Hello, everyone. Welcome to Triple E. Our president, Carol Hinkle, is not here today. I'm Beth Wood. I am on the Triple E board and the program chair, and it's my pleasure to welcome all of you here today and to welcome today's speaker, Jason Dolan. Just a couple of quick housekeeping announcements before we begin. A reminder that if you have not already sent in your feedback for the first part of the semester to Glenn by email, please do so today. And a reminder that we really enjoy and appreciate your questions. So please feel free to type them into the Q&A at any time during the lecture or during the Q&A. Just remember to tap or click on the Q&A button on the bottom of your screen. A little screen will pop up, type in your question, hit send, and it will be there and we will welcome that during the Q&A. It's my great pleasure today to welcome Tracy Dolan. Tracy earned her Bachelor of Science in Health Education from Dalhousie University in Halifax, Nova Scotia, her Master of Science in Public Health in the University of Northern British Columbia, and she began her career in Northern Canada, working to reduce the risk of HIV in vulnerable populations. She spent 10 years in international health, primarily in Sub-Saharan Africa with a focus on HIV AIDS, care and prevention, maternal child health, and youth reproductive health. She also developed and implemented child protection programs in post-conflict communities in Afghanistan and Uganda. She moved to Vermont and served as our Deputy Commissioner of Public Health for 10 years. Most recently, she helped to lead the state's COVID pandemic response, which, of course, made us the most vaccinated state in the nation. You may have heard her regularly on Vermont Public Radio, patiently answering all of Vermont's questions about COVID during the whole first part of the pandemic, or you may have seen her occasionally taking part in the governor's press briefings on television or on radio. On August 30th, she became the Director of the Vermont State Refugee Office, and it's such a crucial time for so many refugees seeking new homes. It's a great pleasure to welcome Tracy Dolan here to talk about her current position and her current work. Thank you, Tracy. Thank you so much, Beth, and welcome to all of the participants. I'm really happy to be here. Like Beth said, I've had a big transition in the last year, going from pandemic response to this work, and I wanna first, and I do this anytime I speak over the last couple of years, I just wanna thank you because I know that so many of you sacrificed so much for your families and for other Vermonters to get us to the place where we are. I know the pandemic is still very real for many of us, and there's still people getting sick. We still have some deaths due to this very damaging pandemic. However, because people like you got vaccinated early, got your booster shots, masked up, and did some very hard isolation, especially in that first year and a half, we are better off as a state. You saved lives, not just your own, but you saved lives of your family members and others in the community. And I just can't thank you enough. And it is this spirit. I think it was one of the health institutes. Kaiser Health Institute just wrote an article about why Vermont is doing so well comparatively. We have one of the lowest hospitalization rates, one of the lowest death rates, and Kaiser said one of the characteristics appears to be Vermonters genuine desire to help each other and to do what they can to protect each other, a real community sense. And that then really extends into this next piece of work, which is the refugee resettlement. And we're already seeing so many wonderful things happening as a result. So I'm gonna pause here and share my screen and get started with just one more moment here. I'll just be, I'll redo that so that I've got sound as well in case I need to, all right. There we go. All right, I think you can see that now. And again, I'm the director of the Vermont State Refugee Office. So for those of you who may not be aware of how Vermont government is structured, we have a variety of agencies. And one of the largest agencies in the state government is the Agency of Human Services. And that is headquartered in Waterbury. And the Agency of Human Services has a lot of departments that you've probably heard of, the Department of Health, of course, you've probably heard a lot about recently, the Department of Corrections, the Department of Children and Families, the Department of Aging and Independent Living, and a couple of others. And my office doesn't sit in any one of those departments, but it does sit in the secretary's office of the agency because it really does cut across all kinds of services when we're welcoming new Americans into our state. All right. I'll go to our next slide. So I'll speak a little bit about the mission. The mission of the State Refugee Office is to promote and provide a safe and welcoming home for refugees and immigrants and to promote their full participation as self-sufficient individuals and families in the economic, social, and civic life of Vermont. So it really is welcoming people here and trying to help them live their best lives by creating an environment where they can do that. Specific to refugee resettlement, the focus there is a little more narrow in that many of the outcomes that were required to report back up to the federal government are really about economic self-sufficiency because that is one of the cornerstones of really being able to make a life here. And so our big focus, particularly in the first year, is that economic self-sufficiency. And so you'll see that when I describe what happens with refugee resettlement here in Vermont. I first wanna give you a definition of what a refugee is. A refugee is someone who's been forced to flee their country of nationality who's unable or unwilling to return because of persecution based on their race or religion, nationality, membership in a particular social group or a political opinion or war or violence. A refugee has a well-founded fear of persecution and they've been forced across boundaries and they can't return home safely. War and ethnic tribal and religious violence are leading causes of refugees fleeing their countries. A refugee may also be referred to as an asylum seeker until their granted refugee status. So sometimes we have people arrive in country, not many in Vermont, but we have some and they arrive with no particular refugee status but depending on their case, they can try to seek asylum and put in an application for asylum. In the United States, a refugee once admitted can apply in one year for permanent resident status. So they can apply for a green card or they can apply to become US citizens. So that's the definition of a refugee. And I'm really highlighting that definition because sometimes people believe that when people arrive here or refugees arrive here, they're simply arriving because they want a better life or maybe financially it was difficult where they are. So they're coming here because maybe they could make more money, things like that. And while certainly that might be true for people in the world who might wanna come here, refugees are different. It's not a choice where they're saying, you know, it's okay here but I'd really like to go to the US because maybe I could do better. Refugees are fleeing a desperate situation. I wanted to play this poem for you to really highlight this. This woman wore sunshine. She is a refugee. She came over from Kenya, I believe she's Ethiopian. And she, her parents came over as refugees. And so she was really able to witness a lot of what happened. And I think her poem will really speak to the nature, the really desperate nature of what it means to be a refugee. No one leaves home unless home is the mouth of a shark. You only run for the border when you see the whole city running as well.   You only leave home when home won't let you stay.  And even then you carry the anthem under your breath only tearing up your passport in airport toilets, sobbing as each mouthful of paper made it clear that you would not be going back. You have to understand no one would put their children in a boat unless the sea is safer than the land. No one burns their palms under trains beneath carriages. No one spends days and nights in the gallbladder of a truck feeding on newspaper unless the miles traveled means something more than journey. No one crawls under fences, wants to be beaten, wants to be pitied. No one chooses refugee camps or strip searches where your body is left aching or prison because prison is safer than a city or fire and one prison guard in the night is safer than 14 men who look like your father. No one could take it, could stomach it.  They smell strange, savage, messed up their own country and now they wanna mess up ours.  I wanna go home but home is the mouth of a shark. Home is the barrel of a gun and no one would leave home unless home chase you to the shore unless home told you to quicken your legs. Leave your clothes behind, crawl through the desert, wait for the oceans, drown, save, be hungry, beg, forget pride, your survival is more important. No one leaves home unless home is a sweaty voice in your ear saying leave, run away from me now. I don't know what I've become, but I know that anywhere is safer than here. So thank you for listening with me to that. I'm gonna give you a little more information about Worson Shire. She is actually a British writer and poet, editor and teacher. She was born to Somali parents in Kenya. So often refugees are living in camps or temporary, almost temporary refugee cities in neighboring countries before they end up in a place like the United States. And so her parents were there and she was born in Kenya in an environment like that. I imagine her parents were the ones who probably left Somalia very quickly. And she is now an award-winning poet. She was awarded the inaugural Brunel University African Poetry Prize and she has been lauded for her incredibly beautiful poetry. This isn't the only one of hers, Worson Shire, if you ever want to look her up. But it really highlights what I was mentioning, which is in case we ever think that people are making some kind of choice, it's a choice of desperation. And so when they arrive here, there's often great trauma. So how many refugees get settled? Now, what we've seen in Afghanistan more recently is unusual. Usually people are refugees for a very long time before they resettle permanently in a new country. So most people, when they're displaced from their homes, they remain in a protracted, extended situation that lasts five years or more. And then at the average length of time, a person will remain a refugee is actually 17 years. So you have families and next generations growing, reproducing in internal displaced persons camps, IDP camps, refugee camps in other countries who keep applying for a permanent life somewhere and less than 1% of them will ever be resettled permanently in a new country. So to get the okay to come to a place like the US or to come to Canada or a place in Europe or any more developed country is like a lottery. And it's an amazing thing that happens, but it's also not that common. Some people ask, why is it that we do so much? Why don't neighboring countries help? You hear this a lot also when there are problems, particularly in a country whose culture is very different than ours, like a primarily Muslim country. People may say, well, why don't the other Muslim countries help? They do low and middle income countries actually host most of the world's refugees. 70% of them are actually in low and middle income countries. Many countries that have scarce resources themselves take people in. So that is the situation that we see. Now, I'm gonna speak a little bit about what happened with Afghanistan because like I said, normally it's years after a conflict or years after someone's been forced out that they might end up, for example, in the United States or even in Vermont. But in Afghanistan, that was an unusual situation because the United States had been there and had been working with Afghanistan, Afghans, helping the military, helping with the non-governmental organizations. When they left and then they saw the Taliban come in right away and take over and saw that everyone they had worked with would be at risk because they worked with the United States military. They felt a responsibility, the United States government, and recognized that those people could be killed or persecuted or jailed or harmed very quickly and thousands of them. And so the US made a decision to quickly remove a lot of those folks. Now, some of them had been in the process of getting special visas because they worked with the US military. Had that process been smooth, had that process had the capacity and the speed, that would have started probably a couple of years before and you might have been able to process many people through that. But that process was not particularly smooth. It started late. And so by the time the US left and by the time the Taliban came in, which was within days, there were tens of thousands of Afghans who had not even entered that visa system. And so the US made a decision to give these people the status of humanitarian parolee. And that's not really a refugee status, but I'm gonna use the word refugee in this general topic. And we are treating them like refugees here for the most part, but it's not exactly refugee status. It's a very precarious status, humanitarian parolee. We did it a couple of other times. We did it after the Vietnam War and we lifted and removed many people who are at risk then in part who had worked with their forces. And it's happened a couple of other times. It happened also when we helped many Cubans who were also at risk because of their association with the United States. So it has happened a few times where we've brought people over. And so that's what happened here. Some of the Afghans who arrived here had a visa, a special immigrant visa, or were in the process. Many were under this humanitarian parole status. And so I'm calling them refugees, but officially they are humanitarian parolees. Luckily, the services that we would normally give to refugees, we are able to give to these Afghan arrivals. The Congress passed an act a few months ago that said we will treat them like refugees for the purposes of all of these services. And I'll describe that in a minute. But one way that they're different is that because they have this unique status, they do not have an easy path to permanent residency or to citizenship. Right now, their only next step to stay is to apply for asylum. The application is difficult. It can take years, although Congress says that they will prioritize them. But between me and you, there's a very big backlog already of these cases who are not Afghans. But normally it takes years and then that gets them to the next step if they're in a, so then they become an assaili. So let's say that takes a few years, then they have an opportunity maybe to apply for a green card and then for citizenship. It's not an easy path. So one thing that's happening right now is that people are lobbying Congress to pass a special act to help these Afghans not have to go through all that. It's called the Afghan Adjustment Act. If an Afghan Adjustment Act were to be passed, those Afghans who are here under this particular humanitarian parole status, which is most of them, would automatically be able to be given refugee status so then they could go ahead and directly apply for a green card or for citizenship. So we're hopeful that that's going to happen, but there's no real sign for sure that it will happen. So in the meantime, we're doing a lot of work to see if we can help the Afghans who are here apply for asylum. Now you might think, well, I guess there are a lot of lawyers who know how to do that. There aren't a lot of lawyers who know how to do that because there aren't that many asylum seekers. So in states all across the country, lawyers who are taking this on, first of all, they don't get paid much for it because there's not much money for it. So they tend to be pro bono, which means working for free. And there's only a handful of them who are expert in it. So here in Vermont, we only have a couple of lawyers who even do this pro bono. So we're having to figure out, how do we train people to help the Afghans to fill out the applications? And where might we be able to find more lawyer help? Could we mentor lawyers so that the ones who do know how to do it can help others? And is there a way to encourage more people to help? So we don't have an easy solution there. So all of that to say, let me sum up. Normally a refugee comes here after many years. Most refugees go to countries nearby, middle-income, low-income countries. But in this case, for Afghans, they came here immediately. So they were not in camps for years like most would be. A lot of them were living in nice homes. They had their car, their job, their usual things. And they were very rapidly, within days, running for their lives and then arriving at bases, military bases in the US and in some other countries, staying there for a few months with nothing and now suddenly arriving with really nothing. And so it's already hard enough to be a refugee with all the trauma that you're running from. But for everything to happen so quickly, they are really in that shocked phase right now. Sometimes we have refugees who arrive here who have been in camps for years. That's difficult too, but the shock of it may not be as extreme because they've already been living that difficult life. I think what we're seeing right now is for some of the Afghans arriving here, the shock of it feels very extreme. I wanna talk to you a little bit about how it all works. So in each state, so I'll give an example, Vermont, the State Department asks the refugee resettlement agencies, so they don't ask the governor, they ask the refugee resettlement agencies, how many refugees can you take this year? And the resettlement agencies look to see what their capacity is, they look at their staffing, they look around at the community, and then they also consult with the state, which is me. They consult with the state refugee office and I check in with the governor, but they really make that decision on their own. And for the most part, my office will say that makes sense unless we think there's a big problem. And so every year that happens, and that happens after the president determines what the overall number is. So in 2021, President Biden issued the presidential determination on refugee admissions. So this is something a president does every year. And he raised that target to 125,000 for this fiscal year. And just for you to know, the federal fiscal year runs from October through the end of September of next year. So right now we're in federal fiscal year 22. The year before that number was as low as 15,000. And I'll show you in a minute what our numbers looked like and how different federal administrations and presidents can impact that. So the president raised it to 125,000, huge jump from 15,000. But because of the Afghan crisis and everything that had to be stood up, they kind of bumped out a lot of the other refugees. COVID also had an impact because some people weren't able to travel because of COVID. So realistically this year, we probably aren't gonna reach 125,000. It might be closer to about 65 or 75,000. So I'm gonna speak a little bit about how it's worked in Vermont in terms of the numbers. I've got here the year's fiscal year 16. So that's the federal fiscal year up to fiscal year 21. I don't have this current year on the chart. So you can see back in fiscal year 2016, if you look at the bottom of this chart, we had a total of 386 refugees. If I were to make this chart longer going backwards, you would see that from about 2008 to about 2016 we regularly had more than 350 refugees between 350 and 400. But then you can see the drop begins in 2017. That was a change in administration. That is when the Trump administration came in. And the Trump administration was very clear that they wanted to reduce the refugee program. They wanted fewer refugees in the country and they set up many more procedures to slow down the whole process. And so you can see how that affected us in a state. So we went from 235 and then the next year, the next number, 133, 115, 23. So you could see it was until February fiscal year 21 when we got new leadership that that number starts to go up. You see the number 47 there. In a minute now, I will show you what it's looking like for this year. The other thing you can see in this chart is where people come from. You can see back in 2016, we had a lot of bootleys. And again, if you look back, you will see that there was war and strife at that time, but also previously because there's a lag period between the major conflict and when people arrive here. We also had big numbers from Congo. Congo has continued to have brutal civil strife. And so you see those numbers coming in constantly. And we had big numbers out of Somalia. Again, I don't know if you can recall back, but Somalia was very much in the news years ago and continues to be off and on for their significant civil strife. So those are some of the big numbers that we had. Now, when I add the column FY22 to this, you will see Afghanistan will be far and away our biggest number. We have had some other refugees who are more traditional refugees coming this year, but very small numbers. Mostly Congo and Sudan, I believe. So that's what it looks like generally. Now I'm gonna talk here, let me go here. We're gonna talk a little bit about what we're seeing now. So back in November, we started receiving refugees into Vermont. We received one family a little earlier, but back in November, we have two resettlement agencies in Vermont. And remember I told you earlier, it's the resettlement agencies who are the primary drivers of how many refugees we get and they are the primary people who are providing that service, especially in that first few months, the first year. So up in Colchester, we have USCRI, and I forget what it stands for. Sorry, sometimes they even forget what it stands for. It used to be called VRRP, the Vermont Refugee Resettlement Program. So they received 130 Afghan refugees so far and they started in November. And this is a lot of refugees to receive in a very short period because the refugees only arrived until February 15th. So that's many every week. Normally we just get maybe one refugee family every couple of weeks throughout the year. So this is a really rapid arrival at a really short time. And if you remember in our chart, you could see there were not many refugees before. So of course there weren't a lot of staff anymore because you didn't need a lot of staff if you were only helping 30 people. So we had a lot of people arriving, a brand new population we've never had, a brand new language, and we hardly had any Afghans in Vermont who can speak who help to help interpret when they arrive and very few staff. So it's a lot happening at once. Another organization which is brand new in the southern part of Vermont is called ECDC. It's another resettlement agency. It stands for the Ethiopian Community Development Council. But the fact that it's Ethiopian has nothing to do with refugee resettlement. It was just founded by Ethiopians. So they received in the Brattle, Borough, Bennington area 90 refugees. And again, even more challenging than Colchester because this was a region of Vermont who's never received refugees. So the health providers have not had training before in how to do medical exams for refugees. All the service providers aren't used to it. We have a school system that's not used to receiving a big influx of new people who don't speak the language. And so that's what we had. And as I mentioned, in addition, about 20 or 30 refugees have arrived slowly from other countries through the usual program. I feel fortunate that I had a background. I was in Afghanistan soon after 9-11 and after the Taliban fell there. So the Taliban were conquered right after 9-11 and I was there in early 2002. And part of my job was to help set up schools and other kind of normalizing activities for children. Somewhere kids could go and feel like their day is normal. They weren't very fancy or highly academic schools and they weren't qualified teachers, but we basically went around to communities. We showed up with some balls, some equipment. We showed up with like those beach mats so that they could lay them down for flooring like a tatami mat and some food and notebooks and a little bit of money. And we would train teachers for a few days and training teachers meant we would find anyone who could read and write, which was mostly mulas, mostly men. We would learn that there are sometimes women who could read and write, but it was difficult to access them because culturally the men tend to control who is available for things like that. So anyway, we quickly trained teachers and provided some materials and helped them make a schedule and the girls and the boys had to be separate. So we would say, let's do girls school for a few hours on Monday and Wednesday and let's do boys school for a few hours on Tuesday and Thursday. And so that's the kind of work we did. We did some other work too, but that was the main thrust of it, really focusing on children. So I got to know a lot of Afghans and so when this tragedy occurred and I happened to be appointed at the same time as the refugee director, it felt like a pretty wonderful blessing, a perfect storm in a way for me and a good way of kind of my background and coming out of the pandemic, that emergency kind of response feeling and then knowing that I had that connection. I was able to reach out to a former interpreter I had whose family was actually stuck in Afghanistan. They had just gone home to visit because they have green cards. They had just gone home to visit for a little bit. His wife and children visit their family in Afghanistan. And then this happened and they couldn't get to the airport and they were stuck there for months. And so we actually reached out to Senator Leahy to try to expedite their case because we knew that in addition to air lifting people out the United States was also trying to get out citizens and green card holders. So I'm happy to say a few months later he texted me one night and said my wife and my four daughters just arrived at the airport in Washington which was pretty amazing because they had not been leaving their apartment for fear of the Taliban. So that's the situation. We've got people who are afraid to leave who are over there and then we've got folks who were lucky enough to get out and they're here. A lot of the people arriving here still have family back home. For the families who come, they have extended family. We have single men who arrived whose families, brothers and sisters or maybe even whose wives and children are over there and there is no easy path for them to get out right now. I don't know that the US government is going to do another major initiative at this time. I know little by little people are working on getting people out but it is not straightforward at all. So now I'm going to talk a little bit about an update on the arrivals. I'm just going to pause and check the Q and A if there's anything. There is one question that I could answer just while I'm in it, if you don't mind. And the question was how long do you think it would take them to get a green card? And I will, I'll talk a little bit about the services in just a minute. So if they have to go through asylum, once they get asylum, the green card application I believe is relatively quick, could be within a year. What we don't know is how long it will take them to get granted asylum. We have heard through Congress or through the United States immigration service that they're going to try to expedite it but we're not sure, we're not sure that that's going to happen. Okay, so update on Afghan arrivals. So normally when refugees arrive here in Vermont, usually we know well in advance that they're coming, the resettlement agencies can find housing for them. They're picked up at the airport, they're given that first warm, culturally appropriate meal and then they're brought directly to their new apartment, not new as in newly built, but new to them. But in the Afghan arrival situation, we had very little notice they were coming. Many of them were arriving at once and we have a housing crisis in Vermont. And so we knew that we would not be able to just slide them right into a place. And we also know that a lot of families coming from other cultures are big and it's difficult to find three bedroom houses. And as you know, I'm sure you're hearing about the housing crisis. People are having trouble buying houses, people are having trouble renting houses, especially affordable ones. So a couple of strategies were used. One strategy used was the host family strategy. And that's where, and that was mostly in the Chittenden area. And that's where families arrived and they were placed with a host family for maybe a month, maybe even up to two months, although usually a month. And while the resettlement agency, so USCRI looked for a place for them. Now we thought, how are we gonna find housing? It's already so difficult because of course you can't push other people out of the way because we have new arrivals. That's not fair. Everybody's looking for housing. But we had a lot of landlords who stepped up who said, you know, I was holding or I wasn't sure, but I really wanna help and I wanna release my unit. And USCRI also already works with a small group of landlords who have had good experiences with refugees and continue to want to rent to them. So that's going okay. It's still hard and tight, but it's happening. We've heard from other states where people are in hotels for months and months because they can't find housing. So we are relatively lucky. Up in Brattleboro, rather than go to host families, they did something a little different. They used a large college campus. There's a big organization in Brattleboro called the School for International Training, which is handy because they are used to doing English as a second language training. They're used to doing cultural orientation for people because it's an international kind of college. So they partnered and said, let's open up our campus. We'll be able to provide food. They can stay here. They can get their cultural orientation here. And then, you know, we'll look for places. So that's what's happening up in Brattleboro. About 50% of the folks in Brattleboro, Bennington area are actually moving out by the end of this weekend into houses, which is great. They started arriving in January. So it's been about two months. And about 90% of the people who arrived in the Chittenden area are moving out and finding places. Employment. So I'm gonna back up here and just talk a little bit about the services. If I can back up, let's see. Just give me one moment. There we go. I just have to hit it a little harder. I'm gonna cruise through this. Oh, sorry. I just stopped sharing. So I'm gonna share again. All right. Thank you. I'm gonna see if I can. It's a little tricky to go back. So let's see if I can get to this spot here. I'm gonna talk a little bit about the services. So some of the core services were refugees. Again, provided primarily about the resettlement agencies. Also by another agency called the Association of Africans Living in Vermont. So employment services. They get some workshops on what it means to be employed. They learn about sick time, how to dress, the hours of work, all the cultural things. They get some assistance with securing housing. They get a one-time payment for basic needs. So the resettlement agency for them, get some money, spends it on their behalf to buy direct items. And if anything is leftover, they get that direct too. So it goes to both. They also get cash assistance if they are eligible for reach-up, which all of them are if they're in a family. If you're a single, you get the equivalent of reach-up, which is refugee cash assistance. And for those of you who don't know, reach-up is basically like the welfare assistance that the state provides for families who are lower income and who need it while they get their feet on the ground. So that's the same thing that's offered to refugees. It's not something special or extra. It's the same that we would give to any lower income Vermonter who is eligible. They also get Medicaid, just like we would give to any other Vermonter who's eligible. And they also get some English language instruction. They're actually required to take English for the first several months as part of receiving that cash assistance. So they also get some training and job development. They can also get vocational training. The federal government has some unique programs there that we can access. There's also interpretation and translation. If you go to the doctor and you speak a different language, the hospital or the medical practice is required to provide interpretation. But if you go to the bank or to the school, the refugee resettlement agency will send an interpreter to help with that. So that's another interesting part, school registration. A lot of folks who come are also children, school children, usually about 50% are school children. In the case of the Afghans, it's about 40%. So they enroll in school and it's amazing. You'll get a five year old showing up who doesn't speak any English and by the time they hit first grade, they speak.  And so they're given a lot more English language, kind of intensive learning, separate from the other kids. And then eventually they try to integrate the classroom. So there are special programs for that. And they also get citizenship classes. Now, in the case of the Afghans, that won't be offered for a while because it won't be relevant. But for most of the refugees, if they've been here for five years and they get their green card, they can then apply for citizenship. I wanna speak a little bit about health and mental health. There are a lot of mental health challenges generally in the world right now, I would say, and in Vermont related to the pandemic and everything else. But when you arrive from another country, particularly so rapidly having to leave like this, you arrive here, you have nothing. You can't speak the language. You feel isolated. You feel poor. You have your extended family at home and you are worried about them because if you were associated with the US military and you were being persecuted or a target, perhaps they are too, there is a famine occurring right now in Afghanistan because the Taliban has not been able to manage what they were given and for other reasons. And the medical emergency. So there's just a lot and then they themselves may have been tortured or imprisoned before they came. So there's so much trauma and, but there are many cultures that do not think of mental health as a valid reason to get help. And so when we use phrases like mental health in other cultures, they might think we're asking them, are you crazy? So if we say, do you think you need a mental health referral, they might say, no, because they think of mental health as someone they knew who was out walking in the winter with no shoes down the middle of the highway. So sometimes we have to use different words like, do you feel sad? Do you feel stressed? And when we use that language, we get a much better response. So we are finding that the Afghans arriving here are open to getting some mental health support and we are approaching it that way. And they are stressed. So it's not like a hidden way of trying to get at it. I mean, the reality is it's very stressful. Our challenge, of course, is that our health system and our mental health system is maxed out. So we're doing everything we can to get people in to see a primary care doctor. Dentistry is a big issue. We are maxed out with our dental issues, with our dental capacity in Vermont, but a lot of people in lower income countries have never had much dental work. So there's often a lot of work if you choose to get that when you arrive. So we're doing everything we can to help in that way. So I think I've talked about some of the challenges.  In other states, you place refugees in a city preferably near a good transportation system. For example, in Southern Vermont, we don't have great transportation, public transportation systems. So we're working with some of the bus systems to make that easier, but really people are pretty isolated. And so we have to figure out, how do you get to work if you don't have a car? Can you ride share? And if the head of the household goes to work, let's say the man, the woman is at home, she's with the kids, but she may not be really nearby other Afghan women. Even though we try to keep them close together, they might not be within walking distance. So it can be very isolating. In some cases, the community comes together and actually buys an old car and that can be helpful. There's also cultural acclimation. There are some really big cultural differences. We notice that the children, when they arrive, the children are very polite. They don't speak back to their parents. They would never raise their voice to an adult. But then they go into the school system and our culture is very different. There are children who are shouting out, who are sometimes talking back to adults and that can be confusing. And sometimes the child might bring that back home and that is not well received back in the home of the refugee family. And we also have challenges where in some cultures, men may be able to hit women and that's very accepted in the culture. It's not okay, but it's accepted. In our culture, it's not accepted. And we have to be very clear at the beginning. Not only is it wrong in our culture, it could result in your children being removed from you if you hit your children. That could be a huge change for some. And so that's a message we try to get out there. Also, things like safety. Think about for some of us who were raised, maybe in the 50s, 40s or even 60s, you get in a car and you don't have to wear a seatbelt when your friend is riding on a bike or motorcycle, you get up on the handlebars. There wasn't a lot of safety. A lot of countries where refugees are coming from, it's still kind of like that. There's not a lot of safety rules. And so things like that here in the US, you might be seen as negligent, whereas in your culture, that might be normal. So all the little things, cultural acclimation. And then I mentioned the history of trauma arriving in a new country. I'm gonna just go for a couple more minutes then we'll pause for discussion. Just wanted to really speak about the workforce. Governor Scott is very supportive of refugees coming into Vermont. The biggest reason being that it's the right thing to do. But a secondary reason also is that we have a huge workforce shortage here. And these people arriving very much want to work. It's the first thing they ask, when can I go to work? So this does fill labor shortages and we've had nothing but positive responses from employers saying, please, we'd love to hire some new Americans, some refugees. I'm using the word refugee a lot in this presentation, but were I speaking about employers and in a more broad way, I would probably use the phrase new Americans, new Vermonters. And so they come in, they do slide into a lot of the lower skill jobs, but not all. We've got accountants, we've got nurses, we've got health professionals arriving. So we've got a mix. And when people have a higher skill level, we try to get them in a job using that higher skill level. English language is the key to getting a better job. So we really push the English language learning if they don't have it. Just a little example here, here are two refugees who were former refugees and who are business people now here in Vermont. We actually find that refugees coming to this country actually have a higher entrepreneurship rate than people who are born in this country. So a real hunger. And I gave a few examples, Google, WhatsApp, PayPal, those are all companies that were actually started by immigrants or refugees. The men tend to participate in the labor force the same as American born men would, but the women, it takes them a while. After about 10 years, they are participating at the same rate, but it does take a little while. And what is needed, this might need to be updated, but long-term housing is still needed. If you know people, that would be wonderful. Gift cards, while we get a lot of donations, it's wonderful to be able to give a cash card for coals or for somewhere or for the grocery store so people can choose their own things. And then cash is always the best donation because it lets the resettlement agency spend it on whatever urgent need comes up. So thank you so much for listening. I am gonna put myself on mute for a minute and I'll turn it over to Beth maybe to get some questions or discussion. Yes, we have some additional questions for you. Does your office have a policy towards refugees who settle in Vermont obtain housing and support services from local and state organizations here and then decide to move to another state? Is there a minimum stay in Vermont required or expected? There is no minimum stay. When refugees arrive in the US, they are free to go wherever they like. They are assigned to agencies. And so they are told that is the best place to go because that's where you'll get the services you need. But if they choose to go somewhere else, they can. The services might not be as strong and there might not be as much coordination. Normally when people arrive here, they tend to stay at least through the first eight months. Probably 60, 70% stay very long-term. Our challenge is more when they go into more rural areas. Historically, if we place a small number of families in a more rural area, they don't stay long because they don't have a sense of community and there's not a lot of services. So we'll have to see how it goes with the Afghans. We are really trying to cluster them so they have a sense of community. Okay, another question. Do Vermodgers who arrived here as refugees some decades ago, such as those from Vietnam or Bosnia, play an active role in welcoming and assisting newly arrived refugees from other parts of the world? They sure do. In fact, there is a former refugee who on her own dime and we've asked if she would like money for it, she cooks the first meal for every single family that arrives at the airport. Even if it's back to back, a family of eight, one day, a family of five, the next, she sets up in her kitchen and she cooks culturally appropriate food because she's Muslim and they need halal meat and she brings it up to the airport and they bring that to their home. So that's one woman. I can tell you, I met a family at the airport a few weeks ago. We brought them to their new home. That home was the second rental property of a Bosnian woman who arrived here when she was six years old with her mother. And out at the airport, this woman held the hands of a six year old Afghan girl and she said, I was you. And then she brought that family to their new home and we actually walked around with the family and the little girls, they would open the door and see a new room and they would put their thumbs up and look at us and say, yes, every time they saw the next room. So it was wonderful. Yes. Okay. Do we have enough translators in Vermont to assist all the refugees? If not, what are the alternatives? We do not have enough translators or interpreters to assist the refugees. The alternatives are not great. We have telephonic interpretation. So every medical provider is required to provide interpretation if there isn't somebody in person and they do use telephonic. The state also uses telephonic. So you call and they get a translator on the phone, but we don't have enough and we do what we can. And it means sometimes, and this is probably for every language group, people have to struggle through sometimes on their own or with sign language and other things, but we do it for the most important ones. We do it for the most important appointments, but often it isn't as adequate as we would like. Are there professionals who are stepping up in providing inexpensive or pro bono services for these refugees? Dentists, optometrists, eyeglasses, hearing aids, et cetera? All of the healthcare providers, so all of these arrivals are eligible for Medicaid, but some of them, the benefits were put in a little late because some of the offices were new and the staff were new. So all that to say, even when they don't have their Medicaid card yet, doctors and others in Vermont are really stepping up and providing them the service and trusting that they will get reimbursed by Medicaid. Is anyone doing it free of charge? Certainly they're putting in a lot of extra time than they would at a regular appointment. A regular appointment time is 15 minutes. These appointments are a lot longer than 15 minutes. So I would say they're certainly putting in some personal time, but they are also mostly getting the Medicaid billing rate. The pro bono place is really all the volunteers coming out. Also the pro bono lawyers helping out, but in the medical system, I can't speak to it beyond that I know they're doing their best, but they are billing Medicaid, which would be appropriate. What might be a good source of cars? Good news garage? Yeah, good news garage is great. Used car prices are brutal right now, unfortunately, but I mean, if somebody has an extra car and they were thinking of selling it, but instead would be willing to donate it, the two places to reach out to would be USCRI and ECDC, and they might be able to then connect you with a group of volunteers who's working with the one of the families or something like that. Will we be receiving refugees from Ukraine? I don't think we will, certainly not in the near future. Like I said before, Afghanistan was an exception in that we saw the tragedy and they arrived here months later. Usually there's a conflict and it takes years for people to arrive in their final destination country and the nearby countries help in the meantime. In the case of the Ukraine, I would think it's unlikely that the US would be airlifting people in on a special status. It does take a long time to get this status and I would guess that Europe will probably absorb most, but who knows, there could be an emergency declaration and that could change, but at this time when we spoke to the US government last Friday right now, there are no plans for a major resettlement effort. And tied into that, Canada has just announced that they will take an unlimited number of refugees from Ukraine. Is there a reason that the US can't sort of pivot and do the same? I can't speak to the federal policy. There might be a difference between what a country says they're willing to do and the timing. So Canada may do that. It could still take years depending on what their process is, but I can't speak more to the federal guidance on that other than to say what we were told was we shouldn't expect Ukrainians anytime soon. Do you think it would have anything to do with the fact that Canada has such a large population of Ukrainian descent? Well, I think that might be the difference. There's a difference between refugees and people who come in through a visa. So if you already have relatives here, yes, your Ukrainian relative could start working on a visa. That's different. Arriving as a refugee would be fleeing from persecution and arriving on that status. That's a different process. So I'm not sure what Canada's proclamation was, but I would certainly think we may start receiving people through the visa process possibly. Okay. How easy or difficult is it for professional people moving here to pick up the same career and practice that here? If they don't have strong English, it's difficult and depending on the credentialing. So we are trying to do better with that, but the US, a lot of the professional organizations do not recognize credentials from countries that tend to be lower income, to be honest. They're often not seen as equivalent. And one thing that I was actually working with the Office of Professional Development on this before all of this happened, they do have someone now who's focused on trying to figure out what we could accept as an equivalent. But if you were at something very high level that required licensing in Ukraine, if you were an engineer, you might not be able to slide into an engineering job here if it requires a certain certification. It happens, it's more difficult, but the English is huge. If you come in here and you're fluent with English, you might be able to, might be able to challenge the exam, submit for a license here. The English really is the game changer, I think. Okay. And someone is asking if we wish to provide money or make a donation, where should it be sent? Where are some good organizations to send the donations to? So Beth, I can send you the link to the web page for the State Refugee Office. And then there's a section under How Can I Help? And there are donate links there for the organizations. Can I do that for you? If you wanna pause, I could put it in the chat right now if you wanted to take one minute or I can send it to you after. I think probably best to send it to me after because the chat closes off like in two minutes. And people won't have access to see it after that. So they can write really quickly. Okay. Can refugees ever choose where they'd like to go? Yes, they can choose where they'd like to go. They can choose where they'd like to go when they arrive, to be honest. They're assigned to places because that's where we're gonna be able to provide good services, but they could decide tomorrow I'm flying to California and they could go there. Now there might not be a place there for them in terms of an organization that can help them. If they walk into a resettlement agency, they'll do their best, but they tend to be assigned to places where we think there's space, capacity. They often go to places where they know family and friends. That was one of the challenges of Vermont. People were not initially choosing Vermont because we don't have a population here already of Afghans, but eventually a lot of places filled up. And now there are some families who wanna come here to be with the families here. So we'll see how that goes. Okay. Well, I think we're just about out of time, but I wanna thank you so much for helping to inform us about the evolution of the refugee program in Vermont and where we are and where we may be headed. And also to thank you for your work that you did with the Department of Health. So it's been a great pleasure to have you here today. So on behalf of Tripoli, thanks so much. Tracy Dolan. Thank you very much. Take care. Take care, everybody.


Bismillah alhamdulillah wa salatu wa salam ala Rasulillah. So we've gone over staying one step ahead of relapse in the past. I won't go over that over here, but we'll summarize it briefly and move to the last section of this book. Staying one step ahead of relapse, page 198. The idea is that when we maintain a period of abstinence from our behavior, our addictive habit or our substance. So we've got a little bit of a period of being away from that, being sober. And we're starting to experience the benefits, whether that be feeling good in terms of our relationships and connections with people, whether that be just enjoying things that we previously did not enjoy. We start to reap the benefits of being sober. One way to think about it is when we first started our addictive behavior, when you first start your addictive behavior, you get a really intense, pleasurable feeling from it. So think back to that first time of whatever addictive habit you have. You get this, you can think about this as feeling normal. Think of a line. And then every day you can have ups and downs. So for example, let's say you get a good grade on an exam, that's it, you feel up. And then let's say you have a really difficult day. Let's say you don't do well on an assignment or at work, or you get in trouble by your boss, you get some negative feedback, you feel down that day. And you go up and down, but you stay within this margin that you tend to not go out of in terms of highs and lows in life. Once in a while, you'll have a really big high and a really big low in your life. So let's say, for example, the birth of a loved one, of a child, that's a really big high. So you're gonna exceed those margins and go up to this high. And once in a while, you'll have a really big low, let's say a death of a loved one, a really significant crisis. And you'll exceed those margins and you'll go really low, okay? Now, what happens with addictive substances and behaviors? The way they work is that they target your reward pathway. Forget about the drug, and we've talked about this a lot in the past, forget about the drug, forget about the behavior. It's the target. They target your reward pathway to then get you to not have your everyday ups, but have a super normal up and high, okay? So that high that you would get once in a while in life, now it's hijacking that system and it's releasing that high. Now, your body responds to that, your brain responds to that because it says, you don't really have the neurochemicals in your bank to support that. So then that's always followed by a low. Even when you have a natural high, it's gonna be followed by a low. So if you pay attention to after you have a big event, let's say you've been working up to a marathon or you've been working up to a big event that can cause a high or you have that baby, you're gonna experience a low in order to recuperate from that. So when you use a drug, a digital drug, a chemical drug, you get that high and then you come down with a low.  And that low is gonna also exceed those margins.  Over a period of time, high, essentially what happens is you have this high and then you come back into your margins in terms of a low. Then you have this high and you come back into your margins in terms of a low. Then you have this high and then you start dipping below your margins and having a significant low. Then you have a high and then you go lower because again, you're depleting more and more of your neurochemicals and you're having less and less of a chance to replenish that. Does that make sense? Okay, all right. So over time, what happens now? Fast forward. Now, when you're getting high, you're not even going into exceeding your margins. You're just having a normal everyday feeling of high. So that feeling you get when you pass an exam or that feeling you get when you have a good day, now you're just getting that from your addictive drug. So it's not even getting you super high anymore. The converse is, although you're getting a sort of normal everyday high, now you're exceeding the margins significantly in terms of your lows. So now you're getting kinda high and really low. But when you go from that really low to kinda high, that differential is significant. Just like in the beginning, that differential is significant. So what happens over a period of time is eventually you just go below your margins. Your everyday low turns into your high. Your everyday low turns into your high.  So what that means is you're getting high just to have a bad day, just to kinda feel normal. But the idea is is that here's where the people make the mistake. Hold on one moment. Here's where people make the mistake. They feel that differential from really low to high and they say, I need this drug to make me feel better. I need this drug to make me feel better or this drug gets me high. They feel that differential in the beginning of the game. They feel that differential in the end of the game. Now what happens is afterwards, if you have the blessing of getting a period of abstinence, a period of sobriety, whether that could be getting locked up in the county jail, whether that be a prison bit, whether that be moving or going on vacation somewhere where you can't use or somebody comes and visits you and you can't use or that you have an important deadline and you can't use or whatever reason, if you have an opportunity to have a significant period of abstinence, then what happens is it allows your brain to slowly reset and replenish and heal, which is an incredible blessing that your brain doesn't stay like that and that you have an opportunity to heal. And then eventually what happens is you start to have your normal highs and lows again. You start to have your normal highs and lows again. And for many people, that's like a honeymoon phase in their recovery. They'll feel like a certain glow after 30 days or 60 days or 90 days or a six month mark or a year mark. There might be these increasingly better sort of feelings and senses of wellbeing. So that's important to keep in mind because when we're on that cusp of sobriety and we're experiencing a period of sobriety, it's important to really remember how that feels. That good feeling in the beginning, that sense of self-respect, that sense of feeling accomplished, that sense of like feeling like we're connecting with people again and doing our responsibilities, being the person in public that we are in private and being the person in private that we are in public, so on and so forth, that's a really good feeling. That's a really strong feeling. So once we experience that, it's really important to document that, to remind ourselves of that, to tell people about that, to tell other people about that because there'll come a time where we forget that and it becomes a distant memory and thinking of using again or thinking of going back to our addictive habit again becomes more appealing. And in the rooms of recovery, they always talk about playing the tape out to remember not just the first time you get high, which is that big differential, but playing the tape out of what that ends up leading to, which is a lot of lows and a little bit of highs. And then eventually you go through the cycle, not everybody does, but some of us go through the cycle where it gets to a point where even if we have a period of abstinence and we go back to our addictive habit, it doesn't do much for us. It doesn't do what it used to do for us and we get back to that low state really quickly. So it's important to remember and play the tape out. So going to the book now, page 198, staying one step ahead of relapse. It's important to when we have that period of abstinence to think back to the last time that we slipped or relapsed and remember that there are warning signs before you enter the situation in which we actually relapsed or engaged in our addictive behavior. There were warning signs before it. There were signs that said, stop, trouble ahead.  Pretty soon it turns into the skull and bones and it's like, no, don't do it. And then eventually it gets to a point where we reach a critical mass and it's hard to turn back. But there are warning signs. So going on to the next page, my warning signs of relapse. So I'm gonna go through a couple. We went through this again in a previous session on staying one step ahead of relapse of some time back. So some of these are, number one, stopping or cutting back your attendance in recovery work, like therapy or counseling. And then number three, fantasizing often about how good it would feel to go back to our addictive habit. While blocking out or thinking very little about the potential negative consequences of the addictive habit. Here's a good one, placing yourself in risky situations. So I'm not gonna do it. I'm not gonna do it, but I'm gonna start hanging around with so and so who does whatever. Or I'm not gonna go to the website but I'm gonna watch this movie, which I know is gonna have some bad scenes in it or so on and so forth.  Dominoes or something. Avoiding talking about feelings of unhappiness. Avoiding talking about feelings of unhappiness. So not talking about what's going on within you and not being aware of what's going on within you. Rejecting help from others. Acting defensive. Oh, here's a good one. So this is the last one they have here because this is often what I see when people leave our sober living homes. They often have this really clear sign of acting defensive when others around you express concern about their wellbeing or their recovery. It's almost like a telltale sign that something's not going right. When somebody holds you accountable or expresses concern about you and you're sort of like taking it as a personal insult or taking it more so as like a conspiracy theory or there's something more going on beyond, I just need to perhaps pull myself up. And then it goes to other relapsed warning signs. So this is like a couple of lines they have of writing. So I think what we'll do is after the session, things like this, we'll just, instead of doing the talking, we'll just sit here and spend more time on the exercises like this, like in this chapter alone, there's so many exercises. So I think what we'll do is we'll focus on that, focus on skills. Okay, so the next paragraph, now looking back at the list, identify which one of these are your top three signs that you are at risk, three signs of you being at risk of relapse. And then you need to start creating a plan. So it's not enough to be aware of the signs. That's a huge step by the way. That's a huge step to be aware of the signs. But then you need to figure out what do I do about it when it happens? And again, you don't have to be perfect at this. Nobody's perfect at this. This is a lifelong endeavor. This is a lifelong endeavor. The important point is just staying in the ring and being aware of this and being better than your previous self. And that doesn't mean like always being better than your previous self. The path to getting better is two steps forward, one step back. But what you generally wanna see is a trend of improvement. So it's not a straight line that we start to improve and become better than our previous selves. It's like I'm doing great and then I'm not doing so good. I'm doing great, not doing so good. Doing great, not doing so good. So when I say the goal is to be better than our previous selves, it's gonna be like this, what we wanna see is its jagged line that's going upwards. So our one step back is still progress moving forward. That's what we wanna see. That's a realistic, looking back, that's a realistic expectation of how people change and move forward. Okay, so what's gonna be your plans? So every time you see a warning sign, what is gonna be your plan? So bullet point one, discuss it with your counselor, your therapist, if you have one, your sponsor, other people in recovery, if you're in a group discussing it there, if you just have a friend that you work on being better with, discussing it with them. Like you might have a friend that you are just making a commitment to be better with. And you can just text it to them. And that's the thing, you gotta go around places where other people are trying to work on themselves and be better. And when you find those places, then you find other people that are trying to do that. And in that context, you can find those types of people and then create those types of relationships because those are important. People are so important in this. The number two is if you don't have a therapist, a sponsor, a counselor, then finding people like that. So maybe the warning sign or the relapse is an opportunity to, if you don't have it to get it. And then the next bullet point is increasing your attendance at self-help meetings. And the next bullet point is call your 12 step sponsor if you have one or seek out a sponsor. So I'm gonna talk a little bit about this because a question came up about this 12 step program about the last, after the last session. So some thoughts that come to mind that I wanna share is, number one, the course, and we went over this in previous sessions in more depth because this book goes over the 12 step program in earlier chapters. So number one point I wanna get across is, and what the book says, is the core therapeutic benefit of the 12 step programs is just being around other people that understand what you're going through and other people that can give you practical advice about how to get out of it. For many of us in the beginning, we feel this sense of it's hard to really relate to other people. It's hard to really get other people to understand exactly what we're going through. It's almost like this feeling of you can't really understand how difficult it is in terms of what I'm going through or what I've tried or how hard it is. There's almost like this sense of exceptionalism that can happen if you spend too much time in that and you don't have an opportunity to learn about other people who are going through exactly what you're going through. So on one end, if you have this sense of exceptionalism that keeps you away from working with other people, that can be really dangerous. But on the other end, if you're able to relate to people, that can be really helpful. So when you do find other people in the, let's say in a peer support group or in a support group or in a group, it can be really helpful because now you have other people that understand what you're going through. But the kicker is here and this is the point I was trying to make. If you can find somebody who understands what you're going through, that really gets it. And then on top of that has made it out of this, whatever that means to you, made it to six months, made it to a year, made it to five years, made it to 10 years, really what you want to do is, you want to look for that person in your life that's always a step ahead of you. So if you're the intern, don't go to the CEO and be like, how do I get to you? You just go to the person that's a little bit ahead of you that was an intern and was able to secure the job. So yeah, if you've got a month, maybe you look for somebody who's gotten six months or a year and then here's the kicker. If you're able to find somebody that can resonate with where you've been who you are, and then they tell you, look, it's possible. You can get out of this, you can lose the urge to drink drug or engage in pornography or engage in a gambling addiction or whatever the addiction is. If you can find somebody to say that to you, that's incredibly convincing and it's worth doing. Now you can like go to the ends of the earth, like you can go and climb a mountain and then pick a lotus flower and then that's your assignment to then take it to a wise man and the wise man says, this is where you can find that person. You can do that. Or you can just sort of hope and pray that that person will come or you can increase your chances of finding that by going to groups that are organized and have those types of things, like smart recovery, there's other recovery groups. The 12 step program is just the most common program. So you might like another recovery group, but whatever city I'm in and I'm trying to refer somebody to a peer support group, it may or may not have another group, but it tends to always have some sort of 12 step group. So in terms of just being available and also having some evidence and study behind it, the 12 step programs shine in that light. One thing I will say though is it's a group. So if you're coming to a group, this is what I wanna respond to that came up last week is if you're going to a group and you find people that are critical or judgmental or coming on just a little bit too strong, you can always try to find another group or if it's a meeting club, just go to another timing at that club or try to find another area. It's actually common, it's the norm. It's not the exception. It's the norm that people have to go to a couple of meetings to try to find a fit because essentially what's happening is you're meeting people. So anytime you're meeting people, there's different personalities. Even if you have, so there's different personalities, there's different likes and dislikes, there's different types of people. So what you wanna do is try to find and survey different groups and try different groups until you find a fit. And what a fit typically feels like is you go into that meeting and you come out of that meeting feeling better. It's a pretty rough standard, abstract standard of what a good meeting is, but it's essentially how you can think of it. You don't go into that meeting and come out feeling judged, criticized.  And so just keep that in mind that if you find a meeting that's not working for you, you can always try to find another one. There are certain factors that are associated with good outcomes. So consistent attendance, typically two to three meetings per week or more has been associated with more better outcomes and less meeting attendance. So there is a dose that can be helpful for particular people. Getting a sponsor has been shown to be more associated about outcomes and not getting one. Actively working the steps has been shown to be more helpful than just working a few and then going to commitments and things like that. So the important thing to keep in mind is it's not necessary to agree with everything that occurs in the 12 step program to derive benefit from it. You probably won't agree with everything in the 12 step program. But again, the core benefit lies in just networking with other people and the social support. Even if the program's not suited for you, every aspect of it is not suited for you. And then yeah, keep in mind it's a, there's a spiritual component to it. So there are gonna be spiritual idea principles and ideas that will resonate with you and resonate with you as a Muslim. And then there might be things that are not going to resonate with you. There's a really good book called Overcoming Addiction, An Islamic Approach to Recovery. Can you see that? It's by the Theba Foundation. Have you heard of this? We've talked about it here before. Okay, all right, great. Okay, good. So it talks about the 12 step program. And then it talks about it from an Islamic perspective and integrating spiritual aspects into it. There's one thing that comes up is sometimes in some groups and also in some parts of the literature, it uses the word our father, which of course is something that is not acceptable in Islam. And we don't refer to God as a father. That's a hard line for Muslims. But it's not about, it's probably less to do with the 12 step program trying to impose a type of religion on the people there. And it's probably more so to do with the spiritual vocabulary of its birthplace in Ohio in the 1930s in the United States. Because what's overwhelmingly the message in the 12 step programs is finding a higher power that resonates with you.  So essentially it's open to you being a Muslim or from a different type of religion and coming in there and practicing and then very quickly focusing on how do I improve myself as somebody with an addiction. So 12 step groups. One great thing about relapse and catching relapse is it may be difficult to get on the books of your therapist for an extra session. It's gonna be difficult to get into an aftercare program from the perspective of immediacy. You gotta look for insurance matches and so on and so forth. Going to a 12 step program or a meeting or some other peer support meeting. If you're having a bad day, chances are you can just look up a meeting online and go to one. So from the perspective purely of relapse prevention, if you're living, if you're in this game for a long time in recovery and it's three years since the last time you've done any recovery work and all of a sudden you're facing a huge crisis or something's happening in your life. It's really easy to just simply start your meeting attendance back up. So that's something to keep in mind as we talk about relapse prevention. There is 12 step groups for alcoholics like alcoholics anonymous. And then there's offshoots, narcotics anonymous, crystal meth, cocaine, marijuana, pornography and other addictions as well. All right, so then it talks about on page 201 my top three warning signs. And this is an exercise where it says warning sign number one and then underneath the plan if I noticed this sign. Next section, putting a stop to the slip. So they make a distinction between a slip in a relapse and we've discussed that in the past. A slip is something you can catch before you fall into a full blown relapse if you're willing to address it immediately. And what it talks about on the next page is a slip doesn't have to set you back tremendously if you're willing to address it immediately by number one, talking about it with a counselor, therapist or sponsor, figuring out what went wrong and putting safeguards into place to prevent it from progressing into a relapse. Now here's some things you can tell yourself to prevent a slip from heading into a relapse. I can leave the slip behind me as long as I don't repeat it. And that's the important thing, okay?  The thing you can tell yourself is I can leave the slip behind as long as I don't repeat it. The next bullet point is I can use the slip as a learning opportunity. If I understand why it happened, I can prevent it from happening again. Number three, I may feel bad about it, but that will pass as long as I get right, as long as I get right back on the road to recovery without wasting any more time drinking or using or engaging in my addictive behavior. I'll feel good about myself again very soon. So what you tell yourself after a slip will decide if you get back on the wagon versus, ah, I did it, I might as well just do it again or let me just go on this binge because once I get back into recovery, it's gonna be a while or I might as well just continue using or whatever else we tell ourselves. So once you preserved a recovery mindset, brought yourself out of the spiraling lapse mode, accepted that the slip has happened. So you're accepting that it's happened. You just have to move forward with it and decided, because there's a sort of heartbreak that occurs with it. If you have all of these aspirations and dreams of what you wanna do, you feel like you're in a place where you don't have to go back to your addictive behavior again, but then you slip. There's almost like this loss that happens. It's a similar type of loss of losing a job or losing a loved one. You almost go into this denial of this isn't happened or and then you go through anger, bargaining, depression, acceptance. So there's almost like this denial that happens when you lapse. So once you've accepted that a slip has happened and decided that you're ready to put it behind you, there are a few more steps you can take to prevent any further engagement in your addictive behavior. So I'm gonna push through this because I wanna finish up today. And it talks about on the next page, learn from the situation. So why is a slip important? It's not just a failure. It's actually an opportunity to learn. Keep that as a mantra. A slip is not a failure. It's an opportunity to learn. A slip is not a failure. It's an opportunity to look at your behavior patterns and start to see where the cracks are. So learn from the situation. So bullet point number one, were there any warning signs before I lapsed in the past few days, weeks or months? So you don't want to be so consumed with denying that the lapse has happened or so focusing on other things that you don't use your mind and energy into the detective work of how did this happen? What were the warning signs? While it's fresh, you want to do the investigation of what happened. Otherwise the more days that pass, the more biased your memory is on what happened. Number two, did you address the warning signs? Was there something more that you could have done? Next, what was the trigger? How did you end up in the situation in which you relapsed? Is that situation going to come back up? How did the relapse affect you? And that's a good one because it's, before we lapse, it might seem like a small thing to relapse because that's in essence what we do. We discount, we minimize what a relapse is going to be. And that's how we get to relapsing. But if we use that opportunity to really think about how did this relapse affect me in reality? So I think it's not going to be that bad, but then I relapsed. Now it's really bad, I feel bad and there might have been some other consequences as well. So how did the relapse really affect me? And to hold on to that the next time that you start to see the warning signs, almost write yourself a letter for the next time that you might start seeing warning signs. How can you cope more effectively the next time you're confronted with a similar situation or trigger? All right, and then the second bullet point. So learn from the situation after a lapse. Number two, set up more support. So step up the support because what a lapse essentially is you've had a hypothesis that I can stay sober with this much work or this much in place. And what a lapse simply is is you've proven that hypothesis is wrong. So now you set up another hypothesis and you say, I need this much now to stay sober long-term. Look, this level kept me sober for three weeks or a month or two months or five days. Now, what is gonna be able to help me reach my goal three months or six months or a year? So now you set up another hypothesis as you step up the support. So what it says is more involvement in self-help groups, getting into therapy or increasing the frequency of therapy. So increasing the level of whatever you're doing if it's working, do more of it. Or for many people the lapse or the slip is the motivation they need to finally go to the meeting or finally get into a program or finally buy the book or buy the ticket and go through the journey. So use that motivation. That motivation after a lapse is golden.  Ideally make commitments while that motivation occurs. And that's how you almost use your addictive behavior against you. That's how you use your relapse for you. Of course, you don't wanna say, I'm gonna relapse so I get the motivation and then I'm gonna go to the program because that's just playing with yourself. More social contact with people in recovery. Step up the support with more social contact with positive people. And then finally, considering medication treatment for your addiction. So there's many medications out there that help reduce cravings for behavioral and chemical behavioral chemical and digital addiction. So you can look into those. And then it talks about revisiting these skills that we've learned through the whole journey of this book and then starting to check off which of these that we will want to learn. So inshallah with this, I think I'll wrap up because what I wanna do now is on page 204, we have a menu of options. On page 204, we have a menu of options of everything we've gone over in the previous sessions. And what it's telling us to do now is out of those many of options, put a check mark next to the ones that you're gonna commit to and use. So I think this will be a good opportunity for us to end here at the end of our journey through this whole book and kind of leave the door open to continuing to work on this. So inshallah next time what we'll do is we will go through like we will have us each go through this and go and make some check marks on what we would want to pick as from the menu of options. And then we'll use that to then go over the book. So for example, one thing it says is motivation enhancing skills. So they give a bunch of options and one of the options is thinking about what stage of change you're in rating your current motivation to quit. So if that's something that one of us checks off then what we can do is go to that section in the book and go from there. But what we'll do starting from next week is inshallah we'll just skip all the talking and the education part and then we'll just go directly into skills building and talking about how we can apply this because we've made it through the whole book. So with that inshallah we'll stop, have some questions and check ins and then we'll end with du'a and go from there.


Welcome everybody. My name is Mark Williams. I'm one of the co-chairs of this meeting along with Rex Chisholm. And so you'll be seeing way more of me than you probably care to, particularly this early in the morning. It's been great to connect with so many friends. I'm always, at meetings like this, I always think of the penultimate scene of Casablanca, where Louis says to his co-workers, alright, round up the usual suspects. So the usual suspects are all seated around the table and we'll be hearing from most of them during the course of the meeting. We're going to try and do a lot probably more than we should in the day and a half that we have together, so we're going to be ruthless about staying on time. And to that end I will be introducing the first of our welcome speakers, which is the Director of the National Human Genome Research Institute, the sponsoring organization, one of the two sponsoring organizations for this meeting. And before I have Dr. Green come up here, I think we all should congratulate Eric on this. This is his official two-year anniversary of ascending to the directorship of the NHGRI. So that's probably worthy of a little applause.


Hey, this is Brett, and this 2017 Ford F-150 Crew Cab Short Box XLT is stock number 12642Z. I am here at Summit Automotive in Fond du Lac, Wisconsin, you're new and used light-duty truck. Headquarters, this 2017 Ford F-150 has the 2.7-liter EcoBoost V6 engine, puts out 325 horsepower. This truck has been fully safety and inspected by our service shop, has a fresh oil and filter change, all the fluids have been checked and topped off, and it is 100% ready to go. I'm going to go all the way around in this video inside underneath, start it up, take a look under the hood, give you the most accurate representation of the truck that I can. BlueJeans Metallic is the color, and I shoot all my videos in 4K, so if you have HD capabilities turned on now, because it is your best way to check out the quality, condition, and options of the truck before seeing in person. Going down the driver's side here, you can see just how nice that box is. The doors and cab are in fantastic condition as well. Always liked BlueJeans Metallic, one of my favorite blue colors on the Fords. Front fender is in great shape, and if you liked the video, you can subscribe to my YouTube channel, which is youtube.com slash Summit Auto. Click the bell notifications, you'll get updates on the videos I do each and every day here at Summit Automotive. This one comes with the factory alloy wheels with chrome covers, and it has Goodyear Wrangler 4 to 2 tires. These are 265 70 R17s, and in the front looks like we have probably about 70% of the tread left on those tires. Once again, front fender looks really good. This is a clean title history, clean car fax vehicle. Front bumper is in great shape, has the factory fog lights, and you get the chrome trimmed grille on there. The hood is in very nice condition as well. I didn't see any major dents or dings on there, and the passenger side front fender looks really good too. Passenger side front wheel, that cover is in okay condition. BlueJeans Metallic's got a lot of metal flake to it. It's got some purples, looks like some silvers in there as well. Really a very nice color, especially in the sunlight. And as you go down this side of this 2017 Ford F-150, take note of how clean that body is, how reflective and mirror-like that paint is. I take these HD videos so if you are far away, or even if you're close by and you just cannot make the trip down, but you're still interested in purchasing the vehicle, you can see the truck here, the truck, and have confidence in the vehicle that you're looking at before you even get here. So when you do get here, there's absolutely no surprises, and you can make a smart and informed buying decision from wherever you're at. If this video helps you make that buying decision, let your salesman know that you saw the video, though it was helpful and that Brett sent you. Back wheel covers in okay shape as well. Looks like it's got newer brakes in the back, and the back tires look like they have probably 70 to 80 percent of the tread left on them. Frame and underbodies in really nice shape, a little bit of surface corrosion on the frame there, but these aluminum bodies, the rest of the body, is in absolutely perfect condition, has all the remaining factory exhausts, and of course the cab corners, lower rockers look good. Comes with a nice set of chrome step bars. Coming around to the back of the vehicle, rear bumper is in nice shape, tailgate is in nice condition as well. This one does have a receiver hitch, and four pin and seven pin wiring back here. You get a Tonneau Pro low roll roll up Tonneau cover, and this one also has a drop in bed liner. That's in pretty nice shape. That's a Ford factory bed liner, and it goes on to the tailgate, which is nice as well. Tailgate shuts nice and solidly, and for full disclosure, this back wheel cover, just about the same as the rest, no cracks or anything on there. Going down the rest of this side, doors and box all look really good, and it does have the door code entry. We do have the code for this truck. If you ever wanted to figure out what your code is for your 15 to 22 Super, or F-150 in the upper right hand-brake screen, I've got a video showing how to find that. It does have blind spot mirrors on there. Inside the XLT package gives you the gray cloth interior, 40, 20, 40 split bench seating in the front, no rips or tears. Smells very clean inside this truck, and it does have a power driver seat with lumbar. Comes with a set of weather tech floor mats, auto headlamps, tilt, telescopic steering wheel, power windows, locks and mirrors. We'll take a quick look at the back seats.  These headrests do fold down for better visibility when nobody's riding back there, and you get a nice flat floor back here, which is nice if you got pets. Put the seats up and they're not going to ruin your seats, and they're going to have a nice flat place to lay. Side curtain airbags, child safety locks on the back doors, and being an aluminum body. Inside of the doors and sills are all in fantastic condition. We'll hop inside, check out the miles, the radio, and everything that this truck has to offer on the interior. And we're going to start it up here. Starts right up. You can see this one has 52,773 miles. You get a miles to empty, as well as a compass display. Instrument cluster is very nice and clean. Comes with the multifunction steering wheel, cruise controls and information center controls on the left, Bluetooth and audio controls on the right. This one has the six speed automatic transmission with the optional tap shift, and it has the AM FM. And let's see if we can get it to turn on here. AM, FM, and Sirius XM radio capabilities on there as well. You do have stability control, start-stop capabilities, volume and tune controls.  And it does have the USB and sync symbol down there for connecting to your Bluetooth cell phone, 12 volt power point. And the passenger side floor mat and seat are in excellent condition as well. No rips or tears on there. Once again, that headliner is absolutely perfect, and it does smell very clean in here. I don't think it's ever been smoked in. And you get map lights up there. We'll take a quick look under the hood. I would personally like to thank you for checking out the video today. And hopefully from this HD video, you've been able to verify the quality condition options, and of course, cleanliness of this truck all the way around inside out. I think it's in fantastic condition, considering the age of miles on it. And under the hood, we have the EcoBoost 2.7 liter V600, 325 horsepower engine base. Very clean, runs very smooth. And once again, this truck has been fully safety and inspected by Ulrich Service Shop. Has a fresh oil and filter change. All the fluids have been checked and topped off. And it is 100% ready to go. There is the emissions sticker. And I would highly recommend this truck from a quality and condition standpoint. Very nice condition. New retires, really clean inside and out. And to see more pictures of this truck, or one of other 550 new and used cars, trucks, SCVs, minivans, wranglers, half tons, three quarter tons, one tons, you name it. We got to go to that website right there. Summitauto.com, full pictures and descriptions of every single vehicle from two locations, all at summitauto.com. And if you'd like to check out more HD videos, you can go to youtube.com slash summitauto. Remember to like, subscribe, and share on this video and all the videos that you see there. Click the bell notifications, and you'll get updates on the videos I do each and every day here at Summit Auto. And in fact, in a second, you will see a link to subscribe to my YouTube channel in the upper left. A link to more F-150 videos that I've done in the upper right. A link to this vehicle on our website in the lower left. And a link to one of our latest YouTube videos in the lower right. Click those, check us out. And we're super excited to help you with this Ultra Clean 2017 Ford F-150 Super Cruise Short Box XLT and Blue Jeans Metallic. Thanks again for checking out the video. Remember to like, subscribe, and share on the YouTube channel. I really appreciate it. Thanks again.


Yes, in case you were wondering that is me in my pig version I just choose to hide it from the real world because I'm too beautiful So today we are back with some more Peppa Pig EXE videos It's been a while since he's actually seen some of these all right So we did come across some very interesting Peppa Pig videos today. They're a little iffy. They're weird man You just have to watch them for yourself.  Pepper I thought he was gonna die Pig in a blanket Daddy Pig is using a bucket to catch the drips Got that drip Are you kidding me the video was all good in the build-up and then at the end what that was the cheapest Was that even supposed to be a jump scare? All right now moving on these next two videos are by the giant worm Peppa Pig on YouTube kids be like What do we have here? He's playing Minecraft. He just killed pigs in Minecraft What is wrong with Peppa Pig, bro? See that's what happens when you drink too much milk. Oh George his name is George. Oh, he has like little hairs Peppa, do you want to watch this bro? May I play some Minecraft? Oh Peppa in the zone right now George J. Oh RJ Grab me the controller and I shall bring no harm It was strong as heck. Oh Will be terrified tonight. The next video is Peppa Pig meets Finn and Jake from Adventure Time The Peppa looks like a man Wait, there's no one on the TV What are they watching? I just hear a voice. Oh He is in airplane pigs can fly. Oh gosh, shouldn't we be going on an adventure or something? Dude Okay, I Used to watch all of your videos when I was younger Take is a fan of this What was that for? PTSD have some bacon. I was gonna hear have some pancakes George Come with me I'll pass but thanks for how let you play clash royale on my TV. Really? Haha.   Let's see who's next She lurking man Why didn't the mom and dad run away like Peppa? No way she doesn't find her Wow, she didn't find her Nice hiding spot. All right in our final clip is by the one and only long wolf Now if it wasn't for this guy right here, none of this would have ever I don't know like this long wolf is the one that got us into like the scary Peppa Pig like the YTP and all that stuff You guys recall watching my earlier Peppa Piggy XT videos This is where it all started make sure to go check them out and we're gonna watch this video scare to poop Evil pigs resurrection 12. I don't recall I watched this or not, but we're gonna watch it previously So it goes way back Where the actual hell am I?  Well, I was in the basement. No wonder there was no exit To the door. I was like 20 locks. Geez. Oh, what the heck was that? What is this place? Why don't look behind you?  Oh, she dead Maybe there's a Maybe there's nothing to be continued. Oh, that was fairly short. Alright you guys well those were some Peppa Pig dot exe videos I try to find some of them actually these weren't that bad.  Thank you for watching and I'll see you all in the next one


Sorry Joss Heathen, but the Jostus League has been cancelled and Zack Snyder's Mastercraft, the Jostus League 4-Hour Cut on HBO Max, is a goooooooood! I've been telling you for a year or so that I've seen Zack Snyder's cut of the film and it was PERFECT! And now what do we see on Twitter? They're starting to apologize, or they're starting to... They're starting to rewind history and change it. They're saying that they like Snyder's version all along, and that Joss Whedon's version was a goddamn embarrassment! And you know what? They're right, but they're also wrong, because they didn't stand up for Snyder back then. They didn't stand up for Snack Snyder's Perfect Vision! Let us once again, Birds of Grey. We all know that BVS, short for Batman vs. Superman Down of Justice, is a cinematic darling. It's a collection of some of the best writing performances, and everything you can think of that's good in this world, combined in one film. Much like the beautiful director's cut of Daredevil that fixed everything, even though there's still a playground fight scene in that film with two adults on teeter-totters, Batman vs. Superman is ranked right up there with it. But enough about BVS, I've already gushed over it, I've already creamed over it for years, I can't cream anymore, I'm all dried up. Nothing left? E on the gauge. There has been a slow trickle of news, though, coming out for the New Justice League film on HBO Max. What we're seeing are some very hard-hitting things, like the fact that the Joker's back, baby! That's right, and here's the thing, here's the hot take of the day. You're not supposed to like the Joker, okay? You're not supposed to be friends with the Joker, you're not supposed to hold hands and go get a Sunday. On a Sunday. Joker's supposed to be vicious, he's supposed to be serious, he's a clown prince. So the fact that I hated Jared Leto as Joker means he did it right. Means that he's doing it right, and Zack Snyder knows how to use this actor to his full potential, and that's why there's new scenes shot specifically with this version of the character in mind. The true character boiled down to its pure uncut essence, that he's gonna drip-feed us until this movie releases. Intermission! If you see this film in the two theaters that are open, you're gonna be treated to an intermission halfway through, because this movie's so long and so chock-full of genius, that your brain will literally melt to the ground, out your ears, eyeballs, nose, and then finish.  I mean, come on, only guys are gonna see it. So we know we're gonna get more scenes with Cyborg, we love him, he's great, Rey's great, we love him. We know we're gonna get more scenes with Flash. Perfect. Perfect casting there. I loved Flash in that film. I loved what they did to my hero! And we know we're gonna get more strong! Femus! With Wonder Woman. And frankly, I'm just over the moon for this sh**. The king himself, Zack Snyder, has tweeted out a new image. Oh my god, is this Joker? Oh my god, is this Joker in black and white?  I just saw The Cloud Prince in black and white, in 4x3 aspect ratio for some reason, like all the released footage has been, which is bizarre. Yeah, he looks amazing. He's Jesus Christ. They did it. They really did it. I know. I know. I love YouTube. She's so happy like I am. We have black suits, Superman? Are you kidding me with this? Wow! Wow! Cool beans. We have new bad guys with Doomsday. There's a bad evil old woman behind him. Granny something. Cantaloupe.  We gotta pretend to know her. Like she's the greatest thing ever. And it's so cool that she's in the film. Well look her up. What am I not paying you for? Cut this out. You've been screwing up in the past and not editing these correctly. Well dance in your grave. And I just really have to say that I am super pumped that they chose to put the Joker in this from Justice League and not Harley Quinn, not Margot Robbie, not the one person that people all universally really liked. So that's where we're at with the Justice League. Sound off in the comments, give this video a like, hit that notification bell to get more of these dumbass things in the future and I'll see you next time on the cringe baby. And he's in that suit. He's just like laser eyes down. Like what scene could that be from?  Like what is happening in that scene? I keep asking myself that because I legitimately can't see most of it. But I'm like wow that's cool. You like how I was like the man of steel. I was like Khaleesi Grimes, like Khaleesi of steel.