Health Care

You are currently browsing the archive for the Health Care category.

Matt's PictureMatt Sena, M.S. , BrainWise master instructor, trainer and Board member, compiled a summary of his ten years of work using BrainWise with Fetal Alcohol Spectrum Disorders (FASD) children and caregivers.   Matt worked with the aboriginal peoples of Alaska, and his reflection on teaching BrainWise discusses strategies to successfully introduce and implement BrainWise in a culturally sensitive and effective way.  Matt prepared the summary for Gary Brayton, Ph.D., who is seeking funding to teach BrainWise to FASD populations in Canada.  

Dr. Mary Cazzell, a member of the BrainWise research team, was one of six distinguished educators nationwide to be awarded a 2012 research grant by the National League for Nursing.  The competitive award was presented to her in Anaheim, California for her study titled: The Impact of Critical Thinking upon Clinical Judgment during Simulation with Senior Nursing Students.  The award reinforces her work in the area of measuring executive cognitive function.  She will examine how well nurse educators are helping nursing students develop critical clinical judgment, skills, knowledge, and ethical behavior to address the complexities of nursing practice and bridge the education-practice gap. Dr. Cazzell is a professor for the School of Nursing at the University of Texas at Arlington, and joined the BrainWise team in 2009.

The common language of BrainWise, otherwise known as the Ten Wise Ways, helps create a small culture in which coaching and mentoring can have an important impact on group dynamics, according to Matt Sena, a master BrainWise instructor and Community and Family Services Division Program Manager for Chugachmiut, Inc., in Anchorage, Alaska. Sena calls BrainWise “the most powerful doorway that I have found” for affecting peer and family dynamics.

Sena has taught BrainWise to adolescents and families since 1998, when he held a dual position as alternative education and vocational counselor for a dropout retrieval school in Grand Junction, Colorado. A colleague there had a copy of “Positive Life Choices,” an early version of the current BrainWise curriculum, which Sena began to use. He went through the lessons, and was able to teach himself, although he later received formal training through BrainWise founder and director Dr. Patricia Gorman Barry. Sena found immediate results in both the individual learning and groups he facilitated. “These were alternative students who had already dropped out, so they had a hard time with school and paying attention; but they were really working with me on BrainWise, following it, staying involved and reaping good benefits,” Sena explained. “My goal was to get them to move back into their area high school and be successful. Now, when I go back to Grand Junction, I still run into them and it is great to see they have succeeded in life.”

According to Sena, BrainWise is one of the most popular youth interventions that Chugachmiut, Inc., a tribal organization representing the Chugach native peoples of Alaska, employs. “Everybody we work with in the local communities has had exposure to BrainWise. We work with other public health initiatives too, and often combine strategies, but with BrainWise, people clearly understand the terminology.” For example, Sena explains that when he teaches about suicide prevention, youth and community members “get,” and retain, the term “Red Flag Warning” when referring to cues they would look for in suicidal individuals.

A consistent challenge for Sena as a practitioner in a community environment is to come up with strategies for adolescents from difficult home situations. As opposed to counseling adolescents in a group home environment that is highly structured, Sena works with young men whose family situations may not provide adequate support. “If you can create a small culture and have positive male role models, then that’s great. But, we don’t always have that,” Sena said. “I have a small circle of Alaska native boys who live in a mobile home park. There is no room indoors, so they are sent outside to hang out in a pack. I look at that as an opportunity to get them together and teach them some Wise Ways so they have skills to think through things on their own. The key is to positively affect peer dynamics so that the coaching and mentoring influences come through their natural peer group.”

In his work with families, Sena sees many types of struggles, including suicide, neglect, child abuse, and domestic violence. He points to a lack of relationship skills as a common thread to many of these challenges. Last summer, Sena handled a case in which the court had mandated separation of a father from his family due to charges of physical abuse and alcohol abuse. According to Sena, “This was the hardest thing I ever had to deal with. This family wanted to do well and be together, but they needed a vehicle to help them through.” With the family in his office, Sena observed the father’s frustration as his four children ages 3, 4, 5 and 8 began crawling under the sofas and being disruptive. “Their current relationship methods were unsuccessful, and they had to reinvent some strategies to change that,” Sena explained. “I needed to provide information that was relevant to a huge range of ages. BrainWise provided a really good way to integrate so many different intellectual levels in the room.” Over a course of several sessions, Sena worked with the family using the Ten Wise Ways as a structure for building relationship skills. According to Sena, “After learning the Wise Ways skills, they could use language to work through their issues.”

Sena credits BrainWise as being “really beneficial in my work with families. I think BrainWise is a very solid approach to doing prevention strategies not just with youth, but across the board. The Wise Ways work really well and you can customize them to the interests and needs of your community. Here in Alaska, a prevention strategy needs to be adaptable for an intergenerational population. BrainWise excels as that type of approach.”

BrainWise founder and director Dr. Patricia Gorman Barry received a Texas-sized welcome for her presentation: How to Be BrainWise: Teaching Teens to Make Good Decisions, at the National Association of School Nurses (NASN) 2011 conference, held August 15 and 16 in Midland, Texas. School nurses from across Texas Region 18, which represents 34 school districts, attended the two-day conference.

In her remarks, Dr. Barry discussed some of the biological and social factors that can lead to risk behaviors in teens. In addition, according to Dr. Barry, “Many youth never learn skills to stop and think, manage emotions, consider consequences or plan effectively, or they are taught them in a ‘hit or miss’ fashion.”

Dr. Barry related the success of BrainWise in helping young people learn to make choices that have positive consequences. She explained that executive functions, the higher brain processes that control impulses and emotions, must be learned. Dr. Barry discussed how the BrainWise program helps individuals understand this need by teaching them about the brain using metaphors taken from neuroscience. Once students gain an understanding of why they need to build connections, they can begin a series of lessons that teach thinking skills and develop higher brain processes that control impulsive and emotional behaviors.

Finally, Dr. Barry explained that managing emotions and impulse can be difficult, so it takes practice to make good decisions. Students gain practice by using skills in class and at home. A checklist reminder of the skills is provided to the students, and can be the basis of a reinforcement program.

Dr. Barry was invited to speak at NASN by Cathy Harris, school health specialist for Region 18, Texas Education Services Center in Midland. Harris had learned about BrainWise from a school counselor who was using the BrainWise One-on-One curriculum with students in her school. When Dr. Barry returned to Denver after the conference, she received an e-mail from Harris with positive praise for BrainWise. “I was on the phone this week with Odessa’s counseling Department and Amarillo, so I am glad to help spread the word (about BrainWise). I love the checklists and will start applying them personally,” Harris said.

Testimonials praising the BrainWise Program continue to arrive. A public health nurse from Jefferson County recently shared some very positive experiences from incorporating BrainWise thinking skills into his home visits with low income clients.

Armando Reyes is one of several public health nurses who collaborate with Jefferson County Human Services to provide in-home care, individualized consultation, education and psychosocial support to low income women and their families. Reyes represents a program that focuses on preventive healthcare, offers referrals to appropriate healthcare providers or services, and helps clients choose sound, health-related behaviors.

BrainWise founder and director Dr. Patricia Gorman Barry recently received the following comments from Reyes:

“BrainWise delivery is going great! It remains the primary intervention with our clients and I cannot say enough about its effectiveness and usefulness in helping our clients make healthier choices. I am becoming more familiar with other curriculums (Partners in Parenting intervention, Making Parenting a Pleasure) and I have been using BrainWise concepts as a means to reinforce certain tools addressed in those curriculums. I have to say that without BrainWise, it would be more difficult for parents to grasp specific concepts, apply them to parenting and other relationships, and have better outcomes.

“I am teaching a client that last part of Wise Way # 10 tomorrow and in our time together, I have seen great progress in her ability to make healthier choices with parenting (she yells less and uses positive parenting tools), she is able to talk to her case worker without becoming defensive or explosive, and is starting to use ‘I’ statements to advocate for herself when talking with her husband. Needless to say, BrainWise implementation is going great and we are seeing some positive outcomes.”

For caregivers such as Reyes, BrainWise is becoming a significant resource to teach clients to become self-sufficient through improvement of life skills, social resources, health habits and child care skills.

Dr. Barry receives the Jefferson County Public Health Champion Award.

Dr. Barry receives the Jefferson County Public Health Champion Award.

BrainWise Program founder Dr. Patricia Gorman Barry, PhD, RN, has been named a 2009 Public Health Champion of the Year by Jefferson County. Dr. Barry was chosen to receive the award for her work developing BrainWise, a curriculum that teaches decision making skills. Jefferson County public health nurses are using the program to improve the lives of some of the county’s most vulnerable populations.

In 2009, Jefferson County Department of Human Services contracted with Jefferson County Public Health to provide public health nursing services to their clients who are receiving TANF benefits or are involved with the Division of Children Youth and Families. Frequently, these services are provided to families in crisis with multiple children and complex health issues, including child abuse, substance abuse, domestic violence, and mental and physical health problems. The clients often do not know how to utilize the resources available to them to become self sufficient.

According to Rebecca Persing, DNP, RN, the BrainWise curriculum is the foundation for nursing interventions provided by the Jefferson County Public Health Nurses/Human Services Collaboration. “BrainWise has enabled our Human Services clients to have both the belief and the skills they need to overcome the patterns of family functioning and environmental factors that led them to involvement with Human Services,” Persing said.

As the primary nursing intervention, BrainWise gives nurses tools to teach clients skills that will help them make better choices and decisions. Persing says the program “allows nurses to address multiple problems with clients of all ages simultaneously and provides a common language.” She notes that, “Clients readily relate to the curriculum’s lessons on the brain and appreciate its non-judgmental approach to help them overcome barriers to being self-sufficient.”

Jefferson County Public Health will honor its 2009 Public Health Champions of the Year at a luncheon and awards ceremony on April 7, 2010. Dr. Barry will join representatives from ten other agencies who will be recognized for their work improving the health of Jefferson County. The Jefferson County Board of County Commissioners and Board of Health will present the awards.

The BrainWise Program is helping Jefferson County Public Health nurses maximize patient care and improve outcomes for a wide variety of client issues. The public health nurses, in collaboration with Jefferson County Human Services, provide in-home care such as individualized consultation, education and psychosocial support to low income women and their families. The focus is on preventive healthcare, referral to appropriate healthcare providers or services, and assisting clients with choosing sound health-related behaviors. The agencies are looking to BrainWise as the primary intervention for this initiative, which aims to make clients self-sufficient through improvement of life skills, social resources, health habits and child care skills.

When making home visits to a TANF (Temporary Assistance for Needy Families) or Child Welfare client, for example, a visiting nurse can use the 10 Wise Ways to frame the discussion regarding the client’s network of support, wizard or lizard brain choices, red flag warnings, emotions elevator or other BrainWise concepts. According to Rebecca Persing, RN, DNP, “These tools will help the nurses provide adults and children with thinking skills and resources to solve problems and function adaptively in family, school, work, and community contexts.”

Future plans call for expansion of this collaborative effort to include providing resources for nurses to send text messages customized for each client. In addition to reinforcing the practice and use of BrainWise thinking skills, texting is expected to help keep expenses down and maximize nurse contact with clients. Clients’ knowledge of BrainWise skills and confidence in that knowledge will be assessed using an online program called Confidence-Based Learning (CBL). Evaluation of the program will be completed by two educational psychology professors from the University of Northern Colorado who will be using pre-and posttest assessments.

BrainWise founder Dr. Patricia Gorman Barry is optimistic about the future of this effort, and its adaptability to other programs. “If BrainWise thinking skills can be evaluated, and eventually delivered using CBL technology and text message follow up to improve at-risk family issues, this system could be utilized as part of an intervention for similar families and applied to other high-risk behaviors,” Dr. Barry said.