In This Issue:
BHWP Spotlight
A Study in Wellness
Wellness in Practice:
BHWP Spotlight
Reimagining a Well Body
It was two years ago that we at BHWP, as a team, made the commitment to redevelop our DIMENSIONS: Well Body Program. We knew it would be a huge undertaking. Taking deep dives into the evidence base of what is actually needed to support physical health and well-being is no simple task. But we knew a change was necessary.
Similar to many other nutrition and weight management programs, our original Well Body Program focused on energy balance using a “calories in, calories out” model.
Standard Model (Calories In, Calories Out)
In this model, eating too much and exercising too little leads to obesity, which then causes chronic diseases, such as cardiovascular disease and diabetes. If this were the case, the treatment is straightforward:
- Take in fewer calories by eating less or exercising more
- Lose weight
- Reduce your chronic disease risk
But is this what really occurs? Given the most current evidence, this model falls far short in explaining the associations between obesity and chronic disease. For decades, healthcare providers and government guidelines have advised Americans to reduce calories and increase energy expenditure to lose weight. Despite this nearly universal advice and effort, obesity rates are not declining. In fact, they have dramatically increased.
Reimagining A Well Body: An Alternative Perspective
In contrast, mounting evidence finds that obesity should be viewed as a physical indicator or a signal that a person has or is at risk for disrupted metabolic function, insulin resistance, and chronic disease. Therefore, the key to treatment and behavioral intervention lies not with reducing calories to lose weight, but rather with identifying the ways we can prevent metabolic dysfunction and insulin resistance.
Behavioral Factors Influencing Metabolic Health: Stress, Sleep, Nutrition, and Physical Activity
In the new Well Body training, we explain how nutritional choices and trends in the U.S. diet have led to a rise in metabolic syndrome, insulin resistance, and associated disease. We also focus on the interactions between stress, sleep, nutrition, and physical activity, identifying interventions that support overall physical health and wellness in these four areas.
The program focuses on strategies to engage individuals, enhance motivation, and practice sustainable behavior change. Utilizing Motivational Interviewing, a Well Body motivational intervention, and a 6-session group curriculum, we have designed a training that lives up to its name—Well Body—and can strengthen your ability to transform the health of the people you serve.
We hope you will like it as much as we do!
A Study in Wellness
Peer Support
I was nervous as I walked into the classroom on that early summer day. No longer a student, I returned to this classroom as a co-facilitator and instructor. I was eager, yet terrified, to guide my students into a relatively new and promising field. As the students filed in, I realized I wasn’t the only one who was scared; fourteen people of mixed backgrounds came tentatively together to learn how to turn their past struggles into a roadmap of hope as peer support specialists.
Peer support is rapidly becoming an important topic within behavioral health circles.1 Peer support specialists, who are also known as peer navigators or peer coaches, are people with “lived experience” in the realms of substance abuse and addiction, a mental health diagnosis, or someone who has experienced homelessness and/or trauma.2 They are not only living in recovery, but they are then able to model that recovery and guide others to find it for themselves.
Peer specialists learn specific skills that enable them to do this effectively. In our classes, we teach about trauma and trauma-informed speech, strength-based feedback and proper boundaries, empathetic and reflective listening, goal setting and motivational interviewing, WRAP (Wellness Recovery Action Plan) basics, and many other topics including stigma, personal advocacy, and group facilitation. Once trained, the peer specialists can then learn so much more through work experience, becoming masters at finding and offering resources and advocating for their clients. They can provide everything from a compassionate ear to bus passes, respite beds, housing programs, and 12-Step groups.
This can extend the reach of a clinician considerably.1 In a field where providers can easily become overworked and burned out, peer specialists provide not only support for those trying to find a sense of balance, but also for the clinician who can only spend a small amount of time with each client. Research is also finding that clients seem to prefer to meet with someone who has “been there” and understands the stressfulness of finding shelter or the struggles of dealing with a mental health condition or addiction.3 Since peer specialists have had to navigate the difficult terrain of resources themselves in order find their way to wellness and recovery, they bring an authenticity to the environment that is valuable both to the client and to the agency.
As I stared at my new students, I knew that the skills they would learn in this class would enable them to be an important asset within their communities. Like the supports of a bridge, their compassion and efforts would help others to walk over turbulent waters and touch the sky.
References:
- Daaleman, T. P., & Fisher, E. B. (2015). Enriching patient-centered medical homes through peer support. The Annals of Family Medicine, 13(Suppl 1), S73-S78.
- James, S., Rivera, R., & Shafer, M. S. (2014). Effects of Peer Recovery Coaches on Substance Abuse Treatment Engagement Among Child Welfare-Involved Parents. Journal of Family Strengths, 14(1), 6.
- Gidugu, V., Rogers, E. S., Harrington, S., Maru, M., Johnson, G., Cohee, J., & Hinkel, J. (2015). Individual peer support: a qualitative study of mechanisms of its effectiveness. Community mental health journal, 51(4), 445-452.
Wellness in Practice
Awake!
A friend’s text read, “Got kale?” He’s been pushing us to harvest kale from his garden over the last few days. His harvest has been abundant, garden boxes overflowing with two different varieties of kale and Swiss chard. Tomatoes, zucchini, beets, and carrots are yet to come. I send back a quick text, “Be right over.” I grab my keys and head out to collect some kale for our salad dinner.
I love sharing and receiving garden fresh fruits and vegetables. So far, we’ve received rhubarb (and now kale) and given sour cherries. Not only do we get to visit with our friends while picking cherries or clipping kale, we prepare and eat nourishing foods that taste—alive! And it encourages me to consider new ways to prepare and preserve this great abundance of food. I know I’m fortunate. I grew up with a father who loves to garden, nurturing fruit trees, vegetables, and herbs.
While I provided only minimal support bringing glasses of cool water for him to drink), I experienced the pleasure of reaping the rewards of his labor. I tasted the difference between ripe fruit just picked off a tree and fruit that ripened in a refrigerated box.
I know what it’s like to truly be nourished by food fresh from a garden. It is this experience that I recall when I am doing the work of gardening—weeding, trimming, watering—the tedious labor of it. And it makes it all worthwhile.
Serenity
Every summer my family makes an effort to spend a little time off the grid. This year we chose a camping destination just far enough from civilization that we had no use for our devices and ample opportunity to engage in our beautiful, natural surroundings. The first day of adaption is always a bit of a shock. Who packed the bug spray? Do I really have to brush my teeth with a cup of water and no sink?
By the second (or third) day, sleeping two inches from the hard ground in a nylon bag doesn’t seem ridiculous at all. Instead it seems peaceful – despite the chirping grasshoppers and the howling coyotes in the middle of the night. For me, much of the peace comes from not having to worry about schedules, news headlines, bills, weeds to pull, and the rest of my endless to-do list. The volume of the constant chatter in my head has been turned down – way down. My greatest concern is getting the campfire completely out at night after making our s’mores.
One of the greatest joys of spending time in the woods is seeing the transformation in my kids. Without passive entertainment as an easy option, their imaginations flourish. We spend an afternoon doing a 
scavenger hunt for heart shaped rocks, branches that form our initials, and perfect pinecone specimens. The wildlife provides them endless amusement. Who can improvise the most attractive feeder for our hummingbird friend?
Now at the end of our adventure, I am savoring the varied reasons I love camping (did I mention s’mores?). It feels luxurious to take time just to be quiet and still. I recognize the benefits of feeling unburdened by simply leaving all of the “stuff” behind at home. This reminds me that what often weighs me down are the complexities and responsibilities I have built into my daily life. I’ve made these choices and, for the most part, I value and enjoy them. But I remind myself that I have the option of changing them, too. And while I may not change them, I should probably make time to head to woods more often – knowing that I can fit all of my life-sustaining supplies in the back of a Subaru.
In the Flow
When I started my staycation two weeks ago, the plan was to focus on restoring balance to my physical health. I set a physical activity goal to walk, hike, or otherwise be physically active outside for at least three hours every day. I slipped on my Fitbit, announced my plan to family and friends, and I was set to go. Two weeks later, I’m pleased to say that I achieved my goal and then some.
According to my Fitbit data, I took an average of 17,000 steps each day and traversed an impressive (for me) 78 miles over the two-week period. I dropped five pounds and slept better at night than I have in a very long time. But the benefits of staying active far exceeded my original expectations of getting stronger physically. You see, I brought my camera and a good book along on walks. With the camera, I was able to enter the flow of daily life in the area of Golden, Colorado where I live. It was wonderful to experience the many small treasures (trees, spiders, wild flowers, rocks, hawks, and other animals) that surround me. This was deeply enriching both emotionally and spiritually. And I found my tension literally melting away. Equally, the book in hand was a constant reminder that I was engaged in a journey and not a marathon. Occasionally, I stopped by a river or took my place on a park bench to read. I remembered that it is much easier to absorb and reflect upon new material when my mind is quiet and calm. Intellectually, I felt reanimated and alive.
Happily, I did not always hike alone. I invited my husband and friends (especially those friends I hadn’t seen in a while) to join me on mountain treks. Some of these ramblings lasted five or six hours, which was ample time to deeply reconnect. So, my physical action plan provided a social wellness booster too.
Intellectually, I know that wellness is as a multidimensional concept inclusive of the human heart, mind, and spirit—one that is strongly influenced by our relationships with other people and the planet, our vocation and our ability to be autonomous and feel financially secure. My experiences over the past two weeks have allowed me to sense this interconnectedness on a profoundly personal (and not just an intellectual) level. Now, it’s a great feeling to return to my job enriched and brimming with renewed passion for my work.