Integrative-Sustainability: A New Model for Wellness Psychology

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Clarissa E Steffen, Ed.D., ND, CADCII, ICADC, CNHP, CMH, NCC, BCC, Coaching Choice
College © 2017
Integrative-Sustainability: A New Model for Wellness Psychology
Clare E Steffen, Ed.D., ND, CADCII, ICADC, CNHP, CMH, NCC, BCC
Introduction:
Old models of sustainability tend to consider only environmental factors and ignore a radial
holistic perspective. Certainly, we must consider a more dynamic point of view. As we
understand that not only personality, but relationships exit on a continuum we must also consider
that this continuum in not linear, but that it rotates in a radial fashion with many facets
connecting, and integrating.
Overall Arching Concepts:
Humans and all living beings do not exist in isolation; they intersect and relate in many ways
and on multiple levels. Some elements maintain a consistent connection while others may
experience a momentary or fleeting connection. Whether the connection is fleeting or consistent,
there is a lasting impression, or trace element that creates a chemical memory of the event or in
some cases a deeper connection that becomes a conduit that forms a neural network. Each
experience influences our being and becomes a part of who we are and what we become. It is the
relational connection between these experiences, acceptance of self, and ability to adapt and
maintain health and well-being that promotes sustainability. A formula for an integrative
approach to developing sustainability in counseling is provided with the acknowledgement for
other models that contribute to this integrative approach. This model primarily consists of
development of conscious choice, emotional intelligence, synchronous-self, and life balance in
counseling.
Moving Beyond Resilience to Sustainability:
In psychology we focus on resilience but perhaps it isn’t enough to just focus our efforts on
determining ways to become more resilient. Respectfully, the study of resilience has been
critical in advancing our understanding of trauma. In life, loss and traumatic events occur, and it
is not necessarily a one-time circumstance. When multiple losses or traumatic events occur, the
individual, family, or community becomes more vulnerable. Simply being resilient to withstand
these occurrences may not be enough. More importantly we need to focus on applying the
principles of sustainability.
So what is sustainability? In medicine we have recognized the need to provide integrative
treatment in effort to offer total wellness. The blending of various professional services as a
collaborative team makes it easier for the patient to navigate the system and it offers a higher
degree of support.
Psychology, counseling, and mental health services all play a significant role in connecting the
patient to support services. How do we move the patient to the role of client, who exercises a
higher degree of choice in utilizing mental health services? Perhaps we may need to consider the
direction of positive psychology and more importantly, wellness coaching as it empowers the
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Clarissa E Steffen, Ed.D., ND, CADCII, ICADC, CNHP, CMH, NCC, BCC, Coaching Choice
College © 2017
individual and assumes a position of human equality at the gate. While the provider of mental
health services must maintain expertise and knowledge in their ability to provide treatment, the
patient must experience a high degree of trust in the healer’s ability to guide them toward
wellness. The concept of being a healer, mixes model and schools of thought that do not typically
occur in coaching, and although the concept exists in psychology it is not without conflict or
debate.
The shift of maintaining expert skills while connecting on an emotionally available human
level is a delicate art form. As this shift occurs, the patient and the mental health provider
engage in an exchange of knowledge and skills that releases the patient to become more
independent, self-sufficient, and free to consider informed choices that increase their level of
wellness. The picture of what the terrain of wellness looks like will vary depending on the initial
status, level of functioning, and skills acquired by the individual in treatment.
Consider the process below that offers insight into what will necessarily happen to bring an
individual to a wellness perspective when using an integrative-sustainability model.
Integrative-Sustainability
When working with an individual we must explore their cultural beliefs and influences to gain
understanding of how they relate to time and place. It would also be beneficial to examine their
connection to the roles they function in within their life and how they see the work contribution
they make on a social level. Ideally, there would be synchronicity between these self-views, but
if it is a source of conflict that would become part of the focus of treatment.
If there are issues of incongruence between what the individual thinks and feels and how they
behave, and this results in distress, this would become a focus in treatment. Ways in which the
individual displayed an ability to adapt and change would be explored and utilized as foundation
for growth.
The importance of resilience is exhibited when it occurs as a part of a dynamic and not as an
isolated incident. We look for resilience in a relational manner, so that we can promote balance
in mind, body, and spirit to create a wellness perspective, and lifestyle. Examining the
individual’s worldview and seeking examples of universality and acceptance represent a healthy
worldview that may increase functionality, even in times of distress.
Sustainability Counseling:
Accepting that the course of treatment is a dynamic process, and that everything is relational
may allow us to return to the question of exploring integrative-sustainability. Perhaps the
answers to wellness extend beyond the scientific. The realms of the spiritual and philosophical
hold many solutions to the human condition. If we want to examine sustainability, we must
consider how to go beyond healing and motivate others to thrive. Understanding how to motivate
another human being is a complex process, and is another example of why we must hold a radial
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Clarissa E Steffen, Ed.D., ND, CADCII, ICADC, CNHP, CMH, NCC, BCC, Coaching Choice
College © 2017
versus a linear view of the continuum. This model is limited by graphic representation, but
offers a foundational view of how we might build sustainability.
Sustainability Counseling Model
In assisting our clients in their ability to develop new and healthy choices, we promote
adaptation and change in thinking. These changes in thought impact emotional functioning and
are geared to increase cognitive flexibility and emotional resilience. Introducing the concepts of
mindfulness and wellness practices offer a broader view. The influences of neuroscience and
brain-behavior relationships provide us an opportunity to delve deeper into understanding
functioning, accurately direct skills development, and treatment outcomes. When the client
actively participates in treatment, they learn in a manner that may increase their ability to transfer
and generalize what has been learned. When this occurs, and when supports are put in place to
maintain new learning and skill rehearsal, these changes stand a better chance of maintaining and
sustaining.
The process of applying the integrative-sustainability model in counseling is ongoing and
dynamic. See the model below and consider that each of the elements of sustainability
counseling would be independently and holistically explored during each phase of treatment to
create an integrative approach.
Ongoing Information and Relational Process
Choice and Sustainability:
This discussion on integrative-sustainability may be the first of many to follow. In part, the
solution lies in moving choice from an automatic to a conscious level, but isn’t the human being
more than the sum total of the choices they make? Constructivist views might have us believe
that we are deterministically stuck and will reside from which we came and never have the
opportunity to transcend that existence, but there are many examples in life that disprove that
thought process and support resilience. What lies beyond resilience if not sustainability, than
what?
Existentially, we seek to understand our purpose and meaning in life. The bigger question of
why do we exist becomes replaced by how do we maintain existence and sustain life at the
highest level of functioning possible for each individual? The remedy to despair and hopeless is
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Clarissa E Steffen, Ed.D., ND, CADCII, ICADC, CNHP, CMH, NCC, BCC, Coaching Choice
College © 2017
choice. Having the skills and ability to create healthy choice will allow us to experience freedom
and to experience self-empowerment.
Sustainable Choice Model
Choice, like resilience has been explored by psychologist and is often linked to learning, but
perhaps we need to expand the concept to fully explore all that choice encompasses. If we return
to the original premise that everything in life is relational, than this would also apply to the
choices we make. Dividing choice into four quadrants provides a self-organization tool that can
be shared with clients.
Life, is defined by our relationship to self and others and the manner in which we make a
contribution via work or our personal/intimate, or social relationships. Health is viewed
holistically (mind, body, and spirit). Conscious intelligence is devised of knowing, intuiting, and
monitoring and regulating the use of our thoughts and feelings. Love connects to the other
quadrants and is the force that drives us to function by connecting us to self, others, and the
social contribution we make through the work we do or the roles we play in life. The four
quadrants create a functional force and life balance that is movable and dynamic or interactive.
Strengths-Based Triad:
It is recommended that the counselor who utilizes integrative-sustainability apply a strength-
based model that promotes dynamic functioning, a focus of well-being, and positive planning
with the client. The idea behind this is to involve the client in their own healing process to
encourage the development of a wellness perspective and promote any necessary lifestyle
changes to maintain and sustain wellness. Elements of traditional or evidence-based models,
westernized medicine blended with holistic and spiritual models are combined to create this
integrative approach to creating sustainability for your client.
Strength-Based Triad
Dynamic Functioning Focus of Well-Being Positive Planning
Promotion of Social & Emotional
Intelligence
Healthy Mental Status and
Mind-Body-Spirit Connection
Grounding to Earthly Elements
and Tree of Life
•Process
•Psycho-Education
•Cognitive-Behavioral
•Medical and Mental
Health Diagnostic
Management
•Cultural Acceptance &
•Faith & Healing
Integration
•Healthy Empowerment
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Clarissa E Steffen, Ed.D., ND, CADCII, ICADC, CNHP, CMH, NCC, BCC, Coaching Choice
College © 2017
Input
•Healthy Relationships
Inclusion
•Gender Orientation
Equality
•Community Integration
•Transition
Dynamic Functioning:
The body of literature on social and emotional intelligence is met with controversy, but yet it
persists and has many supporters internationally. What it has accomplished is a way in which the
lay person can understand cognition and examine ways in which they may understand their
thinking, label their feelings and monitor and regulate emotions in a developing healthy
relationships. Bringing this to your clients by offering psycho-educational services that teach the
tenets of social and emotional intelligence are considered beneficial.
Cognitive-Behavioral theory (CBT) has provided many tools for clients to track and learn how
their thinking effects mood and functioning. Utilizing this approach and any of the new versions
of CBT, such as Dialectical Behavioral Therapy (DBT), Acceptance-Commitment Therapy
(ACT), or the like, expand their thinking and skills set, and can be applied as a way to analyze
relationships for their degree of health.
Focus of Well-Being:
Generally, medical treatment when combined with psychological services involve a mental
status exam. Significant information can be gathered in this process, but it is also important to
incorporate holistic thinking when examining the client. In the event that the client is given a
mental health diagnosis, it is critical that they be provided the necessary tools to manage their
condition and go beyond seeing themselves as their diagnosis, but rather as it being one element
of their total being. It is crucial that we incorporate, include, and appreciate their cultural
identity and take an inclusive approach in treatment. Respectfully, including the client’s gender
orientation and identity adds another element of the wellness identity, and is simply a part of the
total picture.
Positive Planning:
Having intent and a mindful approach is the starting position, but it must be followed up with
planning and action. Without this in place, we are doing an injustice because we miss the
opportunity to access skills, strengths, and aspects of resilience that support sustainability.
Having a flexible plan can contribute to feelings and thoughts of confidence that support healthy
choice. Considering the individual’s spiritual, religious, or earth spirit beliefs provides another
facet to counseling. The tree of life is found in many circles and can be used as a symbolic way
to connect to becoming grounded. If another symbol has more meaning or significance to the
client, this image can be used in replacement of the tree of life. What is important is that there be
personal meaning and relevance in the symbol and that it is a visual or mental image that is
committed in memory and represents life balance and wellness.
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Clarissa E Steffen, Ed.D., ND, CADCII, ICADC, CNHP, CMH, NCC, BCC, Coaching Choice
College © 2017
The ultimate outcome of any therapy or counseling is healthy self-empowerment, connecting
to a healthy community to avoid isolation, and the ability to adapt and transition with flexibility
and ease. Having a self-directed plan that promotes life balance, wellness, and sustains healthy
functioning would allow the client to terminate treatment and function independently.
Summary:
At this point, this position on integrative-sustainability is merely theoretical. There are a
number of components of the theory that are evidence-based and supported scientifically. The
place in which the subjective meets the objective is where this theory fits. The split between
these views seem arbitrary when one considers a radial perspective. There is room for both to
coexist in an integrative model of wellness. Collectively, what comes before influences what
follows or happens next. The universal consciousness or essence remains a part of the greater
spectrum of life. We are united and thus, the well-being or illness of one impacts that of another.
In universal love, we support the dignity or integrity of each living being. The continuum
expands and creates a centrifugal force of well-being. We mindfully attract wellness when we
couple intention with action. Resilience is extremely important and not to be ignored, but
perhaps we can offer a next step that will allow clients to claim total wellness and sustain it for
life.
References:
Integrated Health Care: Collaboration between health professionals to provide complete
treatment to patients and improve overall well-being. Retrieved June 7, 2017 from the American
Psychological Association website: http://www.apa.org/health/integrated-health-care.aspx.
Katz, M. (2012). On Playing a Poor Hand Well: Insights from the Lives of Those Who Have
Overcome Childhood Risks and Adversities. New York: Norton Professional Books.
WHO Integrating Systems of Care. Retrieved June 7, 2017. From the World Health
Organization website: http://www.who.int/healthsystems/technical_brief_final.pdf
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Clarissa E Steffen, Ed.D., ND, CADCII, ICADC, CNHP, CMH, NCC, BCC, Coaching Choice
College © 2017
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