Efficacy of Grit Wellbeing program for individuals attending residential rehabilitation for substance use problems.

The Grit program + the standard residential rehabiliation recovery six week program. Participants in the Grit program will receive 2 program sessions per week, delivered in a group setting, over the course of 6 weeks alongside standard residential treatment. The 12 x 50 minute Grit sessions are detailed below. The program will delivered by a clinical researcher, with a minimum of provisional registration in psychology and training in clinical psychology, and LLW staff who have been trained in the program. The Grit Wellbeing Program incorporates key elements of strengths-based mindfulness and Rock and Water psychosocial competency training to increase the social, emotional, psychological, and physical wellbeing of young people and decrease their risk of adverse outcomes. Session 1: The program begins by explaining the mind-body connection, and how to breathe, ground and centre. Youtube videos are used to demonstrate breathing techniques, and the participants are invited to practice belly breathing. Grounding is then taught using a series of exercises focusing on balancing and anchoring oneself to the ground. Breathing and grounding techniques are then practiced in combination. Finally, participants are taught how to centre themselves by activating their core muscles using simple tensing and stretching exercises. These activities are conducted in a circle, individually, and in pairs. Session 2: This session will be directed towards the final component - focusing, through an extended focus on breathing and on being mindful. The session begins revising the previous session, and revisiting belly breathing in particular. Mindfulness is then introduced using a short video to explain the often rapid activity of our mind. Simple mindful activities are then introduced, to increase participants awareness of how their mind wanders and how to breathe, ground, centre and focus. Focus activities include a mindful check-in, mindful eating (e.g., popping candy or chocolate), mindful boxing (with boxing gloves and mitts), and/or Chinese boxing (hand exercise). The session concludes with a 10 minute mindful breathing audio track. Session 3. This session focuses on social identity and support, first focusing on the benefits of social support and its importance, identifying types of social groups that we belong to and their importance, followed by a task where clients map out their social world, visibly displaying their social connections, the importance of these connections, and links between their various social groups. Session 4: This session focuses on character strengths. It begins with an exercise to revise teachings on breathing, grounding, centering and focusing, followed by team based exercises - to draw upon and highlight strengths. Participants complete a character strengths survey. Participants learn how to identify their own strengths, while also identifying the strengths of others in their group (using exercises to strength spotting and strength feedback). The session concludes with some breathe, ground, centre, focus exercises (tag, boxing, or shooting hoops - boxing gloves and mitts/basketball required). Session 5: This session focuses on social wellbeing. Beginning with a refocus on breathing, grounding, centring and focusing, and a mindful check-in. Social games are then integrated with discussions on compatability and loss, as well as barriers to obtaining social support. Ways to give and receive support is then explored, with a re-emphasis on strengths, and how ones strengths can be used to enhance social connection. Session 6: This session focuses on identity and values. Beginning with a refresh of breath, ground, centre and focus, clients then begin activities mapping out their various roles, interests, and traits; followed by values based activities, mapping out their ideals and values, and steps that can be taken to move towards these ideals. Session 7: This session focuses on communication. Beginning with a practical activity to demonstrate the difference between cooperative versus competitive engagement, the session then moves into an exploration of aggressive, passive and assertive communication styles, with role plays and practical demonstrations, as well as tips for how to communicate more assertively. on social and emotional wellbeing. This session as focuses on boundaries, active listening, and the importance of body language. Session 8. It begins with a strength spotting exercise, followed by a mindful check-in. The session then focuses how to identify emotions and ways to increase positive emotions using music. The music and mood posters of the key components, are used to facilitate this process. Practical demonstrations will follow of how to identify emotions, and how music can enhance positive emotions (speaker) – and how they can be enhanced by breathing, grounding, centering and focusing when listening to music, and other pleasant events that can be used to enhance positive emotions.. Session 9: This session focuses on emotional wellbeing. It begins with a strength spotting and breathing, grounding, centering and focusing exercise, followed by a mindful-check in using music. This session focuses on negative emotions, factors that can lead to negative emotions, and strategies that can alleviate negative emotions (e.g., exercise, spending time with friends, music). Practical exercises focused on how different types of music make participants feel, and how they could use music to improve a negative mood - through mood mapping. Exercise mapping is introduced as another way to gradually shift or alter one's mood. Session 10: Focuses on managing thoughts and cravings. It begins with a revision of core components (breath, ground, centre, focus; strength spotting) and then a Chinese boxing exercise. There is a discussion about thoughts, a quiz to distinguish thoughts from facts, strategies to identify unhelpful thoughts, followed by meditative techniques to mange thoughts. Urge surfing is also introduced as a method to manage cravings. Session 11: Focusing on Healthy me. It incorporates physical activities to highlight the benefits of physical exercise, which is followed by discussions on the current physical exercise guidelines, and ways to incorporate physical exercise into daily living. Sleep and diet is similarly explored, examining recommendations, and practical ways to improve sleep and diet habits. Session 12. This session continues to revise key components from earlier sessions, with a specific focus on checking-in during difficult moments, identifying instances when clients are likely to be most vulnerable (i.e., HALT - Hungry, Angry, Lonely, Tired), and ways to manage these situations. Goals towards future recovery plans are developed. This session concludes with a recap on participants personal strengths and achievements through the program. Participants receive handouts to remind them of the key exercises from each session, and develop goals at the end of each session to implement throughout the following week.