Raising a Child with ADHD: Symptoms, Treatment, and Hope for the Future

If you are a parent or caregiver, then you don’t need us to tell you that raising a child is hard work. This already daunting task can become even more challenging if your child suffers from a disorder like attention deficit hyperactivity disorder, or ADHD.

Speaking broadly, ADHD is a disorder characterized by inattentiveness, hyperactivity, and impulsivity. Individuals who have ADHD might struggle to concentrate on tasks for extended periods of time or inhibit their own thoughts and actions. They might have trouble adhering to strict rules and schedules, and they could have a tendency to say or do things at socially inappropriate times.

Because ADHD usually develops during childhood, parents and caregivers often find themselves in charge of managing their child’s disorder. They might have special difficulty helping their child navigate the highly structured environment of the school classroom. On their worst days, they might find themselves frustrated, exhausted, and struggling to know how best to help their child with this challenging disorder.

Raising a child with ADHD isn’t easy, but fortunately, help is out there. Thanks to modern psychiatry, ADHD is very treatable, and many individuals with ADHD go on to live full, normal lives. They just might need a little help learning to manage and cope with their disorder.

To learn more about ADHD, we spoke with Dr. Tammie Dones, who is one of our three staff psychologists at Cummins. In today’s blog post, Dr. Dones explains the basics of ADHD and how individuals can overcome its challenges to lead happy lives.

Dr. Tammie Dones
Tammie Dones, PhD, HSPP, Psychologist at Cummins Behavioral Health

What Is ADHD and Who Does It Affect?

ADHD is what’s known as a neurodevelopmental disorder. In less scientific terms, this means that ADHD is the result of abnormal development of the nervous system.

“When ADHD is studied in a lab setting, there are brain differences in the frontal lobe, which relates to what we call ‘executive function,’ “ Dr. Dones explains. “Executive function is kind of like our mental secretary or our mental organizer. Executive functions in the frontal lobe also help us inhibit responses. For example, if I thought right now, ‘I’m thirsty, I’d like to get a soda,’ my brain can tell me, ‘Don’t do that, you’re in the middle of an interview.’  But some people with ADHD don’t inhibit that well.”

ADHD can be broken into three distinct types with slightly different symptoms:

  1. Hyperactive Type: individuals have difficulty paying attention and controlling their behavior, and they tend to be highly active
  2. Inattentive Type: individuals have difficulty paying attention and frequently experience procrastination, hesitation, and forgetfulness
  3. Combined Type: individuals experience hyperactivity/impulsivity as well as inattentiveness

Dr. Dones provides some examples of what these symptoms might look like in action:

“The combined and hyperactive types are characterized by over-activity. This could be restlessness or fidgeting. One of the criteria is being ‘on the go’, or feeling as if driven by a motor. With the inattentive type, there’s difficulty sustaining attention and focus, difficulty harnessing attention and focus, and difficulty often with emotional regulation. And then the other cluster is impulsivity, which of course affects your attention span as well, because if you’re trying to do, say, a math worksheet, but another thought crosses your mind, your mind drifts away from the math worksheet.

Impulsivity has other social and life management aspects, too. There tends to be about a 25% to 30% delay in general maturity in somebody accurately diagnosed with combined type ADHD. This means reaching life milestones later. For example, an 18- or 19-year-old with ADHD is going to have a harder time managing their debit card, driving without impulsivity, and things like that.”

Approximately 5% of children are diagnosed with ADHD, making it a fairly common mental disorder. Males are about twice as likely to be diagnosed with ADHD as females. The typical age of onset is 4 years old, although the inattentive type is often harder to detect and might not be diagnosed until closer to age 9 or 10.

How Can ADHD be Treated or Managed?

If your child has been diagnosed with ADHD by a psychiatric professional, there are several different treatments they can receive to help manage their symptoms.

To begin, prescription medications tend to be highly effective at reducing symptoms of ADHD. The specific medications used to treat ADHD, known as stimulants, help to regulate impulsive behavior and improve attention span by increasing the levels of certain naturally-occurring chemicals in the brain. According to the Cleveland Clinic, these medications improve ADHD symptoms in 70% of adults and 70–80% of children.

Dr. Dones adds, “At Cummins, we have a strong psychiatry staff. They’re very experienced, and they stay on top of the research in terms of side effects and things like that. So medication treatment is fairly common.”

Whether or not medication is used in treatment, it’s also important for individuals to learn strategies for managing their ADHD symptoms. For example, Dr. Dones emphasizes the importance of using visual cues and “thinking out loud.” She says, “You want to do things that draw that mental organizer or mental secretary out into the open. This could involve visual prompts and cues or the adult thinking out loud to help the child.”

Dr. Dones gives an example of what this might look like from her own life experience: “When I was teaching my daughter to look both ways before she crossed the street, I’d say, ‘Now, we’re going to look both ways before we cross the street.’ I wonder how many times I said that? Probably 9,000 or 10,000 times. Because we want that deeply trained in their brain, right? So for someone with ADHD, that type of thinking aloud, with their parents verbally mediating things using prompts and cues, is really important.”

At Cummins, most people who enter treatment for ADHD can also benefit from our life skills services. These services are specially designed to help individuals learn and implement skills for managing their disorder in the real world—not just in therapy settings. “ADHD is kind of a point-in-time disorder,” Dr. Dones explains. “Oftentimes, the problem isn’t a lack of knowledge; it’s that we don’t perform the right behavior at the right point in time. It’s like, ‘Oh, I knew that, but I didn’t do it right now.’ The skills training matches well to what people need when their symptoms happen in the real moment. So that’s one thing that I’m proud that Cummins has.”

Many individuals who have ADHD continue using the self-mediating skills they learn in treatment throughout the rest of their lives. Adults diagnosed with ADHD continue to use a lot of prompts, cues, and calendar reminders,” Dr. Dones says. “Post-it notes are a typical thing I’ve heard about from clients. They would say, ‘I knew I didn’t want to forget this appointment; look, here’s my post-it!’ People with ADHD, whether it’s inattentive or hyperactive, also tend to have a rough time with sense of time. So time either feels like it takes forever, or it passes without them noticing. So they might use timers like how some people do with social media now. They have those timers on their phones that say, ‘After 45 minutes, I have to get off this social media device.’ Those are the kinds of things that a person with ADHD might have to do just for normal tasks.”

The Role of Family Support in Recovery

As we mentioned in the previous section, parents, caregivers, and other family members play an important role for children diagnosed with ADHD. The younger the child, the more likely it is that they’ll need help learning how to manage the symptoms of their disorder. Family members can be instrumental in modeling and guiding new coping behaviors.

However, the experience can be challenging for everyone involved. “I think it’s important to meet the situation with as much grace, compassion and nurturance as you can, because ADHD is a chronic problem,” Dr. Dones says. “It can wear parents down. It can frustrate parents. Some of the things that are inherent to the disorder make it hard for children or teenagers to profit from experience. So you’re like, ‘I told you that yesterday.’ But it’s kind of lost on them. So you need to be patient, consider each day its own day, and reteach the best you can.”

Children who have ADHD may face frequent punishments and sanctions for their behavior outside of the home environment. It’s important that caregivers deliver praise for good qualities and productive behaviors whenever possible. “These kids are going to hear, ‘You messed up. Did you forget? What are you doing? Stop it!’ They’re going to get yelled at. So somebody has to counteract that self-esteem damage,” Dr. Dones says.

Having a young child with ADHD can be emotionally challenging for parents and caregivers. On top of the difficulties in managing their behavior, parents might also worry about their child’s future. They might wonder if their symptoms will ever improve or if they will ever be able to fit harmoniously into society. The good news is that many people live full and successful lives despite an ADHD diagnosis. For example, actress Emma Watson, gymnast Simone Biles, and musician Justin Timberlake are just a few people who have had great success in their lives despite living with ADHD.

Dr. Dones says, “When we say ADHD is chronic or lifelong, that can be discouraging. But people do improve. There are developmental lags, but a developmental lag eventually catches up. It’s an additional challenge for that person to meet each day, and a responsibility to manage things that come naturally to the next person, but many people do manage successfully.”

Although ADHD, like any mental health problem, can be a challenge for the individual diagnosed and those who are close to them, it is a disorder that many people can nevertheless rise above. With proper treatment and support from caring individuals, many children can grow up to be healthy, happy adults despite their ADHD.

If you’re concerned about your child’s behavior and wonder if they might have ADHD, we encourage you to speak with their primary care provider to voice your concerns. Your child’s doctor can look into the situation and determine next steps with you as appropriate.

Alternatively, you can call Cummins Behavioral Health at (888) 714-1927 to discuss the possibility of receiving a mental health assessment for your child. Our staff will treat you and your child with the respect you deserve and help you see the hope of recovery from ADHD.

Introducing Cummins’ Transportation Services for Justice-Involved Individuals

If you stop a moment to think about it, you’ll probably agree that life can be difficult.

Most of us want to live our lives the best we know how. The problem is that our best efforts don’t always turn out how we’d hope. As a result, we all make mistakes in life. We might disappoint someone we care about, fail to meet one of our obligations, or take an unwise action with possible legal consequences. Some mistakes are small and easily fixed; others can get us into serious trouble.

Everyone deserves a second chance, but not all second chances are created equal. When a mistake ends with involvement in the criminal justice system, for example, there are debts that must be paid and obligations that must be met before the mistake can be forgiven. A person who violates the law, even unintentionally, is responsible for dealing with the consequences. However, this doesn’t mean they don’t deserve a little help.

With this in mind, Cummins Behavioral Health will soon begin offering free transportation services for our clients who are involved in, or have been involved in, the criminal justice system. These individuals may have a variety of appointments they must attend as they work to rebuild their lives, and lack of reliable transportation can be a significant obstacle. By providing free transportation to important medical and legal appointments, we hope to remove some of the barriers these individuals face on their journeys toward recovery.

In this blog post, we’ll explain how these transportation services will work and why we believe they’ll make a difference for our clients and our community. We’ll also include explanations and insights from Tracy Waible and Jessica Hynson, who have been instrumental in bringing these services to Cummins.

Tracy Waible, LCSW, LCAC, Cummins' Director of Recovery (left) and Jessica Hynson, LMHC, CSAYC, Cummins' Director of County Operations for Marion County (right)

How the Services Originated

Our transportation services for justice-involved individuals are a collaboration between Cummins Behavioral Health and Indiana’s Family and Social Services Administration. More specifically, they are funded by a year-long grant from the Division of Mental Health and Addiction (DMHA).

The process started when the DMHA indicated its desire to fund programs of this type. Tracy explains, “We receive emails periodically for various grant opportunities, and when this one came through, we knew that we had to apply. We have an obligation to look at whether our consumers have the ability and resources to do what we are asking. If not, we need to help them problem solve those barriers—one of them being transportation.”

As part of the grant application process, Tracy and Jessica coordinated outreach to community partners who would also benefit from having these services in place. “The Director of County Operations in each county reached out to partners, like local court systems and the Department of Child Services, and asked for letters of support,” Jessica says. “I know Putnam County even got one from the 911 dispatch center because they have a good partnership.”

“We received letters from almost every county, and multiple letters from some of our counties. So I think those stakeholders were all really excited about this opportunity, and definitely willing to send us referrals and to help this to be successful,” Tracy adds.

Ultimately, Cummins was awarded a grant to pay for five vehicles—one for each of our counties of operation—and reimbursement for time spent transporting consumers. Since public transportation options are sparse in Indiana, and services like Lyft and Uber are not consistently available in rural areas or have extremely long wait times, we anticipate our transportation services to be a significant benefit for our consumers.

How the Services Will Work for Consumers

Once our transportation services are up and running, any Cummins consumer who is involved in the justice system will be eligible to use them. “They’re for anybody justice-involved,” Tracy says. “That could be DCS, probation, drug court, veterans court—any kind of legal involvement.”

Individuals will be able to submit an online form to request a ride to an appointment. This could be an appointment for Cummins services, a physical health appointment, a court-related meeting, or other legal appointments, to name a few possibilities. Once a request is submitted, the appropriate staff in that county will review their availability and make arrangements to provide transportation if at all possible.

Due to the specific details of the grant, the services will only be available to existing Cummins consumers or those who are beginning services with Cummins. Tracy explains by way of an example: “There’s a large correlation between justice-involved and substance use disorder. We worry about that gap between leaving incarceration and entering treatment, because maybe a person has 30 days of sobriety now, and they’re at risk of overdose if they leave and start using again. If we could transport them straight from jail to an intake or to some kind of support, we’re hoping to reduce drug overdose and recidivism.”

Piggybacking off of Tracy’s example, Jessica gets to the core of why we’re so excited to provide these transportation services. “This justice-involved population is one of the populations that struggle to get back on their feet, because there are just so many barriers constantly in their way,” she says. “I think some people sit in jail and think, ‘OK, I’m going to turn my life around.’ They’re motivated, but then they come out to the same environment, the same challenges, maybe more challenges, because now they have a record. So I’m very excited to have the opportunity to break through some of those barriers, just by saying, ‘Well, we can do that. We can take them there.’ “

“If I think about our mission, vision and values,” Tracy adds, “and if we know that there’s always hope, and recovery as possible, I don’t want transportation to be the barrier to making that a reality for the people we serve. Because if I don’t have a way to access the care, then I’m more than likely going to become more hopeless, and not be able to do the things that I’m hoping to do with my recovery journey. So I think that’s why I’m excited about this. It’s going to give people an opportunity to tap into that hope and to see what recovery is about.”

At Cummins, our mission is to inspire the hope of recovery, to achieve excellence in all aspects of care, and to make the goals and aspirations of those we serve our highest priority. We are thrilled to improve our services for justice-involved individuals by adding these transportation services!

We will update this page with information about requesting transportation once the service is live.

If you enjoyed this article and would like to help spread our message of hope and recovery, we encourage you to share it with others!

What You Should Know and What You Can Do About Indiana’s Youth Mental Health Crisis

If you are a parent or legal guardian to a child or teenager, then you might be aware that youth have been facing increasing mental health challenges in recent years.

Several statistics from the office of the U.S. Surgeon General showcase the severity of the situation. Even prior to the COVID-19 pandemic, mental health challenges were the leading cause of disability and poor life outcomes among American youth, with as many as 1 in 5 children ages 3 to 17 suffering from a mental, emotional, developmental, or behavioral disorder. In addition, more than 1 in 3 high school students reported persistent feelings of sadness or hopelessness in 2019—a 40% increase over the previous decade. And most sadly, suicide rates among youth ages 10–24 increased by 57% from 2007 to 2018.

Fortunately, there is much work being done to address this growing crisis. Among other initiatives, the Indiana Family and Social Services Administration (FSSA) announced earlier this month that it’s entering an $8 million partnership with Riley Children’s Health to provide mental health services at pediatric primary care offices across the state. This partnership will integrate mental health services into Riley Children’s Health’s primary pediatric care settings throughout Indiana, which will make it faster and easier for Hoosier parents and physicians to help youth with their mental health needs.

In light of these recent developments, we wanted to do our part to inform our community about the state of the current youth mental health crisis. We know that frightening situations like these can be improved if we understand why they are happening and what we can do about them.

In this week’s blog post, we’ll provide a brief overview of youth mental illness in our country, including why it’s on the rise and what you can do to help a child or teen who is struggling with mental health challenges.

What Is Causing the Youth Mental Health Crisis?

When discussing the mental health of young people, it’s important to explain that many mental illnesses first manifest during childhood or adolescence. The age at which a person first displays symptoms of a mental illness is referred to as the disorder’s “age of onset“.

Across the world, about 1 in 4 people will experience a mental illness sometime in their life. This means that as many as 25% of youth may experience the onset of a mental illness that negatively impacts their overall mental health. According to surveys by the World Health Organization, the average age of onset for various types of mental illness are as follows:

  • ADHD: ages 7–9
  • Phobia-related anxiety disorders: ages 7–14
  • Schizophrenia: ages 15–35
  • Substance use disorders: ages 18–29
  • Generalized anxiety disorder and PTSD: ages 25–53
  • Mood disorders: ages 25–45

As you can see, the development of a mental illness is one factor that may affect a child’s well-being. However, a number of environmental factors are also contributing to the youth mental health crisis our country is currently experiencing.

According to the U.S. Surgeon General’s Advisory on Youth Mental Health, research suggests that factors like the growing use of digital media, increasing academic pressure, limited access to mental health care, financial insecurity, highly-publicized societal violence, and anxieties about climate change may be worsening young people’s mental health and wellness. More research is required to determine precisely these subjects are affecting youth.

The COVID-19 pandemic has further added to the mental health challenges of many individuals; children and teens whose daily routines have been disrupted by the pandemic, who have experienced greater financial instability as a result of the pandemic, or who have lost a family member to COVID-19 are most likely to have suffered mental health challenges as a direct result of the pandemic.

What Can You Do About the Crisis?

Clearly, the challenges facing youth today are not ones that are easily solved. But there is plenty that we can do to help.

We have already seen signs that our government and health care professionals are attempting to respond to the crisis. In October of 2021, the American Academy of Pediatrics declared a national emergency in child and adolescent mental health, urging the country to take steps to address the problem. The following December, the U.S. Surgeon General’s office issued its advisory, signifying the federal government’s commitment to addressing the crisis. And in Indiana, the state government is allocating tens of millions of dollars to make mental health care more accessible and more effective for all Hoosiers. These are all encouraging signs.

There are also several things you can personally do to look after your child’s mental health. First and foremost is to have your child screened for mental illness and mental health challenges. Screenings are an important part of prevention and early intervention for mental illness, and they can often be obtained through your child’s pediatric primary care physician. In addition, Mental Health America offers free online screening assessments for a variety of mental illnesses, including an assessment that parents and guardians can take for their children.

In addition to screenings, the importance of talking to your child about their fears, worries and challenges cannot be overstated. Young people need trusted adults whom they can confide in without fear of judgment or punishment. As a parent or legal guardian, one of the best things you can do is normalize mental health challenges and encourage your child to share their struggles with you. The more they believe that you understand and support them, the better off they will be.

Dr. Ashleigh Woods, Cummins’ Senior Psychologist, adds,

“One of the biggest challenges I see facing children, teens, and families is lack of connection. Human beings are social creatures, and connection to others is what helps us regulate our thoughts, feelings, and bodies. When a parent or caregiver engages face-to-face with their child, that child’s mirror neurons and vagus nerve react to the caregiver’s facial expressions, tone of voice, etc. Not only is the child taking in what their parent is saying, but those nonverbal cues are also having a neurological impact on the child’s developing brain.

If we can help families improve both the quantity and quality of their face-to-face interactions, we can improve their connections and create more emotional safety and stability, which goes a long way toward building resiliency.”

Ashleigh Woods, Psy.D., HSPP, PMH-C

There is no question that many young people in our country are struggling with their mental health and well-being. Of the challenges they face, some have been around for generations, while others are more unique to today’s world. None are easily solved, but they can all be helped by unconditional love and support from caring adults.

If you are the parent or guardian of a child or teen, we strongly encourage you to speak to them about their mental health. Listen to their concerns, and show them that you’ll always be there to help. Share your own concerns about their mental health with their pediatric physicians.

You have the opportunity to be a powerful advocate for your child’s mental health. We encourage you to make the most of it!

Wellness for Care Providers: Putting Wellness Into Action

For caring professionals, looking after the health and wellness of other people is what we do. It’s in our job titles and our lists of daily duties. But it is difficult, personally taxing work that requires us to also keep close tabs on our own physical, mental, and emotional health. It’s impossible for us to help others if we don’t first do what we must to help ourselves.

Our “Wellness for Care Providers” blog series has been all about self-care strategies for people who serve others. In previous entries, we’ve covered:

If you’ve been following along with us through each topic, then the only thing left to do is take what we’ve learned and develop an action plan for your self-care. By assessing your current level of wellness and your strongest and weakest areas of self-care, you can create a specific plan for improving your wellness according to your needs and desires.

In this blog post, we’ll walk you through the completion of your very own Self-Care Action Plan, beginning with a quick review of popular self-care strategies as well as wellness-depleting situations you should strive to avoid in your life.

Top Self-Care Behaviors for Practitioners

When discussing wellness and self-care behaviors, sometimes it can be helpful to know what works best for other people like us. Information and suggestions from other people can help us adopt new behaviors with the confidence that they’ve already been “tried on for size”.

Throughout our wellness series, we’ve often referenced the book The Resilient Practitioner: Burnout Prevention and Self-Care Strategies for Counselors, Therapists, Teachers, and Health Professionals by Thomas Skovholt and Michelle Trotter-Mathison. As part of their research into self-care, the authors reviewed several studies surveying professional psychologists and practitioners. Some of the most effective self-care strategies among those surveyed included:

  1. Maintaining social supports. Humans are social animals, and a little support from family, friends, colleagues and partners can go a long way toward keeping us happy and healthy.
  2. Using humor. Laughter can’t cure every malady, but it can be surprisingly helpful for managing our mental state and putting the little difficulties of life in perspective.
  3. Maintaining self-awareness. Like humor, practicing self-awareness and mindfulness can help take the sting out of negative thoughts and emotions. Remembering that negative situations are not permanent gives us a better chance of seeing the light at the end of the tunnel.
  4. Taking vacations. We all need a break from work sometimes. If you have the ability to take vacations, do so. If not, try to find other ways to unplug from your work from time to time.
  5. Consulting with others when you need guidance or second opinions. The work of a care provider is stressful, so it’s OK to ask for guidance or advice when you’re unsure what to do in a certain situation. Handing off even a little of the responsibility can do wonders for overwhelm and overwork.
  6. Setting realistic goals. You won’t be able to change everyone’s life. You won’t be able to do everything you want to. Expecting that you will is a recipe for disappointment and shame. Instead, do the best that you can and expect for it to not be enough sometimes.
  7. Maintaining strong personal and professional identities. When you know who you are as a person and as a professional, you’ll better understand what is important to you and what isn’t. This knowledge can help you prioritize demands and feel confident that you acted on the situations that were most critical.
  8. Balancing personal and professional demands. Maintaining good work-life balance can be easier said than done, but it’s important to make the effort. Pay attention to how much energy you’re investing in your personal life versus your professional life. When the balance tips too far in one direction, be unapologetic about re-centering it.
  9. Exercising. We all know exercise is beneficial for both body and mind. Even if you don’t enjoy exercising, any amount can do you good. Try to find activities and times that fit your lifestyle and schedule, and stick with them. The outcomes might surprise you.
  10. Engaging in hobbies and leisure activities. It’s not healthy if we have little in our lives besides work and personal demands. Hobbies and leisure activities are great ways to find enjoyment in life and refresh ourselves when things becomes too stressful or chaotic.
  11. Creating comfortable work environments. For better or worse, we spend a large portion of our lives at work. One way to improve our enjoyment of work is to make our work environments as comfortable as possible. Sometimes this can be as simple as creating a clean, calming, organized workspace for ourselves.

Wellness-Depleting Situations to Avoid

Wellness priorities and practices often vary between individuals, so it’s normal for self-care to look a bit different from person to person. However, according to The Resilient Practitioner, there are some situations that are almost universally harmful to a practitioner’s self-care and well-being. You should be on the lookout for these situations in your personal and professional life and take action to rectify them if at all possible.

Common wellness-depleting situations for practitioners include:

  1. Toxic supervisor and/or colleagues. Poor relationships with our work peers can be extremely draining on our motivation and emotional state. Sometimes, we can compensate for this by increasing self-care in other areas and seeking emotional support from friends and loved ones. In other cases, it may be necessary to change our working situation.
  2. Little fun in life or work. Taking life too seriously all the time can often make it seem joyless and dull. If we find ourselves in this situation, we can work at “manufacturing” fun by actively exercising the humorous and playful parts of ourselves.
  3. Poor understanding of one’s own needs. It’s normal to not always know exactly what we want in life, but it’s important for us to understand what we need in order to feel well. When you feel discontent or imbalanced, pay attention to which parts of yourself are being neglected or pushed too far. Introspection of this kind can help you determine your optimal range of wellness and know what you must do to stay within that range.
  4. Lack of a professional development process. We may lose all joy in our work over time if we’re unable to see a clear path of professional progression. It can be helpful to map out the “big picture” of where we’d like our career to go and then strategize each step we can make toward that goal. This might also be a topic to discuss with a supportive supervisor.
  5. No energy-giving personal life. Even the most fulfilling work in the world can leave us feeling empty if we don’t have a rich personal life to balance it. This is why it’s so important to develop and nurture all the dimensions of the personal self.
  6. An inability to say no to unreasonable requests. As helping professionals, helping others is what we do, sometimes at our own expense. But we must have boundaries in place that prevent us from giving so much that we can no longer care for ourselves. This is where our priority-setting self comes into play.
  7. Vicarious traumatization from work situations. The nature of our work sometimes puts us in traumatizing situations or in close emotional proximity to the trauma of others. Good support from supervisors and colleagues can help prevent this vicarious traumatization from taking a toll, as can following disciplined wellness behaviors.
  8. Giving too much in personal relationships. Again, it can be easy for helping professionals to slip into the habit of giving too much, even in our personal lives. We must work to build relationships where we both give and receive support in order to keep our emotional and loving selves well cared for.
  9. Constant perfectionism in work tasks. Being consistently too demanding of ourselves is a guaranteed recipe for frustration and burnout. We must give ourselves permission to make the occasional mistake, just as we do for the individuals we serve.
  10. Continual unresolved or ambiguous professional losses. When our work with a client doesn’t end as well as we’d hoped, it’s important that we receive proper closure on the situation. A supportive supervisor can make all the difference in the world in this regard. They can help to put the loss in perspective and provide reassurance that we as the practitioner did nothing wrong.
  11. A strong need to be needed. Many who choose to enter the caring professions enjoy the feeling of being needed by others. We must be careful to balance this desire with practices that nurture our self-sufficiency. Remember that you have value as an individual outside of your ability to help others.
  12. Professional success defined solely by client success or appreciation. When our job is to help other people get better, it can be difficult to separate our success from their success—or even from their appreciation of our efforts. To counteract this tendency, it can be helpful to develop the parts of our personal self that are more inwardly focused, such as our solitary and spiritual selves.

Completing Your Self-Care Action Plan

Now let’s complete your personal Self-Care Action Plan so you can put everything you’ve learned into practice.

In previous articles, we’ve explained how to assess your work stress level and self-care/other-care balance, your professional self-care, and your personal self-care. You’ll finish your plan by assessing your overall level of self-care and creating steps for working on areas of weakness.

Step #5: Assess Your Self-Care Strengths and Weaknesses

Using the information you gathered in Steps 1–4, take some time to write an informal assessment of how successfully you are nurturing your own wellness. Focus specifically on which areas of self-care you are excelling at and which can be improved upon.

Honesty is crucial at this step, because you can only develop an effective plan of action if you are honest about where your wellness practices are lacking.

Step #6: Develop Your Plan

Your action plan should focus on no more than two domains of self-care that you would like to improve upon. For each self-care domain you chose, you should write out:

  • A specific goal you would like to achieve, including measurable outcomes and time frames
  • The method by which you will achieve the goal
  • How you will reinforce and maintain your new self-care behaviors

For example, let’s imagine you have lax professional boundaries that are causing you to feel overwhelmed by requests from co-workers and clients. You decide that you would like to develop stricter work boundaries. Your action plan might look like this:

  • Specific Goal: Reduce work-related interactions during non-working hours by 50% over the course of 4 months.
  • Method for Achieving the Goal: Inform all colleagues and clients that you will not answer communications outside of work hours, with exceptions for emergencies. During months 1 and 2, monitor how often you still receive communications outside of work hours, and only respond to those that seem highly important. Monitor colleague and client response to your decreased responsiveness. During months 3 and 4, begin to respond only to communications that appear to be true emergencies. Monitor colleague and client response to determine if you are being too lax with boundaries, too strict, or just right.
  • Reinforcement for New Behavior: To offset any stress associated with disappointing colleagues and clients, set aside 30 minutes each week to journal, specifically ruminating on how your stricter professional boundaries have increased your overall health and wellness.

When choosing your goals, remember to keep realistic expectations. Don’t try to change too much too fast, and remain open to the possibility that you might need to reassess your plan if it doesn’t play out as you had hoped.

This brings us to the end of our series on Wellness for Care Providers!

We could all use a little help sometimes to improve our self-care practices and routines. But for those of us who care for others as a profession, maintaining our own wellness is especially important.

We hope this series gave you some useful ideas to implement into your wellness regimen. If you enjoyed it, we encourage you to share it with a friend who might also find it helpful!


Wellness for Care Providers: The Many Facets of Physical Self-Care

For those of us who work in the caring professions—such as health care, education, emergency services, criminal justice, and social work—our job is to care for the well-being of other people. However, this is difficult to do if we aren’t also managing our own health and wellness. As Cummins’ Professional Development Specialist, Ciera Jackson, likes to say, “You can’t pour from an empty cup.”

In the previous post of our series on Wellness for Care Providers, we discussed the many dimensions of the personal self and how you can practice personal self-care. However, we left out one dimension of the self that is significant enough to warrant a separate discussion: the physical self.

Physical self-care is essential for overall health and wellness. Not only do we enjoy life more when we are physically healthy, but the health of our physical body also has a direct influence on our mental and emotional health. One of the simplest and most effective ways to improve mental and emotional well-being is to focus on improving our physical well-being.

In this post, we’ll divide the physical self into its core components and share some simple advice for maintaining each one. We’ll be guided once again by Ciera Jackson, who shares her thoughts and suggestions on this topic.

Ciera Jackson, MSW, LCSW, Professional Development Specialist at Cummins Behavioral Health

Nutrition: Providing the Right Fuel for the Body

Physical self-care is all about keeping our bodies as healthy as we can, and a large part of keeping our bodies healthy involves being mindful of what we are putting into them.

It can be helpful to think of food and drink as fuel for the body. Giving our bodies high-quality fuel helps them run more efficiently and can make us feel better all around. By contrast, low-quality fuel creates strain on our bodily systems and can make us feel worse.

“What you put into your body will fuel you,” Ciera says. “If you’re eating McDonald’s Big Macs all the time, you’re probably going to feel like a Big Mac. Versus if you’re putting vegetables, water, and various nuts and berries into your body, you’re probably going to feel like that.”

Maintaining good nutrition is a crucial component of physical self-care. Here are a few pieces of advice to keep in mind when it comes to nutrition:

  • Try to avoid processed foods. These foods typically contain fewer nutrients and more unhealthy additives like salt, sugar and fat than “whole” or unprocessed foods.
  • Don’t skip meals; eat small meals. Eating smaller portions more frequently is better for your body than consuming large amounts of food all at once. Ciera acknowledges that this can be a challenge when we are short on time. “Sometimes as practitioners, especially if you’re in the office and you have patients back to back, it can be hard to get those meals. But if you keep little snacks in your desk, or if you carry a little cooler or something, then maybe you can kind of eat quickly.”
  • Try new foods. Eating the same things every day can cause you to miss out on essential vitamins and nutrients. Experimenting with new foods is an easy way to increase your nutrient variety.
  • Feed your body veggies. Vegetables are perhaps the best type of food you can eat, so you should make an effort to eat as many as you can. “Even if it’s just one vegetable that you like, find one and stick with it,” Ciera encourages.
  • Your body needs water! Beverages like coffee, tea, fruit juice and soda pop are not good substitutes because they may contain added sugars or dehydrating ingredients. Make an effort to drink pure water every day.

Exercise: Keeping the Body Active

The benefits of regular physical activity have been well documented for many years now. Here are just a few of them:

  • Exercise controls weight
  • Exercise combats health conditions and diseases
  • Exercise improves mood
  • Exercise boosts energy
  • Exercise helps with sleep
  • Exercise can help with brain functioning

We all know that exercise is good for our health, so why do many of us have such a hard time doing it?

“Many of us live a fast-paced life,” Ciera says. “We want things quickly. Research has shown that if exercise could come in a pill form, many people would take the pill, hence why there are so many diet pills and ‘lose weight quick’ programs out there. People want to be healthy or lose weight, but it is very difficult for them to do it.”

Of course, a shortage of time can be a legitimate barrier to getting enough exercise, especially when we have responsibilities to family and loved ones on top of our work duties. “We have to be honest with ourselves about when is the most optimal time of day to actually get a workout in,” Ciera advises. “And maybe you have to start small. Maybe you don’t have time during the week, but you can exercise just during the weekend. Maybe you can start with one day of the week and then work your way up. Something is better than nothing.”

Finally, Ciera suggests finding and sticking to a few exercises you enjoy rather than pushing yourself to do exercises you don’t like. “You know what I like when I go to the gym? The battle ropes. Those are fun for me. So you have to find what you like. Maybe it’s strength training, maybe it’s lifting weights, maybe it’s the stationary bike. Whatever it is, find your thing and stick with it,” she says.

Sleep: The Body’s Recovery Period

Our bodies are highly sophisticated biological machines, but they can only run for so long before they need to recuperate. Sleep is our natural recovery period, during which many of our bodily systems are “recharged” for continued use.

Adults need between 7 and 9 hours of sleep each night in order to function properly. “When you’re not getting enough sleep, you can be cranky. When you don’t have enough sleep, you’re just not yourself. So, getting a good routine down is important. Just like we do for children, as adults, we should have a sleep routine,” Ciera says.

Keeping a sleep routine helps our bodies prepare to go to sleep each night, which can be beneficial if you struggle to get enough rest during the week. Some activities you can try for your before-bed routine include:

  • Turn off all electronics 30–60 minutes before bed. “For some people, electronics tend to stimulate them,” Ciera says. “So if they’re looking at their phone, then they’re just wired to it. However, for some other people, it’s their way to wind down. It just kind of depends on who you are.”
  • Take a bath or shower. Bathing, especially in warm or hot water, can be soothing and sleep-inducing for some people.
  • Dim the lights. A reduction in light levels is one of the body’s natural cues to prepare for sleep.
  • Use aromatherapy. Some popular examples include candles, oil diffusers, and lotions.
  • Drink hot tea, hot chocolate, or warm milk. Just remember to avoid anything with caffeine or large amounts of sugar.
  • Listen to relaxing music or an audio book.
  • Meditate.
  • Write in a journal.

In addition, it can also be helpful to go to bed at the same time each night and to use your bed only for sleeping and intimacy. These habits can help provide behavioral cues for the body when you are ready to go to sleep.

Hygiene and Medical Checkups: Maintaining Bodily Health

The last major component of physical health involves the normal bodily maintenance and preventative actions we should be taking on a regular basis.

Personal hygiene standards may vary from person to person, and some amount of variance is acceptable. However, the primary utility of hygiene is to prevent illness and injury, so there are certain behaviors that everyone should try to follow.

For example, it is generally advisable to wash your hands before eating, before putting your hands in your mouth or eyes, and after using the restroom. These guidelines are especially true when you are in a public place. “It makes people feel uncomfortable if you’re in a public bathroom and you walk out without washing your hands. It makes people feel uncomfortable when you cough or sneeze, especially in your hand, and you don’t at least hand sanitize. It just does,” Ciera advises.

Beyond other items like regular bathing and dental hygiene, it’s important to schedule the preventative medical, dental and vision checkups recommended by your health care providers. “As people who are in this field, we can be so bad about this,” Ciera says. “We can be upset with our consumers when they miss their appointments, but we can be so poor at doing this ourselves. We will reschedule and reschedule and reschedule our own appointments, or just not schedule our appointments, because it doesn’t fit in our day. It’s not convenient. We might have to take time off. Don’t reschedule them. Don’t put them off to the last minute. It’s OK to take your kids to their appointments, it’s OK to take yourself to your appointments. See about your family, see about yourself. Period.”

Finally, Ciera encourages you not to feel embarrassed or ashamed if you are struggling with your regular hygiene and need help to meet your needs. “I can’t tell you the number of people who have come to me and told me, ‘Hey Ciera, I haven’t showered in a week. I haven’t showered in weeks. And I am struggling,’ “ she says. “These have been social workers. These have been therapists. These are people who have degrees. Sometimes people struggle with depression and other mental health disorders, and it’s nothing to be ashamed or embarrassed about. But you also have to take care of yourself and understand what is going on. And I do say that with sensitivity, because sometimes we don’t know how to say, ‘I am struggling, and I need help.’ “

Now that we’ve discussed the physical self in detail, you can add your assessment of your physical self-care to your Self-Care Action Plan.

Take a moment to brainstorm and write down some specific ways you are practicing physical self-care on a daily basis. Then, give yourself a rating from 0–6 for how well you are currently nurturing your physical self, with 0 being not at all and 6 being very well.

You’ll use this information to assess your overall wellness and create your action plan, which we’ll cover in our next and final blog in our series on Wellness for Care Providers!

Yoga, meditation

Sexual Assault Awareness: Finding Hope and Healing After Sexual Violence

Sexual assault is a horrible and deeply traumatizing experience, and it affects nearly half a million people in the U.S. each year.

Among women, who are disproportionately affected by sexual assault, 1 in 6 individuals will be the victim of an attempted or completed rape sometime in their life. For men, the number is 1 in 33.

Unfortunately, sexual assault is a problem even in our own community. For Sexual Assault Awareness Month back in April, our staff created an interactive display at our Marion County outpatient office. The display provided a number of teal awareness ribbons and invited visitors to pin one to a wreath if they or someone they knew was a victim of sexual assault. By the end of the month, every ribbon had been pinned to the wreath.

Survivors of sexual assault often continue to suffer long after the assault itself. They may feel ashamed and alone, psychologically isolated from the rest of the world. They may feel as though recovery is impossible and their pain will continue forever. If you are a survivor of assault, we want you to know that you are not alone, there is hope of recovery, and behavioral health organizations like Cummins can help you—if you’d like to be helped.

In this blog post, we’ll explain how you can begin your journey of healing and regain control of your life after a sexual assault. We’ll be aided by advice and insights from Tara Wilkins, our Marion County Outpatient Team Lead, who is passionate about helping survivors of assault and abuse.

Tara Wilkins, MSW, LSW, CCTSI, Marion County Outpatient Team Lead (left), and the interactive sexual assault awareness display in our Marion County office (right)

Isolation: The First Barrier to Recovery

Many survivors of sexual assault struggle with feelings of isolation. This may seem ironic when we consider just how many individuals suffer from assault each year. But the truth is that despite its prevalence, sexual assault still carries a large sense of stigma for its victims.

“Some people think that if this happened to you, then you must have done something wrong, you must have done something to warrant this,” Tara explains. “And because of that, there’s so much shame involved. When you’re going through this, you’re thinking, ‘What did I do wrong?’ Or, ‘I wish I would have done this differently.’ Or you don’t want to talk about it for fear of being judged.”

This fear of judgment often leads survivors to keep the assault to themselves, which can have the unfortunate effect of making them feel alone, isolated, and misunderstood by their friends and loved ones.

But as statistics show, survivors of assault are not alone. Many others have gone through the same experience and can relate to the situation. Although it’s often difficult to speak out about an assault, doing so can help you find support and break down this sense of isolation.

Tara says, “There’s so much power in a ‘me too’, because it happens to more people than we realize. And by sharing that, and how you’re overcoming the adversity, and all those things, it helps move you from ‘I’m a victim and this happened to me’ to ‘I’m surviving and thriving now.’ “

Finding Hope After an Assault

Even with understanding and support from loved ones, it can be hard for many survivors of assault to find hope for a better future.

Any form of sexual assault is a horrific violation of a person’s body and mind. This sort of violation often leaves scars. It might trigger long-lasting feelings of depression, anxiety, or post-traumatic stress. It’s only natural for someone to lose hope under these circumstances. The good news is that, once again, statistics show that people do recover, and hope can be regained.

“You know, I love a model in one of the books we use for our women’s therapy group,” Tara says. “It’s called the Spiral of Trauma and Healing. Essentially, it just depicts what everyone encounters, which is at the beginning, a trauma happens. And then you have this downward spiral where you feel very confined by, in this case, a sexual assault. It just really grips hold of you and impacts your life, and so the spiral gets tighter on its way down, because a lot of intrusion and avoidance and all these other things are happening. And then once you enter treatment, and you begin to work on your recovery journey, then you’re on this upward spiral of expansion and recovery. And I think that’s a really great depiction of what happens.”

The Spiral of Trauma and Healing (pictured below) provides validation that recovery is possible, though it does take time. As Tara mentions, seeking behavioral health care can be very helpful for your recovery journey. Another option is to join support groups that provide education and tools to help you heal.

Tara adds, “We have a Women’s Trauma Group at our office. You don’t have to be a victim of sexual assault to participate, but many people there are survivors. We use Trauma-Informed Yoga in there, and we do a lot of psychoeducation to give them tools to help them self-regulate and feel safe. So at Cummins, that’s one way we do that. And I often refer out to other agencies, to a specific support group, a therapy group, or things like that.”

The Spiral of Trauma and Healing, by Stephanie S. Covington, PhD, LCSW

How Behavioral Health Services Can Help

As we’ve said, sexual assault can often create difficult mental health challenges for survivors. There is no shame in seeking out help to overcome these challenges. Therapy is a safe place to discuss painful memories and to learn coping skills for dealing with trauma.

One of the best parts about therapy is that most organizations now offer many different modalities of care, so you can work with a therapist to find the types that work best for you. Tara elaborates: “When I first started at Cummins, if you wanted to treat someone with trauma or sexual trauma, you had Cognitive Processing Therapy, which is an evidence-based practice approved by places like the VA, or if you were working with kids, you had Trauma-Focused Cognitive Behavioral Therapy. We now have so many different things. We have therapists in every location trained in EMDR, which is a phenomenal tool. We also have opportunities to do Shame-Informed Therapy, which is one of the things that I use frequently with my survivors, and Internal Family Systems Therapy.”

At Cummins, one of the most important aspects of therapy involves giving survivors control over the services they receive. “One of the things we do is when we get an intake, you know, we’ll assign providers, but I think the most fundamental thing that happens is putting this person in the driver’s seat,” Tara explains. “I’m not going to say as a therapist, ‘Oh, you’re here for this, so we’re going to use this method.’ I really like to lay out all the options that someone has available to them, let them know the pros and cons, and let them choose.”

Having permission to control their own care can be comforting for anyone, but we believe it’s especially therapeutic for people who have experienced an assault. “At some point, their control has been taken away,” Tara says. “They didn’t have control over their body. They didn’t have a choice. And so this is one small, tangible thing I can do, to say, ‘This is your choice. You’re in the driver’s seat.’ We as therapists are saying, ‘I understand what happened to you. I understand how this can make you feel. And we’re going to give you as much control as possible with this.’ “

Here at Cummins, we understand how devastating sexual assault can be. For survivors of assault, a single event can create severe and long-lasting challenges to their health and wellness. But we would like all survivors to know that they are not alone, and despite all odds, they can recover.

If you or a loved one has experienced a sexual assault and would like to learn more about mental health treatment options, you can call us at (888) 714-1927 to learn how Cummins can help. There is no obligation to your call.

With the right help and support, you can recover from sexual assault and find peace and happiness in life again. Your assault does not have to define you. Healing is possible.

Polyvagal Theory for Mental Health Care: Applying the Work of Deb Dana in Therapy

“Safety is not the absence of threat, it is the presence of connection.” — Gabor Maté

For providers of behavioral health care, it’s very important that the people we serve feel safe around us.

The process of therapy requires vulnerability from those in care, and vulnerability is difficult or impossible unless a client feels safe opening up to their therapist. Without this sense of safety and trust, the therapist won’t be able to make the emotional connection needed to help the consumer succeed in therapy.

Therefore, one of the provider’s chief duties is to make the individual feel safe and comfortable to engage in treatment. But how can we do this? There are many strategies that may work, but at Cummins, we prefer a trauma-informed approach to care that incorporates the developing science of polyvagal theory.

In fact, we have recently begun training our providers on the work of Deb Dana, LCSW, who has pioneered work in applying Dr. Stephen W. Porges’ ground-breaking polyvagal theory to therapy practice with clients. Deb Dana has written several books describing clinical strategies and techniques that further apply this foundational understanding, including The Polyvagal Theory in Therapy: Engaging the Rhythm of Regulation.

We’re very excited to be incorporating Deb Dana’s techniques using polyvagal theory into our own clinical practices! In this blog post, we’ll provide a brief synopsis of polyvagal theory and preview how it can serve as a framework for mental health care.

Deb Dana, LCSW, author of The Polyvagal Theory in Practice

The Bodily Response to Danger

At some point in your life, you’ve probably had the experience of feeling unsafe.

If you think back to one of those instances, you’ll remember some interesting physiological symptoms. First, at the moment you detected danger in your environment, there’s a chance you might have frozen in place. Perhaps it was only for a second or two, or perhaps it was for longer than that. During those few moments, you made a rapid and instinctual assessment of the threat at hand without moving or speaking.

Then came the rush of adrenaline. Your body entered a state of high alert as your senses sharpened on the source of danger. Depending on the situation, you made a gut decision to either move away from the danger as quickly as possible, or, if you were threatened by a person or animal, to confront the aggressor in order to end the threat of danger. And then you did so, almost without conscious thought about it.

When you reflect back on the event today, you can probably understand it in its greater context. Using the logical part of your brain, you can surmise whether or not the perceived threat was a legitimate threat to your well-being, and you can judge whether you acted reasonably or unreasonably in the heat of the moment. You might even have some idea of how you wish you had reacted instead. But at the time of the incident, it would have been nearly impossible to have these kinds of thoughts.

Why is this so? Polyvagal theory offers an answer.

Polyvagal Theory: Linking Physiology and Cognition

As human beings, our cognition is closely linked to our physiology, and our physiology is closely linked to our perceptions of danger and safety. Polyvagal theory states that the presence or absence of a perceived threat activates different parts of our brain and autonomic nervous system (ANS), which produces different physiological states.

When we feel calm and safe, we are operating in what polyvagal theory calls the Engagement State. This state is associated with higher-level cognitive processes, social interaction, and emotions like joy, compassion, curiosity and mindfulness. When we’re in the Engagement State, the ventral vagus nerve and associated ventral vagal complex of the ANS are activated.

If we perceive a threat in our environment, our ANS may shift into the Mobilization State. In this state, our sympathetic nervous system is activated, which prepares the body to move in response to the threat. The Mobilization State may trigger “fight or flight” behaviors, and it is associated with emotions like anger, fear, anxiety and panic. Importantly, higher-level reasoning and social engagement are extremely difficult when in this state.

Finally, if the perceived threat is so great that we feel unable to counteract it, our dorsal vagus nerve and dorsal vagal complex may become activated, triggering the Collapse State. In this state, we might feel ashamed, hopeless, disassociated, depressed or even suicidal. At lower levels of dorsal vagal activation, we may also exhibit freezing behavior, which can occur when a sense of danger comes on very strongly and abruptly. While temporary, “defensive” freezing behavior can be useful for surviving dangerous situations, prolonged dorsal vagal activation is especially dangerous to our mental and emotional well-being.

The 3 Organizing Principles of Polyvagal Theory

In addition to the three physiological states described above, polyvagal theory proposes three key principles that explain how our bodies shift between them. They are:

1. Hierarchy

The three states of polyvagal theory are always activated in a specific order, without skipping any state. As our level of arousal and perceived danger increases, we move from the Engagement State (ventral vagal activation) to the Mobilization State (sympathetic nervous system activation), and then, if arousal continues, to the Collapse State (dorsal vagal activation). As arousal and perceived danger decrease, we move from the Collapse State to the Mobilization State, and if we are sufficiently calmed, then to the Engagement State.

It should be noted that arousal can happen very quickly, such as when someone who is calm jumps to freezing behavior in response to an abrupt threat. However, this is the one notable exception. In most cases, an individual does not move from a state of calmness and connection (Engagement State) to a state of numbness and hopelessness (Collapse State), or vice versa, without first passing through the state of frustration or anxiety (Mobilization State).

2. Neuroception

Neuroception is the premise that our nervous system can and does take in outside information and respond to that information. Importantly, this process happens without our conscious awareness.

Neuroception stands in contrast to perception, which is our capacity for consciously interpreting the world around us. While perception is moderated by conscious thought, neuroception is not. Neuroception explains how a person, object or environment that subconsciously reminds us of danger can create changes in our autonomic nervous system, even if we consciously know the person, place or thing does not pose a threat to us.

3. Co-Regulation

As our bodies and bodily systems mature throughout our lives, our autonomic nervous system develops the ability to self-regulate. For example, once it is sufficiently developed, our ANS can “learn” to transition out of heightened states of arousal on its own. However, this development process begins with co-regulation, which involves mirroring or mimicking the behaviors and arousal states of others.

Co-regulation can be seen commonly among young children, such as when an upset child is soothed by a parent or caregiver. Through neuroception, the child’s ANS responds to the calming cues given off by the parent and successfully de-escalates its own arousal level. Although co-regulation becomes less critical as self-regulation skills develop, it remains a useful principle to leverage in situations such as therapy and counseling.

Applying Polyvagal Theory to Clinical Practice

So, what exactly does all of this have to do with providing mental health care?

For individuals receiving care, seeking and receiving mental health services can be a challenging experience. For starters, a person who is seeking services may feel a variety of difficult emotions, such as uncertainty, anxiety, fear, or shame. What’s more, the therapeutic process may elicit upsetting thoughts and feelings as the consumer works through whatever issues they are seeking help for.

In some circumstances, these difficult emotions—perhaps coupled with traumatic memories or certain features of the treatment environment—may cause a person to feel unsafe, triggering an ANS response. If this happens, they will be temporarily “locked out” of the cognitive processes associated with the Engagement State, which are necessary for productive participation in treatment.

As care providers, we can use our understanding of polyvagal theory to help prevent this from happening. Although this is a nuanced process, Deb Dana’s framework poses three essential elements of practice:

1. Context

Some people seeking services may feel unsafe if they do not fully understand what is happening in treatment and why it is happening. For this reason, providers should demystify the process by consistently explaining what will be done, why it will be done, and how it will be done in the context of our brain and our nervous system. This will reduce the chance that the individual’s ANS will detect a perceived threat via neuroception.

2. Choice

Individuals may also be prone to feeling unsafe if they believe they don’t have any control over their treatment. This can create the feeling of being trapped within treatment, which may trigger ANS arousal. To prevent this, providers should ask their clients what they would prefer to do or offer multiple choices whenever possible. This will help the individual feel safe in the knowledge that they are in control.

3. Connection

As we mentioned above, the emotional tolls of treatment may cause some distress for the person receiving services. To prevent or counteract this, providers must constantly monitor their own emotional state and strive to remain in the Engagement State of the ANS. Doing so will assist the consumer in staying or becoming calm via the principle of co-regulation.

Robb Enlow, LCSW, Cummins’ Chief Clinical Officer, explains:

“Part of what any therapist, nurse, teacher, or communicator has to do with other people is co-regulate. If you’re in an ugly frozen state, and the person you’re communicating with is in an ugly frozen state, that’s not a pretty conversation. In fact, sometimes we see that clinically. The parents are frustrated and triggered, the child is screaming and triggered, and neither one of them are communicating effectively with each other. They’re both frozen or very ‘fight or flight,’ and it’s just not working for them. The idea is we get them regulated to the ventral vagal state, or the social engagement state. When people are truly in the social engagement state, that’s when your brain is able to do miraculous things. When you calm down those cover ups, those protective, defensive parts, the rest of your brain is able to access creative, curious things that you’re just not able to access when you’re not in that state.“

At Cummins, we are always working to provide the most effective care possible for the people we serve. Part of this means training our providers in new and promising clinical practices. (In fact, continuous learning is one of our core organizational values!)

To this end, we’re thrilled to be incorporating polyvagal theory and the work of clinician Deb Dana into our standards of care. We believe it will further improve the knowledge base and therapeutic effectiveness of our care providers, which will in turn result in better outcomes for our consumers. And this, after all, is our most important goal.

If you are interested in advancing your career with a position at Cummins Behavioral Health, we encourage you to visit our employment page. We are always looking for talented and passionate people to join our team!

Wellness for Care Providers: Nurturing the Personal Self

Let’s face the facts: working in the caring professions—such as health care, education, emergency services, criminal justice, and social work—is often stressful. On top of attending to the people they serve, care providers must also make time to manage their own health and wellness.

In previous entries in our “Wellness for Care Providers” series, we’ve discussed:

We’re now ready to discuss the concept of the personal self and personal self-care. Whereas the professional self is the part of a person that identifies with and is nourished by their work, the personal self is the part of a person that’s concerned with everything outside of work. It is who we are on a day-to-day basis when we’re left to do as we please.

There are actually many different dimensions to the personal self, such as the emotional self, the playful self, and the solitary self, to name just a few. Good personal self-care is about properly nurturing each dimension of the personal self; if any one dimension receives insufficient care, we may begin to feel unhappy, stressed, aimless, or otherwise unwell.

In this post, we’ll break down the various dimensions of the personal self and provide some instruction for nurturing each one. We’ll once again be guided by insights and advice from Ciera Jackson, our Professional Development Specialist here at Cummins.

Ciera Jackson, MSW, LCSW, Professional Development Specialist at Cummins Behavioral Health

10 Dimensions of the Personal Self

Here at Cummins, we use a model of the personal self inspired by the book The Resilient Practitioner: Burnout Prevention and Self-Care Strategies for Counselors, Therapists, Teachers, and Health Professionals by Thomas Skovholt and Michelle Trotter-Mathison. This model divides the personal self into a dozen different sub-selves.

Today, we will discuss 10 of them in detail:

1. The Emotional Self

Humans are emotional beings at our core. The emotional self is the part of us that needs to feel and express our emotions in order to be at peace. If we keep emotions bottled up for too long, our emotional self will suffer.

The emotional self can be nurtured in a variety of ways. “Some people might journal. Some people might have a good cry everyday,” Ciera suggests. Others might use art as a way of expressing their emotions. One of the easiest things you can do is simply speak with friends or family members about emotions that may be troubling you.

Attending therapy is also a great way to nurture the emotional self—even for people who are therapists themselves. In fact, studies show that 86% of psychologists who prescribed therapy to their clients found therapy to be helpful for themselves, as well.

“How many people who are in the field ‘take their own medicine’?” Ciera asks. “A lot of people wonder, ‘If I admit I’m a clinician who goes to therapy, does that make me lesser? Does that mean something negative for me?’ And no, it doesn’t. I tell people that I go to therapy. I do it because I need check-ins, I need accountability, I need perspective.”

2. The Financial Self

Whether we like it or not, we have to admit that money is an important part of life. If you have poor money skills, are financially unassertive, and tend to have a consuming nature, then you will eventually experience financial stress. For practitioners, this will make it harder to form empathetic connections with clients and remain focused on meeting their needs.

“My grandma always used to say, ‘Have some money for a rainy day,’ “ Ciera says. “Rainy days come. It’s bound to happen, whether it’s unexpected car expenses, house expenses, health concerns, or whatever it is. And if you don’t have anything in savings, that tends to be stressful.”

For these reasons, it’s crucial to develop your financial literacy, and preferably to live a little below your means. “It’s important to have that financial self-care, even if it’s just, ‘For each paycheck, I’m going to send a certain amount to a savings account, so that if I don’t see it, I don’t touch it,’ “ Ciera adds.

3. The Humorous Self

Just about everyone likes to laugh. In fact, laughter has been proven to carry surprising health benefits, such as improving immune system functioning and helping to prevent heart disease. In a study of psychologists regarding coping strategies, maintaining a sense of humor was also the #3 career-sustaining behavior. It’s important to laugh, have fun, and be playful regularly in your life and even in your work.

Ciera shares an example from her own life: “When I first started in the field, I was working with families involved in DCS. I don’t know if I really knew what I was getting myself into. But I would go home every day for six months straight and watch The Nutty Professor and laugh like I had never seen the movie in my life. That was my thing.”

If possible, it can be helpful to use humor at your place of work, as well. Joking around with your co-workers (in appropriate moments) can be a great way to bond, form friendships, and relieve stress in a communal way.

4. The Loving Self

Affection is a powerful source of professional vitality. The loving self is the part of us that needs to express affection and receive affection from other people.

“If all you have is work, then that’s not a flourishing reality for you,” Ciera explains. “That’s not something that is going to be long-lasting, because eventually you’ll burn out. I know some people tend to be ‘workaholics’, but you have to look forward to something other than work.”

We all need to have people or things that we care about outside of our work. These might be family, friends, pets, a mentor or mentee, and so on. These relationships can nourish the loving self by providing it with the affection it needs.

Of course, maintaining relationships outside of work also requires us to make them a priority whenever possible. “How good are you at spending time with the people outside of work? Do you make them a priority?” Ciera asks. “You have to ask yourself, ‘Do the people who are closest to me always deserve my leftovers?’ And work on getting better at not giving them your leftovers, but giving them some of the best parts of you.”

5. The Nutritious Self

It has been said that “Happiness is a steady rhythm of blood glucose.” While this might not be an absolute truth, it is nevertheless true that our bodies and minds need fuel to be healthy. This is where the nutritious self comes in.

Good nutrition can be complicated and may look different from person to person. However, there are many rules of thumb that can be helpful for most people. For starters, it’s generally a good idea to eat plenty of fruits and vegetables and limit your consumption of fats, sugars, and processed foods. Drinking plenty of water is also essential, so you should drink whenever you feel thirsty, and limit dehydrating beverages like coffee, tea, soda, and alcohol. Breakfast is also an important meal not to skip, as it jumpstarts your metabolism and provides fuel for your body to begin the day.

Above all else, it’s important to develop a long-term perspective with regard to eating habits. “Do what is sustainable for you,” Ciera suggests. “If you’re going to change eating habits, make sure they’re sustainable eating habits for you. That way you’re doing something that is not just going to get you quick results, but long-lasting results.”

6. The Playful Self

Even the most serious people—and those who perform the most serious work—need to have fun from time to time. After all, the world of play helps make the world of work possible. The playful self is the part of us that needs to be silly and light-hearted sometimes.

“I think sometimes when we get to be adults, and especially in this field, we can become so serious, or so focused on what it is that we’re doing, or drained, that we’re just like, ‘I don’t have time for anything else except my work,’ “ Ciera says. Playfulness, like humor, is an important counterbalance to stress and anxiety.

Once again, there are many different ways someone can nurture their playful self, and the best methods for you will be those that align with your interests. Many people enjoy games of various types, whether they are card games, board games, video games, or games based in physical activity. Another common example is attending festivals or partaking in amusement park rides.

“You don’t have to spend money to have fun,” Ciera adds. “You can just get creative. Channel your inner child.”

7. The Priority-Setting Self

Most of us feel like we always have too many things on our “to do” list. When we don’t have enough time to finish everything, we are liable to feel overwhelmed and over-extended.

Ciera says, “Sometimes we start so many things at once that, for some people, they don’t get anything done, and for other people, they feel like they have to get everything done. That stresses them out, and then if they’re stressed, they can become snappy, and that can stress out other people around them, or make other people around them uncomfortable. And it just makes the whole atmosphere unpleasant.”

To satisfy the priority-setting self, we need to learn to do the most important things first and leave the rest for later. Ask yourself: What has deadlines? What’s more time sensitive? What’s more urgent? Put a star or asterisk next to those tasks, and put aside the rest until you have time for them.

8. The Relaxation/Stress-Reduction Self

As care providers, our work can be stressful and hectic. This is to be somewhat expected, but it can’t be sustained forever. Our relaxation and stress-reduction self demands that we also make time for peace and serenity.

“You have to practice de-stressing, period,” Ciera says. “You can’t carry the weight of the world on your shoulders. Everything is not within your control. You can do what you can do, and after that, it’s up to your client, it’s up to your family, it’s up to your boss, or whoever. Do what you can do, and then let it go.”

Everyone has their own methods of relaxing and de-stressing, but activities like meditation, mindfulness, yoga, and relaxation training work for many people and have been proven to reduce instances of high blood pressure, heart disease, depression, cancer, arthritis, and gastrointestinal disorders.

It’s worth mentioning that stress-reduction activities are not always easy to maintain. “Sometimes it takes practice, and I’m not saying it will be a day of practice. Sometimes it takes weeks, months, or even years to get to that point of giving yourself permission to just be,” Ciera says.

9. The Solitary Self

People are social animals. We all enjoy talking to and spending time with other people (especially if we like those people). But we each also have a solitary self that needs to be alone every once in a while.

Solitude means removing yourself from the known channels of life. It means unplugging from the electronics and being at one with yourself. It means getting away from the noise in order to refill yourself.

Although we all require solitude sometimes, it comes easier for some than for others. “A lot of people struggle with this because it means being alone,” Ciera explains. “Some people really enjoy being by themselves and have no problem with this at all. For other people, it’s like the worst thing ever.”

If you’re someone who hates to be alone, know that it’s alright to embrace solitude in baby steps. Ciera says, “It’s OK to start small if you do struggle with this. It can be 5 minutes of just saying, ‘I’m going to unplug for 5 minutes and just do nothing.’ “

10. The Spiritual or Religious Self

The spiritual or religious self is the part of us that seeks connection to something larger than ourselves. An active spiritual or religious life is important for many people because it gives meaning to the “big questions” of life. Are people basically good or evil? Is there an afterlife? What moral rules should govern your life?

Nurturing the spiritual or religious self can also help practitioners find meaning and purpose in their work. When the things we do every day are in service of a greater purpose—whatever that purpose may be for us—then we are more likely to find our work personally relevant and important. We’re also more likely to believe that we’re living a fulfilling life.

In essence, spirituality and religion provide codes for us to live by and give greater context to our actions. “For a lot of people, spirituality or religion is important to them because it just helps govern their day-to-day,” Ciera says.

Self-Care Action Plan Step #4: Assessing Your Personal Self-Care

Now that we’ve reviewed the various dimensions of the self, let’s discuss how to assess your personal self-care for your Self-Care Action Plan.

You can begin by considering: How well am I nurturing each part of myself? What am I specifically doing to nurture each part of myself?

Next, make a list of the 10 dimensions of the self we discussed above. Next to each dimension, write down specific activities you are currently doing to nurture that part of yourself. If you can’t think of any, leave that space blank. Then, give yourself a rating from 0–6 for how well you are currently nurturing each dimension of the self, with 0 being not at all and 6 being very well.

Once you’ve done this for all 10 dimensions, write down your three strongest and three weakest areas of personal self-care. This will give you a better understanding about which parts of yourself are most nurtured and which parts you most need to focus on in the future.

Every one of us is a complex, multifaceted individual. Our individual identities, or “who we are” as people, are layered in several important ways. At a high level, we all possess a professional self and a personal self, but even the personal self can be subdivided into multiple smaller selves that make up our identity. In order to be fully well, all of these sub-selves must be regularly nourished and maintained. Only then can we feel content, fulfilled, and inspired to do our best work as practitioners.

We hope this article helped you discover some dimensions of yourself you might have never thought about before—and gave you some ideas for how to better sustain them. In Part 5 of our series on Wellness for Care Providers, we’ll dive into one final dimension of the self that we skipped today: the physical self. Until next time!

MHA Bell Seal for Workplace Mental Health: What It Means for Cummins, Now and Moving Forward

At Cummins, we place the highest value on people’s mental health and well-being.

This shouldn’t come as a surprise—after all, we are a provider of behavioral health services. However, our concern doesn’t stop with the individuals and communities we serve. We’re also invested in the health and well-being of our own team members.

Cummins has recently been awarded the 2022 Platinum Bell Seal for Workplace Mental Health from Mental Health America. The Bell Seal is a national employer certification program to recognize companies that prioritize employee mental health and well-being. Our award at the Platinum level—the highest level available—signifies our commitment to creating mentally healthy work environments for our staff.

We know that providers of behavioral health services have difficult jobs. In their daily work, they must support and empathize with individuals who are experiencing extremely challenging life situations. We believe service providers deserve the same amount of support and empathy they give to their consumers, which is why we are so committed to the wellness of our team members. We believe our receipt of the Platinum Bell Seal award stands as validation of our commitment.

Keep reading to learn more about this award and what it means for Cummins Behavioral Health moving forward.

Announcement_Twitter and LinkedIn Platinum

How Cummins Received the Bell Seal

Mental Health America (MHA) is the nation’s leading community-based nonprofit dedicated to addressing the needs of those living with mental illness and to promoting the overall mental health of all. MHA’s efforts are guided by its Before Stage 4 (B4Stage4) philosophy, which holds that mental health conditions should be treated long before reaching the most critical points in the disease process.

MHA has spent decades researching mental health in the workplace, and in 2019, MHA introduced the Bell Seal for Workplace Mental Health to recognize organizations that support employee mental health and well-being. The Bell Seal recognizes employer advances in workplace mental health by awarding Bronze, Silver, Gold, and Platinum recognition levels. The purpose is to help employees identify mentally healthy workplaces as well as guide employers who are committed to creating them.

Cummins is heavily committed to the wellness of all our team members. In order to provide the best quality care to consumers, our staff need to be mentally healthy themselves and have tools for self-care. Therefore, we do our very best to care for the whole employee, both their mental and physical health. With this in mind, we hoped to receive a Bell Seal certification from MHA to demonstrate this commitment to the communities we serve.

As part of the application process, MHA conducted a rigorous evaluation of Cummins’ policies and practices related to employee wellness. Areas of focus included workplace culture, employee growth opportunities, benefits packages, compliance practices, and staff wellness programs.

We believe our receipt of the Bell Seal at the Platinum level is a testament to the wellness-first workplace we have cultivated at Cummins. In particular, we have a strong wellness program in place for our staff, and we acknowledge that there is always room for further improvement for staff wellness. Our vision is to be the provider and employer of choice for mental health services in Indiana, and the Bell Seal award confirms that we’re well on the way toward our goal of cultivating a mentally healthy workplace.

1General Mental Health Promotion_TwitterLinkedIn_Platinum

What the Bell Seal Means for Cummins’ Future

Cummins Behavioral Health recognizes that our industry is currently going through challenging times. Put simply, the need for mental health services in America is greater than what can be provided. Last year, government data showed that an estimated 37% of the national population lived in areas experiencing a shortage of mental health professionals.

The situation was undeniably made worse by the COVID-19 pandemic, and federal, state and local governments have increased funding for mental health services in response. But training and developing new service providers takes time, and meanwhile, many current providers are overworked and struggling with high levels of work-related stress.

Cummins believes that one crucial way we can alleviate this problem is by prioritizing the health and wellness of all mental health service providers. This is one of our primary goals both now and for the future, and we believe the MHA Bell Seal certification will help us to achieve it.

To begin with, we hope this award will demonstrate our commitment to provider wellness to employees and our community at large. In addition, the certification must be renewed every year, which will help us maintain focus on our goal of employee wellness. The annual application process will keep us aware of our strengths and bring to light areas for potential improvement in our wellness programs and initatives.

As we mentioned above, our vision for the future is that community and healthcare partners view Cummins as the provider and employer of choice in central Indiana. The MHA Bell Seal for Workplace Mental Health will be an essential asset for realizing that vision for years to come.

“Cummins’ vision is to be both employer of choice and provider of choice. These are complimentary goals, and one cannot be achieved without achieving the other.” — Amy Mace, CEO of Cummins Behavioral Health Systems, Inc.

You can learn more about MHA and the Bell Seal for Workplace Mental Health by visiting


Wellness for Care Providers: Sustaining the Professional Self

There are certain jobs that carry inherent health risks for the person doing the job. Police officers, fire fighters, construction workers, and military service members are a few jobs that come to mind. But these aren’t the only individuals whose line of work puts them in harm’s way.

Caring professionals like nurses, teachers, social workers and mental health therapists also suffer risks to their well-being because of their work. For caring professionals (also called helping professionals), investing in the physical and emotional health of other people is part of the job description. This is fine when care providers are able to adequately prioritize their own self-care, but that doesn’t always happen in practice.

In previous posts, we’ve explained how insufficient self-care can lead to burnout and why the cycle of caring can make self-care difficult for caring professionals. In this post, we’d like to talk about the professional self—the part of a person that identifies with and is nourished by their work—and how you can sustain your professional self for increased wellness in your work.

We’ll be guided by insights and advice from Ciera Jackson, our Professional Development Specialist here at Cummins.

Ciera Jackson, MSW, LCSW, Professional Development Specialist at Cummins Behavioral Health

The Hazards of Professional Practice

The first topic to consider when discussing professional self-care for care providers are the inherent hazards of practice.

“If you’re a first responder, for instance, you probably expect that there is some kind of risk that you are taking when you sign up for that job,” Ciera explains. “You might not consider that if you’re signing up for social services of some kind. You may consider that it’s an emotional job, but you don’t necessarily consider the word ‘hazard’ associated with social services.”

Nevertheless, there are certain risks to professional wellness that a person implicitly accepts when choosing to work in social services. Ciera identifies the following 8 hazards as some of the most significant:

1. The consumer wants a quick solution, but we can only offer slow success

“They want it now,” Ciera explains. “‘I don’t want to be depressed anymore. I don’t want this anxiety anymore. I want my kids back right now.’ They want it now, and we tell them, ‘You have to put in the work.’ A lot of times, that’s not sufficient for them, especially if they’re in the mode of crisis. They just want it to be fixed because they’re hurting. So sometimes, if you’re not careful, you can end up working harder than them, and that’s something that can’t happen.”

2. Sometimes we aren’t the right person for a particular consumer

“Yes, you may have whatever title you hold, but sometimes you’re not the person for them,” Ciera says. An example might be if a consumer has experienced past trauma and is not comfortable working with a male therapist. In situations like these, you shouldn’t insist that a consumer work with you if you know you aren’t a good fit for them. “If you can get them the help they need with a different person, because maybe in some way you’re a trigger to them, then do that,” Ciera advises.

3. The consumer might not be ready for change

Sometimes a consumer might say they’re ready to change in a moment of crisis, only to lose their interest in doing the work later on. Ciera illustrates, “You’re still trying to offer solutions, and they reject the solutions. So you’re spinning your wheels in mud trying to help them, and they don’t want the help anymore. They’re no longer in action phase; they’re back to pre-contemplation. And you’re working harder than them, and that is something that you should not be doing.”

4. Negative feelings are projected onto us

“Sometimes people will say things to you that are not necessarily about you. They may seem like they’re about you, but they’re not about you. Don’t take it personally,” Ciera says.

5. The inability to say ‘no’

As caring professionals, we might feel obligated to grant every request our consumers or co-workers ask of us. But it’s vital for our own wellness that we turn down unreasonable requests that might damage our well-being. Ciera’s succinct advice is, “Set boundaries.”

6. Regulation, oversight and control by external, often unknown others

Ciera explains, “Sometimes there are higher-ups, things that are outside of our control, administration…Things happen that affect us, that affect our consumers, and we don’t necessarily like it, but we have to go with the flow. And sometimes we have to save face even if we don’t like it. That’s just how it is.”

7. Normative failure

None of us enjoy failure, especially when that failure negatively affects the people we’re trying to help. But because we can’t control every factor in our work, some amount of failure will be inevitable. “Some things are going to hit us hard some days, and other days we’re going to have great days,” Ciera says. Our work requires that we find ways to weather the hard days.

8. Practitioner trauma (emotional and physical)

“If there are times when you feel emotionally or physically unsafe with co-workers or with your consumers, say something,” Ciera urges. “Be sure to always be aware of your surroundings, and be sure to always keep documentation updated so supervisors may know where you are or what consumers you are dealing with.”

The Professional Self: Factors that Sustain vs. Factors that Deplete

When we talk about self-care, it’s common to use the metaphor of a full or empty glass. For caring professionals, the job requires us to “pour out of” our own glasses to fill the glasses of our consumers. If our glass ever becomes empty, then we’ll be unable to continue helping our clients, so we need to find people, places and things that “pour into” our glasses as well.

There are some factors that sustain or “fill up” our professional selves, and others that deplete or “empty” our professional selves. According to Ciera, the following factors are among the most impactful:

1. Finely tuned professional boundaries vs. boundaries that allow for excessive other-care and insufficient self-care

Ciera is quick to stress the importance of professional boundaries for caring professionals. “I cannot say this enough: boundaries, boundaries, boundaries. Professional boundaries are huge. You have to know when to turn it off. You have got to know when to check it at the door.”

Ciera likes to illustrate this point by telling a story of what poor professional boundaries look like:

“My sister is in the same field that we are in, and she used to work at a particular company. She had an on-call phone, and she was always supposed to be available to her clients. I will never forget one particular client. He called, and called, and called, and called, and called. We would be at dinner and that phone would go off; we could have Thanksgiving or Christmas, and that phone would go off. That phone would go off at 3 in the morning. It was the company’s stance that she was supposed to be available to him regardless. She needed to drop what she was doing, answer the phone, and see what he needed. And 9 times out of 10, there was never an emergency. Her position with the company was, ‘We need to teach our clients to be self-sufficient. We need to teach our clients to problem-solve in the case of an emergency.’ And their stance was, ‘We hear you, but you still need to see what he wants.’ So essentially, she had to prioritize him versus prioritizing herself, and ultimately she left because it was not feasible. That depleted her.”

2. Good supervisor support vs. Poor supervisor support

A supportive supervisor or manager can make a big difference when work becomes especially stressful. “It’s helpful when you feel like you can trust your supervisor, and when they can give you sound advice,” Ciera says.

By contrast, poor support can make a stressful situation even worse. Ciera says, “When you don’t have that support, then you feel like you’re out there by yourself. You might wonder: if you make a bad call, are they going to turn their backs on you? Are you going to be the one who ‘takes the fall’ for it?”

3. Humor and playfulness vs. Excessive seriousness

Just because our work is serious doesn’t mean there is no room for humor and playfulness. In fact, a little bit of lightheartedness (when appropriate) can help to counterbalance the often traumatic stories and experiences we witness. “When you enjoy going to work, that can keep you there,” Ciera says.

As Ciera explains, an atmosphere of excessive seriousness sometimes comes from the top down. “When you have a manager, a boss, a leader who’s too rigid, when there’s no wiggle room, when it’s their way or the highway, when they can’t hear anybody except themselves, sometimes that drains you.”

4. Constant focus on professional development vs. Little attention to long-term professional development

Few things are worse for the professional self than the feeling that our career has hit a dead end. It’s important that we frequently think about our next career steps and find ways to continue developing as professionals. Ciera illustrates this point with another story from her own life:

“I remember when I first finished undergrad, and I had an interview at a particular office. It was a great interview, or so I thought. The lady told me right then and there, ‘This is great, but I’m not going to hire you.’ I thought, ‘OK, did I not interview well?’ And she said, ‘I’m not going to hire you because this is not what you really want to do.’ She said, ‘I see you going way beyond here. You would be a great asset here, but you’re not going to really be happy here.’ And I can appreciate her saying that. She said, ‘My goal is to develop people, and if I were to develop you…I’m not even going to start you here. I’m not going to waste your time.’ So when you are a leader, or when you are sitting with your boss or team lead, it is important for you to be listening, or for them to be asking things like, ‘What’s next for you?’ They don’t have to do this every session, but you should have periodic check-ins. You also have to begin to ask yourself, ‘What do I want? Where do I want to go?’ “

5. Tolerance of some ambiguous endings and normative failure vs. Inability to accept any ambiguous endings or normative failure

“A lot of people, no matter what job they’re in, don’t get in it to fail,” Ciera says. “But you’re going to have failures. You’re going to have cases you don’t win. You’re going to have consumers who regress, who end up back in the system. Normalize the failures.”

An ability to accept some failures goes hand-in-hand with the idea of being realistic about your work. “In an ideal world, I’m sure we would have lots of things, but what’s realistic in our here and now? What’s realistic for this client? What is baseline for this client? If you’re expecting people to be perfect and make no mistakes, then that is not realistic,” Ciera explains.

6. Attempting positive closure at the time of professional separation vs. Neglecting the importance of positive closure at the time of professional separation

As we discussed in our previous blog, it’s important for the well-being of both providers and consumers that there’s an appropriate sense of closure at the end of a therapeutic relationship. “If you can have a good closure experience, that is something that will definitely help you throughout your professional career,” Ciera explains.

Ciera also provides an example of how lack of closure can be damaging:

“I had an experience where I was leaving a company, and my supervisor was not happy about it. I was trying to give proper notice, but he said, ‘You can just leave today.’ And instead of letting me end with my clients appropriately, he just shut it down. My clients had my phone number, and they were calling me saying, ‘I’m not working with any other provider.’ Because for them, they didn’t get proper closure. So when you can have a good transition, that is something that sustains the client and you as a professional.”

Self-Care Action Plan Step #3: Assessing Your Professional Self-Care

Last time, we introduced the concept of the Self-Care Action Plan and explained how you can get started creating your own plan. Today we’ll continue by explaining how to assess your level of professional self-care.

To begin, ask yourself: How well am I sustaining my professional self? What specifically am I doing to sustain my professional self?

After a little brainstorming, assess your professional self-care by considering:

  • Is my work meaningful to me?
  • Do I feel a high degree of professional success?
  • Am I able to appreciate the small victories of my work?
  • Am I thinking long-term about my career?
  • Do I have a professional environment where growth is encouraged?
  • Do I receive enough support from my peers and guidance from my supervisors?
  • Am I able to have fun at work in appropriate moments?
  • Do I find ways to keep my work exciting instead of boring?
  • Am I setting appropriate boundaries with my clients and co-workers?
  • Am I able to accept professional failures when they occur?

Based on your answers to these questions, give yourself a rating from 0–6 for how well you are sustaining your professional self, with 0 being not at all and 6 being very well. If you’d like, you can give yourself a rating for each of these questions, then find your average score.

Once you’ve done this, write down your three strongest and three weakest areas of professional self-care. This will give you an idea of which practices you can count on in difficult times, as well as which practices you can work to improve in the future.

Those of us who choose to work in social services do not choose easy careers. In fact, we assume a number of occupational risks when we take on the work. In order to protect ourselves from these risks, it’s important that we find ways to nurture and sustain our professional selves—and minimize our exposure to factors that will “empty our glasses.”

We hope you found this article helpful for your own professional self-care! In the next entry in our series, we’ll cover personal self-care as a caring professional. See you then!