We’ve highlighted some of the high points of our conversation below and how it relates back to the mental health community. As our own team gears up to attend CMC: Foundation for Change 16-hour ITC workshop, we’re excited to share the genesis of where this compassionate and science-backed model for recovery support work started.
To view the full interview, head over to our YouTube channel.
INTERVIEW TIME STAMPS:
(02:18) – Dr. Kenneth’s origin story with CMC: Foundation for Change
(07:21) – The genesis of the Beyond Addiction book
(14:42) – The differences in the ITC Approach and CRAFT
(25:39) – The intangibles of the ITC workshop
(33:03) – The physiological effects of sharing and owning your “humanness”
(43:01) – Applying ITC to chronic mental health issues
(53:06) – How to support families when their loved one don’t see a need for change
DR. KENNETH’S ORIGIN STORY WITH CMC FOUNDATION FOR CHANGE
Dr. Kenneth Carpenter is a professionally trained clinical psychologist and has spent most of his career working with people struggling with substance abuse. For 24 of those years, he worked in treatment development and research at New York State Psychiatric Institute at Columbia University. About ten years ago, Dr. Carpenter extended his experience by working in the community. Through the encouragement of friends and colleagues at CMC, Dr. Carpenter reached out to see if there was room for a new member and they were gracious enough to make room.
His career at CMC began in clinical work. Not long after, he connected with colleagues at The Partnership for Drug-Free Kids (now Partnership to End Addiction) who were looking at a collaborative effort to start a peer-to-peer support system. The idea was to have parents-helping-parents throughout the country to discuss evidence-based principles and ways of helping their children.
The CMC: Foundation for Change, a not-for-profit, was founded in 2017 to support the mission of providing evidence-based tools and change to anyone who desires to support a loved one in a way that opens the doors to make change more accessible.
The genesis of the Beyond Addiction book
Beyond Addiction was a calling between Tom Hedrick and CMC to bring together studies, ideas, and a set of lenses in a language that could be impactful for parents and families looking to help loved ones struggling with addictions.
The message of Beyond Addiction resonated with parents and families across the globe and helped the developmental process of creating the workshop, training parents to become peer specialists or peer-to-peer support coaches.
The new delivery format of CRAFT had a bigger impact amongst parents than how it was previously being disseminated. It highlighted the importance of adapting the language that psychologists use to one for parents to use. In doing so, it allowed parents to have a common language to talk to one another in a way that resonated with them, which ultimately caused the message to scale and amplify in a way we didn’t foresee.
THE DIFFERENCES IN ITC APPROACH and CRAFT
Community Reinforcement Approach and Family Training (CRAFT), developed by Bob Meyers, highlights the importance of environment and context in change.
Many times, people struggling with an addiction are not the ones that are going to reach out for help. It is often their families, the ones on the front line, that call wanting to know how they can be helpful. This finding emphasized that not only is community important, but that there is a way to help families out of isolation and help them be intentional in how they respond to their loved one that can support motivation and change, and hopefully increase the likelihood of their loved one seeking help.
An analogy I often use is, if we think about a garden, it’s about watering the flowers that you want to continue to support to grow versus if you’re tending to a garden that has weeds or unwanted flowers. Yes, it can be nerve wracking and anxiety provoking, but if we just turn off all the water, there’s not going to be much growth at all.
So how can we help with intentional responses? Intentional gardening continues to support the flowers we want to grow and be more strategic on how to respond to the things you don’t want to support. We can make room for those conversations and respect the values and the process of how you want to be with your loved one.
So in that sense, CRAFT encompasses all of that.
Invitation to Change Approach (ITC) incorporates other elements that you wouldn’t find explicitly outlined in CRAFT. While both approaches emphasize the importance of communication, what you find in the ITC approach is a little bit more “nuts and bolts”. It brings in communication strategies that are found in motivational interviewing as well.
The ITC houses a different set of processes and talks about it in a different language than CRAFT would. Both leverage positive reinforcement as being a critical anchoring point, the idea of self-care if you’re in the helping role can be one of support, but self-care is also being able to stay connected to what’s really important in a way that makes room for all the emotions that come along with that and saying “that’s okay”.
That doesn’t mean you’re doing anything wrong and it doesn’t mean things aren’t working. When we care for things and people that we love, it’s also a vulnerable spot for us because caring also means experiencing all those other emotions that come along with seeing loved ones struggle. ITC highlights that and the importance of self-compassion as a practiced skill.
As human beings we can be really present with others when they’re struggling and offer that caring and coaching voice. But when it comes to sitting with ourselves, when we’re struggling, for some reason our own self-chatter takes on a different tone and a different tolerance. So how do we practice just sitting with ourselves in a way that would be similar to the way we sit with those we really care for who are struggling and that doesn’t come so easy to us as human beings? ITC makes room for acknowledging that and acknowledging that it is a practice of self-care that doesn’t come naturally in a lot of ways.
THE INTANGIBLES OF THE ITC WORKSHOP
One unintentional result of the workshop has been community building – and that has looked different depending on the workshop. When we first started, it was for families and for many, it was the first time they had sat in a room with other people who were walking along the same road. We noticed the sheer impact of people being able to be in the presence of others experiencing similar things. It created a community where the workshop participants felt less isolated and were able to talk and learn a common language and ideas. The experiential component was a different approach that had its own momentum, and more than anything, gave permission to our attendees to share their story while not being asked to leave their “humanness” at the door. They left feeling empowered and feeling seen in a way that other workshops didn’t provide.
I like to highlight that because it’s not a requirement, but there’s a natural unfolding that occurs when people are allowed to be there as a human-being and what all that means professionally and personally and be able to interact with each other in that way. When you leave the training with something more than just the stated objective, it helps people step back into their world, in whatever is waiting for them on the other end of a weekend that brings the concepts into play in a much different way than if it was just a didactic presentation. We include these exercises because they have sticking power in a different way.
I’m a professional, I’ve studied psychology, but none of the psychological training I’ve had or the experience or academics, have been able to educate me out of the human condition. And bringing that fundamental idea back to the experience of the workshop (again, it’s not a mandate that people have to be present that way), ultimately pose the question: how do we travel this human journey and how does it infuse our work?
The physiological effects of sharing and owning your “humanness”
The way we interact with the world can mean a lot of different things, and that includes relationships that change us on different levels. It is easy to lose sight of that when we get caught up in our different camps, but when you step back you begin to see that it’s all those things interacting together in different ways that create the full experience.
How your body registers things on a biological and physiological level is communicated throughout your body. It speaks to the complexity and the historical aspect. Physiology is a historian. We experience sensations because of previous experiences. So what’s learned is also recorded in our physiology and our neurobiology. That’s the nice thing too – that there is no one way we can think about helping create a context of change that can impact all those different levels.
People get caught in the quicksand of a discouraging message. If physiology’s just a historian and I have a certain history, does that mean I’m imprisoned by my physiology? The openness there is, it’s not a historian who’s put down its pen.
In that moment of realization is where change can lay its roots and practice. And that’s the other point of the workshop. We try to make the process of living, trying new things, learning and continuing to interact in a way that gives you permission to practice and not be perfect.
APPLYING ITC TO CHRONIC MENTAL HEALTH ISSUES
On a macro level, we talk about three major things with the ITC Approach:
- How do you understand the things you’re seeing?
- How do you understand your loved ones’ process?
- How do you support yourself while you’re trying to understand and be of help to your loved one?
And that means how do you become aware of yourself? How do you check in with your values? How do you practice self compassion with the judgmental chatter that can come with that process and how do we think about communication and intentional responding or the behavioral components in ways that would be supportive?
Beyond Addiction dives into how to understand a loved one’s change process as one size does NOT fit all and how we can embrace the idea of uniqueness and individual journey.
How can I understand that? How can I understand that change is a process that occurs over time? What lenses am I using when I’m looking at my loved one and their struggles? How can that transcend when I’m trying to understand something that doesn’t make sense to me? That’s a really critical ingredient because that’s ultimately what people are asking for: I don’t understand what’s going on here. Is there a set of lenses you can offer me to help me make sense of this?
Communication and reinforcement is the scaffolding around connectedness and connectedness grows when interactions are validating. If both people feel seen in a relationship, there’s roots that take and a strength that comes from that. So no matter what situation, we can practice communicating so we’re both feeling seen here.
Having permission to see the totality of the people we’re with is critically important in terms of that idea of relationships and connectedness. Anytime we’re experiencing not being fully seen, it has an impact on the relationship.
How to support families when their loved ones don’t see a need for change
First and foremost – validate that yes, this is a real challenge. It is disheartening when family members are seeing that there are benefits to change sooner than their loved one. And this is often on a continuum. Sometimes the loved one has had zero thoughts that they should even consider changing. Other times, they have thoughts and those silent moments where they wonder if things don’t seem to be working with them, but continue to keep that to themselves because they don’t believe they’re in a position of taking any steps to making change.
And then, introducing the idea that it could be helpful to have conversations, knowing that it’s not a one size fits all. For some, it’s thinking about broadening the perspective. I’ve found it helpful to reorient families to things that they’re noticing that are going well? It seems like a ludicrous question, but it’s important to point out if we’ve lost sight of the bigger picture. What are the things that your loved one’s doing that you would like to see them continue to do? And how are you supporting those? As human beings we’re sensitized to threat. So that could be conversations of how they want to be present during this time?
Most often, people are coming to the table saying, “I don’t even know myself anymore. I’m responding to this situation in ways that I just regret. It’s not the way I want to be there for my loved ones.”
So that could be another discussion on clarifying values. What’s important? How do you want to be present here? When you think about how you want to be seen as being supportive in this situation, can we think together on what that looks like for you? Let’s make room for that. It’s not putting out the fire initially, but it’s coming at it from a different perspective. Which is how you reconnect to the kind of person you want to be in this. There’s something inherently powerful in having people be able to reconnect with their why that becomes more impactful.
Change is an ambivalent and motivation shows up and goes away. It’s a dynamic process.
Can we make room for motivation to start to grow? If we view it as a tide, there’ll be moments when it shows up and moments where it doesn’t. And if we help people get those lenses, they start to see motivation pop up in different forms that create moments for engagement, discussion, and collaboration that sometimes aren’t seen because of all that swirling around.
Within that same context, we talk about how you support yourself, stay connected, look for opportunities and think about how to respond in a consistent manner with your values to try to help and give feedback to your loved one about how you see changes being something desirable. That brings in the idea of limits and boundaries and other ways that we can talk about intentionally responding to the behaviors that you’re seeing while allowing for the opportunity that connectedness can still be front and center
As professionals, we willingly step into the messiness of people’s lives. And, they’re looking to us to help them navigate these unsettling moments. As humans we have this pull to want to help make things better, to have answers and to have lenses that are useful.
It is complex and reverberates around us as we all sit in this unsettled space. It would be awesome to have a crystal ball to just say, “these are the outcomes that we’re going to give you if you just do this, this and this”. Unfortunately we don’t have a crystal ball, but we do have processes! The ITC approach says that we can help you think through how to be there, while not being alone, in a way that’s consistent with the way you want to be present for your loved one. You’re allowed that as part of this process and these set of tools can help shift some of that ambiguity that is really hard. Nonetheless, it impacts us, no matter what role we play.
Thank you Dr. Carpenter for this thought-provoking conversation!
If you’re interested in registering for the ITC Professional Workshop or purchasing the new companion family workbook for Beyond Addiction – the links are below! We’d love to hear your thoughts over on our YouTube channel, where you can view the full interview with Dr. Carpenter!
Registration for the ITC training
“Communication and reinforcement is the scaffolding around connectedness and connectedness grows when interactions are validating. If both people feel seen in a relationship, there’s roots that take and a strength that comes from that. So no matter what situation, we can practice communicating so we’re both feeling seen here.”