Wednesday, August 28, 2013

Embracing Change: A Farewell to Behavioral Health Matters

By: Kim Smith, Marketing and Development Specialist

Change is a part of life. Everyone has their own personal story of change. For you, perhaps it’s starting a new job or maybe it’s something as mundane as having to order the turkey on rye because your favorite deli was out of egg salad. No matter what change you are navigating, change is certainly one thing that we’ve all experienced.

The biggest change in my life right now is the arrival of my first child, a baby boy, on August 2. There are many welcomed aspects of this change: the blessings of new life, my new exciting role as a mother and all the fun memories this little one and I will cherish. Some of these upcoming changes may not be so exciting: sleepless nights, dirty diapers and paying for college!

The wonderful thing about change is that what it brings isn’t always permanent because it brings with it the promise of even more change. One change coming that will affect us all is the hiatus of Behavioral Health Matters. With recent changes here at Colonial Behavioral Health and my taking of maternity leave, we’ve found ourselves without the resources to maintain Behavioral Health Matters.

I want to thank you all for your dedication to reading our weekly posts and the enormously positive feedback we have received. Thank you also to all who have written articles and contributed your knowledge and expertise to making Behavioral Health Matters a success. Our 20 months of blogging would not have been possible without your dedication to serving the people in our community.

Therefore, go and embrace the change occurring in your life. In the words of Winston Churchill, “to improve is to change.”

Sincerely, Kimberly Smith
Marketing and Development Specialist at CBH – and Monitor of Behavioral Health Matters

Wednesday, August 7, 2013

What is a 12-Step Program...and could one be right for you?

By Janis Omide, MS, CSAC


A set of guiding principles (accepted by members as 'spiritual principles,' based on the approved literature) outlining a course of action for recovery from addiction, compulsion, or other behavioral problems. [1] The 12-steps were originally adapted from a Christian Evangelical group called the Oxford Group—and first published in the book Alcoholics Anonymous (also known as The Big Book) in 1939.

Psychiatrist and author, M. Scott Peck, M.D. published the following regarding the founders of the 12-step program:

Thus I believe the greatest positive event of the twentieth century occurred in Akron, Ohio, on June 10, 1935, when Bill W. and Dr. Bob convened the first AA meeting. It was not only the beginning of the self-help movement and the beginning of the integration of science and spirituality at a grass-roots level, but also the beginning of the community movement. (1993 book, Further Along the Road Less Traveled, p. 150)

Robert Burney, M.A. is an author, counselor, and a pioneer in the field of inner child healing and codependency recovery. He stated in his book, Codependence: The Dance of Wounded Souls:
I believe that in a hundred years historians will look back and pinpoint this milestone as the single most important event in the twentieth century. This milestone was the founding of Alcoholics Anonymous in Akron, Ohio, in June of 1935.
Besides the invaluable gift of sobriety that AA has given to millions of Alcoholics, it also started a revolution in Spiritual consciousness. . . .

The spread of Alcoholics Anonymous, and the other Anonymous programs which sprang out of AA, is the widest and most effective dissemination of this radical revolutionary concept that has ever occurred in Western Civilization.

As noted, the Alcoholic Anonymous (AA) 12-steps became the foundation of all other 12-step programs.


These are the original Twelve Steps as published by Alcoholics Anonymous: [2]
  1. We admitted we were powerless over alcohol - that our lives had become unmanageable.
  2. Came to believe that a Power greater than ourselves could restore us to sanity.
  3. Made a decision to turn our will and our lives over to the care of God as we understood Him.
  4. Made a searching and fearless moral inventory of ourselves.
  5. Admitted to God, to ourselves, and to another human being the exact nature of our wrongs.
  6. Were entirely ready to have God remove all these defects of character.
  7. Humbly asked Him to remove our shortcomings.
  8. Made a list of all persons we had harmed, and became willing to make amends to them all.
  9. Made direct amends to such people wherever possible, except when to do so would injure them or others.
  10. Continued to take personal inventory, and when we were wrong, promptly admitted it.
  11. Sought through prayer and meditation to improve our conscious contact with God as we understood Him, praying only for knowledge of His will for us and the power to carry that out.
  12. Having had a spiritual awakening as the result of these steps, we tried to carry this message to alcoholics, and to practice these principles in all our affairs.

Where other twelve-step groups have adapted these steps to address their “powerlessness”, the main altered wordings are in Step 1 and Step12, see List of Twelve Step alternate wordings.


The American Psychological Association summarized twelve-step programs as the process that involves the following:
  • admitting that one cannot control one’s addiction or compulsion;
  • recognizing a Higher Power that can give strength;
  • examining past errors with the help of a sponsor (experienced member);
  • making amends for these errors;
  • learning to live a new life with a new code of behavior; and
  • helping others who suffer from the same addictions or compulsions.


Twelve-step programs are always accompanied with The Twelve Traditions (which were also developed by AA in 1946). The traditions were adopted in order to help resolve conflicts in the areas of publicity, religion and finances—for structural governance. Click here for the Traditions Checklist.

A key factor for the 12-step program’s effectiveness in part is due to the members being encouraged to practice the spiritual principle of anonymity and confidentiality. Other shared factors to the success of a 12-step group includes that the program is voluntary; there are no dues or fees; it is self-supporting through member’s contributions; it is not associated with any denomination, politics, organization or institution; it does not endorse nor oppose any causes; and the primary purpose is to overcome the powerless behavior and to help others to achieve the shared goal.

As a result of AA staying true to its purpose and principles, it is estimated that there are approximately 114,000 AA groups and over 2,000,000 members in approximately 170 countries. -– At-A-Glance, 2012 (AA General Service Conference-approved literature).

Also, as a result of AA’s 12-steps, there are over 50 “other” Twelve-Step Groups working on a course of action for whatever the participants need to recover from. See listing in website.


Most Frequently Used:

Al-Anon/Alateen – Strength and hope for friends and families of problem drinkers. Click on the blue words to enter the official website.

Alcoholics Anonymous – Official website for Alcoholic Anonymous (AA). The only requirement for membership is a desire to stop drinking. AA’s primary purpose is to stay sober and help other alcoholics to achieve sobriety. Go to the How To Find A.A. Meetings section of the site and follow the instructions.

Narcotics Anonymous – Official website for Narcotics Anonymous (NA). NA focuses on the disease of addiction rather than any particular drug. Go to the Find A Meeting section of the site and follow the instructions.

Many members of 12-step recovery programs see the “guiding principles” as more than just 12-steps towards stopping an unwanted behavior, but they become one’s guidance towards a new way of living.

The twelve-step meetings (affectionately know as “the rooms”) can be very cathartic and for some, “life changing”. Please feel safe in knowing that there are many reasons to admire and respect 12-step programs. Should you ever “desire” to attend, DON’T HESITATE!

1. VandenBos, Gary R. (2007). APA Dictionary of Psychology (1st ed.). Washington, DC: American Psychological Association. ISBN 1591473802. OCLC 65407150.

2. Alcoholics Anonymous (June 2001). "Chapter 5: How It Works" (PDF). Alcoholics Anonymous (4th ed.). Alcoholics Anonymous World Services. ISBN 1893007162. OCLC 32014950.

Janis Omide is a Certified Substance Abuse Counselor with a MS Degree in Rehabilitation Counseling for Addictions from the Medical College of Virginia/VCU. Currently, Janis is a Therapist for CBH assigned to provide SA counseling to VPRJ’s Therapeutic Community. She has over fifteen years of experience in the profession of providing treatment to people with addictions of varied ages, genders & cultures: Substance Abuse (SA) Counselor in out-patient and residential; Vocational Rehabilitation SA Counselor; SA Specialist for ex-offenders/probationers & DUIs; SA Therapist for Doctors/Nurses; and including counseling people with co-existing psychiatric and substance use disorders.

Wednesday, July 31, 2013

From Family Dinners to Family Stories—Another Path to Resilience

By: Jane Ferguson, LCSW

While raising my two children, I was acutely aware of studies showing the benefit of family dinners in reducing risky behaviors and promoting school achievement in children. Like many other busy parents of busy kids, I struggled to create this meaningful family time, scrambling for quick recipes and insisting that reluctant teens take at least 15 minutes to sit at the table. On many days we only managed to exchange a few words between mouthfuls before taking off for the next activity.

Eating meals together as a family is still linked to these benefits, according to current research. But if you are one of the busy parents who rarely manage to accomplish this, you can stop feeling guilty. Food is not the only way to forge family connections and promote well-being. A recent quiz in Parade Magazine (February 17, 2013) compared the effect of several activities on children’s well-being. When matched against eating a consistent breakfast, sports participation, and regular attendance at religious services, children who knew more about their personal and family history had higher self-esteem and a greater sense of control over their lives.

Marshall Duke and Robyn Fivush of Emory University, who conducted the original research in 2001, used a measure that asked children 20 questions about their families. Those who could answer more questions about their families tended to be the most resilient. Resilience is defined as the ability to recover quickly from adverse events, and is generally considered a positive indicator for mental health and happiness. The authors speculate that learning about family history is effective because it helps children feel connected to something larger than themselves. Fraternities, sororities, religious organizations and community groups know the importance of this; new members are steeped in their history and traditions to create a sense of roots and belonging. The need to be part of a tribe seems hard-wired in our species.

Learning about your family through shared stories not only strengthens a sense of connection, but can serve as inspiration. When you learn that your grandmother raised five children on her own and worked two jobs in order to send them all to college, chances are good you will feel pride in this heritage of strength and independence, and recognize the value of self-reliance and education in your own life. The abstract values we try to instill in our children—compassion, hard work, courage, commitment—become more real and seem more possible when attached to family members, even those we have never met. A biological relationship is not even required; traditions are more about culture than genetics. Family stories help us build a meaningful narrative that shapes our core values and provides a strong base for developing a sense of self. Maybe this is what our teachers had in mind all along when they assigned those autobiographical essays and family tree projects in school.

One more thing —not all narratives are equally effective. The most effective type of family story is called the ‘oscillating’ narrative, in which family members have been through ups and downs, all the while sticking together, loving one another, and enduring as a family. So take heart, your family story does not have to be perfect. In fact, it’s better if it’s not.

So take a minute and think about the story of your family. Are you a family that cares for others and always has room for one more at the dinner table? Are you a family that never gives up or always finds a way to make lemonade from life’s lemons? Get out the family scrapbook and show your son the picture of his great-grandmother who came to this country looking for adventure and a better life. On the way to soccer practice, tell your daughter about your oldest brother who saved up his allowance to buy food for stray animals. You don’t need long stories or intricate details. A few sentences about an interesting ancestor (or even yourself!) can light your children’s imagination and get them thinking about how some of these qualities might live inside of them. And you don’t even have to turn on the stove to reap the benefits….although a family dinner now and then couldn’t hurt.

Jane Ferguson received her Master’s Degree in Social Work from Rutgers University and is licensed in Virginia as a clinical social worker and school social worker. She has over 30 years of professional experience working with children and families in outpatient, inpatient, and military settings and is currently employed by Williamsburg-James City County Public Schools where she serves as Lead Social Worker. She also serves as school representative on the Family Assessment and Planning Teams for James City County and the City of Williamsburg. Helping children develop and thrive by building on their strengths and supports is a core value of her professional practice.

Wednesday, July 24, 2013

Families in the Driver’s Seat: Are We There Yet?

By: Stephany Melton Hardison, MSW

For any family or professional that has been involved in Systems of Care or even with their local Family Assessment and Planning Team (FAPT) or Community Policy and Management Team (CPMT), they have probably heard of or come across the concept, “family driven and youth guided care”, or other concepts like, “family support” and “family engagement”. These wonderful concepts relate to the idea that families should be supported, engaged and empowered to be at the table driving their own care while ensuring the systems are truly meeting and hearing the voices and needs of families and youth with mental health needs. I do not think anyone would argue with the importance of these concepts. Where we can get stuck sometimes, is with the “how”.

These are difficult concepts to master, even for the best of us, and there can often be barriers or challenges as we try to implement them in our communities. So how do we get there? Simply, families and youth will get you there. Many, many states and Systems of Care communities from across the country have shown how when families and youth are partners and leaders in their communities, family and youth outcomes improve and services and supports become stronger and more effective. Virginia and its communities can get there too!

The good news is that many of Virginia’s communities have already been building and developing these kinds of efforts, including right here in your community. Colonial Behavioral Health understands the importance and power of families and youth, and we applaud them for taking the first steps to moving towards a family driven and youth guided system.

We at NAMI Virginia and through our program, the Virginia Family Network, are also taking valuable steps towards developing a statewide family and youth voice. We held our first annual, statewide Family and Youth Leadership Summit in May. The summit brought parents and youth from across Virginia, which is amazing considering such an event was a first for Virginia. What is even more amazing is that the entire day exemplified how our families and youth are an untapped source of leadership, wisdom and expertise. You could feel the energy and momentum being built in that room. We are planning on building on that momentum by hosting a two-day advanced parent leadership training and a two-day advanced youth leadership training.

Since part of our mission is to empower families and youth to be engaged, active leaders in their communities, there are countless examples that highlight how much harnessing the leadership potential in families and youth can make a difference for other families, youth and communities. So many of our incredible parent and youth leaders are involved in our efforts because someone saw their potential and gave them support.

If there is a lesson to be learned here, it’s this: do not underestimate families and youth and the knowledge and experience that they bring to the table. Do not underestimate the power we have as parents, youth and community leaders to make a difference. Again, how do we get to family driven and youth guided care? We get there by engaging and empowering families and youth to be leaders in their communities. We all can take an important step by simply looking for and encouraging families and youth to get active and involved and providing the opportunities to do so, such as recruiting parents and youth to serve on local committees, sending a family or youth to a conference or training, or starting a parent and/or youth group. Not everyone will step up to the plate, but there is always at least one that will, and you are never going to find them unless you give them the chance.

Want more? Here are some ideas on how to promote family and youth leadership in our communities:
  • Recruit at least one parent and youth representatives to serve on local committees and workgroups.
  • Connect parents with other parents and youth with other youth, as peer to peer support is incredibly valuable as we move along our journeys. For example, identify a parent who can start a parent support group and provide them with the capacity and infrastructure to do so. 
  • Recruit and train a parent and/or youth to be a co-trainer at staff trainings. 
  • Share relevant resources and information with parents and youth. 
  • Refer parents and youth to the Virginia Family Network or other family organizations in your community. 
  • Refer or provide training opportunities for parents and youth. For example, scholarship for a parent or youth to attend a local training that supports their leadership development or scholarship a parent and a youth go to a national parent and youth conference, such NAMI or the Federation of Families for Children’s Mental Health. 
  • Host a social event for families and youth to get some respite and a chance to support and network with each other. 
  • Recruit and train a parent and youth to help with your quality improvement efforts. For example, recruit some families and youth to provide feedback on your satisfaction surveys so that they are more responsive to family and youth experiences and needs. By doing so, your results will probably be more robust and helpful.
To sign up for our monthly e-newsletter that includes local and national resources or for information on the Virginia Family Network and how you can get involved, visit or contact Stephany Melton Hardison at or 804-285-8264 ext 206.

We are here to help you in your efforts!

Stephany Melton Hardison is the Director of Children and Youth Policy and Programs and the Director of the Virginia Family Network at the National Alliance on Mental Illness of Virginia (NAMI Virginia). Stephany has worked in the mental health field since 2003, providing education, support, and training to youth, families, and professionals including working for the state chapters of the Federation of Families for Children’s Mental Health and the National Alliance on Mental Illness in Massachusetts. She brings her extensive expertise in family networks to the VFN, having led the statewide family network in Massachusetts. In Virginia, Stephany serves on Virginia’s System of Care Planning Team and works closely with the Office of Child Mental Health. Her experience as a child of a parent with mental illness has motivated her to dedicate her career to supporting and advocating for families affected by mental health conditions. Stephany holds a Master’s of Social Work degree with a concentration in Community Organizing, Policy , Planning, and Administration from Boston College.

Wednesday, July 17, 2013

Transformational Leadership in Behavioral Health

By: Lee Phillips, MSW, LCSW, CSAC

The transformational model of leadership has gained considerable traction among leadership theorists and researchers over the past few decades. The leadership model appears to be a fairly reliable and unitary construct referring to a set of leadership behaviors which are associated with a variety of positive organizational outcomes. Under the transformational model, the leader focuses on creating positive change in followers through behaviors which help them "transform" into more motivated, satisfied, and harmonious members of the organization. According to Fisher (2009), transformational leadership is generally characterized by the four types of leadership behaviors, often referred to the four "I"s
  • Idealized Influence
  • Intellectual Stimulation
  • Individual Consideration
  • Inspirational Motivation

Idealized Influence

The concept of idealized influence is similar to what can generally be thought of as charisma. Although the vast majority of literature on charismatic leadership focuses on the potential for negative social consequences, there is also an argument to be made that the charisma is a component of highly effective transformational leadership (Aaltio-Marjosola & Takla, 2000). In a sense, idealized influence refers to a "leader's ability to generate enthusiasm and draw people together around a vision through self-confidence and emotional appeal" (Fisher, 2009, p. 362). At a more tangible level, a leader can become a more idealized leader by modeling desirable role behaviors within the organization and culture. By positioning him or herself as a positive role model, a leader can thereby engender trust, respect, and even admiration of subordinates. In mental health terms, this has similarity to what clinicians refer to as "fostering transference" with their clients. By exhibiting the types of behaviors that one would expect from a leader in a given situation, one can generally assume that they will be automatically afforded greater deference within that situation.

Intellectual Stimulation

Transformational leaders help to provide intellectual stimulation for their subordinates. In practice this means that transformational leaders foster more democratic working environments than other types of leaders, because they are frequently engaging in their team members in creative and innovative problem solving (Fisher, 2009).

Individual Consideration

Individual consideration occurs when the leader gets to know their team members and show them individual respect and concern. If team members are being recruited as intellectual collaborators in organizational problem solving, their personal needs and preferences will naturally emerge. Leaders can further the sense that individual consideration is occurring by regularly assessing their followers' personal goals and working to create new opportunities which match their goals (Fisher, 2009).

Inspirational Motivation

The transformational leader moves team members toward action by building their confidence levels and generating a belief in a cause (Fisher, 2009). This concept is highly compatible with the previously discussed aspects of transformational leadership. Through individualized consideration and mentoring, individuals are led to work toward improving themselves and their status within the organization. By providing a positive model, individuals are given direction and momentum for guiding their own role behaviors.

Benefits of Transformational Leadership
  • Employee effectiveness is positively affected with extra perceived effort (Jung, Yammarino, & Lee, 2009).
  • Organizational citizenship behaviors and job satisfaction all are all being linked to transformational leadership. 
  • Increase in group cohesiveness among group members; each member is propelled by the group to accomplish more than could be done. Group cohesiveness among work teams results in more and better group interaction, stronger group influence, and greater individual involvement in the group (Wang & Huang, 2009). Particularly in service agencies where turnover rates are high because of provider burnout, higher levels of group cohesiveness may serve as a protective factor by increasing the level of support that workers receive from one another.

Psychological Well-Being & Transformational Leadership

Psychological well-being is the subjective experience of being in a positive state of mental health. Several studies have found that a leader's behavior can affect the mental health of his followers, but there has been little research examining the possible mechanisms for this interaction. Arnold, Turner, Barling, Kelloway, & McKee (2007) noted that there is an established connection between transformational leadership and the sense of one's work being meaningful. It is not uncommon to hear workers in mental health service organizations describe their work experience in terms of a progressive loss of meaning. High case loads, inadequate funding, and arduous paperwork all contribute to the type of crisis that leads to burnout. It is the sense that one is simply making no difference in the world by continuing on with his or her work. By directly enhancing the sense that there is meaning in the work that mental health care providers are doing, transformational leadership has a potential to strongly affect worker satisfaction and reduce burnout. And because this effect improves psychological well-being, it may also help clinicians to exercise a higher level of clinical judgment than they would otherwise be capable of. This improves the quality of services that are provided and so circularly enhances the sense that meaningful work is done.


Aaltio-Marjosola, I. & Takala, T. (2000). Charismatic ledership, manipulation and the complexity of organizational life. Journal of Workplace Learning, 12(4), 146-164.

Arnold, K. A., Turner, N., Barling, J., Kelloway, E.K., & McKee, M.C. (2007). Transformational leadership psychological well-being: The mediating role of meaningful work. Journal of Occupainal Health Psychology, 12(3), 193-203.

Fisher, E. (2009). Motivation and leadership in social work management: A review of theories and related studies. Administration in Social Work, 33, 347-367.

Jung, D., Yammarino, F.J. & Lee, J.K. (2009). Moderating role of subordinates' attitudes on transformational leadership and effectiveness: A multi-cultural and multi-level perspective. The Leadership Quarterly, 20, 586-603.

Wang, Y. & Huang, T. (2009). The relationship of transformational leadership with group cohesiveness and emotional intelligence. Social Behavior and Personality, 37(3), 379-392.

Lee Phillips holds a Master of Social Work degree from Norfolk State University and a Bachelor of Arts degree in Communication with a minor in Theatre Arts from Old Dominion University. Lee is a Licensed Clinical Social Worker and a Certified Substance Abuse Counselor in the state of Virginia. Lee is currently pursuing his Doctor of Education degree in Organizational Leadership with an emphasis in Behavioral Health at Grand Canyon University in Phoenix, AZ. He is currently pursuing a doctoral dissertation study titled, "What Matters in Social Work Management: A Qualitative Study of Leadership Styles". Lee has worked in several mental health and substance abuse treatment settings including outpatient and inpatient settings for the past six years.

Lee is employed full time as a licensed intake psychotherapist with Central Access at Colonial Behavioral Health in Williamsburg, VA. Lee is employed part time in the private practice sector where he provides psychotherapy services to adolescents, adults, couples, and families. His research and academic interests include: Adolescent Risk Behavior, Adolescent Mental Health Services, Gay and Lesbian Issues with Adolescents & Adults, Cognitive Behavioral Therapy in Clinical Social Work Practice, Group Treatment for Substance Abuse, Progressions in Organizational Leadership, Macro Level Social Work Practice, Servant Leadership and Transformational Leadership in Behavioral Health, and Treatment of Adolescents and Adults with Substance Use Disorders.

Wednesday, July 10, 2013

Mindfulness Meditation: Self-care for Busy People

By: Dr. Pamela Capetta, Ed.D., NCC
Notice your breathing as you begin to read this article. Take a few nice breaths and notice if you can feel the texture of your breath as it crosses over your lips or through your nostrils. Notice your thoughts. Are you judging whether this piece will catch your attention or if you will stop reading now? Are you thinking about what has to be done when you finish this article?

If you followed the suggestions above you have already begun to practice mindfulness. Mindfulness is practiced by paying attention to purpose in your life as it unfolds moment by moment. By using a lens of non-judgment and curiosity we can begin to view our lives with more acceptance and compassion. There is evidence that this practice helps decrease automatic responses to stress and increase neuroplasticity in the brain (new brain cells).

Mindfulness is often done in a formal meditation but can be done anywhere and anytime as a form of self-care. By becoming committed to this simple practice of paying attention and "naming and noting" the present moment experiences, we become aware of patterns of thought that disrupt our peacefulness. Return to your breath over and over to keep the ever wandering mind in the present moment.

Notice your body. Are you sitting down or standing up as you read? Do you have any aches or pains in your body? Notice the clothing you have on today. Do you like the colors and textures of the clothing?

Notice your emotions. Are you feeling: Peaceful? Anxious? Calm? Rushed? Sad? Joyful? Sleepy?

One of my favorite homework assignments for myself and my clients is to watch the wind blow for ten minutes daily. Often folks look at me like I am crazy when I make this suggestion. Try it. Watching the wind blow is a simple process. You have time.

Watch your breath and notice the way you feel when you breathe. Notice your surroundings. Look at the colors of objects around you. If you can't get outside, notice the air from a fan blowing. Notice how the breeze or stillness of the air touches your skin.

Becoming an active member of your self-care team will be time well spent!!

Dr. Pamela Cappetta Ed.D., NCC, is a graduate of the College of William & Mary with master’s and doctoral degrees in education, as well as a specialty in Professional Counseling. She is a Licensed Professional Counselor and a Licensed Marriage & Family Therapist, a National Board Certified Counselor, and Certified Holotropic Breathwork Practitioner. Cappetta also holds a certificate in Chemical Dependency from Old Dominion University.

For more than 30 years, Pamela Cappetta has practiced psychotherapy, devoting her career to helping others cope with and heal from trauma, chronic pain and illness, depression, anxiety and addictions. Her commitment to treating each person in the context of his or her environment has included compassionate and creative work with families, groups, individuals, couples and professionals.

Wednesday, July 3, 2013

Independence Day 2013

There will be no regular blog post today. Instead, in honor of July 4th, we ask that you join us in remembering the faithful service of all the men and women of our Armed Forces. Happy Independence Day. See you next week.

- Behavioral Health Matters