Health Hubs?

Health Hubs are non-profit knowledge-sharing websites where health professionals share what they know with the public about what works and where to find it - on a particular health topic.

The Insomnia Hub

Why Can’t We ALL Learn to be Totally Fit? 1Americans spend up to $107 billion a year on sleep, including 60 million scripts. Did you know that sleeping pills often don’t work or can be dangerous?  Most of the 1 in 3 with insomnia don’t know that Doctors’ Guidelines say to first try the non-drug therapy (CBT-I).  It seems like only the hype is heard – like ‘Ask your Doctor’ ads.

All in healthcare professions are urged to promote best practices using social media.  Imagine if the entire community of sleep professionals spoke up together in one place – over the hype … for what’s proven to work and where to find it.

On the Insomnia Hub … together, we hope to spread ‘what works & where to find it’ … We LEAD

Leverage the Insomnia Hub & other social media to
Effectively promote ‘what works’ to
Accelerate consumer demand for best practices &
Disseminate the best science about Insomnia.

 

The CBT Hub

Cognitive Behavior Therapy (CBT) is a highly effective treatment that works for many, many conditions. All too often, my patients express that they wished they would’ve known about CBT many years before – when they first began treatment. They feel that they’ve lost time, money, relationships, opportunities, as well as better health … not knowing about CBT.  As well, many clinicians lament that if only we had something like a pharmaceutical industry to promote CBT, we’d help so many more people.

What are Health Hubs?We believe that by harnessing the power of social media, a community of concerned clinicians can speak up together in one place – to promote CBT ourselves. We hope to show a measurable impact, as we post on the CBT Hub – especially about ‘CBT success stories’ – and further spread links to our posts via other social media platforms.

For more, visit the CBT Hub.

 

More Health Hubs

What are Health Hubs? 1

We hope to develop a whole array of Health Hubs in the future. If you’re interested in helping us, contact me at drcary@mac.com.  If you’d like to see a Health Hub on another health topic, please use the comment section below to add to our list.

We are looking for behavioral health groups (societies, academic departments) that would like to develop/adopt a Health Hub that its members would curate.

Also, we are looking for behavioral health educators who would like to incorporate Health Hubs into their courses, as a hands-on learning of social media skill development for health promotion – using the Health Communication Hub as a platform base.

 

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Why Open Health Hubs?Why have Health Hubs?

Millions of us act like self-care dummies. Take insomnia. We spend billions on pills that never fix the problem. Few know that a sleep doctor would suggest that we learn a handful of (proven) CBT skills – to END insomnia!

Why Open Health Hubs? 1Does your doctor share?

Prescription for Health showed that patients get healthier when providers ‘share’ resources via their website.

So, imagine a health communication campaign that makes it easy for ANY clinician to ‘share’ via a curated network of Health Hubs – open to everyone – that spotlight proven practices and resources.

An interdisciplinary George Mason collaborative has begun a health communication campaign … see ‘Share CBT-I … using the Insomnia Hub.

Why Open Health Hubs? 2Doctors aren’t trained to share

Professional schools train in Clinical Prevention & Population Health competencies … but, they DON’T train in digital health promotion skills!

Why not create ‘ONE’ (Open Networked Education) health comm course (or practicum) that shares ‘ONE’ platform (Open Health Hubs) to train students interprofessionally to …  (1)  Translate & promote best practices, (2) Bridge to best resources, and (3)  Compete to have an impact?

Why Open Health Hubs? 3How to train all clinicians

Worldwide, students learn quality improvement (QI) skills at the IHI Open School. Hundreds of schools in the health professions (medicine, nursing, etc.) require their students to train there – online. For credit, students learn online & apply QI skills locally. Their service saves lives; it’s known as ‘open’ service learning.

Likewise, what if an open course (or open practicum) taught social media skills to students in the health professions – to share with consumers what works?  As their service, students would co-create open, scholar-curated Health Hubs – to improve health outcomes.

Why Open Health Hubs? 4Could service learners build a network of Hubs?

Imagine if an interdisciplinary academic team directed the ‘ONE’ course (or practicum)?

In the ‘ONE’ course, any student anywhere could learn how to post messages – to “bridge” health consumers to what works. Students could interprofessionally ‘peer-review’ each post. And, they’d publish their posts to learner-curated Health Hubs (e.g., physical activity, smoking cessation).

Why Open Health Hubs? 5Could professional societies adopt a Hub?

Suppose the ‘ONE’ course adopted and curated a specific Health Hub, to not only disseminate health science to the public, but to try to improve consumer demand for what works – semester by semester.

To promote their members and fields, professional societies  (‘participatory medicine‘ or ‘lifestyle medicine‘ or ‘health communication) could adopt/curate a Health Hub, by offering continuing ed credits to members taking the ONE course.

Why Open Health Hubs? 6Could GAH prevent suicide?

For instance, what if Give an Hour  (GAH) members, as their President offered, took the ‘ONE’ course for continuing ed. Their 7,000 civilian mental health providers could adopt/curate a Hub, spotlighting their post deployment resources.

What if a Health Communication program partnered to use the Hub as a learning lab? Their students could study which types of messages helped which type of service member to seek which kind of help … to improve health outcomes.

Why Open Health Hubs? 7Wanted: Public Health Leaders

Future public health leaders need to learn how to leverage communication and technologies – to help us all get more fit.

What if a School of Public Health adopted a Hub to promote, recruit, and lead college teams to compete to be ‘the most fit’ campus?

Mason’s health comm courses have piloted and presented this concept:  March Madness for Total Fitness.

Why Open Health Hubs? 8Wanted: Social Entrepreneurs

In behavioral health, we need SOCIAL entrepreneurs who can leverage SOCIAL marketing – to compete with the billions spent on hype … like ‘Ask your Doctor’ (for a pill).

Why not try a University-based social enterprise, using ONE health comm course and Health Hubs to generate revenue?  For example, one way might be to seek an NCAA sponsorship for a Mason start-up that hosts an annual … March Madness for Total Fitness.

Why Open Health Hubs? 9Wanted: Educators & Researchers

Help answer empirical questions:

Could the ‘ONE’ course (with Health Hubs) improve interprofessional communication competencies to promote evidence-based practices/services?

Could the ‘ONE’ course increase consumer demand for ‘what works’ (e.g., smoking cessation)?

Could the ‘ONE’ course leverage an intercollegiate competition to improve population health?

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Imagine Mason’s March Madness for Total FitnessImagine Mason’s March Madness for Total Fitness

In 2006, Mason students believed they could be the best of the 'final four' of March Madness.  What if we could re-create that kind of excitement every year?

What is Total Fitness?

What’s Total Fitness?At the time I taught at the Uniformed Services University, I watched the entire military transform its definition of health to include the ‘whole person’ in the whole community (watch the vidoe for more).  They used a train-the-trainer model to teach over 30,000 Army soldiers to train 10’s of 1000’s of other soldiers to be totally fit.

At the 2012 Living and Leading with Resilience Conference, Colonel Bates and I presented a way for George Mason University to LEAD …  kickstart an intercollegiate competition – for communities to compete to be the most totally fit – using that military training.

Creating a Culture of Total Fitness

Can’t civilians be Totally Fit too?Dr. Seligman at U Penn led the Total Fitness train-the-trainer program. He stated, at the Mason Resilience conference,  “If we can train Drill Sergeants to lead resilience training in Army units, I don’t see why students can’t train their peers to be more resilient.”

Mason’s Distinguished Communication Professor, Dr. Kreps thinks it’s a testable hypothesis …  The science says that if a health communication campaign makes it POPULAR, EASY, & FUN for students and faculty to join … we can create a culture of Total Fitness.

Piloting ‘Shared’ Service-Learning

Imagine Mason’s March Madness for Total Fitness 2In 2010, we began pilots across 4 undergrad and graduate courses, testing some ideas …

Would faculty integrate the development of an intercollegiate fitness competition into their existing courses using service-learning?    RESULT: Yes, it was EASY for faculty.

Would students opt into a service-learning project and collaborate across courses to develop the competition together?    RESULT: Yes, they had FUN too!

Service-Learning Pilot #1

Imagine Mason’s March Madness for Total Fitness 3Dr. Rowan’s Writing for PR class conducted a survey to learn what would make it ‘POPULAR’ to join a Total Fitness team. Freshmen surveyed said: (1) Get course credit (i.e., service-learning) to help develop the competition, (2) Use retailer incentive (i.e., a Starbucks gift card), (3) Use smartphone to verify points.

Survey results from the PR students were then shared with students in Dr. Kreps’ Health Comm 404, who – for their service-learning project – designed the fitness challenge.

Service-Learning Pilot #2

Imagine Mason’s March Madness for Total Fitness 4Dr. Kreps’ Health Comm 404 service-learning project was to design a FUN Fitness Challenge.

They tested a mobile health app – called WIZIT – with QR codes that converted to fitness points and prizes (sponsored by Starbucks).

And, they recruited students from yet a 3rd course (Comm 200) to actually test out the fitness challenge – as a service-learning project.

Service-Learning Pilot #3

Imagine Mason’s March Madness for Total Fitness 5Students who opted into this service-learning project downloaded the ‘Wizit’ app on smartphones. The one who logged in the most laps (back & forth between 2 Starbucks) during a week, won a Starbucks gift card.

Their reactions were mostly positive with suggestions for how to improve it for the next time. Overall, students among the 3 pilots were very enthusiastic about the potential for launching and leading a March Madness for Total Fitness.

Posters & Presentations

Imagine Mason’s March Madness for Total Fitness 6These health communication pilots were presented at 5 conferences:

2010 NIH mHealth Summit

2010 American Psychological Association

2011 Association for Prevention Teaching & Research

2011 Council of University Directors of Clinical Psychology

2012 Living and Leading with Resilience (George Mason University)

Who at Mason would join a competition?

Imagine Mason’s March Madness for Total Fitness 7Janet Walker, then Director of  Wellness by Mason, suggested that their annual Resolution Solution fitness challenge could collaborate with an intercollegiate fitness challenge. Their coalition spans the entire University.

Educators who teach relevant courses could offer students the option to join a ‘Total Fitness’ team for service-learning. As students apply what they learn in courses, they’d ‘serve’ to improve their team’s performance and/or help build the intercollegiate competition.

42 Grad Programs Would Join

Imagine Mason’s March Madness for Total Fitness 8When we presented the idea of March Madness at the Council of University Directors of Clinical Psychology 2011 Conference, we surveyed these Directors.

Asked if they’d integrate the service-learning aspect into their Clinical Skills training, 42 Directors indicated that they could see it as part of their clinical Practica … engaging patients as well.

Next Steps

Contact us (drcary@mac.com) if you’re interested in developing the idea of an intercollegiate challenge for total fitness!

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