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February 2, 2018

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Breathing Life Into Relationships

Pacific Quest’s Young Adult Family Program: Breathing Life Into Relationships

By: Dr. John Souza, Young Adult Family Program Therapist


In Hawaiian culture the taro plant symbolizes family or “Ohana”.  The word Ohana itself comes from the taro.  The “Oha” are the new growth emerging from the corm, an underground storage organ that is the foundation of the taro.  Adding the word “na” pluralizes the Oha, thereby creating a group growing together or an “Ohana”.

Dr. John Souza

Within the word Ohana are the words “Ha” and “Hana”.  “Ha” is the sacred breath of life carried by all and which joins us.  “Hana” is the work into which we breathe our life; and in which we engage with joy knowing it is through our shared work that we make our family relationships healthy and vibrant.

Breathing Life Into Families

Pacific Quest’s Young Adult Family Program has become a haven in which families come to practice joyfully breathing life into their relationships. In 2017, our Family Program had the privilege of hosting 316 students and caregivers. With over 90% of our students participating in Family Program, PQ is an Outdoor Behavioral Healthcare (OBH) program that continues to emphasize integration and diversity, something the garden teaches us is essential for resiliency.  In a time of environmental and social stress, the opportunity for families to have such a place of respite is essential for them to engage in what we call the Corrective Relational Experience.

The Corrective Relational Experience

The Corrective Relational Experience (CRE) is about rebuilding trust and increasing mutual empathy. During Family Program the CRE is achieved by students, parents, and staff embracing two main responsibilities: Practicing Differentiation and Congruence.

Differentiation is being able to separate one’s own thoughts and feelings, both intra-personally (i.e., within one’s self) and interpersonally (i.e., between one’s self and someone else). Additionally, differentiation involves the ability to enter into or exit from a given emotional relationship by choice. Differentiation means not losing one’s emotional self in a relationship, yet also not cutting one’s emotional self off from a relationship: to stay flexibly connected, yet separate.

Congruence is how reflective your values/beliefs (intra-personal) are in a given relationship (interpersonal). That is to say how closely does what you say reflect what you actually want, need,, and feel in a given relationship? For example, if you don’t like a behavior, do you say, “I don’t really like that” or do you only think that, but actually verbalize, “That’s great!”? To be congruent increases authenticity, a critical component of trust and accurate empathy, the heart of the Corrective Relational Experience.

Professional to Personal: Being Part of a Larger Change Process

As a research-informed clinician, I often wonder about the application of research in practice and practice in research. What I’ve found is that the research on Wilderness Therapy and OBH that continues to point to the importance of family involvement in the development and maintenance of gains made by youth in such programs is spot-on. These gains are being supported by the development of mutual trust and empathy between parents and their sons and daughters. Moreover, for me as a clinician, being able to work with entire families in person only enhances the sense of shared trust and empathy within the therapeutic/clinical relationship (between therapist, student, and parents), itself a major predictor of successful therapeutic outcomes.. This mutual influence between clinician and client becomes the nucleus of a much larger change process.  As I the professional, experience greater trust and empathy, it becomes part of my personal experience, which I take home to my family and to my community. As parents experience this CRE, they too take it back to their families and communities. In this way we become like the taro or Ohana, breathing life into our relationships, born of the same source of trust and empathy.

Having Your Own Corrective Relational Experience: Breathing Life Into Your Relationships

There are many ways to have a Corrective Relational Experience. Below are just a few suggestions of specific skills PQ families have used to foster their own CRE’s. Feel free to modify these or make up your own!

  • Breath: It sounds simple, but this rhythmic, sensory-based activity will help keep you regulated and better able to relate to another person. I like to inhale for four counts, pause for one, exhale for eight, pause for one, and repeat. Feels great!
  • Listen: Again, it sounds simple, but really listening to someone with total openness and suspension of judgment or an agenda is challenging. Try inviting someone to share with you for five minutes while you listen; fully open yourself up to hearing whatever they have to share. Be sure to thank them for sharing!
  • Reflect: This is a great skill to use in tandem with listening. However, try to limit your reflections to only those words used by the speaker. Not only will this minimize you inadvertently inserting your own opinions or judgments about what the speaker was sharing, but will also let the speaker know the correct message was conveyed and received.
  • Share: Related to listening and reflecting (and essential for building trust and empathy) is the art of sharing your own struggles. This involves knowing if you need to share more or if you need to share less. If you need to share, be sure that what you share is focused on the relationship in the present moment and involves feeling words such as happy, mad, scared, confused, etc. If you need to share less, let the listener know that you’re practicing creating more space for them to share.
  • Ask for Feedback: A great way to not only practice vulnerability, but also truly honor your relationship with another person, is to ask them for feedback on the relationship. Ask them to share how they feel in the relationship, if there are realistic ways they see that you could more effectively support the relationship, if they have ways that they want to better support the relationship. The key is to remain curious and focused on improving your bond with the other person. Should you find yourself struggling to do either of these two things, repeat the above skills, beginning with breathing or simply request to take a break and return to the conversation at an agreed upon time in the not-too-distant future.

The most important element in any CRE is a genuine desire to improve the relationship. This includes listening, sharing struggles, and setting clear boundaries.

I wish you and your relationships all the best.

A Hui Hou (until we meet again)!

For more information on Pacific Quest’s Young Adult Family Program, please email

January 13, 2018

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Why is Group Therapy Important?

By:  Genell Howell, Primary Therapist

Every week, therapists at Pacific Quest lead two group therapy sessions with students in the field.  Why is this form of therapy important?  This setting allows for greater accessibility of students to share some of the issues that they’ve been holding on to as well as develop greater trust within the group.  In addition, it helps students develop a psychoeducational understanding of some of the areas they struggled with at home.

Genell Howell, MA, CSAC

I recently led a session with an adolescent Kuleana group, where we began to examine the concept of our life narrative through art therapy depicting peaks and valleys.  In this group, we used pastels and paper and drew mountains to signify the wonderful aspects of our lives, and valleys or gulches depicted the more difficult times. Students were given creative reign and interpretation to create as many canyons, rigid cliffs and elated peaks within their artistic depictions. We discussed how the peaks represented the high points of their life and the valleys the more challenging times.  Once students created their masterpieces we processed the experience of creating our images, as well as interpreted what they signified to us.

By creating a narrative that allows students to reflect on their life story they build greater emotional resiliency, introspection, and rational detachment. Instead of staying stuck in limiting beliefs such as “it will always be this way” or “it will never get better” students reflected on the ebb and flow of life as well as ways to modulate the highs and lows through healthy coping strategies.  Some of the initial coping strategies that we discussed was what worked to pull one through the harder times in their lives prior to attending Pacific Quest, and what they were using now that they were in the program. Some of the new strategies included working in the garden, incorporating mindfulness, and learning how to play the ukulele.

Due to the forming aspect of the group we were able to incorporate some of Dr.Brené Brown’s psychoeducational research on shame resiliency.  According to Dr. Brown, “shame is the intensely painful feeling or experience of believing that we are flawed and therefore unworthy of acceptance and belonging.”  Dr. Brown’s shame resiliency theory bases the ability to gain connection by practicing authenticity within healthy prosocial communities. In the art of developing shame resiliency there is greater movement towards compassion and self empathy and movement away from fear, blame and disconnection.   Students were able to define how they often hide their emotions and life experiences due to the shame of feeling different or the fear of rejection.

In addition, we discussed the importance of being in a prosocial community where one can feel heard, authentic, and have a sense of belonging, which is a vital component to the healing process. The seed of vulnerability was planted as an area of growth as they continue to form a positive peer group throughout their stay, which is a vital part of the program.

See Dr. Brené Brown’s Ted Talk here:

The Power of Vulnerability

February 20, 2017

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Eating Disorder Treatment: A Different Approach at PQ

By: Andrea Sussel, MSS, LCSW

It’s time to talk about it

Eating Disorder Treatment: A Different Approach From Traditional Models | Pacific Quest

Andrea Sussel, MSS, LCSW

The National Eating Disorders Association has created National Eating Disorders Awareness (#NEDAwareness) Week to shine the spotlight on eating disorders and put life-saving resources into the hands of those in need. This year’s theme is It’s Time to Talk About It. Andrea Sussel, PQ Therapist, shares how we can make that happen without doing further harm.

Eating disorders, food and body image are not easy things to discuss. Conversations can be riddled with unintended triggers, for example, I have heard from many people who are in recovery say that when someone tells me I look “healthy” they instead hear “you look fat”. So how do we discuss these issues without contributing to the struggles of another?

  1. Focus on what our bodies can DO and how they FEEL, not on how they LOOK.
    Because our approach is one of whole-person wellness, students can begin to focus on what their bodies need and how their bodies feel versus how they look. While this is occurring, we are simultaneously providing a lot of education – including lots of research – about whole-body, whole-person wellness. From a programmatic perspective, shifting this focus includes de-emphasize mirror gazing (at PQ we have very few to begin with) and also having students wear clothes that are loose fitting and uniform.
  2. Remember that exercise and movement is for our physical and mental health, not for weight loss.
    Experiencing what are bodies can do, and moving them shamelessly is an essential part of healing from an eating disorder. At PQ, we educate our students about metabolism and how food as fuel translates into a greater capacity to live our lives with more vibrant energy. Movement takes the form of working in the garden, yoga, swimming, weekend hikes, and daily core workouts. It takes reinforcement to rewire the societal messages that tell us to exercise to control weight. At Pacific Quest, we move for a higher quality existence, one that helps us feel more connected to our bodies and our passions.
  3. Speak up when we hear “Fat Talk”, don’t let it go unaddressed.
    Pacific Quest is a Fat Talk free zone. Having appropriate boundaries about what we can and can’t talk about helps not only break the pattern of negative self talk, but gives space to encourage new and healthier patterns to emerge. PQ is also “lookism free”. Lookism is defined as a “construction of a standard for beauty and attractiveness, and judgments made about people on the basis of how well or poorly they meet the standard.” At Pacific Quest, you can be healthy at any size. We don’t subscribe to one “look” being beautiful – all looks, shapes, and sizes are!
  4. Remember, food is medicine.
    Sometimes what isn’t being said is just as important as what is. Getting involved in food preparation can be a healing activity, as individuals start to rebuild their relationship with food. And at Pacific Quest, growing your own food is akin to teaching someone how to fish; learning and beginning to appreciate that entire developmental process can lead to lifelong shifts in understanding and healing. Students have the opportunity to learn about their own relationship with/to food as well as the relationship with their body. The place where these two relationships overlap is in the garden, making Horticultural Therapy a powerful therapeutic modality. There is also a lot of healing that comes from preparing your own food in a community setting. Because Pacific Quest is not a primary eating disorder program, students with eating disorder patterns are able to observe and “rise to” the normative eating habits of the rest of the group.

The Pacific Quest model imparts skills to make progress and healing sustainable for eating disorder recovery for a lifetime: You learn how to truly feed all your hungers at Pacific Quest.

August 19, 2016

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Family Fridays: We Have Our Son Back

By: Alumni Parent

If you are reading this, you might be a parent who is at the end of your rope and desperately looking to solve one of the biggest problems you have faced in your lifetime. I am so sorry you are where you are, it is excruciating. I know intensely how you feel, since I sat right in your spot about four months ago.

Prior to leaving for Pacific Quest my sixteen year old son was knee deep in a major depressive episode, self medicating with marijuana, and completely stalled in school. He was hopeless, demoralized, mostly shut down and his low points triggered suicidal thoughts. Our local doctors felt he was “showing improvement” but we never really made it off rock bottom for the good part of a year. My husband and I took a leap of faith and decided to be proactive instead of waiting until our son landed in the hospital or worse, which we knew was imminent. Remember you as parents are the only people who truly know your child. Trust your instincts!

Right now you are standing in a position to potentially save your child’s life. It is time for an intervention, and you are faced with the decision of where to turn for help. Do your best to take the guilt, pain, sadness, fear, anger, frustration, and disappointment you are feeling at this moment and toss it out the window. You need to find clarity to make the best decision to benefit your child’s long term health and well being.

If I had only known how well my son would be doing after a month at Pacific Quest it would have been a much easier decision. PQ was like a breath of fresh air after beating our heads against the wall for over a year. Each person that came in contact with my son was the best we had ever seen and had an unbelievable passion for their work. Pacific Quest provides a top notch platform for your child to completely reboot.

Alumni Parent Reflections | Pacific Quest: Wilderness Therapy for Teens & Young Adults

A painting of my son that I did from a photo taken during his first month at PQ

Like many wilderness programs, PQ transports your child back to 1900 and they will live as their great grandparents did as children. Leaving behind TV, Netflix, Instagram, Snapchat, texting, Facebook, their music, video games, junk food and all the vices they were using to cope. Also left behind will be their friends, family and in my son’s case his varsity lacrosse team. Everything they have ever known gone in a flash! Just your child, the garden and their thoughts, hard work with tons of support.

Yes, it will take time to adjust but you will all survive. Pacific Quest stands in a category unto itself. Horticultural Therapy and overall wellness are the heart of the PQ approach. The kids learn how to restore the health of their mind and body through a clean diet, sleep, exercise, lots of internal work and lessons in the garden. As they progress through the challenging stages of growth in the program the reality of what they need to do to change the trajectory of their life comes into focus. Yes, this is all in a tropical environment, but it is no vacation your child will work hard and begin to own their choices.

Right now you most likely cannot imagine what it will be like to see a glimpse of that kid you raised, not the stranger living under your roof at the moment. That child who loved you unconditionally. Their lost essence will eventually reappear at Pacific Quest, and you will be eternally grateful.

When my husband and I saw our son at the Family Program we could not believe the transformation. The light in his brain had turned back on and he was absorbing everything he learned in the garden. He also stayed focused on the curriculum since it is a requirement of progressing towards graduation. How many wilderness programs have an academic curriculum in tandem with the therapeutic and wilderness component? Your child will be so happy to have those credits when they put the academic pieces back together.

After graduation from Pacific Quest, the focus will be on reintegration back into modern society. Your child will need continued support stepping back into their world, to face life’s challenges and pressures head on. Sustaining good habits takes practice, time and support. We chose to send our son directly to a therapeutic boarding school where he is continuing all the work he started at Pacific Quest. We are also working hard as a family to do the work we need to do to support our son and brother. We have implemented family behavioral goals which we created in the garden at PQ. At this point we are looking forward to reuniting as a family in six weeks for the first time in 8 months.

Change does not come easily, if it did everyone would do it overnight. The kids make tons of progress in wilderness weekly and are motivated to get home and back to their lives. Once they realize PQ may not be their only stop and it is going to be a marathon not a sprint, reality sets in and the life sustaining work begins. From that point forward they have to choose to really own their future choices. For our family the key was to find a place where our son could grow, learn, achieve success and also fail with the help of qualified staff supporting him every step of the way. At his new school he is working on regaining traction in his education, positive coping and social skills, positive identity development and we are all working on improvement of our family dynamics.

Sending your child away might be the most courageous decision you make in your life time. Wishing you peace as you embark on your journey.

June 30, 2016

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The Healing Power of Assertiveness

By: Jeremy Nunnelley, LPC, NCC
Primary Therapist

On the continuum of communication styles, there are passivity, aggression, and assertiveness. While passivity leads to issues not being known and a lack of support, aggression leads to conflict and the degradation of relationships. In both of these cases, the person who is trying to communicate is left feeling misunderstood and alone. Assertiveness is often referred to as the middle ground between these two maladaptive ways of communicating. Through learning to communicate in a way that is clear, responsible, and respectful to others, a person can have the experience of being heard and understood while nurturing close relationships.

Jeremy Nunnelley, LPC, NCC

Jeremy Nunnelley, LPC, NCC

The popular culture understanding of assertiveness involves standing up for oneself and refusing to be a “doormat.” In other cases, those who have tended to communicate aggressively learn to communicate more respectfully. There is truth in both of these ways of understanding assertiveness, but there is the potential for assertiveness to be so much more. When we practice communicating our thoughts and emotions in way that is respectful to ourselves and others, assertiveness can become a way of being in the world – a way of valuing ourselves and the people around us – a way of being unafraid to share who we really are. The basic skills can expand into a path to living openly, honestly, and courageously. Shame can be dispelled and anxiety lessened as we feel increasingly understood and relationships strengthen.

At Pacific Quest, we begin teaching assertiveness very early in the therapeutic process as students use “I feel” statements to describe their emotional states at the end of each day. As social interaction increases throughout the program, students meet new challenges in being open and vulnerable, and therapists help students examine the role they may have played in isolating themselves. Students experience the development of confidence and courage while surrounded by peers who are honing the same communication skills. It is common for students to excitedly remark after a group session that they feel heard and understood.

Simultaneously, parents develop their abilities to be assertive as they engage in family calls and communicate with their child through letter writing. Therapists guide parents through examining their roles in their family and expressing their thoughts and emotions assertively to the therapist, each other, and their child. Siblings are also invited into this process when appropriate. When the whole family system has developed these communication skills and an understanding of their value, the individuals in that family may all have the experience of being heard, understood, and supported. The end result is greater self-confidence, closer relationships, and sense both caring and being cared for. While the basics of assertiveness are well-known, the potential for healing is often underestimated.

June 18, 2015

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Five Tips for Meaningful Communication with Your Teen

Communication is a precious life skill, and teaching your teen how to effectively communicate will not only help them throughout their adolescence, but their entire adult life as well. However, preaching to, or nagging at, your teen to open up to you usually isn’t the best route. Common problems for teenagers, such as bullying, body issues, underage drinking and others can be difficult for your teen to talk about. Here are five tips to help you experience meaningful and effective communication with your teen:

1. Give them options

When teens shut down communication on a tender subject, Dr. Fred Peipman suggests giving them options on how they would prefer to communicate on the issue. Let your teen know they can talk with you later on, write to you in an email or risk losing out on the opportunity to influence your decision making. Preferences vary from teen to teen, so encourage your child to communicate their feelings via the medium that makes them feel most comfortable.

3. Maintain a respectful tone

One of the quickest ways to get your child to shut down is to use a condescending, “parental” tone. Make it a priority to keep all communication respectful and to never raise your voice. According to research published in the journal Child Development in 2013, yelling at your kids can be just as bad as spanking and can possibly lead to emotional development issues and/or behavioral problems including vandalism and violence. Slow down your reactions and remind yourself to practice active listening and heartfelt responses.

3. Incorporate a meal

“Hangry”: It’s a combination of being hungry and angry, and it’s a very real emotion for your teen. Always make sure your child has been well fed before attempting a heavy conversation. Talking over a meal is also suggested, as it gives all parties something to do with their hands, making everyone feel less awkward.

4. Be mindful of body language

When communicating with your teen, you must be aware of both your and their body language. Make eye contact (but not too intense) and keep your hands and feet still, avoiding wild gesticulation. Body language can lend clues to common problems for teenagers, so educate yourself on the signs.

5. No monologues

If you want your teen to communicate with you, you have to be open to listening. Approach the situation first with your undivided attention and understanding. Process what your child is really saying, rather than spending the time attempting to think up a response. Once it’s time for you to speak, keep it honest and to the point. You may feel like lecturing your child, but you will often get the best interaction when you allow room for a healthy rapport.

Engaging in meaningful conversation with your teen is the first step to a healthy, happy relationship. If you’re still having difficulties getting your teen to open up, Pacific Quest can help. Pacific Quest’s therapists utilize many communication techniques in our Wilderness Therapy program which have proven to be successful.

Download the Adolescents Program Guide

November 8, 2010

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Tweet Tweet: The Negative Impact of Technology - Pacific Quest: Wilderness Therapy for Teens & Young Adults

I apologize in advance for the irony in the title, as I am using social networking to bring attention to the negative impact of technology.  It seems contradictory, but blogging and other social media tools are very effective in sharing information.  So later in this article when you read that you should limit your computer time, please wait until the end of the article to do so:)

Calling the attention of policy makers, school administrators, teachers, doctors, nurses, social workers, parents, aunts and uncles…  basically EVERYONE!  Children are in need of your undivided attention.  Children demand face to face interaction to promote psychological development and well being.  With the rise of technology, rough and tumble outdoor play and imaginary games are being replaced by the unilateral LCD screen, otherwise known as television, computer, cell phone, ipod, ipad, etc.   While research is emerging regarding the individual and societal effects of the rise of technology, momentum to teach balance to children is likely not going to come from the top down.  The movement has to start with educating parents and teaching them to role model and draw boundaries with their children regarding how much screen time is okay.

A group called Zone In, based out British Columbia, has assembled a fascinating “fact sheet” that addresses various facets of the impact of technology on child development, behavior, and academics.  They cite academic articles pertaining to developmental delays, obesity, psychological disorders, psychotropic medication, child development, academic performance, declining empathy, media violence, cyberbullying, and technology addiction.  Each article they present suggests a correlation between technology overuse and varying symptoms.  A 2010 article cited by Zone In reports a scary statistic:

Elementary aged children now average 8 hours per day using a combination of technologies (TV, video games, internet, cell phones and iPods), with total amount of exposure time averaging 11 hours per day. Two thirds of children report their parents do not restrict their access to technology, and 75% of these children have TV’s in their bedrooms (Kaiser Foundation Report 2010).

This fact is terrifying! Children demand dyadic interaction with real people.  This stimulates adequate development of sensory integration, motor skills and interpersonal attachment. It is difficult parenting in this day and age of technology.  Parents attention is often whisked away to their iphone or blackberry, as business, social networking, and news is at the palms of their hands.  How is mom or dad supposed to tell their child not to text at the dinner table when they have their blackberries out responding to work emails?

The answer is not simple but it can start with parenting.  Parents need to hold themselves to the same standard of that which they hold their children.  For instance, limiting technology interaction outside of school and work can be a solid first step.  Parents can model this by replacing technology time with family games, outings, and conversation.  Kids need help setting limits, and this is where parenting comes in.  Limiting time on facebook, twitter, youtube, television, and videogames is very important.  Parents should be hyperaware of their child’s technology use and help them to balance it.  The main thing for parents to teach is moderation, as technology skills are a crucial aspect of the 21st century work force.  Kids need to help to discern when to turn off the computer or put down the phone and go play outside.