Communication is the linchpin of the work that we do within Crestwood, and it is a primary means for conveying our Crestwood values of Compassion, Commitment, Family, Enthusiasm, Flexibility and Character. As we strive to become more trauma-informed and committed to conveying an unconditional positive regard for those we serve, the words we choose and how we convey them become ever more important as they are the vehicles with which we convey our attitudes, perceptions, and beliefs. Sometimes, even with the very best intentions, we choose words or say something in a certain way that is received as offensive by another. There are layers of cultural, ideological, identity, and historical dynamics that contribute to this. It is therefore crucial that we become educated about and sensitive to the individual triggers of those that we serve, those of our colleagues, as well as our own. At Crestwood Treatment Center in Fremont, we practice a method of communication that we call “Non-Aversive Communication.” Essentially, we avoid using language or communication styles that are perceived as triggering with our residents.  Common to the experience of those we serve at our Crestwood campuses, is a loss of independence. Whether it’s a short stay at one of our PHFs or a long-term placement at one of our SNFs, within our programs the people we serve do not have the full breadth of their prior independence. It is thus fair to assume that a primary trigger is any circumstance or interaction that indicates that the resident is not in control. We run the risk of communicating this when our actions or words suggest that we are in control when we don’t create space for choice or voice and when we suggest that we know what is right for that individual.  This is the difference between telling a resident who has a limited income and whose goal is to obtain their own apartment, “That’s nice, but let’s find a goal that’s more realistic for you,” and instead saying, “That’s an admirable goal. Tell me a little bit about why this is important to you.” It is the difference between telling a resident with severe dementia who has had an episode of incontinence, “You’re wet,” and instead saying, “Here’s something nice for you to wear.” It is the difference between telling a resident who is in acute distress and agitated, “You need to calm down,” and instead approaching that person and saying, “My office is open, I’m here to listen.” It is the difference between saying “That’s breaking a rule of your program,” and instead saying, “You’re usually really on top of your goals. What’s different for you today?” It is the difference between saying, “No,” and instead saying, “This seems important to you, tell me more.” There is a power dynamic inherent to the roles we hold with those we serve. Communicating transparency about this power dynamic further conveys respect, validation, and compassion. The intention of each of the latter of the previous statements is the same. It is an intention to acknowledge the individual by conveying respect that their experience, opinions, and choices may be different than our own, but are equally valued.  It is conveying that each individual’s aspirations are valued and worthy of dignity and that they are deserving and have very real and important thoughts and feelings. It is through such conveyance that trust, and therapeutic relationships are built.  It is our privilege to accompany those we serve as they work towards recovery and wellness. It is our responsibility to clear the driver’s seat for them on that journey. The driver’s seat does not mean that the people we serve know how to drive yet or where and how they will reach their destination. But making the driver’s seat available, ensures that we are not creating additional barriers to getting in that seat. It means that we communicate our belief in the driver’s ability to get there and on the road that they choose.  Contributed by: Karen Scott, Program Director, Crestwood Treatment Center, Fremont

For the past year, the Crestwood Bakersfield Campus has been piloting an Empathy Enhancement training for our staff as a way to provide more compassionate care, improve customer service, and combat burn out. Last year, after conducting several new employee orientation trainings, we began to discover there was a topic missing in our curriculum and that was empathy. Empathy is defined by Psychology Today as the experience of understanding another person's thoughts, feelings, and condition from his or her point of view, rather than from one's own. Empathy facilitates prosocial or helping behaviors that come from within, rather than being forced, so that people behave in a more compassionate manner.  We began to research the idea of how to improve our ability to empathize and support our staff, and we discovered so much. According to Frontiers in Public Health Journal, “ Greater empathy in healthcare professionals improves client outcomes and satisfaction.” In the early 1990s, Theresa Wiseman, RN, began developing empathy training for hospital staff and discovered there are four qualities to empathy: perspective taking; staying out of judgment; recognizing emotions; and communicating empathy. Studies have shown people served are more likely to adhere to treatment plans when their providers are empathetic.  Also, when staff are more empathetic there is a reduction in recidivism   At Crestwood Bakersfield, our approach is to utilize self-reflection and skill building to improve and increase these individual empathy qualities amongst our staff. In the four-hour Empathy Enhancement training our staff receive in orientation, we practice specific skills and exercises that have been shown to improve these individual qualities.  We have measured our training success by adapting a widely-used empathy measurement tool, the Toronto Empathy Questionnaire (TEQ), to measure our staff empathy at Day 1, Day 30, and Day 90. To date, we have had more than 80 staff participate in the Empathy Enhancement training, in addition to another 60 hours of training that includes Wellness Recovery Action Plan (WRAP), Dialectical Behavior Therapy (DBT), Trauma-Informed Approaches, and Cultural Diversity. We have seen an increase in TEQ scores by 1-2 points 30 days after receiving the initial training (average score of 49.8 to an increase average score of 51) and another 2 points after 90 days! In addition to numerical statistics, we have also heard comments from staff regarding their own personal insights into their ability to empathize with positive self-reflection, changes in habits and better communication when interacting with our clients. Staff have said that they are building stronger relationships with those that we are serving simply by making better eye contact, respecting a differing perspective, and using reflective statements. Other staff have commented that it has also strengthened their personal relationships outside of the workplace. Rhonda Van Cleve, the Bakersfield Campus Administrator, and I have been very fortunate to be able attend and present at several CASRA conferences on what we have discovered since beginning our empathy pilot program.  It’s been an honor to teach empathy skills and share with other organizations how helpful this training has been for our staff and clients.  At Crestwood Bakersfield, we look forward to continuing our Empathy Enhancement training at our campus and are hopeful that these skills will continue to spread beyond our Crestwood campuses and into local communities throughout California. Contributed by: Sarah Wood, Director of Staff Development, Crestwood Bakersfield

This week has been a week to pause and search our hearts. We have had moments of elation with space travel. We have had reminders that although some businesses are now open, we are still in the early stages of a global pandemic, with increased numbers of COVID-19 cases and deaths. We have also had one of the most tragic and painful moments of our lifetime, witnessing police brutality that resulted in the death of George Floyd. As a result, we have seen our communities around the country rise up and march side-by-side seeking justice. We have seen community after community stand up for equality, integrity, commitment and compassion. There is nothing more aligned with our Crestwood values than the dignity of human life and the ability to treat people with respect and kindness. We condemn racism and bigotry as we battle stigma for people. We have the profound duty and opportunity as a community of diverse Crestwood family members to dismantle generations of inequity and racism. We are committed to supporting justice, as we look for a way forward to create a better world that will be based on compassion, love and equality and it will take the commitment and effort of every one of us to make it happen.

From the Santa Barbara Independant: The Department of Behavioral Wellness has contracted with Crestwood Behavioral Health Inc. for the operation of the county’s first ever Mental Health Rehabilitation Center (MHRC).  Located at the Champion’s Center in Lompoc, this program will open on Monday, November 30 and provide 34 beds for people experiencing the impact of mental illness.  With the support of this program, many individuals will be able to return from out of county care, to live within their community.  After further renovations occur, additional beds will be added. Read the full article here.

From KCLU in Santa Barbara By  LANCE OROZCO •  DEC 2, 2020 KCLU's Lance Orozco looks at the opening of a long sought new mental health facility in Santa Barbara County which is designed to transition people from inpatient care back into the community. Click here to read the full article.

To:   Our Residents, Guests, Persons-Served and Family Members As we are transitioning to the next phase of COVID-19,  our focus on ensuring our persons served, staff and family members are safe and healthy. The guidance from CDC, CDPH and our Pandemic Support committee has changed as the State and Federal State of Emergency has ended regarding the Global Pandemic. Family is one of our Crestwood values and we understand that connecting with family members is incredibly important. All visitors to Crestwood campuses are encouraged to mask while in the campus.  We ask if you have any symptoms to please refrain from visiting to support the health and wellness of all our persons served, staff and visitors. In the event you are not able to visit in person, we have a variety of other ways visitors might consider connecting with your loved ones. These include telephone, email, text, or through Skype or Facebook. We will do what we can to support these alternative ways to communicate. Should you have any questions, please feel free to contact the Campus Administrator. For additional information, please visit the CDC COVID-19 information page @ https://www.cdc.gov/coronavirus/2019-ncov/index.html . Thank you for your understanding and help during this time.

May 1-3, Crestwood, Crestwood Recovery Resilience Solutions (CRRS), and Dreamcatchers Empowerment Network were represented at NatCon23 , one of the largest mental health and substance use treatment conferences! The annual conference is held by National Council for Mental Wellbeing and took place in Los Angeles this year!

On May 24, members of the community gathered near the steps of the State Capitol in recognition of Mental Health Matters Day! Crestwood was proud to once again be a sponsor for this annual event presented by Mental Health America of California. The event is an opportunity for people to discover mental health resources and listen to several speakers on various topics of mental health, wellness, and fighting stigma. Thank you to staff from our Sacramento Home Office, as well as two Crestwood interns who helped staff our table to talk about Crestwood and hand out swag! It was also nice to see some persons served and staff from Crestwood Center Sacramento stop by our table!