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 Inc. started a big growth spurt in the spring of 2014 from Solano to San Diego. That year we opened two new distinct programs, with some exciting and significant outcomes and contributions. In April 2014, we opened our sixth Psychiatric Health Facility (PHF) at our Solano campus and in June, we opened our seventh Mental Health Rehabilitation Center (MHRC) on our first campus in San Diego. These programs are very different, but serve the same type of clients at different points in their recovery. The PHF is a soft place to land for clients who need to stabilize during a time of crisis. The MHRC is a gentle, homelike space conducive for clients to transition back into the community. The commonality between both programs is that they share the best of all of the research and practices that Crestwood has used in space conversion and intentional space utilization such as the welcoming room, comfort room, serenity room, living room, dining room and library The welcoming rooms are dedicated to the ritual of welcoming which is based on the research and information shared by Bruce Anderson of Community Activators. It also reflects the principles of Crestwood’s First Impression program. The welcoming ritual is our way of greeting the new client when they come through our doors. This initial engagement in our welcoming room is frequently one of the most important moments in treatment. The welcoming room has comfortable furniture, fruit and snacks and a quiet, peaceful environment for the client to be welcomed into our facility. The assessment process is also part of our welcoming ritual. We use a conversation approach for the assessment and we utilize the CARF-accredited Primary Assessment that is designed to be a narrative discussion with the client. This has been an effective tool in initiating the relationship with the client, setting them at ease and garnering the most accurate and authentic information. Crestwood’s comfort rooms provide clients with a calming place to be. We designed our comfort rooms based on extensive literature review, visits to calming and comfort rooms in New York State, attendance at conferences and interviews with experts in the field.  Our comfort rooms are used as a tool to teach individuals calming techniques in order to decrease agitation and aggressive behavior. The goal for clients in using the comfort room is to develop practical skills that can be used in inpatient settings and after being discharged from care. Our serenity rooms are based on research from a New York State grant on Positive Alternatives to Restraint and Seclusion (PARS) and serve a dual purpose. The first is to provide a space that is calming and self-regulating for clients to be in that then reduces the likelihood of coercive treatment. The secondary purpose is to honor the spiritual growth of each client by creating a sacred space designed to support them on enriching their spiritual journey. Our serenity rooms are dedicated to support the internal growth and opportunity for contemplation, meditation and introspection. The living rooms in our programs are designed to be an environment that is specifically for the community to congregate and visit. It is based on the promising practice in the Living Room model from Recovery Innovations. The space is less clinical and is as homelike as possible. The colors are comforting and the furnishings are aesthetically pleasing.  This room can be used for community meetings and occasionally for groups and staff interactions. It is a place where people are treated with respect, have choices and feel safe.  The other elements of the Living Room model that are in place include peer providers, Wellness Recovery Action Plan (WRAP), inclusion and comfort. This model is closely aligned with the full-array of trauma-informed care approaches that we employ. Our library space is designed to provide another indoor space to be used by and for the clients.  This space has resources including self-help books, meditation books and books for leisure. The space is light and open at all times for clients to use. Crestwood’s dining rooms support our wellness initiative which includes healthy heart diets and exercise. This room is also used for recreation activities, movies, arts and crafts, games and therapeutic groups. One room that we don’t have in the programs are the restraint and seclusion rooms.  Crestwood has an initiative to eliminate the use of restraint and seclusion so we have created a trend of decreased restraints and a greater understanding and awareness of the issues surrounding their use.  In 2011, Crestwood received a grant from the Substance Abuse and Mental Health Services Administration (SAMHSA) to attend the Effective Use of Peer Programs to Prevent the Use of Seclusion and Restraints Conference in Boston. Crestwood was recognized at that training as one of the leaders nationally on reducing seclusion and restraint throughout our organization. Our level of seclusion and restraint for similar programs was one-fifth the national average according to SAMHSA consultants. Crestwood incorporates trauma-informed approaches into each program, as well as using WRAP principles and Dialectical Behavior Therapy (DBT) assumptions to create antecedent plans for clients and staff. As a result of creating these types of innovative spaces in our programs, Crestwood has been recognized by SAMHSA for the effective use of space and the positive effect it has on each client’s outcomes. All of these spaces are designed to provide our clients with the best environment possible to support their recovery.

Alternative therapeutic approaches have been used to treat a variety of medical and psychiatric issues.   It is often found that an unbalanced physiological system can negatively affect a psychological system, producing symptoms of pain, stress, and nervousness, which can then worsen an existing disease. As more evidence becomes available through scientific research, it appears that stabilizing a person’s physical state, leads to improving their mental state and overall well-being. With this concept in mind, Crestwood Wellness & Recovery Center in Redding decided to conduct an assessment and analysis of their clients and found that many of their clients possessed muscular skeletal complaints that they claimed affected their mood and psychiatric condition. To address this need, the facility’s treatment team decided to incorporate a chiropractic approach to help their clients. The treatment team contacted Dr. Ronald Henninger, a local chiropractor, to begin the process of treating their clients. This new chiropractic approach is in addition to the existing modalities used in their clients’ wellness plans and with the intention of offering enhanced treatment from a greater holistic perspective. Dr. Henninger has a passion for treating people with physical and psychological issues and said, “Working with these clients is rewarding and fulfilling, they are truly special and wonderful people.” The response from the clients has been overwhelmingly positive to this chiropractic program.  One female client, who has utilized a wheelchair for many years, said that after her first few chiropractic adjustments, “I can now sit up much straighter and my back doesn’t hurt. I feel so much happier.” The staff also reports a male client who often mumbled and was hard to hear, is now speaking much louder and with greater clarity after receiving chiropractic treatment from Dr. Henninger. The holistic approach of using chiropractic medicine, in addition to traditional mental health tools, appears to be beneficial in treating clients with both physical and psychological symptoms. Once again, Crestwood continues to lead the way with innovative approaches in mental healthcare and helping to inspire others toward success.

We experience many changes in life. Change can often be frightening, daunting and it can cause anxiety and resistance.  There are seasonal changes, economic changes and personal changes for each of us. The definition of change includes the act or process of making or becoming different and to undergo transformation. What we do know about change is that it is inevitable. Change is the only constant in life, it is the one thing we can count on, and it can be an incredible opportunity for growth. Crestwood Behavioral Health Inc. has change as one of our primary goals in providing mental health recovery services. In the world of mental health recovery, change is the goal as a person moves through the recovery process.  Change allows a person to learn new behaviors, to let go of characteristics that are no longer needed and to replace them with more beneficial ones. It can be as simple as learning to take a bus or as dramatic as letting go of fear and replacing it with trust.  It can be learning to let go of regret and replacing it with gratitude and learning to let go of selfishness and replacing it with kindness and love. It is through change that people learn to live independent lives and to support each other and themselves. So as we face change, remember that it is an opportunity to stand and take that next step forward and it is in this movement that we will continue to grow and thrive.

Crestwood’s Values Providing a Compass for Growth At Crestwood Behavioral Health Inc., we are excited about new opportunities.  So as Crestwood continues to grow, we always use our corporate values as the lens for every decision and change in direction. Our values are our compass to move forward as an organization and are revisited frequently throughout the year and always when we are faced with new opportunities, threats or decisions. Our values are simple: Commitment, Enthusiasm, Flexibility,  Integrity, Family, and Compassion. Each of these values holds its own set of principles and beliefs that act as a guiding force to us as a company internally, as well as externally in our relationships with stakeholders and partners. Commitment is the glue that holds our organization together. It is the promise to follow through and to stay uncompromising to our vows and obligations.  Commitment is what binds us together as a work force; it is the motivation to get up and be on time for work because you don’t want to let your coworkers or clients down. It is the pledge to provide recovery-based, socially-responsible services for our clients. Enthusiasm is exemplified in our tenure of excited and motivated employees. The average length of employment for Crestwood is seven years. Crestwood employees have  a strong pride in themselves and a natural enthusiasm for the work they do.  It is often seen in our facilities that staff members with 20 years of tenure are still as excited about what they do as our newest employees. Flexibility is the hallmark of Crestwood. We continuously adjust and reinvent service models to utilize the most current research, evidenced-based practices and to meet the ever evolving needs of our communities. Flexibility allows us to provide our clients with the most appropriate programs and services. We understand – and strive to meet – the range and variety of mental health needs of our clients, their families and their communities. We provide innovative and effective programs and services that enhance our clients’ wellness and promote their recovery. Integrity/Ethics is the cornerstone for all we do. Ethics is defined as morals, beliefs, and principles that are a system or defense for right and wrong conduct.  It seems simple, yet as we often read in news articles, hear at industry meetings, or observe in our own communities, it is often not so simple. Crestwood as an organization holds ethics as a core value.  In all of our partnerships, integrity, trust, respect and dependability are all non-negotiable. We hold corporate responsibility at the highest level of commitment. Through our continuous quality improvement and our performance improvement process, we analyze and recommit to providing the most ethical and efficient services to all of our stakeholders. Family is the foundation that Crestwood was built on. We have a rich background of being founded by a family who are committed to the operations. Our partnerships with clients, their families, our staff, the community, business associates and volunteers all comprise the Crestwood family. We focus on family involvement and education and make every attempt, where appropriate, to bring in families as a part of client care. Compassion at Crestwood is demonstrated with warmth, kindness and caring in everything we do for our clients and staff. We seek compassionate employees in the recruitment process and we nurture compassion in the training, supervision and general operations.  We honor the preservation of each client’s self-respect and dignity. At Crestwood we live these values and use them as the barometer for our success and view all of our corporate decisions through this lens. And with our values, Crestwood is excited to take on the challenges and opportunities that this new period in behavioral healthcare brings.

The Discharge with Dignity Program that has produced extraordinary results. Crestwood Wellness and Recovery Center in Redding has created the Discharge with Dignity Program that is helping to instill self-esteem and confidence in their clients who are being discharged. Many of the clients at the facility have found themselves, due to a variety of reasons, owning very little possessions. Although the facility has helped many of them to obtain needed clothing and personal care supplies, it wasn’t uncommon for the clients to pack their limited possessions in plastic bags as they left the facility. So even though the clients had progressed in their wellness, enjoyed relief from their recent troubling symptoms and gained new tools to effectively re-engage in the community, they often felt undignified arriving at their new residence with their possessions packed in plastic shopping and garbage bags. To help alleviate this issue, the facility staff began the Discharge with Dignity Program to collect backpacks, suitcases, and related items. Now as clients prepare for discharge, they are notified of the Discharge with Dignity Program and are offered suitcases or backpacks to store and transport their possessions in. They are also offered toiletry items, such as travel-size soaps and shampoos, to accompany their luggage. This simple gesture and assistance has made a remarkable difference in the attitude and confidence of the facility’s clients who are continuing on their journey of wellness and recovery. “It is heartwarming to see clients hold their heads up high with their suitcase in hand,” said Nicoletta Groff, Administrator.  Many of their clients have stated that arriving at a new residence with nice luggage, instead of garbage bags, has fostered self-worth and pride. First impressions and perceptions are very powerful, not only for the new acquaintances, but also for the clients.  The Discharge with Dignity Program gives these clients that little boost of confidence that helps them to shine.

Two Amazing Graduates who are Making a Difference and Giving Back When Crestwood San Diego opened in June 2014, a client named J. was admitted to the program in its second week of services. It was then that J. and staff created and began working on her personal plan for recovery. In just a little over three months, J. became Crestwood San Diego’s first “graduate” meaning that she had successfully completed the program and was ready for discharge to the community.  J. felt that her experience at Crestwood was so valuable that she decided to return to the facility as a peer volunteer to assist others on their personal journeys of recovery.  After a couple of months of work as a peer volunteer, J. was offered a paid position as a Rehabilitation Assistant at Crestwood San Diego. She accepted that offer and has since completed a Peer Training course through NAMI.  J. continues to work in this capacity at the facility, providing inspiration and support to the clients, as well as staff. Crestwood Chula Vista  opened in June 2015, and one of the clients  adm itted there shortly after was A.   A.  soon became a participant in the Crestwood Chula Vista’s Dreamcatchers  Empowerment Network  Vocational Program , designed to provide support and education to those with the goal of finding employment. Following J.’s lead from Crestwood San Diego ,  A. became  Crestwood C hula Vista’s second “graduate”.  A. n ow  returns twice  a week to the facility  in the role of peer volunteer, providing meaningful support to others. In addition to providing peer support, A.  also  leads a  weekly bible study group at the  facility .  He currently has the  goal of becoming a Rehabilitation Assistant like J., and is well on his way to achieving that goal with the support of staff at Crestwood Chula Vista.

It’s unusual to observe collaboration as it is happening. It is far more common to celebrate the success of collaboration after its culminated.  Crestwood’s collaboration with San Diego Health Care Hospital system and San Diego County Behavioral Health Services has provided an incredible opportunity to observe it in real time with measurable milestones and outcomes. This collaboration story began in 1992 when a case manager from San Diego County was seeking a placement for a very challenging client and a Crestwood facility in northern California was willing to take a chance. Later that case manager’s program manager got a chance to visit this client at the Crestwood Facility in northern California. What she saw there that day left a very positive impression that she remembered for many years to come. This was the first collaboration between Crestwood and San Diego County and set the stage for future events. Fast forward to 2013 when that very astute and dedicated program manager, Anna La Rocca Palid, LCSW, who is now a leader as a Behavioral Health Program Coordinator in San Diego County Behavioral Health Services, contacted Crestwood about the need in San Diego County for secured behavioral healthcare services. The county had grown tremendously and there were more challenging people to serve and insufficient programs to serve them. They needed a provider to work with the community and them to serve at least 40 clients requiring intensive, secured, recovery-based services. The county also wanted a provider who thinks outside the box, has creative individualized employment programs, recovery services and focuses on integrated alternative tools for clients and they chose Crestwood to be that provider. Crestwood and San Diego County Behavioral Health Services began devising a plan to address the county’s needs. Crestwood found a beautiful site for a 42-bed Mental Health Rehabilitation Center (MHRC) on a hospital campus in San Diego and created the first of two programs – Crestwood San Diego. Crestwood San Diego opened in June 2014 and quickly filled up with 42 clients. Before long, there was a flow of individuals successfully reintegrating into the community and new admissions moving into the program. The hospitals in the area felt a sense of relief and the new services served their purpose with helping many clients with their recovery. Soon Crestwood San Diego was full and the San Diego County behavioral healthcare system again felt the pressure of impacted Emergency Departments, long waiting lists at the psychiatric hospitals and a bottleneck in the mental health system. So they looked among themselves to find a possible location for a 40-bed MHRC. Paradise Valley Hospital found a location that would work. Crestwood and Paradise Valley Hospital started discussions about creating a 40-bed MHRC on this site. Dimitrios Alexiou, FACHE, President and CEO of The Hospital Association of San Diego and Imperial Counties and San Diego County Behavioral Health Services worked very closely together to successfully garner support from the San Diego County Board of Supervisors and the community to commit to the 40-bed MHRC in Chula Vista. Crestwood and Paradise Valley Hospital invested significantly in an extensive refurbishing project to create a beautiful, homelike, welcoming recovery-based MHRC known as Crestwood Chula Vista. Crestwood Chula Vista opened in July 2015 and is Crestwood’s ninth MHRC in California. Collaboration is working with others to do a task and to achieve shared goals. The wonderful collaboration of these groups created an environment that enabled San Diego County Behavioral Health Services to provide beds to some of the clients in greatest need for these services, helping them with their recovery and easing stress in the community and local hospital emergency rooms. It is clear to see that through collaboration we can make a difference.

I first learned about Crestwood four years ago in Boston, where I met Mertice “Gitane” Williams, Crestwood’s Vocational Wellness Educator, at a Trauma Summit hosted by the National Center for Trauma-Informed Care. My introduction to Crestwood and subsequent work with Crestwood has had a profound effect in my personal and professional life. I train and consult on creating trauma-informed systems all over the country and in some other parts of the world. As many of you know, trauma-informed care (TIC) is about operating from a set of values consistent with trauma-informed principles. First and foremost, Crestwood values are very much aligned with the values of TIC. But more importantly, Crestwood lives and practices its values, which makes it a trauma-informed organization. Creating trauma-informed organizations is a journey. This journey can be difficult and challenging, but rewarding. Crestwood understands this and has made a commitment to this journey for the long haul. This is what makes my journey with Crestwood unique. I have assisted many organizations in this journey and some organizations introduce TIC as a “flavor of the month”, and then later that energy fades away. But this is not the case at Crestwood. Two years after my big training for Crestwood on TIC, the DVD of that training remains mandatory viewing for their new staff orientation. Of course, I still blush when I walk into a program and get recognized from that DVD! Trauma-informed care is about healing. There are experiences in all our lives and our clients’ lives that leave an emotional wound, and some of those are deeper than others. A very wise Native American psychologist once said that trauma is the “wound that does not bleed.” Therefore, our job is to create a system of care that ultimately helps heal these wounds. We can call it many names, but ultimately most everything we do boils down to promoting healing. Crestwood understands this concept and that is why the many initiatives that Crestwood embarks on helps people heal. For example, the development of welcoming rooms to replace intake/admission rooms is a significant move towards healing. When clients walk into a Crestwood building, their first encounter is to walk into a room that says, “We are here to make you feel safe and wanted” versus “We are here to fix you.” Practices that empower clients to manage their treatment honors clients’ self-determination. Also the preponderance of rocking and sliding chairs in the programs provides rhythmic and repetitive movements for self-soothing and building new self-regulatory pathways, which are important in a client’s healing journey.  All the environmental improvements and enhancements convey the message to your clients and staff that you provide them with a place to live and work that reflects their importance in this world. The Dreamcatchers Empowerment Network program is not just a vocational program, it is a program that helps clients rediscover and reinforce their worth in this world and that they can make a difference. There are many big and small things that are being implemented throughout Crestwood. I urge you to view all of these as steps in the healing journey and that there is no deed too small to make an impact on healing. There is no job or function that does not contribute to this journey.  The Crestwood motto, “It’s About Growth” is founded on the understanding that it is hard to grow without healing from the past. Practicing trauma-informed approaches is akin to preparing and tilling the land to ensure growth is possible. A good gardener knows that it is important to know the nutrients that already exist in the soil in order to supplement and enhance what is already there.  This is why it is also crucial that you recognize and honor the many years you have been conducting healing practices with your clients. Your journey is in discovering and implementing healing practices that will augment the wonderful things you all are already doing. Lastly, I thank you all for the privilege in making me a part of the Crestwood journey!

At Crestwood Bakersfield, Wellness Recovery Action Plan (WRAP) is an important part of the healing and recovery process for their clients. Their motto and goal is to stay well by playing and focusing on their key recovery concepts, which include hope, personal responsibility, education, self-advocacy and support.  WRAP is used to learn to uncover each person’s own wellness tools and put them into action on a daily basis. Many of the WRAP activities they have incorporated into their classes are team building activities, which help others learn how to work as a team, increase problem solving skills and improve communication. “Our goal is to incorporate more fun, interactive and competitive activities into our WRAP trainings.  Just recently I developed a WRAP Trivia/Crestwood Family Feud game which has been helpful in understanding why WRAP is such a vital part of our lives,” said Linda Johnson, Director of Recreation Therapy. Another creative way Crestwood Bakersfield is presenting WRAP in their programs is by having individuals team up into pairs, with the assignment to create and design a WRAP community in which people would enjoy living.  This exercise is not only a lot of fun for the clients, but it also brings communication, group understanding and decision making skills in to play. “Since so many of us enjoy being in a peaceful setting, we have also incorporated a beach theme into our WRAP classes this summer, with ocean sounds, beach sand, sea shells, candles, lounge chairs and many other soothing items which seem to help ease the pressure of daily life,” explained Linda. Crestwood Bakersfield continues to find wonderful ways to support clients in their recovery through innovative WRAP activities and they love to say, “We are playing. What are you doing to stay well?”

Recovery is a choice; a person has to choose to be willing to work on their own recovery and actively participate in determining what recovery means to them. Not only is recovery a choice, it is an ongoing choice that is deeply personal and one that a person has to keep choosing every day, even though it may be difficult at times. At Crestwood Center at Napa Valley when a client is not ready to begin their journey of recovery, we let them know that we are here to help them when they decide they are ready. We are able to offer compassion, support and empathy in a non-judgmental manner. We offer a variety of opportunities they can participate in that will hopefully make their choice for recovery easier such as WRAP, DBT, working for Dreamcatchers Empowerment Network, art therapy, and various addiction-based recovery groups. Independent studies are also available for those not comfortable in groups. Once one of our clients makes the decision to begin their journey of recovery, it then becomes an ongoing choice, a new habit and a new way of life for them. Eventually, choosing recovery for them becomes easier. Recovery may be difficult for so many reasons such as facing uncomfortable thoughts, doing things they may not want to do, and even things they may believe are unnecessary. Sometimes the process of recovery includes not having much power or control over one’s own life for a time. So we try to provide our clients with tools, skills and plans they can use to gain empowerment and independence. Sometimes the realization of having to make the choice of recovery for the rest of their lives can be overwhelming, but we always remind them to take it one day at a time.  We encourage them by letting them know that when recovery does become a habit, it stops being so daunting. The work we do at Crestwood Center at Napa Valley can be frustrating at times because we cannot force a client to work on their recovery, as much as we want it for them. But more often than not, our work is very rewarding when we can help a client with their recovery. We can never give up hope and instead we can hold the hope for the hopeless and support their decisions. We can continue to help others discover their own path on the road to recovery by offering counseling, encouragement, our life experiences and our strengths. Our goal is to let our clients know that recovery is a choice that is worth making, so that they can maximize their life and achieve a sense of balance and fulfillment.