Liz Unruh (Host): Hello, listeners, and thanks for tuning in to the Well Within Reach podcast brought to you by Riverside Healthcare. I'm your host, Liz Unruh, and joining me today is Shawn Cooper, who's a Clinical Case Manager at Riverside. And today we're going to be talking about the transition from group therapy to everyday life.  

Liz Unruh (Host): Shawn, thanks so much for joining us today.

Shawn Cooper: Thanks, I appreciate you having me on. It's a pleasure for sure.

Host: Yeah, so can you tell us a little bit about yourself and your role here at Riverside?

Shawn Cooper: Yeah, I appreciate you having me on. It's definitely a pleasure. I have been with Riverside for a little over two and a half years. I spent some time as a mental health specialist where I facilitated group therapy on the adult mental health unit, and then for almost about the last year and a half, I've been a clinical case manager, spent some time on the senior behavior health unit, and now I'm back to the adult mental health unit.

I am a Kankakee native, so grew up right here in town, with three siblings, and my mother, and I'm also an Olivet Nazarene graduate. Graduated with my bachelor's in 2013, and I have completed my course requirements, for my MBA, and will graduate in May of this year. So, super excited about that.

Host: Yeah, very exciting, and it's great that you have those Kankakee roots. We always like our Kankakee natives around here.

Shawn Cooper: For sure.

Host: Just for people who maybe didn't listen to our podcast about group therapy, can you just give us a little recap about what group therapy is?

Shawn Cooper: Yeah. So group therapy is a type of therapeutic tool that typically involves one or two clinicians that are licensed professionals that have, you know, between maybe five to fifteen individuals wanting to work on themselves develop skills.

And so group therapy is primarily about teaching evidence based coping skills and techniques as well as kind of receiving that social support and accountability from other people. So typically groups last between maybe three weeks to three months. And the benefits of group therapy, I know a lot of people are kind of hesitant because, you know, social anxiety is something real, I always say, I'm an extrovert, so it's a little easier for me, but I say, you know, allow yourself to be vulnerable and take that chance because you don't know what you might learn or take away from it.

The dynamic I really enjoy about groups is it allows you such a diverse background, right? So you're going to be there with people who might have a very different experience than you, maybe a different generation than you. Come from a different background, socioeconomic status. And so you get to just learn a lot and hear a lot from other people and get that support and accountability while also giving you perspectives that maybe you wouldn't otherwise have interacted with.

Host: Yeah, I think that's definitely a good benefit of group therapy is seeing the other perspectives and experiences that other people had to kind of relate your experiences to theirs and see not everyone's experiences are the same. So I know today we're talking about kind of the transition from, okay, you've completed that three week, three month, group therapy and now you're looking to take some of those skills and transition to real life.

Are there some common challenges that you observe clients facing when they exit group therapy and go on into their everyday lives?

Shawn Cooper: I think the hardest part is group therapy is typically Monday through Friday, you know, five days a week and maybe up to three hours a day. And so typically the first kind of barrier or challenge is like that transition from not having that daily support and those daily check ins with the people that you become super familiar with and provide you that support and motivation.

And so kind of transitioning to being more independent. And, having to implement those skills and find then your next layer of support is kind of one of those things that can be a challenge for some. And we got to think about, right, we're going back into the real world and everyone isn't focused on being their best self, right?

And so now back in our real world, whether that's being at work, being at home, interacting in the community, everybody's not trying to, yeah, work on themselves, and so that's something that we also have to get better at, just adjusting back to what a more higher stress environment.

Host: Oh yeah, for sure. And I know something you touched on there was your support system. How do you approach the topic of establishing a new support system outside of the structured group environment?

Shawn Cooper: Yeah, so one of the things that we work on in group is identifying a support system. And that's one of our protective factors. And so what we want to do is is build that support system, whether it's with our family, our friends um, a neutral party and make sure that they are aware of kind of what are our expectations and they're willing to commit to providing that support to us.

Host: Yeah. I think that's really important. Having any type of support system, especially if you're dealing with creating that best version of yourself, like you say, that we're trying to create in that group therapy setting. So besides creating that support system, are there any other skills that individuals learn during their time in group therapy that would be beneficial to apply to their everyday life post therapy?

Shawn Cooper: Yeah, 100 percent. I think the top one that I would say is like emotional intelligence is a skill that you definitely work on while you're in group therapy. So we're working on identifying how am I feeling? What am I feeling? And how can I express or communicate that to someone else? So being able to one, identify it and then two, express that appropriately is definitely a very essential skill to utilize, right, in all relationships, professional, personal, romantic.

And so that would be one. I think another one is cultural humility. So again, being in that group dynamic with people who might be different than you, understanding that we're all learning, right? None of us are perfect and that there can be humility in terms of how we interact with people who are different than us.

Also, obviously communication and how we communicate to other people and the delivery of things and how we can utilize I statements, how we can utilize empathetic listening, responsive listening. So, not only am I engaging with you, but I'm repeating back what I heard from you so again, that can kind of translate into all your relationships throughout your lifetime.

And then I would say like problem solving and conflict resolution are things that you kind of build as well in group therapy and is going to help you along your journey.

Host: Oh yeah, for sure. I could definitely see that, especially if you have, while you're creating that support system, that conflict resolution could be, could definitely be good. If someone might be like, I don't want to help you, it's like, well, okay. Perhaps I should find someone else for my support system. Yeah. So, I know that's something that I've talked to some of our other mental health professionals at Riverside about is when you're looking at your mental health and trying to better yourself, something that is really important is creating routines that create a positive outlook on.

Are there any insights you can share about the importance of establishing and maintaining those healthy routines after leaving group therapy?

Shawn Cooper: Yeah, I think habits are key. And in the hospital setting, we kind of start our day the same every day in terms of group therapy. And we end it the same way.

So every morning we do a check in group and kind of identify how am I feeling physically, how am I feeling emotionally. And identify a goal to work on for that day. And so that's a good base to kind of even bring that outside of there to really incorporate into your everyday lifestyle and, building a habit and at the end of the day, we kind of do a reflection group and kind of talk about, okay, how did today go?

Did I excel in the goals that I had or achieve those things? What can I work on, where can I improve, and kind of just provide some reflection and maybe that helps you journal when you go home or do that verbally with someone else. And those habits are key, right? I can think of um, my wife's a big reader.

And so at our house, we have a pretty large library. And so in those bookshelves, right, every week, if we don't dust those bookshelves, that dust accumulates pretty quickly, right? And so, what's important in maintaining that habit, is that we are staying consistent. And so even if I'm feeling really good, I should still be incorporating those skills that I've learned because eventually that dust accumulates and things will become a little bit more rusty and hard to, like, bounce back from if I'm not using it right on a constant, on a daily basis.

Host: Yeah, so definitely keep that bookshelf dusted.

Shawn Cooper: I know, I try to. Another part of it that we kind of incorporate is like safety planning and that's kind of another skill that we utilize before you exit group therapy is, okay, what are some of these things I need to make sure that I'm aware of to catch myself, before I slip up too much.

Host: Yes, for sure. Those all seem like great habits to get into. And like you said, keep the analogy you use, keep the dust off the bookshelf, like keep practicing it so that you can keep going and use those skills.

We're going to take a quick break to talk about finding a primary care provider. Riverside knows that health, especially your mental health, is your greatest asset, and that your primary care is your partner in health. If you're starting out on your mental health journey, a great first step would be talking to your primary care provider. If you don't have a primary care provider, Riverside can help. Find a primary care provider that fits your needs at riversidehealthcare.org/primarycare.

And we're back. So, Shawn, in your experience, what are some of the effective strategies for helping individuals maintain the progress that they've made in group therapy as they integrate back into their daily routines?

Shawn Cooper: Sure. So I'll kind of break down a couple of the different, like, therapy modalities and talk about some of the benefits that even I've gained from learning them and practicing them. So CBT is one of our essential modalities and it kind of talks about the connection and interconnectedness between our thoughts, our feelings, and our behaviors, right? So they all impact and influence each other. And so in CBT, one of the skills that we teach is cognitive reframing. So I can't necessarily control how I feel, but what I can control is how I think about things. And so what we want to do is eliminate or reduce our negative thinking and our negative thoughts and reframe those into the positive.

And in creating more positive thoughts, we're going to then influence our emotions and influence our behavior or action based off of those thoughts. So that's one way that we can kind of implement that if I'm thinking, oh, this is going to be a terrible day. I've kind of set myself up for failure, right?

And so instead of that, in the morning I'm going to say, I have an opportunity, right, to do better, to start fresh. And so having that can lead me to maybe experiencing more positive emotions, and then I'm going to act out in a more positive manner.

DBT, another one, kind of teaches a lot of emotional distress tolerance skills. And so one of them that's my favorite is opposite action. So when I feel super emotional or overwhelmed, I'll eat. Right, I'm a stress eater, and so instead of doing that, right, what it teaches us is when we have an uncomfortable emotion, if I feel vulnerable, overwhelmed, stressed out, instead of going to what my urge is, is to eat, instead what I'm going to do is do something the opposite, right, so let me get on my elliptical for 10 minutes and do that, right, or let me go and talk to my wife or talk to my kids and do that, and that's going to then eliminate, right, some of those negative patterns.

Behavioral activation is another one that I think is super important. And so Simon Sinek talks about the chemicals that are in our brain that help us feel better. So whether that's endorphins, dopamine, serotonin, oxytocin; behavioral activation says, even when you don't feel like doing it, do it anyway. And so even when I'm feeling down, I'm going to still follow through with those routines and those habits. So whether that's physical activity and exercise, whether that's being social and going out and interacting with other people; I'm going to do it anyway. And that's going to bring about some of those emotions and some of those chemicals that help us along the way.

Host: Yeah, for sure. Those are all effective strategies that people can definitely keep in mind as they're making that transition. So I know one thing that people are always worried about is, okay, I did this program; um, what if I relapse or what if I have setbacks? I know that's often a big concern. How do you assist clients in building the resilience and coping skills to address this challenge?

Shawn Cooper: Yeah, I think it's important to realize what is resiliency. Resiliency is that capacity to recover quickly or bounce back or know that you're going to make it through it, no matter what is the situation. And so, what I like to teach in terms of building that resilience is understanding that you're we're going to all make mistakes.

None of us are perfect human beings. And so we have to be realistic with ourselves and be objective in that slip ups are going to happen. But the benefits of that safety planning is when we start recognizing the warning signs, we catch ourselves sooner. And then we can kind of, yeah, bring it back.

As well as remembering that two things can be true at the same time. Right. So even when some things aren't going the way I necessarily prefer it to be or want it to be; I can still be optimistic and hopeful for that as well. And so hope and faith, I think, are two strong values as well that kind of interact with being resilient.

And I would throw out there too, maybe my pitch to like individual therapy and after group therapy, having that individual therapist, I think is a good way to make sure that you have that resiliency and you're building those coping skills, to help you in terms of setbacks or relapse.

So if you're seeing a person, you know, on a consistent basis that's going to help you. And if that's a professional, I think it helps even more. But if say, you can't do that, at least find somebody who wants to be consistent and is willing to be that mentor in your life or whether you find a life coach, spiritual counselor, or whatever it is. I think that's a super important part of the journey as well.

Host: Yeah, it's part of that support system that we talked about earlier in the podcast. I know that there's this balance, when it comes from, you've created the support system, but you also want to do things independent. and do this for you, but we all know that the ongoing support is crucial. How do you guide clients in finding the balance between going about it individually or having that support system?

Shawn Cooper: Yeah, I think self awareness is key and that's one of those traits that comes out of our emotional intelligence. So being aware of where I currently am at and what I objectively need is important. And so, noticing when those red flags are going on is helpful to realize, okay, when I need to rely on my support system and not just try to push through.

Um, I think our culture is big on us being self-efficient, self-fulfilling and not being reliant on other people, but it's okay to be secure with other people and to, reach out and ask for help. That's one of the hardest things sometimes to do.

Host: Yeah, for sure. I know that sometimes you're just like, I can do this myself, but the best thing to do is reach out and find someone that you can ask for that help.

Shawn Cooper: Yeah. And I think even just being aware of different times in our life, those can be some of the triggers that we talk about. So whether that's the seasons. Right? Seasonal depression is something that people experience, whether that's certain anniversaries, so whether it's death anniversaries or loss of loved ones or relationships or whether that's, you know, certain time of the day or certain people that I have to interact with, right? Whether it's those family members or those co-workers, if we're aware of, okay, this is going to be a harder thing for me to work through or this season of time, it's difficult, then I need to rely on that social support system again more and not try to just keep pushing through myself.

Host: Yeah, for sure. So lastly, reflecting on your experience, what's one valuable lesson or piece of advice that you'd like to share with others who might be helping someone make this transition out of group therapy?

Shawn Cooper: Yeah I think I would say Brene Brown quotes it really great in terms of doing a lot of work around shame and she kind of helps us articulate it in saying that feeling guilty is feeling like the action that I made was bad.

So what I did was bad, but shame is that I am a bad person. And so my biggest pitch to everyone I interact with, right, is to eliminate that feeling of shame. I think it's a very dangerous emotion and a very cyclical emotion that just gets worse and worse and worse. It's a kind of snowball effects.

And so, whether you are the person or whether you're supporting the person working through things, we want to decrease any types of shame and thoughts of shame. And I think I then would say that remember and understand that you are inherently good. It is my belief in that as a strengths focused person, I think that there's greatness inside of each and every one of us.

And so understanding and remembering that there's greatness inside of you, that you are inherently good, that you are worthy, that you are valuable. You shouldn't be ashamed of who you are and mistakes that you've made. Push through, be resilient, empower yourself and overcome.

Host: Yeah. Thank you so much. That's some really great advice and thank you for joining us today, Shawn.

Shawn Cooper: Thank you.

Host: Yeah, and thank you for tuning in to the Well Within Reach podcast with Shawn Cooper with Riverside Behavioral Medicine and your host, Liz Unruh. To learn more about the services provided by Riverside's Behavioral Medicine Department, visit our website at riversidehealthcare.org or call our Central Intake Department at 844-442-2551.