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What is Harm Reduction?

What is Harm Reduction?

Harm reduction is a focus on reducing harms associated with substance use.

It is a targeted approach that uses practical, client-centred and non-judgmental approaches to reduce risks and harms when someone is using psychoactive drugs.

Here are the core ethics around harm reduction:

1) Compassion and non-judgement

Harm reduction practitioners will meet clients “where they’re at.” Old, simplistic views marginalized and stereotyped folks who use psychoactive drugs. A harm reduction approach does not attempt to change and judge behaviour. Instead, practitioners will focus on the client not as a “user” or “addict,” but as a whole person worthy of being heard.

2) Transparency and accountability

Conversations are focused on open dialogue that is continually shifting. This means that clients should hold practitioners responsible and accountable for their behaviours rooted in problematic ideologies that reinforce the marginalization of folks who use psychoactive drugs. Practitioners should continue to reflect and acknowledge how their actions can reinforce systems of oppression and actively work to dismantle these behaviours.

3) Client-centered

This places the client as the driver and decision-maker in their life. This means that the practitioners involved in a client’s care should promote the client’s capacity to make decisions in their own best interest and this should be the active focus of the care.

4) Incremental

Practitioners should highlight and note the incremental change in client’s lives. By acknowledging that folks are much more likely to make a series of small changes over time rather than big changes all at once. These small changes should be respected as integral moments to a successful and meaningful life.

Harm reduction calls practitioners to look at themselves and the institutions they’re a part of and to work to dismantle any behaviours, policies, and language that reinforces systems of oppression. It refocuses conversation to embrace the client and engage in relationship building and client agency.

What to do about Burnout?

What to do about Burnout?

Ever wondered if there’s anything you can actually do about burnout?

It can feel hopeless but there are a number of ways to address it. Here we’re going to explore one possible approach to overcoming burnout.

Wait, what’s burnout again?

That can be tricky to answer. There are multiple avenues to explore when attempting to define this thing we call burnout. One of the challenges of defining the concept is that it typically involves aspects of a variety of mental health challenges, such as depression, anxiety, post-traumatic stress disorder and panic disorders. Here, I’ll use the term to highlight someone who is experiencing:

  • A lack of satisfaction in their work

  • Extreme fatigue

  • Negative attitudes and separation from the vocation

And why do we need to talk about it?

Burnout is important to discuss for a variety of reasons. First and foremost, it affects those working in helping professions as frontline workers to an exponential degree. This includes and is not limited to:

  • First responders (Emergency response workers and firefighters)

  • Social workers

  • Nurses

  • Teachers

  • Doctors

This is problematic because the folks most at risk often went into their careers because they are empathetic, caring, and compassionate individuals. Therefore, it is important to note some of the signs and risk factors for burnout so we can be vigilant in navigating if we are at risk for burnout. Some risk factors include:

  • High stress at the workplace

  • Increasing cuts to funding

  • Dangerous work environments

  • Understaffing

  • Isolation in the workspace

  • Limited access to support

  • Sexism, racism, homophobia, and transphobia existing within workspaces

What would therapy look like?

Even if it’s challenging or downright dysfunctional, we can’t always change our immediate environments to suit our needs. There are, however, practices that can be applied in everyday life that fundamentally impact how we manage stress within challenging environments. One approach is applying cognitive behavioural skills and practices. It might look like this:

1. Explore phase

The beginning of therapy would be around assessing and identifying triggers such as:

  • Organization-related challenges (budget cuts, system gaps)

  • Client-related challenges (vicarious trauma, challenging population)

  • Personal challenges (emotional demands)

  • Setting-related challenges (high caseload, dangerous work environments)

By identifying some of these stressors we will be able to target what is challenging us most at work, at home and in our relationships and adapt and respond appropriately. Although, we will not be able to change all the factors contributing to burnout, by identifying some risk factors it will help us focus in and eventually identify areas we can intervene.

2. Identify phase

The next stage involves cognitive restructuring, which is a fancy word for identifying our moods, thoughts, physical sensations and behaviours. This would look like identifying:

  • What situation triggered emotions

  • What are thoughts and beliefs tied to situations

  • What feelings and emotions are prevalent

  • What behaviours are present (lack of concentration, in ability to sleep) and noting how these situations trigger “dysfunctional thinking”

By first identifying these triggers we can then look inwards and highlight that there is some dysfunctional thinking that causes us greater challenges. Therefore, therapy would look to:

  • Assess the advantages and disadvantages of our thought patterns

  • The impacts our thoughts have on our emotions

  • Labeling cognitive distortions that we hold (overgeneralizing, mental filters, etc.)

  • Identifying implicit rules and assumptions we carry

  • Generating alternative viewpoints

3. Armour phase

The last stage would be to assist in enhancing protective factors. This can include, but is not limited to:

  • Exploring areas of “purposeful” self-care

  • Exploring self-regulation skills like deep breathing, meditation, grounding exercises

This isn’t the only way therapy for burnout can be modelled, but it’s one way that it can be used to assist those most affected by burnout. The goal is to build a strong self so that we are better able to take care of ourselves and those that we assist in our careers, families, and relationships.

Maslach, C., & Leiter, M. P. (2016). Understanding the burnout experience: recent research and its implications for psychiatry. World Psychiatry, 15(2), 103–111. doi: 10.1002/wps.20311

Sean works from a strengths-based perspective — centering your unique strengths and supporting you as you build on them— and uses modalities such as cognitive behavioural therapy, mindfulness-based approaches, narrative therapy, and rational emotive behavioural therapy.

5 Great Mental Health Books to be Stuck Inside With

5 Great Mental Health Books to be Stuck Inside With

COVID-19 has us all stuck inside and exploring different aspects of our mental health. I thought it would be a good time to suggest books that have helped me develop and ground my knowledge on the diverse topics that impact our emotional and mental health. 

Here is a short list of books that have had a major impact on me and taught me to think critically and compassionately:

The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma by Bessel Van der Kolk, M.D.

  • Bessel Van der Kolk takes the reader on an exploration of his career and the tools he developed to assist his clients in healing. His transformative trauma research began when he was working with soldiers coming back from Vietnam and noted that typical talk therapy wasn’t having the expected results. He was disillusioned but he challenged himself to go deeper and seek alternative therapies to respond to the challenges he was finding in his practice. This book is essential reading if you’re interested in how human bodies have evolved to respond to stress and trauma. It explores how we hold trauma in our bodies and offers helpful solutions for healing journeys.

It Didn’t Start with You: How inherited Family Trauma Shapes Who We Are and How to End the Cycle by Mark Wolynn

  • Wolynn’s book is an introduction to how family trauma continues across generations. Mark highlights that for many years the medical world has not recognized how serious trauma’s impact is on health, bodies and relationships. Mark grounds his work in modern research and demonstrates that trauma can impact bodies in ways that are beyond our capacity for recognition. The message is that, until we learn to take this insight seriously, we will continue the cycle.

Saving Normal: An Insider’s Revolt Against Out-of-control Psychiatric Diagnosis, DSM-5, Big Pharma, and the Medicalization of Ordinary Life by Allen Frances, M.D.

  • Frances (the chair of the DSM-5 task force) asks why mental health diagnosis is increasing at such a large rate and considers how Big Pharma is exploiting this market to pathologize normal, everyday challenges. Frances explores the history of the DSM (Diagnostic and Statistical Manual of Mental Disorders) to give the reader an inside perspective of how it has been developed, who is in charge of making changes, and the pressing challenges of diagnosis in the modern age. Frances approaches the DSM 5 with a critical eye and challenges the reader to do the same.

Troubling Masculinity: Reimagining Urban Men edited by Ken Moffatt

  • Troubling Masculinity explores a variety of ways masculinity might be reimagined in the modern age. The critical thinkers and theorists featured in this work consider issues of race, gender, sexuality, and social class to challenge and “trouble” how we think about masculinity. I believe this book could be an entry point into a discussion about the challenges men face in society and a meaningful exploration of the root causes of toxic masculinity. In this trying time, very few books are offering concrete solutions to the problem of toxicity. This book seeks to evolve masculinity into something to be embraced and nurtured instead of shamed.

A Dialogue on Love by Eve Kosofsky Sedgwick

  • When I began reading this book I was having challenges related to grief, identity, and relationships. In this piece, Eve discusses her terminal cancer diagnosis and how she grieves for her body, her family, and her relationships. She incorporates her therapist’s notes, her diary, and keen critical analysis to delve into how identity is formulated beyond the body. This book holds so many crucial ideas that challenge secular spaces to invite in a new spirituality. Sedgwick’s spirituality is grounded in the earth and challenges us to sit with the very real way we intimately hold and impact those around us.

These books have had a major impact on my development as a therapist and I hope they’ll have a positive effect on you, as well.

5 Ways to Manage Financial Anxiety

5 Ways to Manage Financial Anxiety

The past week saw a huge stir in the markets with oil prices dropping, the threat of COVID-19, and folks rushing into the supermarkets.

It’s perfectly normal that we start feeling the turbulence at home. Here are five tips to help us refine and manage that “stock anxiety” so we’re better able to manage emotions in stressful times.

1. Recognize and analyze the cognitive biases that impact judgement

One common bias at times like these is loss aversion. We often feel the impacts of loss to a greater extent than the gains we have experienced. Acknowledging this helps us to gain perspective: while highlighting a drastic drop we may be discounting the prior gains we have made.

Another is catastrophizing. It’s when we give greater weight to the potential outcome that would be most damaging. This is a troublesome bias to hold when working with something as unpredictable as the stock market because it moves along arbitrarily and is often hard to predict. This bias accelerates and enforces damaging thought patterns that may have negative impacts and increase our feelings of anxiety.

2. Seek mentorship and peer support

This provides us with a platform to meet with like-minded individuals that have dealt with similar situations. We can gain realistic tips on how to manage our anxiety when dealing with the stock market. In addition, it reminds and reassures us that the ebbs and flows of the market are to be expected.

3. Put things into perspective— adopt a bigger picture

We can use graphs to highlight the peaks and valleys that our stocks show. Adopting a bigger picture perspective allows us to see that these peaks and valleys are all over the stock market and this is not the first dip in the market and it won’t be the last. Adopting a perspective that considers the impact these dips will have in the future can be beneficial for our next moves and it can reduce some initial anxiety.

4. Research

Find an area you’re unsure of and learn. These moments of anxiety are often exacerbated by lack of understanding about markets. We can ground our anxiety and manage our expectations with validated expertise about trends from objective viewpoints that are outside of our own. We can also use this research to challenge some of the negative thought patterns that may reinforce anxiety.

5. Relax

When we experience dips in the market this triggers a fight or flight response in our body that is having a real impact on our anxiety. It is important to remind ourselves that we are safe from harm and practice exercises like meditation and mindfulness to ground ourselves in the knowledge that we are safe.

It’s completely normal to have anxiety when we face financial and fiscal challenges in the stock market. These challenges bring on new feelings of unknowing that impact our bodies in very real ways. It is integral to sit with ourselves, pay attention, and notice how stress is manifesting in our bodies.

The effort we put in now can be the foundation on which we build a strategic response to anxiety with a goal of preventing overwhelm. We’ll feel the benefits now and in the future.