Phase 4: Introduction to Integrity Phase
Integrity means wholeness. The family manifests a genuine change of heart and attitude. The student and family are constantly learning and consistently demonstrating internal control. Individual and family values become part of daily living and decision making. The student displays leadership and is an example to the community around her. The family is sincere in therapy and active in transition planning
1. Earn the Choices and Accountability (4.1), one bead assigned from your therapist, and one of your choice, for a total of three beads.
2. Write what Integrity means to you and share in a community setting. Identify a time when you weren't living with Integrity, as well as a time that you have recently.
3. Discuss your core issue and meaning in a general group. Include what you have done to overcome your ego-defense mechanisms, and what tools you now use instead.
4. Find a quote that is meaningful to you in relation to Integrity. Share what it means to you with your Values Coach, and in a Family Therapy session.
5. Pay attention to examples of Integrity being displayed (with yourself or others) and record them everyday for three weeks.
6. Plan and lead a Rec Therapy task focused on honesty and integrity.
7. Complete the Women's Health Module.
8. Complete the Nutrition Module.
9. Complete School Requirements.
10. Demonstrate through peer feedback (4.2) that the majority of your peers are in favor of you earning Integrity Phase.
11. Demonstrate maturity and insight, and manifest a genuine change of heart. Pass this off through an interview with Treatment Team.
12. Identify 5 ways the parents could reinforce their daughter's core issue, and 5 ways they can reinforce her core meaning.
13. Write what Integrity means to you and share in a family therapy. Identify a time when you weren't living with Integrity, as well as a time that you have recently.
14. Complete one bead assigned by your Therapist.
15. Pay attention to examples of Integrity being displayed (with yourself or others) and record them everyday for three weeks.
16. Each family member re-write their personal prioritized values list (4.3) and definitions.
17. Complete the Value Based Rules and Consequences Worksheets. (4.4)
18. Resolve a problem without the help of your Therapist. Use five principles you've learned at New Haven.
19. As a family begin working on a Relapse Prevention Plan. (4.5)
20. Student explores peer relationships and support systems in family therapy.
21. During your home passes focus on the following as a family:
a. Start researching options for a therapist, school, activities, AA, etc.
b. Hold family community meetings.
c. Plan and carry out a family service project.
d. Have family dinners.
e. Make some changes to your physical surroundings in order to create a new environment.
f. Continue creating/strengthening your support system.
g. Implementation of your family rules and consequences.
h. Plan and carry out a family activity.
22. Parents will review with their Therapist the Home Works© support services.
4.1 | Choices and Accountability Beads
Discuss the principle of personal accountability with your Therapist. Write a one page answer on why we are accountable for our choices, and what accountability has to do with freedom. Share your writings with your Therapist.
Discuss with your Values Coach how the value Choices and Accountability relates to trust. How can you apply this value to your life to be more trustworthy?
Find five articles from the newspaper that deal with tragedies caused by bad decisions. Identify and write down what decisions could have been made to prevent the problems. Then, find five articles that show examples of good decisions. Report to the community about the articles and your conclusions.
Read a biography on a positive, influential, and good person. Write a list of 10 choices that the person made that were helpful in his/her life. Discuss with your Values Coach what you learned, as well as choices you would like to make for your future.
With your therapist, talk about a time when you made a bad decision. What were the consequences you had to deal with? Talk about how you think the situation would have been different if you had made a better decision.
For two weeks choose to control your temper and be accountable for your attitude. Make a plan of how to do this with your Values Coach. At the end of two weeks report to him/her on how you did and how it made you feel.
Look up the definition of Accountability in the dictionary and discuss it with your Values Coach. Then write your own definition of the value Choices and Accountability and discuss whether or not you live by this value, and whether or not you think It is important.
Think of at least two situations where your choice would cause sadness. How would that choice affect your parents, siblings, friends, etc? Write your answers to each on paper and discuss them with your Values Coach.
Ask three staff and two girls what they think about the value Choices and Accountability. Do they live by it? Is it important? How has it impacted their lives? Report your what you learned and your feelings to your Values Coach.
Make goals for the next two weeks on good choices you will make. Discuss your goals at the beginning and at the end of the two weeks with your Values Coach. Write down how you achieved them.
4.2 | Peer Feedback
Integrity means wholeness. The family manifests a genuine change of heart and attitude. The student and family are constantly learning and consistently demonstrating internal control. Individual and family values become part of daily living and decision making. The student displays leadership and is an example to the community around her. The family is sincere in therapy and active in transition planning.
On Integrity Phase the student shows:
- shows she can follow the rules without complaint and without staff direction
- shows she can do chores well and without complaint
- shows she can be open in therapy
- shows she can participate and learn in school and groups
- shows she can take responsibility for her treatment issues by going to uncomfortable places in therapy
- shows she understands her core issues
- shows she can correct inappropriate behavior without justifying it
- shows she can be honest with staff and peers
- shows she can make good choices
- shows she can give feedback respectfully and accept it non- defensively with all people including her family
- shows she can make choices that match her values
- shows positive leadership in the community
- shows internal motivation
- shows respect for those around her by not participating in gossip
4.3 | Personal Values List and Definitions
Each family member re-write their personal prioritized values list and definitions.
Download the following worksheet and identify your 10 values and their definitions.
4.4 | Values - Rules - Consequences
Creating Value-Based Rules and Consequences
At New Haven we believe that happiness comes when one's actions match their beliefs or values. Because of this, we feel that rules should exist to help teach values, and that consequences should directly relate to the rule. The following exercises are designed to help your family create rules and consequences that correspond to your family values.
In Family Therapy make a list of 10 of your basic family rules (It does not have to be 10, use a number that works for your family). After you have decided on the rules, go back and identify what value you feel each rule teaches. Use the Family Rules worksheet to help you.
Now look at both your list of Family Values (2.8) and your Family Rules Worksheet (4.4). While looking at both lists, discuss the following questions:
- Are all of your Family Values epresented in your Family Rules?
- Did your Family Rules help you to identify other Values that are important to your family but are not on your Family Values list?
The goal of this exercise is to help you understand the connection between family values and rules. Rules should exist to teach values. Make changes to these two lists as necessary so that your Family Rules are based on your Family Values. We have included the Value Based Rules Worksheet to help you. The worksheet should include each of your family values, and at least one rule or tradition to teach each value.
In family therapy read together the page Positive and Negative Consequences. Discuss the different types of consequences, and identify which are most effective in your family. Then, as a family come up with at least one consequence for each of your family rules, and identify which type of consequence it is. Record these on the Consequences Worksheet.
The Four Positive Consequences:
- Definition: This privilege or reward is the natural result of the choice.
- Example: I choose to do my homework, I learn something.
- Definition: This privilege or reward is dictated by the situation, and it makes rational sense to everyone involved.
- Example: I choose to do my homework, so I get a good grade.
- Pre - Arranged
- Definition: This privilege or reward is set up before I make the choice. Everyone involved agrees on it whenever possible.
- Example: I choose to do my homework, so I get to go to the mall with my friends.
- Self - Imposed
- Definition: As added incentive not to break a rule, I reward myself.
- Example: I choose to do my homework, so I buy myself a new CD.
The Four Negative Consequences:
- Definition: The consequence is the natural result of the choice.
- Example: I choose not to do my homework, and I am lost during the class discussion the next day.
- Definition: This consequence is dictated by the situation, and it makes rational sense to everyone involved.
- Example: I choose not to do my homework, so I get a bad grade.
- Pre - Arranged
- Definition: This consequence is set up before I make the choice. Everyone agrees on it whenever possible.
- Example: I choose not to do my homework, so I do not get to go out with my friends that weekend.
- Self - Imposed
- Definition: I impose this consequence on myself, as an added incentive for me to not break the rule.
- Example: I choose not to do my homework, so I stay after school and do it in the library.
4.5 | Relapse Prevention Plan
Old habits die hard. Especially in emotionally difficult times, it is easy to resort to reacting in old ways that are comfortable for us. It would be impossibly ideal to think that after we left New Haven/Sunrise, we would be perfect and never relapse into old behaviors. It is important to remember that even if we do slip into an old behavior or pattern, all is not lost. Relapse is a part of recovery and helps us understand how and why we need to continue progressing. When addressed effectively, relapse can be a great learning experience and open doors to greater understanding.
We've created this Relapse Prevention Plan to help your family remember how far you've come, how you did it, how to keep progressing, and how to get back on track when you slip.
Step 1: How far we have come
In family therapy review the progress each family member has made. The more specific you are, the more concrete your plan will be.
- What has changed in the way your family relates to one another?
- How are roles and boundaries different? In what ways do family members feel different?
- How does each person think he/she has changed? How that has helped the entire family?
- Discuss what enabled each person to make the critical changes.
- Identify and list your family's strengths.
- Working together, choose a symbol that will remind everyone of how far you have come.
Step 2: How relapse can happen
- The first step towards a relapse begins with a Trigger. When we are trigger this can lead to Pre-Contemplation.
- In this stage we begin to Imagine or fantasize what our old behavior would be like. We typically begin to have urges to return to old behavior that is unhealthy; we then begin to move to the Contemplation stage.
- This is the stage we begin to think about old behavior and its possibilities. This is typically the time we experience cognitive distortions such as all-or- nothing and black-and- white thinking. As we contemplate relapse we begin to move into the Preparation / Determination / Planning stage of relapse.
- Preparation / Determination / Planning
- We begin to plan ways to create opportunities to return to old behavior. For example, we plan to go to a party where we know we will have opportunities for relapse. We may make detailed plans, such as how to get to the party. Once at the party, we may easily move to the next stage of relapse known as Action.
- We have gone through the process of change which now allows us to act out old behaviors. Examples of these behaviors could be lying to get to the party, drinking, fighting, etc. It is essential if we have gotten to this point and lapsed, that we do not allow ourselves to begin to maintain old behaviors also known as the Maintenance stage.
- We continue to act on old behaviors, such as hanging out with former friends who aren't good for us. Typically, at this point, we will not listen to our healthy support network. We are fully engaged in our former negative behavior(s). We still have many choices still at this stage. Two of the obvious choices are: 1) to continue in a downward spiral by perpetuating old thoughts and behaviors; or 2) we can learn from our relapse and choose to return to healthy behavior.
Step 3: How to prevent relapse
Triggers come in the form of People, Places, Thoughts, and Emotions. Being aware of triggers is vital to the prevention of relapse.
Each member of the family should identify high-risk People that might commonly act as triggers for relapse.
List the People you are most worried about, who may trigger you. For each Person list three things you can utilize to help you deal with that Person in healthy ways. Use a separate sheet of paper if you need more space.
Each family member should identify high-risk Places that might commonly act as triggers for relapse.
List the Places you are most worried about, which may trigger you. For each Place list three things you can utilize to help you deal with that Place in healthy ways. Use a separate sheet of paper if you need more space.
Each family member should identify high-risk Thoughts that might commonly act as triggers for relapse.
List the Thoughts you are most worried about, which may trigger you. For each Thought list three things you can utilize to help you deal with that Thought in healthy ways. Use a separate sheet of paper if you need more space.
Each family member should identify high-risk Emotions that might commonly act as triggers for relapse.
List the Emotions you are most worried about, which may trigger you. For each Emotion list three things you can utilize to help you deal with that Emotion in healthy ways. Use a separate sheet of paper if you need more space.
In this stage you are starting to Imagine / Fantasize / Glorify and this typically occurs after a trigger. This stage is typically known as pre-contemplation. List ideas that come into your mind regarding unhealthy behavior. List ways to prevent glorifying or fantasizing about old behavior.
After you begin to entertain ideas you then move to the stage of Contemplation. Identify common irrational beliefs, cognitive distortions and rationalizations. Identify healthy ways to deal with cognitive distortion.
Preparation / Determination
Once you have begun to contemplate old behaviors this can lead you to the next stage known as Planning / Preparation / Determination. Each of us have common ways we begin to prepare or plan for relapse. List the ways you Prepare/Plan for relapse and ways to counteract/prevent this planning.
Preparation/Planning leads to Action. In the Action stage we lapse, beginning to act out our old unhealthy behaviors. Create a list of unhealthy old behaviors and healthy ways to Prevent/Counteract those Behaviors.
Create a Denial Interruption Plan. If we have begun to act out old behaviors we could also begin to maintain those old behaviors. This stage is known as the Maintenance stage. Here again we have a choice, we can continue in our old behavior and begin a downward spiral or we can learn from it.
Create a denial interruption plan. This plan includes people, places, words etc. That will help you realize the relapse that has occurred and what you and other can do to learn from your relapse rather than continue the downward spiral.
Often we have warning signs that indicate we are vulnerable for relapse or that we have relapsed. It is essential that you teach yourself and your family how to identify these warning signs. They will act as beacons that can guide you back to a healthy lifestyle. They can also act as ways to help your family and peers know when you are in danger. Identify your relapse warning signs. Identify which ones you have the most difficulty combating. Below is a list of warning signs to help get your thinking process started. Make sure to individualize your warnings signs as you refer to the list.
- Lack of confidence / Over Confidence
- Defensiveness / Overreacting
- Isolating / Avoiding
- Daydreaming / Tunnel vision
- Changes in eating or sleeping
- Hopelessness / Helplessness
- Magical thinking
- Unexpected unplanned events
Each family member should identify their Warning Signs of relapse and three ways to counteract those Warning Signs.
List your Warning Signs. For each Warning Sign list three things you can utilize to help you deal with that Warning Sign in healthy ways. Use a separate sheet of paper if you need more space.
Ask one family member and two peers to each identify relapse warning signs they see in you. Ask which behaviors they observe and why they feel these are warning signs.
It is essential when trying to maintain healthy change that we have a plan. This plan also helps us to prevent relapse.
Create a list of constructive, healthy activities that will allow you to continue to maintain the healthy positive change you have made. Some examples are creating a regular exercise program, regular time with family, etc. This list can be one you draw from on a regular basis that will help you maintain the healthy choices you have already made.
Here is a list of things that will help your family prevent relapse. Please complete this list with additional things that you and each family member can do to help protect yourselves against relapse.
- Continue individual therapy with an outpatient therapist.
- Continue family therapy with an outpatient therapist.
- Hold weekly family community meetings.
- Complete an individual goal each month.
- Complete a family goal each month.
- Check in with a staff member each month.
- Return to visit New Haven.
- Carry with you, or display in a prominent place, your family symbol to help remind you of your progress, and your commitment as a family.
Step 4: How to respond when a relapse occurs
Write down a detailed plan of what you will do when relapse occurs. Be sure that this plan includes:
- Each family member's needs and how those needs will be met.
- What each person's role will be in helping to overcome the relapse.
- What your family will do to maintain open communication.
- A review of step one in this plan: What is your family not doing anymore that has contributed to the relapse?
- Think about your family symbol, and discuss what role it will play in helping you recover from your relapse.
- A discussion of what your family has learned from the relapse.
Family Phase Application
Instructions: In order to apply for your next phase, each family member, values coach, and therapist(s) must complete their part. Once each section is complete, the form can be turned in with the student's values binder.
Download the following document to complete the family phase application.