Eskenazi Health’s Hoosier Heartland Healing Collaborative (HHHC)
Over the past decade, residents of Indianapolis have experienced substantial challenges related to violence and addiction. Where violence and addiction are present, the consequences ripple throughout the community resulting in chronic, multi-generational trauma. Systems of support – health care providers, corrections staff, educators, faith leaders and other community leaders – often find themselves in a position where they lack the skills to work through their own secondary and personal traumas, leaving them at risk for many of the same challenges faced by their patients, clients, students and parishioners.
Eskenazi Health Hoosier Heartland Healing Collaborative, a new Eskenazi Health-led program in partnership with Center for Mind-Body Medicine and funded, in part, by the Herbert Simon Family Foundation, aims to equip the community with skills proven to aid in alleviating trauma and secondary trauma. Using Center for Mind-Body Medicine’s evidence-based model, the program teaches participants how to use self-care and group support as tools for stress- and trauma-relief along with how to build resilience.
The program consists of two parts for trainees. Individuals will first go through the Professional Training Program and then follow that up with the Advanced Training Program. After the two-part training, individuals will be able provide people who are struggling with stress, anxiety and depression with instruction in basic stress- and trauma-relief services through mind-body skills groups, self-care workshops and in other appropriate settings.
CMBM Professional Training Program for The Eskenazi Health Hoosier Heartland Healing Collaborative
What is Mind-Body Medicine?
Mind-body medicine is based on the scientific understanding of the inextricable connection among our thoughts, sensations and feelings, and our mind, body, and spirit – between ourselves and the social and natural world in which we live. It focuses on the interactions between mind and body; and the powerful ways in which emotional, mental, social and spiritual factors can directly relieve stress and improve health. It is used with individuals, groups, and entire populations.
Mind-body skills are scientifically validated to reduce stress and restore physical and psychological health. The mind-body approach heals individual trauma and builds community-wide resilience.
The Center for Mind-Body Medicine’s (CMBM) approach to wellness is grounded in practical, evidence-based skills for self-care, nutrition, self-awareness, and group support. It emphasizes an approach that respects and enhances each person’s capacity for self-knowledge and self-care.
What’s the Science Behind It?
Mind-body approaches use the conscious mind to directly affect the workings of the brain and the rest of the body. The techniques exert their effect on the hypothalamus, the switching station in the brain, which exercises control over the autonomic nervous system (which controls heart rate, blood pressure etc.), the endocrine (glandular) system and the immune system.
The scientific literature on these approaches is now rich and robust. Studies dating from the late 1960’s have shown the power of mind-body techniques to balance the over-activity of the sympathetic branch of the autonomic nervous system (“the fight or flight” and “stress” responses) which is implicated in many physical and emotional diseases and conditions, with parasympathetic nervous system stimulation that promotes relaxation.
More recently, these techniques have been demonstrated to create beneficial changes in many of the body’s physiological responses (including blood pressure, stress hormone levels, pain response and immune functioning) and to make a significant clinical difference in conditions as diverse as hypertension, HIV, cancer, chronic pain, and insomnia as well as anxiety, depression, and post-traumatic stress disorder.
What is the Center for Mind-Body Medicine?
The Center for Mind-Body Medicine (CMBM) was founded in 1991 by James S. Gordon, MD, a former researcher at the U.S. National Institute of Mental Health, a clinical professor of Psychiatry and Family Medicine at Georgetown Medical School, and former chair of the White House Commission on Complementary and Alternative Medicine Policy. Over the last 30 years, CMBM’s 160 global faculty members and 5,000 trained clinicians, educators, and community leaders have successfully brought programs of self-care and group support to hospitals and clinics, schools and universities, and to social service and community-based organizations around the world - particularly to populations touched by conflict, terrorism and natural disasters such as Bosnia, Kosovo, Israel, Gaza, Haiti, hurricane-ravaged southern Louisiana, Houston, and Puerto Rico, and with U.S. soldiers and veterans. Mind-Body Skills Groups (MBSGs) are CMBM’s signature small group model for teaching and learning self-care skills. CMBM Professional Training Program for The Eskenazi Health Hoosier Heartland Healing Collaborative
MBSGs have repeatedly, in studies published in leading, peer-reviewed journals (including the first randomized controlled trial of any intervention with war-traumatized children), reduced the percentage of war-traumatized children and adults who qualify as having Post-Traumatic Stress Disorder (PTSD) by 80% or more. Published research also demonstrates statistically significant decreases in depression, hopelessness, anxiety, anger, sleep disturbances, and stress hormones, and increases in quality of life.
CMBM’s work has been featured in The New York Times, The Washington Post, The Atlantic and on CBS 60 Minutes.
What is this training program about?
The Center for Mind-Body Medicine (CMBM) and Eskenazi Health have created the Hoosier Heartland Healing Collaborative (HHHC) with the goal to bring an evidence-based program of population-wide healing and resilience-building to Indiana. The vision of HHHC is to address the psycho-social-spiritual needs of those on the front lines of community support. This Initiative will equip the community at large with skills proven to aid in alleviating trauma and secondary trauma, increasing self-regulation, and building resilience and hope for the future.
The Collaborative is organizing and implementing a comprehensive program of training, guidance and support for 140 mental health counselors, therapists, emergency first responders, teachers, school counselors, community health workers, and religious, spiritual and community leaders as they learn and integrate the CMBM model into their existing programs and services. In addition to the Collaborative partners, the program also aims to engage other local organizations that provide direct health, behavioral health, educational and spiritual services to the area’s most impacted children and adults.
CMBM’s pioneering model is grounded in self-care and group support. It teaches participants a number of practical, easy-to-learn techniques, including:
● several types of meditation
● guided imagery
● biofeedback and Autogenics
● self-expression in words, drawings, and movement
These techniques and the “Mind-Body Skills Groups” in which they are taught make use of people’s strengths; encourage them to experiment with their own abilities; enhance their sense of control; and are interesting and fun.
The program uses a “train-the-trainer” approach. Participants first learn and practice the techniques on themselves, and then teach others in small, supportive Mind-Body Skills Groups, Self-Care Workshops, and individual and family sessions. This approach enables service providers to address their own stress, trauma and burnout, as well as help their communities.
The training program consists of a three-phased curriculum, each setting the foundation for the next. As a condition of acceptance into the program, each participant must be able to commit to all three phases of the curriculum. CMBM Professional Training Program for The Eskenazi Health Hoosier Heartland Healing Collaborative
The first phase, the Professional Training Program, will be held September 30, October 1, 2 and October 5 & 6. More information about this training is described below. The second phase, the Advanced Training Program, is scheduled for *November 12, 13, 16, 17 and 18, 2020 and teaches participants how to deliver this group model to their clients, patients, students, friends and families. *This is the projected window for the Advanced Training Program, and the final dates will be announced no later than the Professional Training Program.
Upon completion of these first two phases, trainees will participate in a third phase (Practicum) in which they will co-facilitate two 8 to 10-week Mind-Body Skills Groups (MBSG) with supervision. From there, a select group will then be prepared to lead the effort locally through participation in CMBM’s Certification Program and a Leadership Training Program. The selected local Leadership team establishes the foundation for a long-term, sustaining presence in the community.
What happens at the Initial Professional Training Program (Sept 30, Oct 1, 2, 5 and 6, 2020)?
CMBM’s Professional Training Program offers an introduction to mind-body skills within the group context and focuses on teaching participants how to use these skills in their own self-care and how to begin to integrate the approach and techniques into their ongoing work as clinicians, community health workers, social service case workers, clergy, teachers, counselors and other caregiving professionals. These simple, transformative skills are the ideal antidote to stress and burnout, and the perfect tools for the caregiver’s toolkit.
The training includes extensive scientific material on the biology and physiology of stress and burnout and on the specific techniques used, as well as experiential work in an intensive, supportive small group.
Over the course of the 5-day Professional Training, trainees will participate in large group plenary sessions in which senior CMBM faculty teach the science of mind-body medicine. Plenary presentations include:
● Overview of the New Medicine
● Introduction to Mind-Body Skills Groups
● Biological Underpinnings of Mind-Body Therapies
● Imagery
● Mobilizing, Transforming, and Celebrating the Emotions
● Genograms
● Breathing, Physical Exercise and Movement
● Trauma and Transformation
● Spirituality and Healing
● Body Awareness
During the training program, trainees will also participate in eight Mind-Body Skills Groups in which they will learn one or two mind-body techniques (such as meditation, guided imagery, biofeedback, working with drawings, breathing and movement). The group combines the didactic learning, experiential learning, practice and group support. In the small supportive groups, led by CMBM faculty, trainees practice mind-body techniques and experience their effects personally. The small groups provide an opportunity for self-expression and mutual support. These experiences of self-care – experiencing one’s ability, for example, to lower blood pressure or decrease anxiety – enhance each person’s sense of self-CMBM Professional Training Program for The Eskenazi Health Hoosier Heartland Healing Collaborative efficacy and self-responsibility even as they provide direct physiological benefits. The groups also offer members support in making the major changes in lifestyle which are required to alter the course of chronic physical and emotional problems. This is not a therapy group! However, we find that sharing and connecting with others creates a wonderful learning environment, helping each individual become more self-aware and more engaged in their own self-care.
Participants are never forced to share beyond their comfort level; but in order to share the techniques with patients and clients, it is crucial that they experience them first hand and “walk the talk”. Each group has approximately ten participants and one faculty member, and the group stays together throughout the program, learning together and often becoming friends for years to come. A majority of participants list the small group in post-program evaluations as their favorite part of the program! And understandably– this is the part that supports your own healing and self-care, and eventually that of your family, friends and patients.
Eskenazi Health Hoosier Heartland Healing Collaborative: A Comprehensive Wellness Program for Our Communities
Eskenazi Health’s Hoosier Heartland Healing Collaborative (HHHC) is a multi-year initiative will build on an established partnership between Eskenazi Health and The Center for Mind Body Medicine (CMBM) to enhance the capacity of our community to address challenges of chronic stress and trauma. The program is being made possible, in part, by a grant from the Herbert Simon Family Foundation. During the multi-year project, thousands of local residents will be impacted by the expansion of CMBM’s in-depth, mind-body medicine training. The ongoing supervision and mentorship of 140 key staff from Eskenazi Health and collaborating organizations, as well as the development of a local leadership team will build a solid foundation to support the work for years to come and provide a program of population-wide healing and wellness that can be a model for similarly challenged cities across the United States.
The proposed project includes the following components:
Professional Training Program (PTP) – This initial five-day training provides a comprehensive introduction to CMBM’s approach through didactic instruction on the scientific basis for the model and small and large group experiences of mind-body techniques. The training includes in-depth material on the biology and psychology of stress and trauma as well as the specific evidence-based mind-body techniques used.
Advanced Training Program (ATP) – This additional training (four to five days) is designed to help trainees deepen their experience and confidence with the skills learned during PTP, and equip them to utilize the skills with patients, clients, students and colleagues. It includes a combination of didactic lectures on implementing the model along with practicums in which trainees lead groups, teach the techniques, and receive support and feedback from senior CMBM faculty.
Upon completion of the training, all trainees will be equipped to implement the CMBM model of self-care and group support in their work organizations during a Practicum phase. Trainees will be expected to lead Mind-Body skills groups and workshops for trauma-affected children and adults, community members, colleagues, clients, and students. They will also integrate the principles and practices of mind-body medicine into their work with individuals and families. Intensive supervision and mentorship will be provided to support new Trainees as they integrate the model into their work.
After completion of the Practicum phase, the Collaborative will identify forty facilitators to participate in CMBM’s Certification program. This Certification process enhances their understanding of the model, strengthens their skills as a facilitator, and deepens their commitment to carry the work forward in the community. A subset of twenty of the most skilled Certified Facilitators will then complete Leadership and Supervision training, equipping them to provide supervision to local participants, and ensuring the sustainability and continued growth of the program.
Standardized assessment tools will be used to evaluate the program’s impact on facilitators and Mind-Body skills group participants in the community. It is expected that facilitators and participants will experience decreased levels of depression, anxiety, and stress, with results that are maintained at a three-month follow-up. Research indicates that trauma, stress and violence feed off of each other, often with tragic results. Similarly, stress has been identified as a key risk factor for addiction. By teaching tangible skills to better manage stress, anxiety, and depression, the project addresses the key root causes of widespread addiction and violence in central Indiana and will be expected over time to contribute to significant reductions. The program will be carefully documented so as to become a replicable model throughout the country.
The Eskenazi Health Hoosier Heartland Healing Collaborative: Training Participant Selection Criteria & Guidelines
Participant Selection Criteria Guidelines
Since space will be limited in this program, we have developed the following guidelines to help us select applicants who will be best positioned to help us achieve our goal of reach and sustainability. The Eskenazi Health Hoosier Heartland Healing Collaborative (HHHC) and CMBM will vet and select participants based on the following criteria.
Applicants with the following qualities will be given priority for acceptance into the program.
Program participants should:
1. Be in a position to reach a significant number of people in the Greater Indianapolis area or the participant’s surrounding community
2. Have the capacity to implement a group model in their normal service delivery to clients/patients/parishioners/students/colleagues
3. Be eager to participate in the training – engaged, excited, willing to put in some energy
4. Be able and interested in learning new skills
5. Demonstrate a capacity for self-awareness
6. Have the capacity to be self-reflective and open to new ideas
7. Have the ability to be present to others without being reactionary
8. Commit to 100% participation in each phase of the training program in which they are selected to participate
9. Commit to co-facilitation of two rounds of 8-week mind-body skills groups (MBSGs) in the community and/or with colleagues
10. Commit to co-lead one workshop introducing mind-body medicine to the community you serve
Ideally, an even number of people (not less than 4) will represent each partner organization/coalition so that they may better support each other and enhance the commitment to long-term sustainability within their organization. Organizations should consider size, dispersal ratio within the organization, and their commitment to long-term engagement with the Collaborative and use of the Mind-Body Medicine Model when considering their attendance commitments.
In some cases, it may be most efficient to organize a meeting with potential participants to elicit interest and address questions.
It is essential that both the partner organization as well as the training participant is aware of and committed to the full scope of the program. See document “HHHC – Commitments of Trainees & Partner Organizations”
It’s important to emphasize that the initial training is very experiential. This first training is for them, the trainees, to have the full immersive group experience rather than simply trying to understand the model cognitively. They will be learning from each other, deepening their own self-awareness and learning skills through large group lectures and small group participation.