Effects of Loneliness

Exploring the Forms and Effects of Loneliness

In November of 1960 Elvis Presley sang Roy Turk’s lyrics to teenagers through their transistor radios:

Are you lonesome tonight
Do you miss me tonight?
Are you sorry we drifted apart?

-Roy Turk – 1926

The theme was so popular the song was released by popular singers and bands more than seven times…each time becoming a hit.

What is Loneliness?

Human beings are social by nature and need human interaction and connectedness. When people experience adequate levels of human interaction and connectedness, they feel a sense of satisfaction. On the other hand, when people are experiencing inadequate levels of interaction and connectedness, they feel lonely – something’s missing.

Therefore, loneliness is a noticeable difference between people’s desired level of social interaction and the actual level of social interaction. Loneliness is a sense of connection to others who help to satisfy one’s needs. It is the feeling of no one to talk, relate, or share with – even though people are all around. Being with loved ones does not guarantee absence of loneliness.

Loneliness is not synonymous with being alone. People who are alone are by themselves and not with other people. Some people view aloneness as a positive and others see it as negative.

In our society filled with people who communicate primarily with a wide variety of technology, face-to-face social interaction has become less common, feelings of connectedness are rare, and people are lonelier than ever before. Technology can provide a false sense of being connected twenty-four hours a day, seven days a week. This feeling of virtual connection, however, may be deceiving, and people benefit with social face-to-face connections with other people.

People experience loneliness for many different reasons. Most of these reasons are related to feeling a lack of social support and fall into five basic categories:

  1. Life Changes – Loneliness often occurs in the midst of major life changes such as loss of loved ones, moving to a new city, or not being able to work because of an illness or disability. These types of major life changes often discourage people to meet others.
  2. Getting Older – As people age, they experience the death of friends and family and often feel as if they have fewer people who share their life experiences.
  3. Inadequate Social Skills – When people are unable to communicate with others because they have weak social skills, they are at risk for loneliness. A lack of adequate social skills can make it difficult for people to develop and maintain relationships with others.
  4. Personality Characteristics – People often are shy or lack the power of self-esteem to make friends easily, and therefore receive fewer responses to their overtures and less support from other people.
  5. Situational – People often experience loneliness when they are surrounded by people who have different ideas, values and interests. Therefore, when people do not have friends, family members, and acquaintances with whom to share experiences, they perceive themselves to be different, and feel lonely.

Almost everyone will experience loneliness from time to time. Different forms of loneliness exist.

Situational Loneliness –people feel lonely due to a situation or experience. This is a temporary situation.  An example would be moving to a new city where a person does not have any friends and has not made any acquaintances. Even though this situation brings on feelings of loneliness, these feelings will naturally disappear once the person has made new friends. This state of loneliness is usually a transient form of loneliness that changes as the situation or circumstances change.

Chronic Loneliness – This is a form of loneliness that persists over time, regardless of the situation or circumstances. This chronic form of loneliness usually results from having a weak or non-existent support system, a lack of social skills, shyness, and/or low self-confidence. An example would be a person who lacks the self-confidence to initiate conversations when meeting new people, or a person who fears being alone. This type of loneliness often requires the person to take action and build a new set of social skills. A specific type of this loneliness involves people with mental health issues. Even if they have a great support system and are surrounded by those who care, their issues cause them to feel alienated and lonely. They need to see a medical professional if it continues.

As loneliness becomes a bigger problem for people on all levels of society, it is important to distinguish the specific symptoms of loneliness. Because loneliness is an extreme emotional state in which people experience powerful feelings of isolation from others, it is accompanied by a variety of thoughts and feelings. People who are lonely will exhibit many of the following symptoms:

• Crying a lot of the time

• Feeling “hollow” inside

• Feeling alienated from other people

• Feeling as if you are alone, even though you

are surrounded with others

• Feeling as if you are not accepted

• Feeling as if you are not as worthwhile

• Feeling as if you are not loved

• Feeling as if you cannot make friends or build

stronger relationships with acquaintances


• Feeling as if you do not have the same

interests and values as those around you

• Feeling as if you have nobody with whom to

share personal concerns and experiences

• Feeling cutoff or disconnected

• Feeling damaged and unloved

• Feeling empty

• Feeling lost with no direction

• Feeling physical pain akin to a “broken heart”

• Feeling sad


Effects of Loneliness

Negative feelings of loneliness can lead to a variety of other health-related concerns and stress-related conditions including heart disease, high blood pressure and stroke. In addition, loneliness is often related to addiction, various forms of anti-social behavior, disrupted sleep Effects of Loneliness - Coping with Lonelinesspatterns and various mental-health conditions. People experiencing long-term (chronic) form of loneliness are more susceptible to experiencing these wider effects of loneliness. If your participants are experiencing any of these effects, suggest they see a medical professional.

This article was excerpted from Coping with Loneliness
By Ester R.A. Leutenberg and John J. Liptak, EdD

Coping with Chaos in the Twenty-First Century

Chaos and Confusion

Coping with Chaos Workbook and Card DeckExcerpted from Coping with Chaos
By Ester R.A. Leutenberg and John J. Liptak, EdD

Definition of chaos: a state of utter confusion – Complete disorder – a jumble.

One thing that all people can count on in the twenty-first century is living with chaos. Chaos refers to a state of confusion in your life, the experience of random or unpredictable occurrences, and/or a lack of order to your daily life, space and belongings. Chaos can be seen in the many changes in the workplace, cell phones ringing and people constantly beset with interruptions, the barrage of new information flooding into your brain, thousands of choices, new and improved product ideas, new technologies that arrive daily, and new family structures. Often a family member volunteers or is forced to take on a new role such as caregiving. These are just a few of the many ways people are experiencing increased chaos in their lives which leaves them feeling irritated, frustrated, exhausted, angry, overwhelmed and/or confused.

Many people are interested in returning to the days when life was simpler, calmer, more controllable and more predictable. People want their lives to be full of events, people, and things they can predict and count on. Instead, they feel like they are losing their sense of purpose, control and predictability, and the result of these feelings is a sense of exasperation and weariness.

Faced with many choices, loads of information at everyone’s fingertips, and complex technological systems, people seek to establish order and control in their chaotic lives. More than ever before, it is important to understand chaos and attempt to find patterns in the chaos.

This can be seen throughout history:

  • Religion – Various religions have tried to make sense of the world by coming to terms with evil and making sense of a world that seems aimless, violent, and full of random acts and events.
  • Science – The history of science is an ongoing attempt to discover patterns in the physical world and to understand incomprehensible and disorderly events. Scientists usually spend their lives searching for laws and patterns that can be repeated and therefore understood.
  • Mythology – Myths have been handed down through the ages to help cultures make sense of the randomness of events. Myths include parables related to birth, death, journeys to distant lands, magical beasts, mythical heroes and heroines, and gods and goddesses.

People often ask, “Why worry about chaos…there’s nothing you can do about it?” The fact is that people can control the chaos in their lives. It can be quite liberating to realize that chaos, although unsettling, need not be as frustrating as people believe. They can learn to define patterns of chaos and redirect their energies and abilities.

A New Way of Looking at Chaos

The Chaos Theory is one of the best theories for dealing with the chaos in the lives of people. This Chaos Theory was developed in the 1970s when James Gleick and Edward Lorenz found that small changes and fateful events set off patterns that could affect everything in their surroundings. They referred to this as the “butterfly effect” when they observed that a butterfly flapping its wings in China could affect weather patterns in Europe.

Therefore, even though chaos finds its way into the lives of every person, it is critical that people find ways to effectively cope with and overcome the chaos. The Chaos Theory suggests that there is no chaos; rather, there is a pattern and underlying order that can be defined by observing it with the right lens.

There are several ways to embrace and manage chaos:

  • Expect it – In the twenty-first century it is almost impossible to avoid chaos in life. People need to be aware that their plans are likely to be interrupted and changed, and that everything cannot be predicted and controlled.
  • Understand it – By seeing chaos for what it is and accepting and controlling it, people can see chaos as freedom from predictable routines and constraints. Eventually, chaos can be seen as a transition point to a more controlled, calm and satisfying life.
  • See it for what it is – Chaos Theory reminds people that even in chaos one can find distinct, critical life patterns. When people are able to identify the patterns in their lives, they can work to control the chaos and live simpler lives.
  • Control It – Chaos Theory suggests that there is always going to be chaos in the lives of most people. The secret is to be alert to the opportunities chaos brings and find ways of doing one’s best to control it so that it does not negatively affect one’s life.

All people at some point will experience chaos that will come from a wide variety of sources and can cause people to feel frustrated, stressed out and weary. Most people see this chaos as a symptom of the twenty-first century and feel that there is nothing they can do about it. In reality, chaos can be seen for what it is. People can do something about it and control it in their own lives.

The following worksheets will help your clients begin the process of controlling the chaos in their lives. Try them first yourself so you can guide participants through the process.

Click here to download these worksheets.

Problem Solving Styles and Skills

Sharpen Your Problem Solving Skills

Practical Life Skills Workbook Problem Solving StylesExcerpted from Teen Practical Life Skills
By Ester R.A. Leutenberg and John L. Liptak, EdD

There are, in general, four problem-solving styles:

  • Social sensitive thinking
  • Logical thinking
  • Intuitive thinking
  • Practical thinking

A social sensitive thinking problem solving style is one in which you want to find the best answer for all people involved (focusing primarily on their emotions and values, and you are most comfortable when they add emotion to the problem situation.) You depend on what has been successful for you in the past, rather than focusing on the facts of this new issue. You try to put yourself in the other person’s place so that you can identify with the person. You will solve problems based on your value system that respects other people in a situation. You are caring and want to support everyone involved in the problem. This indicates a high level of interpersonal skills.

Here are some indicators that you use the social sensitive thinking style:

  • You are considerate to others in the situation.
  • You are guided by your own personal issues.
  • You are compassionate.
  • You assess the impact of the problem on other people.
  • You want everyone to be satisfied in the situation.
  • Others call you caring and/or compassionate.
  • You always try to treat others fairly.
  • You believe that positive interactions are important in solving problems.

A logical thinking problem solving style involves the exploration of the problem and the effects of your environment. Using this style, you identify the problem that has occurred, explore alternatives in solving the problem, and develop a plan for solving the problem based on information. You carefully weigh the costs and benefits of the various ways to solve the problem. You gather and consider additional information about alternatives and the possible consequences of each alternative. The ultimate solution you find to the problem is based on a logical problem-solving approach.

Here are some indicators that you use the logical thinking style:

  • You are analytical.
  • You look for possible solutions to problems.
  • You rely on your good judgment.
  • You are reasonable.
  • You have good common sense.
  • You want everyone to be treated equally.
  • You develop solutions and then choose the best options.
  • You remove yourself emotionally from the situation.

An intuitive thinking problem solving style is one in which you solve problems based on gut-level reactions. You tend to rely on your internal signals. You identify and choose a solution based on what you feel is the best possible solution for everyone involved. You do not spend a lot of time collecting facts and gathering information before you decide on a solution. This style can be useful when factual data is not available. It is important not to substitute intuition for gathering needed information to solve the problem. You often solve problems based on hunches or your sixth-sense about the problem situation.

Here are some indicators that you use the intuitive thinking style:

  • You consider the future.
  • You communicate creatively.
  • You develop imaginative solutions to problems.
  • You reach solutions quickly, based on your hunches.
  • You look for similarities in other problems you have needed to solve.
  • You need the problem to make sense to you.
  • You are able to see new possibilities.
  • You see the big picture.

A practical thinking problem solving style is one in which you take in information that is clear and real. You want to know what is happening in the situation. You notice what is going on around you, especially the practical realities and facts. You may overlook recurring themes, focusing instead on the concrete issues involved in the situation. You rely on and trust your previous experience in dealing with similar problems.

Here are some indicators that you use the practical thinking style:

  • You stick with it until you find a solution to a problem.
  • You focus on what is really happening.
  • You trust your experience from previous problem situations.
  • You trust facts rather than other people.
  • You are perceptive.
  • You are able to remember specific facts about the problem.
  • You understand ideas through practical applications.
  • You carefully work toward conclusions.

The Problem-Solving Process

There is no simple step-by-step process that will guarantee you a solution to every problem you encounter in your life. The problem-solving process is a search for, and implementation of, the best possible solution for a specific problem. As a problem solver, you will develop your own method for solving problems. One of the best ways of doing this is to try to use the most effective aspects of the four different styles. The following is an outline of how to integrate the four styles in the problem-solving process. Before you begin, write down a problem you are currently struggling with.______________________________________________________. Use this issue when working through the following steps:

Step 1 – Define the problem by using practical thinking characteristics to see the problem situation as it really is. You can do so by answering some of the following questions:

  • What or who caused the problem?
  • Where did it happen?
  • What happened?
  • When did it happen?
  • With whom did it happen?
  • Why did it happen?
  • What was your part in the situation?
  • What was resolved?

Step 2 – Consider the possibilities using intuitive thinking characteristics to brainstorm all possible solutions to the problem. You can do so by answering some of the following questions:

  • What other ways did you look at the problem?
  • What did you learn by information you gathered?
  • What were the connections to the bigger picture?
  • How did the other people fit into this picture?
  • What did you think caused the problem?
  • What were some possible ways to approach the problem?

Step 3 – Weigh the consequences of courses of action to resolve the problem using logical thinking characteristics. You can do so by answering some of the following questions:

  • What were the pros of each option?
  • What were the cons of each option?
  • What do you think would have been the outcomes of each option?
  • What was the result for each person involved?

Step 4 – Weigh the alternatives to each course of action using social sensitive thinking characteristics. You can do so by answering some of the following questions:

  • How did each alternative fit with your values?
  • How were the other people involved in the situation affected?
  • How did each alternative help everyone involved?
  • How did each alternative enhance positive interactions?

Step 5 – Decide which aspects of Steps 1 – 4 will be most effective in solving this problem.

Step 6 – Act on your decision.

Step 7 – Evaluate whether the problem was resolved successfully.

Click here for printable versions of the problem solving activities above, more worksheets, and educational handouts.

Girl-Centered Practice: Transforming Community

See the Girl: Transforming Community Through Girl-Centered Practice


This paper is a collaborative effort between three staff members at the Delores Barr Weaver Policy Center and a faculty member at the University of North Florida written after discussing our collective desire to share the work the Policy Center is doing to engage communities, organizations, and individuals through quality research, community organizing, advocacy, training, and model programming to advance the rights of girls and young women, especially those in the justice system. Our personal and professional identities are tied to partnership and mutuality with girls and young women. We value their lived experiences, knowledge, culture, ethnicity, and language, which aligns with the tenants of Relational-Cultural theory. With this paper, we hope to highlight the need for comprehensive, girl-centered practice to transform communities, share the girl-centered practice model of the Policy Center, and clarify how the constructs of Relational-Cultural theory are used to “See the Girl”. Inderjit Vicky Basra, LMSW, at vbasra@seethegirl.org. Dr. Natalie Arce Indelicato may be contacted at n.indelicato@unf.edu. Vanessa Patino Lydia, MPA may be contacted at vpatinolydia@seethegirl.org. Dr. Lawanda Ravoira may be contacted at lravoira@seethegirl.org.

Over the past two decades, efforts have been made to increase gender-specific services and understand gendered pathways for girls involved in, or at risk for entering into the juvenile justice system; however, there is still significant opportunity for reform. Radical transformation of community and public resources, attitudes, and responses to address the unique psychosocial and educational issues of girls are needed (American Bar Association & National Bar Association, 2001; Bloom & Covington, 2001; Sharp & Simon, 2004; Sherman, 2005). In addition, comprehensive girl-centered practice models grounded in Relational-Cultural theory (RCT) should be adopted. Those place growth fostering relationships and the lived experiences of girls at the center of decision making and advocacy, and offer girls many points of access to needed services along the continuum of involvement with the justice system. In this paper, we discus why comprehensive girl-centered practice models are critical to continued reform, offer an example of a girl-centered practice model grounded in RCT, and illustrate, through sharing several stories, how we are creating growth fostering relationships to transform community as we “See the Girl”.

Click here to download the Delores Barr Weaver Policy Center Girl-Centered Principles

Why Comprehensive Girl-Centered Practice Models are Needed

Researchers, practitioners, and policy makers have begun to acknowledge gender bias within the juvenile justice system and have started to examine the unique needs of girls. Resulting gender specific programming and service delivery models have included acknowledging the unique needs of women and girls, their perspectives, development, and the biased attitudes that prevent or discourage young women from recognizing their potential (Belknap et al., 1997).

While these contributions have significantly advanced the dialogue regarding system reforms, they typically have been translated into single policy or intervention programs, which have not addressed the overarching system practices within or across programs at local and state levels (Ravoira & Patino Lydia, 2013). For example, a policy change may focus on a school suspension, a specific charge, or a dependency issue, rather than seeing the interconnectedness among all aspects of girls’ lived experiences. Ravoira and Patino Lydia (2013) note that this “piecemeal response can result in compartmentalizing the lives of girls with little or no interfacing among the systems charged with providing services and interventions” (p. 300). Another consequence of this approach is that it tends to minimize the importance of mutuality, or connectedness, which is at the core of growth in relationships, particularly for girls and women (Miller, 1997). Without continuity and coordination among multiple points of care, relationships are often short-term interactions with providers rather than the deeper, mutually empowering and growth-fostering relationships that girls need to overcome the disconnections they have faced and continue to face as they navigate multiple systems (Covington, 2007). Additionally, it is important to note that most gender responsive treatment programs or policies do not include the girls or families in the development of the programs and policies that are provided for them, which inevitably leaves them feeling more disconnected and increases the risk for revictimization by the system.

Contextual and sociocultural challenges for girls who are involved in the justice system frequently include poverty, addiction, history of family violence, housing instability, sexual and/or physical abuse, caregivers’ physical and mental health problems, caregivers’ incarceration, and educational failures (Acoca & Dedel, 1998; Patino, Ravoira & Wolf, 2006; Watson & Edelman, 2012; Zahn, Hawkins, Chiancone & Whitworth, 2008). These relational disconnections and violations happen early and often for most girls. Kaplan (1986) discussed the consequences of these types of chronic disconnection including feelings of loss, inhibition to take action, internalized anger, and low self-esteem. Miller and Stiver (1997) also named the consequences of chronic disconnection as the central relational paradox. They wrote:

In the face of repeated experiences of disconnection, we believe people yearn even more for relationships to help with the confused mixture of painful feelings. However, they also become so afraid of engaging with others about their experience that they keep important parts of themselves out of the relationship and develop techniques for staying out of connection. (p. 2)

Not being able to represent oneself authentically can lead to psychological distress, inauthentic expressions of self, and lack of connection with others (Miller & Stiver, 1997). This is similar to situations Gilligan (1982) described for adolescent girls who, when they perceive the threat of loss of connection, lose theoretical “voice” by keeping important thoughts and feelings, either verbally or non-verbally, out of relationships in order to save the relationship. Chronic disconnection can lead to decreased energy, disempowerment, confusion, diminished worth, and turning away from relationships (Jordan & Dooley, 2000). Turning away from relationships can result in feelings of isolation, which has been described as the source of most suffering (Jordan & Hartling, 2002). Further, these disconnections occur in the context of individual, family, and sociocultural experiences (Jordan & Hartling, 2002), which calls for comprehensive intervention at all levels, as well as models of care that allow girls and young women to enter at multiple points along a continuum – from prevention to intervention to system advocacy – in order to have support to navigate the various connections and disconnections in their lives.

Relational-Cultural theory gives a theoretical underpinning for why comprehensive, girl-centered models are needed for continued system reform because it argues that systemic change, along with relationally focused individual intervention, is needed to move girls out of condemned isolation to connection and empowerment. Comstock and colleagues (2008) noted:

RCT complements the multicultural/social justice movement by (a) identifying how contextual and sociocultural challenges impede individuals’ ability to create, sustain, and participate in growth-fostering relationships in therapy and life and (b) illuminating the complexities of human development by offering an expansive examination of the development of relational competencies over the life span (p.279).

Although chronic disconnections can lead to psychological distress, researchers have consistently found that connected relationships predict health and well-being (Meyers, 2000; VanderVoort, 1999). People who have supportive, close relationships with friends, family, and support networks are less vulnerable to negative life events and some physical illnesses than those who have few social ties (Meyers, 2000). Relationships provide the opportunity to develop a positive sense of identity through constructive feedback, meaningful connections, and other people with whom one can work through problems (VanderVoort, 1999). Relationships promote positive and creative growth in addition to protecting us from stress (Jordan, 1992). Relational Cultural theorists argue that growth-fostering relationships, characterized by movement toward mutuality, mutual empathy, and mutual empowerment, are essential for lifelong resilience (Jordan & Hartling, 2002). Hartling (2005) defined resilience as relational rather than a unique, internal quality that is the ability to be tough or resistant to difficult challenges. Therefore, from an RCT perspective, resilience can be nurtured through developing and maintaining growth-fostering relationships. This is a critical perspective when engaging and reengaging with girls who are marginalized.

Delores Barr Weaver Policy Center Girl-Centered Practice Model

Several years ago, I, Lawanda, was to give testimony before the Florida legislature about urgently needed changes in the justice system. On my way to the session, I stopped at a lock up facility to talk with the girls about what they felt needed to change. We sat on gray metal chairs in a small circle. I shared with the girls why I was there and asked each girl what message they would like me to share with members of the Florida House and Senate who had the power to change how girls are treated in the justice system. Maria, an intelligent, thoughtful girl who had spent most of her adolescence locked up simply said:

Ask the adults to be there for us, to do what our parents couldn’t do, be somebody we didn’t have. Be a friend. We don’t have anyone to really talk to. That’s where you can start to help us. Whether we are good or bad, I have no one. And I really try to be good, but I always mess up. See me for who I am, not who you think I am. See me for who I can become.

“Seeing the Girl” is the mission of the Delores Barr Weaver Policy Center. Utilizing Relational-Cultural theory as a framework, along with decades of knowledge and efforts toward advancing the rights of girls involved in, or at risk for entering into, the juvenile justice system, the Policy Center has created a comprehensive, girl-centered practice model to “See the Girl”. We do this by creating and maintaining mutual, growth-fostering relationships with girls, among staff and trainees, and within the community. The Policy Center is unique. The model is grounded in and driven by the voices and lived experiences of girls. All aspects of the Policy Center’s work, from research, service delivery, and training to advocacy efforts to reform the system, is informed by girls and their families, who are considered partners in the work. This is how the Policy Center operationalizes the concept of mutuality and challenges systems to move toward a “power with” versus a “power over” paradigm with regard to girls in the community. Transforming community requires a mutual understanding among all those who are involved in girls’ lives, including families, schools, mental health and medical providers, and the court system.

History and Approach of the Policy Center

The Policy Center is an outgrowth of the Justice for Girls movement that began in Florida in the late 1990s. In response to the need for reform, the Justice for Girls: Blueprint for Action (Ravoira & Miller, 2007) called for comprehensive reform in how Florida responded to girls in the juvenile justice system. The Blueprint stated that girls have a fundamental right to fair and equitable treatment, to freedom from violence and exploitation, to be valued and respected by those who interact with them, to be able to trust the system, and to have a system advocate. It is through these rights, coupled with the RCT framework, that new training and community awareness initiatives, service delivery modalities, changes in public and organizational policy and practices, individual and system level advocacy, and research were initiated. The work is about operationalizing girl-centered principles (see Table 1) that guide our mission and addressing issues that violate girls’ rights. We provide access to a continuum of services and support for girls and young women—starting from prevention through intervention—such as skill-building in elementary schools, girls’ groups in alternative schools and detention, individual counseling, comprehensive care management, and transition services. Although each component of the Policy Center’s girl-centered practice model is outlined separately in Table 2, it is critical to note that, in practice, the programs are interconnected and are continually being informed and updated through feedback from girls engaged with the Policy Center and in response to policies that either support or violate rights of girls within the community and nationally. The model demonstrates the need for comprehensive services to address the fragmented and disconnected experiences girls are facing.

The programming and services at the Policy Center are based on understanding the trends of the local community in incarcerating girls and the needs of girls. We develop an understanding of girls’ needs through listening sessions where we provide space to listen to girls and ask them for their recommendations and what they want others to know. This information is used in our advocacy agenda to educate the community about what girls are experiencing. We partner with girls in every aspect of our work because we believe they are the experts of their life stories and should be partners in making recommendations for system reform, program development, and advocacy efforts. Additionally, we use relational, reflective research practices that include vetting assessments and measures to ensure they are appropriate, strength-based, and help to build connection and relationship with the girls. For example, we measure the strength of the therapeutic relationship, but would not use assessments that include questions that are blaming or do not provide context to understand her experiences.

The girl-centered practice model components have been developed based on the information and insights girls and families share with staff at multiple points along development, implementation, and evaluation of services. For example, girls in the Girl Matters: It’s Elementary program to reduce suspensions and increase social supports share that the most impactful part of their involvement is the relationships they build with the interns. The interns share the great experiences they have working with girls from a girl-centered lens.

When using a therapeutic alliance measure with girls involved in the justice system, preliminary data shows that although there is not always agreement about what needs to be done to improve a situation, the girls report when having a voice in their goals and plans that they feel appreciated and heard. Ninety percent of the girls reported that something had changed in their lives that they feel good about. At the beginning of counseling, girls noted changes in family relationships. As girls continued to attend sessions, they identified positive school related outcomes. With time they named examples of changes about how they saw themselves. Programming staff attributes this emerging pattern to how the therapeutic goals emerge. Initially, meet girls where they are—which is often starting in crisis—and then working to stabilize basic needs and family relationships before moving towards addressing school and other goals. As Basra explained, “We see the therapeutic process at work when the work deepens and the girls’ understanding of who they are shift, as other people reflect back to them their value and worth, even when they make mistakes” (Patino Lydia & Zayets, 2016).

Our qualitative research with girls confirms that they have experienced relational disconnection from individuals and institutional systems. The research also indicated many points of intervention where connections could be strengthened (Patino & Moore, 2015). This information affirms our comprehensive services at multiple points along the system that are grounded in mutual empathy and mutual empowerment, the building blocks for growth fostering relationships (Jordan et al., 1991). Research has shown the mental health benefits of situations where individuals receive support from others as well as situations where benefit is derived from ongoing exchanges of supportive behaviors (Cutrona, 1996). These exchanges are the cornerstone of mutuality in relationships with girls and their families, as well as among staff, at the Policy Center.

Building Internal Staff Supports and Community Partnerships

Among Policy Center staff, mutuality is nurtured through the multidisciplinary team approach to staffing and supervision. Everyone is invested in relational growth with the girls and with one another. Communication about clients and their needs happens daily, and we value the different perspectives that all team members bring. We have found this to be very helpful in growing our collective and individual knowledge base. One of our newest staff members shared that she loves the “we environment” of the Policy Center. In prior work environments, she stated that she felt like she was always on her own and at the Policy Center she feels like she has a whole team supporting her and everyone is invested in the girls’ successes.

The Policy Center recognizes that a key component to implementing the girl-centered principles in practice depends on hiring staff that understands the importance of the Center’s values and their roles in shifting the culture. Our hiring process focuses on connecting with the core values of the staff along with recognizing the skills they bring. Through the questions asked during the interview process, we hope to better understand how a candidate would make choices aligned with the organization’s values. Individuals applying for a position at the Policy Center meet with the hiring supervisor, the CEO/President, the team they will be working with, and with anyone else at the Policy Center who is interested in participating in the interview process. The extended interview process also allows for a relationship to be built and for the individual to better understand the culture of the Policy Center and what it offers the community. In this way, the Policy Center team and the interviewee can see if the Policy Center is the right environment to work together to address the needs of girls.

The Policy Center recognizes that the development of girl-centered tools and ongoing training are critical components to effectively meeting the needs of girls and young women, families, and the community. Ongoing training and professional development is provided for the community, Policy Center staff, and student interns. This helps providers interact with girls in a girl-centered manner, allowing our community to see the girl, not just the behavior. This is especially important when interacting with girls who have often experienced trauma. Experiencing trauma can affect the way a girl or young woman perceives and responds to the world, yet staff members are, at times, ill-equipped to respond in an effective manner. We make significant effort to ensure that our language, trainings, and curriculum do not result in victim blaming. As a way of creating mutuality and shared power, we invite girls to co-facilitate trainings and presentations with us. Many times, presentations are designed with the girls and the girls decide what they would like to present.

Through training undergraduate and graduate interns, we have opportunities to develop mutuality in our relationships, as well as help them build the skills to develop mutual relationships with the girls. Many interns share that they initially work with the girls in elementary school assuming the girls would learn so much from them. In the end, interns share that they learn just as much from the girls as the girls learn from them, which underscores the RCT concept of mutuality in growth fostering relationships.

Addressing Multiple Levels of Advocacy

Relational-Cultural theory acknowledges that chronic disconnection occurs on an individual level, and also, simultaneously, on a cultural and institutional level. Racism, sexism, classism, and heterosexism create social and cultural disconnections and have a direct impact on an individual’s sense of connection and disconnection. Jordan (1997) wrote, “Due to our culture’s handling of difference, through a system of hierarchy and dismissal, major, chronic, and painful disconnections occur around diversity; racism, sexism, heterosexism, classism, and ageism all become forces in creating disconnection rather than connection” (p. 3). Jordan goes on to say that these forces create deeper isolation, withdrawal, fear, and shame. Ultimately, especially for marginalized groups, this leads to chronic disconnection. At the same time, “empathy across difference”, can serve as a catalyst for growth and validation in relationships (Jordan, 1997).

Since chronic disconnection can occur at the cultural and institutional level, the Policy Center is actively engaged in public policy changes that impact the advancement of girls’ rights. Advocacy is provided at the individual, community, and systemic level. On the individual level, advocacy for each girl is provided during participation in multidisciplinary staffing, in court, in school, and during counseling sessions with girls and families/caregivers. Through advocacy we are able to identify the services that are needed and also identify points along the continuum where the system(s) failed to meet girls’ needs. Many of our girls have experienced acute disconnections and advocacy helps them to engage in the systems to rework the acute disconnections and develop more positive relationships. Through all of the work, we bring authenticity with other staff members and with the girls.

On a community level, the care manager advocates on behalf of the girl with juvenile probation officers, the State Attorney’s Office, the Public Defender’s Office, the judge, and community partners to ensure the voices of girls and their families/caregivers are heard in the judicial system. The care manager helps the girls and families navigate the complex legal system and processes, which includes arranging pro-bono legal services when indicated.

The care manager also works with community partners to build a network of care for each girl based on her complex individual needs. Many times these care plans can serve as alternatives to locking girls up as it gives judges other options and a better understanding of the true needs of the girls.

Finally, what we learn from the girls directs the advocacy platform at the local, state, and national level used to develop better public policies, processes and practices informed by the lived experiences of the girls. For example, when girls were being transported within the residential facility, they told us that they had to walk with their hands behind their backs. The young women told us that this was re-traumatizing for them, given the trauma they had experienced in their lives, and that walking with their hands behind their backs increased their feelings of agitation, stress, and hyperawareness. After hearing from the young women, the Policy Center staff shared the concerns with the administrators at the residential facility and, ultimately, the young women were allowed to walk with their hands by their sides. Administrators reported fewer fighting incidents with guards and other residents due to this change in policy.

From development to evaluation, the Policy Center model is centered on our relationship with girls, their voices, and the research that comes from listening to girls and their families. The goal is to “See the Girl” within the context of her family, community and lived experiences.

What it Means to “See the Girl”

From the relational exchange described earlier between Lawanda and Maria, along with the theoretical foundation of RCT, the girl-centered practice of “See the Girl,” seeing the context of girls’ lived experiences, has emerged. It guides the mission to advance the rights of girls in or at risk of juvenile justice system involvement by engaging others as partners in the movement. It requires staying in relationship through various individual and system level disconnections. In Maria’s case, “seeing” her meant looking beyond her behavior to understanding the historical trauma that was part of her unresolved family and personal history. “Seeing the Girl” meant understanding the acute and chronic relational disconnections Maria faced as she navigated unstable living situations, the responsibility of care-taking for her siblings, and addiction. By age fourteen, Maria started selling drugs to get money for places to stay. She was arrested for drug paraphernalia, and while on probation she ran away and received a violation of probation and began the cycle in and out of locked facilities. Maria’s story is the narrative of most of the girls trapped in the justice system. The Policy Center’s research found that at the epicenter of the girls’ stories are the shared experiences of grief, loss, and trauma as well as resilience and longing for connection (Patino Lydia & Moore, 2015).

Tina’s Story 

Like Maria, Tina’s story also helps illustrate the multiple points at which girls can access and receive services. The first time the Policy Center staff met Tina and her mother was during a juvenile justice staffing where her support team was trying to put together an alternative plan so she would not be sent to a commitment program. The Policy Center had no prior connection with Tina but was invited to participate in the meeting as a possible resource for her and her family. The group was made up of juvenile justice staff, including her probation officer, a representative of the school board, her attorney, a case manager, a therapist, and others who had been referred to Tina and her family.

The group started by reviewing Tina’s file and sharing why they were there. When the group facilitator started reviewing Tina’s past traumas and exposure to violence, the facilitator became very detailed in his questions and comments of her lived experience. The level of details that were shared made everyone in the meeting, including Tina and her mother, uncomfortable. Even though this was our first interaction with Tina and we were not very familiar with her story, the Policy Center staff chose to speak up and ask the purpose of going into such detail in the meeting. The staff member reminded everyone that this could re-traumatize Tina. The meeting facilitator shared that this was how these meetings were conducted, with the intent that everyone would know the details and have better options for Tina. Staff commented that they understood this, but did not understand the benefit of going into that level of detail with everyone. After the Policy Center staff member spoke up, the meeting facilitator became less detailed in his descriptions and shifted the way he addressed Tina.

Tina made eye contact with the staff member, her body language shifted, and she seemed more relaxed. Later, when Tina agreed to work with the Policy Center, she shared that she was grateful that we had attended the meeting and that, although she felt herself getting angry, she did not know how to stop the facilitator from continuing to ask intrusive and traumatizing questions.

The Policy Center provided Tina and her family with therapeutic and care management services. The therapist and care manager met with her and her family in their home and at the Policy Center depending on what was most convenient for Tina. The Policy Center staff attended court dates with her and continued to advocate with her, and at times, supported her basic needs such as helping her to purchase clothing, toiletries, and other items for her home. After a year of services, Tina decided she no longer wanted to participate in services with the Policy Center.

We did not hear from her for over a year until a staff member received a collect call from Tina from the local jail. She had been arrested and was being held until her next court date. She was now eighteen and being held in the adult system. The Policy Center staff was present in the courtroom for her next court date. Since she was not presently receiving services, we were not able to approach the judge and advocate for her best interests; however, we were present and let Tina know that the relationship was still available to her. Tina made eye contact with staff when she was brought in front of the judge. Staff listened and, once the judge moved on to the next case, turned around, held Tina’s mother’s hand, gave her a business card, and told her to have Tina contact her if she needed support. The family later shared that based on their interactions with Policy Center staff they trusted the authenticity of the relationship.

All of the choices the Policy Center makes are focused on keeping the relationship with the girl at the center because no matter what we do, if the girl does not trust us, there will not be growth. As illustrated in Tina’s case, our work always includes her family and her community because they are important to her. By creating a model that focuses on the continuity of care for the girl and her family, we continue to enhance our relationships with Tina and her family. The goal is to be present and continue to build the relationship through the inevitable connections and disconnections that occur. The relationship continues to grow because the same people continue to support her regardless of where she is in the system. This is different from other experiences Tina has had, where her juvenile probation officer and/or case manager changed at different points.

Regardless of the program girls participate in or what point along the continuum of services they enter into, we recognize the importance of relational connection in girls’ lives as we coordinate services within multiple systems. We make efforts to divert girls from incarceration, and identify appropriate, girl-centered interventions. The importance of growth fostering relationships to mental well-being is central to the interactions Policy Center staff have with girls and each other. Knowing that disconnection is the source of psychological suffering, Policy Center staff are able to understand and “See the Girl” through the disconnections she has experienced and connections she is driven to establish (Jordan, 1997). Jordan (1991) pointed out that even in relationships that are mutual overall, not every specific interaction is mutual. Therefore, even the most connected relationships will inevitably experience disconnection. Policy Center staff recognizes this inevitability, and contends that disconnections in relationships can serve, depending on the response of both parties, as opportunities for further growth. Policy Center staff recognizes that strategies of disconnection can be authentic experiences and someone can be disconnected from therapy but not from an authentic relationship (e.g., calling therapist while on the run). It takes energy to be connected. From an RCT perspective, if the hurt person is not able to express her feelings or is met with apathy, or disregard of her experience, she will begin to distort herself in order to keep the relationship. In our experience, most girls feel less powerful in most of their relationships; therefore, much of the service delivery component of our work involves establishing mutually empowering relationships, respect, and acknowledging relational disconnections. Counseling and care management focus on discovering and addressing the relational disconnections that often manifest as depression, anxiety, and/or externalizing behaviors such as substance abuse, running away, and aggression. Girls are an integral part of their care planning which focuses on the ability of girls to learn and employ healthy coping mechanisms and skills.

The approach to working with girls and families is relational and contextual, and the benefits of the continuity of care management and therapeutic services can follow a girl regardless of her point of entry. This type of intervention creates incredible opportunities for better understanding of girls’ perceptions about their relationships and how their connections, disconnections, and sense of supports may shift over time.

Ann’s Story

Ann’s story is an example of how relationship building happens over time and occurs in the context of providing comprehensive support and care management. Ann was 16 years old and referred to the Policy Center by her mother and an investigator working with the family. She was very hesitant to reach out and connect with the Policy Center. Ann’s mother was incarcerated, she did not have a relationship with her father, and she did not feel comfortable coming to the Policy Center on her own. Although many appointments were scheduled with the counselor, Ann continued to make excuses for why she could not meet with our staff. The counselor told Ann that she would meet wherever Ann wanted to meet and would support her in any way she needed, including providing bus passes. One day, the counselor received a text from Ann asking, “Do you think you could bring me a bus pass? I have a class at 6:00 pm today and I have no way of getting there. I also tried looking up different bus schedules and different buses, and I am not sure which one to take.” The counselor immediately reached out to her supervisor and shared the text she received. They agreed that providing Ann with bus passes was an important part of building an authentic, trusting relationship. The counselor replied to Ann’s text message by saying that she was in a meeting, but as soon as the meeting was over she would meet Ann and bring a bus pass. Once the counselor arrived at Ann’s house with bus pass and the bus schedule, they sat down and reviewed the possible bus routes. Ann shared that tonight was her first college class and she was very nervous. The counselor explored with her what was making her nervous and they set up a plan to help her through the evening, which included being able to text the counselor when and if things became too overwhelming. The counselor also told Ann that if she did not hear from her that evening, she would check in with her the next day. From that moment on, Ann has been regularly attending her meetings with the counselor and feels supported.

The Policy Center recognizes that relationships are not only built during the counseling session, but by being present when someone needs you the most. Many times we lose clients even before we ever start working with them because we are never able to build mutuality in the relationship. Our clients need to know that they matter to us and that their well-being matters to us. By dropping off the bus pass and spending time to listen to Ann’s concerns, the counselor was able to build a relationship that showed Ann that she mattered. Mutuality is the ability to step outside of the therapeutic “expert” role into the authentic trust building moments of connection. It is the ability to create a work space that gives permission for staff to build a relationship with the girls based on the needs of the girls in that present moment, allowing the girls to be the lead on how fast and when the therapeutic relationship will develop.


There are many girls and families hurting in our communities. The way a community and service providers respond is a critical piece to transformation. When we “See the Girl” as part of the community fabric, it has a lasting impact. Communities are transformed through mutual empathy, as it decreases the experience of isolation and increases the capacity for connectedness (Miller & Stiver, 1997).

Creating and participating in growth-fostering relationships are not only critical to individuals’ psychological well-being and development (Comstock, Hammer, Strentzsch, Cannon, Parsons, & Salazar, 2008), they are essential to creating vital and responsive communities. Growth-fostering relationships are the central building blocks for both individuals and the communities in which they live. Service providers can contribute to community transformation by developing comprehensive care models grounded in Relational-Cultural theory. The Delores Barr Weaver Policy Center has developed a girl-centered model, informed by Relational-Cultural theory. Together, we are creating system reform and transformation in our community through a comprehensive approach to service delivery, research, advocacy, and training for girls who are involved in, or at risk of entering into, the juvenile justice system.

Ultimately, “Seeing the Girl” transforms the community by reducing the number of girls involved in the juvenile justice system, keeping more girls connected to their communities through engagement in social services instead of locking them up, and sending a clear message to girls that they are valued, have power, and play significant roles in our communities. Communities are transformed by the healing power of mutual relationships.


 Delores Barr Weaver Policy Center Girl-Centered Principles

Our mission is guided by girl-centered principles.

·         Acknowledges girls as experts of their lives and relationships.
·         Embraces sitting where the girls sit and seeing what they see.
·         Honors and values girls’ lived experiences, knowledge, culture, ethnicity,and language.
·         Understands health as more than and different from the absence of illness.
·         Emphasizes the importance of girls’ connections (family, friends, schools, and others).
·         Recognizes the dynamic community in which girls live, play, and learn.
·         Focuses on the intersectionality of gender, race/ethnicity, sexual orientation, nationality, age, ability, and education.
·         Uses reflective practice and listening without judging.
·         Ensures that programs are guided by gender relevant theories.
·         Promotes activism and informed advocacy.

Note: Developed with Dr. Barbara Guthrie, RN, PhD, FAAN

Delores Barr Weaver Policy Center Girl-Centered Principles
Community Need Policy Center Response Description
Service Delivery (Prevention) Girl Matters: It’s elementary school-based interventions Services provided in schools to interrupt school disconnection include individual care management and referrals to appropriate resources, groups for girls, mentoring and skill building, and or advocacy within the school system regarding academic and disciplinary matters.
Service Delivery (Prevention) Girls Leadership Council The Council is open to girls, age 12-21, and provides a bi-monthly meeting to promote confidence, leadership, knowledge, and safety.




SAVVY Sister Groups for Girls Groups for girls are intended to increase girls’ knowledge and coping skills to address girls’ pathways into the juvenile justice system. Each topic addresses safety with self, with others, in the program, and in the community. Girls explore both their personal and societal values. Additionally, they learn and practice important skills including communication, building relationships, activism, and team building.
Service Delivery (Intervention) Care Management


Care management includes crisis intervention, individual level advocacy to have access to appropriate resources, monitoring of the quality of services, mentoring, transitional and re-entry services, housing, employment support, school connectedness and re-engagement, and advocacy at multi-disciplinary team (MDT) meetings. This includes helping girls as they transition back to the community and their families. Care managers also help girls and families navigate the legal process, which can include arranging pro-bono legal services when warranted.
Service Delivery (Intervention) Girl-Centered Counseling and Telemental Health Individual and family counseling is provided with girls who are referred due to their juvenile justice involvement (e.g. probation) or risk of involvement. Sessions focus on discovering and dealing with the relational disconnections driving her behavior, which creates difficulties for the girl (internalizing and externalizing behaviors). Girls are part of care planning, which focuses on the ability of girls to articulate coping mechanisms, learn, and employ healthy coping skills.
Research Girl-Centered



Ongoing inclusion of girls’ experiences, recommendations through listening sessions, assessments, and surveys, which inform service delivery, continued research, and advocacy for shifts in public policy.
Training Community-based


Based on research, information shared by girls and community needs, trainings are developed or experts are brought in to train professionals in our community.






The Policy Center is one of the first organizations to collaborate with a local university to develop a continuing education curriculum focused on Girl-Centered Practice and Development of Advocacy skills.
Advocacy System Level


Work with local, state, and national lawmakers and lobbyists to develop policies that advance the rights of girls.
Advocacy Community Level



Care managers advocate on behalf of the girls with probation officers, the State Attorney’s Office, the Public Defender’s Office by increasing awareness of Policy Center practice model and developing a contextual understanding of girls’ behaviors.
Advocacy Individual Level Advocacy


Advocacy for girls provided during multidisciplinary staffing, in court, in school, and with families/caregivers. Care managers also help girls and their families navigate the complex legal system.

Relational-Cultural Theory Series, Previous Articles:

What is Relational-Cultural Theory?
Transforming Community Through Disruptive Empathy
Combining the Neuroscience of Relational-Cultural Theory and Clinical Practice
RCT: The Power of Connection Through Student and Professional Mentorship
RCT: It’s All About the Relationship
Unpacking White Privilege: An Experiment in “Going There” with White Relational-Cultural Practitioners
Integrating Critical Race Theory and Relational-Cultural Theory


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Finding Intellectual Well-Being

Enhancing Your Intellectual Habits

Excerpted from Intellectual Well-Being Workbook
By John D. Liptak, EdD, and Ester R.A. Leutenberg

Finding Intellectual Well-Being

Intellectual Well-Being Workbook

Developing our mental functions can be a challenging task, but you can do this! The following tips will help:

  • Take one step at a time. By working on one behavior at a time, the task of changing your behavior will not feel insurmountable. Because mental functions are so difficult to develop, it is important to start with small mental functions and work slowly to change one at a time. By trying to change more than one behavior at a time, people set themselves up for failure. Keep it simple!
  • Create a support system to help you develop your intellectual functioning. Who can you ask for help and support in modifying your intellectual functions? Choose people with whom you feel comfortable, people who would be helpful in a specific area of your life, and people who know that you are trying to make changes. You don’t have to suffer in silence to successfully develop new, more effective thinking skills. Let people know about your desire to change and allow others to support you.
  • Write everything down. Saying you are going to make changes will not suffice. Working on defined behaviors and writing concrete goals that you set for yourself will help you to be successful.
  • Be persistent in your efforts and do not give up on yourself. Remember that it takes time to change ingrained thinking patterns. Do not expect immediate results. The purpose of setting goals is to help you take smaller steps leading to your overall goal.
  • Be accountable. If during your efforts to make positive changes you slip and go back to old thinking habits, don’t let this stop you. Attempt to learn from your setbacks and use your newfound knowledge to make successful choices to move forward. Monitor your progress.
  • Reward yourself for a job well done. Healthy and meaningful rewards provide you with positive feedback and motivate you to continue in your efforts to develop greater intellectual well-being. Find ways to reward yourself for each job well done.

The following are some ideas to help you broaden your intellectual well-being. Open your mind, avoid rejecting ideas as going too far, or being too outrageous for you. Journaling about these questions will help you refine where you are and where you want to go.

Am I thinking outside the box?

For what problem are you having a difficult time finding a solution?

With whom does this problem occur?

Is this problem at work, in school, in the home, in the community, or somewhere else?

How do you typically solve your problems, or find solutions to your problems?

Who can help you solve this problem?

Is there any reason not to ask this person for help?

Think outside of the box. What are a few possibilities of actions you can take to solve this problem?

Am I open to new ideas?

Do you consider yourself flexible or rigid? Explain.

Do you consider yourself open to new ideas or closed? Explain.

What was a time you were presented with a new idea, refused it, and were so glad?

What was a time you were presented with a new idea, refused it, and were sorry later?

What was a time you were presented with a new idea, immediately open to it, and sorry later?

What was a time you were presented with a new idea, immediately open to it, and it worked out great.

How does this quotation from Edward de Bono relate to you?

Studies have shown that 90% of error in thinking is due to error in perception. If you can change your perception, you can change your emotion and this can lead to new ideas.

Am I using my imagination?

How would you describe your imagination?

In what ways do you use your imagination?

What is an example of a time when you used your imagination and it enhanced your intellectual growth?

How does your imagination help in solving problems?

How do you use your imagination by picturing images in your mind?

What has been a barrier to your using your imagination?

Some tips to help you along the way.

Outside the Box

  • Try to look at a situation or task from a different perspective.
  • Think differently with an open mind and find new ways of functioning creatively.
  • Challenge your assumptions and beliefs. Where did they come from? Just because some things have always been done a certain way does not mean that they must continue to be done that way.
  • Break pre-conceived norms or rules to get ideas or the solutions you need. Try doing something backwards to get a new perspective.
  • Gather a few people together and free-style, brainstorm solutions.


  • When you have ideas, jot them down to avoid forgetting them.
  • Brainstorm for ideas. When brainstorming, state ideas regardless of how different they sound at the time. Write down all ideas and then revisit them at a later time. You can do this by yourself or with partners.
  • Get away from habits and routines. When you do, you will find that the mental habits which are stifling your creativity will disappear.
  • As you daydream, jot down ideas that simply pop into your head. Because your subconscious continues to work while daydreaming, you will generate more creative ideas than when you are concentrating on a task.
  • Keep a piece of paper and pencil by your bedside. If, during the night, a thought pops into your head, write it down and go back to sleep. There might be more!


  • Be creative and try different ways of thinking by engaging in puzzles like crossword puzzles, number puzzles, jigsaw puzzles, etc.
  • Read books that will take you to new worlds. This will allow you to experience sights and sounds that do not exist in your present world. Regardless of the plot of the book, think about new ways that the story could have ended.
  • Think about stores, businesses, and online shops where you interact and how you could improve upon their products, packaging, logo, service, etc. Think about ways (in your mind) that you could envision each working more effectively.
  • Try new hobbies and activities such as learning a new language or researching a country you know nothing about. You will look at the activity from a different perspective.
  • Try a guided imagery CD to help you visualize.

Good luck as you develop true intellectual well-being. Remember that this is a difficult task to master, just as learning to play a Bach toccata or shoot consistent free-throws takes time. Practice, practice, practice and you will be successful.

Stress Management

Stress – A Problem for All Ages

Stress Management Coping With Everyday StressorsStress Management article and exercises excerpted from Optimal Well-Being for Senior Adults, Vol. 1 by Ester R.A. Leutenberg and Kathy A. Khalsa, CPC, OTR/L and Coping with Everyday Stressors  by Ester R.A. Leutenberg and John Liptak, EdD.

We live in a world fraught with stress. Stress has many sources and can bestress  generated from within a person through self-imposed thoughts and feelings, while others stressors come from the environment: Stress is completely age tolerant. Our reactions to stress might be different as we get older, but it is out there waiting to pounce.

Stress generated from within a person ‒ Stress can be self-imposed through low self-esteem, anger, feelings of hopelessness, feelings of helplessness, anxiety, perfectionistic tendencies, jealousy and hostility. For example, people who are perfectionistic often bring stress upon themselves by being too careful and worrying about tasks being perfectly accomplished.

Stress generated from the environment – Stress can be felt from the results of environmental catastrophes such as severe storms, earthquakes, tornadoes, hurricanes, floods and acts of war. For example, people who are trying to rebuild their homes and lives after a hurricane find themselves struggling to meet their most basic needs.

Stress generated from conflicts – Stress can be the result of situations in which people are faced with an incompatibility with people, needs, demands, opportunities or goals. For example, a person who does not get along with a co-worker will experience stress on the job.

Stress generated from daily hassles – Stress can be the result of minor irritating annoyances that occur in daily life. Some of these daily hassles may be losing keys, car breaking down, waiting in long lines at a store, waiting for appointments, and getting stuck in traffic. For example, a person having to sit in traffic going to and coming home from work will experience stress.

Stress generated from economic factors – Stress can be the result of economic factors such as losing money in the stock market, not having enough money in retirement, growing inflation, and amassing too much debt. For example, many people have to work later in life because of a lack of enough money to live on in retirement. People may struggle with overcrowded housing, inadequate heating or air-conditioning, dangerous neighborhoods, etc.

Stress generated from changes in families – Stress can be the results of changes in the family such as parents’ separation, divorce, blended families, loss of loved ones, change in residence, birth of a child, adoption, changes in health of family members, and caring for aging parents. For example, people who are forced to care for aging parents often feel guilt, and are stressed because it takes time away from work and other family obligations.

Stress generated from changes at work – Stress can be the result of changes on a job, loss of work, changes in a role played at work, uncomfortable physical demands in the workplace, a lack of safety, interpersonal demands such as an abrasive supervisor or co-worker, and having too much work to complete. For example, a person who must work with an abrasive supervisor will feel uncomfortable most of the work day. In order to successfully deal with all of the various types of stress, people must find creative ways of coping. The exercises that follow will help you manage your stress and move forward to lead a happy, healthy life.

The stress experienced by seniors is greatly impacted by past lifestyle choices and the tools we have learned to cope with our stress. Stress Management – Past and Present will help clarify those skills that work well and those that do not.

Stress Management – Past and Present

The lessons we learned in our past inform us on how we manage stress now. Answer the following questions in your journal or discuss them with a friend. If you wish, click here to access a printable version of the worksheets.

In your past:

  1. Think back to your childhood. How did the adults in your life manage their stress?
  2. As a child or teenager, how did you manage your stress?
  3. What is a memory from your childhood or teen years when you managed stress in an unhealthy way?
  4. What is a memory from your childhood or teen years when you managed stress in a healthy way?

In the present:

  1. What was one way in the last month that you managed stress?
  2. When you are at home, what is one stress management activity that is immediately accessible?
  3. Who is one person in your life, who can support you in managing stress well?
  4. What is one goal or boundary that you can set to assist you in stress management?

How did the lessons you learned in your past inform how you manage stress now?


Physical Distress Symptoms

How you move and hold your body tells a great deal about your level of stress and physical wellness.  Look at the list of stress symptoms below. Which of these do you exhibit and when do you find yourself experiencing them? In your journal list the symptoms and write about when and with whom you experience them. Write about how you might overcome this. If you wish, click here to access a printable version of the worksheets.

Foot tapping (impatience)

Tight, hunched shoulders (anxiety or frustration)

Tightly folded arms (anger or disappointment)

Sagging shoulders (fatigue)

Biting nails (anxiety or worry)

Frowning forehead (worry or fatigue)

Clenched teeth (stressed)

Biting or Licking Lips (nervousness)

Downturned corners of mouth (disapproval)

What other physical distress symptoms do you exhibit? Write about those as well.


Stress Relief A to Z

Good coping skills are a must to handle the stress we all experience. On the left you will find a list of skills. In your journal write what you would do, following the A to Z pattern. If you wish, click here to access a printable version of the worksheets.

Stress Relief A to Z


Your Own Stress Relief A to Z Suggestions


Avoid negative people. A
Be yourself. B
Change your thought. C
Don’t think you know all the answers. D
Exercise often. E
Feed the birds. F
Give someone a hug. G
Hum a joyful song. H
Invite a friend to dinner. I
Join others when invited. J
Keep a journal. K
Look up at the stars. L
Make duplicate car or house keys. M
NO! Just say it with no excuses. N
Open a door for someone. O
Pet a friendly dog or cat. P
Quit trying to fix other people. Q
Repair things that don’t work properly. R
Stand up and stretch. S
Take a shower. T
Use time wisely. U
Visualize yourself relaxing. V
Walk in the rain. W
X–plore a new idea. X
Yak with a friend. Y
Zoom into a healthy restaurant. Z

To download a digital copy of these stress management worksheets, click here.

Integrating Critical Race Theory and Relational-Cultural Theory

Weaving a Fabric for Transformative Social Justice Learning: Integrating Critical Race and Relational-Cultural Theories

By Cynthia Renee Donner, MSW, LGSW

Critical Race Theory and Relational-Cultural Theory

Critical Race Theory (CRT) emerged in the 1970s in response to changing forms of racial oppression, drawing from earlier movements and philosophers in critical legal studies and radical feminism (Delgado & Stefancic, 2012). Delgado and Stefancic (2012) define CRT as a movement “of activists and scholars interested in studying and transforming the relationship among race, racism, and power” (p. 3). They also state that most social activists agree racism is a common experience, yet difficult to address because of color-blind perceptions of equality that advance white privilege in perceived and real experiences. A prominent base from which CRT evolved is the “social construction thesis” that “holds that race and races are products of social thought and relations” (Delgado & Stefancic, 2012, p. 8).

Relational-Cultural theory (RCT) is a modern psychological theory developed by Jean Baker Miller, and an initial group of scholars—including Judith Jordan, Alexandra Kaplan, Janet Surry, and Irene Stiver through the Stone Center at Wellesley College in Boston (M. Walker, personal communication, March 6, 2017). RCT posits growth-fostering relationships are central to human development (Jordan, 2010). Social justice activists have joined psychotherapists and educators in applying this theory in conjunction with other critical post-modern theories and advances in neuroscience to strategies that promote justice and healing. In particular, RCT examines the oppressive forces and related trauma and social isolation (Jordan, 2010).

CRT is concerned with disparities resulting from forces of structural oppression and was influenced by feminist views on the relationship between power and the social construction of roles and privileges that support patriarchy and domination (Delgado & Stefancic, 2012). These concerns with disparities are also reflected in what Jordan, Frey, Schwartz, and Walker presented on RCT in the June RCT conference that took place at the College of St. Scholastic, Duluth, Minnesota in 2016. CRT examines oppressive social stratification; “it seeks to uncover the mechanism and structures that actually disadvantage people, even those ostensibly designed by institutions to serve the needy” (Ortiz & Jani, 2010, p. 183). Carillo, Hernandez, and Fitch propose that the lived experiences—and understandings of those experiences—leave diverse teachers/learners in a place of “ideological dislocation, in which their interests and passions are neither consistent with Eurocentrically-based curricula nor fit well as acceptable research questions” (Ortiz & Jani, 2010, p. 181). According to Ortiz and Jani (2010), this ideological dislocation is manifest in higher education in in three ways: there is lack of curriculum content that speaks directly to the experiences of students and faculty of color; students frequently lack mentors who can assist them in successfully navigating the learning environment; and having few faculty of color likely affects the overall research agendas of universities. They write: “Racial assumptions become a part of the development of the psyche for members of all groups through internalization, the phase of social construction by which ‘facts’ become a part of the conscious and unconscious” (p. 181).

Jordan (2010) writes that RCT examines the trauma, isolation, and social shame resulting from human disconnection that accompanies forces of oppression. She further poses the basic premise of RCT that justice is served when interpersonal relationships and institutional alignments are grounded in empathy, respect, and mutuality. Both RCT (Walker, 2008) and CRT (Delgado & Stefancic, 2012) consider the role of stories and empathy as significant features of their philosophical dimensions and related practice approaches.

Transforming Community: The Radical Reality of Relationship

The June 2016 RCT conference sparked a unique synergy. People from diverse communities representing many histories of oppression and privilege convened with Jordan and other current leaders in RCT over the three days to listen, share, and reflect. There were heartfelt stories of struggle and transformation, and many individuals reported a renewed strength or clearer vision resulting from the connections made with new people and testimonies during conference sessions and dialogues. It was evident that several presenters and attendees were well steeped in theoretical and/or experiential understanding of oppression and related traumas and disparities from their respective fields of psychotherapy, education, health care, and social activism. But the focus on and practice of RCT over the three days seemed to launch both RCT followers and newcomers into previously uncharted territory rich in meaningful connections that generated substantive qualities of relief, validation, and hope for many in attendance.

Because these kinds of outcomes are not common among professional conferences or circles of learning and action, they merit particular consideration if the desire is to move communities beyond critical analysis to transformative change through shifts in individual and collective consciousness. Through dialogue that adhered to principles of RCT, conference participants demonstrated how the practical application of this theory facilitates growth-fostering relationships among diverse people and deepen engagement among those pursuing transformative change. This has been a significant missing piece in the curriculum and analytical approaches to social justice organizing in the past.

Implications for Social Justice Education

CRT is important to social work education. Like other critical perspectives, it promotes an understanding of racial segregation and the functions of postmodernism that is described by Ortiz and Jani (2010) as a “refusal of positivism, recognition of intersectionality, deconstruction of social constructions, understanding of categorization, and rejection of totalizing categories” (p. 177). In their argument for CRT as a transformational model for teaching diversity, they point out that because race-based ideology is woven into the fabric of the dominant culture, “research methods, theories, and practice techniques taught in social work education rest on the assumptions and values of dominant culture, which, unless subjected to critique, will have questionable applicability to non- Euro-American populations” (p. 182). In a discussion of explicit and implicit curriculum requirements associated with CRT, they further argue that in addition to teaching students about culture they also need to be taught how to “analyze the institutional arrangements of society, assess how they are shaped by dominant cultural assumptions, and recognize how they may disadvantage members of nondominant cultural groups” (p. 189). They conclude by declaring that CRT is a paradigm that calls forth action across all spectrums of social work curriculum with its use of socially conscious indicators, the nature of questions it poses, and the patterns of interaction it promotes can be conceptualized as social work competencies and be concretized into practice behaviors—with some creativity particularly on the part of social work educators.

RCT offers a framework for transformative learning that can be applied across social work curricula (as demonstrated in the June 2016 conference dialogue sessions) to facilitate understanding of CRT in engagement, assessment, planning, and evaluation in a context of growth-fostering relationships. As Ortiz and Jani (2010) assert, “teaching diversity is more complex than trying to attend to the various differences among people in society and the resulting ‘isms’” (p. 190). They further cite the need for students to be prepared to move outside of their prescribed roles and/or comfort zones, and be ready to engage in dialogues that lead to transformative evaluation and outcomes on micro/ mezzo/macro levels. RCT’s foundational principles for cultivating growth-fostering relationships can facilitate integration of CRT learning and development in cognitive, affective, value, and skill dimensions. These principles are grounded in what Jean Baker Miller proposed as Five Good Things which have been described as “Attributes of a growth-fostering relationship: zest, sense of worth, clarity, productivity, and a desire for more connection” (JBTMI, 2017, para. 15). The leading scholars of RCT have contributed research and curriculum in the fields of neuroscience, psychology, social work, education, and social and environmental justice with practice methods that can be integrated into curricular approaches with CRT and other post-modern theories to prepare teachers/learners for the challenges of today’s fragmented world.

At the June conference, Jordan suggested the “social prescription of self-interest” (how we have been socially conditioned to identify with a separate individual self) is a major consideration in examining the isolation that is prevalent among people and in accounting for the increasing disparities along lines of race and class. The separate self that we are conditioned to identify with is constructed along lines of race, class, and gender which creates an isolating fabric of internalized notions of privilege and oppression around our psyche that prevents us from engaging in growth-fostering relationships. Internalizing that isolated separate self is restricting on both cognitive and emotional levels. It requires intentional reflective work to be aware of how these restrictions impact our worldview and relationships. Conscious effort is required to be fully open, empathically present, and responsive with others who are different.

Learning how to connect with others in growth-fostering relationships may be the glue to hold movements together that are focused on transformative justice. People who benefit from or succumb to the dominant individual-centered mindset are not typically invested in transformative social change; and yet they regularly challenge our classroom, professional, and community learning circles. Individuals who expect to be taught what will be on the test, so that they can pass it and receive the degree that will land the desired job are conditioned to do so. The “what’s in it for me” worldview competes with critical thinking to the degree that people adhering to this mindset are not easily motivated beyond personal self-interest to examine the role of structural power and privilege affecting social conditions across micro-mezzo-macro practice fields. The separate individual self-interest orientation combined with privilege that comes with perceived or real socioeconomic status inhibits some people from stepping outside of the comfort zone of conformity and, in the June conference, what Walker called the field of anxiety between right and wrong. CRT suggests that this results from internalized social construction of race and the real socioeconomic benefits afforded people who fit the categorical expectations of white—including behaviors as well as skin colors. Walker further discussed how people are often willing to learn how to talk in politically correct “pseudoempathy” terms (i.e., Minnesota Nice), but not necessarily willing to walk in the field which demands critical curiosity void of judgment and the courage to be vulnerable.

For some the shame of identifying with a privileged group’s discriminatory beliefs or the inability to overcome one or more experiences with oppression is an additional layer of socially prescribed separateness that perpetuates isolation and suppression of voice. As Schwartz and Frey asserted in their presentation at the June conference: “shame is a social emotion,” and too often shaming is a public experience for people in classroom and professional/field encounters. They proposed that learners benefit from a context of mutuality (especially within the dynamics of power in the learning process), and appreciation that their thinking and efforts matter.

The experiences of trauma and shame associated with structural forces of oppression permeate lived experiences of both teachers and learners in a way that influences cognitive understandings of those lived experiences. The socially conditioned orientation toward a separate-self places the challenge of transcending these experiences and related beliefs deep in our individual and collective psyches. Schwartz and Frey went on to state at the conference that we all have “possible selves”— images of who we want/don’t want to be. They suggest that “feedback loops” are a powerful way to learn from and deal with our possible selves and the disconnection in emotional reactions to others’ thoughts and actions—providing the teacher/mentor is grounded in genuine openness to learning and utilizes reflection and support from colleagues.

Jordan cited the importance of relationship in her discussion of relational resilience. She wrote that it is “Movement to a mutually empowering, growth-fostering connection in the face of adverse conditions, traumatic experiences, and alienating sociocultural pressures; the ability to connect, reconnect, and/or resist disconnection. Movement toward empathic mutuality is at the core of relational resilience” (JBTMI, 2017, para. 39).

Implications for Marginalization 

Jordan suggested at the June conference that “closed hearts are taught” through socialization of the separate self in a society where “unacknowledged privilege is embedded in every social structure and system of the U.S. culture”. She further stated that capitalism has woven the fabric of U.S. history since early colonization, and stories of injustice continue as the interconnected threads of oppression have tightened under extreme corporate-capitalist control of global economies and political systems. Banks and Craddock pointed out in their presentation at the conference that “social exclusion and perceived social exclusion can be deadly”. They proposed that the psychological resistance to marginalization and other forms of social pain (e.g. overt and covert microaggressions, stereotype threats, exclusionary policies) is a part of the lived experience of people who occupy our classrooms, community, and professional circles. Pain can be enhanced by the combination of ideological dislocation and human disconnection that compels silence while inducing fear and isolation.

How might more inclusive policies and practices transform organizational and institutional systems if they ensured people coming together were grounded in analytical dimensions of RCT and relational dimensions of CRT? Social work values and guiding principles demand that implicit and explicit curriculum ensures inclusion of experiences and perspectives. As teachers, we have more to learn and can be transformed by students. As teacher-learners we must recognize as Frey stated at the conference that “expertise is fluid” and therefore must “be aware of our own disconnection to emotional reactions” to students and others with different in views or experiences.

Walker suggested in her keynote presentation at the June conference that our “embodied difference—or racialized bias/ narrative” is part of the human experience and yet we seldom acknowledge this in ourselves, much less make it part of our classroom discussions, nor hold each other accountable through institutional or community dialogues. Empathic dialogue is increasingly rare in our sociopolitical realms today, with rancorous debate dominating in public discourse and social media. It seems challenging for most people to actively listen to a speaker or connect interpersonally for any length of time, evidenced by the constant need to ask people to turn their communication devices off during class or professional meetings. Dialogue enables us to make meaning of our stories and experiences. Mutual compassion and genuine empathic listening, unconditional positive regard and courageous curiosity are important elements of dialogue that can take us to deeper levels of understanding. The conference dialogue sessions incorporated these elements, and demonstrated the cognitive and emotional levels of understanding that can be reached toward individual and collective transformation.

Ortiz and Jani (2010) emphasize CRT principles of asking the right questions, focusing on structural transformation, honoring contextual competence, refusing assumptions. Walker in her conference address identified five practical steps for respectful and courageous engagement with each other: Embrace the whole brain, all voices; pause, breathe; question normalcy; learn about people who’ve resisted racialized power systems; and develop a community of allies. Perhaps more focused and deliberate integration of both these approaches in classroom and community learning circles can foster transformative justice. Given the social and interpersonal isolation in current times, a firm base of knowledge and skills for growth-fostering relationships with diverse people is central to social work education. We are social beings, wired for connection; but unfortunately we are dealing with social systems that challenge this core aspect of humanity. Combined, both theoretical paradigms could help us through the struggles of transformative change—CRT for analysis to help us deconstruct oppressive forces and understand the complexity of intersecting systems, and RCT for building growth-fostering relationships into new and better ways of understanding and being with each other and the world.

About the Author

Transforming Community Relational Cultural TheoryPrior to teaching in the Undergraduate Social Work Program at The College of St. Scholastica and being Coordinator of that program delivered at Fond du Lac Tribal Community College, Cynthia Donner worked for over two decades with non-profits in the Duluth, Minnesota area. In merging a life-long passion for social justice with the role of educator, she strives to create spaces and opportunities for people to discover the transformative potential of connecting with and contributing to shared stories. Cynthia Renee Donner may be contacted at Cdonner@css.edu.

Relational-Cultural Theory Series, Previous Articles:

What is Relational-Cultural Theory?
Transforming Community Through Disruptive Empathy
Combining the Neuroscience of Relational-Cultural Theory and Clinical Practice
RCT: The Power of Connection Through Student and Professional Mentorship
RCT: It’s All About the Relationship
Unpacking White Privilege: An Experiment in “Going There” with White Relational-Cultural Practitioners


Delgado, R. and Stefancic, J. (2012). Critical race theory. New York: New York University.

Ortiz, L. and Jani, J. (2010). Critical race theory: A transformational model for teaching diversity. Journal of Social Work Education, 46 (2). Council on Social Work Education.

Jean Baker Miller Training Institute (2017). Glossary of key terms. Retrieved from: https://www.jbmti.org/Our-Work/glossaryrelational-cultural-therapy

Jordan, J. (2010). Relational-Cultural Therapy. Washington, DC: American Psychological Association.

Torres, C. A. (2007). Paulo Freire, education and transformative social justice learning. Retrieved from http://www.ipfp.pt/cdrom/Pain%E9is%20Dial%F3gicos/Painel%20A%20-%20Sociedade%20 Multicultural/carlosalbertotorres.pdf

Sleep Issues: Exercises and Worksheets

Sleep :  Are we getting what we need from the sleep we get

We often hear how important it is to get enough sleep… the right kind of sleep. Even setting the alarm on a cell phone can trigger an electronic lecture. “Join us to learn better sleep habits.” Many of the suggestions we hear make perfect sense for dealing with sleep issues. Go to bed at the same time every night rings true to us. It follows that if we have regular bedtimes we will fall asleep easier. We know our bodies respond to habitual behaviors. We’ve trained them to do so. However, reality steps in and we find it almost impossible to get to bed at the same time every night, let alone get up at the same time each day. Where do we go from here?

sleep issuesThe following material is excerpted from the Coping with Sleep Issues Workbook by Ester R.A. Leutenberg and John Liptak, EdD.

Many people feel that their sleep issues are just a normal part of their everyday life. Sleep issues can be disruptive and leave one feeling tired and sluggish throughout the day. These issues can continue, get worse, and become a sleep disorder.

Identifying and awareness of your sleep issues will help. Things pertaining to your sleep habits that you take for granted may be okay, or they may not be okay. Use the following information to help you document your sleep issues.

If you know or live with someone with sleep problems, send them a link to this blog and ask the person to do the exercises. Even better, interview the person by asking the questions posed below, and writing the answers down.

Your responses will also serve as a guide to take to your medical provider who can guide you to healthier sleep.

Click here for a set of printable worksheets covering the following topics.


My Sleep Issues

Name ______________________________________ Date ______________________

How many of the items below that pertain to you and/or your situation? Describe your experiences in your journal or print out a copy for your use of the worksheet.

While Sleeping …

I am able to recall a frightening nightmare.

I am afraid I will leave the house when I sleepwalk.

I am confused upon waking after I sleep walk.

I am hard to console when I awaken after sleep walking.

I am often sleepy during the day.

I am sweaty and my heart is pounding after a bad dream.

I dream about doing work while I am sleeping.

I awaken out of breath.

I am confused if someone wakes me up.

I awaken feeling frightened.

I engage in aggressive behavior.

I awaken sweating and breathing fast.

I awaken with a dry mouth.

I awaken with a sense of panic.

I awaken with my heart pounding from fear.

I cannot fall back to sleep when I have a nightmare.

I do not respond to others when walking in my sleep.

I feel scared at the end of my dreams

I have difficulty staying asleep.

I often choke or gasp during the night.

I often have headaches in the morning.

I scream and shout.

I snore loudly.

I wake up and sit upright with a look of panic on my face.

I walk around while I am sleeping.

I will often scream while sleepwalking.

My dreams feel like they threaten my safety.

My dreams become more disturbing as they unfold.

My nightmares are so realistic they are scary.

Others say my breathing stops when I am sleeping.


Sleep issues can become worse if not treated. Treatment usually consists of a combination of cognitive-behavioral activities like the ones in this workbook as well as medication. Consult and bring the three pages that you just completed with you to a medical or sleep professional to ensure you are doing everything possible to treat your sleep issues.


My Self-Care Sleep Habits

Sleep habits are often dependent on wellness habits that you display during the day. Think about some of your wellness habits and how they may be negatively affecting your ability to sleep at night. In the chart that follows, write about how you can make positive change in your wellness habits.

Self-Care Habit My Present Self-Care Habits How I Can Take Better Care

Eating habits

I eat a heavy snack an hour before bedtime.


I can take a light snack a few hours before bedtime.


Eating habits



Consistent bedtime rituals






Intake of liquid



Medications/drugs legal or illegal



Nap during the day












Highlight each Self-Care Habit you can change immediately to ensure healthier sleep.


Exercise for Better Sleep

There is a specific correlation between stress and a lack of sleep. Research has shown that exercise is critical in the reduction of stress. Physical activity earlier in the day can be a key factor in your ability to let go of some of the stress and sleep well. Answer the following questions in your journal or print a copy of the worksheet for your use.

  • What types of exercise do you do regularly (jogging, walking, swimming, aerobics, etc.)?
  • How much time do you spend regularly in the activities above?
  • Which types of exercise do you like best? Why
  • Which types of exercise do you like least? Why?
  • What exercise classes would you like to take?
  • What stops you from taking those exercise classes?
  • Are there any team sports that you could join?
  • Why don’t you exercise more? (Be honest!)
  • How can you compensate or overcome the reasons you do not exercise more?


Nutrition Influences of Sleep

Your food habits may have an influence on the amount and restorative power of the sleep you are currently experiencing. Journal about your current food habits, and then identify changes you would be willing to make. Note your current habits about the food group in question, and then identify the changes you want to make.

Proteins (example: milk, eggs, meat, poultry, fish, dried beans, oats, rice, whole-grain bread, whole-grain pasta, cashews, broccoli, peanuts)

Fats (example: butter, cheese, chocolate, pork, bacon, beef, veal, hotdogs, margarine, mayonnaise, canola oil, lunch meats)

Bad carbohydrates (example: sugar, corn syrup, sodas, doughnuts, cookies, cakes, pies,sugary cereals)

Good carbohydrates (example: potatoes, sweet potatoes, fresh fruit, fresh vegetables, corn, oats, wheat, soybeans, black-eyed peas, kidney beans)

Vitamins (example: liver, fresh fruit, fresh vegetables, whole-grain bread, milk, cheese, salmon, tuna, potatoes, poultry, peas, soybeans, whole-grain cereals, seafood, carrots, seeds)

Drinks (example: water, alcohol, coffee, sweetened fruit juices, sodas, hot tea, iced tea, lemonade)


Stress Management for Better Sleep

The relationship between stress and your ability to sleep well has been well documented. People who are experiencing a great deal of stress do not typically sleep well.

Write down the stress management techniques listed below that you will commit to trying.

  • Avoid hot-button
  • Be assertive with others – you have needs and wants too.
  • Breathe deeply.
  • Do not try to control what cannot be controlled.
  • Eat nutritionally.
  • Enjoy life’s simple pleasures.
  • Express your feelings in a safe, effective manner.
  • Focus on the positive.
  • Forgive yourself and others.
  • Journal about your feelings associated with stress.
  • Keep and prioritize a to-do list.
  • Learn how to say “No” when you feel overwhelmed.
  • Look at the big picture of life and see where your issue fits in.
  • Manage your time well so that you have time for yourself.
  • Plan your time effectively.
  • Prepare and accept that unexpected problems will arise.
  • Relax with calming music.
  • Schedule time for Yoga or stretching exercises.
  • Spend less time with people who stress you out, if you can.
  • Take control of your own environment.


Sleep Concerns

People who have sleep problems or disorders often have concerns when retiring for bed because of some of the issues that go along with their sleep patterns. Going to sleep with these concerns, and worrying about falling asleep, can make it more difficult to fall asleep. Sometimes, talking or writing about the issues will help.

In your journal identify three of your concerns associated with your sleep.


Taking Worries and Fear to Bed

We often worry and fear things we cannot control. Read the Serenity Prayer out loud. Make photocopies of it, cut it out, and tape it to your bathroom mirror, by your bedside, or any places where you can easily see it and re-read it.

God grant me the serenity

To accept the things

I cannot change;

Courage to change

the things I can;

And wisdom to

know the difference.


Bed-Time Self-Care

Print out this page. Cut out the tips below that pertain to you, and those you need to remember. Post them in places that you will see them. (bathroom mirror, refrigerator, etc.)

Reduce your liquid intake before bedtime.


Refrain from eating a large meal or snack before bedtime.


Remember that your bedroom is for sleep and intimacy only.


Get at least seven hours of sleep.


Have a bedroom free of and electronic products.


Turn your alarm clock around so that you cannot see it from bed.


Don’t go to bed unless you are sleepy.


Go to sleep and rise at the same time each day – even on weekends.


Avoid watching television shows that are upsetting before bedtime.


If you aren’t asleep in 20 or30 minutes, get out of bed until you are tired.


Keep a comfortable room temperature. Cool, but not cold.


Think positive thoughts as you are falling asleep.


Establish relaxing bedtime rituals.


Maintain a healthy diet.


Consider the things you have to be grateful for as you are going to sleep.


Make sure that your bedroom is quiet.


Review the good things that happened during the day as you get undressed.


Free your mind as you get into bed.


Avoid alcohol before bedtime.


Use caution with sleeping pills that can become addictive.


Do not allow cats or dogs in bed with you no matter how much you love them.


Exercise regularly but not three or four hours before bedtime


If there are noises, use a fan or white noise to block out the sounds.


Avoid stimulants like nicotine and tobacco before bedtime.


Avoid caffeine several hours before bedtime.


Lower the lights a few hours before bedtime


Finish eating anything an hour before bed.


Reduce the number and time of naps during the day.


Make an appointment with a medical professional.


Make an appointment with a sleep professional.



Using Mental Imagery

Mental imagery (or guided imagery) harnesses our brain’s natural tendency to create vivid mental representations of our beliefs, desires, experiences and goals. It’s also a simple, inexpensive, and powerful tool for soothing symptoms and creating positive change. The use of mental imagery has been found useful with some sleepwalkers as well as people with other sleep problems.

Mental imagery is using memories of visual events to project a mental picture in your mind.

An example:

I picture myself at a beach in Delaware where I used to live. When I begin to feel anxious or stressed I can project myself back to that beach and begin to feel relaxed and sleepy. I just close my eyes and picture myself sitting in the sand. I notice how blue the water looks and how white the waves appear as they come in. I imagine walking along the beach looking for seashells. I smell the fresh air and hear the seagulls chirping above. The sun is warm on my body and I feel safe. With each breath I take I imagine breathing in the beautiful, vivid colors that are present. This is my personal paradise.

 Now, write out a pleasant imagery scene that you will like picturing and remembering.

Before going to sleep each evening, you can begin to imagine this scene vividly.


Support for My Sleep Issues

In overcoming any sort of sleep issue, regardless of how minor or severe, support is important, and sometimes critical. Support can come in many different forms and from many individuals in your life. In the following boxes, list people whom you can rely on to suggest healthy lifestyle changes and activities that allow you to have a healthy bedtime sleep.

Make a list in your journal of all those who could support and help you with your sleep issues. Note how you believe that person can help you. Possible supporters could come from medical professionals, sleep issue professionals, family members, friends and acquaintances in the community, people with whom you work at a volunteer job, spiritual sources, or other groups you might know. Print the worksheet for your use if you wish.

Click here to download printable worksheets related to this article.


Racism is Not a Thing of the Past

We like to believe that we have conquered racism. There is no such thing as being pulled over by the police for driving while being brown anymore, right? Click here to read the story about Nubia Escobedo from November 16, 2017.

We all hoped bias against black children in school was gone in the 1960’s.  Not so. The reality is quite different. Read this article in the American Bar Association’s Journal about its impact today.

Racism discussed in the Social Well-Being WorkbookWhen I think of the size of this problem I am overwhelmed into inaction. What can I do…no, what can all of us do about this pervasive issue? Here are some suggestions from Ester Leutenberg and John Liptak from their workbook, Social Well-Being that we can all manage.


  • Become more aware of your own perceptions and biases. Think about your biggest bias when it comes to diversity and whether it is valid for ALL people.
  • Observe and listen when speaking with people from cultures different from your own in order to become more aware of their values, beliefs, customs and feelings.
  • Do not view everyone from the same point of reference. Instead, have empathy and attempt to “put yourself in the shoes” of other people when communicating.
  • Be aware of the differences in the ways that people from various cultures communicate.
  • Meet people from other cultures, take time to learn about them, and share your experiences.


  • Treat everyone the way that you want to be treated.
  • Give equal consideration and understanding of the viewpoints of others, and value those views with equal importance.
  • Be open-minded and non-judgmental when communicating with people from backgrounds different from your own. Think about how you can be more open-minded and non-judgmental.
  • Develop an awareness of how cultural differences make life more exciting. Think about how boring life would be if everyone were the same. Make a plan to experience and explore cultural differences.
  • Allow yourself to experience things that are different from what you are accustomed to.


  • Diversity enriches your life. Think about some of the ways it does.
  • You learn the most from people whose beliefs, perspectives, and experiences are different from yours.
  • Diversity challenges stereotypes, encourages critical thinking, and prepares you for a global society and economy.
  • Diversity prepares you to be a good global citizen who is ready for a complex and pluralistic society.
  • People with different backgrounds, skills and experiences bring new ideas and fresh perspectives to all facets of life and career.

Try these easy suggestions above. They are great starting place for what should be a life-long effort for change.

For a different spin on the issue read this article about white fragility.

Unpacking White Privilege

Unpacking White Privilege: An Experiment in “Going There” with White Relational-Cultural Practitioners

By Lisa Eible, DSW, MSW, LCSW

Transforming Community Relational Cultural TheoryWe were an informal group of educators, social workers, and therapists who felt deeply moved by ongoing race-related violence, and the difficulty in talking about race-related topics, even among RCT practitioners. We formed an informal group to examine our own white privilege and to address race-related issues and have been meeting for the past year and a half. As the poster describes, we are focused on further development of our personal and professional lenses in the application of RCT to racism (interpersonal and systemic). We seek to understand our individual and collective journeys and to further develop Relational-Cultural theoretical constructs related to racism. We expect and plan further work on this topic, as our group work continues. Lisa Eible may be contacted at lmeible@yahoo.com.

From its inception and early beginnings, Relational-Cultural theory (RCT) has been characterized by co-creation. Jean Baker Miller strongly held to the notion that the work itself was “in relation”—that is, ever changing in a context of mutual learning and impact (Miller, 1976). In this rich collaborative tradition, a group of Relational-Cultural practitioners began working together on a personal, professional, and theoretical journey related to racism and white privilege after the 2015 Jean Baker Miller Institute (JBMTI) in response to yet another national race related tragedy—the Charleston, South Carolina church shooting. A call to action developed there for further RCT work specific to issues of racism and white privilege. Miller (1976) cited the importance of a “good conflict”; and authors such as Ayvazian and Daniel Tatum (1994), Daniel Tatum (2004), Jordan (1997), Tatum and Garrick Knaplund (2004), and Walker (2002) addressed racial issues. Our group thought there was another layer of “unpacking the knapsack” of white privilege which needed to be done (McIntosh, 1989).

A call was made for conference attendees and other RCT practitioners who were interested in working on issues of racism.  It was decided that the group would be composed, at least to start, of those who identified as “white”.  We observed, in the group’s conception, a need for “us to work on our own issues” and not place additional stress and expectations on our sisters and brothers of color to help us “get it”.  This was a decision made in love and protection, not with the purpose of exclusion. It was also a place to start, not a forever decision.

Initially, two groups of social workers, therapists and educators from across the United States and Canada were established and began meeting in Fall, 2015, via on-line meeting forums. While all group members identified as “white” and “female”, there were cultural, religious, and sexual orientation differences among group members. The initial goals were to raise each person’s individual awareness of their own privilege and to name how it impacted the lens through which they experienced the world.  The longer-term goals of the group are to contribute to the Relational-Cultural theory literature as it relates to issues of race, diversity, and white privilege, as well as to develop some sort of individual or collective social action agenda.  The two groups combined to form one group after the first series of meetings due to a smaller number of participants at that point, and has continued as such through April 2017.

A closed Facebook group was set up to share information that included materials such as worksheets, journaling, readings and videos (ex. Race—The Power of an Illusion, Wealth: America’s Other Racial Divide). Survey Monkey was used to gather data from the nine participants in the final group. In response to the question, Have you changed as a result of your participation in this group, participants answered:

  • I feel more empowered to speak up on issues of privilege and racism…this group has provided connection and a safe learning place for my continued growth.
  • I am angrier. In a good way.
  • I am more knowledgeable about the history of racism and institutional privilege in the United States and more aware of how it has affected my habitual perceptions.
  • I have become more conscious of my white privilege and have initiated numerous conversations with other white people about white privilege.
  • I speak up in uncomfortable situations, whereas before I would be silent. Even if I don’t think I will change anyone’s viewpoint, I make it known that there are other perspectives.
  • My self-awareness has increased though I know I have to keep learning. I also appreciate the access to resources…. I use and will continue to use these resources to expose others in my community. I see it as my responsibility to educate other white people.

In response to the question, “What was your biggest learning/takeaway from this experience/group dialogue,” they replied:

  • I still have a long way to go with my understanding of privilege. This process is a marathon not a sprint.
  • I was once again struck by the importance of taking time for the growth process to unfold, and to continue to hold the responsibility for learning rather than looking outward to people of color to educate me.
  • How helpful it is to have an ongoing white affinity group to learn with.
  • That I have the option to deal or not deal with racism and privilege, whereas others are confronted with it daily.
  • We are all uncomfortable and will all make mistakes (embrace and acknowledge the mistakes).
  • I would say becoming sensitized to the pervasiveness of my privilege. Once your eyes are open, it’s impossible to “unsee” things. And the group has given me courage to act.
  • Hearing the complexity with which some of my colleagues describe their own growth in this area has helped me grow too.

When asked about their experiences and observations, they cited scheduling and technology issues as well as the emotional nature of the interactions. One participant seemed to summarize the emotional impact: Several group members noted that the group provided support in tolerating the shame about unacknowledged privilege, opening participants up to greater consciousness and action.

Since the initial series of meetings, the group has continued to meet, and further published work is anticipated and planned. Our group members include: Christina Borel (christina.borel@gmail.com), Denise Dojka (dmdojka@comcast.net), Lisa Eible (lmeible@yahoo.com), Shannon Finn (finnshannon@hotmail.com), Lisa Frey (Melissa.Frey-1@ou.edu), Catie Green (cagreene@email.wm.edu), Lynne Lieberman (llieberman@comcast.com), Betsy Nordell (bnordell@wellesley.edu), Audra Sbarra (as455@nyu.edu), Harriet Schwartz (harrietschwartz14@gmail.com), Erica Seidel (drericaseidel@gmail.com), and Gail Walker (GW8215724@aol.com).


Ayvazian, A. & Daniel Tatum, B. (1994). Women, race and racism: A dialogue in black and  white. Boston: Wellesley Centers for Women Publications.

Daniel Tatum, B. (2004). Racial identity development and Relational Theory: The case of black women in white communities. Boston: Wellesley Centers for Women Publications.

Jordan, J.V. (1997). Women’s growth in diversity: More writings from the Stone Center. New York: Guilford Press.

McIntosh, P. (1989, July/August). White privilege: Unpacking the invisible knapsack. In Peace  and Freedom Magazine (10-12).

Miller, J. B. (1976). Toward a new psychology of women.  Boston: Beacon Press.

Tatum, B. & Garrick Knaplund, E. (2004). Outside the circle? The relational implication for white women working against racism. Boston: Wellesley Centers for Women Publications.

Walker, M. (2002). How therapy helps when culture hurts. Boston: Wellesley Centers for  Women Publications.

Relational-Cultural Theory Series, Previous Articles:

What is Relational-Cultural Theory?
Transforming Community Through Disruptive Empathy
Combining the Neuroscience of Relational-Cultural Theory and Clinical Practice
RCT: The Power of Connection Through Student and Professional Mentorship
RCT: It’s All About the Relationship

LAUGH! Using Humor as a Stress Management Tool

Laugh laugh laugh laugh laugh…

Don't Get Mad Get Funny - Laugh

Expressions such as, “Oh, just laugh it off” or “Don’t be such a sour puss” don’t make me smile. They make me more annoyed than I was before someone tried to lighten my load. Furthermore, I often snap back with something pithy such as, “Great! What other trite expression can you offer?” Not helpful to anyone. Leigh Anne Jasheway in Don’t Get Mad Get Funny offers a path to find healthy laughter that actually works.  The following is excerpted from her book.

Finding Your Funnybone

Before you can begin to use humor as a stress management tool, you need to understand some things about your sense of humor and your ability and willingness to smile, giggle, or laugh so hard it hurts. Everyone has a different sense of humor and unless you are attuned to yours, you will end up missing many opportunities to use your humor skills to deal with life’s little unexpected miseries.

A recent study reported that the average American five-year-old child laughs out loud around four hundred times a day, while the average adult laughs out loud only fifteen. Young children are truly hedonistic – when something is no longer fun, they stop doing it. We adults call that a short attention span.

A boy laughs while readingReaching adulthood does require a degree of buckling down and getting serious. Let’s face it – there are things we have to do whether we want to or not. But so many of us have lost the sheer capacity for fun, joy, and laughter that even when we have the opportunity, we miss it.

Many adults face a debilitating disease that has never been medically diagnosed: humor impairment. Humor impairment is the inability to find humor even in situations that are funny to most other people. My personal term for this state is constipation, because if you can’t release your emotions through laughter, you emotional and spiritual systems are “backed up”.

Your level of humor constipation is often a result of the environment in which you grew up. If laughter was always present in your family, your ability and willingness to laugh with others is probably great. On the other hand, if, like me, you grew up in a family where laughter was frowned upon, you will probably find it more difficult to express humor in front of others.

But, as with any other behavior, you can change. I grew up in a family where expressing any type of emotion was seen as a sign of immaturity. As a result, I was a most serious child, preferring Edgar Allen Poe and Sylvia Plath to the daily comics. I married a man who believed that neither laughter nor tears were acceptable or desirable. Today, however, I make my living teaching laughter and comedy and performing as a stand-up comic. My background has truly taught me how bleak and unhealthy a life without humor can be. (By the way, I still love Edgar Allen Poe and Sylvia Plath, but now they rub shoulders on my bookshelves with books by Dave Barry and Rita Rudner.)

Take this short quiz to determine how willing and able you are to laugh at life and its foibles.

Your Laughter Profile

  1. During an average day, I laugh out loud, snicker or giggle:
    1. Once or not at all
    2. Two or three times
    3. At least once an hour
    4. Constantly, I’m under medication
  2. When I am alone and read, see, hear, or think something funny, I:
    1. Smile to myself
    2. Laugh out loud, but look around to see if anyone saw me
    3. Laugh out loud and find someone with whom to share the funny thing
    4. Take a cold shower
  3. In the past year, I can remember:
    1. At least one time I spent at least a whole minute laughing
    2. At least two to five times I spent at least a whole minute laughing
    3. More than five times I spent at least a whole minute laughing
    4. I can’t remember – what was the question?
  4. When I’m around other people, they laugh and joke:
    1. Never
    2. Sometimes
    3. Often
    4. I never hang around other people, they might laugh at me!
  5. When faced with daily crisis (the dog peed on the rug, I missed the project deadline again, my daughter needs brownies for school NOW!) I respond with a laugh:
    1. Never
    2. Sometimes
    3. Often
    4. Only if it’s someone else’s rug, deadline, or child
  6. I do things intentionally to make myself laugh:
    1. Never
    2. Sometimes
    3. Often
    4. That might hurt!
  7. The people I spend most of my time with:
    1. Leave me feeling drained and depressed
    2. Don’t really affect my attitude
    3. Make me laugh a lot
    4. Usually steal my lunch money
  8. I can name:
    1. One thing that almost always makes me laugh
    2. Two things that almost always make me laugh
    3. At least three things that almost always makes me laugh
    4. My closest relatives
  9. I laugh at myself:
    1. Never
    2. Sometimes
    3. Often
    4. Only when I’m not in the room
  10. I do silly things on purpose (wear strange buttons, make funny noises, and do things to see how others will respond):
    1. Never
    2. Sometimes
    3. Often
    4. No one ever notices
  11. When I hear people laughing at work, the first thing I think is:
    1. I wish I could get paid to goof off
    2. I wish I knew what the joke is
    3. How wonderful that they’re having a good time, I think I’ll join them
    4. That it’s Saturday and I shouldn’t even be here

How to score your laughter profile

Give yourself the following points for each letter: a=0 b=1 c=2 d=3. Then add them up to obtain your total score.

If your score is less than 5, you are suffering from humor malnutrition. Someone probably told you “Grow up, get serious!” and you did. In order for you to find the humor in daily events, you will have to start slowly – first by convincing yourself that humor is an acceptable emotion and one that is healthy when used regularly.

If your score is from 6 to 15, you occasionally have a good laugh, but your life lacks humor regularity. Remember, laughter is like exercise – you have to do it regularly to get the full benefit. Use it or lose it! You’re good at expressing humor when you find things funny, but your goal now is to try to find humor in those things that usually make you angry, annoyed, or irritated.

If your score is from 16 to 20, you are humorously fit! Not only do you approach life with the right amount of humor and benefit from it, you also probably make other people’s lives more enjoyable. You should become a friend and role model for people around you who need the healing power of humor yet who don’t seem to be able to use it in their lives.

If your score is from 21 to 33, you’re downright silly, aren’t you? Don’t stifle those childish instincts! Sure they told you in school that the class clown would never go anywhere in life. But they were wrong! Look at Chris Rock! He’s taking it to the bank.

Click here for a printable version.

Your Humor Compass: Where do you find the funny in life?

Friends laugh togetherNow that you have a better idea of your ability and willingness to use humor on a daily basis, it is important to understand the kinds of things that you find funny. After all, just as our taste in food or art varies, so does our taste in what is and is not funny to us.

An important note here: You do not necessarily have to laugh out loud to find something funny. One of my best friends and I went to a movie together a few years ago. I laughed so hard I couldn’t see through the tears. She sat there quietly. Afterwards, she said the movie was one of the funniest she had seen in years.

Ask yourself the following questions to determine the types of humor that you will be able to use to most effectively manage your stress.

  • Do you laugh more at the physical or slapstick humor you find in the Three Stooges, I Love Lucy, Perfect Strangers, and The Mask, or do you prefer verbal humor, or do you enjoy both?
  • Do you have a strong sense of humor ethics? In other words, do you find certain specific types of jokes to be offensive rather than funny?
    It is important for you to understand the types of humor that distress you rather than tickle you. They may include stereotypical jokes, put-downs, or humor about certain subjects that are too close to your heart for you to find them fanny at present.
  • Do you like jokes that focus on things you have in common with the comedian?
    Studies indicate that many people do prefer humor that speaks to their own personal experience, which means that we often prefer comedy from people who are similar in age, race, or gender.|
  • Do you like topical humor, jokes that build on current events?
    Late night humorists are scheduled to appear on television after the news to help people cope with the negative images painted during the evening newscast. If this type of humor is appealing to you, you can try, yourself, to find humor in your local newspaper and nightly news report.
  • Do you like wordplay and puns?
    An interesting thing that I have discovered is that different types of humor appear to be more or less popular in different parts of the United States. When teaching humor classes, I have noted, for example, that people from the Midwest tend to enjoy the humor of puns more than people from other areas of the country.
  • Do you prefer humor that stands on its own, or do you like props and gimmicks?
    Some people find Gallagher extremely funny (for those of you who don’t know, he’s the guy famous for smashing watermelons on stage). Others think he’s just silly.
  • Do you regularly find humor in things that aren’t necessarily meant to be funny?
    For example, do you make jokes about commercials, billboards, medical forms, or warning labels on food packages?

Answering these questions for yourself will help you identify the types of humor to seek out, as well as the types of humor you yourself may attempt in order to reduce your stress and have more fun in life.

Mental Health Issues: Erasing the Stigma

Erasing the Stigma of Mental Health Issues

Managing Intense Anxiety WorkbookExcerpted from Managing Intense Anxiety Workbook
By Ester R.A. Leutenberg and John J. Liptak, EdD

Mental health stigma can be divided into two types. Social stigma is characterized by prejudicial attitudes and discriminating behavior directed towards individuals with mental health issues. Perceived stigma is the internalizing by the people with mental health issues of their understanding of discrimination.

The following worksheets will help you learn to change the stigma of mental health issues and deal with their impact in a more effective way. Click here for a printable version.

The Stigma of Mental Health Issues

People who experience mental health issues in their lives are prone to reoccurring symptoms. When this happens, they often have a stigma placed on them by other people. Often the stigma attached to this issue stops one from moving forward—being unable to talk about it for fear of being judged or labeled. We can erase the stigma of any mental health issues by starting to discuss it with one person at a time, and taking the time to explain the anxiety you lived through in the past.

Let’s start with people with whom you have already shared your story.

With whom have you discussed your issues?


What did you say? What was this person’s reaction? What did the person say?


How did you feel?








People in your community or your house of worship








If any one of the above reacted in a negative way, to what do you attribute that reaction?






If we stamp out the stigma attached to mental health issues, shed the shame and eliminate the fear, then we open the door for people to speak freely about what they are feeling and thinking.

~ Jaletta Albright Desmond

Journal about what this quotation means to you. How can you do your part to erase the stigma of mental illness.

Glenn Close said, “The most powerful way to change someone’s view is to meet them … People who do come out and talk about mental illness, that’s when healing can really begin. You can lead a productive life.

Name a time when you have changed someone else’s view – about anything.




How did that feel to you?






Name a time you were tempted to talk about your anxiety issues, but didn’t? Why not?






Write about a situation in which you talked about your anxiety issues.







How did that feel? How did it work out?






Who is a trusted person you can talk with and begin to heal? Anyone else?




Who is a trusted person you can ask for a referral of someone to talk with in order to begin to heal




Anyone else? In an ideal world, how can you lead a more stable life?






How can you contribute to changing stigma?






Ways I Am Treated

Think about some of the ways that people treat you because of the symptoms you show due to your mental illness. In the spaces below, write about those who treat you unfairly and why.

I am criticized by my family and/or friends …






I am ignored by my family and/or friends …






I encounter problems at work …






I encounter problems at home …






I am subjected to teasing or harassment …






I am laughed at …






I treat myself unfairly by …






I treat myself fairly by …






The Stigma of Going to a Mental Health Therapist 

Many people have pre-conceived ideas about anyone seeking therapy.

Do you know of anyone who has gone to a mental health therapist? Write what you know about

the experience. ______________________________________________________________________










Here are some facts about mental health and mental health therapy.

  • Mental health includes how you act, feel, and think in different situations.
  • Mental health problems can be caused by many different things including medical health issues, abuse (emotional, physical, verbal, sexual), stress, worry, loss of a relationship, food issues, ADHD, STD’s, family changes, addictions, traumatic event, problems, wanting to build up self-confidence, etc.
  • If someone goes to a mental health therapist, this does NOT mean the person is crazy. Mental health therapists treat people the same as any other medical doctor treats problems.
  • There needs to be a good connection between you and the therapist. Your therapist should be someone you feel you can trust.
  • This might take a few meetings and/or a few therapists, to find the right one for you.
  • Non-judgmental people who truly care about you will not judge you in a negative way. They will be proud of you for seeking help.
  • The therapist does not assume that you have a mental illness. The therapist assumes something is troubling you, knows that no one leads a perfect life, and admires you for trying to make changes in your life.
  • The therapist’s job is to help you understand what’s going on.
  • The therapist will not tell you how to live your life, or how to think, act, or believe.
  • The therapist is not an advice-giver, but will help you think about how to increase your quality of life.
  • The therapist may have some thoughts, and with you, will help you make changes.
  • The therapist can help you to increase your life management skills.
  • The therapist will help you recognize and express your feelings in a healthy way.
  • The only person who can “fix” your problems is you, but a therapist will help you with an action plan.
  • The mental health therapist may suggest that you see a medical doctor for medication.
  • Therapy can be a slow or long process. Being open and honest, and wanting to feel better, will make the difference.

Place an X by the facts that you were not aware of.

What are your concerns about talking with a mental health therapist?_ __________________________








After learning about these facts, consider making a commitment to speak with a counselor or therapist.

National Military Appreciation Month

May is National Military Appreciation Month

Excerpted from Veterans: Surviving and thriving after trauma
By Ester R.A. Leutenberg and Carol Butler, MS Ed, RN, C

Forward by John Sippola, LTC, ret., MDiv

Veterans front coverDeclared by Congress in 1999, May was selected National Military Appreciation Month as a month-long observance honoring the sacrifices of the United States Armed Forces.  There are more military related observances during the month of May than any other month, so it is an appropriate time to celebrate the men and women in uniform.  During May, we recognize Loyalty Day, VE Day (the end of World War II in Europe on May 8, 1945), Armed Forces Day, Military Spouses Day and Memorial Day.

War casts a long shadow. For far too many service members and their families, the initial expressions of welcome, joy and relief are soon overshadowed by hidden wounds to mind, body and spirit. Too many veterans find they are engaged in yet another desperate battle. And, in this hidden war after the war they discover enemies they feel ill-equipped to fight. Aftershocks of war-related trauma and dangerous undertows of depression sabotage their mission for a more satisfying life in community. Moral injury drowns the quest for inner peace, and substance abuse undermines hard-won gains.

Initially, homecoming is happiness, applause and affection, but reintegration to daily life does not resume as they knew it. Veterans, their partners and families have changed. The labor market may not welcome their skills; their finances may plunge. Statistics show alarmingly high suicide and unemployment rates.

Help abounds via the Department of Veterans’ Affairs, Department of Defense, Wounded Warrior Project and numerous governmental and private agencies. Many veterans are reluctant to seek assistance due to the perceived stigma of asking for help; others are too overwhelmed, unaware of available resources, or receive little or no help for other reasons.

As more veterans return from combat, society is increasingly aware of their needs. They will be directed toward professional and spiritual counselors. Veterans differ from other abuse survivors; they have seen atrocities and experienced horrors most civilians cannot comprehend. Their intelligence, determination and resilience that served our country are now needed to save themselves, to heal their invisible and visible wounds.

One of the issues Veterans face is how to problem solve when they are overwhelmed with problems. They often need help finding a way to break their difficulties down to something manageable. The exercise, Problems Can Be Opportunities, will help them discover a way to prioritize their issues and work through a solution…a solution that works for them. A facilitator’s guide is supplied here.

A downloadable version of the exercise “Problems Can Be Opportunities” is found here.


RCT: It’s All About the Relationship

Relational-Cultural Theory Series, Previous Articles:

What is Relational-Cultural Theory?
Transforming Community Through Disruptive Empathy
Combining the Neuroscience of Relational-Cultural Theory and Clinical Practice
RCT: The Power of Connection Through Student and Professional Mentorship


It’s All About the Relationship

By Julie Kim, MSW, LICSW 

Transforming Community Relational Cultural TheoryFrom: Transforming Community: Stories of connection through the lens of Relational-Cultural theory

Edited by: Connie Gunderson, PhD, LISW, Dorothy Graff, PhD, LICSW, & Karen Craddock, PhD, EdM

As a student counselor with Health Services at the University of Minnesota, Duluth, I am sharing a personal story relating insights and experiences about surviving systems of oppression to living. Learning about Relationship-Cultural theory (RCT) clarifies the impacts of racism and oppression and helps people of color move from survival and isolation to building a foundation to live a meaningful life. RCT reflects my values, validates my personal experiences, and has taught me about the power of connection and healing. Julie Kim may be contacted at juliek@d.umn.edu.

“It’s all about the relationship” is a phrase Connie Gunderson says quite often. It couldn’t be more true, as I reflect on my life journey so far. Relational-Cultural theory (RCT), developed by the work of Jean Baker Miller, identifies the concept of chronic disconnection, a disconnection which promotes condemned isolation to such a degree that relationships are feared and persons have a sense they do not deserve loving relationships filled with understanding.

As a Korean girl, adopted at a young age into a white family, and growing up in a predominantly white community, I began my journey into condemned isolation. Being told daily that I didn’t belong, I wasn’t wanted, and I needed to go back to my country was reinforced through people’s attitudes and by systems I was involved in every day. Always feeling a sense of being left out, of being different, I was a label of ridicule, especially because of my appearance. Hearing comments such as: “Chink, you would be cute if your eyes were bigger. Can you see out of your eyes?” was a normal occurrence. I experienced an additional sense of condemned isolation because, since I was not fully Korean, I didn’t fit into the American culture and I did not belong in my home country. “Where do I belong?” and “Where do I fit in?” were common questions that continued until I reached my early 30s.

Learning about racism and beginning to understand the personal consequences of racism turned my world into wonder, curiosity, and the unknown. “What am I supposed to do with this information?”, and “Will it change my life?” At the time I remember thinking: “It was never my fault.” This was a defining message that promoted internal change. I began to seek people who would support me for the way I looked; who understood my life experience; and who accepted my authentic self; an authentic self no longer ruled by fear, people’s glares, or by people asking me personal questions about whether or not I was a “foreigner”, or why I was in the United States.

Living authentically didn’t come easy at first. I constantly questioned myself about whether or not my perceptions and ideas were valid. However, as I moved into deeper questions and reflections, my relationships became deeper and more intentional. Feeling accepted and understood was profound and life changing and I started to believe “I do matter” because my relationships reinforced this every day.

My journey continues and I am constantly reminded of my story as I listen to college students of color share their experiences which are very similar to my own. My goal is to help them recognize that they are enough, their multiple identities matter, and to teach them to live authentically. I say this because I know that no one can do this work alone or in isolation. For example, I was provided the opportunity to teach an all student of color course and in doing so, we created an environment that was not influenced by institutionalized systems already in place. In looking back, the students and I created an environment from the basic tenets of Relational-Cultural theory that modeled interdependence, empathy, mutuality, and connection. SunNy Vang, a class participant, summed up the learning experience for all by stating:

My experiences with relationship building in our class began from a place of vulnerability. As a person of color, I struggle tremendously with a sense of belonging. Knowing that I do not “fit” nicely with what is considered normal or customary; I learned to appreciate it and to acknowledge that I have more to contribute to my community. These awarenesses did not happen overnight. We had discussions every day that reflected our reactions, thinking processes, and how we felt about a number of awesome and sad things. We all came from different places and our stories were welcomed. We connected on a far deeper level compared to other classes.

The students and I focused on building empathic relationships, and it truly fostered a responsive and relevant teaching and learning environment in ways that included much more than racial, social, and ethnic demographics. We supported each other by validating and embracing each other’s knowledge, values, experiences, and differences. We all became more mutually responsive persons. I’m truly grateful for the students, as their insights and experiences have helped me to grow and continue to heal. Connie Gunderson was right, “It’s all about the relationship”.

Difficult People: How to Deal with Them

Types of Difficult People and How to Deal with Them

Excerpted from Coping with Difficult People
By Ester R.A. Leutenberg and John J. Liptak, PhD

Coping with Difficult PeopleDifficult people are everywhere. Difficult people are those who frustrate us to no end. (In fact, others may view each of us as a difficult person.) We encounter difficult people at home, in the workplace, school, grocery market, anywhere. Often how much they affect us depends on our self-esteem, ability to recognize “hot buttons” and effectiveness of communication skills. Although one meets many different varieties of difficult people, we have suggested six types that seem to be the most common. These difficult people will have some or all of the following traits:

WHINERS are people who find fault in others and everything they do, blame others for what happens in their lives, and know for certain what should be done but rarely work to improve or correct a situation. They whine in a high-pitched tone, cry and grumble to complain about problems rather than working to fix them or find solutions for them. They are often able to see problems that need solutions, but choose to complain about the problems rather than working to solve them.

KNOW-IT-ALLS are people who think that they know more than everyone else. They believe they have more knowledge and expertise and have all of the answers, and they know they are always right. They do not like to be corrected and will often be impatient, defensive, defiant and sarcastic with people who disagree with them, or they shut down or argue without reason. They feel they are experts on all subjects, behave arrogantly and take exception to anything said to them.

AGGRESSIVE PEOPLE are often angry, impatient and explosive. They use strength, coercion, force, and power to make their point. They often intimidate others into agreeing with them or giving up their point of view. They are critical of people who do not agree with them, and they use ridicule, belligerence, accusations, and verbal, emotional, and/or physical abuse as a way of putting people down. People who interact with them feel a need to be cautious (as if they are walking on eggshells.)

PASSIVE PEOPLE are hard to understand and hard to get to know. They are usually shy, quiet and reserved; they simply want to blend in and not be noticed. They rarely share their opinions or assert themselves to get their views across. They do not talk or share a lot and do not feel the need to respond to questions, especially personal ones. They often appear aloof and detached.

NEGATIVE PEOPLE are usually pessimistic people who will always say such things as “that will never work” and “we have tried that in the past.” They are skeptical that anything will turn out right or be right. They drag others down and make everyone’s environment as negative and as pessimistic as they are. They are unable to see the positive in anything and will always believe that things will not work out.

YES-PEOPLE are super pleasant and agreeable. They usually promise something that they cannot deliver. They seek approval and are afraid to say no to other people, especially the important people in their lives. They say what people want to hear and will agree with each person’s opposing views or opinions.

Here is a model that you can use to build positive relationships with difficult people.

In this model, participants can deal effectively with difficult people in their lives by following a few critical steps including:

  1. Identify the person’s personality type and what makes the person so difficult for others to handle.
  2. Learn and utilize critical communication and listening skills to build a positive relationship.
  3. Cope effectively with the person.
  4. Learn skills to respond effectively and/or to confront the person.

Sounds simple. Now for some tools to help.


Interacting with Whiners
Don’t . . .


•       agree with the person’s complaints

•       get defensive

•       counter-attack

•       say “You’re such a whiner”

•       be tough on the person if it’s not their usual style

•       be sarcastic (“poor poor you”)


Do . . .


•       listen attentively

•       ask clarifying questions for precise information

•       ask “how could it be better?”

•       create a problem-solving scenario: “What if…”

•       be supportive

•       kindly point out the person whining when he/she might not realize it

•       listen for a bit and then try to solve the problem with the person



Interacting with Know-It-Alls
Don’t . . .


•       attack the person’s ideas

•       put yourself or your ideas down

•       ask the person cite their source debate

•       think the person doesn’t know a lot –they might!

•       try to make the person look bad


Do . . .


•       listen attentively

•       respect the person

•       paraphrase the person’s points

•       suggest alternatives to the person’s viewpoint

•       remain neutral throughout your conversations

•       keep your humor



Interacting with Aggressive People
Don’t . . .


•       argue

•       retaliate

•       escalate the hostility

•       fight against the person

•       try to win the argument

•       take the behavior personally

•       submit to their wishes

•       wait for them to run out of steam


Do . . .


•       divert attention, if possible

•       offer information that explains your situation

•       look for common interests and agreement

•       remain calm

•       acknowledge the person’s feelings

•       explain your feelings using “I” statements

•       set limits on violence and aggression

•       walk away if necessary



Interacting with Passive People
Don’t . . .


•       fill in the silence with conversation

•       exclude the person in activities

•       complete the person’s sentences

•       talk too much too soon

•       ask too many questions or appear nosey

•       exclude the person in conversations

•       assume the person is disinterested


Do . . .


•       ask open-ended questions

•       provide opportunity for the person to speak

•       wait in silence

•       be attentive

•       expect responses

•       find a topic the person has interest in

•       be playful, fun loving and friendly



Interacting with Negative People
Don’t . . .


•       agree with the complaints

•       get defensive

•       counter-attack

•       think it is a reflection on you

•       accept blame

•       spend more time with the person than you need

•       lose focus on your own energy and positivity


Do . . .


•       listen attentively

•       ask clarifying questions for precise information

•       ask “how could it be better?”

•       create a problem-solving scenario

•       be supportive

•       remain detached

•       say, “now tell be something positive”



Interacting with Yes-People
•       Don’t . . .


•       help them out by doing the work they agreed to do, and aren’t doing

•       get caught up in their need for approval

•       ask more of them than they can do, even if you know they’ll say yes

•       let them get you in the middle by saying yes to say yes to someone of a different opinion

•       give them praise when they say yes, again


•       Do . . .


•       help them turn down activities

•       be clear about priorities

•       show them ways to say no

•       if they do accept a task, help them create a timeline for completion

•       help them set boundaries

•       build a relationship and try to talk to them

•       make suggestions for alternatives



For each of these types of negative folks answer the following questions:

The person I know that behaves as a _____________________ is ______________. (It is suggested that you use code names that only you will recognize for this exercise.)

This person behaves_____________________________________________________________





My strategy for dealing with this person has been ____________________________________





A better way I might deal with this person __________________________________________





A downloadable version of the above is information is available here.

Recognizing Unwanted Thoughts and Feelings

Recognizing Unwanted Thoughts and Feelings

Managing Unwanted ThoughtsExcerpted from Managing Unwanted Thoughts, Feelings & Actions Workbook

By Ester R.A. Leutenberg and John Liptak, PhD

People who encounter unwanted thoughts, feelings, and actions face frightening experiences. They may have a difficult time distinguishing between what is real and what is not real. They usually regret what they thought and felt, and/or how they acted. They find that often this interferes with their work, school, family relationships, and interactions with friends and people in their community. Unwanted thoughts, feelings and actions can cause confusion, be difficult to deal with, and disrupt any setting. Mental health issues contribute to unwanted thoughts, feelings and actions. When adults experience these symptoms, they are typically challenged by being and remaining in touch with reality. They have difficulty coping with the stressors and demands of their daily lives.

How Do Unwanted Thoughts, Feelings and Actions Issues Manifest Themselves?

Because there are so many bizarre ways these feelings can manifest themselves, disturbances can be very difficult to identify and manage. It is critical to be aware of, to understand, and to acknowledge how symptoms are commonly experienced. Although most or all symptoms do not have to be present, those that are present will typically cause significant distress and/or impairment in daily functioning. Listed below are some possible symptoms:

Agitation Cold manner Confused thoughts
Dangerous actions Delusions Detached from others
Difficulties in the workplace Disinterest in maintaining personal hygiene Disorganized speech
Feelings of entrapment Flat affect Forgetfulness
Hallucinations Inability to understand and accept reality Inability to communicate well with others
Inability to express emotions Inability to make good decisions and judgments Inability to think clearly and rationally
Inappropriate behavior Incoherent speech Increased drug/alcohol use
Intense anxiety Loss of appetite Loss of interest in everyday activities
Loss of touch with reality Mood swings Problems maintaining relationships
Problems in school Rigid actions Strange actions
Suicidal thoughts Unusual movements Withdrawal from others socially

Intense Anxiety

Sources of Unwanted Thoughts, Feelings and Actions Issues

As with many different types of psychological problems, the origin of these unwanted thoughts, feelings and actions issues are difficult to pinpoint. Because of their complex nature, these issues are often brought on by one or a variety of these sources:

Genetics and Biology

Psychotic disturbances often run in families and thus researchers believe that they are inherited, but that is not the only cause. A complete medical and psychological history should be collected by a medical professional to identify family members who may also have experienced disturbances with unwanted thoughts, feelings and actions.

Brain Chemistry

The structure and functioning of the brain has been shown to have an effect on the incidence of psychotic disturbances. Chemicals in the brain (neurotransmitters) that communicate between neurons, also seem to play a role. In addition, the structure of the brain found in healthy individuals is different from that of people who experience disturbances with unwanted thoughts, feelings and actions. An examination to explore the structure and functioning of the brain should be conducted by a medical professional.

Life Events

An inability to cope with major stressors can be a factor in disturbances in thoughts, feelings and actions. Some of the major stressors might include traumatic shock or abuse. An examination of the person’s life events that may be causing unwanted thoughts, feelings and actions needs to be conducted by a medical professional.

Medical Conditions

Disturbances with unwanted thoughts, feelings and actions are more likely to occur in people with poor medical health in general, or those who suffer from an existing psychological problem. A medical history can reveal conditions that might induce problems in thoughts, feelings and actions, and should be examined by a medical professional.


A history of problematic drinking, tobacco, marijuana or other drug use has been associated with the development of disturbances with unwanted thoughts, feelings and actions. A history of a person’s drug, tobacco and alcohol use should be examined by a medical professional. People experience many different types of problems related to unwanted thoughts, feelings and actions.

In order to help participants deal successfully with unwanted thoughts, feelings and action issues, facilitators need to have a variety of assessments and activities to help their participants open-up and begin to feel they can manage the symptoms of their unwanted thoughts, feelings and actions and realize that they are not alone.

When to Worry?

Disturbances in unwanted thoughts, feelings and actions are difficult to manage because they blur the line between what is real and what is not real. The good news is that people can develop the skills needed to manage the symptoms and progress forward to begin enjoying life more. Unwanted thoughts, feelings and actions that accompany many of the mental health issues that people deal with daily can be a very frightening way to live. People who experience these issues over time are at risk of having a serious mental illness and need to seek a medical professional.

Suicide Warning!

People who experience severe bouts of unwanted thoughts, feelings and actions are often at risk for suicide. Sometimes they can become irrational and think that the only way to escape the pain is to attempt suicide. Remember to take any talk about suicide or suicidal acts very seriously.

Signs of suicidal thoughts
Withdrawing from family, friends, and activities of interest in the past Increasing use of harmful substances
Giving away possessions Expressing severe hopelessness about the future
Making a plan for dying by suicide Calling or visiting people to say goodbye
Getting legal affairs in order Engaging in reckless actions
Talking about killing or harming self Expressing feelings of being trapped with no way out
Purchasing a weapon


Serious Mental Illness

If participants have a serious mental illness, they need to be taken seriously. Facilitators can take an active role in their finding help immediately. All disturbances of thoughts, feelings, and actions need to be thoroughly evaluated by a medical professional, and then treated with an appropriate combination of medication and group and/or individual therapy.

Self-care: indulgence or essential?

Self-care: indulgence or essential?

Many of us have been brought up with the idea that taking care of ourselves in any way but the most basic healthy eating and exercise is selfish. We should think of others first. We should take care of our kids, our community, our church, our friends, our coworkers, our pets before indulging ourselves. The list of priorities goes on and on. Where do we put taking care of ourselves? Self-care often winds up at the very end of the list…the place where we never arrive.

What we really need are what Nikisha Brunson, co-founder of Urban Bush Babes describes as “everyday healthy rituals that help keep your body and mind energized.” For one person it might mean spending an hour each day knitting, for another reading, for yet another a soothing bubble bath. Each of us is different except for that one outstanding issue: we need to care for ourselves to maintain the energy we need to care for others.

Yoga Class Self-CareSelf-care is not just for the self-indulgent “women who do lunch.” It is for every one of us. It is crucial to finding peace of mind and to finding what is needed within ourselves to give back in this uncertain and often scary world.

Self-care is especially important in times of grief. It is easy to bury oneself in the details that crop up when you have experienced a loss. The following exercises are excerpted from Griefwork: Healing from Loss by Fran Zamore, LISW, IMFT, and Esther R.A. Leutenberg. They are applicable to all of us, whether we are experiencing a loss or just experiencing our day-to-day life.

Are you doing enough for yourself? Download “Self-care Domains” and keep it handy. During the next couple of weeks fill in what you do for yourself in each of the five domains: Physical, spiritual, social, emotional, and intellectual. You will find that many activities are applicable to more than one domain.

Here are some examples:

Going to exercise class

  • Physical because it is good for my body and my health
  • Social because I have friends and/or acquaintances in the class
  • Emotional because I release some anger and/or frustration when I exercise


  • Physical because of health benefits
  • Spiritual because I walk in nature and find that to be my spiritual connection
  • Emotional because walking is a stress-buster for me

Self-Care Man ReadingReading

  • Intellectual because I’m stimulating my brain by thinking
  • Social because I go to a book discussion group
  • Emotional because I’m reading escape novels
  • Spiritual because I’m reading uplifting book

At the end of two weeks, review what you have entered in the self-care domains. Make an effort to add new things in areas you’ve neglected.

Self-Care Exercises


Check ‘nourishments’ that you would be willing to commit to do in the next month.

On the blank lines at the end add some of your own activities. Get involved in something new.

  • do a craft or hobby
  • write in a journal
  • exercise
  • call a friend
  • meditate
  • take a long warm bath & light a candle
  • go to a place of worship
  • listen to music
  • go to a movie, even if I cry
  • read
  • go to a museum
  • work in the garden
  • care for a pet
  • volunteer
  • __________________________ __________________________
  • __________________________ __________________________
  • __________________________ __________________________
  • __________________________ __________________________
  • __________________________ __________________________

Journal about your self-care. Remember you are writing for yourself. Don’t worry about spelling, sentence structure, and the like. Just write your thoughts as they come to you. Refer to this entry when you are feeling guilty for taking time for yourself.

Self-Care Man Hiking

LEISURE (Download here)

Leisure or recreational activities serve many healthful purposes, including self-care. Some can be intellectually stimulating and some promote socialization. Others are healthful because they are a physical outlet. Still others may provide a needed spiritual dimension.


Accomplish something…bicycle to the store

Be alone…meditate

Be a spectator…go to a sporting event or concert

Be sociable…accept an invitation to a social gathering

Be spiritually uplifted…take a walk in the park or go to a house of worship

Compete in a sport you like

Continue to learn…take an adult learning class for credit or audit

Exercise alone…walk on a treadmill at home or go for a walk in nature

Exercise with others…ask a close friend to go with you

Keep emotionally stimulated…discuss issues openly with trusted friends / family

Keep mentally stimulated…do crossword puzzles, play Jeopardy

Keep physically stimulated…join a health club

Relax…take some sunscreen, a magazine, and sit outside

Return to a hobby from the past…find an old train collection in the attic and set it up

Be creative…participate in arts, crafts, knitting, sewing, writing

Journal about your self-care. Remember you are writing for yourself. Don’t worry about spelling, sentence structure, and the like. Just write your thoughts as they come to you. Refer to your list when you are at a loss for something to do just for yourself.

RCT: The Power of Connection Through Student and Professional Mentorship

Relational-Cultural Theory Series Previous Articles:

What is Relational-Cultural Theory?
Transforming Community Through Disruptive Empathy
Combining the Neuroscience of Relational-Cultural Theory and Clinical Practice

Relational-Cultural Theory (RCT) in Practice:

The Power of Connection Through Student and Professional Mentorship

By Connie Gunderson, PhD, Jane Larson, MSW, Corrie Ehrbright, MSW, Vanessa Thoennes, MSW, Amy Anderly-Dotson, MSW, Anthony Klar, MSW, Ashley Tuve, MSW, Will Wales, MSW

Relational-Cultural theory (RCT) recognizes the primacy of relationship, and emphasizes the intrinsic human desire for connection through mutual empathy, radical respect, community and social justice. The purpose of this paper is to share the voices and experiences of MSW students who completed an advanced practice course in Relational-Cultural theory at The College of St. Scholastica in Duluth, Minnesota with the instruction of Dr. Connie Gunderson. Core aspects of learning included the opportunity for students to collaborate with faculty at the Jean Baker Miller Training Institute at Wellesley College in Boston, Massachusetts and participate in a mentorship program with RCT practitioners throughout the USA and Canada. Their experiences demonstrate that with the power of connection and the value of intrinsic inter-relationship mutual learning, growth and change are possible as students integrate Relational-Cultural theory into field placements and other professional settings. Connie Gunderson, PhD, LISW may be contacted at cgunderson@css.edu.

This article shares the voices of MSW students who completed a course in Relational-Cultural theory at The College of St. Scholastica. It will briefly describe the course curriculum for your frame of reference and focus on students’ learning and reflections of their professional growth during the course, and the implications of applying RCT in clinical social work practice.


Brief Introduction to Relational-Cultural Theory

Relational-Cultural theory evolved as a developmental and psychological model in the 1970s through the collaboration of four women psychologists, Jean Baker Miller, Irene Stiver, Judith Jordan, and Jan Surrey, in Boston, MA. These women, along with other scholars and practitioners, began to challenge mainstream, traditional psychologies of human development that were grounded in a belief of the separate-self. From their perspectives, psychological theories that valued and fostered a separate-self worldview, based on individualism and autonomy, promoted a culture that was fundamentally antithetical to the health and wellbeing of persons and communities. In refute, the women posited that health, well-being, and growth are based on the primacy and centrality of relationship and relational movement rather than the focus of acting in one’s sole interests (Miller, 1976). This paradigm shift in thought and action has affected how counseling, therapy, organizational development, and policy changes are understood and practiced. In 2012, an editor at the American Psychological Association recognized Relational-Cultural theory as one of the top ten psychological theories of our time (Carlson, 2012). This is a tribute to the scholarship of the women who dared to challenge the status quo in the field of psychology.


Relational-Cultural Theory (RCT):

An MSW Course Curriculum

In the fall of 2014, MSW students at the College of St. Scholastica had the opportunity to study Relational-Cultural theory and its approach to human development, clinical practice, and social justice.

The course curriculum included an in-depth exploration of RCT theory, collaborative mentorship with RCT clinical practitioners, an introductory training experience at the Jean Baker Miller Training Institute at Wellesley College in Boston, MA, and two community-based educational events, hosted by the College of St. Scholastica and the Duluth community, featuring Dr. Judith Jordan and Dr. Connie Gunderson. The course was designed to engage students to learn about growth fostering relationship with each other, RCT mentors, and RCT scholars. The students were encouraged to reflect and practice the tenets of RCT in all aspects of the course. To assist in this process, students worked in small groups with RCT mentors to examine RCT through comprehensive literature reviews and collaborative discussions. Each small group critically reflected on how the theory and tenets applied to clinical social work practice.

A student reflected that RCT mentorship was a unique way to build relationship and foster learning:

I feel very fortunate to have had the opportunity to work with our mentors. They brought a wealth of experience, wisdom, knowledge, and fun to the table. They were willing to answer questions, share resources, and offer guidance. Most importantly, they brought themselves to the relationship and, I believe, we did as well. In true RCT fashion, our mentoring relationship was one of a reciprocal nature with all of us engaged in mutual learning.

This next section includes brief summaries of the students learning and reflections of some of the primary RCT tenets.


Basic Tenets of Relational-Cultural Theory

Mutual Empathy

Mutual empathy is one of the essential factors necessary for growth in relationship (Jordan, 1986). According to Hartling and Miller (2004), mutual empathy is not a static one-way process, nor is it a relational courtesy, but rather a complex skill that helps us “know” another person’s experience. To be empathic requires vulnerability. Jordan (1992) likens mutual empathy to a “life-giving empathic bridge” where people with different views and perspectives can come together and engage in dialogue that creates change (p. 2).

The practice of mutual empathy in therapy encompasses not only empathizing with clients’ experiences but also with their strategies of disconnection (Miller & Stiver, 1994). It is also a corrective experience allowing clients to build positive relational images and know they can have an impact on the world and the people in their lives which, in turn, contributes to a sense of empowerment (Walker, 2004). As clinicians, being mutually empathic also means identifying and empathizing with our own experiences and strategies of disconnection which can interfere with the ability to be fully present and engaged with our clients (Jordan, Walker, & Hartling, 2004).

Walker (2004) notes that all people deserve to be treated with dignity. Radical respect is a key aspect of mutual empathy. Without radical respect it is unlikely that clients would allow themselves to be vulnerable enough to authentically engage in a relationship. The practice of mutual empathy is paramount – without it, healing cannot take place. A student allowed herself to experience mutual empathy as she wrote:

Boston was an opportunity for me to join and experience the special bond the class already seemed to have. I wasn’t sure what to expect. When I walked into the airport the morning we were flying out, ready to cry over the fact I had to leave my babies, two of my classmates greeted me immediately with smiles, hugs, and words of reassurance. It was in that moment that I knew I was going to be part of something special. Special seems like an understatement here. The bond we all created in Boston was nothing short of extraordinary, and that bond continues to grow.



Authenticity is being able to fully represent oneself honestly in relationship (Jordan, 2004). When we are able to be authentic we are able to better know, understand, and discuss our thoughts and feelings with others (Miller & Stiver, 1997). The benefits of authenticity have been stressed in many fields including psychology, sociology, philosophy, and spiritual traditions (Chen, 2004). For example, a recent study on authenticity, life satisfaction, and distress indicated that the ability to be authentic in relationship was connected to an increased feeling of life satisfaction and decreased levels of distress (Boyraz, Waits, & Felix, 2014). As an example of this, a student wrote:

Authentic interpersonal relationships are critical to client health. Yet so many clients come to therapy in a state of profound isolation. RCT is refreshing because the focus is on healthy and authentic relationships, rather than on symptoms of mental illness.

Another student reflected:

The RCT class was like nothing I expected. The class was small and intimate. We got to know each other’s quirks and personalities on a deeper level. This was something new for me, since I was used to blending in, and being unnoticed. In the RCT class I was visible. When I spoke, people heard me, and that was something I had never experienced before. In this environment I learned my voice was accepted. For the first time, I realized I could make a difference outside of the classroom, and connect with others on a deeper level.

These results support the importance of helping clients share their personal stories, explore thoughts and feelings, be true to themselves, and feel free to engage in meaningful ways with others.


Social Justice

As clinicians it is important to understand that chronic exposure to social disparities, such as race, gender, and class-based stereotypes, are painful and foster self-doubt and feelings of unworthiness (Comstock et al., 2008). RCT invites clinicians to think beyond symptom reduction and remedial helping interventions (Comstock et al., 2008). Clinicians are encouraged to explore the social challenges and barriers clients may deal with on a daily basis. For example, Birrell and Freyd (2006) describe in their article, Ethics and Power, how cultural oppression, social exclusion, and other forms of social injustices underlie the pain that individuals in marginalized and devalued groups routinely experience in their lives. During the training in Boston, Dr. Maureen Walker explained that although oppression is often institutionalized at societal levels, it is necessarily enacted in the context of interpersonal relationship, therefore the fragmentation caused by the violation of human bonds can only be healed by new and healing human bonds (Walker, 2014). While at the training in Boston, a student became more aware of an important social justice issue while attending a lecture by author, Allan G. Johnson, who wrote The Gender Knot. The student noticed:

During the training, I was introduced to new perspectives about gender and privilege in our culture. I began to understand how white males have a status of unearned privilege in our society. As a white male with this unearned privilege, I became increasingly aware of how I may be perceived by others based on this unearned privilege alone. For example, I recognized how women are often discounted in our culture by being referred to as “guys.” This demonstrated how “male dominant” our society is.

As a clinical social worker, it is critical to be cognizant of the deep-rooted issues of power and privilege and to be able to address clients’ experiences with their environments and systemic assumptions and practices from a relational human rights perspective.



Many traditional therapeutic models view boundaries as a rigid line of separation. Clients may be subject to what the therapist determines as rules or boundaries. This perspective often carries connotations of control and separateness. From an RCT perspective, boundaries are viewed as an opportunity for connection and a place of meeting and exchange (Walker & Rosen, 2004). One method that fosters a power-with relationship is a conversation initiated by the therapist with a client at the beginning of the relationship. To create an environment that is mutually respectful and safe, therapists and clients need to discuss and clarify the purpose and focus of their therapeutic relationship. Here, boundaries are discussed and mutual agreements are developed to establish a constructive therapeutic relationship. For example, therapists respect clients by focusing on the clients’ needs during the therapy hour, and only use a “judicious use of self” when offering feedback and responses. Clients respect therapists by honoring the therapists’ need for personal privacy inside and outside of the office. This is critical in establishing a positive relational connection (Walker & Rosen, 2004). During the semester, there were discussions about the need for healthy professional boundaries. A student reflected:

I have struggled with the some of the traditional models of mental health treatment. For example, a therapist who is intentionally aloof and objective (if that is even possible) exudes judgment and superiority. Sadly, I have witnessed clinicians who repeatedly tell clients what is wrong with them, interpret clients as manipulative and treatment resistant, and unilaterally design treatment plans that clients must follow or face significant consequences. This does not model a growth fostering relationship, or offer a client a safe place to be vulnerable. An RCT clinician tries to relate with a client in a professional manner with mutual empathy, fluid expertise, a judicious use of self, clear boundaries, and clarity of purpose.



RCT focuses on safe and healthy therapeutic relationships. So the concept of power is central to RCT. Power is present in every relationship. How power is perceived and manifested is critical. RCT suggests that power is defined as the ability to facilitate change (Jordan, 2010). For example, relationships that strive to acknowledge and respect each person’s ability to contribute, while recognizing the different roles and needs each person may have creates an environment that supports empowerment, connection, and growth (Miller & Stiver, 1997). The students explored how they experience power in their work with clients and in their organizations. Recognizing how people use power to interact in relationship has been insightful. One student wrote:

The privilege of going to Boston to learn from the founding scholars of RCT was life changing for me. It’s not every day that someone like me, has the opportunity to meet people like Dr. Jordan, Dr. Banks, and Dr. Walker. They generously supported our efforts, and they invited us into mutually responsive relationships. How amazing to be invited to call or e-mail them with a question, or a thought, and get a response! How amazing to be asked to share our personal experiences, so they could learn from us.


Constructive Conflict

Relationships are not static. They are quite dynamic. In therapy, clients and therapists naturally move along a continuum between connection and disconnection (Comstock et al., 2008). Disconnections and resulting conflicts may cause fear. Conflicts in therapy can be seen as pathways for transforming misunderstandings to empathy, and for building bridges between one another through collective relational struggle (Comstock et al., 2008). RCT suggests that with increased mindfulness and a willingness to address inevitable conflicts that occur in therapy in a constructive “win-win” manner, clients can feel safe, become more attentive and responsive to relational movement, and gain confidence in their ability to grow in relationship. A student reflected on her insights about the importance of providing a safe climate for conflict and struggles to occur:

I have learned so much about the value of relationships and the importance of building them with clients. Many clients have experienced loss and trauma and are searching for safety, so it is important to be able to provide that for them.

RCT has changed my interactions with others – I find myself listening more and asking more questions rather than offering solutions right away, which has always been my instinct. I have learned how to create a space that is open and safe. Through this course I have found my voice and been able to share what I have learned about RCT outside of the classroom.

RCT has also taught me the importance of fostering and maintaining relationships that have already been established, to know when disconnections occur, and how to work through them in respectful ways.


Connection and Disconnection

Therapists will likely work with clients who have been referred by social services, the courts, and other programs. Clients may wish for connection with a therapist and hope that the therapist will care enough to listen and understand their story, and, at the same time, clients may feel ambivalent and guarded about treatment. The desire for connection and authentic engagement may be overshadowed by protective strategies to stay out of relationship and to feel safe – to be relationally disconnected (Jordan, 2005).

A disconnection is defined as a psychological rupture that occurs when a child or adult is prevented from participating in a mutually empathetic and mutually empowering interaction (Miller & Stiver, 1997). According to Miller and Stiver (1997), two key features are necessary to bring about re-connection. A person must be able to take some constructive action within the relationship to make one’s experience known. And the other person in the relationship must be willing and able to empathically respond in a way that supports a new and better connection.

Clients’ disconnections are not the only ones that need to be respectfully responded to. Therapists bring their own strategies of disconnection to a therapeutic relationship. The need for connection, based on mutual empathy, with other professionals is recommended for all who are working in clinical practice. Thus, it is important for therapists to participate in professional supervision to support their own personal and professional growth. One of the fundamental beliefs in RCT is that one never needs to be isolated because of the power of connection. A student wrote about her struggles with connection:

I had a profound life changing experience when I went to the Jean Baker Miller Training Institute. Before leaving for the trip to Boston, my hope tank was on empty. I had been compassionately working for a rural agency. I was devastated when the agency suddenly eliminated my position. When I left for Boston with my cohort, I wanted to isolate. It was what I knew. However, while in Boston, I rediscovered who I was as an individual, a spouse, a mother, and as a social work professional. I realized I had been lost for over two and a half years. My life had been weighed down with shame and guilt. The environment I had been working in created these lonely and negative feelings. I noticed that the most fearful and difficult part of my journey in graduate school has been exploring who I am and who I am becoming. I have had to force myself to look at the positive attributes, skills, and passions that are inside of me.


The Five Good Things

A culture that fosters growth and is grounded in radical respect, hospitality, and community offers an environment that provides us with The Five Good Things: a sense of zest, clarity about ourselves and our relationships, a sense of worth, an enhanced capacity to participate in our world, and a desire for more connection (Jordan, 2010). From this perspective, life’s journey is inherently relational. For example, we grow through and towards relationships during our lifetime, rather than towards separateness and independence (Jordan, 2010). One student expressed her ideas: “We wish to feel safe and to offer safety to others. We wish to give and receive love and kindness. We strive to increase our capacity for relational growth by developing mutual empathy, mutual empowerment, and resilience.” Another student wrote about her experience with The Five Good Things:

Because of this course, I have zest in the face of the most trying time of my life. I have more clarity about myself, others, and my relationships than ever before. I have a sense of worth and an enhanced capacity to be productive. Most of all, for the first time in my life, I have the desire for more connection, and for that I am grateful.

Another student added how RCT concepts are intertwined:

Last year, at the beginning of my RCT journey, Dr. Gunderson spoke about The Five Good Things, growth fostering relationship, mutual empathy, and authenticity. Until then, I had never heard how these concepts could be linked together. I knew instantly, I found a “theoretical home”. Everything, from that point on, has been moving me towards learning how to live and practice RCT in my personal and professional life.

The course taught students to apply theory to real life situations. Students were able to engage with peers, mentors, clinicians, educators, and scholars. They created a safe place to explore, struggle, and support each other to develop personal and professional skills critical for comprehensive clinical practice.


Future Collaborations

The College of St. Scholastica has integrated RCT into the Masters of Social Work curriculum. There are plans to offer RCT as an undergraduate course to first year students to assist them as they adjust to college life. It is clear, scientific studies are continuing to emerge with data that supports RCT and demonstrates that humans are neurologically wired for connection (Banks & Hirschman, 2014). To assist in providing ongoing evidence in this field of study, Graff, Gunderson, and Larson completed and are in the process of publishing a study on the C.A.R.E. program with MSW students (Graff, Gunderson, & Larson, 2017). This is in the process of being published. This study focused on the relevancy of the C.A.R.E. assessment tool and specific C.A.R.E activities for the relational health of students.

In addition, in collaboration with the Jean Baker Miller Training Institute and Wellesley Centers for Women, engaged CSS faculty and staff, current students and alumni, along with other professionals organized the Transforming Community: The Radical Reality of Relationship Conference in June, 2016. We are currently establishing the cornerstone at the college and with our community to offer ongoing training in Relational-Cultural theory/ therapy in Duluth, MN.

Clearly, the “relational movement” is alive and well on this northern Minnesota campus and in our local community as CSS faculty and students introduce RCT in field placements, professional settings, and with clientele. Collaboration between the College of St. Scholastica and the RCT scholars and practitioners from Boston and elsewhere in the USA and Canada demonstrate that change is possible as we work collaboratively to foster healthier relationships for students, clients, and professionals.



Professional social work education integrates theory and practice and teaches students to engage, assess, and intervene with clients in a wide range of settings. RCT suggests working from a paradigm that places the focus of clinical assessment and intervention on relational development and interaction. From a relational perspective, we approach persons and their environments with a belief in intrinsic inter-relationship. We see the challenges for human rights through a relational lens. We incorporate a relational perspective into how we make policy decisions. For some, this is a significant shift in thought and action.

As the St. Scholastica MSW students graduate and move into the clinical world, integrating the tenets of RCT into their work may not always be easy. A student noted that she has much to learn as she embraces a relational paradigm in her personal and professional life.

I still feel like an infant or a toddler with RCT. I am still in wonder of everything. I am learning and exploring. I realize that RCT is not based on a set of facts to memorize, or quick steps to follow. It is a way of living and being with everyone and everything around me. This theory takes time to develop and understand.

Yet, as more practitioners and organizations truly recognize the centrality of relational interdependency, and as research continues to confirm that we, as humans, are literally hardwired to connect, and as persons consistently challenge power-over systems that intentionally isolate and marginalize “others”, a relational movement that is already underway will be ever-present to foster well-being for all persons and for the planet in which we live.



The students of the advanced course in Relational-Cultural theory would like to thank those who offered their assistance while writing this publication. We thank Dr. Gunderson for her endless support throughout the course. Her guidance challenged each of us to explore new ways to connect and relate with others.

We thank our mentors. We are grateful for their willingness to stand with us as we explored the tenets of Relational-Cultural theory. Their experience and insight enhanced our learning and broadened our perspective of social work.

Finally, we thank Dr. Amy Banks, Dr. Judith Jordan, and Dr. Maureen Walker. The training experience was life changing for us. We are moved by your passion for intrinsic human connection and your willingness to support each of us as people and professionals.



Banks, A., & Hirschman, L. A. (2015). Four ways to click: Rewire your brain for stronger, more rewarding relationships. New York: Penguin.

Birrell, P.,. & Freyd, J. (2006). Betrayal and trauma: Relational models of harm and healing. Journal of Trauma Practice, 5(1). doi: 10.1300/J189v05n01_04

Boyraz, G., Waits, J.B., & Felix, V.A. (2014). Authenticity, life satisfaction, and distress: A longitudinal analysis. Journal of Counseling Psychology, 61(3), 498-505. doi: 10.1037/cou0000031

Carlson, J. (2012). In e-Connections Newsletter. Spring, 2012. Wellesley, MA: Jean Baker Miller Training Institute, Wellesley Centers for Women

Chen, X. (2004). Being and authenticity. New York: Rodopi.

Comstock, D., Hammer, J., Strentzsch, J., Cannon, K., Parsons, J., & Salazar, G. (2008). RCT: A framework for bridging relational, multicultural and social justice competencies. Journal of Counseling and Development. 86, 279-287.

Graff, D., Gunderson, C., Larson, J. (2017). [Assessing MSW student’s health and wellness with the C.A.R:E. program]. Unpublished raw data.

Hartling, L. M., & Miller, J. B. (2004). Moving beyond humiliation: A relational reconceptualization of human rights. Excerpts from a paper presented at the Summer Advanced Training Institute: Encouraging an Era of Connection, Wellesley College, Wellesley, MA.

Jordan, J. V. (1986). The meaning of mutuality. Work in Progress, No.23. Wellesley, MA: Stone Center Working Paper Series.

Jordan, J. V. (1992). Relational resilience. Work in Progress, No. 57. Wellesley, MA: Stone Center Working Paper Series.

Jordan, J. V. (2004). Relational resilience. In J. V. Jordan, M. Walker, & L. M. Hartling (Eds.). The complexity of connection: Writings from the Stone Center’s Jean Baker Miller Training Institute. New York: Guilford Press.

Jordan, J. V. (2005). Commitment to connection in a culture of fear. Work in Progress No. 104. Wellesley, MA: Stone Center Publications. doi: 0.1080/02703140802146423 Jordan, J. V. (2010). Relational-Cultural therapy. Washington D.C.: American Psychological Association.

Jordan, J.V., Walker, M., & Hartling, L. M. (Eds.). (2004). The complexity of connection. New York: Guilford Press.

Miller, J.B. (1976). Towards a new psychology of women. Boston: Beacon Press.

Miller, J.B., & Stiver, I.P. (1994). Movement in therapy: Honoring the “strategies of disconnection. Work in Progress, No. 65. Wellesley, MA: Stone Center Working Paper Series.

Miller, J. B., & Stiver, I. P. (1997). The healing connection: How women form relationships in therapy and in life. Boston: Beacon Press Books.

Walker, M., & Rosen, W. B. (2004). How connections heal: Stories from Relational-Cultural therapy. New York: The Guilford Press.

Walker, M. (2004). How relationships heal. In M. Walker & W. Rosen (Eds.). How Connections Heal: Stories from relational-cultural therapy. New York: Guilford Press. Walker, M. (2014). The Power of Connection. Jean Baker Miller Training Institute Lecture. 24. – 26. October 2014. Wellesley, MA: Wellesley College.

Mindfulness Meditation and the Opioid Crisis

Mindfulness Meditation

Almost everyone in the US is aware of the current opioid crisis we are enduring. Millions of addicted are added each year. Since 1999 the use of opioids has increased five-fold. Statistics from 2016 (the latest available) show that 42,000 people died of opioid-related issues in just that one year.

What can be done to alleviate this crisis? In a paper titled “Mindfulness Meditation-Based Pain Relief: A mechanistic account”, Fadel Zeidan and David Vago report that research supports the claim that the widespread use of opioids to alleviate chronic pain has led to the exponential rise in misuse and addiction. Their paper further states that mindfulness meditation could very well be a narcotic-free tool to reduce chronic pain. (Vago, Zeidan, 2016.)

Mindfulness, research has learned, is an excellent complementary treatment for a variety of health and wellness concerns and aligns with scientifically-backed theories in modern psychology. The importance of increasing resiliency in the face of the inevitable difficulties, both physical and mental, can’t be reinforced too often. Although mindfulness-informed practices don’t magically change life circumstances, they can help cope with rapid change, life transitions, and physical symptoms (i.e. pain) as well as enable us to more fully savor success. (Torney, 2018.)

Mindfulness Meditation 30 ScriptsWith the above information in mind we present the following from 30 Scripts for Relaxation, Imagery & Inner Healing, Ed. 2, Vol. 1& 2 by Julie T. Lusk.

Relaxation and visualization can heal the body, mind, and spirit. Progressive muscular relaxation and conscious breathing help relieve tension and stress. Guided imagery encourages people to experience internal harmony, to heal emotional and physical upsets, to increase body awareness, to enhance relaxation, to get in touch with the healing source of energy for emotional and spiritual strength, to receive direction from their own inner guide, and to connect with the environment.

Here are some tips to help you use these mindfulness-meditation scripts effectively with your clients.

Working with guided meditations

Everyone is different, so each person will experience guided imagery uniquely. These individual differences should be encouraged. During a guided meditation, some people will imagine vivid scenes, colors, images, or sounds while others will focus on what they are feeling, or experience it as a concept. This is why a combination of sights, sounds, and feelings should be incorporated into the meditations. With practice, it is possible to expand your participants’ range of awareness.

By judicious selection of images you can help deepen their experience and cultivate their awareness in new areas that can enrich their lives. For instance, a person who is most comfortable in the visual area can be encouraged to stretch his or her awareness and increase his or her sensitivity to feelings and sounds. (See Flower Meditation below.)

Be careful, however, when presenting themes and techniques that are unfamiliar to you. Since people respond in a variety of ways to visualization, avoid generalizing about the benefits of any given script.

If your groups are composed of people who are emotionally ill or especially fragile, be sure you have the necessary special training or professional guidance before introducing them to visualizations.

Preparing the group or individual

Some type of physical relaxation sequence should be used prior to every guided meditation. Breathing properly is essential for complete and total relaxation. Unfortunately, very few people take full breaths, especially when under stress. When a person consciously uses deep breathing correctly, stress is reduced and the mind can remain calm and stable. It is important that people focus on their breathing, with full deep breaths through the nose. Before beginning any guided meditation, briefly describe the images you will use and ask if they make anyone feel uncomfortable. People who are afraid of water may find images of ocean waves to be frightening rather than calming. Be prepared with an alternate image. Let participants know that if they become uncomfortable, they may, at any time, open their eyes and tune out or change the visualization. As you read a script, people will follow you for a while and then drift off into their own imaginations. They will usually tune you back in later on. If they know this in advance, they won’t feel as if they are failing by being inattentive. So tell them this is normal and to let it happen.

Choosing the right atmosphere

Select a room that has comfortable chairs for sitting or a carpeted floor for lying down. Close the door and shut the windows to block out distracting noise. If possible, dim the lights to create a relaxing environment. Low lights enhance the ability to relax by blocking out visual distractions. If the room lights cannot be controlled to your satisfaction, bring along a lamp or night lights. Adjust the thermostat so that the room temperature is warm and comfortable. If the room is too cool, it will be hard to relax and remain focused. Suggest that people wear a sweater or jacket if they think they may get cold. If distractions occur—a noisy air conditioner, traffic, loud conversations—try raising your voice, using shorter phrases and fewer pauses, or incorporating the sounds into the guided meditation. For example, you might say, “Notice how the humming sounds of the air conditioner relax you more and more.” Or, “If your mind begins to drift, gently bring it back to the sound of my voice.”

Using your voice

Speak in a calm comforting, and steady manner. Let your voice flow. Your voice should be smooth and somewhat monotonous. But don’t whisper. Start with your voice at a volume that can be easily heard. As the guided meditation progresses and as the participants’ awareness increases, you may begin speaking more softly. As a person relaxes, hearing acuity can increase. Bring your voice up when suggesting tension and bring it down when suggesting relaxation. Near the end of the guided meditation, return to using an easily heard volume. This will help participants come back to normal wakefulness. You may tell participants to use a hand signal if they cannot hear you. Advise people with hearing problems to sit close to you. Another option is to move closer to them.

Pacing yourself

Read the guided meditations slowly, but not so slowly that you lose people. Begin at a conversational pace and slow down as the relaxation progresses. It’s easy to go too fast, so take your time. Don’t rush. Many script authors use ellipses…to indicate a brief pause. Spaces between paragraphs would suggest a longer pause.

Leader’s notes and script divisions should not be read out loud. Give participants time to follow your instructions. If you suggest that they wiggle their toes, watch them do so, then wait for them to stop wiggling their toes before going on. When participants are relaxed and engaged in the imagery process, they have tapped into their subconscious (slow, rich, imagery) mind—and they shouldn’t be hurried. When you’re leading the meditation, stay in your conscious (alert and efficient) mind. Pay careful attention to all participants. You may have to repeat an instruction if you see that people are not following you. To help you with your volume and tone, pace and timing, listen to a recording of yourself leading guided meditations.

As you reach the end of a meditation, always help participants make the transition back to the present. Tell them to visualize their surroundings, to stretch, and to breathe deeply. Repeat these instructions until everyone is alert.

Using music

Using music to enhance relaxation is not a new idea. History is full of examples of medicine men and women, philosophers, priests, scientists, and musicians who used music to heal. In fact, music seems to be an avenue of communication for some people where no other avenues appear to exist.

Your music should be cued up and ready to go at the right volume before you start your meditation. Nothing ruins the atmosphere more quickly than having the leader fool around trying to get the audio going. Jim Borling, a board certified music therapist, makes the following suggestions on the selection of music:

Tips on Music Selection

  • Custom select music for individual clients or classes whenever possible. Not everyone responds in a similar fashion to the same music.
  • Matching a person’s present emotional state with music is known as the ISO principle. If you can match the initial state and then gradually begin changing the music, the person’s emotional state will change along with the music. If a person is agitated or angry, begin with fast-paced music, and then change to slower-paced selections as relaxation deepens.
  • Choose music that has flowing melodies rather than disjointed and fragmented melodies.
  • Don’t assume that the type of music you find relaxing will be relaxing to others. Have a variety of musical styles available and ask your clients for suggestions.
  • Try using sounds from nature like ocean waves. Experiment with New Age music and Space music, much of which is appropriate for relaxation work. Classical music may be effective, especially movements that are marked largo or adagio.
  • Adjust the volume so that it doesn’t drown out your voice. On the other hand, music that is too soft may cause your listeners to strain to hear it.
  • Select music based upon the mood desired. Sedative music is soothing and produces a contemplative mood. Stimulative music increases bodily energy and stimulates the emotions.
  • Select music with a slow tempo and low pitch. The higher the pitch or frequency of sound, the more likely it will be irritating.

Processing the experience

You may wish to add to the richness of the guided meditations by asking participants afterwards to share their experiences with others. This can be facilitated by creating an atmosphere of trust. Ask the group open-ended questions that relate to the theme of the exercise. Be accepting and empathetic towards everyone. Respect everyone’s comments and never be judgmental or critical, even if people express negative reactions. 


Do not force people to participate in anything that may be uncomfortable for them. Give ample permission to everyone to only do things that feel safe. Tell them that if an image seems threatening, they can change it to something that feels right or they can stop the imaging process, stretch, and open their eyes. Emphasize to participants that they are in total control and are able to leave their image-filled subconscious mind and return to their alert rational conscious mind at any time they choose. Likewise, clients may want to explore what feels uncomfortable to them in the safety of the experience. Advise participants that it is not safe to practice meditation or visualization while driving or operating machinery.

Integrating the mind, body, emotions, and spirit opens up vast inner resources of intuition, wisdom, and personal power. The mind and body are one, and what you believe and feel is reflected in your body. Sometimes your thoughts may lead to illness, aches, and pains; and other times, they lead to exhilarating feelings of joy, pleasure, and peacefulness. Likewise, the condition of your body and the way it is feeling affect your thoughts. This is why it is impossible to worry when you feel relaxed.

So many of us live as if fragmented—thinking of one thing, saying something else, acting one way publicly, while feelings, moods, and emotions provide a constantly changing and inconsistent undertow. Guided meditations will help you focus on using the mind body connection to heal the body and emotions and to bring thoughts, words, actions, and feelings into harmony and alignment.

A definition of mindfulness

Mindfulness is the moment-to-moment attention to the present without judgment or reactivity. Mindful breathing and other mindfulness practices help you to achieve moment to moment awareness in a non-judgmental, detached way, thereby increasing the amount of time per day spent in rest and digest mode. Conscious attention to breathing is common in many forms of meditation and is used by top athletes to enhance performance. The following exercise will help your clients breathe mindfully. Download the following Mindfulness Breathing exercise here.


  • Sit in a comfortable position either on a chair with your feet on the ground, or on the floor with your legs comfortably crossed. Sit tall with your spine extended so that your breath can enter your entire torso. Relax your shoulders down and move your shoulder blades towards each other.
  • Place one hand on your abdomen and the other above your chest near your collarbone.
  • Inhale deeply from the bottom of your abdomen. Feel the expansion pressing against your lower hand.
  • Continue to fill your torso until you feel the hand on your upper chest expand. Hold the breath for one second.
  • Release the breath from the chest to the abdomen. Picture a cup of water emptying from the top to the bottom as you exhale. Note how it feels to be empty of breath just for a second before your next inhale, then repeat this long, slow even breath nine more times. Return to the breath count as your mind wanders, which it naturally will.
  • Return to natural breathing. Take a moment to stretch, and write about your experience in your centering journal. Don’t worry if mindful breathing feels awkward or uncomfortable. It will feel more natural the more you practice. Remember, these are muscle responses. You can’t throw a football like Tom Brady or play the trumpet like Wynton Marsalis right off the bat, either. Practice, practice, practice.

Now your client is relaxed and breathing properly, try reading one of the following scripts, using the tips above to make it as effective an experience as possible.


Flower Meditation (Download Flower Meditation exercise here)
Julie T. Lusk
Excerpted from 30 Scripts for Relaxation, Imagery & Inner Healing, Ed. 2, Vol. 1
By Julie T. Lusk.

Time: 20 minutes

In this visualization script, participants increase their ability to imagine seeing, touching, smelling, and feeling.

Note: Obtain fresh flowers for participants before using this script.

Feel free to modify this script. For instance, flowers could be substituted with pine cones, sea shells, etc.



Place the flowers at eye level in front of you … Gently gaze at them without straining your eyes … Look softly at the shapes of the flowers, stems, and leaves … Become aware of their shapes and sizes. See their colors.

After you have spent a few minutes looking carefully at the flowers, close your eyes and visualize the flowers in your imagination. When the visualization becomes difficult, open up your eyes and look at the flowers once again. Close your eyes once more and recreate a vision of the flowers. Repetition will increase your ability to visualize images in the mind’s eye.

Touching and Feeling

Reach out and touch the flowers, stems, and leaves. Take your time to discover how the flowers feel … Explore the softness of the flowers and the feel of the stems and leaves. Discover their moistness, noticing the variety of textures.

Investigate the physical sensations of touching the bouquet of flowers. Run your fingers through the bouquet and listen to the sound of touching them … Allow the sense of touch to sink in through your fingertips and into your memory.

Stop touching the flowers and close your eyes. Experience the sense of touch through your memory … When the memory of touch begins to fade, reach out and touch the flowers with your fingers. And then imagine touching the flowers once again.


Bury your nose and take a full, deep breath. Let the flowers tickle your nose. Smell the fragrance and the freshness of the flowers. Enjoy.

Remember how the flowers smell and recreate the aroma in your imagination. Keep practicing until you are able to imagine the scent of the flowers from memory.

Thoughts and Feelings

Sit quietly and reflect upon the magnificence of the flowers. Open yourself up for new insights and realizations.


Relax, close your eyes, and imagine looking at a glorious bouquet of flowers … You may imagine any kind of flower you wish…roses … daisies … mums … baby’s breath … marigolds … bird of paradise … any type of flowers you wish.

See the radiant colors … the rich reds … luscious yellows … deep purples … pure whites … soft pinks … gorgeous oranges … all the shades of green.

Become aware of the textures … patterns … and shapes of the petals … Look at the leaves … and the stems … Observe the flowers in their various degrees of unfolding.

This time, imagine reaching out and touching the flowers … .Feel the softness … their moistness … the texture of the petals … leaves … and stems … Imagine rubbing the flowers with your fingers … Touch the flowers … Feel them.

Experience touching the flowers … Run your fingers through the flowers and listen to what you hear.

Now imagine the scents and fragrances of the flowers … Breathe in their perfume … Smell the aroma … Fill up your lungs with the fresh smell of the flowers.

Take some time to reflect on the diversity and beauty of the flowers that grow for our enjoyment … Think about the life cycle of the flower … Enjoy.


When you’re ready, open your eyes and stretch.

Repeat the above instruction until everyone is alert.


Sun Meditation for Healing (Download Sun Meditation for Healing exercise here)
By Judy Fulop and Julie T. Lusk
Excerpted from 30 Scripts for Relaxation, Imagery & Inner Healing, Ed. 2, Vol. 1
By Julie T. Lusk.

Time: 10 minutes

In this script, participants experience the healing power and energy of the sun as they imagine it warming and relaxing them.


Allow yourself to become as relaxed and comfortable as you can … Let your body feel supported by the ground underneath you.

Slowly begin to see or feel yourself lying in a grassy meadow with the sun shining it’s golden rays gently upon you … Let yourself soak in these warm rays … taking in the healing power and life giving energy of the sunshine.

This magnificent ball of light has been a sustaining source of energy for millions of years and will be an energy source for millions of years to come … This ancient sun is the same sun which shined down upon the dinosaurs … upon the Egyptians while they built the pyramids … and it now shines upon the earth and all the other planets in our solar system and will continue to do so forever.

As the sun’s rays gently touch your skin, allow the warmth and energy to flow slowly through your body … pulsing through your bones … sending healing light to your organs … flowing to your tissues … recharging every system … and now settling into your innermost being … your heart center.

Sense your heart center glowing with this radiant energy. If you wish, give it a color … Take a few moments to allow this warm and healing energy to reach your innermost being … physically… emotionally … mentally … and spiritually.

Pause for 30 seconds

As this healing energy grows and expands, allow yourself to see, feel, and sense this energy surrounding your being … growing and growing … Allow this energy to grow further and fill this room … this building … surrounding this town … spreading throughout our state … to our country … and out into the world … and finally throughout the universe … reaching and touching and blessing all.

Pause for 30 seconds

You may share this healing energy and power with anyone you’re aware of right now … Mentally ask them if they are willing to receive this healing energy … If they are … send this source of healing energy to them … giving them the time they need to take in this energy and make it theirs in their own heart center.

Pause for 30 seconds

Now take your attention back to your own heart center … Find a safe place within you to keep this healing and powerful energy … a place to keep it protected and within your reach … Give yourself permission to get in touch with this energy whenever you wish.

With the warmth of this energy in your being, begin stretching, wiggling, and moving … Slowly open your eyes, feeling alive, refreshed, keenly alert, and completely healthy.

Repeat the above instructions until everyone is alert.

Conflict Management Styles

What is My Conflict Management Style?

Excerpted from The Conflict Management Skills Workbook
By Ester R.A. Leutenberg and John Liptak, PhD

In many ways, conflict is a basic fact of life. We have all experienced conflict in our personal and professional lives. Because conflicts are disagreements resulting from people or groups having differences in attitudes, beliefs, values or needs, there will be times when conflict is inevitable. People experience differences in any relationship. That conflict exists is not a bad situation, as long as the conflict is managed effectively. Resolving conflicts can be beneficial and lead to growth and maturity. Outcomes of constructive conflict management will increase confidence in several aspects of life management:

  • awareness that problems exist and need to be solved
  • creative problem solving and decision making
  • sense of well-being
  • motivation and energy to take action
  • implications / attitudes / responses of empathy and caring
  • commitment to relationships
  • impact of respect, trust and commitment.

Any conflict has the potential to be incredibly destructive to a relationship. Managed in the wrong way, it can lead to extreme differences between people that can quickly spiral out of control. Each person will experience this Negotiations Model based on their point of view in a conflict as they use the following format to help them resolve their issues / problems:

Negotiations Model Conflict Management

The following are types of conflict management styles. Read the short description of each style and then journal about the following three questions for each one.

What I like about this style.

What I don’t like about this style.

When does this style work, or not work?


People with a Compromising Conflict Management Style try to find a solution that will partially satisfy everyone. This is often called the middle-ground approach because participants are willing to negotiate and come up with a compromise in the situation in which both people feel satisfied. They may also be willing to sacrifice the compatibility of their relationship with others in order to reach an agreement. They give a little to get a little, and they believe that both sides should make concessions in order to reach a resolution. They have discovered that it is important to back off from some issues in order to gain on other issues.


People with a Competing Conflict Management Style attempt to achieve their goals at all costs and as quickly as they possibly can. They take a firm stand and know what they want. They usually insist that the other people let them have their way, regardless of how much it affects their relationships with others. They operate from a position of power and are usually more concerned with having their way than with the feelings of others. No matter what the cost, winning is the most important thing for them. The use of this style can leave people feeling unsatisfied and resentful.


People with an Avoiding Conflict Management Style usually are willing to give up their own goals to maintain relationships with other people. They would rather hide from and ignore conflict than resolve it. They may give up personal goals and display passive behavior creating a personal loss situation. To do so, they generally avoid conflicts within important relationships. They may avoid other conflicts by physically removing themselves from the environment or by not coming into contact with the others who represent the potential for conflict. They may avoid others psychologically by not speaking or by ignoring them and another conflict situation, and subsequently, the conflict often goes unresolved.


People with a Giving-In Conflict Management Style usually give up their personal and professional goals so that other people can achieve their goals. They usually value their relationships with others so much that they attempt to smooth over the situation and give them their way. For them, the goal is often of no importance but the relationship with the others is of high importance. By giving in, they avoid the risk of a confrontation so they can continue to get along with the other people.


People with a Collaborating Conflict Management Style tend to want to meet the needs of all people involved in the conflict. They can be highly assertive, but are more than willing to cooperate effectively and acknowledge the importance of everyone involved. They are interested in bringing together a variety of viewpoints to get the best possible solution for everyone. They want all sides to be satisfied. They support open discussions, brainstorming and creative problem solving to come to a consensus.

Please enjoy these three conflict management worksheets and exercises:

Conflict Management Quotations
Conflict Management Process Steps
Causes of Conflict