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Svoboda Wellspring Modification Proposal Draft

Modifications of the Wellspring Program

 

Lois Svoboda, MD, volunteered at Wellspring during Paul Martin’s illness, prior to his death.  That experience familiarized her with the program and led her to the conclusion that modifications need to be developed so that Dr. Martin’s insights could be applied in settings that do not have a residential facility in which to house clients.

 has articulated in detail how the Wellspring model can be adapted to a nonresidential setting.  The Svoboda adaptation, put together with the help of volunteer Patricia Cartledge, includes the following elements:

 

·         Admission criteria

·         Pre-screening

·         Comments on cost

·         Pre-counseling information and testing

·         Program description

 

Admission criteria.  The prospective client must:

 

·         have been in a cult

·         not have a diagnosed DSM  disorder, unless certain conditions are met

·         not be actively addicted to any substance or drug

·         come voluntarily without coercion

 

In the case of a diagnosed mental disorder, a referral from and permission to communicate with client’s therapist may be requested.  Also, a diagnosed DSM disorder, particularly Axis II, does not exclude a potential client from treatment  (Personal communication:  Sammons, 2013). [This section is confusing and contradictory.  It is especially troubling given the high distress levels reported in the Wellspring research.  Do you perhaps mean that the person must “not have a diagnosed DSM disorder that would interfere with the educational and counseling approach of Wellspring?]

 

Pre-screening.  Although the initial inquiry may come via e-mail, a telephone intake should be performed by the facilitator or a well-trained, experienced, and highly skilled telephone intake person.  The intake person should inform clients of cost, including an initial deposit, a portion of which is nonrefundable to cover the cost of phone work, screening, testing, if performed, and at least the first day of treatment.  The balance should be paid upon arrival, unless special payment arrangements are made.

 

Although a nontherapist may handle the initial intake call, the therapist must complete the phone intake and review of pre-visit information and testing (see below).  Screening work performed before the first visit ensures that only clients who can benefit from the program are accepted.  Inadequately screened clients can cause great disturbance to both themselves and the staff.  Inappropriate clients may include those actively addicted to alcohol or drugs; individuals so highly dissociative that they are unable to ground themselves enough to process information properly; individuals still in a “cultic mindset” closed to information that might challenge their beliefs.

 

Pre-counseling information and testing.  An admission packet is mailed to the client several weeks before his/her arrival.  The packet should include:

 

·         Orientation to treatment

·         Contact info of and introduction to personnel

·         Tentative schedule

·         Basic information sheet

·         Admissions paperwork, including documents that must be signed

·         Goals for care

·         Assigned reading and journaling homework

·         Permission to treat

·         Permission for release of information

·         Emergency contact information

·         Authorization to videotape, if desired

·         Statement of client rights, responsibilities

·         Code of conduct during treatment time

 

A sample packet is available for inspection online:  url.

 

Clients are asked to return these materials to the therapist before the first visit.  They are also asked to send pertinent medical records and a brief autobiography, including a family history and delineation of the client’s psychological, social, and vocational goals for the program.

 

Psychometric testing may be conducted in the client’s local area or in the treatment city prior to the first visit.  Traditionally, Wellspring has tried to do pre- and post-treatment testing with the following instruments:

 

·         MCMI (Millon Clinical Multiaxial Inventory-III)

·         Beck Depression Inventory

·         Lifton’s Criteria Questionnaire

·         DES questionnaire

·         Dissociative Experiences Scale

·         Post Traumatic Stress Diagnostic Scale

·         Group Psychological Abuse Scale

 

Detailed information on these instruments and can be found online:  url.

 

The Treatment Program.  The treatment program includes the following components:

 

·         Intensive counseling sessions

·         Cult education workshops

·         Group discussions, when possible, preferably with local former members, if available

·         Strategic planning for self-care post treatment

·         Socializing – people in cults know how to work;  they don’t know how to play and must relearn this skill

·         Followup [Is this not part of the program?]

 

The program is highly customized to meet specific needs and provide follow up.  Historically, Wellspring staff has contacted clients after 6 and 12 months for detailed follow-up.  Except for the basic core curriculum, there is no one-size-fits all cult recovery program, and recovery usually takes years, although the person is often able to function throughout most of that time.

 

Client must have computer access.

 

Sample Schedule

 

The treatment program is implemented in a coordinated schedule of activities.  The following is a sample of such a schedule – with commentary.

 

Day one.  Remember:  clients’ tolerance of intense material takes precedence over schedule!  Stop when client needs breaks.  Client’s needs were ignored by the cult.  Don’t repeat that insult!  Also client must be treated with utmost respect at all times, with no manipulation or guilt, shame, or scolding, contrasting with their treatment while in the cult!  Transparency in the treatment team is desirable, although the focus must be on the client rather than the staff.  Observing ethical boundaries is mandatory, as in all trauma care.

 

9:00–11:00 am.  Introduction; lay out overview of 3 days.  First day’s counseling, 90-120 minutes, attended by both members of treatment team.  Content:  Client will tell his/her own story with few interruptions, taking as long as needed.  Putting one’s own story into words in the presence of a witness forces one to acknowledge the reality of one’s own experience.  Putting it into words also forces one to relive the experience, which, although it may be retraumatizing, can also be the first step to healing.  The client’s story may include:

 

·         early exposures and impressions of the group

·         recruitment

·         early, mid, and late experiences in the group

·         what needs the group seemed to promise to fulfill

·         relationships in the group

·         including relationship with the group leader

·         work or occupation in the group

·         rules and expectations of members

·         attitudes toward sex, marriage, family, and parenting

·         attitudes toward money

·         family of origin

·         red flags

·         leaving the group—your responses and the group’s response

·         life since leaving

·         rebuilding your life

 

11-11:30 am.   Break

 

11:30-12:30 pm.   Workshop/lunch:  Topic:  Lifton’s criteria and\or Singer’s 14 points.

 

1:30-3:00 pm.  Counseling, 1.5 hours if tolerated & desired

 

3:00-3:30 pm.  30 minute break: take a walk, listen to music, do errand, let brain rest.

 

3:30-5:00 pm – Workshop – may review homework, complete Singer’s 14 points, - choose from topics

 

5:00 6:00 pm.  Dinner.

 

6:00-7:30 pm.  Group discussion to recap the day, answer questions, address issues of client’s choice.

 

Day two and three.  Similar to day one, with the last counseling session ending at 3 pm on day three,  followed by a wrap up as follows:

 

·         Review of course

·         Follow up plan

·         What did you learn?

·         What questions are still unanswered?

·         Complete partially finished topics from previous days.

·         Fill out satisfaction survey

·         Suggestions for improvement

·         Plan for follow up testing and telephone follow up in 6 months.

 

3:00-4:30 pm.  End

 

Remember, in spite of their glowing promises, cults don’t solve problems, they shove them underground, only to have them emerge later when the person leaves the cult.

Not all topics can be covered in one intensive, but repeat intensives may be desirable, during which more topics may be covered.  Client and therapist may select topics these topics together or individually.  Among the topics that appear to be useful in workshops and counseling discussions are:

 

·         Cult education using media, internet, movies, music

·         Psychological sequellae of cult experience,  e.g., mile and profound depression, anxiety, relaxation-induced symptoms, brief psychotic episodes

·         Cognitive issues, e.g., difficulties with critical thinking, indecisiveness, blurring of mental acuity, loss of previous mental sharpness due to disuse, loss of executive function due to disuse

·         Dissociative states - a disruption in the  usually integrated consciousness of a person.

·         Lack of boundaries due to cult disregard for them

·         Poor judgment, either due to disuse of brain or naivete

·         Cult-induced or cult-reinforced passivity

·         Grief and anger issues, e.g. regret over lost time and opportunities, remorse over activities while in the cult that hurt others, grief caused to either family of origin or family of procreation or both by cult induced behavior

·         Self-expression/ Self-identity, e.g., art, music, sculpture, dance, movement, writing, journaling

·         Social issues or skills, e.g., sense of alienation,  being out of step with culture, different, not fitting in,  sense of being damaged, personal boundaries, hypercriticalness with self and others, hanging on to impossibly high cult standards, sense of a “let down” after exalted experiences and expectations in cult, “is this all there is?”  “I was going to save the world” - loss of sense of elitism, cult implanted phobias

·         Trust and relationships. Recovery is based on relationship because it is relationship that has been damaged by manipulation and abuse; trust has been destroyed.

·         Sexual issues, including having been married to an unsuitable mate by the cult, difficulties finding a mate, or getting along with mate, repercussions from suppressed sexuality in ascetic cults or hypersexuality in sexually acting out groups; sexual abuse issues; sexual identity issues

·         Spiritual, e.g., fears of joining any group or church,  loss of own faith, disillusionment with all religion, fear of having been damaged spiritually, rigid legalism, confusing voice of authority with voice of God, fear of punishment, damnation, sense of anomie, of drifting in space without a compass or map

·         Finances, e.g., living within a budget, banking and checking accounts, vocational needs, Applying for public assistance

·         Other practical skills, e.g., ADLs, (activities of daily life) banking, taxes, transportation, applying for jobs, school, arranging for medical and dental care, time management, organizing one’s life

·         Parenting, i.e., meeting the needs of children often conflicts and competes with the self-focused needs of the cult leaders; hence childcare is often relegated to unqualified people so parents can do the important work of ‘saving the world’.

·         Other family issues

 

One promising new resource is a book recently released by Livia Bardin entitled Starting Out in Mainstream America, which addresses the multiple needs and issues facing anyone who is entering a new culture, e.g., re-entering the mainstream of society after a cult experience.