Episode 5 Clinical Care Dynamics Watch Now https://youtu.be/6LvzSlgkwtE *Fast forward past 5 minute prep time to watch episode
Listen Now Episode 5 We venture down some of the elements that clinical teams come across as they provide quality addiction treatment.
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Select Quotes I hope we can bring somewhat closer to families who are viewing this, the notion that the quality of care really matters. Under the hood of all the hyperbolic language that you will be reading when you go to addiction treatment websites, and hopefully we can bring you a little closer to what success might look like, and have some grace for yourselves as well in this process as well. Brandon Burns, CEO We have this expectation of addiction treatment, in general, being linear, and that there is an equation that you plug people into and then on the outside you get sobriety, and that’s just not how it works. There is relativity to what success looks like. And again, I think it’s based on how much better the client is living when they leave. Sometimes they make small increments, sometimes you see these huge strides, but regardless there’s usually movement, and as long as there’s movement you have the recipe for success. Clinton Nicholson, MA, LPC, NCC - Chief Operations Officer Episode Transcripts Episode 5 Transcript all right welcome back to another episode of finding peaks we are in chapter five of our episodes here right episode five yep yeah good good energy behind it we're feeling a little bit looser than we were in the beginning we're not so serious we did try to come up with a joke for this to to lighten the mood coming into it but we failed to deliver here but we do want to give a shout out to sandra who's been watching our videos with consistency and providing feedback to jason friesma you so far are our number one fan yeah and we thank you i would do this but i did that a lot last time yeah apparently good call made the blooper reel we don't want to be we don't want to be cliche so um so in this episode i want to talk about a client noah who recently came through our program um and of course for viewers that's not the real name of the client so protecting uh anonymity here and hipaa of course and um i think what comes up for me about this and one of the things that i'm really trying to work on from an advertising lens is that addiction treatment centers across the country you get to their website and they talk a lot about hope and change and we're we're in a position to be able to help you and your loved one um through the recovery journey um but below all that hyperbolic language is a real responsibility to treat an individual who's suffering from both addiction as we've been consistent about here that is an actual mental health disorder and this individual that we're thinking about here presently also was a bipolar borderline so has greater complexity than just a standard you know addiction mental health disorder in that regard and within each and every day of treatment it seemed like every 48 hours he would become distressed out of discomfort whether it was stuff he was experiencing in the groups and so forth but really required our team in any given moment to be able to wrap our arms around that and jason coming from you know a much smaller program that didn't always have the opportunities to wrap our arms around individuals like this i just wanted to talk or express or you know show families that you know in some way each and every day here at peaks there's an intensity about what we do and there's an enormous amount of energy that goes into it and really without i think necessarily prompting a question about it just walk through what it's like day and day of the clinical life of okay we're running a group client leaves the group how do we as a company i guess i'm asking a question now wrap our arms around that individual and make sure that they're safe and whole while also not making it a distraction for the rest of the group and the clients that are in our care um where was the question and all that like i missed it see this is why i'm gonna lead with you did you did i hear your question i did okay yeah i know you did there wasn't a question to repeat it for me okay um what was the question yeah that's what i thought right so let me i'll i have an answer to a question i didn't hear it okay i have one of those two okay go first so part of part of your statement uh you talked about the intensity of peaks and and in noah's case particularly i think it's in particular i think it's interesting because he struggled actually with some of the intensity if you will of our programming and so when you talked about kind of the the intensity of peaks to be able to wrap around him it was actually our staffing that allows allowed us to kind of wrap around him and provide him some relief from the intensity that he was kind of experiencing within if you will and we were able to kind of provide him some one-on-one care and also some grounding opportunities outside of actual clinical sessions so they could stabilize because because he he was a pretty is a pretty complicated individual with a pretty complex constellation of uh disorders um so we were able to both provide the intensity and provide the relief from the intensity i heard something completely different in the statement but that's okay so um you can just say whatever you want i think right well that's pretty on brand for me yeah yeah um so i guess starting with the very very first thing you said this idea of something that we've talked about in the past this idea of addiction being a mental health diagnosis right and so um i don't think that there's i've ever treated or had a client who has not had some sort of co-occurring diagnosis when they come into treatment there's almost always an underlying mental health [Music] some some other other underlying mental health issue that's going alongside with the with the actual addiction component of what they're in treatment for and so what ends up happening i think a lot of times particularly with families is there's there's a lack of understanding that they're not we're not actually just treating this addiction we're not just treating this behavior that they're seeing as disruptive we're treating all of the underlying issues and symptoms and acuities and complexities that go along and have attributed to that addiction at the same time so when somebody comes in and they have this high level of acuity i mean and again noah's case was extremely complex you know borderline and bipolar uh manic episodes you know certain paranoia you know and then walking into an intensive program that is i think we talked about it i don't know if it was in last episode or episode of before that uh one of our roles in in treatment is to agitate and to sort of get some of those underlying issues and symptoms to the surface so that like like jason just said so we can address them um but when you have that high level of acuity it can be it's a really delicate dance and being able to do that and um i think usually in in noah's case the what ended up happening is there's just a lower tolerance for the ability to handle treatment in its entirety right because we have a you know our program in particular is 45 days long and you know we were able to get a certain amount of time with him and be able to be successful within that certain amount of time but the but because it doesn't maybe look like families expect it to look that that idea that we were successful is harder to see and harder to understand yeah so on nearly every addiction treatment center website they say dual diagnosis programming what do we want to share with families about what that means and then what it means to actually treat something of that nature because at peak's recovery right for example to have a stabilization model that's 45 days long there are things we will fulfill within that time frame and there are things that we will not be able to fulfill in that and whether the program's 90 days is in that regard there are limitations of programming and programs should be taking an honest approach about that so through that dual diagnosis lens um you know what can we share with families about what those opportunities look like within treatment and then what is a treatment center responsibility about that and is there an ordering to it as well too i know i'm asking multiple questions here but in order and do we deal do we touch the addiction first craving states move on to the others or is it sort of you know as symptoms are arising and coming up we're just dealing with them you know in turn great question brian and certainly uh being a dual diagnosis are great questions thank you long series of questions yeah uh for us to answer through the first half it's the philosophy i guess one through four yeah yeah that'll be great um i do think dual diagnosis certainly became it's a popular phrase i think it's been around i don't know probably a decade now at least very common and i don't know a treatment center that says they aren't dual diagnosis truthfully and what it does mean a lot of times is hiring first of all clinicians that know both mental health and substance abuse treatment it also usually means medication management having good medical care in addition to the clinical support and then practically speaking it is meeting individuals where they are and being able to have good clinical dialogue and being able to to meet clients where they are where they are in order to help them or to provide the support they need to address both issues because symptoms of meth use look very similar to bipolar disorder and frequently people walk in with the diagnosis of both and being able to distinguish which which is actually primary is part of our job especially in the stabilization period is is really honing a good diagnostic set i would say yeah i actually did a screening earlier today for a client who is looking to go into treatment with methamphetamine addiction and during the screening you get you know you're you're collecting symptoms you know you're trying to identify like are we looking at a substance use disorder uh that is primary or is this a primary mental health use or mental health disorder um and like jason said you know there uh a lot of times substance use mirrors the symptoms of other mental health diagnoses and so you really don't know you know it's kind of all up in the air and it and there's a part of me from like maybe like a more philosophical standpoint that thinks that it's just a diagnosis right it's a mental health diagnosis period and we have the ability to help so um i think the idea of dual diagnosis again sort of reinforces this binary pers perception that addiction is somehow different than other mental health diagnoses and that addiction treatment therefore is somehow different than other mental health treatment and i don't think that that serves the client i don't think that it serves i think uh from a like a so a social perspective and cultural perspective i think that it actually uh reinforces alienation and shame of the addiction community well i think that's a great point actually and and not to go on too big of a tangent with that but um a while ago i was asked to come and guest lecture at a at a graduate program here in colorado springs and um they didn't have any addiction focus and they asked me to come and speak in their class and even before i went in there was there were a couple students that were like yeah i don't have any interest in dealing with addiction and then as part of my lecture i gave i talked about how if you're going to be a counselor you're going to deal with addiction like i don't i don't care uh if you're in a private practice in in one of these buildings downtown or at a mental health clinic like you're going to deal with addiction because they are so interrelated and and a little chicken and egg which comes first uh sometimes that's helpful in the diagnostic process and um sometimes it's not but like i just think it's so prevalent and to just it's almost to have distinct to call a dual diagnosis it's really why why do we do that like it's actually all kind of part of the same bucket it's just a diagnosis correct or a couple of diagnoses yeah so exactly yeah but it's all one and the same and i think the more uh we understand addiction and the more we understand actual mental health in general um uh as we become more advanced in our understanding of neuropsychology and all of the sort of different areas and ways in which the brain impacts uh us behaviorally and emotionally i think that we start to see uh how you know the brain doesn't really care like whether or not this is you know you're depressed because you're using um because of a substance that you're putting into your system or a hormone that you're lacking the reality is that you're just depressed and so being able to um sort of get rid of these kind of preconceived ideas and move towards a more a truly holistic model in which we just learn how to best help people and we stop focusing so much on these diagnoses i think that we actually get much more i don't know for me that that's that's where the excitement of this field comes from for me is being able to sort of take out uh these old ideas and ways of approaching things and looking at um new models new ways new uh approaches and uh kind of just wait and i think it all starts with how we actually talk about addiction and how we talk about mental health yeah all excellent excellent points and i appreciate you guys really running with a series of questions there um and informing everybody about that i think it's a dual diagnosis i feel like you did yeah okay yeah or i lost sight of all my questions and your answers were so extensive that they just saw you looking at your hand right yeah right like so for me you know we have a 45-day curriculum in essence to stabilize and then anchor folks into recovery uh no one in this instance i think from the time he admitted in the program we were able to achieve 25 or 26 total days of support through another intervention at the beginning through another treatment program back into our program but 25 days falls short of 45 days and we set strong expectations from the beginning that we're going to do everything we can to get to 45 days and um you know upon his discharge i felt like you know what maybe we felt a little short here there's something of from my position where i feel like we you know we could have done more but when i reflect on it and documentation everything we did an extraordinary amount for this individual and then just before we started this uh video session today um you know we're getting positive feedback in a way about you know the dad's experience and hey my son's talking differently and all this sort of stuff so my question is here is is it's not necessarily in days at times and it feels like we need more time more time more time to work with individuals and in this guy's case it's certainly true that he could use more time in treatment episodes and i think he's in an outpatient program at this time but what does success look like in treatment if we can't quantify it in days or finishing you know curriculum and that sort of stuff because when i reflect on his you know his time with us we did a lot in a way that other treatment centers you know may have fallen you know short out of staffing or whatever the issues might be at the end of the day i'm quite proud of what our team has been able to deliver in that regard and certainly past peaks would have you know three years ago peaks would have missed this opportunity i'm in an extraordinary way so um so what does success kind of look like here [Laughter] in all seriousness though i do think here's how i conceptualize it everybody walks in with a different start line and everybody has a different finish line and and what i mean by that is it's easy to to just think like in a race terms of like hey we offer a 10k race and so it's exactly different for some people it takes herculean effort for them to make what to other people would seem like a small amount of progress but everybody walk every human who walks into our program has an entry point where they are starting and and they're all over the place from homelessness family you know absolutely nothing to [Music] i still have a lot going for me but i'm just recognizing this is getting out of control and so with those different start lines not everybody's going to have the same finish line not everybody's going to you know walk out to um you know a restorative a job and family back intact and and a car and you know a nice bow um around it but but can we provide enough runway in 45 days which is pretty arbitrary number by the way yeah um so i want to make sure i point that out but like can we in a in a length to stay with us can we provide um progress whatever that might look like can we provide you know some distance and in noah's case like you know his start line was was pretty far back from other people and he was able to make significant progress does his finish line look like everybody else says no it doesn't but did he make dramatic progress absolutely he did yeah i think um i mean i like that metaphor of like the everybody has like a different starting line and first i i think to take it maybe one step further than that i think some people are playing actually different sports right like there's a whole track and field thing going on there like some people are running some people are throwing shot put some people are um i don't know javelin like i'm going to start pulling out from there but the olympics are coming up so yeah exactly yeah so [Laughter] you're welcome japan yes um tokyo uh so i think that again it's all it is there's a sort of certain amount of relativity to it and again i think we have this expectation this sort of treatment in general being kind of very linear in that there's a an equation that you just kind of plug people into and then on the outside you get sobriety um and that's just not how it works and so it's there's a relative relativity to what success looks like and again i think it's all based on how much better is the individual or the client living when they leave you know and it's sometimes it's uh again they're making these small increments sometimes you see these huge strides but regardless there's usually movement and as long as there's movement i think that you have at the very least the recipe for success so yeah yeah absolutely um you know for me it means a lot to express to families what these different starting lines and finish points look like within treatment because in the desperation of searching for treatment it's easy to simplify it to think well if johnny just gets 90 days that's an extraordinary amount of time and change will happen in that change happens in seven days it can happen in 20 days it can happen in 90 days it might take years for some individuals depending on where their starting point is in this and really just hope that we can bring somewhat closer to families who you know who are reviewing this the notion that the quality of care really matters under the hood of all the hype hyperbolic language that you'll be reading when you go to addiction treatment websites in that regard and hopefully we can bring you you know just a little bit closer to what success might look like and to have some grace for yourselves as well in this process too because each family has in this as well two different starting points and endpoints as well to healing so um thank you guys again for your time episode five that's a wrap thank you for joining us we're going to start inviting some new folks um in the coming weeks um onto the program to um you know increase laughter and bring some quality here that we lack at times as well too so looking forward to bringing new individuals on here shots fired until next time