Getting off the farm and out to explore the island is a big hit amongst PQ students. This past weekend, students of the young adult program travelled mauka to the Ka’u Desert, situated on flanks of Mauna Loa. The students enjoyed a great lunch, punctuated with views of the ocean, volcanoes, and indigenous plants and birds.
Three years ago I was known for running away from Pacific Quest on several occasions. Now I look back and see how far I’ve come.
I attended Pacific Quest at a very rough point in my life. I was suffering with several mental health issues as well as the aftermath of severe emotional trauma from childhood. I have anger issues, attitude issues, self and esteem issues.
Through the beautiful hearts and souls that comprise this program, from therapists to field staff, I healed from alot of early childhood issues, learned to love myself, developed coping mechanisms to cope with my mental health issues, and made meaningful connections that i never thought i could make. I also had a genetic test done that allowed me to find out the right type of medication I should be on.
Three years later, I left California and moved to North Carolina with my mom, where I have been pursuing horticulture and landscaping, with a deep passion of becoming a horticultural therapist down the line. I am a Certified Plant Professional through North Carolina Nursery and Landscape Association.
I still struggle with mental health and emotional issues, however, with the continued coping skills learned from PQ put into action such as meditation, journaling, exercise, gardening, and well as my own continued pursuit of counseling outside of PQ, I’ve created a life that is truly worth living. I finally have healthy friendships and relationships that I enjoy and feel joyful most days regardless of the circumstance.
One of my favorite quotes is that “people will only meet you as deep as they’ve met themselves”. I definitely met myself in a meaningful and often painful way at PQ, which in the life changed me and made me grow for the better.
Thank you PQ. When things are rough, I think of all the loving hearts that have pushed me to be my very best self and help me recognize the potential for a better life.
With love and gratitude, 26 year old female alum
Written by: Ashley Cipponeri
We are celebrating another year as a Gold Status Research Designated Program! The Pacific Quest team is dedicated to ongoing research efforts put forth by the University of New Hampshire and the National Association of Therapeutic Schools and Programs (NATSAP). Gold Status is the highest status granted by the NATSAP research committee for data collection rates.
PQ data indicates that a significant number of our adolescent and young adult students that graduate Pacific Quest report a reduction in clinical symptoms and remain below the clinical cut-off six months and one year post treatment. We utilize a normed and valid survey known as the Youth Outcome Questionnaire for adolescents and the Outcome Questionnaire for young adults.
We are grateful for every family that has contributed to our data collection efforts since we began this partnership with UHM and NATSAP in July 2014. We look forward to continued data collection using normed and valid measures and our continued contribution to the outdoor behavioral health research database.
Dr. John Souza, Jr., LMFT, DMFT
Outcomes studies on wilderness therapy/outdoor behavioral healthcare (WT/OBH) programs serving youth ages 12-17 have demonstrated that family involvement in treatment increases the likelihood of long-term maintenance of individual students’ gains from such programs. This same body of research has linked caregiver participation in family activities to an increase in trust and empathy between caregivers and students. However, as some researchers have uncovered, these gains may not necessarily generalize to improvements in family functioning. Moreover, when considering family involvement in the treatment of young adults (herein referred to as emerging adults or EAs; ages 18-25) there remains the historical remnants of a socially constructed bias against such involvement; based on the presupposition that the paragon of EA development is “independence” from caregivers.
Pacific Quest’s Family Program for Emerging Adults
At Pacific Quest (PQ) we have considered the above research findings and social constructions, and in response have developed our Family Program for Emerging Adults based on a practice-based evidence/research model. Data from our practice suggests not only is family work with EAs appropriate, it can often be a critical element of their treatment process as caregivers report a correlation between our Family Program and an improvement in family functioning. This has led us to conclude that the ultimate aim in the treatment of EAs may not necessarily be to only encourage greater independence, but also to cultivate intentional interdependence.
Clinical and Theoretical Foundations
PQ’s Family Program for EAs is embedded within an integrative WT/OBH model designed to treat a variety of emotional and behavioral problems by way of horticultural therapy and other experiential modalities. Our Family Program for EAs builds on this model by creating opportunities for corrective relational experiences (CREs); unexpected moments when caregivers and EAs are able to attune with one another and are therefore transformed. During these CREs caregivers and students learn in what ways they mutually influence one another and thus how to be intentional with that influence. The nature of human nature is that we are not independent, but rather are reliant upon each other. Through intentionally designed CREs, family’s at PQ become more cognizant, and thus able to influence this reality.
The Corrective Relational Experience
Over several years of observing Pacific Quest’s Family Program for EAs, we have come to understand that while there are a number of smaller CREs throughout the two-day intensive program (consisting of caregiver-only meetings, family therapy with primary therapists, and multi-family therapy groups) the overall Family Program is itself a CRE. We have found this CRE to consist of two primary clinical dynamics: Differentiation and congruence (see Figure 1): Development of one positively influences development of the other. Moreover, these processes mediate the establishment of accurate empathy and trust, which in turn can encourage the maintenance of differentiation and congruence.
Improvements in Family Functioning
PQ’s Family Program for EAs has been correlated with improvements in family functioning. This has been measured through a pre/post-test design employing the psychometrically supported Global Assessment of Relational Functioning (GARF). The GARF consists of three subdomains:
• Interactional/Problem Solving Skills
• Hierarchy and Organization
• Emotional Climate
Of 161 caregiver respondents, all reported improvements in the three GARF subdomains (see Chart 1). Overall, the subdomain reported most positively impacted during Family Program was Emotional Climate. Communication (an aspect of the subdomain Interactional/Problem-Solving Skills) was identified by 85.7% of respondents as the specific aspect of family functioning most positively impacted by the Family Program.
At Pacific Quest we have answered the call from researchers to improve family engagement in WT/OBH. We have also recognized the interdependent nature of human nature and used this as the impetus for our work with EAs and their families. By employing a practice-based evidence/research model we have correlated our Family Program’s CRE approach with improvements in the emotional climate and communication aspects of family functioning. Future practice/research with EAs might consider how to generalize such improvements in family functioning by creating CREs with others (e.g., siblings or families-of-creation) and in other environments (e.g., a transitional program or a caregiver’s home).
I love the idea of “Farm to Table.” Eating at restaurants that take this approach is so satisfying – food right from the garden, even better when the food is organic. There is nothing quite like the crunch from a raw green bean that has been harvested that morning! While this dining option appears to be hip and trendy these days, farm to table is how our ancestors sustained themselves every day.
Living in Hawaii, where food grows abundantly, I got to thinking that it would be a healthy challenge to see if I could pull off the “Farm to Table” lifestyle. So I planted, replanted, weeded, pruned and harvested. I repeated the cycle and repeated it again and again. After about a year I’m proud to report that I’ve achieved a seventy percent failure rate on the food I’ve planted. Consequently, I do eat thirty percent of my food from my garden, which I consider a mild success. I am still mostly a ‘Safeway to Table’ guy at this point (which is fine because they give fuel points and gas on the Island is expensive).
So why am I proud of my seventy percent failure rate? Because I learned I need to keep planting. I learned that “Farm to Table” is, in fact, all about resilience, perseverance, and practice. If I choose to focus on the seventy percent failures, then I will be unlikely to plant. If I choose to focus on the thirty percent yummy goodness from the garden then I’ll be more likely to keep planting.
I’ve also learned that I can be resilient and strong in this way – like my ancestors. So I choose to keep planting. I strive to be as skilled as they were and I will enjoy the vast majority of my food from my garden. I have to persevere in my planting, struggling and learning.
This past year, I have been particularly inspired by the effort and growth of my Pacific Quest students. Witnessing their journeys of self-discovery, personal strength and resiliency is reaffirming and heartwarming. Our alumni substantiate that their personal development at PQ is easily transferrable to life on the mainland. The awareness, skill sets, and confidence our students develop are indeed sustainable. Our students clearly know what ‘keep planting’ means, in their own, unique ways.
In addition to his extensive clinical background prior to his work at Pacific Quest, Mark served as Director of Clinical Quality for an integrated healthcare agency. Mark also holds a masters degree in School Counseling and has a breath of professional experience as a teacher, school counselor and Head of School. Mark holds a deep sense of learning styles, learning differences, and student engagement strategies to skillfully help young adults effectively utilize their learning preferences to advance their personal growth.
Mark is dedicated to supporting emerging young adults in their recovery from behavioral health issues including anxiety, depression, isolation, and problems related to substance use. Mark utilizes a variety of therapeutic approaches that include a solution-focused framework, Jungian depth psychology, ecopsychology and earth-based healing, rites of passage, and Dialectical Behavior Therapy (DBT). He has training in the Hakomi method as well as EMDR, which he continues to develop as part of his practice.
Mark believes Pacific Quest combines innovative best practices and evidence-based standards to a degree of quality that is virtually unmatched. Mark is honored for the opportunity to promote and facilitate change in the lives of clients and families accessing care at Pacific Quest.
Mark enjoys fishing, hunting, being on the ocean, teaching, and growing food. When he’s not in the garden working with students, he is exploring the beauty and dynamic landscape of Hawaii Island along with his wife and daughter.
“Mark White was an extraordinary therapist for our family. He guided all of us in a clear, caring manner and we will be forever grateful to him.”
“Mark has been excellent! His communication has been wonderful.”
Written by Theresa Hasting, LMHC
I remember my first job out of graduate school, working in a psychiatric inpatient facility, and listening intently as nurses and doctors spoke about the patients with whom we were working. A patient in particular sticks in my mind, a young adult female who had been in and out of our facility ten times in the past two months, who loudly exclaimed her self-harm for all to see and hear. The stigma of Borderline Personality Disorder (BPD) that I witnessed some twenty years ago is still with me. Since that time, I have revised how I think of people who present with these symptoms and with this diagnosis, realizing how these behaviors do not define them, but rather how they are an expression of fear, of pain, of vulnerability, and of anxiety.
An article, that many of you may have seen, recently floated across Facebook: “We need to treat borderline personality disorder for what it really it is – a response to trauma.” I was intrigued and as I read through the comments posted prior to the reading the actual article, I realized just how much the stigma of BPD hasn’t actually changed in the past twenty years. I still hear parents gasp with shock and fear at the mention of BPD traits.
Let’s forget the Facebook article, that while true and accurate, isn’t actually a credible source and instead examine scholarly research. A study by Bandelow, et al, (2005) indicated that those diagnosed with BPD had a statistically higher rate of early childhood trauma than the control sample. These traumas ranged from abuse and neglect, parental separation, childhood illnesses, medical trauma, unhealthy family systems, etc. Premature birth was also noted as statistically higher for those diagnosed with this disorder. This is one of many research articles making this link.
In practice with adolescents and their parents, those presenting with borderline traits consistently have a history of trauma and as they describe the symptoms we are so familiar with (poor ego strength, instability in functioning and achieving goals, impairment in relationships, frequent mood changes, separation insecurity, anxiety, impulsivity and/or risk-taking, and hostility), they talk about really wanting connection, to feel safe in relation to others, fearing rejection and abandonment, and having big emotional responses to small situations that they don’t understand any more than the next person. Sometimes, I hear stories of a big Trauma and other times I hear stories of little traumas that accumulated over time. It may be that there were dozens, maybe hundreds of little emotional betrayals and hurts that added up and derailed a child’s ability to trust someone with their care. They described the need to be impenetrable and safe while simultaneously tormented by the human desire to feel closeness, created the push/pull dynamic that friends, families, and therapists are so acutely aware of.
The Facebook article is right…it is time we recognized BPD as a response to trauma. Rather than focus on the very difficult symptoms to manage, recognize the strength being presented to you in their ability to survive. Recognize that inside the layers of muck, there is a precious human being desperate for safe connection. With this new formulation of BPD at hand, we also have to look at how we treat BPD. Ultimately, we have to approach treatment from a trauma-informed lens, one that aims at healing, providing reparative experiences, and teaching healthy attachment. To do this, we must focus on emotional regulation, emotion tolerance, debating negative self talk, building ego strength and finding ways to celebrate success; all in the context of healthy relationships being role-modeled and the clinician providing a safe, non-judgemental space to hold what is present and return it back to the person in a form they can digest in order to heal the relational trauma of the past. Only then, will a person be able to move to a place of accountability, examining unhealthy relational patterns, and work on their ensuing identity crisis as the “get better.”
Ultimately, what a client who presents with these symptoms needs from their treatment team is compassion and the unwavering ability to see through the unpleasant layers of protection they have covered themselves in. Or, in the words of the late Dr. Karyn Purvis, who specialized in relational and developmental trauma: “It is powerful for [people] to know that they are loved and adored even in the midst of their worst behaviors.”
Theresa Hasting received her Bachelors of Arts in Psychology from McMurry University in 2003 and earned her Masters of Arts degree in Family Psychology from Hardin Simmons University in 2005. She is currently enrolled in a Ph.D. program in Depth Psychology at Pacifica Graduate Institute.
Theresa has extensive training in trauma informed care; examining the impact that trauma and chronic stress has on a person’s neurochemistry, brain development, attachment style, cognitions and behaviors. She is a Trust Based Relational Intervention Educator and certified SandPlay Practitioner. Additionally, she has specialized training in Motivational Interviewing and Trauma Focused Cognitive Behavioral Therapy. Additionally, Theresa has been a trainer/consultant for the Nurturing Parenting Programs® since 2011 and has facilitated Nurturing Parenting groups since 2008, utilizing individual, in home, and group parenting classes.
Prior to joining the Pacific Quest team, Theresa worked as a Clinical Director for a large adoption and children’s behavioral health agency. She developed training for staff and families on Trauma Informed Care topics, Nurturing Parenting®, and Trust Based Relational Intervention® (TBRI) principles. She also has experience as a clinician for adolescents and adults in psychiatric settings. Theresa has worked with youth and adults who have experienced physical and sexual abuse, attachment trauma, adjustment issues, depression, anxiety, emotional and behavioral dysregulation, substance abuse issues, psychosis, and interpersonal conflict. Theresa has presented at many state and national conferences. She is a member of the American Counseling Association (ACA).
Theresa’s passion is working with youth and families to facilitate healthy relationships. She has a strong belief in the need for holistic, whole-person oriented work that focuses on “re-setting” the mind and the body. Pacific Quest attracted Theresa because of its focus on these key aspects of treatment, which are often overlooked in other treatment settings.
Theresa has a diverse background and a keen sense of appreciation for other cultures. Having grown up in Prague, she has a love for international travel and hopes to share these experiences with her husband and daughter. Theresa enjoys cooking, photography, scuba diving, travel, and going on adventures in the Hawaiian islands.
Theresa is wonderful!. We cannot thank her enough for the work she did with all of us. She does amazing work.
Theresa was incredibly helpful. She was the perfect fit for our family and we enjoyed being challenged and pushed.
Theresa is the best!
Kumu Carrie’s 6th grade class gathered at 8am for their usual attendance, announcements, and oli to start off their Ho’okele class. However, today there was a change in scenery. The desks were pushed aside and in the middle of the room lay a tray of soil, bunches of mint and oregano cuttings, and an assortment of plants, seeds, and books on therapeutic horticulture. Kumu Carrie invited me to be a guest speaker for her class on the benefits of nature and the topic of therapeutic horticulture, and it was a pleasure to rearrange the classroom.
The students wasted no time noticing, commenting, and examining the plants. The observed some to smell good or bad, some were fuzzy or dry, and some they thought were pretty or ugly. We all started by sharing a little bit about our history with gardening, and shifted into a deeper exploration into our senses by exploring the mint and mexican oregano. I then taught the students the basics of the Neurosequential Model of Therapeutics (NMT Model) and discussed how they could use their senses to help ground themselves and regulate their nervous systems. They were excited to share stories of what the herbs reminded them of, take nibbles of the leaves, and some students even shared their experiences with essential oils in helping to calm their emotions.
Next the students were given a basil seed to hold in their hands. They were told to watch and see what happens as a few drops of water were added to the seed. The student gave voice to their uncertainty by saying, “What’s going to happen?… Is it going to explode?…Is it going to be ok?… It looks like it’s getting fluffy!” Students were able to relate to how sometimes in life it can be hard to sit in uncertainty while other students said they love suspense and mystery.
The students proceeded to plant the basil seeds, digging their hands in the soil. The students all showed each other their dirty fingernails and learned about the microbes that have coevolved with humans and live in the soil. Students learned that when these microbes interact with our hands, they can release endorphins in our brains. One student inquisitively asked, “What are endorphins?” The class was astonished to learn that these chemicals in their brains help them feel good.
Last but not least, the students were given the chance to label their seeds. Giggles were heard across the room as newly planted seeds were being named, and worms were being unearthed in the soil bin. Soon ‘Wormy’ was the talk of the classroom, and everyone was huddled around the soil bin searching for worms to add to their pots of soil and seeds.
After the most extensive worm hunt by 6th graders of 2019, the class circled up and recited a Mahalo oli and the class was dismissed. The energy of the students was palpable as they were buzzing about their new plants, talking about gardening, and discussing how they were going to take care of their new seeds.
Thank you very much to Kumu Carrie for inviting us into your classroom and gifting us with an opportunity to share the joy and healing powers of gardening. Mahalo nui loa.
When I was sent to Pacific Quest, I had to really accept that there is no fairy tale ending. A handsome prince won’t come take me a away and solve all my problems. Being bullied into isolation left me with only books, video games, and TV. All were perfect examples of an ideal world where if you keep going for long enough, the time to stand up on the lunch table and roast the bullies will happen. All I needed to do was wait.
But there is no half-giant to tell me I’m a witch or talking cat to tell me I’m the moon princess reborn. I realized I needed to go through some intense treatment to actually find a reason to keep going through life. So, for the next two and half months, I worked hard to get a grip and continue a normal life. I was then sent to Solstice East to work even harder and dig even deeper.
I now know how to (realistically) stand up for myself, stay in the moment, and overall stay stronger than I’ve ever been. By learning regulation skills, social awareness, and all sorts of other things that would exceed the word limit, I learned to not wait for the magic white horse or closet that leads to an adventure. I found my own superpower which is my resilience, strength, humor, love, and empathy. Instead of looking for an unrealistic outside source for myself to fix my problems, I turn inward and stand strong for my opinions and my life.