V. Therapy Techniques and Theories Utilized by Journey’s Quest:

Outside of those few specific intervention noted above, Journey’s Quest also employees the following therapeutic interventions.

DBT Theory

DBT maintains that some resident-student, due to invalidating environments during upbringing, whether those environments are school, home, or church, and due to biological factors as yet unknown, react abnormally to emotional stimulation. Their level of arousal goes up and they escalate much more quickly than others, peak at a higher level of intensity, and take more time to return to a normal baseline of interaction than do others. This explains why some individuals diagnosed with a borderline personality are known for crisis-strewn lives and extreme emotional liability (emotions that shift rapidly). Because of their past invalidation, whether real or perceived, have very few methods for coping with these sudden, intense surges of emotion. DBT is a method for teaching skills that will help in residents learn to deescalate and return to a more appropriate level of interaction with family and peers.

How it works

Dialectical Behavioral Therapy (DBT) consists of two parts:

1. Once-weekly psychotherapy sessions in which a particular problematic behavior or event from the past week is explored in detail, beginning with the chain of events leading up to it, going through alternative solutions that might have been used, and examining what kept the client from using more adaptive solutions to the problem:

Both between and during sessions, the therapist actively teaches and reinforces adaptive behaviors, especially as they occur within the therapeutic relationship . . . the emphasis is on teaching patients how to manage emotional trauma rather than reducing or taking them out of crises. . . . Telephone contact with the individual therapist between sessions is part of DBT procedures (Linehan, 1991).

DBT targets behaviors in a descending hierarchy:

• • decreasing high-risk suicidal behaviors
  • decreasing responses or behaviors (by either therapist or patient) that interfere with therapy
  • decreasing behaviors that interfere with/reduce quality of life
  • decreasing and dealing with post-traumatic stress responses
  • enhancing respect for self
  • acquisition of the behavioral skills taught in group
  • additional goals set by patient

1. Weekly 2.5-hour group therapy sessions in which interpersonal effectiveness, distress tolerance/reality acceptance skills, emotion regulation, and mindfulness skills are taught (these will be titled DBT elementals) and are part of the intervention curriculum and approach at the center.

Follow-up studies

Since the 1991 paper and the introduction of DBT as a Therapeutic approach, Linehan has been involved in several replication studies and has written a book and a skills training manual about DBT. Her results consistently show that DBT does seem to reduce the amount of self-injury and crisis among clients.

Family System Model

A.  It is the nature of the mind to be subdivided into an indeterminate number of sub-personalities or “parts.”

B.  Everyone has a Self and the Self can and should lead the individual’s internal system.

C.  The non-extreme intention of each part is something positive for the individual. There are no “bad” parts and the goal of therapy is not to eliminate parts but instead to help them find their non-extreme role.

D.  As we develop, our parts develop and form a complex system of interactions among themselves - systems theory can be applied to the internal system. When the system is reorganized, parts can change rapidly.

E.  Changes in the internal system will affect changes in the external system and vice versa. The implication of this assumption is that both the internal and external levels of system should be assessed.

Goals of Family Systems Model

A. To achieve balance and harmony within the internal system

B. To differentiate and elevate the Self so it can be an effective leader in the system

C. When the Self is in the lead, the parts will provide input to the Self, but will respect the leadership and ultimate decision making of the Self

D. All parts will exist and lend talents that reflect their non-extreme intention.

The Strength of Family System Models

A. Focuses on strengths: the undamaged core of the Self, the ability of parts to shift into positive roles

B. IFS language provides a way to look at self and others differently

C. Language encourages self-disclosure and taking responsibility for behavior

D. IFS language is powerful

E. Provides a way to work with “resistance” and denial

F. Ecological understanding of entire therapy system, including therapist

G. Respect for individual’s experience of the problem

H. Clients provide the material - the therapist doesn’t have to have all the ideas

I. Therapist looks at client’s Self as “co-therapist” and trusts the wisdom of the internal.

Experiential Therapy

A term for a group of therapies that employ controlled or released emotion or “spiritual” experiences and power of conscious cognition and responsibility as the primary vehicles for inner growth and self-actualization.

Included:

A. Emotional-release therapies that are usually short-term and intense (encounter group therapy, holding on and release exercises).

B.  Emotional control therapies that focus on gaining greater control over the body through training (yoga, meditation)

C. Religious and inspirational therapies and groups

D. Cognitive-emotional therapies such as Ellis’s rational-emotive psychotherapy (RET)  and Dr. Glasser’s reality therapy

E. Rope courses, hiking, camping, snow shoeing.

F. Art therapies: painting, drawing, clay and sand tray work.

Intervention strategies will also include; anger management, poly-substance addictions, individual, group and family counseling. Focus shall be on building self-esteem, dealing with psychological disorders such as body distortions and eating disorders, self-abuse, suicidal ideation, entitlement, Oppositional Defiance Disorders, generalized anxiety, depression and a married of other such challenges. Residents will be placed in specialty groups as is identified and needed to help the resident-student address all aspects of treatment.

Relapse Prevention

The Recovery components of Journey’s Quest Adolescent will include peer support, substance use educational groups, mentoring and integration of recovery into the educational curriculum whenever feasible.  We will suggest a standard out-patient therapy program after termination from the residential center.

Relapse can often be part of an individual’s return to home environment process.  Therefore, parents will participate in therapy with the resident and during home visits. It will be part of the therapeutic model for parents to go to therapy and work with the residential therapist via phone conferences. The center will make every effort to accurately gauge the student and family’s commitment to the therapeutic process.  Drug and alcohol urine screens will be used when resident-students return from home visits and when deemed necessary.  While the school recognizes that relapse may occur during the recovery process, drug dealing, or drugs and alcohol consumption on the campus, cannot be tolerated and will result in charges filed and additional treatment interventions. All residents upon admission and after home visits will be subject to search upon returning to campus.

Recap of Therapeutic Intervention Program at Journey’s Quest

a) A twenty-four hour, seven days a week residential living in a therapeutic environment.

b) 12-24 month residential stay

c)  Academic School leading toward student graduation and credit transfer

d)  A strong clinical treatment program that includes the following therapeutic interventions:

• Dialectical Behavior Therapy

Behavioral Therapy and Cognitive Behavioral Therapy Interventions

Adlerian Approach

Existential Therapy

Person-Centered Approach

Reality Modalities

Components of the Family System Model

Why Try? Behavioral Intervention Techniques

e) Anger Management

f) Poly-substance Abuse Therapy Intervention

g) Spiritual Intervention Therapy

h) An array of emotional and psychological Axis I and II disorders such as:

Oppositional Defiance Disorder

Eating Disorders

ADD/ADHD Behavioral Management

Asperger’s, Tourettes Syndrome

Depression

Anxiety

Self-esteem and Self-abuse issues

Bipolar Disorder

Borderline Personality Disorders

Academic Failure

Others

• 1. Specialized Small and Large Group Interventions such as:

• Morning Team Meeting-called Sunrise Group (Conducted by Milieu Manger)

• Sunset Group

• Adoption Issues Group

• Spiritual Issues Group

• Substance Abuse Groups

• Male and Female Issues Group

• Clinical Issues Group

• Milieu Family Systems Group

• Others As Needed

1. Equestrian and Animal Therapy Intervention
2. Recreational Team Building Intervention with the and parents
3. Family Therapy via phone conferences and on campus Multi-Family Intervention Weekends.
4. 5–Level therapeutic progress phase system