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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.

Topics:

The delicate dance between intensity and relief.
The variabilities of “Dual Diagnosis”
What success can look like outside of “the length of treatment”.

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

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Episode 6 The Value of Boundaries Watch Now https://youtu.be/-8tECXEYUds *Fast forward past 5 minute prep time to watch episode

Listen Now Episode 6 We discuss the complexities of boundaries and how establishing them within the recovery process is pivotal for yourself and your loved one.

Topics:

Our interpretation of the complexion of boundaries
A similar metaphor that can help explain boundaries and how close or far you can hold loved ones in your life.
We recognize how hard it can be to hold these boundaries, but we speak on how important it is to hold those boundaries for yourself and your loved one.
Establishing boundaries doesn’t mean you don’t love your family member.

Select Quotes The difficulty is in identifying who you are. Boundaries require a lot of self-reflection and self-awareness. You have to have a pretty good understanding of your personal identity in order to create boundaries, and when you are talking about families, particularly families that are impacted by addiction, those identities are completely enmeshed. It’s really hard to see where a mother's love turns into enabling, or where manipulation turns into survival. It’s really hard to be able to figure them out. And I think that’s where most of the time that’s why these boundaries are created in frustration and anger because there isn’t enough self-reflection and self-awareness to be able to do it unless you’re actually in that stable emotional state. Clinton Nicholson, MA, LPC, NCC - Chief Operations Officer We have a need to connect with other people. It feels good to have people close, and sometimes it feels worse to be pushing people away. When we allow people too close to us and they aren’t safe, it does create pain and chaos, truthfully. Or conversely, we can move that boundary out so far that it creates this loneliness, this wall. We then can challenge people and see if they are safe and worthy of being closer to us. Sometimes they are, and sometimes they’re not. We can then be mindful of how close or how far away we keep our loved one. And sometimes it hurts to push boundaries out with people we love, even if it’s really important and keeping yourself safe. Jason Friesema, MA, LPC, LAC - Chief Clinical Officer Episode Transcripts Episode 6 Transcript [Music] welcome to back to finding peaks episode six here live at five again with clinton chief operating officer for peaks recovery centers and chief clinical officer jason friesema everybody and myself brandon burns your host excited to be back here again today talking about um things that are important to this industry absolutely um the topic that i wanted to bring forward and discuss with you guys today is on boundaries um i was sitting with a staff member yesterday and i think kind of a backstory to this is that when people are engaged in you know a recovery journey or um or work within this industry the notion of a boundary is sort of intuitive and there's a real sense about it you know we say boundary hold a boundary do that and i think we get it but it's not clear to me that families get it i was talking with one of our staff members and asked her to define what a boundary was and her face got you know big and glowing and kind of smiley like i know what it is i just don't know how to tell you what it is and i think there's a gap there in families in the way that they understand it and i think it's often met with what we're going to put a wall up in between you and your loved one or something like this and i think that's the common sort of colloquial way in which it's viewed for me a boundary is um so i'm gonna i'm gonna test my clinical skill sets here and what it is let's do it it's a it's a it's an emotional distance between you and your loved one the person who um is going through or suffering from addiction in this instance to me it's one thing to be supportive of them and continue to love them in a very familiar sense of things namely as a family member and it's another thing to state okay my boundary is i'm not going to give you money for drugs and alcohol well fine you want me to go do x y and z on the streets to come up with this money and then it creates a sort of tension and we seemingly sort of collapse in the boundary because we don't want them to do those other things but i think strongly that emotional distance is the reduction of suffering we don't want to suffer at the same time of the individual so as swift as i can make this question so that it's not fumbling here is that kind of an accurate interpretation that i'm providing for what a boundary is and if it is not what is your view of a boundary jason we'll start with you oh wow okay surprisingly calling me out absolutely yeah um i'm gonna put a boundary up and say clinton i mean i think you're exactly right the boundary is some sort of delineation that says this is where i stop and you begin right like that's like a boundary of a i don't know of land and um whether it's backyards or whatever like i think and to your point i think you you actually your story of like the boundary creates the space so that regardless of what's happening on your side of the boundary it's not going to derail or hurt or cause me to suffer i can i can have empathy looking over this boundary and recognize that you are suffering but it's not going to create that suffering for me and oftentimes that's where boundaries get so blurred right is that it seems like sometimes we have families that that will reach in and pay off a drug dealer or buy heroin for their loved one because they don't they don't want them to suffer anymore and and we do call that a boundary violation and it's because they haven't been able to make that delineation between this is where my loved one starts and where i end clinton over to you over to me yes um i agree actually so surprisingly okay next question yeah well said yeah um boundaries are definitely about um it's for me it's more about differentiation right like being able like you said to to see where i stop and where you begin um and i think like you said brandon intuitively we know what boundaries are but we have a hard time talking about them we have a hard time recognizing them and generally speaking of culturally we don't ever really work on what it means to create a boundary and so it's it all seems very familiar and very new at the same time for most people but uh in the end you're creating that emotional distance and in between those two in that distance you've got this little like uh kind of river that you can navigate the sort of complexities of relationships and so um yeah so hold on okay i don't i don't mean to but maybe you're already going in this direction but i do think uh the thing with boundaries too is if they aren't if they aren't made outside of like a contentious or highly emotional state then usually that creates problems right like usually boundaries oftentimes are enforced out of anger or frustration or pain and and they aren't kind of thought through right so like going back to the the backyard metaphor it's like we're not gonna put a fence up up here but like now i found dog poop and you know like i don't know if it's on your land or my land and i'm just really pissed about it and and i'm going to have this response and so like having having a willingness to prospectively create boundaries is such a key component in a recovery process to say not in the moment not when somebody's in withdrawals what you will or will not pay for but like you know like when somebody's maybe in a program like peaks now's the time to establish those boundaries so that when when maybe the loved one begins to push on the boundaries you can just fall back on them because the emotions are up and i want to respond in the way i used to but now i'm not enforcing this boundary with anger i get to just enforce it uh and just be sad on my side of the boundary i guess it's for me are you going to disagree with me no i agree with you i think every time you agree with me just make sure you mention that i agree with jason okay great however i completely disagree with jason and what he just said no uh i think it the difficulty is in identifying who you are right like boundaries require a lot of um self-reflection and self-awareness and you have to have a pretty good understanding of your own personal identity in order to create boundaries yeah um and when you're talking about families particularly families that are impacted by addiction those boundaries are those identities are completely enmeshed right there there's just it's really hard to see where you where a mother's love turns into enabling right or where um manipulation turns into survival right like there's just it's really hard to be able to figure that out and so i think that that's where most of the time that's why these boundaries are created in frustration and anger because there's not enough self-reflection and self-awareness to be able to do it unless you're in that actual emotional space that makes sense yeah yeah it does yeah absolutely so we've used you know words in principle to describe this and so i'm going to uh attempt through a stolen metaphor here to present kind of what it looks like conceptually um it's a little bit medical so bear with me clinical might have to come along on a medical journey with me i'm on it i know it's outside the box yeah um but i think about it in this stolen metaphor from a group setting i was in once upon a time that it's um it's it's similar to a cell that we as individuals are the nucleus within the cell and the cell membrane is permeable it can allow for things in information and so forth to come into the cell and then it also has this very fluent component of it that it can even flow so if the membrane's out here i can bring the membrane really close and when we're in intimate relationships family and so forth we bring people really close to here so for me the metaphor resonates because as we go to create the boundary and we move people away in the sense of like i'm not going to pay for your drugs and alcohol i'm not going to suffer in the same way with you it's not a wall we still see the infra the individual we're still willing to allow information within it but we're really creating a space of safety um that informs it so i don't know if that totally resonates you know for the sake of time about you know um as a fluent metaphor here but i'm curious if you guys see it similarly or um if that's inappropriate maybe a way that families can start thinking about it conceptually yeah i mean i think ultimately we have a need to connect to other people and we want that membrane we want it close uh and so it feels good to to have people be close and and sometimes it feels worse to kind of be pushing people away but like um when we allow people too close to us and they're not safe it does create pain and usually chaos truthfully or conversely we can move that boundary out so far that it creates kind of this loneliness and and this wall and so we are i actually teach this uh in in some of my groups about how like we can challenge people and see if they are safe and worthy of being closer to us and sometimes they are and sometimes they're not and we we can kind of be mindful about how close or how far away we keep our loved ones and sometimes that it hurts to push boundaries out with people we love even if it's really important and even if it is protective and keeping us safe um it can be really painful yeah yeah i i mean i think i take a slightly different approach clinically just again focusing more on identity right like really helping people to identify who they are um focusing on purpose especially now that they are shifting their identity from uh one of active addiction to one of sobriety and abstinence so but again i think that that level of awareness helps to it doesn't make the membrane more permeable but i think it makes it easier to recognize where what that membrane feels like exactly how translucent it is exactly how permeable it is and to also know what feels comfortable versus what will ultimately become chaotic so yeah yeah and uh i was speaking with a past uh client's mother just yesterday who you know some new things are coming up for the individual as she progresses in a recovery journey and so she was just looking for you know thoughtful feedback and i reminded her as we you know go to implement or continue forward with the boundary that she has set with her daughter in this instance okay you're looking at your daughter on the other side of you know this membrane you know so to speak and that distance that's between you i get it as like a mother that's got to pull on the heartstrings and i think really what i would like to resonate here for you know the audience is to just recognize that i think we're in agreement here that that is a difficult thing to do and to look through your loved ones in front of you suffering in a in a fairly significant way and with that space and that distance what can we you know as far as feedback to families who are appearing through the membrane they've held the boundary and they're witnessing their loved ones you know suffered you know jimmy who was six years old in the birthday party and all the positive memories right they're looking at a very negative situation and who isn't a parent that wants to jump forward and rescue and save in that regard so what do we say to them and and on top of that how important is it to continue forward with that boundary to reduce their own internal suffering and the impact on the individual on the other side well a lot of times if we're talking specifically about addiction here too like a lot of times it is honestly the suffering and pain that creates the change and so frequently when when parents or other loved ones are softening natural consequences uh for their loved one like maybe their kid is a lawyer to get it somehow thrown out on a technicality that's kind of great news in the moment but like it doesn't create kind of the the longer term change that just allowing a kid to face natural consequences will create and and i get it as a as a father like it it hurts sometimes to watch my kids you know face the world the world is hard sometimes and sometimes they have to fail a class or fail a test or bump into things that are hard or have a difficult break in a relationship and that sort of thing and it's difficult as a parent to watch that and i can feel the urge to want to protect them like that that was healthy a long time ago when they were really young it was my my job as a parent to protect them now they're older and they're an adult it's important for them to kind of face some of their own consequences because that's what's going to lead for them to change right uh softening that i think creates a scenario where it removes some of that ability to change or to recognize kind of the consequences of their own behavior i don't know if that makes sense but like i think that's an important piece the softening of it because the converse of this too is i've watched parents soften consequences for their loved one and then be like why won't they change and it's like they're not fit you're facing all the consequences they're not facing the consequences that's why yeah yeah they're change requires some level of tension you know if you're taking all of the tension away because of the narrative of that you're telling yourself as far as like what a mother does what love looks like who your kid is like you know playing back these birthday parties from when they were younger um you know you're not actually looking at reality or addressing reality and you are you're creating more difficulties and barriers than anything but to answer your other question as far as what do you tell parents who are looking through that membrane i guess for me it would be to stop looking through the membrane and actually look at the reflection of yourself in the membrane because you have to stop looking outside like it's there's no more at this point if you've made it to a residential treatment facility for addiction then that's it like there's there's no more trying to fix this um and do it the old way it's now you have to lean in and let the process happen and you have to have faith that your family member is going to be able to get through it because you cannot take them through this all you can do is become healthy within yourself and figure out but it's just a thing and figure out what your boundaries are and what your boundaries what boundaries you need your non-negotiables to to make you happy and to to be healthy so that you can actually show up for your kid in a way that it's not about softening the edges but it is about being there to support them when they fall yeah so you know whether piercing through the membrane you know visually or you know reflection in the cells the common experience that i witness happening is you know be prepared to be emotionally beat up there's a manipulative you know individual namely on the other side trying to accomplish their goals namely to continue to use drugs and alcohol you know sort of at will and so we become punching bags in that well you weren't a good mother and you weren't a good dad and if you had done this i'd be here and i don't need this and that chaos that falls out of it can be quite penetrating but i want every family member to know there's no certain rule book about how to raise a child and do things perfectly here and just because you set the boundary you know from this room to you as a viewer know that we know you love your loved one there is nothing every family member i talk to no matter how frustrated or seemingly angry the situation has come to they love their individual their family member and their love life and so i just want to honor that you know as far as the love mechanism goes within that and that we see that and you know maybe at the the end of this you know um episode here what would you guys like to add to that notion i i mean i think you captured it really pretty well and pretty passionately brandon but like that isn't to your point um it's almost never a lack of love uh it's almost never a lack of care or concern or willingness to work um work to get somebody out of the suffering it's just it often times just a lack of information or lack of skill um and then a little bit of what clinton said too which was like sometimes it takes parents too of like i don't how could i have a drug addict i don't want to have a drug i don't want my kid to go to rehab like sometimes there is that that self message of like working through one's own shame about about being in a situation and you know i'm just here to tell you like addiction and mental health affects so many families so many loving families so many caring families uh from all walks of life it permeates all of those families and it's not a reflection of good or bad parenting quite frequently it's a factor of many other things absolutely i mean i think i would go i would actually say that boundaries are love like that is the healthiest way to express love is through boundaries because in that moment when you have healthy boundaries you've given one another space to to be able to explore within yourself to integrate um to uh and also to interact in a way that's healthy that is supportive that's genuine um and really yeah i guess for me boundaries are probably the ultimate expression of love and it feels so counter-intuitive but that's kind of recovery like a lot of it is very counter-intuitive you know um and but if i could tell parents one thing i would probably leave them with that yeah wonderful well i've greatly appreciated this conversation i think boundaries is an important topic that we should definitely come back to and hopefully provided some insights that make this concept more clear for individuals and families going through treatment you know approaching treatment whatever the case might look like but it's a very impactful tool that we all have access to in each and every moment to nurture change in our loved ones behavior especially when they're suffering from addiction are you know any underlying or co-occurring mental health disorder order along the way so that's a wrap for episode six greatly appreciate everybody joining us again here full cut thanks for joining us again with finding peeks and we'll see you next time for episode seven [Music] bye

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Episode 38 Breaking Down Stages of Change Watch Now https://youtu.be/_dlQdvfQRZM Listen Now Episode 38 Our team breaks down the Stages of Change and how this model can shed light on better understanding an individual’s willingness to accept addiction treatment help.

Topics:

1st Stage of Change - Precontemplation
2nd Stage of Change - Contemplation
3rd Stage of Change - Preparation
4th Stage of Change - Action
5th Stage of Change - Maintenance

Select Quotes Getting people to make changes is a process. What we are trained to do in our field is to make changes 1 degree at a time to get all the way to 180. It’s way too easy to say, ‘quit using drugs, start taking your medications, just change, stop it, 180 degrees right now’. But what the Stages of Change model is saying is that there is actually a process for getting people to make changes. Sometimes people can work through that process rather quickly, but sometimes it’s just about planting these little seeds of doubt to have them think, ‘well maybe this isn’t working for me’. Finding Peaks: Episode 38 - Breaking Down Stages of Change Episode Transcripts Episode 38 Transcript hello everybody welcome back to another episode of finding peaks uh joined today by your favorite host brandon burns chief executive officer for peaks recovery centers and we've had a day here at peak so we're we're just emotionally regulating at this moment with jason friesma chief clinical officer peaks recovery chief operating officer clint nicholson everybody so welcome back i'm going to carry the internet i'm going to pull these guys out of the rut that is their operational nightmare for the day things happen in addiction treatments so we've been navigating that beforehand but we're going to roll into stages of change we're going to pipe it up a little bit here okay yeah all right so i'm ready yeah all right i am guys are into it jason's ready so which means he goes first so jason always goes first go first so i have to be ready you go first yeah say something got it so i was talking to a friend of ours in addiction treatment who works on our behalf and we were talking about um you know a situation in which uh you know individuals as they go through uh using abusing drugs and alcohol she called it high hopes that there's this moment when you're using math heroin or otherwise and you think you know what i don't want to do this anymore i'm going to change my life tomorrow and i'm going to stop and i'm going to get my job and get my life back together and all those sort of things so kind of a silly little set of language there called high hopes and in the stages of change that feels like the pre-contemplative stage of that yeah so i hope i delivered that i was hoping for a little bit of a smile maybe from you on that but you expect clint to smile i'm sorry i lost my

so high hopes is pre-contemplation right and from that clinical lens because it's superior to my philosophical lens at least in navigating addiction treatment is that accurate is high hopes the pre-contemplative sort of phase of that or would you describe it in another way yeah i mean i think high hopes uh is a really nice way to put the old term denial like hey i'm just i can solve this on my own or things aren't that bad or um everything's going to be okay or yeah so it is a hopeful tone i'm not sure i think it feels hopeful very fleetingly would be my guess yeah i think that makes sense the i mean pre-contemplation is i've always understood it um this moment of um maybe there's a problem you know maybe i do a little too much heroin you know but i still got it under control there's still that feeling of um that that sense of efficacy that you have in act that you're holding on to that you start to recognize there may be a little bit of disruption but it's not a level of disruption that really requires any immediate sort of response so that would be the kind of pre-contemplation moment i don't i mean it may be a situation in which right you're sitting down you're having coffee with somebody and you're like hey maybe i have an issue and you're talking out loud but it seems more of an internal sort of struggle pre-contemplation right is that is that accurate yeah i mean i don't think it i think if if anybody's having a problem with you or your behavior it is definitely not you yeah like that like it's other people's issue and they are too sensitive or not understanding me or too conservative or whatever it might be like it's not me it's it's them yeah absolutely yeah it's definitely still the world's fault yeah that moment what is a what is a general way somebody comes into you know peaks recovery and they're pre-contemplative like well my mom said i got to do this or i have to be here what is the first sort of clinical strategy to support the individual to go into the next phase of the stages of change oh great question um so actually literally the strat the clinical strategy for dealing with pre-contemplation is to raise doubt that's it right like it isn't necessarily to get into an argument it's just to simply begin to find little cracks in in the thinking which you would appreciate brandon and begin to like whittle away a little bit like how's that working for you or you know you're kind of you're kind of saying that um

maybe your addiction isn't out of control but um you also just told me that uh you haven't paid rent in two months and you might get evicted like that doesn't quite match so it's just a little subtle opportunities to kind of point out some discrepancies basically in the thinking yeah developing discrepancy that's really what you're doing when uh you know when i so sometimes you know i i've been on the phone or discussions with families and they you know their loved ones in treatment and they're pre-contemplative and the parents sometimes say the same things to us or to the individual pre-treatment that we say to them and then we're talking to them and um they're like oh yeah yeah you know you're right there is an issue here and i got this going on then we share that with families and families turning like i've been telling them that for years um as what is it about that as a scenario in that pre-contemplative stage it it's you know that you guys are familiar with in the clinical setting uh you know for me kind of to expose i guess the direction of my thinking about it is that um the individual in those moments is no longer able to hear the parent and the way even if the information is obvious you know don't do drugs heroin whatever that somehow we're able to bring that to light in a new and sort of meaningful way

um as a parent um i do think uh my my my kids god love them because you know hi um i do think they had can uniquely uh ignore a parent voice at times right like you you were once a kid i think clinton was once a kid too and like you you do figure out a way um to be able to just ignore people that have been saying the same things over and over to you and and um and sometimes you just need to hear things from somebody outside your chain of command if you will you need somebody outside um objectively looking in and offering a new perspective and also offering likely just different words um and i can certainly understand parents being frustrated about that um and i've heard that same feedback too of like i've i've been saying this over and over and um and of course they have but you know and your kids have been ignoring you forever and ever too like i mean that's just kind of true and so i think it there's just can be so much more weight and power and i i think there's an objectivity too of like you know i do think we are trained to really fully listen to people and i think our admissions department does a great job of listening um to people and their problems all the way through so when somebody feels all the way heard yeah and then on the back end of that they're like man i've heard all of that and i don't have any of the baggage i never changed your diaper or anything like i'm just hearing all this for the first time and you have a problem like it does carry a different weight and i think that we approach maybe from the clinical perspective you approach with a bit more curiosity it's uh and i think that element of curiosity helps people like jason say feel heard and feel to a certain degree validated like being able to recognize that i under i see this is your reality i see that this is these are your beliefs and that this is kind of your perception of the situation and i'm going to offer you something a little different i'm going to just flip that a little bit and i'm curious what it looked when i when i show you it your life this way what does that do and rather than trying to tell somebody that they're living their life wrong you're you're being more curious about sort of why they're living their life the way they are and what it would look like to live life a little bit differently so there's a softer delivery and then i think it's why jason and i have beards because people take people's beards more seriously yeah so thanks that's a huge difference yeah yeah sure obviously they take jason very very seriously very seriously yeah the grays help too absolutely it really does yeah and so would it be a you know uh obviously there's a well obvious to us i think that there's a skill set right and being curious from a clinical standpoint but would we like to make a recommendation that you know you see your loved ones struggling with you know drugs and alcohol and x y and z behaviors look you know really you know devastating and are frustrating the situation um you know not necessarily to put on like the clinical lens but just to be more curious about that you know what you know okay i hear you that you're going through those things but just walk me through it you know like what's going on with you you know that how can i support you this type of language rather than stop doing that and you're going to ruin your life and you're going to die and that sort of telling aspect what i really i think that's a great point what i think about i i mean we're kind of introducing this topic of stages of change um which is implying that getting people to make changes is actually a process right and i think what we are trained to do in our field um is to change to make changes sometimes one degree at a time to get all the way to 180. you know and and i think it's way too easy to be like quit using drugs or start taking your beds or whatever it might be just change stop it um 180 right now but like i think the stages of change model is saying you know what well actually there's actually a process for getting people to make changes and sometimes people can work through that process relatively quickly and sometimes it's just about um you know just planting these little seeds of doubt in their mind of like maybe this isn't working for me i mean i'm actually surprised you haven't broken down the word pre-contemplation i'm not sure that's actually an english word um until stages of change came about but like it's literally before you think about something right like that's what that word means right pre-contemplative would be probably more appropriate yeah yeah yeah i try to keep it really high level you know we only have so much time the deep dives they can get distracting pretty soon we're wondering whether

or whether or not he was delivered by storks yeah sure so we got the individual in you know maybe the parents got them to go from pre-contemplation to contemplation the next stage of change right they go to a treatment and they say you know what i kind of recognize i got a problem you know stealing from mom whatever the case might be or they get into treatment mom doesn't know what she's talking about okay jason you're a guru you got me i think there's probably something to look at here now we're in this contemplative stage um what is what are they contemplating like like reasons for change or should i change at all or cause there seems tones of pre-contemplative in contemplative as a stage of change how do we break those apart okay

so uh i mean i think strictly the contemplative would be when people begin to think maybe i have a problem maybe i don't pre-contemplatives i you know at least as i understand is i just don't have a problem and obviously you know there's some gradations between those thinking but like contemplation is where people land when it's like okay i'm in treatment now you know maybe i can admit that things aren't going great for me now and and so our job kind of when people are contemplating maybe have a problem maybe i don't is again it's it's the same method though like you keep asking you maintain your curiosity um because the contemplation is about you know do i have a problem basically that needs some sort of solution or intervention still really people people in contemplation are still not entirely sure they need help of any type and so that's what the contemplation is about and um you know i think in motivational interviewing your job in contemplation tends to be to tip the scales like to try to get them to weigh their options and then likely the need for change or adjustment will then tip the scales toward you know the next stage of change um is how it plays out but like really what it's about is just helping somebody explore this and again i think you know if you're not professionally changed to do that trained to do this like you don't you it's hard to be in that ambivalent state you know and i've had i mean i've had um somebody with a heroin addiction being like i only shoot up twice a day i know people who shoot up six times a day i'm not sure i have a problem right whereas you know if you're a parent of somebody that's shooting up here when that's shocking just a problem of course that's a problem absurd but but but they're thinking um uh well if i want to back up even further like i do think people are constantly resolving their cognitive dissonance right like if if

people don't end up shooting up heroin twice twice a day um overnight it's been a series of decisions they've made and somewhere along the way those decisions have made sense and then the next decision made sense and then the next and then the next and so there's a lot of cognitive distortions that are in there a lot that have that have been put in place to resolve their cognitive dissonance and so now they get to walk it back and be like it doesn't just go away automatically a lot of times for a lot of people it's like no we get to walk this back is this really okay um and it is surprising maybe that to to help people walk that back may be surprising it may seem self-evident to a lot of but it but it's a caring aspect to just be like no i'll help you walk this back and like you can actually look at you know some of these lines that you know maybe it isn't usually um in these ways and i think you know especially like when people are suffering with some alcohol use issues i find that you know people have a lot of ability to be like well i don't drink that much or i drink less on the weekend or less on the weekdays and i always make it to work like they have all of these stories um that they tell themselves and it's just our job to kind of help them unpack some of that and then and maybe point out uh some some things that are in disparity with them i talk a lot we do yeah i think i think that was very thorough uh my sort of simplistic way when i'm doing coffee dates with clients i think about when they're in that contemplative state to couch it into terms of responsibility and sustainability and it becomes pretty difficult to couch like fentanyl use or you know heroin or meth use into any sort of responsible framework and then even if we could get it there you know to say well i have pain you know then we can go right into the sustainability you know side side of it and most of the time there's no sustainability it gets awkward of course in conversations you're an addiction treatment sometimes you want to promote abstinence based on the individual you know that you're speaking with and you know sort of the the you know american narrative is somewhere in there that there's responsibility and sustainability at least into drugs namely pot and alcohol in that regard um and that way of things so i don't know if i'm gonna prompt a question from this but that's i'm listening for because you promoted what he was saying i'm just hopeful that you can promote now what i'm saying you're saying about responsibility and sustainability as a contemplative what i said

i think if you're looking at uh responsibility and sustainability through like a contemplation lens you're basically again trying to draw um dissonance right like well so you you're telling yourself a narrative right or a story about how you are living a responsible and sustainable life but then you're also saying that you know maybe when you uh you're you're picking up your kids from school while you're intoxicated right so there's a there's a dissonance there right there the narratives aren't aren't meeting like you've uh like jason was saying when you're using it's any sort of substance there's a process of sort of calibration where you're constantly recalibrating your reality to make sense of your behavior and when you can pull back a little bit and show somebody their behavior from a more objective standpoint and say well here you're saying this but then i'm but you're also but you're doing this like help walk me through how how those two things make sense then you actually the dissonance starts to be created in the in the disruption of the narrative yeah so and that's in that kind of is speaking to what you're talking about but i think that yeah you're that sustainability and responsibility fall apart pretty quickly when you highlight the dissonance and narrative and again yeah the title of your book that you should write uh from this would be the philosopher's guide to stages of change because because i do think you you've created really with un unknowingly created really um helpful questions to help kind of tip those skills and get people into action by causing them to think really deeply about the sustainability of their lifestyle yeah yeah well and for our viewers out there if you caught it there's a slight talking down happening about like that is adorable language brandon with responsibilities did you miss you were doing so well did you miss jason's point on dissonance because there's a better word you guys would never we can't because you're our boss i appreciate it i appreciate it but i caught it so now we move from contemplation to preparation what is preparation because i don't even have alleged to walk off there in that direction i don't i don't even know how to approach that from a questionnaire standpoint yeah this brute force what is preparation i'm ready yeah that's really i mean that that is a great question it's just saying that there is um a brief transitional period of time when somebody says okay i have a problem to when they're fully ready to take whatever actions they need so it's just it's this step that maybe clinton can talk to more because it's a more of a pragmatic thought process of like okay you have a problem there is a solution how do we bridge the gap between your problem and a solution so pragmatically take it away yeah no so that we've uh accepted dissonance at that point right you're like you're right like the way the way that i've calibrated my reality versus the uh the way that i'm living my life are incongruent with one another and there's an acceptance of that it's like yes i have basically i have a problem and uh and in preparation there is this moment of and i'm ready to do something about it um what am i going to do and so preparation is figure is answering that question what am i going to do to resolve this issue that i've accepted is real and problematic um and you begin the state the steps of i don't know the probably the first step would be a google search right like treatment like i need help i need support um i'm gonna um figure out the the path that is going to best support me in sort of resolving this um dissonance that i i have created in my life and that i've identified and accepted is there that's really what preparation is yeah i mean i think it right like if you know some people uh may come into peaks in denial that they have a mental health issue right maybe like a bipolar um issue and so they won't take meds maybe or they you know can't see how they're affecting other people's lives and through these processes we get them to be like okay i i think i'm i may need some help okay well then let's then now now we're in preparation here's what help looks like you're gonna have to take medications because this is a mental health issue and it requires there's a there's an imbalance of chemicals in your brain and we we need to address that um it's also gonna likely require um some psychotherapy and here's how you utilize individual therapy and group therapy like it's just kind of laying out kind of the plan yeah basically it's a treatment plan and then at the very end of that there's a commitment to the plan yeah right and so that's sort of like when preparation becomes action it's like all right i agree like i commit like i'm putting my stamp on that and now i'm ready to move forward so uh that preparation piece is just getting that plan organized and and every sort of everything laid out and then at the very end there's the commitment that all right i'm ready i'm going to go do this now is this in the you know you guys have uh obviously brought us to this step this next step in stages of change that is the action item when maybe this is where you know we've kind of uh jabbed at holistic models of care but this is really where that holistic approach comes in right that this is your unique action plan versus somebody else who's in treatment you know alongside you and we have these action plans and then we create them for the individual or support the creation of it with the individual so that they can best succeed because it's you know their plan is something that's meaningful for them uh and now we're kind of maybe we're creating awareness through like deep dives into you know clinical work um that expose you know ways of informing the action item but it seems like we're kind of in that sort of behavioral modification or how are we going to get this right and be consistent with it um to succeed yeah i think that's a good way to put it i think some of those behavioral uh like i look at some of the behavioral things you described as kind of the scaffolding and i think some other things can be going on underneath that some of that deeper um clinical work is part of that action phase um and i in well i think that's all i had to say about what you said yeah i think action is it's it's both of those things it's those deep dives to figure out motivation why do i do these things and then there's that exploration of and sort of practice of like how do i do it differently like um and collectively that is the action stage um it there it's it's a hefty hefty stage i think that sometimes people um think oh action boom it's like it lasts 30 days because that's how long treatment lasts that's actually no that's that's a small part of the action process action is because action requires a level of integration and practice that requires repetition right um so but it's uh it's where the work is done that's that's where you really you put in the blood sweat and tears and it's um it's it's a heavy lift really it's the heavy lift part of the stages of change so the the sort of fifth stage of change here is maintenance the kind of like the the difference between pre-contemplation and contemplation um it seems like through the action items through the repetition we're already engaged with maintenance yeah absolutely so i guess if we can kind of parse those out how are they different than one another i mean that is pretty tricky i mean it's kind of like maintenance is just less action yeah it's kind of a lot of the same things you just don't need to do as much like if you think about it as a weight change uh metaphor like the action phase would be losing weight or gaining it i guess is that if that's what you need to do and then the maintenance phase would be maintaining the same weight like what do you have to do you still can't eat maybe how you were eating before right um but you don't you don't have to be as aggressively uh trying to lose weight or whatever like you just get to kind of maintain so it doesn't it isn't a return to old behavior but it is like i have the the things i need and and um i think a lot of times too maintenance phase to me is when um you both will roll your eyes at this a little bit but like where people have access a lot to their intuition and they can trust it again where they they know what they need to do to keep um on the path that they're doing whereas a lot of these other things require some outside input a lot of times to help guide and all of that and then once people are in maintenance phase they're usually well attuned to okay i know i know what i need to do to kind of keep the weight off if you will for sure yeah i think it's a level of integration into your life and where it's it's less about practice and course correction and more about um like you you've started to fully integrate like a healthy lifestyle right like working out just becomes part of your day you know a healthy diet just becomes part of uh it's just how you eat it's not even a diet anymore right it's just how you've chosen to start eating um yeah it's it's a that maintenance is really the moment in which it just becomes your life yeah and it's it's not really even a matter uh it's kind of like trying to parse out though at what point does practice become not practice anymore and you're actually just doing it so but yeah that's that's pretty much on point well stage is a change everybody uh you know what to me it just you know it feels like you know what the stages have changed are are really like you know the the building's burning down and you know we got to put the fire out and it's really becomes like the foundation sort of scaffolding for sort of putting it all back together and even though the scaffolding is up all the work that goes into it whether it's clinical whether it's medical whether it's brute force action whether it's the meetings the rooms uh all of the things that sort of follow suit for getting uh you know the home restored in that regard um seems to start with the stages of change in that regard just kind of as like the brick and mortar of it um and that way of things so i think it's important to get familiar with this language for how it operates within you know treatment episodes for the individual as they go through it um you know but at the end of the day uh it is more of a scaffolding and that um there's a ton of work that goes into that so uh at the end of this we're not trying to simplify recovery journeys they're quite complex and uh require deep dive but you know the the stages of change in that regard really give us a foundation to work from in that way of things so uh appreciate you guys told you we would get through this together yeah we did it we had a rough day today and so hopefully all smiles now at the end of this absolutely and yeah uh thanks for everybody for opening our phones until we open our phones again thanks again for joining us on an episode of finding peeks finding peaks at peaksrecovery.com uh send us your thoughts ideas questions so that we can continue to build on these episodes and give you the uh education and insights on your end to support uh your loved ones or friends uh family and so forth um the tick tocks the instagrams the facebooks all those sort of things i would love to see you uh following us on those social media structures and until next time thank you

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Episode 37 A Motivated Recovery Watch Now https://youtu.be/KNSP3eKfqRE Listen Now Episode 37 A special guest who is an alumni, and now a pivotal part of our admissions team, opens up about his inspiring recovery journey in order to give hope to others who struggle with addiction.

Topics:

Jake opens up about his personal journey as well as the story behind his inspiring recovery.
Listen first, solve later - Peaks’ admissions team motto, and how Jake applies it to helping others
How Jake was able to shift his mindset in all aspects of his life that required rebuilding from the ground up.

Select Quotes I just felt like a number at other treatment centers, like an assembly line of people who were just going through over and over. It is actually really sad to say; people are not getting the quality of care they deserve at these places. And then when you come to Peaks your treatment plan is individualized, it’s tailored to you and what your needs are. I came in with a backpack of trauma following me, legal troubles, the nonexistent relationships with my family, I had burned so many bridges. Then at Peaks, I was assigned to a great therapist, case management helped me with my court cases, and then I was in bad health so the medical team helped there. So I think having everything addressed as a whole, that is really what it took to turn the tide and get me out of the hole I was in. Jake Neiber, CAT, Admissions Coordinator Episode Transcripts Episode 37 Transcript hello everybody and welcome to another episode of finding peaks it's your infamous president and founder chris burns grateful to be here i got my main man to my left a chief clinical officer jason friesma also known as the freeze let's go and what am i also known as motivational specialist motivational special i got it down like that dude it's like yeah easy peasy as my youngest son would say and to my right i'm just really grateful to have just an awesome professional even better person jake nieber one of our admissions coordinator um just really grateful to have you on today thanks for joining us excited to be here today for having me absolutely man coming off a heart day yesterday which is my second favorite day of the week and i just wanted to define heart day really quickly for the people um in the last year specifically in the pandemic i had watched myself use wednesday as kind of this pivot point to kind of coast into the weekend with a lot of my things spiritual mental emotional and physical and in the last year i found it necessary to turn that hump day into what i think we should call it in recovery which is heart day which is where people in recovery are called to become a little bit stronger a little bit more resilient and a little bit more connected and it's been my experience that's where the people in recovery get to pass everybody else so let's go jake was actually is an alumni at peaks recovery centers about three years ago uh yep in march it'll be three years nice man so he's an alumni at peaks recovery um also uh an admissions uh coordinator as well with us but has also worked other positions at peaks i just kind of want to open it up to jake and talk with you a little bit about your journey and kind of how you got here both with peaks certainly but maybe even more specifically kind of your journey you're from southern california been to multiple treatment centers specifically in that southern california area and we were talking a little bit before the show and and something that i was reminded of was that initial phone call that i had with your mom um and it was after uh to your point nine treatments and it was hopeless disconnected and in despair and she essentially told me on the phone what are you gonna do that all the other people that said they were gonna do something who couldn't follow through what can you bring of value and i told her i don't know what the other people did but what i can tell you is that we'll care deeply and we will care more than the last place you were at and maybe just talk a little bit about your experience a in in california but maybe that breath of fresh air that happened when you came to peaks and kind of got to see the other side of the industry which is a caring component yeah absolutely um it was definitely a rocky ride to get to peaks my experience in southern california was was tough to say the least i went to 10 treatments in total peaks was my 10th treatment and so not only was my mother defeated i was defeated i mean we didn't have a relationship because of it um there it was disconnected like you said i mean every time we would talk it was it was just like you know what are you gonna do like you know how are we gonna solve this and we were both everybody in my family it was just lost i mean it was it was just that that topic that that no one wants to talk about you know and so coming to peaks it was it was definitely a hard experience to want to do it again i mean for a 10th time you know you're just you're lost it's like yeah what it what is going to be different and i have to say you know walking in the door i remember we had coffee when i came in within like the first week and that was something i had never experienced i don't think i ever even met the owner um or president of a company before i had come at any other treatment center i just felt like a number at other treatment centers like it was just an assembly line of people that were just going through over and over and it's it's actually really sad to say but i mean people are just they're they're not getting the quality of care that they deserve at these places um you know when you come to peaks i mean your treatment plan is individualized it's it's tailored to you to to what your needs are i mean i came in i had you know backpack of trauma following me i had legal troubles um the relationship with my family it was non-existence i burned so many bridges and you know i had assigned a great therapist case management helped me with my court cases um and then you know i was in bad health i had a medical team to help me out with that as well so i think just having everything addressed as a whole um that was really what it took to finally turn the tide and get me out of the the hole i was in yeah i think that's really cool man and and i could i could feel that on the front end of like even with you when you showed up and i i know not to call this anymore but i was worried i was worried about your ability to navigate this process more specifically your ability to trust again right because when you get on the phone with a professional and you're vulnerable and you say please help me and they put their best foot forward and they hurt you that is defeating and that's got to be really difficult and um just to be able to reboot and and to be able to trust again and to lean into that is something unique and something that's i think speaks wholeheartedly to your approach to recovery and more specifically the way that you work with families now yeah having had that experience i don't know that there's anybody we had angela in here as well as had a similar experience in madeleine and others and that admissions team again another shout out best admissions team in the united states right um but really leaning into these calls with the experience that you've had and being billing being willing to listen first solve later has been something that's been set in here from other admissions people can you kind of speak to how that has prepared you to not be a good admissions coordinator but a great admissions coordinator and that is what i hear from the families that you get to work with wow that's that's amazing to hear i mean that's an honor i mean honestly i i just i can relate with people it's as simple as that like i've i've been through it i've seen my mom go through it you know and that's something that still sits with me you know is the pain it's it's the struggle that my family went through to get me there and so when i get families that call um it's being able to put myself in their shoes you know it's it's um it's really close to my heart yeah you know and so i think um like you said listen first that's huge because a lot of times people the uncertainty that comes with you know having a loved one coming to treatment or bringing yourself into treatment it's just it's through the roof you don't even know what's going on half the time who can i trust what do i do from here i mean it's it's a lot of calls like that yeah um and so i think having that relationship with people is first and foremost you know letting them know like hey this i'm someone you can trust um and our program is something that you know it's which what you see is what you get you know we're not hiding anything there's it is really a place where you can come and have a nurturing environment and feel safe expressing yourself working through some of these underlying issues that are always you know intertwined with addiction um and and just the way i like to look at it too is what we do i mean have you heard of the you know someone described the difference between sympathy and empathy to me before you do it that sounds like something it could have been um but it's like so the way it was described to me is sympathy is you know you're walking along you see someone in a hole and you're like hey man that really sucks that you're down in that hole empathy is you're walking along you see someone in a hole you get down in the hole with them and you're like this really does suck that's what it does suck yeah you know yeah and i think the biggest thing for me when i came to peaks is i was in a hole we all knew that everybody knew that but someone sat there next to me and said hey how are you going to get yourself out of this hole and i don't think anybody ever asked me that they were like you're going to do this you're going to do that you're going to someone genuinely is like cared enough to be like how are you going to get yourself out of this hole and put me in the driver's seat you know allowed me to take responsibility for my own actions yeah so i love that too because we're coming off the back of and maybe a lot of people still do it is this rock bottom approach you do this you do this because you don't know you're not informed and your best thinking got you here which is how i kind of got sober which isn't trauma informed and really leads me and probably a lot of us in a way to have some really hard edges oh yeah you know jason what is it like on the clinical side of things just having admissions coordinators and specialists that really have big hearts and lean in and the very way your clinical team does it kind of sets the stage i mean it's it's weird just sitting here listening to jake because obviously i knew jake from back in the day like you did and um

it is wild that we've done this long enough chris that like the people that we've helped are now helping us um yeah and i have the privilege of meeting with jake every week every other week somewhere in there we schedule it every week it turns out to be every other week probably but um but just to watch uh the man you're becoming basically and i i it made me actually want to ask you like what do you think kind of the inflection point was at your in your recovery like okay i can start to believe in myself and trust myself because you described so well us coming alongside of you and being like how are you going to get out of this hole when did you start to believe you could get out of the hole

like what was the moment that i took responsibility myself i think that's a great way to put it better way to ask the question um that is a really good question i would have to say the first 30 60 days that i was in treatment i mean i was so broken beaten down and had to work i had to start from scratch i had to literally reinvent myself you know it's almost like just taking the identity of who i thought i was who i had all this shame and trauma wrapped up in and saying like you know what i'm that's behind me now i i think i need to completely start from scratch from ground zero and then build myself from the bottom and that probably started once i moved into the iop into sober living we had a server living house at the time um and so being able to you know get a job reintegrate myself back into society have a therapy meetings that i scheduled you know for myself making amends to my family

all those experiences i mean that was really the point is is once i started having that freedom to be able to go out use the skills that i had learned in treatment in these therapy sessions in groups everything that we do and finally start to apply it and then see results get positive feedback from others you know and stay connected with the community and have people be like you're doing a great job you know how long did it take you to be ready to make amends with your family i think that could be helpful for people watching to know that like it doesn't you know like because sometimes you talk to families where it's like hey he's been there two weeks i think he needs to be apologizing to us and he's like okay cool wow i mean gosh that it's touchy it is touchy yeah i mean there's no right answer to that question right um there is some people that you won't end up making amends to because it could do harm you know to to bring that relationship back right um but i would say the way it just worked out i mean my dad came out to visit i think i was within the first six months of recovery yeah and i did it then um it was great you know and those experiences bring us closer together i mean today i can say i have a happy loving relationship with both my mom and dad which is something i never thought i would have um and that's been a blessing and then my mom came out to visit this was actually recently over summer this past summer she came out to visit and so that that took you know over two years to do oh it says the first time it was a little bit more deeply rooted

like you really speak to something so important that it it took two years not to get the courage up but for you to like do the introspection and figure out how to do it and probably to get the nerve up to do it i would imagine too because you value that relationship and there was so much damage there yeah shout out to your mom by the way yeah yeah yeah she's a big listener um yeah are you what was the question you said uh the courage just like why did it take two years maybe that's the question because i think it's important for families to understand like you enter a process and it takes time before you're ready to be like you know what i get my side of the street now i can understand how i cause damage right because families are used to hearing i'm sorry with no meaning behind it exactly yeah i think that was a big part of it too it was a gut feeling that's what i would say um it was a gut feeling that i had and i just knew that the time was right i think you know going off what you said the introspection that it takes to do a you know proper amends with someone yeah i mean for it to really come from the heart i didn't want it to be like that either because i know i've made so many empty promises and done this but my own living amends in a sense where in that two years i had you know built a life that i can be proud of um that was something that you know i think helped you know it was kind of like look i'm not just saying this this time like you know i have changed um and and there was some conversations i think leading up to the the men's the actual conversation that we had where the relationship was in a better place as well so for for families like you're saying i mean i don't think there's an expectation there for loved ones i don't think there's a hard line i don't think it's black and white i think everything um it's it's unique to the person yeah and i really love and i think we should speak to too really quickly just that immense process within the 12-step framework is a community-based resource and it really is about they don't say it because in 1935 they don't say shame but it's really about dismissing my own shame yeah right and getting that the hell out of here so i don't have to drink again right and the way we we fight shame is we go out and we make these amends but we have to change the behavior because to continue to do the behavior is only going to exacerbate the shame and so that's why we call on really taking your time with this making sure you're ready because quite frankly if i haven't changed the behavior i can't make the amends because i need to show my family system this change of behavior and ensure that i don't have to go back and do it again because then it just turns out to be just another apology and so both family and people in care i just i really encourage people to give themselves time and space to navigate that process because it's an event and a really big process and it's something we should get to if we're doing this process well but to do it well we need to give ourselves time which is really cool and you bring up a good point man you said feeling safe here yesterday i was having a smoothie with a female client and i walked right in i said i i was looking at your list and it said it had all of these fruits that she liked and i saw strawberries and grapes and bananas and dragon fruit and i go in there and i know the exact one i'm getting for right and i go in and i get the berry the banana the banana berry burst and i bring it right to her and i'm like i got everything everything you wanted on here i'm so happy she takes a drink and she goes i've been working on this in therapy but i told you no bananas

she's always and i need to not worry about what you're gonna leave here thinking about me i need to tell you use my voice and say i told you no bananas and i said no i got it right here and i looked and i said you're right it says no bananas and i was like i really appreciate you doing that that is something she had talked about with her treatment team potentially about using her voice and utilizing an opportunity and here i came the president and founder dropping off a 10 smoothie and she said you got it wrong that's where i want peaks recovery centers to be because she deserves presence and in that moment i wasn't present my goal in monday was to be present and very quickly she showed me that i have some room to grow which i thought was awesome yeah and i think that's kind of peak's culture is like people can come up to ownership and say hey you said you're going to be here at 9 00 am you got here 906 i kind of hurts and i think that's the safety and trust that we can build with the chris burns the jason friesman the jake neighbors and that can really foster connectivity and trust moving forward you know so what did i say i said well i'll be back next week with a smoothie with no bananas you had my word yeah you know is there anything as we get ready to kind of um finish up here is there anything that you would like families to know again jake is admissions coordinator he fields hundreds of calls with not only vulnerable people but families that are just in chaos they're hurt they're in fear is there anything you want to leave the viewers with something specific that you just want to let them know to dismiss fear or shame or just create some connection is there anything you'd like to say before we wrap up um

you know for families i just know it's really tough and i guess i would say you're not alone i think that would be the biggest thing um that seems to be very comforting to hear for a lot of people because it feels like you're alone in those situations i think addiction isn't it's an isolating disease that's what it is um and it's not just isolating for the person who's in the middle of addiction the families are experiencing those the same feelings but they don't get to use substances to drown those feelings out a lot of the time so it can be even more intense yeah um and so i think that's that's what i would say you know you're not alone in this there's a lot of other families that are going through what you're going through and i would definitely you know just reach out reach out for help yeah that's absolutely huge man it's so interesting i was texting with madeline a little bit before he caught over here and there's a guy coming in tonight she's like if you could just reach out to him and just see how he's doing he needs a little bit of support because his family has a bunch of substance use and he feels all alone right so when we leave here i'm just going to reach out just another person in recovery and just simple stuff like that there's no and that's another thing i just want to give a shout out to you in the admissions team of just i do all of the introduction calls at peaks you hear from the founder first and um i can't tell you how many times i've gotten on the phone and they say um hey jake you know jake and i'm like do i know jake of course i know jake um if it wasn't for jake we wouldn't be there i have heard that at least three times in the last three months they'll say something like jake has been working with us for four weeks he called us every week just to see how we were doing just to touch base and so families are experiencing the beauty that is your recovery man so thank you for coming on thank you for being who you are thank you so much for having me absolutely cool that's awesome well all right we're going to wrap it up here please find us on all your social media outlets as well as your podcasts we got instagram facebook podcast we got a tick tock tick tock tick tock yeah follow us on tick tock we're releasing videos we're going to figure out a way to get finding peaks potentially on instagram if that works we got a lot of viewers on instagram that have been hit me up uh in the message saying hey can we have this aired on instagram so maybe that'll be a thing until next time let's go

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Episode 36 Addressing The Opioid Epidemic Watch Now https://youtu.be/bdKRUZjDvzA Listen Now Episode 36 Our clinical team walks through many informational aspects of the opioid epidemic and the barriers addiction treatment centers face in order to fight this crisis.

Topics:

Our clinical team discusses what it’s been like walking through the opioid epidemic while the COVID-19 pandemic
The increase in the prevalence of opioids and fentanyl
The power of opioids and why people choose to abuse them
How MAT has been helpful and the outcomes we’ve seen from it

Select Quotes There should be a sense of urgency. I think we have lost a little bit of that momentum because of the pandemic. What we have actually seen of these two things continues to elevate and escalate together. We have to stay vigilant, and as you said Brandon, we have to change the narrative around what it means to get treatment and the types of treatment that are available. MAT is the gold standard for opioid treatment, which is based on data, science, research, and decades of study. As an industry, we have to be more open, and as a society, we have to again to continually work on eliminating that stigma around what opioid treatment is, specifically Medication-Assisted Treatment. Clinton Nicholson, MA, LPC, LAC Chief Operating Officer Episode Transcripts Episode 36 Transcript hello everyone finding peaks 2022. first for 2022. yeah i was counting down episodes in the past we're counting up because we reached like 36. geez in 2021 and now we're at one so it's easy to start the county you guys are all welcome anybody who's been following us in 2021 knows what i'm talking about absolutely and you guys have experienced what i'm talking about in real time for those who are joining us for the first time in 2022 jason friesma chief clinical officer clint nicholson chief operating officer and yours truly brandon burns chief executive officer of ossifer here we go 2022 rocky start yes in any case so we don't lose the audience yeah diving into this episode for this year the thing that i wanted to discuss today was the opioid epidemic that's taking place at the same time as this historical pandemic over the past two years uh of course covet 19 has taken 826 000 lives or something of that nature super tragic and unfortunate um happening alongside of that another 186 000 lives to the opioid epidemic which i think represents about what 23 24 of the covet 19 does so we're talking about significant losses by comparison and you know given the pandemic i haven't seen a lot about it as an epidemic taking place in the background and just wanted to remind you know viewers out there certainly family systems who are struggling with opioid addiction fentanyl heroin whatever the doctor prescribed at the end of the day whatever the drugs are called on the streets and so forth um just kind of talk about it out loud and then just reinforce with you know the general viewers as well too uh kind of how tragic this story is and what we're witnessing and certainly we experience you know at uh peaks uh individuals coming into treatment struggling with you know opioid use disorder um as well as the consequences of it uh prior to or even after treatment in that regard so um in sort of kicking this off um you know clinically what have we seen around this as an issue and

kind of what's our what's our best foot forward and kind of as a as a small treatment facility with 36 beds you know to operate here in supporting such a large uh issue that's taking place all around us

yeah so as you were kind of doing that intro brandon i i do think about how um when we conceptualize sometimes we talk about it clinically that the opposite of addiction is connection and so when we've been walking through this pandemic and particularly at the beginning of the pandemic when everyone was at home and isolated um it created a great deal of disconnection and we saw a huge spike i think not just in overdoses but certainly in suicide as well um and then what goes along with that is i do think increased access particularly to fentanyl um people i i've been talking to some of the young people that have come through peaks and just the ability to order fentanyl uh even through the dark web and have it delivered literally to your home press pills or whatever um has become commonplace that's kind of a new thing and and the other thing i was thinking about when we were talking before the show as well is that there used to be a great deal of fear i think among among addicts about getting drugs laced with fentanyl and all that and now it's literally a drug of choice i've i definitely have seen fentanyl becoming people's drug drug of choice in a way that i hadn't seen prior in my career and then obviously phenol so potent and and i'm positive the increase in fentanyl is leading to at least partially the increase in opioid overdoses how about you clinton life so i started the when the pandemic started i was still working in medication assisted treatment specifically for opioid addiction and so i i got to see a kind of an interesting transition time um as that as the pandemic hit as kovit hit access to opiates actually really became difficult so a lot of people entered treatment at that time a lot of people would start things like suboxone or methadone and it there seemed to actually be at least initially a moment of um relief right and because it seems like the like the opioid epidemic had kind of actually started to plateau and like the pandemic was gonna maybe even accelerate that a little bit um however as access to heroin went down is really what happened um the access to fentanyl increased and like jason was talking about fentanyl is nothing if not unpredictable you never know what you're going to get you never actually know their potency it's a relatively new drug on the streets so there i think there's a lot of people still trying to figure out exactly what

like how to use it which uh makes may sound weird to the viewers but i mean there is this sort of like trial and error period unfortunately to air with fentanyl is to die i mean that's just you're gonna overdose so um it's been a very uh i think we're in a really scary time when it comes to opiates especially as jason was mentioning again that fentanyl becomes a drug of choice like that is just it's dumbfounding to a certain degree that that would be your actual go-to when before like uh it is there was so much fear around it and to a certain degree fear can be really healthy in the sense that it keeps you alive um but as that fear starts to dissipate the risk of increased um opiate deaths and overdoses is is going to really start to um to escalate yeah yeah and and just to um kind of bring the viewers close to sort of the um oh god what what's the word i'm thinking of here jason read my mind i'm working on it um close to the start the uh sophistication of the delivery of these drugs it's not the word i'm looking for but it's the next best word just just you stop nodding but the sophistication of it when i think about there's a gentleman in treatment during the pandemic kind of when we're allowing letters and things to come into our treatment center and the gentleman that i have in mind got a card and it was addressed to him uh kind of from mom or it was from his grandmother in that regard it looked really benign and so our policies at that time was to open up these letters in front of our clinical team members and those sort of things read them out loud just to make sure there was nothing you know traumatizing or shameful or anything and that and we could process it in real time you know when he gets the letter and oh it's from grandma opens it up and reads it back to the clinician and it sounds like just a small simple love you hope you're doing well and then inside it there's a really small packet of uh fentanyl uh in that regard and um and in that way you know grandma to be clear from the dark web but so the letter coming in just looks like this you know sort of benign instance from grandma and it has drugs in it and of course that's a learning lesson for us at peaks you know at the end of the day to change our entire protocols about how letters come in at the end of the day but that's kind of how clever it is at the end of the day um and how it's operating all around us and so just be mindful of those sort of features within your own housing environment and so forth about how these drugs can be coming in because it could be very sort of elusive in that way absolutely um and so you know so we have this major problem of course fennel the epidemic taking place what is it in your guys's experience at least in you know speaking with patients who are right in front of us each and every day that's so alluring about this drug in particular by comparison to say you know maybe alcohol or whatever other drugs that are out there for these individuals what is the thing that's like once they have ingested it we're off to the races it feels like yeah i i mean i actually think that um opiates do two things they um help to kill uh physical pain but they also help to kill emotional pain right so there is a sort of dissociation that you achieve or a sort of distraction or numbing of emotional escalation that i think becomes the allure i don't think that it's a lifestyle thing anymore i don't think that there's a culture around it like there used to be i don't think that there's some sort of heroin chic sort of mentality that use that was really prevalent in the 90s and early 2000s i think that we are in a place of just escapism and the allure becomes a way to control your emotional environment when the actual external environment is so chaotic and unpredictable and that's to me in my experience and speaking with clients that's the actual hook right there is this ability to control your emotional space and to feel um or to numb out those feelings that you just that make you feel out of control kind of like a blanket of safety absolutely absolutely when it's so immediate and it's so complete yeah right it isn't like somebody having a beer after a long week of work and feeling a little bit of a relaxation this is like complete absolutely dissociation from all of that um and i think that gives it a huge amount of power and i the other disturbing thing i've heard people talk about with this as well is um you know the the drug narcan which um can kind of interrupt an overdose um that that does give people like you know thankfully our society gives that drug away uh pretty freely um but it does create this whole other situation too where people then feel really free to push their boundaries as well with the drugs and and really almost i've i've even had a couple clients talk about intentionally overdosing to be saved by the narcan like the movie flatliners from back when i was a kid yeah and um and so there is this whole like it's

it's a new frontier i would say for sure um and i i think you said it pretty well clinton like you know i've been doing this since uh heroin was chic in the early 2000s um and actually it was like this opium den and we're getting back to the 60s and it's going to be so great and um and really this isn't that this is people at home alone uh or on a street alone um and it is not a party and it is not a social event it is uh something that people do primarily alone or if they do it in groups it's just for them to try to have some semblance of safety around it if you will but that's what i've observed yeah yeah it becomes it's emotional control and i think to some degree all substance use is i think that there is an element to that but particularly with opiates and in the past there's been a certain level of predictability because not only like jason said is it is it sort of a complete emotional takeover but it was a predictable emotional takeover and now that predictability factor is starting to go away because you just don't know what you're going to get if you're getting it off the street even if you're getting it off the dark web you don't know i mean now the big thing is pressed pills right that are made to look like oxycontin that are made to look like percocet that are made to look uh like you know like a hydrocodone that you would get from the dentist you know um but it's but they're just made to look that way and what you never actually know what is going to be inside of that so every single time you put something in your body you're really i mean it's this like russian roulette moment all of a sudden and um i don't know being in the industry it's it's just it's extremely frightening to think that there's so much risk out there right now um and again it doesn't seem like the the level of risk the level of risk is outpacing our response to it and our ability to respond to it effectively yeah yeah i mean it you know there's no doubt that you know anybody who's coming into a treatment center certainly is suffering in their own ways um other drugs give a little bit more space and cushion though right if a relapse takes place on the other side of programming and whatever that looks like you know if it's alcohol um you know certainly there's a variety of patient demographic who it could be immediately detrimental for but for mo for the most part most people can have a few stumbles on the other side of it and you know for individuals who leave you know treatment with us like i do have and maybe it's a sense among all of us but just more fear about those individuals even if they're on medication-assisted treatment or whatever the protocols are that they're leaving treatment with because you just don't know what that next thing is going to be and then it's you know i think about the you know narcan and the use of it you know in people actively exploring what those limits are and then having that sort of buffer right there if somebody has an archon next to it that exploration is scary and there's also this preventative measure as well too and you know for the audience i think i just wanted to review kind of like what that feeling was and i think the emotional aspect of it and the blanket that we feel because when you watch it take place and i have um opioid addiction and you know my family and history around being in front of it and seeing people you know use needles and so forth but i think a lot of people on the outside look at an individual who does this and you know they maybe are shooting it maybe they you know snort it however they're ingesting it but there's this sort of immediate um kind of just like nodding off and then falling over and you know my experience of people who don't understand it or close to it are like why would anybody live like that look look at what they look like you know it's very tragic to look at somebody who is going through that as an experience but wildly at the same time right they're experiencing this emotional safety and this warming blanket all around this very euphoric event so what looks really sad and tragic to us is oddly quite comforting to the individual from their own internal suffering which makes it a just a wild sort of experience to be on the other side of it at the same time and certainly sad and so uh you know just kind of a follow-up into that is you know we talked a little bit about it before we you know launched into this episode but are we experiencing from the patient demographic that we see different from you know maybe meth and alcohol and pot or whatever the case might be a certain sort of vulnerable a vulnerability of the individual that we can maybe highlight from who might be more susceptible to it and i know that's probably a big ask is a question you know by comparison to you know the diversity of the patient demographic who comes through who experiences these issues with fentanyl and opioids and so forth but um you know is there anything that we can maybe look out for to think that you know maybe i'm more susceptible versus somebody else or is it something much different than that hmm i mean god if i if i had a really good answer to that question i mean we would be in a totally different place if we could actually be able to sort of have those predictions i mean emotional vulnerability yeah for sure i think that puts anybody anybody who's in an emotionally vulnerable state is at risk for substance use in general for opiate specific i i mean we're all over the place now you know i think that um you know part of opiates again in general it's not just the sort of psychological addiction there's a physiological component as well it's there there's so many contradictions in opioid treatment uh like when you when you're out when you first get out of treatment is when you're actually at your most vulnerable for overdose you know you wouldn't think that but because your tolerance is decreased and you still have you have low coping skills and ability to manage triggers you know that moment in between uh those those first 90 days are just so it's such a high risk moment which is why at peaks we really really push medication assisted treatment because it's something right it's a one blanket to help people it's it's not a blanket rather it's a tool for people to help manage those triggers it's another coping skill there is actually a physiological medication sort of protection that's there but generally speaking it's i i wish that i could say yes this type of person is the one that's at high risk so make sure that you watch out for that but it's just not a real thing i i at least not in my experience i don't i don't know what it is yeah i don't i don't know how predictive it can be but i do think at the same time i think it's a great question because uh i've absolutely worked with people that you know they're they've never done a drug in their life they're my age and they blow their knee out and have surgery and start to take opiates and it it has such a great dissociative effect that they get hooked on it at an older age but i certainly you know the younger demographic would be who we would see the most uh with an opiate addiction but but i've absolutely seen people where it's almost like a hand slipping into a glove when they have an opiate for the first time and they all they want is more even if like they have a perfectly functional happy life but i've watched people ruin their lives kind of later in life too post-surgery or with some irresponsible prescribing at times too but but if we could say like oh well anybody post-surgery is it risk it's it's not yeah which isn't i mean the majority of people aren't yeah like the majority we've all had surgeries and yeah i've been prescribed medication for the pain and we're fine you know like you come out on the other side without any with nothing to worry about nonetheless in fact a lot of people are really resistant to it they're like ah i get sick i get nauseous yada yada so i think that you know addiction in general is this sort of like biopsychosocial uh hodgepodge of factors right i think that it there's so many different variables that go into it and um opiates are no different i just i do think that opiates have an element another element of risk involved though because of the um the physiological addiction addictive qualities i mean their withdrawals are so painful and so extreme and happen very quickly you know so the physiological dependence often times outpaces the actual psychological addiction so you you can kind of get caught and before you even realize it your body is already telling you that you need more before your mind is is actually asking for it or wanting it so that to me that's that does lend to an increased risk yeah well speaking of the the vulnerable populations maybe we can you know sprinkle a little flavor of vulnerability on it or who's more likely to succeed post-treatment or interventions of matte medication-assisted treatment if you're for the viewers out there you can look up the the united studies the national institute on drug abuse i think they have great uh end values as far as the participants in the studies and the outcomes that they're following but it there seems to be this median age of about 33 years old and you know we talk about the gentleman who you know busts his knee doing whatever you know ends up in the hospital gets you know loads of opioids gets addicted in the process uh those individuals are seemingly um like wildly successful 65 percent or higher for the united studies on matte regiments and you know they live a life free of opioids beyond that uh in that regard but the age below 33 i mean it's like a cliff it just drops you can look at the the charts it just literally falls right off it's almost like they're not even showing up to the studies you know one day into it two days into it and so forth and you know my reading of that is like we have this event that causes the individual to actually be on the opioid and then we have this other event i don't feel emotionally safe i'm you know just emotionally not well and don't feel safe in this world and so i take it for the first time to maybe quell this different type of pain or i'm doing it because my buddy told me to do it i'm getting high uh in that regard for the first time and so maybe anywhere in there for you know you guys where you see that difference between the young adult and the older adult as far as medication assisted treatment post treatment as far as success goes or are we still seeing sort of a just a hodgepodge now with the fentanyl because it's so much different than heroin and all the other you know opioids that have come before him no i think those studies are actually pretty reflective of what happens i think the older you are one the more coping skills you've developed throughout time the more stable uh the more stable the sort of like psychosocial factors that we mentioned earlier actually have become you have more access to family friends and are just again i think a more able to engage in the world um even when there are even when facing difficulties i think when you're young if the younger you start the less coping skills you have the less resources you have access to the less experience you have navigating when life falls apart because as adults we all know that life just constantly is falling apart and the older you are the more time you've had to recover from that you have that experience of being able to recover i think that the the medication like suboxone or methadone i think that those are just going to they increase the ability for opiates to not be the factor that brings you down uh or it it makes it less likely for opiates to be that that crumbling moment in your life um however when you're young and you're emotionally vulnerable and you've already gone through this experience and you have loc you don't have the coping skills to navigate these sort of difficulties um the chances of going back to that old coping skill which would be opiates whether it's heroin or fentanyl or other prescription medications i think is just that much higher i mean that would be my experience i don't have much to add to that i think you yeah really well so and and going out here as well too i think that you know one of the major challenges of opioids in general was that this industry through its abstinence-based model really naturally stigmatized the process for individuals to really create that space like when i think about suboxone for example right you know if you get a you know the the a case of like well i want to use today you know even if you stop taking suboxone right you really have this preventative 24 36 hour maybe 48 hour window um where you know the whether you're you know intravenous user intramuscular you know whatever the ingestion method looks like in that regard we really have this protective moment uh in place you know vivitrol as well too as another drug that creates these really long time flights uh sublicate injections as well too that reduce those when we're triggered those moments to immediately sort of use and it seems wild that we stigmatize that for so long as an industry you know through that abstinence-based lens and i think that also led to some shaming events for those individuals experiencing something wildly different than somebody maybe you know right or wrong on meth or whatever the other drugs might be in that regard so you know really just wanted to advocate um for these drugs and these methods moving forward because the notion here sometimes is like oh they just want to keep being high and i think that's just language that we just got to do away with because i would even if somebody is seeking it for that reason it's seemingly better than seeking fentanyl to be high and also gives us an opportunity to continue to save lives one day at a time in that regard and you know if your loved one is out there struggling with you know opioid addiction or fentanyl or otherwise and they're proximate to you um you know reach out to your local you know authorities as resources so that you can locate narcan and have that in the cupboard because it is literally life-saving and within seconds can change and overdose into somebody breathing again and getting their functioning back and all that sort of stuff so really just want to advocate for having that in the cabinet if you're close to somebody who you know has that particular addiction um or is vulnerable to it in that regard and um you know with that said any kind of last thoughts around that for you guys or

i mean it's hard not to be a little scary and alarmist about it i do think there's a lot of good solution out there but i i know kind of to wrap it all the way around how we started the episode like when people come in with a fentanyl addiction um it certainly captures my attention because it is literally about saving a life because to your point um it could be any moment that that person uh doesn't make it and that is the case with a lot of drugs but it's urgently that case uh with fentanyl i i don't know why i feel like saying that warning yeah i guess yeah i i think that there should be a sense of urgency yeah you know in fact i think that we lost a little bit of the the momentum because of kovid and the pandemic and what we've actually seen is those two things have just continued to elevate and escalate together we have to stay vigilant and like you said brandon we have to change narratives around what it means to get treatment and the types of treatment that are available medication assisted treatment is the gold standard for opioid treatment and that's based on data and science and research and decades of study so as an industry we have to be more open and we have to and as a society i think that we have to again continually work on eliminating that stigma around what it means uh what opiate treatment is and in particularly medication-assisted treatment because because this is um yeah you just don't get many chances you know like if you it takes one one time yeah and you're gone absolutely and you know just kind of carrying out here as well too for the you know i i think alarmism is appropriate here it's um it's a tragic drug that can end the life quite immediately and we don't have our uh peaks tags on us right now but i think the sec if if somebody is not breathing or um you know whatever the medical condition looks like um or uh we think that you know they're moving in that direction and pass here at peaks recovery the i think it's like the second bullet point of other than are they breathing the next thing is to put narcan or distribute narcan in that moment now even if they're not on opioids like we're just going to check that box super quick because we only have seconds you know if not you know barely minutes yeah you know in that regard to revive them so even for us anybody who you know sort of has um that symptomology is looking like they're passing away passing out or whatever the case might be almost the first thing we administer is narcan check that box first and then move on to the next protocols i mean that's how um that's how much it's alarming us each and every day at you know peaks to pay attention to in that regard so um so with that uh we thank you all so much for taking a little bit more time than we normally take up with our viewers but this is a big topic um and it's kind of at least in my experience gone this is sort of the way side um with the pandemic you know kind of um you know being right in front of us in the media but this epidemic is real uh it's big it's scary and it's taking a lot of lives uh along the way in that regard so hopefully this has been informational um giving you guys tools and resources to support it in your lives and certainly reach out for help if you know somebody who's struggling with it um because it is a uh it is a tragic drug that's taking lives uh every single day here uh in america so uh with that uh it's hard to go out with a little more energy because talking about opioids is uh a challenge so in that regard for all those first viewers of 2022 um questions thoughts ideas future topics you'd like us to discuss here you can reach out to us at finding peaks at peaksrecovery.com certainly look for us on the social medias uh the twitters the facebooks the instagrams uh i'm always forgetting the tick tocks what the kids are using these days uh in that regard and um yeah i haven't done an outro in a while so i might be missing something but in that case doesn't matter i'll fix it in the future appreciate y'all joining us hope you all have a great new year and we'll see you again soon you

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Episode 35 Meet Our Director of Admissions Watch Now https://youtu.be/4JLEsRi-aPQ Listen Now Episode 35 In this episode, we get to know our passionate admissions director, Erin Greney, as she gives us insight into her professional role within the addiction treatment industry.

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Erin opens up about why she enjoys working in admissions within the addiction treatment center and her passion behind working with people
How she guides her admissions team and drives them to put compassion and empathy first
Why Erin chooses to put people first vs. a ‘heads to beds’ mentality
How Erin’s personal experience plays a role in her role as the admissions director
Everyone on the episode shares a “Best Day” at Peaks Recovery memory

Select Quotes The thing about people calling us, we know it is so scary, overwhelming, fearful, and an unknown experience, whether you have called and been to treatment before, or if this is the first time reaching out for help, it can be a really scary experience for alot of people and families. So whatever we can do to nurture that, and make you feel more comfortable, and support you through the process, we will do it because we truly understand the fear. Erin Greney, Admissions Director Episode Transcripts Episode 35 Transcript hello and welcome to another episode of finding peaks i'm jason friesman chief clinical officer of peaks recovery to my left chris burns president founder and motivational specialist let's go grateful to be here yeah grateful you're here thank you to my right aaron grenny yeah our director of admissions uh really excited to have you here today um we have talked about a lot of things uh in the minutes leading up to this show yes um what i would the thing that i wanted to start maybe by asking you about is uh why in the world do you want to be a director of admissions for rehab that's a great question um so i think that admissions for me and of course i'm biased i say that all the time but it's really an opportunity to connect directly with families clients different people involved at a point in time where it's so critical to make such a important connection and be supportive in any way that you can um and then also there's the kind of direct result of seeing someone get into treatment and all that hope that we have for them in their journey it's i mean it's incredible so yeah and also i love people too so they're directing what you do i do okay good yeah yes um so tell me about kind of we were talking a little bit but what is your philosophy of admissions if you will yes how do you view it so for me the most important piece about admissions is relationship building and being in a position where we are supporting and you know developing trust and walking through this path and the end result is not entirely necessarily even that they come into peaks it's just truly the benefit of helping whether that's with us or somewhere else but building a relationship and being able to help in any way shape or form whatever that looks like for that individual and their family so yeah i love that i love what you have brought to the admissions team the department from like a cultural perspective because when i when i've been involved and and had the opportunity to work with admissions department and even bef the admissions department before you took over we really have this kind of like dire rock bottom approach to get people into care and i've watched you come in and really create some trauma-informed admissions processes which just really like i was talking about it with tris a couple weeks ago just the opportunity you give your team and your department and yourself to hold space and to spend time and to to madeline's point which is like listen first solve later it's actually something that i've never seen in this field every admissions department i've had the opportunity to be around is kind of like sharks they come in and they're bottom feeders and they come in and promise you the world and give you nothing as a result and you've really changed what i think is possible in an admissions department just through your presence and focus on being relational it's just actually been really really cool to watch and i had a lot of fear um when we lost a couple of our admissions people i've been around for a long time and i was like holy crap are we going to be able to do this and actually the compassionate attention to this process creates more opportunity for vulnerable people to get in these beds and um i just couldn't be more proud thank you so much for sure appreciate that it's been really cool to watch yeah yeah it doesn't it doesn't have to be like that and the fact that you guys like sit on the phone with people that can't pay for treatment i think it's just so special and when i say this is the best admissions department like it's not even close um and maybe there's a call center with more people but certainly not the people that we have and it's just it's really special how do you we get so many calls each month and you all are so busy how do you feel so comfortable allowing your team and yourself included to spend so much time with people i mean where's the payoff there yes well one of the the really important pieces about that is we're relying on each other throughout this time as well so that team mentality is something that i mean truly within the admissions team i've never seen individuals so um motivated to support each other and people on the phone in entirely um so you know we'll we'll rely on each other and if someone has a longer call we'll we'll say to each other hey i'm on a long call can somebody you know help out with this call or call someone i've been working with or whatever and everyone is so willing to do that consistently um that it's really incredible to watch and be a part of but yeah the compassion piece is something that you spoke to that i think is so critical that i mean truly every call like that's the motivating factor um is just showing up and being compassionate because the thing about people calling we know this it is such a scary and overwhelming and fearful and kind of unknown experience whether you've called and been to treatment before or this is your first time kind of reaching out for help it's it's a really scary um experience for a lot of people and a lot of families and so whatever we can do to kind of nurture that and make you feel more comfortable and support you through that process i mean we'll do it because we know how scary it is so yeah i love that i think i think i've watched other people approach admissions by taking the the scary moment and then leveraging that fear and really failing the flames of it to try to create uh action on somebody's part it's workable it is it's like you're going to die you better go yeah there's enough of that already we don't know we don't need that yeah yeah how did you or why do you have this approach oh that's a good question um i mean i think so part of it comes from my own of course experience um with recovery and going into treatment and of course i i kind of use that experience as much as i can um and you know i think that what i've seen because i have seen this other way as well and unfortunately in a lot of ways it does work for people but this approach just all together is is what supports everybody in its entirety and the other thing that i think that the admissions team does really well is that we're and we've talked about this we're setting the standard for the care that they will get at peaks so we are wrapping around family systems and clients and educating and you know kind of guiding through because we need to set a tone for the incredible care that the entire team at peaks will give so we need to set a good tone for that we need to set that example from the second they call us when i think you know having having sat on the clinical side for so long and i know i've shared a little bit of this with you but i i feel like a lot of times our clients start to get help before they walk in our door because they are talking to you and and your team and not only are you setting the tone but like you're beginning the process actually um rather than because my experience when people come into treatment scared or their family is scared um it takes a week two weeks three weeks to like begin to unravel that and begin to work on repairing the relationship with the family or whatever whereas if if admissions is kind of a relational process i've watched it um be a much smoother transition into our care uh and having that uh having that alignment and i and i do want to say too um i know your team cares a ton too because like you know i they love to hear how clients are doing along the way and and after and all that so yeah i really appreciate that too echoing what you said chris yeah i mean that's just a huge point to make is like for years we're dropping off scared kids and scared families into treatment and then we have to pick up those pieces and build trust right for somebody who's in a tremendous amount of fear and quite frankly a lot of times is angry because the the family system just went boom get out and go and you have to or you're gone right and so they've really leveraged that connection and as i was saying in group and lisa smith has said it in here before with that connection you have influence without that connection you don't have anything and so we can't move people in any sort of direction without that connection and that influence and i just when somebody shows up supported it's much different than showing up scared and i wonder too just having that experience in prescott arizona you know we've both kind of been through the rigmarole of treatment out there the environment the culture and we saw a lot of things being done a certain way and at times i know we've spoke about it i've just kind of sat back and be like is this the right way right and in fact i think we've learned that it's not and and now we're here and that was one of the conversations i remember having with you on the front end is like the opportunity we have to engage in a really kind of authentic clinical and medical process for the clients that we serve is really cool and being able to promise not kind of throw lobster hail mary out but be able to promise clients that when you come into care this is exactly what you'll get met with and be treated like every single day throughout care it's just it feels so good yes you know yes and i think that for us on the admission side that authenticity and that we truly believe what we're talking about because it's real like the quality of care that you will receive we're we believe that wholeheartedly we see it every day um so that authenticity i think comes through really clearly as well which i mean i think about some admissions people where they kind of have to yeah bring that up and i'm so thankful that we don't have to do that yeah and it's it's real yeah so how do you how do you think your own personal journey of recovery informs how you operate your team i mean we have a lot of conversations about emotion and we're very open about talking about self boundaries i think that's huge for longevity in any role in working in the treatment field particularly again biased in the admissions role because we're dealing with things that are often highly fast moving highly emotional so it's really important for us to kind of have internal boundaries a lot of times so that we can continue to help the next person that calls so just conversations like that i don't think would be entirely possible unless i was pulling from my experience of course you know the the compassion and the patience i mean a lot of that comes from um you know my own experience as well so yeah i think that feeds a lot yeah and what kind of hope because i get on the phone in 2021 and i have the opportunity to pick up the admissions ball i'm usually the first person to grab it after all that great energy has touched that family but what are some of the things before my brain just went completely dead um on that front end um that you're relaying to families as a part of your recovery to like really instill hope because one of the things that i get on and say to him every time is i said i am the most hopeful person you're gonna ever talk to because i believe today that we have an authentic opportunity to walk this path together and to create hope in our lives and to create a quality of life improvement unlike we've ever seen and i only know that through my personal walk and really my personal walk in the last couple of years with all these fancy modalities we have now and opportunities we have to engage in diffusing some intensity and so how do you relay that hope and and maybe it's tied to your story and your own recovery story but um what emphasis do you put on that in that admissions process yeah i mean i think there's a lot of situations where families and you know clients themselves feel like they've been through this process and so it feels like a hopeless place especially if you've tried and it hasn't been successful that's really disheartening that's really hard and so i think to share experiences of you know a lot of people have multiple situations where they're trying and they're trying so trying something different a longer type of care such as 45 days really stabilizing first like we identify kind of where within the last processes what was missing or what did that look like um that something new might be beneficial um so yeah i mean just just kind of sharing that like there is still hope and it can still happen um if we maybe try something a little bit different yeah you know yeah i love that and peaks to me in a lot of ways most certainly our curriculum is just different right and not just the curriculum but the connective tissue yeah the under the tree the opportunities we have to care and it is just i was sitting with yesterday i was i was i was almost moved to tears by my second coffee date yesterday because i sat with a 40 year old mature adult um earlier yesterday morning and he said i've been to southern california treatment i'm hyper vigilant in these places i've worked in treatment and this place is different these group sessions are intentional do you pay everybody to care do they just show up like that it's like really phenomenal and then i have an opportunity to go to the women's house in the afternoon at 3 30 and i just wish more people had the opportunity to do this because i sit down with this young woman who's been to multiple treatments who has been considered and called a chronic relapse she's in our care and she's like i have more hope than ever yes i've only been here 10 days this is different and it is different because of those connective features um and a lot of the things that you bring on the front end which creates a tremendous amount of momentum into company culture and throughout the curriculum in our process so again just thank you i can't rave enough about this admissions team and the first step cultural component to everything we do yes just really well interestingly to just piggyback the question i was thinking of before you even said all that is like what is it like to actually sell the peaks program not sell but like tell families about what we do here honestly there's situations where sometimes we're like we have to calm down a little bit because we're too excited and it kind of doesn't match the tone all the time right so we have to think okay this person is not in a place where if we're excitedly shouting about what we offer although we're so excited about it of course um but it's it's not difficult um again because we we see it we know we trust every single staff every processes every group like we know that it's it's gonna help and it's to be beneficial and a lot of times it's the right situation for a lot of people that call um so it almost feels yeah i mean it's it's exciting definitely um but it's not terribly difficult like we don't feel like we have to over emphasize anything or blur any lines or be dishonest in any way because again it's it's what we really offer and that feels good and that's easy so i'm gonna ask you a hard question though okay you ready yeah of course what's been your best day at peaks my best day at peaks um that's a great question i for me the things that stick out in my mind are hearing someone that i worked with someone that i helped come into the program and was in a dark place and things were hard and you know they weren't doing well to hear that they have gone on to be successful they graduated we hear feedback you know from the team about how much they improved and um you know how their quality of life has increased and they've just gone on there's nothing like that in the world for me having seen the place they're in in the beginning um i mean that's just powerful and incredible and inspiring and all of the positive words so um i can think of a couple obviously i'm not going to name names but i can think of a couple people that i've worked with on the front end and to hear kind of their positive story is amazing

yeah how about you chris what's been your best yes chris what's yours best day of peaks there's a lot i mean i really and i don't say this just for the [ __ ] but i i genuinely am in a place because of the team and because of what we do and how we do it and the people we're walking with and the clients and i was just in circle this morning in crossfit where you know a handful of the guys we were said it before were literally bathing them in detox and now they're in there doing rowing and jumping pull-ups and so like every thursday and friday quite frankly are my best days at peaks because i have an opportunity to engage engage with what i'm passionate about which is client-facing everything activities physical spiritual mental and emotional and just watching people overcome what they thought was possible and every time we leave that crossfit jim i tell all of the guys or all of the women i say hey you didn't know you're going to come to peaks and be a better athlete but you're going home a better athlete and every one of them's like yeah this is cool and so every thursday and friday really especially in the last couple of years because i get to go down and i get to see firsthand what the team's doing how they're respected how they're digesting the information and every thursday friday i find myself texting someone on our team just be like man i don't know what you're looking at but from what i see our clients are satiated they're feeling fed they're feeling heard they're feeling acknowledged they're feeling valued they're feeling worth it and for me that is a perfect day it peaks recovery so yeah today today jason what about you who's your best day oh we know this turn it back it's every wednesday yeah it is every wednesday it is it is um uh when i get a chance to meet with my clinical team and um and even if it's a hard meeting and even if we're wrestling with difficult issues or um you know maybe a staff shortage or you know whatever might be happening at the time um i have a team that i i just love uh to be in front of and and um walking through this process because we we do uh get a chance to be passionate and it is easy um to just access that passion in the heart and um and provide additionally just really good care for people as well um because we do important work it turns out yes um and and that is the thing i i do i kind of wanted to end on this is that um aaron you you have provided that integrity that i think our team needed and because i do think each department when you when you look at medical and clinical and admissions and a residential team and all of our other teams like there is this piece where i think we all are striving to be the best we can and to provide the care and kind of that connective tissue that chris talks about the the things that we aren't paid to do or the things that aren't in our job description necessarily but it's just a privilege to sit uh with our clients at times and and be humans with them and be people um and so i'm grateful for that so uh i feel like what has to go on the top of like every job description it's like you have to be able to show you care you're just not gonna you won't last very long yeah yeah no you can't show it right you can't act because everybody will know yes right top of job description you got to show you have a heart and that you care and if you can't do that you got 90 days yeah and i just love it man that's a great requirement yeah yeah so it is um aaron thanks for joining us thank you so much for having me i'm so glad you came down here thank you thank you i am so excited about this mug i just want to say super quick i know i know we're over but um my team the admissions team is absolutely incredible and i'm very grateful for them and i have two best days because working with my team okay two all right so two best days yeah because they're amazing shout out admissions i will never forget when i'm in the iop office and i walk in and like you three of you are like laying on the floor working in admission talking i'm like you guys it's dark in here they're like is it like you must have been working for a while yeah and they were all working on one thing that had to do with the same admission but that one was like sending out the email one was done it was like i was just like this is beautiful and i'm just sitting there with my ttla like this is awesome yeah you know and and everyone will like do it without asking too they'll be like oh i'll do this i'll do this and i'm like yes yes teamwork yeah it really is all right well that we are out of time now as aaron just alluded to but i i'm really grateful for this conversation um as always uh please follow us on facebook spotify probably uh apple podcast um instagram tick tock i'm new to tick tock got a new account this week nice oh my gosh i've got three followers i don't mean to brag what's the handle what's the uh 14 or jason uh oh wait is it your personal tick tock yeah but oh that's what i'm saying peaks yeah we have a pizza pizza tick tock but i'm saying you can follow us but i i'm a pretty big deal too on there i've got a free fall yeah anyway that's it have a good one thank you

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Welcoming The New Year Watch Now https://youtu.be/i5xo7DrwLLo Listen Now Welcoming The New Year A Happy New Year from our Peaks Recovery Family to yours! In this short and fun episode, our leaders share their hopes and goals for 2022.

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Each team member speaks on their goals for 2022

Select Quotes Happy New Year! Episode Transcripts Episode NYE Transcript hey happy new year from us at peaks we have a special episode today a powerhouse full couch quinn loves sitting in the middle i will say that he's uh really comfortable and uh excited to be here i can tell um so anyway we just wanted to say happy new year to all of you and as part of that we are going to go around and share our goals starting with you christopher burns hello hello everybody welcome to the to the show here today and happy new year uh we are coming off 2021 in which for personally really personally for the last 13 years i've had the best year of my life every year which has been a goal of mine and something that i've been able to walk through but i'm actually getting ready to go on an intention trip not a new year's resolution trip but an intention trip and i want to set some really good intention this year both personally and professionally and personally a goal for me is to really dump more energy into the great relationships that i have in my life today both family and personal to spend more quality time to be more intentional in that time that we spend and to really anchor into some really great friends that i have that because this year has been so busy i haven't had the opportunity to get coffee consistently and so that's what i'm striving for personally and it kind of ties into professional and then the biggest thing that i want to do for the peaks recovery team as well as clients and i'm grateful for this opportunity and this awareness and it is a goal it is to be more present and be more embodied throughout this year than i have ever been and i'm learning um how attractive that can be to the people that it needs to be attractive to and so i just want to really practice this year being where i'm at spending those intentional moments that matter um and connecting wholeheartedly in another year so looking forward to it i cannot wait let's go yeah let's go only one day away

yeah well happy new year everybody uh super excited it's been several weeks since i've been able to be in the host sheet your favorite host of course so our ceo yeah ceo brandon burns title drop that's important he missed it it's okay we'll do it in the future but uh as you all know from episodes you've uh watched uh with me and witnessed um i my goal is just to continue to disrupt this industry like nothing gets me going in the morning more than not only the commitment through that disruption of quality care in the direction of like our patient our company our patients and our company culture our staff continuing to bring more people on to help those in need all of that greatly resonates with me and certainly under the mission of saving lives um in that regard and proof is in the pudding and that's how peak shows up and i'm just excited to continue to do that so um i don't know if that's

any personal goals personal goal not be in that fire truck that ambulance that just went by um personal goal uh is just continue to develop my um my professional acumen about this industry uh continue to find um empathy for others when it's challenging inside company culture uh moments um certainly as you guys know we take a lot of flack at times from the patient demographic and that's a lot of energy to you know receive but at the same time um you know uh the individuals we treat and work with are suffering in that way and so i think you know just continuing continuing to lean into i think those aspects through uh empathy as a as a personal goal of mine uh moving forward so but mostly disrupting it yeah you were way more passionate about that i want to just want to affirm that they caught me yeah i thought it was a left brain thing and then they did the right brain thing so yeah yeah i mean that's what happens when i sit in this seat yeah i'll get you next time i know i get it it's some sort of heady question um listen my goal my goal for this year i i feel like we have uh a team clinically that is ready to continue to grow and develop our curriculum and just continuing to elevate our professionalism i was talking to our clinical team earlier this week and i said we're gonna we're gonna have kind of an incubator of ideas as we uh continue to mold and develop our curriculum uh actually this month so i'm just really excited about that um professionally and getting that that out there and then also um just continuing to grow and develop our family program um i think we provide some really cool stuff during covid and i can't wait to see what we can even do better and then personally i just uh similar to what chris said like i just really look forward to um i plan on just really emphasizing genuine and authentic relationships and uh conversations at every point i possibly can find so that's it for me thanks jay yeah yeah happy new year shout out i didn't hear it happy new year oh and i said it at the beginning okay sort of being the host all right uh man in the middle we've got a lot of hosts in here a lot of yeah should i say happy new year yeah okay

all right so uh goals uh so my personal goal is to get better at sharing uh personal space with people on couches you're doing great that's a great start

yeah he's afraid he might be really good right now really comfortable yeah yeah no personal goals uh i think it's always just to show up and i actually that's going to be 100 into my professional goal to just show up as a leader um show up as um somebody who you can trust and lean into also to make peaks an amazing place to receive the highest level of care possible as well as making it uh one of the best places to work for our employees and staff and team and i think one of my long-term goals sort of professionally is just to continue to bridge the gap between uh substance use treatment and mental health treatment and help to to bridge those two worlds that we can finally have a cohesive way of helping people and providing uh a type of recovery that is meaningful across the board yep love that beautiful okay beautifully said thank you yeah all right aaron bring us home yeah okay so i'm saying happy new year as well yeah sure happy new year yeah well done thank you so much yeah i practice

so mine is also like a dual uh goal i think just as a human being continuing to grow and i'm also in therapy that's fantastic recommend it um so that's going well continuing to do that just not being stagnant as a person and just continuing to grow and develop and that is also true for my professional goal um so continuing to grow and develop my team who is very willing to do so and i'm very fortunate for that just continuing to train and improve and support each other and have the best 2022. that's it absolutely thank you aaron you're so welcome and then your goal uh for the years to follow peaks on facebook spotify instagram tick tock great transition yeah that's great i'm a professional yeah i think they should put their goals in the comments put your goals in the comments finding peeks at peaksrecovery.com yeah and we will read them and hold you accountable to following your goals for the year so anyway some things okay someone's goal wins no we're gonna do this we should do like a five second countdown and go happy new year okay three two one happy new year

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Episode 34 Meet One of Our Admissions Specialists Watch Now https://youtu.be/f3RIJuJXomk Listen Now Episode 34 In this episode we get to know our brilliant admissions specialist, Tris Sampson, as she gives us insight into her professional growth within the addiction treatment industry.

Topics:

Getting to know Tris and where she started
How her professional foundation has helped her transition into her important role as an admissions specialist in addiction recovery
She opens her heart about her passion to help people and to simply be an ear.
Tris talks about a difficult admission she walked through and how she helped the family realize that recovery is possible.

Select Quotes You don’t know what it’s like working with a vulnerable population until you're sitting in front of a vulnerable population. And then some world views of mine right away collapse, and I have a new perspective, and I realize I might have gotten it wrong at some point. And what vulnerable people really need is connective care, compassion, love empathy, they don’t need judgement, shame and pain because they already have enough of that going on. Chris Burns - President & Founder Episode Transcripts Episode 34 Transcript hello everybody and welcome to finding peaks um i am your host today president and founder christopher burns also known as uh motivational specialist got it yeah got it man we're moving up from company cheerleader yeah i got the promotion to motivational speeches it's a pretty big deal you worked hard though yeah yeah thank you man yeah i appreciate that and we have our admission specialist tris sanson sampson grateful to have her on the show just an amazing professional we're going to get to check in with today and just really grateful to be in this room because we actually all started our professional careers at the same spot we were sitting kind of talking before the show and how meaningful it's been to kind of form the shape of our heart on the ground level is kind of infantry soldiers ccas techs house managers jason was over in a psych unit down the road tris was over at cottonwood day tucson and so i was at decision point center and really cut my teeth there and just grateful to be around some professionals that form the heart in the trenches and have really carried that into their higher level positions so we'll just get it going today um we got tris to my right and tris what was unique in your experience at cottonwood day tucson when you first got that tech position and you started to see kind of client facing what pain and shame and mental health look like front and center what was that like for you sure so to be honest i didn't know a whole lot about the industry i started as an intern at a local sixth grade trying to educate sixth graders on substance abuse the fact that they were interested in it i think it's an incredible way to start that's kind of what sparked my interest immediately because

i feel like if you wait too long you wait till high school you wait till you know problems are already arising and no one wants to talk about them so the engagement out of the classes that we got was really really incredible um and then yeah so i started as a tech and they told me that i was going to be working with the adults and i thought that i was going to be working with our youth program and i was immediately terrified like i don't know how to do that i can't do that i'm in early college i've you know my friends are going out every night and i can't be doing this and all of a sudden you know the more i got to know our clients the more i got to be working i mean i was working like an animal i was working like 50 hours a week just because i loved going to work and when they needed extra people or they needed somebody to step in and i knew something about a client or i knew that a client was suffering who i had rapport with it was so easy to jump in and to acknowledge what was going on and to be like well i can i can make a difference and that was huge um no matter the age no matter the background you know the vulnerability of recovery came up immediately and the dynamic of going to college and seeing the issues with addiction and the issues just with drugs being plentiful everywhere but also going to work at a recovery center every day was tough yeah it was really tough and it made a huge impact on my life yeah and i'm sure you see too with like you're going into the party scene and then you're going out as a result the the outcomes of the party scene very quickly um and shout out to university of arizona bear down bear down bear down here we go number eight in the country right now so but i really like that too and having been able to start with young people you bring up a really great point to see the opportunity we have to shape young people and they are just like clay in our hands and then you get to transition into working with adults and it's been my experience that it's a lot like that as well because you're building from the foundation up in a new way of life so it's a really special process to be a part of to your point so thank you for checking in with that jay what was it like you for you right down the road in 1990 yeah the 1900s um i mean you asked that's a good question i went to when i went to college my first degree was going to be in geology um and then i figured out that rocks were cool but like i liked people more so i switched over to psychology um so i got i got a really powerful bachelor degree in psychology which led me to print t-shirts for two years veggie tales t-shirts as a matter of fact but then you know pretty soon after that i'm like okay i do want to pursue this a career in mental health so i got a job as a behavioral health tech it was called um at a place called saint francis hospital here in town it doesn't even it's yeah it doesn't exist anymore the actual building doesn't but um and i remember you know i kind of walked on the job and you know it was a locked unit like you have to be buzzed in and and got report from a nurse and then suddenly i'm on the floor and i'm like this is it is such a transition to kind of know cognitively about schizophrenia or about mania or about substance withdrawal and then you know as a 20 whatever year old back in the 1900s it was wild to just like see all of those things in real life um and to recognize too uh that people were way beyond those descriptors you know what i mean like those were humans those were really people that you know their their brain may not have been working as well as it could have been um but they had families and they had ambitions and they had hopes and they were severely mentally ill that's why they were in a psych unit and um and so walking through that process and actually not to really date myself um and take it on a tangent but we had a smoking room in the hospital on this third floor there was a room we let them in there was a little lighter on the sticker thing on the wall yeah and you stuck the cigarettes as they do in prison in there yeah you hold you held a little button down it was like an old car cigarette lighter anyway now i feel really old but like they don't even make them anymore um but it really kindled that that passion and desire to um to really help people and it and it spurred me into getting a master's degree because i knew i didn't want to be a tech forever as as enjoyable as it was honestly and and um you know in some ways i do look fondly back on it as well because it was just uh you never knew you're gonna get any given day for sure it was always a wild ride yeah yeah yeah that's really cool both your experiences too and just to like you don't know what it's like working with a vulnerable population until you're sitting in front of a vulnerable population and then some some world views of mine right away collapse and i have a new perspective and i realize that i may have even got it wrong at some point and really what our vulnerable people need is connective care compassion love empathy they don't need judgment shame and pain because they already have enough of that going on and so can you talk to me a little bit tris about how that heart formed at the ground level has really transitioned into where you are today as an admission specialist and what you get to do in a similar fashion with kind of a different part of the family system generally you know you're talking to loved ones i know you're talking to clients as well but what is that like that experience um now in this new position well not new position here at peaks but something you've been doing for a while now sure absolutely and i think a lot of it is like we almost become masters of reading between the lines is a huge part of my job right because you're dealing with a lot of different dynamics whether you're talking to grandma or uncle or cousin or scared friend or a client themselves every situation is going to be so different and trying to figure out where the client is at in all of that and what do they want is vital it's vital and sometimes they won't give it to you and sometimes you have to learn from family members to figure out why these people are on the phone with you right um but i think just going back to being a tech and being able to sit with clients and ask them questions as look i'm not part of your clinical i'm i'm not here as your treatment team i'm here just to help in any way that i can i'm here because i want to be here i'm here because i like public health i want to help people and that sounds so cliche but it starts to open up a bigger conversation of oh this person doesn't have access to update my family and you know reach out to my clinicians or all these things and she's just going to sit there and listen to me and i do take that approach a lot of times with families of it depends on who you're talking to but a lot of times you're talking to very very scared parents yeah um you're talking to very very scared kids of their parents um and just being able to relate and ease in a way of

being able to back the program and i trust this program and i trust this program for specific reasons here's a few of them and i don't feel like it comes off clz and it's very easy to speak the truth about it because our program is incredible and our clinical support and just the support of all teams involved is exponential so i just think that being able to get down on everyone's level um very very quickly and have a conversation with somebody yeah i'm not pinpointing you know questions i'm not reading from a book i have a lot of things to draw off of basil based on our program if anybody has questions but my goal is to talk to them what do you want right what are you looking for yeah that's really cool it actually reminds me of what madeline said you know just last week and she said listen first solve later listen first solve later and you just define that really eloquently i thought it was really awesome to to have that ability to sit in what i call and we were talking about last week which is like holding space for vulnerable people and intensified family systems and that can be really tough to do to not get in because you have the solution similar to madeleine similar to the entire admissions team you have the solution right here but to really sit back and listen i think just shows that compassion and the passion that you have for working with this population can you think of uh for our viewers and maybe families that are struggling watching this or loved ones that are struggling watching this can you talk about maybe a complex admission that you worked through and some fear that a family had and how you're able to walk with them into care through connection empathy and grace true absolutely um you know every dynamic is really really tough um whether you're talking specifically to a client but one that comes to mind i was working with a husband and wife that had been dealing with his addiction for a very very long time and the dynamic between her calling and just yelling about the addiction and i need him gone and i need him to you know get it together and all of these sorts of things but realizing and taking compassion for look you've been dealing with this for a long time and i'm going to empathize with that this isn't easy and i hear that this is hard and being able to bring her down of this isn't just on her you know and this isn't just affecting him it's affecting the whole family system and i talk to families about that often um take a second because this is also about you you're not the ones putting you know substances in your body or whatever it is but this is affecting you yeah and so then i would get on the phone with him he's like my wife's gonna divorce me i'm so worried and that's why i'm coming and all of these things and just super heightened but picking on okay can i use my phone okay how many times do i get to talk to people what does the bed situation look like you know what am i looking at and trying to draw back of the things that you're talking about are very circumstantial they're very um what's the word for it

yeah superficial and this is not why you're on the phone with me um and it's tough especially because some of the our clients that call in are very intoxicated um and then all of a sudden the family dynamic grows yeah and brother starts calling you and mom starts calling you you got to talk to trey yeah yeah tris is chris is going to fix this yeah don't call chris yeah everybody call tripp so they can say oh i am so-and-so's brother and uncle and okay all right what is your role in this how can i help educate you right um and just putting as many of the family members at ease so that it is a possibility for somebody to receive care and he he did end up coming in yeah that's that's exceptional too and just i think what you say in that too and we've talked about this before i sat and did a show with jason in 2017 and he said the addict doesn't want to be where he's at it's the last thing he wants on earth he wasn't sitting there dreaming of being an addict or somebody who copes with substances and so when the family calls and they're intensified and the client gets on and he's in they actually both want the same thing you know and that's really holding space for them and guiding them into a position to see that yes we're in fear yes we're angry yes we've been hurt yes it's a lot but we all want the same thing i can assure you there's nobody beating themselves up as bad as the person that needs this help right right and once we start to understand that and empathize with that then you can kind of create that conduit and that channel to really get people in the door and get the resources that they need so that's beautiful thank you thank you jason what has it been like what do you take from that early early experiences at the psych unit and carry with you today and it's been a long time and the field has progressed from then in a tremendous way and specifically peaks recovery but what are some of those things that you keep um that you formed in those early stages of your career

you know chris i think the thing that i that i i you would recognize it's still about me if you if you had been there if it were filmed like i just like to sit and talk to people and it is why um you know when when you're in that world like they they put me on like swing shift um through the weekends because like that's where yeah that's where the action was um and they knew that like i was down for whatever and not i mean i was also trying to learn a lot but i also wanted to learn and collect stories from people too because that's how i learned talking to somebody and watching how um how they present and what they're wrestling with and seeing what kind of interventions even at that level were helpful um and so i think what i pulled from that is is that exact curiosity in that that care um element um because again same thing nobody wants to be in a psych hospital tell you that nobody nobody is like oh it's so great you know the food is yeah yeah you get these great slippers um it's not that's not it um and so you know walking people through that and and you know i can we could spend two hours and me telling stories from that and that was back you know that's over 20 years ago that i was there but it was so impactful in carrying around some of those stories that people came in and shared um was just incredibly powerful i think yeah yeah it's really beautiful those those small meaningful moments of connection and i think brandon our ceo was telling me last week that we admitted into peak's recovery last year something like 200 clients 1200 and something clients that means that last year i sat in front of 1500 people and had a cup of coffee i mean like my world view and my our ability to expand and get to know people face to face with different world views and different walks of life has just been so precious and so meaningful to i know everybody in this room and i think that's ultimately what makes peaks so special is that there isn't a person on this 90-person multi-disciplinary team that isn't willing to take their heart out and put it on the table and have a conversation around it yeah and that is special and i just thank both of you for not only being great humans but just phenomenal professionals um and engaging our clients and the people that we serve with authenticity compassion um and love it's really really cool and um i kind of want to end with this so the uh the first i'm going to give a little shout out here so the first person that i ever sat in front of with a decade sober and a graduate degree um was one of my good friends lenny siegel and he's the owner of pace recovery in huntington beach and i just remember sitting in front of him in a cottonwood day tucson and i said to myself i'ma take your job you know and i didn't take his job but i assume the same role as he does today and tris has quite a bit of experience with lenny and just want to give him a shout out because he's one of those big hearted professionals that i think are few and far between these days and just want to say shout out to lenny i appreciate you and i thank you all for coming on the show today jason it's always great i just love these uh meaningful opportunities to connect with you guys on just a different level outside of the workspace so that's all we got today with finding peaks as i turn up the voice find us uh on your on all of your social media outlet instagram facebook the other one podcast what else are we doing oh i got a tick tock i follow peaks on tick tock follow us on tick tock we're on there as well jason you're on tik tok i just got on top we got a tick tock like two days ago i'm going to get on tape yeah i don't understand it yeah i'll show you okay so thank you so much make it great

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Episode 33 Behind The Care: Exploring Dual Diagnosis Watch Now https://youtu.be/z4UquSNnYLY Listen Now Episode 33 Our team dives into what Dual Diagnosis truly means and the deep understanding a treatment provider must envelop in order to truly help an individual overcome a mental health or substance use disorder.

Topics:

What is true Dual Diagnosis?
When calling an addiction treatment center and asking about dual diagnosis, make sure to ask what their specific approach to treating the specific disorders
What are we alleviating when treating an individual when treating dual diagnosis?
Changing the stigma that substance use disorder and mental health disorders are different or should be treated separately, and how they are actually one and the same.
What does a treatment center truly need to be equipped with in order to treat dual-diagnosis successfully?

Select Quotes If somebody comes into our program and they have depression, an eating disorder, they misuse alcohol and use cannabis, frankly all those things are usually symptoms of the same underlying driving forces and require similar paths towards recovery for all of those. It isn’t that we have separate the eating disorder, separate out the depression, and separate out the addiction, we have to teach the skills and build resilience, and in long term recovery, deal with the etiology of these diagnoses. Jason Friesema, MA, LPC, LAC Chief Clinical Officer Episode Transcripts Episode 33 Transcript all right hello everybody welcome to another episode of finding peeks i almost forgot how to do this it has been with all the whole said exciting yet yes no i didn't want to do the exciting thing though i'm trying to be new i'm trying to be new for you the viewer so you can go you know what i'll watch that guy more often anyways brandon burns chief executive officer for peaks recovery centers chief operating officer clint nicholson chief clinical officer jason friesma jay freeze welcome to the show good to be back fresh out of the holiday season into the holiday season or into the holiday season we are in spirit in the thick of the holiday season we are in spirit here yeah anyways for the viewers in the back i've been listening to a lot of podcasts recently and people start with a little a little joke oh a little oh wow little festive fun yeah conversation i'm trying to recreate a little anecdote okay yeah yeah it works for them how's it going and this is ad-free this is ad-free so that's your name you have that and we're working on it brought to you by peaks finding peaks at peaksrecovery.com let us know if you care about our jokes we haven't actually told a joke yet though happy i know okay give a story you're going to sell though to start this i had no joke i was really hopeful you guys would be on me i don't know no stay with us we're talking about dual diagnosis today i was recently at the natap conference the national association of treatment providers and they do great work at the national level in support of individuals with mental health and substance use disorders and they gather twice per year to bring treatment providers together talk about ethics and a lot of other important things outcomes and so forth in the industry i like to go in there and just talk to the marketers in the crowd just see what's going on and so um when i go up and i ask people about what they do they'll say something like well we do dual diagnosis and we've talked about this on our prior episodes you can go to addiction treatment center's websites and they will say something like we do dual diagnosis treatment so i'm sitting with this uh marketer of company x and uh they say they do dual diagnosis and i was like awesome so you do mental health primary and they're like no no it's got to have a little bit of the substance use disorder in there and i was like well this is how i i mean i'm going to let you guys explain what tool diagnosis is but in diving into it ultimately my experience is that we don't really know what that means in this industry and we really don't know what we're talking about and this is consistent across treatment platforms um namely that we're stating that we do it but what i think we're really doing at the end of the day is stating something more like we do co-occurring disorders so long as there is a substance use disorder primary tied to uh severe anxious disorder or major depressive disorder schizophrenia or whatever it is the substance use disorder has to be at the top for treatment centers to approach it but that's not the true nature of dual diagnosis nor the approach to it at least in my experience and so let's just kick this off with what the heck is dual diagnosis because my interpretation of it is that you can have a diagnosis of a substance use disorder somewhere in the past and then a presenting major depressive disorder happening now and it's dual diagnosis in the fact that they've been diagnosed but they're also not happening at the same time as a co-occurring issue which for me would mean that you could treat mental health primary within that moment under that dual diagnosis lens am i wrong am i the idiot at the conference what's going on never thank you yeah you're welcome yeah i definitely don't think you're the idiot at the conference brandon so you can just take a breath and and feel okay with that okay good thank you um i mean i do think you are right and i do think um your assessment is correct that uh true dual diagnosis um is it can be primary mental health or it could be primary substance use disorder as well i do think at least colloquially when when people mention dual diagnosis it is assumed that one of those diagnoses is uh a substance use disorder is my experience with that word um and actually clint and i are actually dually credentialed we are licensed to be professional counselors which is a mental health license and then we're licensed addiction counselors um and probably not surprisingly there's a huge overlap between those two licenses because a lot of the skills and actually a lot of the skills overlap and i think i talked about it at a previous episode of finding peaks but i really think i would like personally and and i hope as a field we can move away even from calling ourselves dual diagnosis because truthfully um the distinction feels arbitrary it feels like it's still that feels like old language to say you know what you don't have a true mental health issue if you just are an alcoholic you you just have kind of a characterological problem that you need to quit drinking that's that's where it just feels like antiquated uh conceptualization of people with mental health issues right absolutely i think it comes from this idea that somehow substance use and mental health are different like there is this like grand distinction that if you have a substance use disorder then you don't have a mental health issue which by definition substance use is a mental health diagnosis so it's again i think arbitrary in a way i think it's actually kind of confusing and can kind of conflate treatment to a certain degree um i think when you the fact is that if a dual diagnosis can be to mental health i mean it can be i don't know depression and anxiety i mean that's technically a dual diagnosis isn't it a co-occurring disorder would be any two diagnoses that are occurring and presenting it the exact same time it doesn't so this idea that substance use you have to have this special sort of substance use disorder in order to to activate these other mental health disorders in order to treat them doesn't it really it goes back like jason said to sort of old thinking um old definitions and really this this separation that you know we've talked about in length uh but that somehow mental health diagnoses and substance use disorders are different and i think that again getting rid of that language is um one good way to help try to to eliminate this sort of barrier that actually doesn't really exist yeah and the the the project here for the the viewers at the end of the day of course is just to familiarize yourself for how this industry works at least when i'm in this host seat that's what i'm really trying to get at in as many ways as i possibly can to inform you and help you when you call an addiction treatment center and they and you say my son and daughter is dually diagnosed can you help that they're gonna say yes but it's not clear to me that when i talk to treatment centers particularly their marketers that they're aware of like what that really means and what they're actually treating in whether or not there's an actual approach to that at the end of the day other than phrases on websites to get phone calls to ring and so what i'm advocating for here is certainly education and also to responsibility on the part of treatment centers that if you're going to put this stuff on your website you better do it and take it seriously because they're our family's desperate out there for dual diagnosis care and approaches uh at the end of the day so off my soapbox that's my soapbox well while playing appreciate it thank you um so and it's also too that i think um i think we were talking about this a little bit uh earlier as well too but it it does seem to be like um that we're just gonna work on this major depressive disorder thing that's in the brain we're gonna work on this sud thing that's causing the alcoholism and things at the end of the day but that's not really how treatment works right we're working on a variety of different features that are helping and supporting the individual live a better life not necessarily curing those ailments within 45 day episodes 90 or even 6 months to a year long but gradually and slowly but surely making their lives better and so within dual diagnosis approach to you know treatment if we're treating somebody with major depressive disorder for example that's going to take a while to really nurture and treat as a diagnosis so i was hopeful that maybe we could talk a little bit about what we're actually trying to alleviate in between in that time period to improve the life you know maybe it starts with getting out of bed and putting you know getting sunshine on your face and these sort of things but it seems like in a very clinical sense that the project is greater than just these diagnosed things at the end of the day yeah i mean i think i think you're exactly right i think i think it's really important you know when we consider treating somebody with uh depression um i think there are things that need to occur medications usually uh you know alternative um or or kind of new and progressive treatments like like tms like we've talked about or um other ideas uh are important and then there is an entire set of behaviors that i think that need to be encouraged and installed with people in education around how to manage depression and how to notice warning signs of relapse of depression that's i mean i i really it's interesting that we are talking about this because it has been on the forefront of our mind lately of how do we really begin to nurture um the language we use at peace to say uh to merge these mental health issues with substance use and depression and how do we begin to say like there are signs you can tell when maybe you're you're not sleeping uh as you should you're over sleeping or you're not eating as you should you're not getting the nutrients you need you've stopped exercising these are warning signs that your depression is likely beginning to relapse and it's fascinating how similar it is if you just overlay alcohol heading all in the same direction because ultimately if somebody comes into our program and they have depression and they have an eating disorder and they misuse alcohol and cannabis um frankly they're all those three things are usually just symptoms of the same kind of underlying and driving forces and literally require very similar paths toward recovery for for all of those it it isn't we have to separate out eating disorder and separate out depression and and separate out addiction like we have to kind of teach skills and build resilience and also um probably in long-term recovery you know in long-term recovery from all those like deal with kind of the ideology of it so yeah i think that what we've in the past kind of looked at is treating symptoms right like you have this one specific symptom that is presenting itself with major depressive disorder so so we go after that one symptom but that again kind of keeps us at the surface level and doesn't necessarily invite the clinician or the doctor to go further beyond that and kind of look at the systemic issues that are going on and it doesn't necessarily um you know mean that it's all about insight though and developing insight into you know where these like deep seated feelings are coming from it's also the systemic issues that come from just daily living like how do i live my life how do i uh how do i actually change and adjust my my day-to-day behavior to support my long-term recovery and whether that's in um again like jason said recovery is it's a mental health thing too it has i think that we use that term and we automatically jump to this idea of substance use but it's not i mean you can relapse from depression you can relapse from schizophrenia you can relapse from anxiety i mean all of these things happen because the again the behaviors that have been uh or coping strategies that have been addressed or adopted um essentially stop working or you stop using them so and i so this is all my beliefs all of everything that i've you know certainly wanted before i'm really energized by this discussion um so you know in that regard it it seems actually very accessible to actually provide dual diagnosis treatment right i mean take it seriously with licensures and you know the the people actually equipped to be able to handle you know the complexity of such uh diagnoses at the end of the day but so what are some of the you know so somebody comes into peaks and they have major depressive disorder and maybe they smoke pot 30 days ago but it's not a primary concern but it is a thing that you know kind of gets entangled within that depressive disorder um you know at the same time at peaks we've got somebody coming in with you know significant heroin or opioid use disorder on this side and maybe several months ago they felt you know depressed as an episode so you're treating these individuals kind of at the same time and um and then in our industry i think in the way at that service level wants to kind of just push them off into their own centers and say they're two independent things but what i hear and what i experience here certainly is that we're still looking at a brain disorder of some sort and it feels reasonable and manageable to actually have them in the same group stop talking about the darn diagnosis and what's contributing to the diagnoses themselves but the relapse potential for them and i mean call me out if i'm wrong here but sometimes it feels like the thing that's going on for the major depressive disorder you know can't get up out of bed motivated and so forth is also happening with the opioid use disorder and so the underlying behavioral issues often look the same and makes it manageable to have them in the same group and operate from that direction i mean what i thought of when you were saying that brain and like if somebody comes in um and sits and does counseling with me for instance and they have a heroin addiction you would be shocked at how little times a word heroin comes out of my mouth you know what i mean like we don't you know maybe an intake just to kind of get the background and all that like we'll talk about it but like that isn't the thing right like there's all the other things there's there's grief there's resilience there's shame there's all these other things that that are truly what we talk about and building a support system and and um and really those those all apply to whatever malady brings somebody like if somebody needs inpatient treatment for mental health issues they're they're in jeopardy too their life is in jeopardy just as much as somebody who uses fentanyl or something like it may look different it does look different but but like i said you know it's not like 45 days of heroin treatment means all we talk about are war stories and needles and and black tar and all that that that is not the case at all there's all the other things that are underneath that the the human that's underneath all that and and that so and all of in in both of those issues whether you struggle with depressive episodes or you struggle with opiate addiction there's a similar fallout in your life that has to be also addressed right like all of those those two those two diagnoses impact life in the same way they destroy relationships they interrupt stability they they completely um they create barriers to self-growth and self-insight all of those same things happen at the same time they just happen for different reasons but the reality is like jason said that uh you're always talking about the sort of underlying motivations and the underlying things that are happening and rather than just going in it's just similar similarly with depression you don't just sit there and just talk about depression i mean that's depressing absolutely worst counseling session in the world so tell me how depressed you are right now it doesn't make any sense yeah so similarly you're not gonna just say this so tell me about all the heroin you did like that is not gonna get anybody better you know there it's everything around it that is actually what you're focusing on and the reality is that life around any diagnosis is um really similar in the sense that it's it's interrupted it's disruptive and it needs a different approach and intervention strategy to help it sort of be redirected and re-vigorized and reinvigorated rather yeah love it we're on fire right now i feel like it i hope i hope it's burning on the other side of the screen yeah yeah absolutely this is good stuff with words yeah what i what i think i want to uh i'm in a lane of curiosity here now so okay so we have these underlying things so i was i was thinking about it on my drive back from natap thinking about like cocaine use disorder right that somebody has these underlying conditions for which they're operating under and somebody with major depressive disorder has these underlying you know things behavioral or otherwise that are happening and it just seems like at the level of cocaine use you hear there's all types of war stories about people who have very similar traumatic backgrounds you know happening at different times for different reasons and so forth but two traumatized people can go to the party in the club at night both engage in cocaine use significantly that night one will put it down and never come back and the other one gets fired up about it shoots off in the you know the difficult direction of having a cocaine use disorder but it seems like one person is just more vulnerable or susceptible to that in the way that the other person isn't and so the drug use or the addiction actually takes place out of that vulnerability rather than two individuals who still need to nurture these underlying behaviors this one just didn't get addicted and so maybe it goes you know unseen but this individual is still struggling deeply as much as this individual over here and if we're vulnerable to drugs are we also vulnerable to those major depressive disorder states in anxious states as well too differently than other people who experience similar symptomology well i think in in kind of this theme of dual diagnosis like um i did a lot of work with uh guys in the army coming back from iraq and afghanistan before uh fort carson here locally uh got you know kind of got the wounded warrior project and all the other things going um so i was just a community therapist and all of a sudden i i was inundated with all these guys coming in um from the field and you know i like to say like with with ptsd you know if six guys in an armored personnel carrier gets blown up two people die two people get ptsd two people shake it off and keep going it it has it and it's kind of unpredictable um to your point in there probably are factors but like we can't describe we can't predict i at least last i knew we can't really predict who's going to get ptsd out of it and who isn't but to your point like people are differently susceptible to the same the literally the same stimulus event that occurs that's what i observed happened um and i think it absolutely applies to the same thing like some people to your point try a hard drug we're like okay that could take or leave that and other people are like that is uh a glove going on to my hand that that is a natural fit for me um and and it's the parallels are just remarkable i think when you and and you mentioned a minute ago like why would this be so hard to treat these two things but because our entire industry bases upon we have two different licenses for mainly overlapping skill sets to be honest with you yeah um and i think it's just an antiquated if you ask me an antiquated thing and now yeah i don't know go ahead well i i agree i think that you know you have two people that come in with ptsd and then you when the especially when they're coming into treatment what you're seeing are just maladaptive responses to that right so one person's maladaptive response might be to use heroin another person's maladaptive response might be to restrict food you know or to maybe goes maybe they start to develop and go into these depressive states where they're completely detached from the world and their relationships start falling apart um you know it's the reality is that when it that's really what we're treating we're just treating maladaptive behavioral responses to triggers in the world right um so i think that again it this idea of having these that were we live in these sort of separate treatment worlds of mental health or addiction it's just not true i mean it's in the end it's just you know i i've responded to something in a maladaptive way and it's destroying my life regardless of what that presentation or behavior is i'm falling apart and so i need help and that's what we do right yeah to be clear too like there's there are nuances of treatment that do need to be specific right like you can't everybody just can't walk in and you're like oh you have anxiety here's prozac you have depression here's prozac you have a heroin addiction here's prozac there has to be nuanced treatment for all these things and certainly in individual therapy um some form of relapse prevention or whatever there will be individualized aspects of it but you know the overall core um i think is remarkably similar on the treatment of all these things with some little pieces of nuance absolutely certainly more similar than we ever really talk about or giving credit yeah but again yeah to jason's point like it is more complex than that or else this would be a cakewalk right yeah but there is definitely um there is definitely nuance and uh and specificity and specialization um but ultimately as i think clinicians you recognize that really you're just treating people in pain you know yeah what it comes down to yeah it it it's a fascinating hyphenated like is it hyphenated dual diagnosis or is it just good words two i think co-occurring is called coca-cola or you can like smush it together you can do it by the way yeah yeah cocaine yeah later we'll figure out the spelling of this but it's it's a it's it's language that's used all across the board i think as a society we're very familiar with it as a language and kind of what it means but it's it's interesting that it is all the little things you know sort of below the surface of the language that's taking place at the end of the day and how still within the framework of addiction treatment centers and to be absolutely charitable this is not all treatment centers of course i'm just talking about the ones i picked on at this conference uh you know and their marketers bless their hearts they do phps the uh at the end of the day uh where do i wanna how do i wanna take this out on is that though we're saying we do this how quickly it's treated as this binary thing that the sud has to be this presenting factor or else substance use disorder treatment or as a substance use disorder treatment or as an addiction treatment center we can't treat anything else that's going on if we can't minimally tie it to that sud language and so the my point here to the family systems that are watching this if you haven't tuckered out yet in that regard is to be mindful of that when you're calling places and ask those thoughtful questions about that uh at the end of the day because if your loved ones presenting with mental health as a primary major depressive disorder and they smoke pot you know or whatever the case was 30 days prior that on those excited admissions line they're going to say yes we treat dual dino yes we can handle that oh and i heard that that that substance use disorder thing in the background yeah we can definitely do that but it's not about the pod in that condition right we're treating something unique and you want to find a center that can commit to that as a project or all of its underlying features and treat those individuals equally in a room with opioid use disorders and everything else that's going on so that's kind of my general takeaway here they want to leave the crew with any final words from you guys about this though i thought you guys were well spoken oh thank you very good that's usually what i say at the end of things full stop full stop yeah gold stars gold stars gold stars yeah cool yeah yeah there's green and red too but gold's the best yeah okay that's my joke you guys got it the viewers got it too that's it for us here at finding peaks um regarding dual diagnosis hopefully we were able to dive a little bit deeper into that elaborate it on a little bit pull out some of the frustrations from that language and give you all um greater information to guide treatment for your loved ones your family members and so forth finding peaks at peaksrecovery.com questions thoughts ideas hated your jokes brandon send it all to that space find us on the facebooks the twitters the instagrams

what else is out there youtubes yeah itunes itunes a podcast yeah i'll get it right one day i appreciate you all for joining us until next time we are out

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Episode 32 A Care-ismatic Recovery Watch Now https://youtu.be/dtTU-DtN4SA Listen Now Episode 32 A special guest who is an alumni, and now a pivotal part of our admissions team, opens up about her inspiring recovery journey in order to give hope to others who struggle with addiction.

Topics:

Madelyn opens up about her beginning journey of recovery and now walking in the shoes of a professional
What it’s like to not see the potential in yourself when others are telling you otherwise
How no recovery is the same
Sit First, Solve Later - Madelyn explains how she works with families in admissions
Madelyn’s advice to families who are on the edge of seeking help

Select Quotes It’s not always point A to point B. That is so important, and that is why I am so passionate about the admissions team. Because everybody that walks in the door their treatment is going to look different, it’s not going to be the same. And I love that we actually have the ability to honor that, that everybody gets an experience because their needs are different. It’s awesome to be able to say it, and it actually be delivered. Madelyn Padilla, UN Admissions Specialist Episode Transcripts Episode 32 Transcript all right hello and welcome to another episode of finding peeks i think it's a lot of funny peaks so if this is your first one you've got some catching up to do um i'm joined uh today on my left chris burns and my friend hello everybody uh and what is your title um well i'm the president founder but we've been working on some other titles it was cheerleader motivational specialist motivational specialist chris burns uh living up to that title often and to my right i'm very honored to have uh madeleine padilla an admission specialist for us here at peaks um and i think actually more importantly an alumni of peaks and i can't have an alumni on this show and not kind of ask about your experience at peaks from a personal perspective and um and kind of when we were talking about beforehand we don't really need to talk about the problem that brought you to peaks but i'd love to hear kind of what your first impressions were uh let's start there sure because you walked in yeah absolutely um it was a bumpy ride it was a winding road

there was no part where i felt like things were easy or simple or like i was going with the flow it felt like it was a lot of paddling uphill until it wasn't anymore you know and a lot of people were around me supporting that process um just letting me kind of find my own way i've been described as strong-willed in the past really i don't know i don't know where he comes from strong-willed in the past and you have to roll with that you cannot roll against that and if at any point i had felt that people weren't rolling with with me around me wrapping around me that just wouldn't work for me personally i know that so that that's it was bumpy ride yeah kind of that idea that like walking with you and not in front of you that's correct yeah yeah yeah that's a beautiful thing that i got to experience with you and it is it is that energy that you don't want to come up against and say don't do that stop we really roll with that because i think that's something that makes you very unique and special as a professional mean you don't want to lose that zest that sparked that passion and so if you can kind of work with it then you get the result that's sitting in front of us today which is a woman in long-term recovery with integrity and grace and a phenomenal professional wow yeah do you like what moments when you think back on your time in peaks what moments stand out for you okay good or bad okay well i have i have several um one right after kind of the detox process i was detoxing off of opioids so it was rough it was not easy and i got bronchitis at the same time you may remember this and i had my rescue inhaler and i slammed it down somewhere and i'm like today's the day i'm leaving because i i did my detox and i still feel bad of course i felt bad i had bronchitis right but i'm like they they failed me in some way or what this is bs right so i take off off the property and um cara hinkle who's been on the show i'm sure before yeah um she came rolling down in the van just frantic looking all over and she said are you okay and i said i know you want me to come back and she said i'm not worried about that you left your inhaler wow i said well you're get away from me but also come here and give me that give me that and she wasn't trying to tell me what to do she didn't tell me i was wrong she said i'm worried about you because of the bronchitis if you're gonna go please take this with you

dang i never knew about that yeah i didn't either that's a great one i told her she's harassing me get away from me after you're harassing me and then tell us what do you remember from later in your treatment oh my gosh um i i mean like i don't know hope i guess that that maybe things could be different i mean it took a really long time for me my my biggest fear walking into peaks was that was going to work i mean i was so scared i was like if i if this i can pull this off or something actually shifts here what does that mean for me later what does that mean for me five years from now what does that mean for me and that was like inconceivable that was a tough i don't know a tough way why was it so scary

i do think that there's an element of like you you have the life that you think you're worth and you're good with that you know and i was good with that i really was okay with that um and other people seem not okay with that like why are you not okay with that it's my life you know and i couldn't i could not recognize the potential i just could not um at that time but other people seemed to and they kept telling me things you know different things like they could be this way or like uh rachel tap you know she used to tell me every day like you're going to help a lot of people i'm like you're you're crazy

i thought two things i said you know she's blowing smoke you know or i fooled her like i really tricked her i got her you know and then the things that she told me would be true that happened they really did and that's uh that's all i have to say about that that's beautiful absolutely yeah it's interesting too when you in that old lifestyle i love what you said there because we we define a lifestyle we're okay with the lifestyle of which we're worth that's right um and at the time you know for me when i got sober this esteem i was devoid of any sort of esteem and so i was comfortable in my misery and everybody around me is like but there's this thing and you have this potential and there's this opportunity and i just couldn't see it and it's like one of those situations in recovery and it's i come around at every corner and even with 13 years now i'm like i got to get up on this step to be like oh [ __ ] there's that other problem or there's that solution that i could have never seen or integrated otherwise and i think what it takes oftentimes and to your story's credit is it takes a tremendous amount of trust yeah right i gotta believe in the journey you're describing i got to believe in the hope you're describing i got to believe in the walk you're describing and so i have to have great people around me that i can trust and it sounds like in your experience that there was a few people specifically kara and rachel and some others that wrapped around you that you believed in i did that you trusted right um and that creates a lot of safety and when we can get safe you know we can move through and we get outcomes yeah um that you walked through and jason yeah we had a lot of weird on the fly sessions i don't know you know and that was so like thinking back on it was like it's on my time you know we're gonna do this when i want and and whatever and there was one time where he pulled me he pulled me in to his office and i was just direct i don't know what was going on it was just chaos you know just emotional chaos and he didn't say really anything to me but he sat we sat there for a long time and he said you want some cake i was like what he did and he just brings in a piece of someone's birthday and you brought me a piece of cake we just sat there and regulated for like

i don't know too long long enough you know and and that was meaningful and a lot of the the most meaningful stuff is happening in in seemingly meaningless exchanges you know or very mundane exchanges and that's that's powerful and when i think back to my experience at peaks all of the really the big ones that stick was not always what was happening in my treatment planning or was not always it was what was happening in life my life there you know and yeah lots of opportunity and there are opportunities all the time to connect with someone all the time well i appreciate you sharing that story about the cake and i do remember that and i i said yeah yeah okay cool yeah

but i do i do think madeline as i i when i think about you too i think of well a hud trip you did and you led a meditation that i still find to be really profound honestly and i still contemplate it from time to time but i do think um at your graduation when i told you too that you there's like a path through this recovery program and you took no steps on it like you wandered around and meandered around and did it the madeleine way but you you did it right um and you ended we needed to end and you had to do it the madeleine way and i think to your point like um peaks i think you know we've had to change a lot with with covid and and just with um the market and all that like our program isn't necessarily identical to what it was as far as length of stay or what it all looked like um and and some of the things we did however i think we've we've worked really diligently to carry our heart through all of that if the soul if the soul was not the same um i don't think i could have come back yeah and worked here i needed i had to feel it out and guess what was the same it was the thing you walked in the door you could feel you could feel the the energy you know and jason what you're saying about it's not always point a to point b that's so important and that's why i'm so passionate about the admissions piece too because everybody that walks in the door their treatment's going to look different yeah it's not going to be the same and i love that we actually have the ability to honor that that everybody gets a different experience because their needs are different yeah and that's cool to be able to say it but then it gets delivered it's a big deal well i think i think we've talked about it on finding peaks but i want to i i'm reminded of it again as you're talking about it that like so much of doing good work with people doesn't occur at formal appointments some of it does these are important um but it is those between moments of being a human and and giving you an inhaler when you're expected when you're expecting shame or like guilt or whatever and just showing up and being a human and and uh having a a piece of cake with somebody even if it's in quiet um just to regulate i think that that's i think the piece that i think we've had to be really careful to kind of make sure that we don't lose as we've grown and expanded and and walk through uh the last few years like i think it's been really important um that that part maintains and i and um and i think that goes all the way back chris to when you started peaks too if like this wasn't necessarily centered around clinical aspirations this was centered around just helping people who are suffering right and um and i think we've done a great job of building a clinical and medical program around that but it is still that heart i think that has been so important yeah and i think also too to your point is like even when i think back to 2014 2015 and 2016 one of my big pressing issues especially with the young women in programming and the men we're like we need to be of service to vulnerable people and we need to make sure you know the most vulnerable person is the guy that's walking through the door and i used to have a rule that if if that family gets out of the car and grabs their bags before everyone in this house we're all done we're not doing the family activity this weekend we're just gonna go to aaa we're not gonna do it because it's so important and that was in 2014 and 2015 and that's what we really lived in i think in 2021 we actually do that better we are so connected and the care that we're bringing out to that client's car for lack of a better term is so much more broad so much more integrated and so much more intentional with our ccas being trained in mental health with our cca's doing peer recovery coaching with a lot of the stuff we have now that the connective tissue i'll call it um is stronger than ever in my experience and i'm i keep thinking of the the story in that book what happened to you and when she was defining those small meaningful moments with her mom and this was a young person who had done a lot of really cool stuff and they said what's the one thing you remember about mom and she's like eating cheerios with mom at night totally yeah 15 minutes i eat cheerios with mom at night and that's what i remember man and that's the story of peaks is these small meaningful magical moments where we really can connect and that's what i believe the whole industry is

well missing at look at what you remember it isn't i mean we planned groups we had all kinds of clinical interventions that you planned and it was some stupid case study in an office yes i'm sticking to that no but it i i think it just shows how important every interaction is and and really um you can't fake that stuff either no um so i did want to tie this into you and how it informs your role on admissions if you get a call from you know a loved one of somebody who is struggling in addiction how do you find those moments with them or what are you looking for as you're talking to them set first solve later set first solve later we don't have to i know it's the solution i've lived it i've been there i get it but sit first and that's hard for me yeah i'm so passionate about where we can go with this sometimes i start at the wrong end and i've had families politely but respectfully back me up to to what they're actually dealing with right now and kind of ease me into that and then i get a chance to sit first and then we can we can solve afterwards that's important yeah do you have an example of that like when you sat with somebody obviously without sharing too much specific but like give an example of when you've had to slow down and sit with a family well actually as you're thinking of that i was just sitting um with somebody else in the admissions department like two hours ago and they were telling me how um just an empathic statement of like she had gotten a call and just said the family explained the situation and and this person really genuinely just said well that sounds really hard and the family stopped for a second and was like nobody's asked me that right or nobody said that to me nobody's found that and this is about them right they're like no no you misunderstand this isn't about the family this is about them it's their problem and i'm going to just suffer through it yeah and we got to slow that down what what has this actually been like for you and be willing to sit with the answer because sometimes it's hard yeah and it's and it's ugly you know and it's tough but even to be asked that it takes people off guard you know and then they have to think oh what has this been like for me you know and that's where family programming is so important to you yeah wow sounds like that's been hard please come come to this thing come on and it's not about them and their process it's not about we don't care what joe used to be what about you and that and that's important because if that system doesn't heal and and family and their you know their loved one is reunited and it's not at least supported or wrapped around or healed in some way i just don't think it's as successful so that's also exciting to be able to offer the family piece that's a big deal yeah most definitely yeah offering that family piece absent of the individuals he's doing he and she they're doing their thing he's eating cake yeah you know he's fine yeah he's gonna have breakfast lunch and dinner he's got a team wrapped around him yeah and that's what i love really with peaks differently than other programs that i work for and differently than what we've done in the past with pigs is we have this family curriculum that just runs alongside the clients curriculum as well and so to your point when a client gets out of care there's not this huge communication gap it's actually integrated within the family system and now we can begin to communicate in a more appropriate way and it really starts to build the building blocks of that foundation for the family system and to sit down there on campus with these young guys and mature adults and young women and to to watch them light up when they hear that my family's doing their therapy yeah and going to their groups and doing their six-week thing i mean they're almost brought to tears just as a result of their willingness to engage in the process with them so it's a really beautiful thing absolutely i think this is my last question for you madeline but i i was wondering what um if there are some families that are watching this and they haven't had the courage to call maybe a program or an admissions line um is there anything you can offer them as they are trying to figure out what to do with the loved one who's suffering with mental health or substance use

call me i mean obviously

and sometimes it can start with the conversations and sometimes it we don't get resolution yeah there is no solution they're not coming you know and that happens and and i personally engaged in these relationships with someone weeks sometimes months and we and we just talk sometimes they come sometimes they don't and it it's still valuable it still matters yeah i love that because that's that's everything for me it's like that seed gets planted there was this person that held space for me i called peaks cover recovery sat there for 30 minutes didn't sell me on anything i called back two weeks later sat there for 30 minutes didn't sell me on anything that's that seed because ultimately when the time comes where the willingness occurs they're going to call you directly that's right and that's that's a beautiful thing and that's that's what we've always said on the admissions line with peak's recovery and brandon's been a huge component of this he's like we don't care if it's medicare medicaid you sit with these people you find them a resource because they're calling because they need one and so i think that's something we do really special and just draws right back into that carrying recovery and the idea that nobody cares what you know until they know that you care and i do think it's important to know to note that we're actually like as admissions specialists given the space to do that and i've seen both sides of that if it's not qualified jimmy's not coming in today right move along move along push them off the phone right i i've had my supervisor aaron who unfortunately could not be here today she's told me stay on the call i've got your back an hour goes by two hours goes by and then the wrap around how was that are you okay how did that go do you feel okay about that great call i don't i've never seen that person we're never gonna see that person great call that's huge that is that's pretty cool i don't even know that i kind of got you i didn't know that either and uh that's great yeah yeah that's how we wrote that ass team best admissions team i've ever seen not even close let me know who's second i couldn't agree more um i i can't think of a better place to end other than on that i i really appreciate you kind of last minute joining us today i really appreciated it and um i really uh i love the heart of your story and and i want to say this this is you know we've had angel on here you're on here now like this is who answers our phones and um and it isn't about hurrying people through a process either i've listened to some of those calls too and that they are they're powerful um um and i and i love that just styling peaks number means that we do care right out the gate so um with that i think we'll go and sign off i invite anybody watching to uh follow us on uh instagram probably facebook spotify uh wherever you get your podcast that's how i choose to watch these so or listen to these so anyway that's it have a great rest of your day

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Episode 31 Meet Our Director of Outpatient Services Watch Now https://youtu.be/Ozmg7wR5wo4 Listen Now Episode 31 Our special guest, Rachael Tapp, gives us insight into her professional growth within the addiction treatment industry.

Topics:

Rachael opens up about her beginning steps working within addiction treatment and finding her calling in helping others.
How Rachael navigated working in addiction treatment though not experiencing addiction
Jason, who was one of Rachael’s professional mentors, gives his viewpoint on her development.
How do you hold space for someone, and why do you do it?

Select Quotes Empathy is knowing our own darkness well enough to sit in the dark with another. And that is holding space, just sitting in the dark with another. You don’t need to bring solutions, just bring yourself, and just meet the other person where they are. Jason Friesema, MA, LPC, LAC Chief Clinical Officer Episode Transcripts Episode 31 Transcript hey everybody and welcome to another amazingly phenomenal edition of finding peaks uh grateful to be here with some of my good friends and colleagues we got jason friesma chief clinical officer um lpclac that's it that's it lpc uh licensed professional counselor we have rachel tapp who is our outpatient director correct and my name is chris burns i am the president and founder currently but i'm working on another title um also known as motivational specialist motivational specialist so grateful to be here today on this thursday i really love coming in here on a thursday because i spend a tremendous amount of time on the client level on thursday and i'm reminded every thursday and every friday when we get to do crossfit with the clients and kind of run a circle and check in group why we do what we do and why it's so impactful and there couldn't be two more professionals sitting in front of us today that share in that impact and so really grateful to have rachel on for the first time rachel started with us new year's eve 2016. and she actually before the show described her first shift as being pretty intense with not a tremendous amount of training but peaks recovery in 2021 has a great training program continued education you name it we're here for you but maybe talk with us a little bit about rachel um kind of the early professional stages i know you worked over at parker valley hope um and then transitioned over to peak's recovery through a friend of ours named robert jocelyn and yeah a great professional in the community and may just talk to us about that transition and kind of the roles that you've assumed um and stepped into and been promoted within and we'll start there okay um yeah i i started my journey in this field at uh peaks recover nope at parker valley hope um and i think that that was a really good um like stepping stone for me i think i that was where i i think i i found my passion at parker valley hope like for the field um and yeah i mean like you said i i knew robert jocelyn uh he also worked at parker valley hope and then um yeah i was there for almost two years um and it was i mean i learned a lot i completely um you know i was immersed in the in the work there um and i really enjoyed it until i um didn't and um and i reached out to robert who was working at triple peaks and um he yeah i mean he said that there were some positions open and i reached out to him and um and angelica was actually the one who interviewed me initially um and i'll never forget because she did ask me who my favorite superhero was um and i yeah yeah it totally threw me off guard i was like wait what like why why do you care um but yeah it was it was a really interesting question um wait but who's your superhero yeah okay so listen

so i said um i said ant-man oh my gosh that's yeah i'm not really like it wasn't small at all yeah because i i'm not like a superhero really person yeah ant-man small but like powerful but i'm also not like small like i'm not sure yeah that's besides the point um yeah and so i um i interviewed with her and she offered me the position and things uh got better at parker valley so i stayed um so i declined the position and um yeah and there was one day that um i was praying and i was questioning you know if i was supposed to be working in this field like what i was supposed to be doing and angelica called me the next day and i told her i was like listen this is crazy that you're calling me um and she told me she was like rachel i called you because i had a gut feeling to call you um and so like from there on i told her i was like i don't care what shift it is i don't care how much you guys pay me like i'm in um and so i started as the weekend house manager and that's when we stayed on for however many hours

yeah it was great yeah so i started with that and i think uh during you know the house manager position i um i learned that i learn best being thrown in to things like that um i so there like you said like there wasn't a lot of training but i think that that's exactly what i needed um and i don't know if you know this but it actually just reminded me i remember when we hired you and this was you know 2016 coming into 2017 we're talking four years ago yeah and i've grown in the field and our company's grown a tremendous amount but i used to think in that residential director positions like you have to be in substance use recovery you have to and i remember when they hired you and i maybe even told somebody i don't know that she's going to be really functional in this role she's not in substance recovery and to counter that point rachel was the longest standing person in that role was probably the best individual professional we've ever had in that role and very quickly i was shown an opportunity for growth so i just i wanted to share that oh my gosh i didn't know that yeah thank you for sharing it sure yeah yeah now i've come a long way i'm like you actually don't you probably shouldn't be in recovery at least that kind of recovery so yeah well and i actually i i appreciate you sharing that with me because that was something that was really hard for me for a long time like i doubted myself um quite frequently actually um because you weren't the only person who had that response um but yeah i i learned a lot in the house manager position and i remember interviewing for the residential director position um and i mean you remember yeah i do yeah you were there again it was jason and corinne and jason asked me what i did for self-care um and this was a turning point for me as well and jason and i talk about it all the time but my response for self-care was that i sleep that was what you said yeah that's honest just like really embarrassing yeah um but i've uh since grown a lot in the self-care department it's been improved um in the residential director position i i mean i learned i think i i learned a lot about myself in that position um so i learned boundaries i i didn't even know like what boundaries were you know like i was working i don't even know how much i was working and i remember um yeah i remember going to jason and i was like listen like i'm not like i can't do this anymore um and he was like well you said are you running toward or are you running from and i was definitely running from um and that's when we implemented the counselor on call because i was on call yeah became my problem yes yeah well and i think like what that taught me was um what actually happens when you ask for help and like when you like put a voice to what you actually need and yeah i i think mostly boundaries in that position um and then the residential operations director so when i transitioned into that role i think that was when i learned a lot more about um like the professionalism and like the more professional piece so that was when i you know i was invited into the leadership meeting and i mean i think that meeting i um yeah i learned how to regulate my emotions in that meeting uh which was hard but i i think i i don't think i learned the hard way i think i've learned beforehand um yeah but uh a lot of professionalism and just like how to carry myself i i've always known that i have like a lot like this this presence and this energy but i don't know that i never i ever really knew what to do with it and i think in the residential operations director position i think i kind of learned um and now i'm in you know the director of outpatient services position and i think in this position so far i've i've learned um i mean maybe like my power um and

um like autonomy i think i've i've i've felt a level of autonomy and a level of guidance like the perfect amount of autonomy and guidance um yeah and i mean i just continue to learn about myself professionally and personally that's phenomenal too because we come from such a generation and recovery of experience strength and hope experience strength and hope what's your experience strength and hope and most people coming into treatment when you first started were like what's your experience strength and hope how do you share experience strength and hope because rachel was somebody in those rooms that's guiding a circle process and so she's in there checking in with people about their day checking in with cravings checking them in with triggers checking in with how we're doing behaviors how are we eating how are we sleeping and never having been in their shoe how do you navigate that process so well uh so like i said that that was something that was really hard for me i um so from my experience what would actually happen is you know like the clients come in and their first question is like what's your drug of choice and you know like i i learned this the hard way you know i would say well you know like i've never like i don't have a drug of choice i've never used drugs um and i could see immediately like the the wall go up and the the the client without saying it would say um like oh you don't get it you don't understand me um you're not someone i can relate to and so um and this is something i actually walked through with one of with lauren um because uh you know it was really hard and i experienced quite a bit of shame about it um but i think what i what i can relate to is the feelings um so like my response now is you know i've never been addicted to a substance but i know what it feels like to be depressed and i know what it feels like to be so anxious you don't know what to do with yourself i know what it feels like to be um like despair like i know shame i know all those feelings so i think um you know that's how i can relate to our clients now um those that have you know substance use um issues and that i mean i i think that that is almost more like powerful most definitely and to your point what you just shared i was in circle this morning and a client of ours um was talking to bobby actually and said hey you said something to me when i was in detox i want you to know what really helped the way that it shifted the way that i looked at this he's like i thought i was coming here to learn how to not drink which to me meant unhappiness a life sentence of unhappiness and you came in and said you're actually here more to learn how to be happy yeah than to learn not to drink and something so simple like that because it's not and maybe you were the front end of this new progression at peaks because it is so not about coping mechanisms right it's about pain and shame of which most humans can identify and relate to if they give themselves a chance and so i really love that too because it's it pushes it in the direction that it needs to be i think we really would do ourselves a service by quit talking about substances and drug of choice and war stories because it doesn't matter we talk about the stuff that really matters and that's pinging that intensity to get loaded to get high to escape which is pain how has it been for you kind of being because i know jason's been you know somewhat of a mentor and you know it's jason who will ask clients and as well as professionals and his friends really good caring questions like are you running toward are you running away what has it been like as a professional who's been doing this for a tremendous amount of time see a young professional like rachel really grow and flourish as a result of a little bit of guidance and some passion

chris that's a great question and i think um it's been

i mean it it's why i'm here to be honest with you um i've done private practice work i've worked i can i can do counseling kind of wherever actually um not trying to be rude but like the reason i'm here is because of our team and because of um really the tone from from the moment i started at peaks has been to support clients but also to support each other and to and to be a group of people who are um well they're they're here to um be here for one another and and honestly we spent a lot of time at work uh especially lately and uh and frankly um to be able to care and have genuine conversations with people and and to provide a little bit of mentorship or ask a question here or there um or just offer a word of support or um you know have somebody walk into my office close the door and be like wow this is what's happening in my life um it's been a great honor to be honest with you and i think um what you said too and what we probably didn't see four or five years ago when we were doing this is we were setting a stage to really not just help people struggling with substance addiction but to help people that are just struggling um with life and with with depression and with anxiety and with um but with life basically and we had created such an environment that to invite people in that maybe don't identify with any substance of choice like they can come and receive help at peaks too whereas four or five years ago that wasn't the case um and i really related to what you said to rachel um because i was actually the first person peeks hired that wasn't going to aaa wasn't in recovery actually and like mayfield uh yeah that's true i did have me and bobby were like i bet he's got 15 years bobby's like i think he's probably got 20. yeah of recovery so i appreciate that

from you guys that's a really good compliment that you thought i was a heroin addict yeah that's 15 years ago yeah some people might not think that's a compliment but it was but like but in all seriousness like um i know that was outside of your comfort zone to begin to add on people who who thought maybe a little bit differently or came at this a little bit differently um and but what it has done and i think it's really been able to like free peaks to really elevate itself to provide care specifically um to just anyone who's struggling with anything and we can find the empathy for that yeah i really appreciate you saying that and you bring up a really good point too and something that i i know i don't think makes peaks really unique is professionals like jason and professionals like rachel who are willing to sit down and really hold space for people and it's been the first treatment program that i've been a part of and most certainly i'm biased but i watch our team every therapist ccas even holding space for people and it comes from the top down and the ability to sit with people after they hold space with people which can be a really intense situation so i just kind of want to end with how do you hold space and why do you do it

uh so i think it it varies um so for me i think you know you talked about it earlier like the attunement um you know and just being attuned to the client and quite literally meeting them where they're at you know like we talk about it all the time like just meet them where they're at meet and where they're at and i think um holding space is like a different level of meeting people where they're at um yeah i mean and for me like uh i ask you know like what like what do you need right now do you need me to just listen do you need feedback and just sitting there in the uncomfortability um and why do i do it um

i do it because i want to be able to um honestly i want to be able to do something different um i think my you know growing up i think that that was kind of something that um wasn't always welcomed um and so you know it it is kind it's like personally i just i just want to do something different yeah i love that how about you um i'm going to use uh pema children's words who said that um empathy is knowing our own darkness well enough to sit in the dark with another and that's holding space is just sitting in the dark with another yeah you don't have to bring solution you don't have to bring you just bring yourself and you just meet another person where they are i love that yeah both phenomenal descriptions you know in in my experience in the field and in recovery there had been a time where i was just unable to hold space i wasn't at a spot in my recovery with my pain and my shame in order to sit and really what i consider holding space today is leaning in and really leaning in and sometimes clients and people they'll deliver information out that pushes a lot of people away and i think you all do a phenomenal job when that information comes out of just getting closer and leaning in and it's been my experience over the last year and a half most certainly in the pandemic it's like you can feel the trust build when you lean in and hold space and it's just like the client wants to get closer the professional wants to get closer and it becomes much more connected so i thank you both for coming on today it's been phenomenal just checking in about fun stuff that i love to talk about which is passion recovery champaign all of that stuff yeah i really appreciate it great thursday to be here um that's all for finding peeks today please find us on instagram facebook wherever you get your podcast we'll be back next week it's been an absolute pleasure be great

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A Grateful Thanksgiving Watch Now https://youtu.be/PWBrPEzcoi8 Listen Now A Grateful Thanksgiving A warm Happy Thanksgiving from our Peaks Recovery Family to yours! In this short and fun episode our leaders share what they are grateful for, and give their personal thanks.

Topics:

Jason Friesema shares his gratefulness and thanks
Chris Burns shares his gratefulness and thanks
Brandon Burns shares his gratefulness and thanks
Clinton Nicholson shares his gratefulness and thanks

Select Quotes Grateful and thankful because I truly do feel like I am a part of something special. It’s out of that great energy that we continue forward with quality care and saving people’s lives each and every day. Profoundly filled with gratitude for all of that. Brandon Burns, CEO Episode Transcripts A Grateful Thanksgiving Transcript all right welcome everybody to a very short episode of finding peeks today really it's a holiday season we got the thanksgiving coming up in that regard it's literally today it is literally i guess it's restored i'm obviously around all of the hosts today and the people have been you know continually a big part of this here at finding peaks and so a lot of energy in this room trying to um level one up over me at this time it's okay i'm i'm secure in my host seat now at this moment but really today we just want to start with what are we grateful for here at peaks recovery centers and just take this brief opportunity to share that with you all and um i know i'm grateful for the past year a lot's gone on here at peak's recovery but don't want to kick it off with me i think in general fashion as i do we'll lean right into jason friesman chief clinical officer of peace recovery centers and jason what are we thankful for here let's go well i gotta say this is uh when that question was posed to me i actually reflected on just a few weeks ago i i was interviewing a clinician candidate um who i think probably pulled the question off of the interweb on what to ask during the interview and she asked me what my best day at peaks was and i said my best day is actually today because it was wednesday and wednesdays are the days that i get to meet with the clinical team and so i'm just so incredibly grateful to be able to be a part of a team um that is uh diverse that has different perspectives um that passionately carries forward the division that we all share in this room full stop love it love you man yeah absolutely yeah um well we'll just let's go around the room here all right good counterclockwise counterclockwise yeah chris burns president founder of course if that was or also known as uh big burnsie cheerleader no he's emergency he is our motivational specialist yeah yeah i like that definitely yeah because it was cheerleader and he's like no it's gonna be like motivational specialists yeah um you know i was just chatting with the guys before the show um i'm grateful for a tremendous amount today the last year has been wildly intense with the pandemic i'm reminded of this week a year ago this week and that was a time when we unfortunately had to shut down our women's program we didn't have any testing supplies we didn't understand the pandemic like we do now um and for guys like brandon and i um who have showed up and clinton and jason and all of the team that have showed up and poured their hearts and souls into this thing last year was a very real realization that this could go away and that was very scared sad somewhat hurt because it was so much out of our control and i'm grateful to be sitting in this chair today with great team members by our side and in addition to that i'm grateful that peaks recovery is here to continue to help vulnerable people and really more than anything i'm grateful for the team's trust throughout the process i'm a young professional i started young i make a lot of mistakes and the team has just really trusted us throughout this process and gotten behind us and it's just really meant the world so i'm grateful to be sitting here today in a peaks recovery center program who can help more people today than ever and is stronger today than ever so i just couldn't be more proud so thank you thank you thanks chris um it's powerful uh for me um yeah it it really you know i got elevated to the ceo role in i think june or july of 2020 and uh you know didn't understand or know what was what i was really you know becoming a part of in a really big way in that regard and you know the pandemic caused a lot of strain on our staff on our company culture and that strain led into kind of the closing of our you know our women's program uh this time last year in november and there was just a lot of hurtful things and fear that was created for myself in the process and to come into 2021 and to have you come into the role of chief um operating officer as well too which has just been a tremendous value to this company culture i think collectively there's a lot of people missing in this room who've contributed to the success of the company in the last year and the continuation of our mission to save lives um but we showed up in a big way and i think we've learned how to uh manage a company culture in a way that we've never done as a you know kind of thinking of what you were stating chris there's a there's a certain immaturity that takes place for young you know business owners and leaders in that regard and you just don't see everything that you could be taught in you know a master's program and so forth in business and school and um so to be here in this state to be serving women again in programming to have a robust iop program that i think is just invaluably serving that side of our patient demographic to have the health to look forward as leaders in the organization to our team meetings and everything that's brought to us in those moments just grateful and thankful because i really do feel like i'm a part of something special and it's out of that energy that we continue forward with quality care and saving people's lives each and every day and just profoundly filled with uh yeah gratitude for all of that so thanks friend all right top all that yeah jeez that's a it's a high bar all right well i will do my best deep into the field i'm gonna have to crack that door open all right here we go uh like you guys mentioned um it was a year ago almost exactly this week that the women's program closed um and it was actually a year ago uh last week that i started so i i walking into a new job into a new role into a new company and within days having about 30 percent of it shut down and watching staff go away and and seeing this and seeing um a real true impact of what a pandemic can do to not only to a business but just to individual lives and the way that it impacted um people in need who didn't have access to treatment because of that was that was really pretty poignant for me and um i had a very real moment where i had to ask myself should i stay and it was uh yeah and i decided that i believed in this place i just started but i for some reason i just knew that it was the right move and i am extremely grateful that i made the right decision so thank you guys thank you thank you absolutely well i love you guys glad we could take this opportunity to share in this special moment together and you know celebrate uh thanksgiving and our what we're grateful for here at peaks and you know again as we uh go into the holidays collectively all together in this regard you know give grace to your loved ones addiction and mental health is a real thing um i know not all families experience it but many families do and so just give your loved ones grace and there is hope there's places like peaks other excellent opportunities out there on the other side of the holidays in that regard to get help for your loved one in that regard so um love you all thank you so much for being with us for walking through these episodes with us and uh looking forward to the next episode on the other side of the holidays take care everybody happy thanksgiving happy thanksgiving

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Episode 30 What is Medication-Assisted Treatment (MAT)? Watch Now https://youtu.be/l5asH5mYAIM Listen Now Episode 30 Our medical team guides us through the meaning of MAT within addiction treatment and how the intricate aspects can provide hope and stability for those struggling with substance abuse.

Topics:

What is MAT?
What is happening in the brain with addiction cravings, and where MAT can aid in rebuilding a normal behavior type.
The stigma attached to MAT, and how the shift from abstinence to Harm Reduction is effective in addiction treatment
How MAT cultivates hope and stability
What creates an effective MAT program?
The types of medications used within Peaks Recovery Centers MAT program
How long is an individual enrolled in a MAT program

Select Quotes I’m thinking back to 2 years ago when I came on board and we opened the detox facility, and our model of care was very abstinence-based at the time. We would have a client that comes in maybe with an opioid use disorder, they’d do their 7 days of detox on suboxone and are thinking at the time that they are done with their taper, now let’s begin their other medications and dive in with therapy. And what we were seeing over time is more post-acute withdrawal symptoms. When they were discharged out of our care, the rates of relapse were higher because those cravings were still so high throughout the treatment stay. So now integrating MAT we are able to control those cravings and follow them through their MAT treatment and adjust the doses based on cravings. The client also now has the opportunity to meet with our provider and talk about where they are at in their treatment and adjust as necessary. And now furthermore opening our IOP program, we are able to continue that MAT treatment through IOP which gives us more time to find quality resources within the community so that they can continue on this MAT treatment program for as long as they need. So we have seen such a turnaround going from an abstinence-based to more of a harm reduction model just because we did research within our own facility. Kalli Kintz, BSN, RN, Director of Nursing Episode Transcripts Episode 30 Transcript all right welcome back to another exciting episode of finding peaks i i was actually thinking about this before this started and i always say exciting episodes of peaks yeah like is that people are just yeah like just can't just can't wait more brandon more in the background so i hope it's as exciting for you as it is for me uh at the end of the day so exciting episode we talked about it a few weeks ago or at least have promoted it uh joined today with uh medical uh team members uh here at peaks recovery centers uh dr ryan johnson uh md and he is our medical director and director of nursing cali thank you kelly i am spacing on your last name thank you i was going to say kind so i'm glad we got that i dressed i'm new to this everybody is watching first day chief operating officer clint nicholson everybody hello everybody so very excited to be joined by the medical team i think they've got a lot of great things to um help educate on in regards to medication assisted treatment or mat as sometimes you'll see the acronym out there in the world of the addiction treatment space and so in good fashion let's kick this off with what is medication assisted treatment our friend matt our friend matt who is matt we'll find out um so matt is medication assisted treatment and it's a program that we've implemented recently here at peaks to kind of target the cravings of an individual that comes into our program specifically for alcohol and opioid use disorder so swift and to the point wow way to deliver that so i guess in in this way let's let's complicate it a little bit let's nerd out a little bit for with you doc you know uh dr johnson um how does that work within the brain what are we looking at here so the point of it is to cut cravings people crave less they use less and so the first question people had to figure out is what is a craving and what's going on with it so when we have something pleasurable in our body a pleasurable experience like we climb a fourteener we win a marathon we have a spike of a chemical called dopamine in our body and it's basically the pleasure chemical addiction hijacks that chemical so it usually hovers let's say a range between 5 and 25 25 is when you win the marathon when you have sex when you win the lottery five is kind of what you need to get out of bed all not all but almost all chemicals that drugs of abuse cause that to spike irrationally high it goes up to 100 something you can never get in real life and that's why people love it that's why they why they go after it

the medications that we use cut that craving that cram craving is a memory of that initial event of of that drug use and when we when we have that memory in our brain we actually have a spike of dopamine again just a little spike but it's just enough for our body to completely remember exactly what it felt like and we crave and then we go back and we relapse and then so the medications are supposed to stop that and so there's two two different ways they can do that um one is what suboxone does which is it replicates it binds to that dopamine receptor in a way that keeps it from going up higher it kind of gives you a little bit of that satisfaction all the time and so you don't get the big burst and the second way is just by preventing that dopamine spike and that's what the medication naltrexone does and they just work work very effectively in in different ways wonderful beautiful that's great yeah i liked it box it up that's a you're wrap

anything you want to sprinkle on top of that no i think that that's great that explanation of the craving state is fantastic and i think from um when you're looking at it from a behavioral standpoint when you're you're getting these spikes in the brain it is really motivating you and act really activating you to go seek that hundred level again and so from a behavioral standpoint mat helps to sort of um by mitigating those cravings helps to reduce those like drug seeking behaviors reduce risky behaviors as far as going out and seeking um uh an illicit way to achieve that high so yeah so you know for peaks recovery in particular you know going back two years ago or prior to uh two years ago so the first five years of our company we uh we operated very similarly to the way that this uh industry operates that those things are in a way stigmatized because they were adding to the problem or seemingly adding to the problem right if we gave someone suboxone it's like well they're craving and now it's another drug and you know they're using it so the cycle you know perpetuates in that regard so we have pretty hardened philosophy about this but i think that you know from uh you know really the implementation of our detox and you guys coming on board in early 2020 and moving away from that model i think we've seen a lot of extraordinary things you know namely you know lowered ama rates and we've been given a lot of insights to this but one of the things that i think that we've done uh a little bit differently maybe than some other centers out there who are you know um who are you know bringing matt into their program and we're not just treating it as an ambulatory thing we're treating it in-house as an inpatient program and so um you know maybe for the sake of time just highlighting maybe you know alcohol use and opioid use you know where are we seeing the benefits of starting that and continuing without dropping them off at sort of a cliff edge um in regards to the effectiveness of matte within residential and stabilization model of care

you want to do that sure well i'm thinking back to two years ago when i came on board and we opened the detox facility in early 2020 and our model of care was very abstinent based at the time you have a client that comes in maybe with an opioid use disorder they do their seven days of detox on suboxone and our thinking at the time was like okay they're done with their taper so now let's start on other different medications like antidepressants and start diving in with therapy and whatnot and what we were seeing um over time is just more post-acute withdrawal syndrome symptoms and um when they discharge out of our care maybe the rates of relapse you know because those cravings were so high throughout the treatment stay and so really integrating mat were able to control those cravings and follow them through their their mat treatment and we're able to adjust those doses based on cravings too that the client has the opportunity to meet with a provider and talk about you know where they're at in their treatment and we can adjust as necessary and then furthermore with opening our iop program this year we're able to continue that mat treatment through iop and that gives us the ability to more time to case manage them out and find them good resources in the community so that they can continue on this mit treatment program for as long as they need so i just think it's such a turnaround that we went from absentee space to more of a harm reduction model just because we did research within our own facility i think we really saw the benefit of early suboxone in our open and in our opiate users because after getting on their last day of their taper they would they wouldn't say i want to use they'd say i just want to leave i don't want to be here absolutely yeah absolutely and they would just they would bolt and they didn't even recognize themselves that it it was craving and so we found just doing a low dose of the suboxone two milligrams four milligrams um was enough to keep them engaged in treatment throughout the absolutely and it helps to change that narrative that used to be well they're just not ready right i think that that's what we would always go to and the industry would go to back in the day is uh you know you get somebody on day seven of their taper and their those craving states are so intense particularly with opioid users um that they're just they're gonna go they're gonna leave because the brain is literally telling them to go use it's almost to a certain degree demanding that that happen and so they would leave they would pack up go and you know i think in the industry up until that point in the abstinence-based world there's this sort of mentality of oh they're not ready they haven't hit rock bottom you know and and so we kind of kind of throw our hands up in the air and say well hopefully they don't die when they relapse and we get to see him again and now we see him a week after that after we started it and they have hope for the first time ever it's awesome and i also think with with the mit program you know we just talked about after seven days i'm out of here um the prevalence of fentanyl in our society is so huge um somebody could do seven days of detox those cravings are high they go out and they use and we don't know what's in the substance that they're using absolutely and it could be fentanyl lace to the point where um they could overdose coma and possibly die so keeping them on this mat program to control that risk of ama and possibly using unknown substances is huge as well and a lot of people don't know that the mat medications themselves actually help to prevent overdose you know the way that they're designed particularly suboxone which has an opioid component and then it has a actually um basically a naltrexone or a narcan component to it so it's it does help to decrease the the risk of overdose if somebody does use in addition to mitigating withdrawal symptoms in addition to mitigating cravings so it um it really is a really powerful medication that allows people to again because of you you don't have those behaviors that go along with cravings people start to live normal lives you know they get to actually go and start to build a life within society that allows them to um be successful and and be productive and it gets it gets them out of their their habits they're using habits they develop a healthy lifestyle absolutely so this box is not a forever tool but it's a great tool for the first three years of sobriety absolutely great stepping stone so what do you think is essential in running you know a sophisticated medication assisted treatment platform right because at the same time too even though the ideal maybe you know dosages for residential care is four milligrams two milligrams you know at the same time we're going to run into patients who are going to say no no i'm better at eight you know 16 i don't know what the full doses in between are but you know what is it what does it take to really nurture that from a programming standpoint you got anything to say for that i mean i personally think it's it's our wonderful providers um they spend a lot of time with the clients they meet with the clients multiple times a week and they really check in and ask those difficult questions and really allow the client to open up and say because sometimes people may downplay how they're feeling right whether it's they're embarrassed or they don't feel like talking about it and i just think the providers that we have at peaks really have that gift and talent to to ask those difficult questions and pull those answers and so and just having them work together provider and client figure out what is an appropriate um dose and then also following up after that so i do think you guys are a huge component of why it's successful i mean i think there is truth to that because i think that the clients feel cared for they feel someone wants to help me actually get off of this off this drug i'm using and and so listening to them and trying to tailor it individually for their needs i think makes a difference i'm sorry no that tailoring component is huge and and the sort of recognition that when somebody is in a residential facility that dose may actually be lower and they may be sustained on a lower dose because there are a lack of stressors right they're in a sort of bubble that allows them to really those the very early stages of healing and stabilization once you leave that bubble those stressors increase and so those cravings will and triggers will naturally increase with it so being able to meet with providers who will listen to the client and will be able to adjust those doses appropriately given the fact that you know life happens right yeah and so and as life happens triggers cravings all of those things do increase and so i think being realistic about that and being able to have these sort of ongoing conversations in which there is a real um it's interesting that a sophisticated mat program is really a relational mat program if you when you get it gets down to it yeah absolutely and um you know kind of in the the host seat operating here thinking of like where do i want this to go you know in a way because i'm i'm advocating for how not only um addiction treatment centers can behave more responsibly but in better engage with care and provide quality of care not just access to care but the word that's coming up for me certainly here is access to care having providers on site dedicated medical staff members allows for that continuous access in a way that promotes quality over time and i think that's just resonating for me and certainly something that i want to say you know um because it's again what i want families to hear out there who are listening to me as the host within you know the finding peaks episodes is to be curious how these treatment centers are working again because at the end of the day you can call any one of us and our admission teams are awesome and they're going to tell you we have everything available to this but it's just not always true and to the point and if you have a loved one who is suffering from an opioid use disorder for example 96 000 people last year died of overdoses related to opioids in that regard this is a serious thing that's taking place an epidemic you know overshadowed by a pandemic at times but it's a significant amount of people that are dying um you know all the time now as a result of this and so accessing care where there's quality being provided supports and mitigates those risks um you know post treatment in that regard so i'm off my type tyrant here my tyrannical tear here uh moving back into the into the episode here so so what does some of the you know we use matt or i think i think we think about it a lot in terms of alcoholism or opioid you know use in that regard so what are some of the medications that are used you know maybe we'll start with alcohol and move into opioids and then you know what makes them uh effective in that regard yeah so um inpatient we use naltrexone which is actually like an opioid antagonist so it just blocks the effects which also works for alcohol to reduce those cravings and a lot of our clients do start on naltrexone and as they move to the end of their treatment stay we also offer a long-term injectable form of naltrexone called vivitrol and so that just is more convenient when you're out you know discharge and you're back to normal life and getting going it's sometimes it's frustrating to have to remember to take an oral tablet every single day so vivitrol is a program that we implement to inject once a month and so dr ryan is our providers our vivitrol providers so what we do is we get them set up we educate them hey if you're interested if you don't want to take this maltrexon you can get these monthly injections so we get them started on that we give them their first injection if they continue through the iop program we continue the injections for them but ultimately set them up with another vivitrol provider that they can continue to get those monthly injections and a lot of patients just find that really convenient and the great thing in alcohol for that medication is it actually does two things it helps with the cravings but it also helps if if you do drink if you do relapse it doesn't feel as good it blocks some of that pleasure so your relapse lasts less long and you return to sobriety quicker absolutely so in regards to you know opioids as well too you know we have buprenorphine and uh you know suboxone and i think those are common subutex common you know language that's used to of course to describe the medications but um within that i think we have sublicate as well too as an injection right and some what are sort of the trade-offs that we see benefiting not benefiting in regards to vivitrol and sublicate from a provider's standpoint not following you that's fair

you know um i guess if there's insights that can be added to the the notion that right that you know we see hesitancy around sublicate right because it's an injection lasts what two to four weeks depending on body size vivitrol works in a very similar way three to four weeks depending on just a disadvantage to injectables is what you're asking yeah or tension maybe that you're seeing when you're sitting with patients and the tension that arises versus you know suboxone subutex taken you know daily whatever the case might be versus those sort of long-term regimens you know i think part of it is if there's any part of them that still wants to use if they're only 99.5 percent sure that 0.5 percent fights it yeah because they want to be able to get off and use again and so it's kind of an early early sign that they might not be fully in yet but additionally that there's a huge cost difference if your insurance doesn't cost doesn't cover it it's absolutely not affordable by private pay i mean i think it's like a thousand dollars a month for those those shots and the pill version is is reasonable so sometimes it's just a cost reason why we have to continue the pills sometimes the shots are too uncomfortable for people to want i mean it creates puts a little lump under your skin it's a depo so the medication is there for a month and then just slowly dissolves but i think in in all cases they work they work better the other last thing is there's sometimes a provider issue if you're going back to washington we can't always find a provider we know is going to provide it where where you are yeah the access to naltrexone and suboxone we feel is a lot more prevalent when we when we're discharging in case managing somebody out versus injectables um so there's an advantage versus a disadvantage to both yeah absolutely and there's and there's a i think also like a a behavioral component that's there as well as far as what if suboxone is better for you or if no or vivitrol and attraction is going to be the better option for you i think that different at different times in your treatment and at different places you are as far as the commitment to sobriety either one of those can be a better option and i've seen them used really well together as well where somebody does a suboxone regimen which the regimen is the recommendation is a minimum of two years actually so three years has a tremendous amount of efficacy um a year would be the minimum that we would ever really recommend but typically it's a two year regiment and then after that time on suboxone then going to vivitrol as another sort of weight as almost like as a step down um in in the level of care and sort of managing uh cravings and symptoms and almost giving another safety net there so the enrollment period or the the time that's needed there is i mean i guess it's independent per individual right but at the same time too maybe what i'm hearing there as well too is just the concept of neuroplasticity and new neural pathways that support the healthier side of the brain with that supporting cast being you know suboxone naltrexone or otherwise um so it you know so those are those are big time frames but are there any like identifiers to for which like you can look at you know year one you two three or what not to say yeah this is this is a good point to kind of step off this and move into a different direction so the the only problem with the naltrexone the vivitrol is it doesn't protect against overdose right um so so anybody who's using medications off the street with as much fentanyl as there is around we i i'm not comfortable using the pushing the the naltrexone vivitrol in them you want the protection that the suboxone provides which is the naloxone yeah that blocks right and you really i mean for those you really actually want a sick some level of stability when you're starting to engage in those medications because again the risk is there there are added risks actually even though it may be more convenient and it may um in the sense that it's a 30 you know once a month kind of thing but there are risks that um definitely start to present if somebody is still actively using yeah and so opioids and alcohol are in their use um can be very deadly of course long-term use even one-time use with fentanyl lace within it you know meth and marijuana thc present i think uh different types of problems they're not as high risk for you know death um in long-term abuse short-term abuse but at the same time it's still a patient demographic that's suffering in a variety of ways but it doesn't seem like that we have a lot to kind of throw at them differently than those prior you know two substances uh in that regard and so kind of you know when somebody when we pull the pot out of them for the first time right and they can't and they can't use it they seem extremely irritable you know by comparison and you know maybe meth user has to sleep it off but they wake up irritable in a similar sense of things and so uh you know in that regard it's not a harm reduction approach there's nothing significant in the way as far as you know death being imminent maybe on the other side but you know what are things that we're utilizing you know today that can support those individuals in a way in which they're vividly suffering in those early moments so i mean that's kind of two separate questions the the marijuana there isn't any fda mat medication for it we control their anxiety through medications through therapy and that helps because usually anxiety is a trigger for the marijuana use gabapentin is commonly used as an mat for marijuana it's been shown to have a little efficacy and actually n-acetyl cysteine which is just a a supplement has been shown in young kids to help with marijuana but as far as methamphetamine cocaine that those are the medications are those the drugs that bump dopamine directly and there's one medication that's not fda approved but makes sense that we use and that's bupropion or wellbutrin which just it releases dopamine and so after people been using those medications a lot instead of sitting at the at the 25 which is normal they're they're down near zero and all the wellbutrin does kind of get them feeling normal again so it doesn't block the craving state but it um helps them normalize a little faster is the thought at least the kind of innovative thing we're looking at is tms that's transcranial magnetic transcranial magnetic simulation which was new to me two years ago when i when i started here but it's basically this big machine that has magnetic coils that creates magnetic pulses you put a helmet on people and those magnetic pulses are aimed at the prefrontal cortex where depression occurs and basically stimulate it so you end up with stronger cells and those stronger cells secrete more dopamine they create more serotonin you just end up with people that normalize again a lot a lot faster than they would have otherwise and we're seeing see indefinite improvement in people with that so one potential avenue then for innovation in regards to um you know the methamphetamine users and marijuana users even potentially or just stimulate more stimulants okay but yeah absolutely as an mit yeah absolutely tms is definitely a it it's going to help a lot of our population because depression is a huge huge trigger and that's what the predominant it was designed for us to treat the depression and so uh even though it's not um mainstream in the addiction world i think we are seeing just market improvement a lot of patients with it i think it's a fascinating future yeah absolutely yeah absolutely well in that regard i think we touched on a little bit of innovation there and we were able to see extraordinary things happening certainly your wife dr ashley johnson is doing wonderful things in the tms world and um ketamine infusion and those sorts of practices and would love to continue forward with that innovation and and what that looks like you know maybe contrasting with you know pharmacology approaches in the future um as well too so for a future episode we'll we'll invite you back in bring the docs the medical team back and hopefully have a a wonderful conversation about potential uh innovating features of this industry on behalf of addiction and mental health disorders as well too in that regard so we'll come back next time medical team thank you so much for being here thank you absolutely good to have you guys most exciting episode very exciting most exciting yes and so yeah uh as uh as we normally do in exiting here thanks again for joining us i look forward to having you guys on future episodes chris burns jason friesman myself as host um for all the kids out there check us out on the instagram i think we're we're doing tick tock now yeah pretty much the coolest people ever uh facebook spotify um instagram if i didn't say it um finding peeks at peaksrecovery.com uh send your questions thoughts ideas um all of that so that we can speak to you guys directly and speak to what's important to you guys in regards to how this industry operates and so forth so thanks again for joining us and until next time

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Episode 29 Family Shame & Addiction Watch Now https://youtu.be/qMS9I25s_Qk Listen Now Episode 29 Our Family Recovery Coach, Lisa Smith is back on our show to discuss family shame and how to journey through this difficult emotion.

Topics:

Jason and Lisa explain what the difference is between embarrassment, guilt, and shame When a family member feels shame and what that looks like in different scenarios The entrapment of shame within substance abuse How do we shift a family behavior that has been passed down generations?

Select Quotes If we can go up the river a little bit as a family and speak what we feel, what we fear, what we are disappointed in, and what we need, a little bit up the river maybe that person who is struggling can reach out to us and we can pull them out before they get further. Or maybe they can even grab onto a branch that’s hanging and can get themselves out because they are seeing how their family is dealing with their own shame and emotions. That can stop the generational passing of it. Lisa Smith, BA MME, CCAR Certified Family Recovery Coach Episode Transcripts Episode 29 Transcript hello everyone and welcome to finding peaks my name is jason friesma i'm the chief clinical officer at peaks recovery centers here in colorado springs and sitting with me guest today is lisa smith family recovery coach with reclaim and recover she joined us i don't know a few weeks ago and and we had just started kind of having some good conversation and so i decided i wanted to have lisa back and um dive into the the shallow end of the pool and talk about shame and families um before the show we were just kind of talking about that this is a challenging topic and i think it's challenging because um well obviously shame is difficult to talk about and i think it would be helpful if i kind of start by talking about what shame is a little bit and and then how i see it in the family and then maybe you could talk about how you see it in families too as you're coaching them but um just really quick uh shame guilt embarrassment these these words kind of get tossed around and intermix quite a bit but you know clearly they're very different terms and um embarrassment is uh some people say things are embarrassing and really they're probably much more shameful or guilt-ridden but embarrassing is just something kind of light that happens that people are going to laugh off later like leaving your fly down during a presentation or something that's embarrassing and guilt is feeling bad about something you have done and then shame is feeling bad about who you are right and everyone that i've ever talked to that has kids for instance has a i'm a bad mom or i'm a bad dad shame button yeah and and that shame button um i don't care how good a parent they are everybody has it because they have moments where they feel like they could have shown up differently um and that almost inevitably can lead to people feeling a great deal of shame is what i've noticed and then it leads to all kinds of interesting behavior because shame also tells us to not talk about it right to keep keep this a secret or hide it or people knew that i was feeling so shameful they wouldn't want to be in relationship with me and so it leads to all of this kind of externalization of shame and shame comes out in all these really weird places and so that's what i've observed i'm wondering kind of how you see shame in the family recovery coaching yeah realm yes um all of that so i agree um in working with families one of the things that frequently i say is it's okay to feel guilty um and it's okay for your person to feel guilty about their behaviors because if their behaviors are hurtful um to themselves or other people we should know that they're hurtful to other people and that's okay and i think as parents sometimes we feel shame when our kids feel guilty um and that's an important it's an important lesson it's a natural consequence of hurting somebody is to feel guilt about that and that's how we learn to do better and to show up better so guilt and shame sometimes get blurred i think and um understanding the difference between guilt and shame i think is super important now shame on the family side of things um gosh when you've got a person who's um you know got a a substance use disorder there's a lot of going back and thinking you know how could i have done this differently what did i miss you know what what did i do wrong and there's that piece of the shame and then there's um the shame of who they are and how it's a reflection on you yeah um and that's probably i think that's harder than um even you know could i have shown up differently because as as parents you just sort of you work through that like you know i wish my kid didn't fall off his bike and you know i could have caught them and um but how is my child or my spouse a reflection on me and carrying that shame um just it makes you walk through life silence and pushes everybody out of it which isolates you even more and isolates them even more which is the opposite of what both people need in that environment yeah i think i think you bring up some good points too that um what what i watch parents in particular do and sometimes spouses is when they they might not even be thinking about it but it kind of as a internal dialogue i watch parents in particular feeling shame about like hey my my daughter is an alcoholic and i feel like i did something wrong this is exposing that i feel like i'm a bad father i'm a bad mother and so i'm going to try to either prevent that from happening i'm going to try to prevent other people from knowing about it or i'm just going to create kind of this high intensity high pressure world where people can't see that i'm a bad parent because it feels bad when people notice that that i made these terrible mistakes and that i'm a bad parent yeah yeah and it and i and i've watched it really lead to i think the result of that is parents or other family members becoming really hyper controlling and really afraid which usually does lead to control that fear always leads to control um where family members just um well they they try to just control the behavior instead of kind of letting a person as you said kind of walk through their own guilt and all that yeah and in today's world with the social media presence right like so there's these images that we're supposed to be and um i think that the

nobody has those actual images in their household and we all sort of can intellectualize that but that's all you see and at key points in development you know in people's development like graduating high school going to college getting married getting a job picking a career kind of those transitional times when your child is not meeting those milestones and you're and everyone's putting it out there it's like here's all the things that we're doing we're at the state championships and we're doing graduation and we got these awards and this scholarship we're doing these great things and you're just trying to keep your your person safe um that's you know you feel disappointment you feel let down there's all sorts of and then you feel bad about feeling those things because you're trying to help them so the shame is just super deep and there it feels like nobody else is going through it and there's so many people there's so many people going through it um so you know kind of reaching out and one of the things that um about shame is silence just feeds it um the more silent you are the more that shame continues to talk in your head like this you're terrible this is bad this this is a disappointment this is a shame this is this is you're a terrible parent how how are you here and you can't get out of it because there is no connection with somebody else might be actually going through this and can sit with me yeah that is such the trap of shame is that right it does say i'm just going to suffer alone and and i may have shared this on finding peaks once but i i've sat in a group with people and um said i want everybody who feels like they're the worst person in the world to raise their hand and like at least half the group every time raises their hand that they feel that way and i'm it's got to be the same in a lot of families too we're like who feels like they're the best or worst mom or dad in the world that your loved one is dealing with uh substance use or mental health issues and i'm sure most of them literally think the billions of people on planet earth they're the worst yeah um and i watch it happen all the time and and so when somebody's constantly telling themselves that i'm a bad parent and i'm a bad parent um that that usually leads to honestly a disconnect in the relationship with their person yeah and and usually uh a really uncomfortable disconnect and i i wonder how you've seen that in in your coaching yeah a hundred percent um so the shame involved with substance use is huge um i mean people who um have the disease of addiction live in shame all the time they feel that they've disappointed everybody and missed all the opportunities and they're a terrible person and i i say this um and i'm i'm sticking to it i don't think that there's one person in addiction that thinks i know this is this is what i thought would happen this is where i thought this was going to take me um and so the shame of like now i'm here and i can't get out is terrible so when a family feels shame their person sees it they can see their disconnect they can see them pouring themselves into work and disconnecting from relationships they can see unhealthy behaviors that are occurring in the home or with their parents or where their spouse they can see that relationships are within the household are disjunct and disconnecting because in if we connect then we have to admit that there's something there and and sometimes it just feels easier to stay disconnected and so i think that that's actually like throwing extra shame on to the person with the problem um and when a family member can identify that shame and sit with it and call it something and ask for help and ask for someone to just be with me in this moment not only does it model to their person that it's okay to ask for help and and to be vulnerable but i'm taking you off of my plate i'm taking your behavior off of my shame platter and just gonna deal with my own stuff and love you separately from the behavior that i feel is causing me shame

and you and i were talking kind of before we started as well just about kind of the legacy of shame like how um how it kind of trickles down not even flows down uh generation of generation um and i was thinking about that even since we talked about it um my wife works a lot with kids with dyslexia and oftentimes when you you can just follow really negative educational experiences in families usually back generations and generations because probably a lot of those people likely had dyslexia too so they overcompensated and felt really in a lot of shame about feeling stupid or or whatever it might be and it just gets past all that pressure kind of just passes down generation to generation and it does take finally somebody to dig their heels in and say hey we got to stop this transmission of shame um from from one family to uh generation to the next yeah speak to that yeah i think that's so big and you know the the idea of how do we how do we fix this problem how how do we continue to have um you know the number of people falling into substance use that we have and the numbers just keep getting bigger exponentially and i don't have the answer to all the questions i think you know that's a that's deep but um one thing that i have been thinking about recently is what's my piece in it as a family member well my piece is speaking it and and stopping it today so in order to do that i've got to kind of admit to my own shame and sit with that for a second but um if families can i was you know using the example of we're pulling people out of the river and they're coming down and it's like rapids coming down and there's just so many people needing help and there's just not enough there's not enough help in enough time so if if we can go up the river a little bit um as a family and and speak what we feel and what what we fear and and what we are disappointed in and what we need a little bit further up the river maybe that person who's struggling can reach out to us and we can pull them out before they get further or maybe they can even grab onto a you know a stick or something that's hanging and they can get themselves out because they see how we're dealing with our own

our own shame and that will stop the generational passing of it i mean when you were talking earlier about um you know especially families that are high functioning and and doing really well um socioeconomically it's like we aren't those people um i i i think i probably said that we aren't those people um i don't know if i said those exact words but i i definitely gave that image how is that a shame yeah that's terrible we aren't those people well okay well yeah we are actually yeah i mean that's just saying that you know that's something that that lesser people do and if you're doing that then you're a lesser person um and that's just not how addiction works it's just you know it it knows no boundaries i mean it just it'll get anybody so um you know being able to say well maybe we are those people and i was telling you i have this analogy when i was a kid um because i'm old um there used to be high dives at swimming pools yeah yeah so there used to be good old days the good old days not only are there not high tides but i don't even think there's diving boards most places but there used to be high dives right and i've always had this like one desire for

adventure and thrill and two a fear of heights so i would go to the swimming pool i hung out at the swimming pool a lot and i would many times walk up the ladder and then you know everyone has to wait at the bottom with the high dive right and because sometimes you have to come back down the ladder that's probably why they took a walk of shame coming back and having to go down the ladder like i'm not going off the high dock so i did that enough times but i loved it i actually really loved the high dive but i was afraid of it as well so i did it enough times that what i developed was this watch mentality so i would stand and i would watch for a while and then i'd go play and come back and stand watch all these kids going off the high dev and i would just watch and watch and watch and then finally after watching enough kids go off the high dive i'd say they all did that i think i think i can do that i think i'm ready to do that too and i'd go up the high dive and sometimes it was scary but i would go off the hideout because i knew they were okay they went off the high dive that everyone was okay and they seemed to like it so i'm going to do it too and i think that really similarly with shame like gosh if you speak it other people are watching someone else might be watching and and they might not even tell you but in their head they're going oh me too me too this is this is my story too and because you spoke it because you sat with it and you dealt with it um and i saw that you you got through it um i can i can say it too and we can get better and that's how you stop kind of that generational passing because i i really do think that um you know our culture and our society has just become one of putting out an image that is unreachable and um that's not helping us no and it's exponentially making that sense of shame in people stay longer yeah and i couldn't agree with you more so just excuse me to pivot just as we end here um could you kind of talk about reclaim and recover and what it is you do specifically and how uh you maybe combat family shame yeah day to day yeah yeah we address shame every day yeah that was in my tagline yeah um right so i work with families i'm a certified family recovery coach i work with families um in various stages of um loving somebody in the disease of addiction um so sometimes that's people who you know their person is in active use and they're they're trying to help them and they're trying to um just kind of get their life back and and live their life as opposed to surviving it because that's what it feels like sometimes that process can be so long i work with with families whose loved ones in early recovery working on that transitional approach and really changing the patterns that infiltrated the system when the illness kind of came into the family and how those patterns didn't don't serve any of us anymore so let's change let's change the patterns let's change our perspective let's change our mentality and communication um and then um yeah so it's it's kind of twofold working on the the family members really learning how to show up the way that they want to show up how to establish boundaries in the way that boundaries are effective and learn how to communicate with their person and release maybe some of the control that was developed over the course of the addiction and then sometimes it's also just doing some triage and kind of helping families figure out how do i get my person into treatment how do i invite them to get help how do i connect with them while they're in active use so that their journey is honored um regardless of the outcome and that's what i do awesome what i really i just want to tell you i just think the way that you think about and talk about families you work with is so filled with uh empathy and compassion um i'm confident that the work you're doing is really helping to alleviate a lot of that shame that families have to walk through uh in early recovery and it's a gift and um i i've really enjoyed working with you thank you um here at peaks so uh with that um we're going to sign off today on this episode of finding peaks um i invite you to follow us on instagram facebook spotify i don't know wherever you get your podcast apple the apple store anyway have a good one and we'll see in a week

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Episode 28 Behind The Care: The Importance of Treatment Outcomes Watch Now https://youtu.be/bTriiUrAROQ Listen Now Episode 28 With a very special guest, our team addresses why it is so important for addiction service centers to collect treatment outcome data in order to truly impact recovery success rates

Topics:

Joanna talks about why and how she decided to open up Vista Research
The positive aspects that have come forward through pursuing Vista Research and collecting outcomes for addiction treatment centers
Some of the tension Vista Research has come across
Treatment outcomes are increasing throughout addiction treatment centers that are utilizing outcome data vs. those programs that are not

Select Quotes Over the years of Vista Research being created we’ve shown just what a difference being able to monitor patients during treatment for issues like depression, levels of anxiety, cravings, etc. Vista Research allows treatment centers to monitor that, show it in real-time to clinicians, and that helps patients get better faster. And on top of that once the patients leave treatment we will follow up with them 1, 6, and 12 months post-treatment, and confidentially find out how they are doing so we can provide independently verified real success rates. So that’s what we have been doing for the past 5 years. Joanna Conti, Founder of VistaReseach and Conquer Addiction Episode Transcripts Episode 28 Transcript alrighty everybody welcome back to another episode of finding peaks um very excited to be here today again i'm uh ceo chief executive officer at peaks recovery centers here in colorado springs colorado and a couple weeks ago i highlighted the fact that i was going to be bringing on an individual who's an important to this industry in doing incredible work on behalf of the industry and patients alike who have been receiving addiction treatment services and mental health services um over the past few years several years in fact and her name is joanna conte and she joins me today as the ceo and founder of vista research and also the founder of conquer addiction and kind of the way that we're going to walk through this today vista research represents in in essence um outcomes data for addiction treatment centers um throughout the united states and conquer addiction really represents a platform that can speak to family systems in regards to highlighting treatment centers that are providing efficacious care and and actually providing and putting forward their outcome data for people to view and see those differences and hopefully in that way find treatment that is good for their loved one and not hiding behind outcomes that don't actually exist for treatment centers so today we'll focus in on vista research and at another date and time we'll get into the other side of this ever important um platform that joanna's created on her and so uh called conquer addiction so welcome joanna to the production today and i think you're joining us from annapolis maryland correct i sure am brandon it is really a pleasure to be here thanks for inviting me on your show yeah absolutely um you know kind of you know kick starting this we highlighted this from the beginning um but uh vista research is the largest uh outcome um sort of data center across the united states and i think that's fascinating and how many addiction treatment centers or behavioral health centers in general are you guys supporting i think the last time we spoke was roughly around 60. it's about 60 companies a lot of those have multiple locations so it's a lot more different locations than that and we're in

at least a third of all the states we have centers that we're monitoring their outcomes for that's beautiful um and just to kind of put a put a tone to that to think about you know where vista research is at and the significant data that they're pulling in to be serving you know call it 60 centers across one third of the states with multiple you know treatment um programs involved with that you know we might be talking about hundreds of facilities at the end of the day but across the united states there are over fourteen thousand addiction treatment centers uh serving mental health behavioral health or otherwise in that regard and fourteen thousand minus a couple hundred is a lot of treatment centers not participating in addiction treatment outcomes and before we dive a little bit into you know sort of our frustrations around that but certainly going to speak a lot of positive you know aspects about how all of this works in the end how many treatment centers is vista research serving in the state of colorado at this time all of two people peeks has been doing outcomes research with vista for almost three years now and the other treatment center just started so it's way too early to have outcomes for them but wonderful well i'm super grateful to be a part of this to be among the one up until recently and i'm glad that there's more you know getting involved i think there are anywhere from 50 to 80 treatment centers here in the state of colorado so calling on all of you to give joanna a call tomorrow and start taking this seriously because it does matter and i think it will matter and speaking on behalf of peaks recovery centers it has only improved what we're doing here when we take the data seriously so um you know so with that said um you know what what led you to starting vista research in the first place i had a daughter who as a teenager became a very serious alcoholic she was repeatedly drinking to levels that could have killed her night after night and over the course of many years we kept finding ourselves in crisis situations usually in the er sometimes she was airlifted there and each time it was obvious that i needed to find treatment for her immediately and so i would get on the phone and i would start trying to find good treatment centers and one of the things that was so frustrating was i was forced to rely on chance comments that somebody had made oh you should check out this center or you should check out that center one time it was a comment somebody had made at a picnic six months before saying hey if you ever need treatment again you might try this center so i would call these centers and they would always sound so nice and i would say and what is your success rate and they would invariably say trust us we're one of the best the good news is we always found really effective treatment and as a result my daughter has been sober now for eight and a half years she's now exactly i mean we are so incredibly blessed she has a two lovely daughter she has a career that is going gangbusters she's happily married they have a house and i mean we're incredibly lucky but it it was luck and when the worst was behind us i said there has to be a way for the families to coming behind us to find treatment centers with the best outcomes and so just as a labor of love i was running another company at the time i decided to create a website called conquer addiction where families searching for treatment could find treatment centers that were proving that they provided excellent treatment so i built this website back in 2015 and was horrified to discover that there were only five treatment centers in the entire us out of that 14 000 that you talked about brandon there were five treatment centers in the entire us who were measuring their post-treatment effectiveness and were willing to publicly share the results and so i thought well i can't start to promote this website that recommends five centers so it's instead i said you know i'm going to start talking to a couple of treatment center owners and saying i don't understand this why aren't you tracking your outcomes and so i started doing that and enough treatment centers said yeah we want to it's in our plans for next year we don't have a clue how to do it that i thought well there's a business opportunity here and i have an incredibly odd background i'm a chemical engineer by training i've started international non-profits i've helped launch companies in in japan and argentina and um i've run for congress of all things in colorado no less

back in 2004 in the denver area and um one of the things i had done along the way was i taught myself how to program and i'd spent five years running a software company so i could think through how we could cost effectively and accurately measure outcomes research and i thought this can be done so again as a side project as a side hustle i launched vista research group while i was running another company and over the years we showed just what a difference being able to monitor patients during treatment for issues like their depression and their levels of anxiety and their cravings and so forth we can monitor that show it in real time to clinicians and that helps patients get better faster and on top of that once the treatment once the patients leave treatment we will follow up with them 1 6 and 12 months post treatment and confidentially find out how they're doing so that we can provide independently verified real success rates and so that's what we've been doing for the last five years fantastic well thank you for bringing that all to light and didn't know about the politician thing that's really exciting as well too not really i'm a reformed politician very happy to be back in the business world we're gonna we're gonna have to have coffee to talk about that later i'm curious now um but uh so you know kind of just to you know share with the audience what it's like to for this data as it as it's being provided in real time within a treatment episodes you know in essence for us we set them up with a laptop and they run through surveys um each patient on a weekly basis just kind of reporting different metrics for how they're feeling and one of the things that you know to when you know joanna talks about real time that's fascinating that we've come to know and learn and appreciate here at peaks recovery is that sometimes you can go up to a patient in the morning and say you know ask me hey how are you doing this morning they'll say something like i'm doing great man fantastic cup of coffee things are great 15 minutes later they'll sit down and they'll take the survey and they'll report suicidal ideation or i don't feel like living today or these sorts of things and you know for some reason that becomes a safe place for them to put that information to say hey this isn't working with my therapist i haven't met the doctor in the last two days and then in real time we get to respond to that it gets flagged in all the data especially if it's a significant um you know episode that's happening and we get to meet it in real time so um really cool features of that that real-time focus that she's talking about where treatment centers can if they're paying attention to it actually respond in real time to a really distressed patient in that regard so it's a really beautiful thing that's operating and not this sort of static thing that's just to be looked back on in that regard so really cool product in that way again trying to sell other addiction treatment centers to take this seriously because it really can benefit your company culture and your program and provide a significant amount of data to your medical um and clinical teams in real time which i think is fantastic so um moving forward a little bit into the discussion you know now that you've got this started you know over the past several years you've been focusing and honing in on this data what are some of the positive things you've learned since starting vista research um in this regard and i i know we've prompted conquer addiction as to a future episode so we'll just kind of leave it for there for now but um you know what are the positive aspects that have come forward okay so you know your daughter was suffering at a point she's in recovery now but kind of going back to that time you know there were only five addiction treatment centers with outcome data in that regard so you had to have learned an incredible amount you know between the five and the 60 or so that you're serving now and what are some of those positive features that have come to light for you in vista research well i think one of the most wonderful things for me personally is i have talked to so many people who are treating patients who are really struggling with addiction who so deeply care about their patients and are doing everything they possibly can to help those patients recover and it's really been really inspiring to me on a day-to-day basis to talk with so many of the clinicians and treatments and our owners and program managers who really care so deeply about their patients and that has been a really positive experience absolutely and so and and i believe i've talked to you about it in the past but you know our we don't really you know hone in on our slogan here at peaks recovery centers anymore but the original slogan of peaks was a caring recovery and i think that's exactly what you're stating there is that when you talk to these addiction treatment centers at least the ones who are invested in the outcomes through vista research they really do care yes and they really do want to see these outcomes improve you know even at you know peaks is a stabilization model right now and we've just started introducing our iop but you know in that 45 days you know sometimes you get to see the best of individuals and you know see them go from you know pale skin defeated attitudes to having hope at the end of treatment and it's a really inspiring journey but this is the point of outcomes right we've got to do more than just care right right yeah monitoring them during treatment it's very apparent several things first of all we can obvious often identify previously undiagnosed co-occurring disorders that will need to be treated to enable them to fully recover sometimes the fact that they're dealing with high levels of trauma for example flashbacks about traumatic experiences and stuff that may not be something that they're willing to share face to face when they first start meeting with their counselor but because they're filling in these online surveys and we're asking in in such a way

that it's easy for them to admit online then that allows the treatment centers to start dealing with those issues from the very beginning and is one of the several ways that this type of research helps patients get better faster during treatment yeah absolutely and sometimes you know i think one of the major benefits to peaks as well too especially when we get you know cued in the surveys that something is more disruptive than they've revealed to us already you know it can even be at the latter you know period of treatment if we're a 45 day program maybe on day 36 they highlight when they haven't highlighted it before actually i'm majorly depressed and i have this disorder and like it and and what it does for us in real time is you know direction of care is just so valuable it shifts the case management from maybe this you know place we are idealizing as part of a you know sort of just a straightforward streamline recovery journey abstinence-based programming maybe 12-step immersion you know dharma model whatever it might be but now we need to take more seriously the mental health condition that's been revealed and create a different trajectory in that regard so um absolutely helpful and again speaking of that real-time data so um you know kind of putting the bed um those awesome positive features of of your work and what you've got you've had to have learned some of the negative features of of our industry along the way you know and we've talked about it before but you know even at peaks recovery centers i thought yeah vista let's sign up for that because we are going to crush it in our outcomes like we're going to we're going to be 100 we're going to be the conquer addictions front page of what addiction treatment centers need to do in that regard and then the data starts coming in and it's it's kind of a kick in the pants you know it's it it tells you exactly where you're at not within treatment but post treatment and that's where you know to me the data is significant um so there's some tension in there but you know before i i i go on a tangent about some of that negative tension and what it's felt like for us you know kind of what are you seeing on your end that has been you know sort of disruptive through your lens and and having so much hope for um good outcomes what have you learned that that's sort of the the negative features of all of this we have done outcomes research at this point it's got to be for several hundred treatment centers and realize that every single treatment center started doing outcomes for the same reason that you just said they are absolutely convinced that their outcomes are much better than anyone else's and they're hiring us to prove that the fact of the matter is of course that's impossible and this is an industry that until this time really didn't have an accurate way to measure their outcomes and what we found is even among these all highly respected treatment centers there's been a tremendous range of outcomes among treatment centers who have

stayed doing outcomes research for more than a year we've seen success rates between 18 and 50 percent of patients who were reachable and said they were abstinent at one year post-treatment for at least the last 30 days so that's an incredible range from 50 from 18 to 50 the average has been 36 of patients at one year post-treatment who are reachable and who say i have not been able i have not used drugs or alcohol in the last 30 days now that doesn't mean they didn't relapse at six months addiction is a chronic disease unfortunately relapse is a terrible thing that happens frequently but if they're relapse and they have the willpower they have the support system they have the recovery capital to get back into uh recovery we consider that a success and so you know this was this is very interesting information to be able to monitor at different points of time and compare across treatment centers so one interesting piece of learning as i said just to summarize it is that there's an incredible range of effectiveness even among highly respected treatment centers the second thing that's been disappointing is that when we published our outcomes research two years ago and again a couple of months ago we've now done outcomes research for over 10 000 patients who've left treatment at a treatment facility across the u.s i was really disappointed to see that our outcomes in 2021 are exactly the same for the industry as a whole as the last major similar outcomes research that was ever done and get this what would you guess that that last outcomes research was done what year would you guess the last one that was done uh and this isn't a vista research thing right this is the last industry-wise this is the last similar industry-wide research that was published um well you've exposed me here i i want to say that somewhere around the range of like the national institute on drug abuse or uh one of these uh national programs would have done at sampshore otherwise but i want to say 2004 just to throw a year out there 1993.

it has been 28 years since the last federally mandated addiction treatment outcomes research that covered a broad spectrum of patients they had about 4 000 patients and they from from treatment centers across the country and they followed up with them in kind of a similar fashion they found that 36 of their patients were reachable and abstinent at one year post-treatment 2021 36 of the patients are reachable and abstinent at one year post-treatment so that has been a major discouragement and i think the reason why we haven't seen more progress is not from lack of trying but because this industry has not made the effort to accurately scientifically track their outcomes because until you know where you are you don't know what improves it and what doesn't and the most positive thing that we've found is that among treatment centers that have done outcomes research for multiple years they've been able to use the data that they're getting from the during treatment and the post-treatment monitoring and outcomes research and there they've been able to report that 20 more patients are in recovery six months after discharge in the second year they're doing outcomes research than the first so just what gets measured gets managed that's what peter drucker said years ago once you can measure it you can improve it because you can do little you can do little projects you could say well what would happen if we did this and you can measure the impact of that and that is so exciting to me that be from for an investment of frankly 26 000 on average with the treatment centers that were in this most recent research they spent 26 000 a year total on research and 20 percent more patients were in recovery in year two small costs for a significant uptick in contributions right i mean year over year i mean that's what it's about and i think you know exploring peaks recovery centers you know three years ago in our data you know we're below that average and now we're you know above that average now um at this time and the thing that's driving that is like okay we have a curriculum like what about this curriculum is not working i mean addiction treatment centers you know this your patients will tell you what's not working for them in each and every moment they will show you their disgruntled uh ness in those in those real time moments and so you can take the data then and explore within your curriculum what's not working and like joanna said create these you know intimate projects right innovation how do we change week one you know if it's not working compared to week six to inspire people differently the goal isn't to go from 36 percent to 86 percent that would be unreasonable right there's no cure that we're going to locate in here but if we can incrementally move the needle in a positive direction it's can it can be really you know quite powerful and you know joanna you kind of stole my next question there you know do you see things trending upward or not and it sounds like from 1993 to now things have been flat but if you are an addiction treatment center that's at least participating in this data from what we know your outcomes are incrementally improving upwards and that's an advantage not only in the market but above all an advantage to the patient demographic that we serve each and every day and you know at the end of the day you know i guess i want to say something about you know the business model of addiction treatment centers buyers don't have a lot of say in their participation in treatment their life's falling apart mom and dad you know generally family of some sort scrambling in the background to find addiction treatment like you said joanna you know as it goes taking tidbits and advice from other people and then the seller at the end of the day the insurance company and so forth don't have a lot of say once addiction treatment centers get authorization for dates of service and because the buyer and seller don't have a lot of say in this it comes there's a great responsibility for addiction treatment centers to behave properly within that mix because the other two sides don't have market advantages in the way that addiction treatment centers do so there's a real powerful thing there that's you know taking place and by participating in outcomes you are taking seriously and acting responsibly towards the patient demographic that we serve and over time we get more and more people well and that's what joanna's saying about you know the outcomes at least for those participating in this so um because you stole that bullet point we just rehashed it you know to the next to the next question if you could demand one thing from the addiction treatment industry at this time what would that be do the outcomes research monitor your patients during treatment use those results to help them get better and please start measuring your outcomes you don't have to do it through vista research group you can do it wherever but please this is so important yeah it's the only way the industry is going to continue to get better yeah and i you know and i just want to add to that too i know it's easy for you know people to think okay well of course outcome you know research data company wants more people to participate in outcome research data but we're talking to a not-for-profit to be absolutely clear here at the end of the day this isn't about big dollars for joanna this is about uh giving back um to the community and patients within addiction treatment centers in a big way and they are deserving of better outcomes and for us to be innovative as an industry and charge forward in a big way so hear that clearly folks and you know finally with the predicted shortage of addiction treatment counselors swiftly approaching in in the year 2030 you gave me that data set and i was able to read through it it looks like by the year 2030 we're going to have less psychiatrists in this industry due to retirement less people going into school maybe doctors are chasing the big paycheck and anesthesiology and not psychiatry who knows we can only speculate but also i think there's going to be a shortage of about 15 000 addiction treatment counselors at that time primarily counselors who can serve addiction and mental health as a patient demographic so this industry isn't um it's it's only going to continue to face you know more significant challenges in that regard and so how can addiction treatment centers in their families best prepare for this you know in your view and if if we're going to have fewer counselors i mean we already have fewer treatment slots than we need we know that for some patients it's really hard to find a bed when they need it and unfortunately this is this is a disease that if somebody is willing to go into treatment right now and you don't have a bed right now and you have a bed tomorrow it might be too late they may very well change their mind or they may have overdosed in in the meantime i mean this is this is all really awful stuff i mean we we are seeing overdose rates going continuing to absolutely skyrocket and things are just the cove pandemic made things just so much worse so if there's a there is already a shortage of really quality treatment centers and there's a shortage of quality treatment counselors addiction treatment counselors it's only going to get worse so it just is critical that we use every possible tool that we can to make the treatment as effective as it possibly can be absolutely and and so ultimately too what i would love to leave the viewers that before we sort of you know transition into the you know the kind of the final thoughts here on the episode is that um it is through outcomes as as a as a data set or of those data sets that's going to lead us into the future and hopefully become a less fragmented industry i know many of you have joined finding peaks in the past and throughout all of our episodes have heard me say that a lot outcomes is a way to unify this industry to get away from the hyperbolic statements of a caring recovery and those sort of features because for as much as we care we can do more in the direction of outcomes and improving uh quality of care in that regard at the end of the day so you know with that said i do kind of want to transition into a future opportunity here a little bit away from vista research and do conquer addiction and we don't have time today to necessarily launch fully into it but i would love to bring it back because conquer addiction check it out everybody uh joanna you can give us the link to it and everything as well too and we'll make sure that's available to everybody to start viewing prior to us getting to that episode but that where vista research again works for addiction treatment centers and outcomes to approve over time those outcomes are then taken and highlighted in conquer addiction and that is a place where families you know looking for efficacious treatment episodes can discover that and again it's a not-for-profit platform it's extremely inexpensive for addiction treatment centers to participate and who have outcome data and hopefully that can be a continued resource and advantage to people searching for episodes but i think before you know we exit here we we want to caution the consumer about calling in an addiction treatment center and hearing oh we have 80 outcomes or 98 outcomes there's sort of these absurd numbers that are launched in um you know energized admission treatment cultures i to me personally um i don't think it's i don't i don't think i want to say it just because peaks isn't a 98 outcome treatment center um but that just can't be true right and it's not and it's not i mean it that is part of what the industry has really done to shoot itself in the foot just because there have been some bad actors out there that have been making bogus claims and you know advertising on tv about you can walk out in 30 days and be cured and stuff and and i realized that those bad actors are a tiny percentage of the industry but they have tainted everything and when you i have personally had treatment center owners tell me they had 98 success rate 90 85 it's all nonsense i mean what did that mean that that person was not using the instant they step foot out of the out of the treatment center i mean having monitored 50 000 plus patients in addiction treatment over the last five years i can tell you that only 40 percent of those patients are in treatment for the first time unfortunately this is a devilishly hard disease to recover from and as much as i wish it were different a lot of people will need more than one episode of treatment my daughter needed three serious residential treatments multiple iops sober livings over a five-year period it worked in the end but it wasn't a one-and-done type thing i really hope every other family out there does have a one-time success and and their their loved one is able to stay sober forever after but that's not typical so we need we we've taught as an industry we've taught families not to believe the things that they're told from treatment centers we've taught them that some treatment centers will say they have 80 percent success or 90 success families know that's not true it's not realistic and so i think what it's really important is for the industry to start really focusing on truth and sharing independently validated research results that has been scientifically collected i mean guys this is health care right this is this is really important can you imagine going to your doctor with hypertension and not having him follow up with you six months a year later to see how your blood pressure is i mean we have to start treating addiction like the illness the disease it is and measuring what works and doing more of what works and stopping doing what isn't effective that's my plea i'll get off my soapbox now all right i'm i'm so grateful that we had this time together um to speak about um you know outcomes in that regard and in it and i look forward to a future episode with you let's make it a thing let's get conquer addiction on the map as well too and and talk out loud about it because it's an important feature of this aspect it's one thing to get the data it's another to reveal the data um in the honest approach in that way and calling on all addiction treatment centers to participate in this uh to the benefit of the patients um that we serve at the end of the day otherwise we're just making stuff up like a hundred percent of the time uh you know uh our outcomes are 100 of our patients are in recovery 36 of the time right is what we do when we're speaking hype in that hyperbolic admissions energized sense and it just doesn't need to be that way and i i recognize that with you joanna we're talking about a very small fraction of addiction treatment programs you know who um you know taint the waters in a way that you know is not appreciated on behalf of patients and the industry itself but um there are a lot of addiction treatment centers in that regard that do care that are just not participating in this and to me you know for me to to them and from you to them um we can care more and we can do the right thing and drive this in a positive direction so um with that said um i just wanna i'm gonna i'm gonna take us out here joanna i know you're not here in the studio so stick around with me after so uh we can talk a little bit uh more and uh close out here but in closing here at peaks recovery centers um i hope this was a a an episode that was insightful for family systems who might be watching motivational for addiction treatment centers who might be thinking will this really help and will this improve my services 100 from my perspective and what i've seen over the last three years engaging in the data does improve outcomes it's incremental it's challenging they're lower numbers at the end of the day than we want to say 80 percent of all people are in recovery in that regard but that's not a reason to shy away from this um at the end of the day and we believe in it wholeheartedly and i know joanna is doing a wonderful thing for this industry so um moving forward uh looking forward to future episodes here with joanna and on uh i believe chris burns or jason one of them will follow up on the next episode of finding peeks but in the meantime if you got questions thoughts ideas that i can bring forward to joanna for our next episode um with her finding peaks at peaksrecovery.com uh certainly check out uh uh vista research's platform as well as conquer addiction um in that regard and we'll provide links in the bio and that sort of stuff um find us on podcast um what are all the kids using these days joanna the facebooks the twitters um instagrams and so forth we'll be providing more of this insightful information moving forward so thank you for joining us joanna and until next time everybody take care my pleasure thank you brandon

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Episode 27 A Hopeful Recovery Journey Watch Now https://youtu.be/J2zBwFdoVx4 Listen Now Episode 27 One of our long-time employees opens up about her authentic recovery story in order to give hope to others who struggle with addiction.

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We talk as a team about how Kara became a part of our Peaks Recovery team and the growth she has seen throughout her journey.
Kara opens up about her recovery journey and finding safety within herself through somatic experience therapy.
Jason, our Chief Clinical Officer, talks about how it feels to see Kara come so far in her journey.
The transition Kara has experienced becoming a strong professional within addiction treatment and helping others become their best selves.
Kara speaks on what it’s like being a mother throughout recovery and regaining her children and herself.

Select Quotes My biggest superpower is the work I have done on myself, and I get to give that back to our clients. Oftentimes our clients come in, and it's really scary, and they want to focus on all these external things. And I found that when you really focus and turn inside and focus on your internal reality, all that other stuff, it comes. Your external reality will change when you focus on yourself. And because of the work I've done, that’s what I get to give away. Kara Hinkle, CAS Residential Manager Episode Transcripts Episode 27 Transcript hi everybody and welcome to the finding peaks show you have it here today your host chris burns president and founder of peaks recovery centers also known as company cheerleader i was going to say burnsie i was like what's happening we have our chief clinical officer um and one of our longest standing employees jason friesman here today grateful to have you on the show wait wait wait one of who's been here longer well i know how the longest standing yeah thank you every time she's like you know i'm a long-standing employee here yeah you are you are anyway i got that wrong but we have carrot here as well um who's a residential manager with us and just a great professional as well as person in long-term recovery so really grateful to have her on here today i also wanted to mention we all have purple representative of domestic violence awareness day uh one week ago today give or take irritation we're also representing uh bullying prevention month as well as spirit day and that is a topic that is near and dear to my heart domestic violence and bullying and so i just want to stand up for those that can't stand up for themselves today and bring awareness to that because it's a very very important issue of which we see a lot of the results of that um in our behavioral health care companies so grateful to represent in a positive direction for that today grateful to have you both on the show let's get this thing going good to be here so let's do it let's go let's see here we go so we got cara on today i met kara why don't you describe the first time that we met and what that was like for you yeah so you were actually in kansas i don't know if you were marketing or what you were doing but you came on a mint trip with somebody that i actually knew um and i remember you clearly because you i remember you making a scene because everybody had their ipads and their phones and you're like what is this and that's how we met and then you told me about peaks and yeah yeah it was a really cool situation too i was at atchison valley hope and you're right i brought in our former program we had an extended care program which was a bit longer and young guys would go back home and make amends and you know bring somebody in the program that was getting ready to make amends as well and i went into that it was like the rec room at richardson valley hope and i'm sitting down and nobody's talking to me and everybody is in their phone in primary care treatment and i'm like i remember going what are you guys doing what is going on here and i'm like you care what's your name you're like i'm kara and i said what are you doing next and she said well you know i think i'm going to do the the iop the outpatient program and i said how is that different than the time before and you said it's not i've done it multiple times and i said if you want to do something different give me a call gave her my number and i was like she's never going to call mm-hmm oh i'm pretty sure my dad called you yeah yeah yeah and then you followed up too and i was like holy crap yeah your dad said hey did you talk to my daughter i was like i did that is awesome and then kara came out and was a part of serenity peaks recovery center which was our former women's program which means that i'm actually the real og i've been here from the beginning from the beginning the first group of women to go through which i think is really cool yeah absolutely are there any other women that you went through in that first round that you still communicate with yes okay yeah bobby okay bobby um molly yeah kelsey yeah not all the time but i'm still pretty close with bobby though that's awesome yeah a lot of them are still doing good that's awesome yeah i love that those connective features and that and can you talk about a little bit you know what was different you know you'd been with a couple places before peak's recovery hatches in valley hope a few times atchison valley hope i went to a place called teen challenge um you know i to be honest with you when i came to peaks i i think it was just i really felt cared about to be completely honest and i think it was also a big part was because i stayed like i had no intention of staying in colorado and you did ask me that too like okay so what's gonna be different you know i had always went home and i knew that if i had any chance to have to be sober to you know at that point i wasn't seeing my kids that i had to stay um and it was the community it was the connection yeah that's huge and it must be difficult too as a mother to say hey we i actually have to put this on hold yeah and i need to take care of myself and in my experience in the last 13 years that takes good mothers to great mothers and i got to watch you transform from a really good mother who truly cares about her kids into what i see today which is a great mother who is connecting who helps other mothers it's just a really beautiful thing to watch your recovery unfold can you talk to me a little bit about the first few times when you went to treatment what do you think it was outside of the care potentially the connection that kept you stuck um well i mean i will say i don't think i ever got into a lot of the deeper work i would go to you know valley hope which would be 30 days and that just wasn't enough time to get into that work but then i also wouldn't follow through after to whether it be iop or whatever that was individual therapy i never i could never get to that point yeah yeah which was something that i got here yeah most definitely it's kind of like that bridge it almost needs to be compassion and love to get to the other side because they have to feel safe right right and i have to feel safe with the people in front of me and can you talk about what that safety feels like in here yeah um so i mean i think it's grown over the last few years i um so when i got out of peaks i had went through something that was really hard and i was able to stay sober but i started acting out in other ways whether it be you know self-harm or just getting very angry and it was it was really hard there was a lot of grief that i hadn't worked through a lot of trauma that i hadn't worked through so i would say in 2017 2018 is whenever i started somatic experiencing which is a trauma therapy and it focuses more on your body so i was used to very much um talk therapy so i remember when i went in and i met my therapist she started you know sharing this idea with me and i was like like no i was like no like we we need we need to talk about something yeah you know because that's what i knew that's what i knew and she said okay well i want you to be open-minded to it um and so i started doing all these kooky things that didn't make any sense but what i know was that something changed because i used to um you know we carry a lot of trauma in our bodies so i mean i used to show up you know at meetings or large groups of people and i would just get i would feel so unsafe and i would just start crying and or just things like that you know or i would feel unsafe and you know i would you know i would start self-harming or whatever it be and that really helped me to calm my nervous system to calm my body down so i can then process those big emotions yeah whether it be shame or grief or loss whatever it is yeah it's almost like there's like a lock on the top of the box to get to the intensity and the key that opens it is safety yeah no i could never access it because i didn't feel safe within myself yeah once i felt safe within myself i could start connecting with those emotions and getting to the the real yeah the intimate parts of myself yeah which generally speaking we can't see clearly whatsoever until that safety is really contracted for and invested in so yeah i really love you sharing that because to watch you over the years it's just kind of been a steady pace in a recovery direction and it's not like a bat out of hell and it shouldn't be if we're doing it the right way it's sustainable day after day and it's just really cool to have watched you grown into not only in your personal life but in your professional life having been able to help hundreds of people um and be a part of a really really cool process i'm going to swing it over to here because i did the same thing a handful of weeks ago we had angela in here who actually worked with jason too and jason's been a professional in this field longer than most people at peak's recovery the 90s since the 1900s

since the 1900s so i like to swing it back over to jason because he gets a lot of cool examples real time as a professional to see folks that you know he once worked with when we're in a very vulnerable position and now we're doing the same thing for others and so you know just to hear kara show up in this authentic way today i mean

how does that feel for you

um it's it's pretty remarkable chris to be honest with you i you know having known cara now for well over six years i suppose um i think it's there were times when it seemed really dark and hopeless um even in the middle of of walking through a recovery process because um because the path wasn't clear um and i do i do sometimes talk about how um sometimes it's like wearing a headlamp you know chris you've done a lot of hiking i've done a lot of hiking with you with a headlamp on our head and sometimes you have to trust the trail and your headlamp lights up one step in front of you and that's it and i there were times for care where like the headlamp maybe lit up a half a step but that next half step you kept diligently taking it because we i couldn't see the trail ahead of you and you couldn't see the trail ahead of you um six seven years ago like it it didn't seem i don't know it just seemed very big and long and difficult and honestly um i've just got to watch and experience you taking that next step and and now it seems like the clouds departed the sun is up whatever headlamps off like the trail seems way more apparent i think uh for you and i it's it is wild to just watch and and um it is a gift of peaks i think that you know we we started this a while ago now and like um in to know you for this long i think it's just so it's just a gift to me because it doesn't happen in counseling very often either where you get to actually see somebody for this long and watch this much improvement and um to be you know closely close in this story and then be back off from the story for a while and now get to see it be full full circle and now you work with us and it's great to see you every day so yeah that was that interesting that's great yeah yeah absolutely that's what i was thinking yeah it's okay good yeah what he said yeah jason was talking i i wanna i wanna show the viewers how early in peak's recovery history cara got here so our ceo brandon burns he's our chief executive officer he does a phenomenal job running the company far better than i could for certain but i used to take him into circle groups at crestwood yeah oh yeah when serenity peaks remember yeah so i'd take him in he'd fly in from seattle you know doing his marketing job and i'd be like hey we're going to circle tonight and brandon would just sit there and circle just like what is this like he never worked in the field nor was he in uh addiction recovery most certainly and so i just i just remember that you remember having brandon yeah i do yeah yeah you would come to circle every week yeah yeah right into the house yeah for sure i love that he was able to get his start in there because that is just like and he came back yeah you know which is really cool how has it been for you as a professional helping others and growing along those lines oh yeah um yeah over the last four years i have grown professionally i have grown individually and i feel like my biggest superpower is the work i've done in myself like i get i get to give that back to our clients oftentimes right like our clients come in and it's really scary and they want to focus on all these external things you know and i found that when you really turn inside and focus on your internal reality all that other stuff it comes your external reality will change when you focus on this um and because of the work i've done i that's what i get to give away my best superhuman power is the work i've done on myself wow that's extraordinary and that's been really my experience in the last couple of years since i've really got into some sc work it's it's my greatest tool yes is the work that i'm doing and in fact i get out of set or whatever it might be and i just can't wait to share these new parts about myself and these realizations that i think can afford people in the early recovery stages some freedom and some openness and some space to explore what safety looks like for them i want to touch on something too like you have your kids back in your life today yes yeah yes yeah how's that yeah um it's amazing i so hayden my my oldest son is a little bit different but it's a door open i got to see him over the summer and i hadn't seen him for years i mean it was it was such a gift and it's still something that we're working on but it's an open door and i would have i would have never had that had i not stayed and had i not continued the work and for my son jackson having him i learned so much from my children and i really i really try to slow down to pay attention to what i can learn from my children and again because of the work i've done i get to see the messages that are received you know and it makes me become a better parent you know my son will be like well mom like maybe he'll say you know i don't want to tell you that because i was afraid like you would yell at me and i'm like oh that's it yeah that's it right there and i would never be able to know that had i not done my own work so i learned so much from my children and then my daughter dakota my two-year-old that i had in in sobriety that's just been a whole journey in itself because i got to do everything from the beginning sober you know everything being pregnant having her and that is that is a gift yeah yeah so it's been amazing yeah that's absolutely beautiful you know i i'm i'm thinking of just six eight weeks ago when we were at air city 360. and i'm hanging out with jackson and i take him up on the zip line and i can tell the way that kid looks at his mom like she's his hero and that is just such an exceptional thing to have bear witness to be a part of and be in the presence of is just like this real active and purposeful recovery and the fact that your kids actually feel safe to be like oh man you yelled at me yeah i like that that's huge tells me you're doing a lot of things right on that side yeah um jason i was i was just going to pipe in and say you know my kids are older than your guys's kids um but as you're talking i i'm reminded that um i just remember my kids would just hold up a mirror to me and particularly of me as an adult but also me as when i was their age and when they're going to kinder i can remember my kids going to kindergarten and then i would reflect on my own experience going to kindergarten and it would both expose good things and also wounds that would appear and things that i had to kind of that would emerge that i would have to work on uh for myself all along the way all you know all the way up you know to even presently like they still continue to hold that mirror up um and it's powerful because you know your story you just shared too about you your son being afraid to like share with you something hard i'm afraid i was gonna be mad at you what a gift to like have that level of honesty and we talk about all the time chris with your kids too and and what they in the honesty they can provide for you that just demonstrates such amazing trust and and that that wouldn't come if you were passing your trauma and shame on to your kids they wouldn't be able to trust that and i think that's such that's like probably the best part of this whole story actually yeah is uh the trust that that your kids can find in both of you truthfully due to the work you've done yeah i just think it's exceptional to hear a story like that because it says there's hope yeah there's a lot of hope and i have more hope today with the tools that we have at our disposal in 2021 the sc the emdr the connected client centered care trauma informed around every corner we have a real opportunity today to recover in a really meaningful way i think better than ever and so when i hear chronic relapse haven't haven't been successful i say you just haven't had the right people in front of you yeah and i think that today we have a really magical way to walk people in and out of their shame through an authentic process that is connected loving nurturing and compassionate and when i got sober in 2008 it just wasn't that way we were more of a rock bottom approach and i just love this today because it gives people to your point the opportunity to explore for themselves what safety looks like instead of me telling you what it is for you yeah which is how that old approach was but you may even got a little bit of that when we started at peak so um is there anything else you want to say to the people before we jump offline here no just thanks for having me it's an honor yeah thank you for being here and thank you for your recovery thank you for the way that you show up in this world uh as an authentic recovering human um the world would be a much better place if there was a thousand carrots in it so thank you for being here jay freeze you know what time it is thank you everybody

thank you everybody for tuning in again domestic violence awareness day spirit day bully prevention month all of those things are very important near and dear to our big hearts here at peaks recovery centers stay safe out there and if you ever need someone to talk to just give us a call find us on all of your podcasts instagram facebook all of that stuff out there you know what i'm talking about let's make it great

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Episode 26 Helpful Ways To Identify Manipulation and Set Positive Boundaries Watch Now https://youtu.be/gDRFkuxxHTQ Listen Now Episode 26 Our team discusses the complexity of emotional manipulation and ways an individual and family system can both overcome these hardships with positive boundary setting.

Topics:

The cause and effects of emotional manipulation in relation to addiction and treating clients who experience this hardship Examples of how families have been honest about manipulation tactics they’ve used in the past Shame and manipulation How positive boundary setting can be a solution Our Chief Clinical Officer gives his advice as a parent and a father

Select Quotes Boundaries are a lot of times about resilience in general. I think that resilience and being a family that comes together to communicate about problems and not necessarily trying to solve them. I think that parents in general, and this has been my experience as a child, particularly fathers, there's this impulse to solve the problem right away. Your child says I have a problem, well what are you gonna do about it? Rather than just sitting there and saying all right you have a problem, let's sit with the problem for a while, what does it feel like to have this problem? Actually sitting with that and getting used to being in discomfort for a moment. I think that when we try to run away from discomfort is when we get into problems. When we try to protect ourselves from it and we try to avoid it and we try to problem-solve our ways out of it I believe we're going in the wrong direction. It's okay for things to not be okay for a moment, and so if you can do that as a family system you've got a pretty significant leg up and that all of the members of the family at that point recognize that at least have the beginning tools to be able to establish clear boundaries and healthy boundaries moving forward. Clinton Nicholson, MA, LPC, LAC Episode Transcripts Episode 26 Transcript alrighty welcome back to another episode of finding peaks so grateful that you continue to join us and participate in this with us i hope that we are continuing to teach educate or otherwise about this industry about this space its complexities its simplicities its beauty its frustrations everything in between all of the things all of the things um for me personally just i just love coming to do these things yeah especially with you guys yeah it is great uh i think a few times i've missed title giving but again jason friesma chief clinical officer peaks recovery chief operating officer clint nicholson everybody and uh chief executive officer brandon burns just in case anybody's joining us for the first time and welcome back for everybody else so we have a blog on our website called psychological emotional manipulation and it gets a lot of people visiting that particular page and so we just kind of wanted to highlight you know what that means in relationship uh to i think two different things right there's two ways i think to look at psychological and emotional manipulation from an addiction treatment space one those things can cause shame guilt emotional feelings that might drive us towards maybe using drugs and alcohol one day to you know cope with those experiences also for family systems out there when we're engaged with the an individual who is suffering from an addiction we experience psychological and emotional uh manipulation abuse and so forth and so i think uh just to kick this off i think let's start with um you know maybe the cause and effect relationship of it when we experience psychological and emotional manipulation over time can uh have us experiencing guilt shame and so forth and then we end up turning to drugs and alcohol maybe to cope with that i know we talk a lot about uh the latter part of the topic about you know clients patients themselves manipulating family systems but um you know let's talk about it maybe through the client lens and your experiences as clinicians and what that's like um for our patient demographic to experience those things and resulting from that you know moving towards drugs and alcohol as a coping mechanism so i don't think there's a question in there no but yeah i'm i'm what i'm and clinton's answering first yeah but i feel like it's nestled in there you're in a clinical session and you're talking with individuals what is it that comes up often in your experiences uh in regards to that manipulation that they experience for which they are stating you know these are reasons that i'm you know participating in you know drugs now called the coping mechanism i mean the first thing that comes to my mind with that question is certainly working um with some of our younger adult population and um and sometimes there are parents out there that can be a little bit manipulative with their adult children and sometimes um sometimes that manipulation can occur with good intention like trying to get somebody to do uh the right thing and i guess you know overall i look at manipulation to me is trying to change somebody's behavior uh without kind of overtly stating your intention and trying to maneuver situations um in ways that well are manipulative and actually i was just during our family meeting recently i was talking to the families about dishonesty and of course every family on the zoom meeting was like yeah it's it's awful and like it was so horrible and then i asked families in what ways have you been dishonest um with your loved one who's here at peaks and you know the call went a little quiet for a second and then i kind of described how um even as even as loving as it may be but not not speaking the truth to your loved one and trying to change their behavior through maybe just hiding things or withholding money or or um withholding love or attention as a way to try to change somebody's behavior um is a way to be manipulative and regardless of what the intention is it still can kind of come across and be perceived as manipulation that's the first thing that comes to my mind

nicholson i guess the first thing that comes to my mind is the um is like you said it or we're kind of alluding to the sort of um push of manipulation to motivate either trauma or guilt or shame and then um utilizing substances as a coping mechanism or a primary coping mechanism i think that we are surrounded by manipulation of sorts at all times right whether it's i think that it manipulation we just assume that it's this negative thing but we're being manipulated by advertisement we're being manipulated by social media or being manipulated by um peers it's all around us you know like it and it's this idea of trying to again change behavior or promote behavior um in a certain direction and i think there there comes a point where there is a from the addicts perspective where there is a loss of self and then a loss of control and one of the easiest ways to gain back control particularly emotionally is through substances they're effective they're predictable and they are

accessible unfortunately so i that's when i think about manipulation as far as driving or motivating substance use that's what i come back to and then once you're in that substance of use world when you're in the realm uh and sort of culture of substance use i think the manipulation just gets even greater there's a there's a whole it's almost exponential once you're in there because you're in a you're in a group of people and part of a population that is 100 in survival mode and so um and you do anything you can to survive manipulation is probably a baseline almost to a certain degree so um yeah that's kind of where my mind goes it's i think it's a an excellent point because it is true that we think about it in terms of that negative approach right because there are you know certainly in appreciating and understanding phone calls that we get you know coming into you know peaks recovery from family members it's like look if i tell them they're not getting their cell phone when they go to treatment they're not coming and that doesn't matter what treatment center is involved with that they're just not coming right and so you know at times there's this sort of good comp bad cop thing that starts happening and if we had to couch it in terms of you know positive terms it would be a harm reduction principle right the individual's life is out of control and i'm going to tell i'm going to manipulate in this sense to bring them into care but the value proposition will be they'll be better off than they were to begin with but you know at the same time in a family system that's you know maybe negotiating that even with the best of intentions um and the person's life is smiling out of control at the same time uh we're sort of slowly but surely if not rapidly losing trust right within the family system and that's a delicate line and i appreciate it clings i didn't think we were going to go in this direction of like the the positive aspect about it but now it just makes it all the more challenging it feels like from that family perspective and um because it does feel that there are times in which it has like a value proposition uh in that regard but at the same time i think in you know in relation to you know family systems and so forth um not just so we don't get off topic about it but what is it about those those you know going back maybe to the family phone call that you had jason about those experiences you know what were families able to get honest about as examples of dishonesty um on their side of things

well i think i i find that manipulation and particularly um the use of shame as a as a motivator uh to get people to go to treatment or to try to get people to change um is the one that i i think families were able to take the most responsibility for like um and and you know as rene brown talks about like shane is a great motivator in the short term um but it doesn't create long term and systemic change like you can you know you can call somebody a name or or uh tell them they're worthless or whatever as a what you know you're being worthless i need you to you know how you would find worth basically would be to get your life together and and and do this and that might provide provide a little spark to get somebody moving in in a proper direction um but it is actually damaging obviously significantly and um and then you know the other big one that i was thinking about as well as we were talking is um gas lighting like that that seems like i don't know kind of a term that gets used a lot lately um but i but certainly you know that's that's where um somebody blames their own behavior on another person like you know i wouldn't i wouldn't yell at you if you would come home on time or i wouldn't have all this stress or i wouldn't have my heart problem if you would get your life together or whatever and that can like again there's a nuance there like some of that can be real and there's there's a genuine way to share like hey your behavior is affecting me in this way but there's a manipulative way around saying like i'm i'm not going to take responsibility for how i'm speaking to you um this is your fault you brought this onto yourself basically yeah manipulation is very much of one like a a single direction street right it's a one-way street it's it's much more about um there isn't like a reciprocation of ownership in the in the moment and so it's um it becomes just blame basically yeah and once you've started to blame somebody for the um devastation that is your life or the chaos that's in your life and you don't take any ownership of it shame is the result and then once you're in shame again i mean like jason said there's that maybe an initial motivating factor but then the shame actually becomes the motivation to continue the cycle because you start to feel worthless you start to feel like you you don't have any power you start to feel like i'm the reason why everything is wrong you actually start to believe and own these things and that's again when especially if you're doing that in the context of somebody who has substance use once you start to feel out of control you go back to what you know and again substances are really great at that like they're very predictable and they give you a sense of control so yeah short term you may see some movement or nudge in the right direction again knowing that manipulation is really about motivating change and behavior um but in the long term what you've done is in those moments is actually just sort of reinforce a cycle that you're actually trying to break yeah and thinking about um the word gaslighting in that regard in reference to uh or just creating some an additional example about it because you know i always tell i i think the solution here becomes like positive boundary setting right yeah and so we'll we'll slide into that you know within this as the solution but you know i hear a lot from families as well too that okay i went to hold a boundary and i went to talk to my loved one and then they turned around and said to me well if you don't give me that hundred dollars then i can't pay rent or i don't get that hundred dollars and then i'm going to be on the drugs you know or on the streets and you know unfortunately at times within this industry you know potentially prostituting myself and all that sort of stuff that we know happens um you know two individuals is that kind of a gaslighting element

and that's one that i've seen a lot of like i've certainly talked to parents who have you know gone to the heroin dealer and paid paid for the drugs themselves or or definitely pay rent every month even though all these other behaviors are going on um and then are frustrated because their boundaries of like i i my boundaries that they'll quit using well that boundaries are something you set to protect yourself it isn't to change another person's behavior right and even that you know that's kind of weaponizing boundaries if it's like i'm going to set a boundary to get clinton to change my boundaries just that like if if this behavior of clinton's continues um this is what i'm going to do as a result of that to make myself safe again that's what a boundary is that other stuff is just it's aggravation and it's it's disguised as a boundary it probably is its own manipulation but i don't think that's in the in the blog but um i mean i think you slip into the realm of manipulation right and then maybe that's when we start to talk about the other side of that like the family as sort of maybe more of a victim or the recipient of that of those sort of manipulative behaviors and um again i think for me it's when i when i think of manipulation from the the part of an addict i just see somebody in survival mode you know that's all they're doing is surviving and all they want is to feel is to gain control back and again the way they know how to do that is to continue using and i think that's on a psychological level and on a physiological level

and again there's you can't there's nothing you can really do as a family member to change that they have to make the change and so we get into the but you get into the pattern of i'm going to set these what i feel are boundaries in order to try to motivate changes in behavior but really what you've done is just continued again that cycle of manipulation and it becomes uh very quickly it that's when it's a two-way street because it's just manipulation exchange at that point but establishing those healthy boundaries like jason was talking about that's actually how you break the cycle and it becomes about protection right rather than survival it's about safety you know and i think that that's um one way to frame it for families that actually gives them a sense of power back and that's that's how you start to regain control and sort of mitigate the chaos right because it is the the that boundary discussion actually creates a huge barrier to relationship whereas if my boundaries i'm not giving you any money if you're using and that's just my boundary right and then your son or daughter calls and is like if you don't give me a hundred bucks i'm gonna get kicked out of my place a well-established boundary gets to say that sounds really hard and scary what are you gonna do because i'm holding you know i'm not can you the money right but like you can like the boundaries already set and i'm not here to change i'm not here to now stop your addiction i'm here to say i'm emotionally here for you but i'm not financially here for you because uh the finances are just going to the dope dealer right or the response when i think a typical response would be well i'll do it this time but you have to do this right yeah right right oh yeah yeah there's that you quit and i'll do it yeah right which is again just another like it's a more cordial manipulation i guess and it feels better like you're starting to like if i do this and and there's this exchange then we're starting to get control again the chaos is starting to to sort of dissipate but no it's just a it's just an exchange you know you're just continuing the cycle right so there's a there's a there's a delicacy to it there so how you know and you're the uh you're the only uh father figure at least in this room with us right now so yeah um the biggest beer and the biggest beard in this room and it's getting cold here in colorado so this is what we do but in regards to uh you know being a father you know um it i can imagine it's extraordinary challenging to you know hold these boundaries and fortunately you know knowing your family of course that's not the space you're in but you know i always share with families and i think we do that when you go to set these boundaries for your own emotional safety what you're going to hear back well then i'm going to do this and i'm going to live on the streets or i'm going to be in the trap house and all these sort of things that immediately pulls on the motherly and fatherly heartstrings and i think it's you know so difficult for people to conceptualize that the boundary isn't actually severing those streams and that that emotional state still exists and you know maybe from that parental lens you know um you know i can imagine just thinking about it you know for you even with with your kids how difficult that would be to set those boundaries you know for your own emotional safety and yeah maybe just um in that intimate sort of way walk family systems through you know from that parental lens that challenge and what that might be like you know for you if you're in the same because it's easier sometimes easy to give advice it's another one to like kind of internalize it as if it were going to take place in our own yeah and to your point i haven't been in the situation where one of my kids is saying i need 100 bucks or i'm homeless um but what is clear is like um as a parent like my kids struggle sometimes with anything and the easiest thing to do would go to be to go fix it um but but that doesn't teach anything it doesn't build resilience and and so always my strategy is or what i'm always thinking is what's most important is my relationship with my kids and and um and that they're calling me or talking to me about this problem um kind of puts us on the same team and the problem is over here and how do we navigate this and this problem is not my problem like i get to have that boundary um for the most part but like i but how do we how do we want to navigate that because don't get me wrong and you know if if um if my daughter calls from college and is having a hard time my instinct is to go rescue her or go solve the problem first instinct for sure immediately um so it feels it feels um against my instinct to just sit and talk to her and allow her to solve her own problem even if it's hard um but then you know that grows her resilience and her ability to kind of uh um well grow and learn and and i don't want to be rescuing her when she's 30 so i probably should help her engage life at 18. yeah yeah um

feedback on it i never i know it's largely directed at him but share your expertise on my expertise as a as a parent yeah i have a dog and two cats so when hank yeah hank my dog if he were to come to me yeah it's like if you don't get this money i can't get bones you know i don't know i think about the uh that when you talk about that uh the idea of severing the connection that that these boundaries feel like you're suffering but really what severs the connection between family and between family members is actually the back and forth between manipulation that's what it's like you're constantly sawing that connection every time you go back and forth with those manipulations you're actually making it more and more tenuous and to establish these solid boundaries is the first way to heal that so i think from a visual perspective it's one way to think about it but that's really what will cause those that eventual sort of snap or severing of the connection between family members is the back and forth because you lose you lose being genuine and authentic with one another and you don't everything becomes about one-upping the other person rather than just stopping and like jason said being there and listening to them you know and not trying to solve the problem but just help them understand the problem um yeah that's kind of that's my feedback and i'm sure there are families that are suffering and that that sounds very pollyanna-ish absolutely like very much like oh that great jason but like your kid's not about to die and that's true um and i want to acknowledge that um the stakes are higher uh often times when dealing with substance abuse but i don't think um i don't think severing the serving the relationship i think is the actual enemy in all of this absolutely um

and i do think there are times to lean into the like if you know like if you have a lot of uh cachet if you will in the emotional bank account with your kids then you can lean in and push at times i think uh and then there are other times that you have to just support from a distance and and and let your loved one know that there's always a warm meal and and a listening ear and that's about it yeah and we've talked about boundaries and because it seemingly comes back to boundaries uh a lot on this show um because they are so effective when they are understood and that the powerful thing that you know i think we've lightly said it in past episodes but the powerful thing about a boundary is a boundary is not a line in the sand to direct or change the course of someone's behaviors right it is back to i am safe in this moment so you know i shared with a mom a while ago i said what is it like to get a phone call from your loved one well i think it's the last phone call i think it's somebody on the other line going to tell me he's dead that he got in a car accident and killed somebody because of his drinking and so forth and i you know i said to her like that does not sound safe i can only imagine what it's like to pick up a phone like if my loved one called and to have that energy we want to answer that phone when it's loving it's positive they're sharing in their goals inspirations or maybe even sharing and negative features that are taking place in their lives that you know we can support and encourage but we can't be in sort of that 9-1-1 call space at any given time and so you know maybe just kind of carrying this episode out again how can we um convey to individuals family systems and also as well too i think if anything right start talking to you know before your you know what what is it in america it's uh to 22 million people suffering from mental health and addiction that's you know 330 million americans or something like that so you know just shy of 10 percent of our population is going through this at any given time and you know we've seen a variety of family systems coming into peak's recovery centers that come from all walks of life this happens to all walks of life you know at some point i think you know we can start setting emotional boundaries and safety early on before we even know there's an addiction taking place before we get into that you know risky behavior sort of drawing the line in the sand um in that regard so you know how can we support families i guess on the you know before we head out here in regards to again just reminding what those boundaries are how to reinforce them and how to have earlier discussions about their own emotional safety before it gets to that moment where we might be gaslighting or sliding into manipulative behaviors well to the to that example you just gave um as horrific as that is and who would want to just be on edge and that every phone call might mean that this is the one um to your point that is that is a tough way to live and and honestly the first boundary i thought of is so practical and simple but it would be to you know put your phone in a different room when you go to bed and at least create eight hours of a buffer and just say if if a call comes at 2am there probably isn't really much i can do anyway and i it and i know that that can sound so cold and callous but like boundaries you can't live like you're an er doc 24 7 365 like i need to be ready to jump at a moment's not like that's not a practical solution and the only way is probably some sort of physical boundary like that um where that that's how that's going to go that's and and i know so conceptually that's what the boundary is is saying this is i need to create this safe space for me um or i'm not going to take calls that aren't in my contact list or i'm not going to let calls ring through that aren't on that or whatever whatever it is that that you may need um to whatever degree feels right and and boundaries are meant to also be fluid like there might be a season you might need to take a month and just turn your phone off at night and then see where you are and reevaluate maybe that's maybe that felt better or maybe that felt worse i don't know but but learning that that taking care of yourself is actually an important part of of establishing your own mental health and your own ability to be stable because the fact is when that call comes if you do get the call from your loved one like you're probably going to need some energy some emotional uh you're you're going to need some reserves in the bank anyway to offer that support if that call comes so

i mean i love that you had like a really pragmatic answer so i know so can you give us more of a feeler once again clinton since we're still on this one gosh i'll give it the old college try here okay i think it's about boundaries are a lot of times about resilience in general right so i think that if you're trying if you're if we're talking about like before this even happens like what are some of the things that we can do to help build uh to help build boundaries within a family system regardless of if there are issues going on i think that resilience and being a a family that comes together to

communicate about problems and not actually necessarily try to solve them you know i think that we parents in general and this has been my experience as a child particularly fathers yeah at least my father there's this this impulses to solve the problem you know kid says i have a problem well what are you going to do about it right rather than just sitting there and saying all right you have a problem let's sit with the problem for a while you know what does it feel like to have a problem and what does it feel like to resolve and just be in slowly but surely you'll feel through i know it feels amazing way too many times yeah i'm good for the year cashed it all in yeah right i've just been waiting so yeah but actually sitting with that and and getting used to being in discomfort right uh i think that we when we try to run away from discomfort is when we get into problems you know when we try to protect ourselves from it and we try to avoid it and we try to problem solve our ways out of it i think we're going in the wrong direction you know it's okay for things to not be okay and so um and being able to sit in that space as a family i think if you can do that as a family system i think you've got a pretty significant leg up and i think that all of the members of the family at that point recognize that um at least have the beginning tools to be able to establish clear boundaries and healthy boundaries moving forward yeah so absolutely and i and i think in in in going out here um and i appreciate that that was excellent pragmatic feels we switched yeah yeah you'll never see that again viewers that was that was there's a lot of vulnerability in this room and i could feel it yeah just in its and i and i think in going out here as well you know the thing that comes to my mind about this is that your loved one is suffering there is no doubt about that and whatever they're going through mental health primary substance use disorder they are suffering and i think the goal of a boundary is to not be suffering at the same level and to provide some space in that regard so that um you know you can still get uh as wild as it may feel or me saying a good night's sleep while that's happening in the background because your life matters just as much as your loved one's life in that regard so boundaries is to take care of self um and support the individual in a loving way and so thanks again for being here on this episode uh today at finding peaks i got a special exciting guest uh coming up in a few weeks here joanna conte with vista research president founder of vista research and conquer addiction they are the nation's uh largest outcome data collection agency that exists in the country and so um no more fluff about outcomes we're going to talk about it specifically what she's seeing on her end in that regard what frustrations she's seen about treatment centers and their experiences in regards to this but she's got a big heart she's doing something really extraordinary in our industry it's been wonderful to have them creating peaks recovery centers outcome data so i'm really excited to bring joanna on in the meantime send us your thoughts ideas questions finding peaks at peaksrecovery.com uh find us on the facebook the instagram uh podcast uh the gmails

spotify there's another one for the podcast love you all thanks again and we'll see you next time

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Episode 25 Holistic Care: What Does It Truly Mean? Watch Now https://youtu.be/4kn88wSl5CQ Listen Now Episode 25 Our team depicts what ‘holistic care’ can mean within addiction treatment, and how treating the whole person effectively truly requires much more than a holistic approach

Topics:

What is holistic care, and how has the industry has shifted into what treating the whole person truly means

If that is something you are interested in for a treatment center, make sure to ask what holistic treatment truly means to them as a program.

Holistic care and what that can mean within Peaks Recovery services

What holistic care can be mistaken for

Holistic care vs. the medical field

Select Quotes I would ask families to challenge programs that say they are ‘holistic’, and to ask a program to define what that means. Food labels can say ‘all natural', but it might be full of sugar, but it's natural sugar, so it's all-natural. Well saying it's all-natural doesn’t necessarily mean it's healthy. So saying something is holistic doesn’t necessarily mean that the treatment is quality treatment. That’s what we are referring to as well, there isn't a generally agreed-upon definition of what holistic care is, therefore it’s really easy to drop it on a website and say we offer holistic care, well okay, how? And in what way? Jason Friesema, MA, LPC, LAC Episode Transcripts Episode 25 Transcript all right hello again everybody and welcome back to another exciting episode of finding peaks so exciting um i missed you guys yeah it's been a minute i don't miss you guys yeah absolutely i miss the viewers i don't like taking this week off it makes me feel left out so i like to come back with just a ton of energy absolutely i can feel it it's permeating the room yeah good yeah have you noticed our new mugs new mugs everybody yeah these are pretty big deal all right relatively funny jason friesma chief clinical officer joining us today chief operating officer clint nicholson both lpc's licensed professional counselors kind of a big deal philosopher anyways

uh in that regard um so today we want to talk a little bit about this notion of holistic care and to launch into this i i think i reviewed it in our in our last or the last episode that i was on that you know uh peak's mission is to save lives but our vision at peak's recovery is to disrupt an industry through quality of care and uh to the point of holistic care i think i intend today to disrupt this notion this internet word that is on so many addiction treatment center websites uh in that regard and it's a challenging word for a variety of different reasons and you know charitably speaking to it i think it's important to treat the whole individual mind body and soul to approach the individual as an individual and not as an object like all other people within any given setting addiction treatment mental health or otherwise but it's to me just an internet word it doesn't have a lot of oomph within side behavioral health addiction treatment mental health centers and so forth so i think we'll start uh off the bat here with a a firm definition of what we're talking about and i think clinton yeah oh yeah going first going first this is this is new territory for me so um so what i learned in grad school is the idea of holistic treatment or holistic therapy comes from the idea that people do not exist in a void right like we are our symptoms our issues our triggers do not happen outside of an environment but they happen within an environment and oftentimes because of the environment so there's this idea that when you are delivering services and providing clinical therapy that you have to treat the person within a context rather than outside of a context so you can't just simply say oh you're experiencing this one symptom we'll just get rid of the symptom and then you'll be tre and then you'll be cured it's the idea that the symptom actually has a trigger within an environment so we have to look at the trigger outside of the symptom and the context in which that trigger occurs and then also the context in which why in which ways the environment impacts the perception of the trigger and so it starts to get pretty big pretty quickly and i think the initial i mean so counselors work under this holistic model of therapy versus the medical model of therapy and i think that and it sounds great right like there's this really wonderful power and energy behind it that oh yeah we're going to do this holistically and we're going to treat the whole person and it's going to be a mind-body soul thing and also how do we do that right like because you're still in therapy right you're still in treatment and i i i guess i from from my perspective um i wonder how well we've actually integrated holistic therapy and how much we've really pushed and developed intervention strategies that support this idea that we treat people holistically so i think that there's a lot of it's become more of an internet word a buzzword than an actual practice in a lot of ways and it's something that people can just say that oh i do that but you don't actually do that so you believe that you do that but doing it is something different right and and i mean going back to the last episode that i was on as well too with christian and uh you know going over utilization review i've never heard an insurance company turn to a treatment center and say are you providing holistic care you know they're focused on biomedical conditions and all of these other sort of words that we use you know to promote um continuation within treatment episodes but the word holistic uh you know and i'm of course making a terrible joke here about how insurances aren't talking about or speaking to such strategies in that regard um so you know from your perspective jason i believe too it is a buzzword and just kind of curious you know from maybe the first time you heard it to where we're at is sort of an industry um best charitable reading of the word yeah that's a great question i i think the piece that um i would be really curious about or that i would ask families to to challenge uh programs that say they're holistic is just ask a program to define what that means like what does that word mean because i i do think of uh as as you were talking clinton i think of like food labels saying all natural and it might be full of sugar right but it's natural sugar so it's all natural well that that doesn't say it's all natural doesn't mean it's necessarily healthy and i think saying something is holistic doesn't necessarily mean that that treatment is good like what is holistic mean and i think that's what we're referring to as well that there isn't kind of a general agreed-upon definition of what holistic care is so it's just really easy to drop it on a website or on a commercial or something and say we offer holistic care okay how yeah in what way yeah and that's the key right there yeah it's it's not the it's not the what we do it's the how do we do it like how do you actually provide holistic care and in what way in what ways do your does your specific treatment or curriculum or program actually genuinely and authentically address the sort of whole person because it's great to think like oh well you know we talk about the mind we talk about the body and then we talk about the soul but that's still just talking right like there's nothing it's understanding that the person is dynamic but the treatment has not necessarily reflecting the fact that the person is dynamic so i think that we've gone we got the idea right and then we never actually developed anything to to give it some real gusto so yeah um maybe even just poor philosophy at the end of the day

already but the vast majority of addiction treatment services are also and mental health services are rendered in a group setting and whether it's residential treatment or partial hospitalization i mean that's four to six hours of therapy inside a group setting you know downward pressure from insurance in that regard if even if it's in intensive outpatient iop setting in that regard that's three hours you know with anywhere from you know in the state of colorado i think the limit is 12 that you can have at any given time in a group but let's say there's eight to 12 people in a group and the vast majority of treatment is being provided through that modality then it just seems a little silly to be calling things holistic at that point because you know now we're now we're treating a group and though each individual is dynamic within that group it's not clear to me how we arrive at a holistic approach or how we could insert um holistic care within such a setting over the course of 35 to 40 hours of therapeutic interventions throughout a week i mean i think that there's a maybe a bit of irony to to what holistic means at least from my perspective it's actually i think the best type of holistic treatment is to actually take people out of treatment and put them back in the world right to me that's where the only way you can be holistic is if you go back if you you go outside of the sort of confines of that of that therapeutic safety and you go back into the world in which whatever condition that's presenting is actually occurring because if you're not in that world then i don't know that you can be holistic i think that you can speak holistically and you can i don't i don't know like philosophize about it like um maybe really effectively but unless again it's where if you're that's but that's really speaking and doing therapy within the void right it's not allowing people to experience and engage within the context that they're actually that they actually are going to need to be practicing whatever they're learning

and so i do feel like there is this maybe irony in this discussion that we're kind of looking down our nose a little at this word called holistic and then i think about the services we offer at peaks and i'm not trying to necessarily make it a commercial about that but the things that we offer are our people are pretty remarkable from from the medical perspective um not just with medication but with tms the transcranial magnetic stimulation um is pretty innovative and cutting edge and uh you know from from an outside of the medical realm perspective like i'm watching it really have fast and dramatic impact on people's mind and um the other thing that that we certainly offer is a lot of um ability for people to use their bodies at at peaks whether it's through hiking or through uh crossfit or through um mma that were that we've recently added all in the context of building a community as well of people who are recovering and encouraging one another and then you throw on top of that this family our family programming that we're offering three hours a week to our families outside of um care just over zoom to families all over the country to deal with kind of the you know at least some of the support systems and and possibly even um some stressors and to help families kind of reintegrate their loved one back into their their life like i think we do a pretty decent job of engaging people in this holistic way um and yet we are resistant to using that word because the word is somewhat meaningless in a lot of ways i don't know right that was my thinking about it no i think that you're right i think that it's um i think about the mma portion right like that so we offer uh in our women's program we offer them mma so they can go and do mixed martial arts and engage again in their bodies in uh as a as a means of sort of expression and processing but also it it there's a level of social empowerment that's involved in that as well and a sort of challenging of social norms that helps to begin to actualize individuals in a way that they when they go back into the environment actually changes the way in which they perceive the environment and it changes the way in which they interact with the environment so that becomes a very holistic a holistic intervention strategy even though it's something that is not necessarily like cbt right or motivational interviewing but there's a there is a actual behavioral cognitive behavioral transition that does take place in within a holistic setting and so i think that that's actually a pretty good example of holistic treatment but it feels to just say oh yeah we just do holistic therapy seems so much more empty yeah and so maybe it's just the word that is kind of played you know and it's time to to come up with new concepts because um in the end it's it's not just about changing the individual but it's about teaching the individual how to change the world around them as well so yeah one of the um i was doing some googling uh earlier today at work and i actually ran into an uh an abstract of a research paper that was talking about um you know treatment modalities and efficacy of treatment and so forth and it said one of the value propositions that adds to a treatment episode or that creates greater benefits for the individual participating in treatment was these enhanced features so one of the things of course that we do at peaks to ensure that an individual has the opportunity to arrive at treatment we so long as they're local within the area of course we will go you know pick them up from their sober home in the absence of transportation and support them coming over and within this article that was an enhanced feature of treatment that promotes the individual's wellness and supports them receiving those therapeutic interventions in a way that they otherwise wouldn't receive um but holistic can't mean enhanced right or is it or are we just playing on words here because in these articles they're not talking about holistic care they're talking about what feels like more ancillary features that provides or offers up a more extended view of care but you know if if these enhance you know if treatment is here and enhanced features bring us to here it still feels like we're still inside this concept of holistic care sure holistic feels much bigger than yeah no i i think you say that in in my in the way that i perceive the world is somewhat pragmatic and i think that maybe that's i think holistic care is actually very pragmatic you know we have that that word holistic is just like so ah like spiritual like i don't know it seems like amorphous it's kind of hard to like wrap your head around and in reality it's like holistic care is like oh you need a ride right so we can do that right like let's do that for you because it's a barrier and we're gonna so we're gonna help you get through this barrier that's in your like legitimately just in your life and so um maybe there is it's uh maybe we've lost the pragmatism behind what it means to be right a holistic therapy a holistic care provider yeah so i mean because at the same time like a you know i i think anybody reading a website that says holistic care is thinking oh they're going to provide transportation to iot and that's a part of this right yeah right you guys are going to get us a bus pass that's what that means yeah you know um and it's not to take away from you know there are excellent treatment centers using this language on their website and so forth and i think they mean to say something like we care for the individual so much that we are going to think about and open the door to all of the things that are important to them mind body and soul you know spirituality really and the soul aspect of things and um you know one thing at a time we're going to kind of you know work backwards and see what's going on with the individual and what's causing the frustrations and i think you know again too we're dancing around the language of holistic care here with new language or or different language but there's an essence to it that i feel like is just missing here and pragmatism you know the pragmatic approach about it is probably the truth of it right at the end of the day according to me yes we're never gonna maybe achieve this concept of holistic care because we learned it in grad school maybe and then the industry or the profession or whatever just never you know came up with a pragmatic approach to make that a real thing that we could actually anchor into and rely on though um and you know uh and i guess ultimately too we're talking about it because family members get on sites and they read those things and we're trying to disrupt an industry and really just have the family i guess at the end of this really just ask good quest what does that mean yeah that you guys stated this and my daughter presents or you know son or whoever presents all of this uh these you know symptoms and how is this possibly going to be treated because i was listening to that finding peaks episode and brandon said 35 to 40 hours in a group setting kind of pulls on the notion of holistic care so yeah and it's hard to and how do we disrupt the industry on that because certainly the thing that pops into my head when somebody says holistic i'm thinking incense yeah and uh the yoga yoga or the sunrise and the garden of gods in the background some sort of uh bell or chimes or whatever and like i and i think all those things are are awesome if they are directional and they are saying this but this is informing our mindfulness practice and and these are behavioral interventions that can help ground people um that's what i think is probably the intention of the word back in the day right um and now you know and i do think so people may put these things out there without having that underlying intentionality around it and and i think to me if we want to get holistic back as a word there's there should be some reasons and some intentionality to explain around that not just throwing stuff out there and calling it holistic do you guys think that it maybe came from or was brought into the literature of grad school because there were you know therapists or outpatient centers or whatever the case uh is as far as the facility or hospital is concerned that we're just like doing everything under the gestalt lens or just stating we're going to you know dr yalam it or we're just going to have these single approaches to care and maybe we thought no we need to break away from these you know very direct services and really approach it through or maybe it's more of just an intervention strategy right that we're going to use cbt and dbt and mi and in uh you know trauma services and all these sort of things to promote the wellness of the individual i mean maybe that's the well i mean this so the origin of the whole holistic movement it was really just something it was in response to them to the medical model which did sort of treat people at within a void right it's like i identify a symptom i'm going to prescribe you a medication to alleviate that symptom and then that's the treatment right rather than actually saying so what in the environment might actually be causing that symptom that we need to change the environment and not just treat the symptom right so i think that that's where it all kind of initiated it was in response to the medical model and then i think it just got super incense-y like and it became something a um that was a great big idea and wrapped around the idea of person-centered therapy it's like oh so we're person-centered and we're gonna be holistic so sit down on your chair and let's talk and we're gonna fix it and that that's not the same thing so i think it the idea was there everything was great and then again we just lost the idea of well where's the follow-through right yeah well it's it's it's fascinating right if it was sort of a rejection of the pragmatic approach of the medical model right because then what we then we fully and embraced abstinence-based you know approaches to care which in and of itself is not holistic it is just a single path for individuals in that regard and then when we as an industry came forward and said well maybe there's some efficacy of medication-assisted treatment for example and we said no you know abstinence-based so it seems like out of that though it was necessary to leave the pragmatic model of medical in the way that it was being viewed and to come up with this holistic way the therapeutic interventions there started rejecting the potential for new ideas and holistic care in the direction of those medications and i just think that's a fascinating aspect about this as well too so treatment centers who insist on abstinence approach or who refuse to use matte as a treatment uh intervention or as a you know a pharma pharmacological approach i think i got all the words in there letters letters syllables thank you english major uh in there who turn around and only promote abstinence and refuse to do that then would be violating a holistic approach to care in that regard because it's not about the individual it's about our personal treatment philosophy as well too so just highlighting i think in a way when we talk about disrupting an industry uh family systems who are you know dealing with you know the the fallout of opioid abuse and in that regard call a treatment saying think it's holistic and get there and they just rip you know the individual off the drugs and their craving states are through the roof doesn't feel very nurturing from a holistic approach i think you've converted to a holistic point of view absolutely yeah the innocence intervention is over

well i think again what you end up what ends up happening is you get people really good at being sober in one setting like in one specific context and as soon as they leave that context it's game over or at least the odds become very very very low that they're going to be successful so yeah so if we had to kind of you know kind of as a going out credit here you know kind of maybe redefine what it means for us and being charitable to the word and maybe providing some influence to the industry to you know lean into it and take seriously what they might be stating on their sites like what do you think treatment settings that are holistic look like

friesma yeah thank you for that um well i think it's what we are as i mentioned earlier we are trying to create at peaks which where we have medical at the table and saying this is how we can see the brain and this is how the brain works and this is what this individual needs to treat their brain not just not just medications but other medical interventions and i think that's growing like that's that's going to be really innovative um and then a clinical voice saying this is these are the clinical interventions that are going to be best and then and then people uh that can intervene on this is how we build community and this is how we meet practical needs like like recovery coaches um i think could be so uh incredibly powerful and but all of these things being directional and collaborative i think that sounds pretty holistic from my ears yeah what do you think clinton um i just i think you got to get up off the chair you know and you got to get out there into the world and actually practice like there has to be a moment where these things go into action in real time and real space and um we you stop talking about it and you start actually doing it so just programs that have that momentum forward of like this is it's you're gonna be safe here but also we need to figure out how to make you safe out there and so the program is designed to do that and and provides that whole spectrum of care that's what i would look for well i know i'm just playing on words here but it it feels like again too that holistic for me at least falls better under like enhanced care or more to samsha's you know point of view as well too that we're talking about integrated care and that you are integrating as many different features of care that can support the individuals within a milieu at any given time um to uh everybody's benefit and certainly each and every individual within it um so challenge accepted on integrated care i still i'm not feeling too many fluffies about the word holistic in that regard you guys know it's been something that uh i've just detested wholeheartedly being on websites and so forth so just grateful we can have a discussion about it if anything for families you know watching out there and taking a look at this thinking why are we talking about this in the first place again to disrupt an industry the greatest power to do this is family members and the reason we talk about these buzzwords and the internet words as we're talking about it is because i know at the end of the day especially in working the admissions line that people are desperate for change in their lives and the family system is suffering and the individual who's addicted to drugs and alcohol are going through their mental states is also suffering at the same time and we read words like holistic and to me you know the way that i think about families in those moments you it can kind of feel like you know putty and the power then is in the addiction treatment center saying to tell you how it is and so my hope with this is that when you read that on a website i don't care where it's at if the treatment center is great bad or otherwise that you just ask what that means and how they're actually going to implement that and i bet the more and more families start asking the question the word's going to go away from the internet is my belief about it because i think what we've recognized here is that it's kind of hollow it has meaning certainly but at the same time it kind of lacks meaning at um all in all so thanks for sticking with us thanks for talking about this internet word uh holistic again um until next time on finding peaks episode um finding peaks at peaksrecovery.com questions thoughts concerns ideas or uh here's the definition of holistic you guys missed them you guys missed the mark you don't know what you're talking about that's what that email address is good for uh find us on the twitters the facebook the social medias they're all over the place um we love you guys we appreciate you and thanks for joining us again we'll see you next time take care

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Episode 24 Insights Into Family Recovery Watch Now https://youtu.be/iahDg8V6SJM Listen Now Episode 24 A very special guest, Lisa Smith, opens up about her enlightenment towards becoming a Certified Family Recovery Coach, and how she is now helping families fight addiction together.

Topics:

Lisa opens up about why she shifted into a completely new career, helping those families struggling with addiction.

Lisa compares the two different approaches she has experienced while walking through having a son who was in active addiction; the one before learning how to manage this hard situation, and one after.

How she overcame the fear

Lisa gives her insight into connection, relationships, and kindness and how these concepts are intertwined with recovery.

Lisa explains the Family Recovery curriculum she has developed

Select Quotes You’ve got to be able to separate the behavior from the person. It requires you to not take the behavior personally when the behavior starts to happen that you wish didn't happen. This concept really helps to get to a place where you aren’t being led by fear. It's not something that is easy, and it certainly isn't something that comes naturally as a parent, but allowing them to walk their path and establishing the connection, communication, and kindness helps the family to get to a place where the individual understands your intentions. Lisa Smith, BA, MME, CCAR Certified Family Recovery Coach Episode Transcripts Episode 24 Transcript hello and welcome to another episode of finding peaks i'm jason friesma chief clinical officer of peaks recovery to my left chris burns president and founder of peaks recovery hello and to my right uh very special guest lisa smith uh family peer recovery coach or peer family recovery i never know which order to put those words in but um lisa's uh joined us uh lisa i met with you i don't know a few months ago you came to our office and said i'm doing this thing and you got to check it out and um and i was immediately struck by your passion and your uh desire to help families of people who are struggling with recovery and i was i was wondering if you'd be willing to kind of talk about well a where that passion comes from let's start there right well i'm a mom of a son who is in recovery but has struggled for several years with substance use disorder and so i have walked a difficult path in with our family and and the disease of addiction affecting everybody in our family so that's kind of and where i started on this journey of working with other families yeah can i ask the following question that okay cool um and then how i i feel like you become the person that you needed during that journey maybe and and could you talk to that a little bit yeah i did so my son struggled for several years went through several treatment programs and was successful in the treatment programs and we would go to family weekends and we went to several that were really great and you know we felt hopeful and like we had our son back and in looking back at the time i was unable to identify this but in looking back you know we would see growth and progress from him and we were in the same place and we had not necessarily changed anything because we didn't necessarily think we needed to change anything and you know he was the one who was using substances and we had a healthy family and this was his thing so

the last straw was the day i call it the day i went from seeing it black and white to seeing in color because i actually believe that that's what happened i was surviving my life and my son was in active addiction he was living in our home things were not going well and he walked out of our house one day and i turned around and said

i'm not gonna sink on the ship and two things happened one was i had to take a hard look at myself and kind of save myself and do some hard work and the second piece of that was all of the information that we had been given and therapy that we had and coaching that we had and resources that we had didn't sit well with me and my heart as a mother and frankly they weren't working you know sort of a rock bottom approach calling us enablers and um it just really didn't feel like that's how i wanted to mother my son and um so i had to ask myself a question it was not a very good day in my life i said uh gosh my son might not make it and am i okay with the last thing he heard saw and felt from me and that was probably the hardest day of my life because the answer was no i wasn't okay with it and um that's when i dove into finding a better way and i found a lot of data that spoke differently than than what we had been given as resources um by very well-meaning people who just didn't have the bandwidth to support us as a family system so um you know i really kind of dove into a compassionate empathic connection approach with my son and he did not return to our home for another about five months but every single day that he was out and in active use he we had contact with him because we changed our approach with him and i would say that living in our home we did not have that same contact with him um and in that five months he felt loved he knew he was loved i think you know my son knew he was loved like deep down you know we were a loving family but the expression of love and kindness was not being given to him and um that's when everything changed yeah that's huge and i actually remember the the last family program you were in and i was running and you said something that's just coming top of mind right now you said what i love about peak's recovery and this was when we were extended care he said different than the last programs we've been in you guys don't kick the can down the road with respect to the client make it somebody else's responsibility but when you said that and now that i'm sitting with you at the time we certainly kicked the can down the road a little bit with respect to the family and i think you picked up that can and brought it in and said hey i got this opportunity to really be connecting in this and it was just something that popped up in my head when you were talking right there and now i think with peak's recovery and you involved the can doesn't get kicked anywhere it stays purposeful and present in a real direction specifically with the families in care now we've always done a great job with the client we've always been really client centered and i think since you've come on board it's really given us an opportunity to really be intentional with the family system and i think to your point that's when we introduce compassion and that's when we diffuse shame and really create some verbage um that can be connecting in nature and not shaming because that's how i got sober too it was kind of that that rock bottom approach that all or nothing and it doesn't necessarily have to be that way in the way that you speak so brilliantly to your son is an active addiction but you're communicative and you're connected i just think that's the power of compassion that's the power of insight and family systems loving their loved ones into recovery it's really cool yeah and similar to you know there's multiple paths to recovery for people in addiction there's also multiple paths and meeting somebody meaning a family where they are today um and having resources and tools so that they can live in their values and their intentions which is not necessarily the same as mine for my family my son had to not be in our home um you know he was not healthy for us to be at home and that doesn't have to happen um i wish that i had done the work earlier because maybe we wouldn't have had to get to that place but you know meeting families in their anger in their pain today and giving them the tools that maybe they use today or maybe they use next week or maybe they use in four months um just like people in recovery it's very much the same path um and yeah i i think that's really important yeah most definitely can you tell us about a time where you did it different like were you you went on your own path uh with your son and his process where you had this opportunity to either respond in the way you used to respond or respond in your new way yeah because i think a story would i think help yeah definitely well um this was not necessarily when he was in active addiction all the way i have stories there too but this is a kind of a big one um my son was in sober living in boulder and um it was a pretty controlled sober living environment like kind of right out of inpatient sober living so still a lot of safety nets and he had been there uh two or three months and was not wanting to be there anymore wasn't connected with the the people and it just you know when looking back it probably wasn't the best place for him at that moment and he called us facetimed us actually and we answered my husband and i and he had his mask on and it looked like he was on an airplane and um so we kind of looked like where you where are you going and he said well i um yeah i bought a one-way ticket to salt lake city and i left my sober living can you go get all my stuff that i couldn't fit in my one suitcase so um yeah we were that was a moment where we could have definitely and i wanted to react in a way that was not have would not have helped him but instead we asked him the phrase what do you need in place for your recovery to be successful and he just answered and he had thought about it he really had and um and so we said okay and then you know subsequently we said what do you need from us to support your recovery how can we help you and he was able to tell us you know i need help i need to find a therapist i need to do these things and i've contacted this other sober living in salt lake and you know can you talk to them and um so we walked with him on his journey that he chose he was not in active use so it was a little bit easier to support him in that i mean he was potentially making healthy choices and had good intentions but that could have gone a whole different direction um and probably nobody would have blamed us for it going a different direction um so that i i would say that's an example of just saying you know this is your journey and we're gonna we're here for you we're here for you and we're gonna help you make this work um if your intentions are recovery and that's always been our message is we will support you in recovery how did you figure out how to deal with your fear right because i do think your initial responses were fear-based right where it was like i'm feeling afraid so i need to really control and maybe even micromanage your son's life and so how did you pivot away from fear maybe so there's a concept that is um hard and it's called radical acceptance right so um and it i i work on it daily um and it's it's the idea of accepting reality not necessarily behavior not not actions not um you know yeah just not actions but we're here so i had started to and my husband as a family we've all this isn't just me um this is a system thing had already done that work of accepting well we have a son who is not what we thought not who we thought was going to be but this is who he is and he's actually really great and um

that takes i think it takes daily work because you've got to be able to separate the behavior from the person in order to do that and um also it requires you to not take the behavior personally um when behavior starts to happen that you wish didn't happen um like getting on an airplane and and moving without telling us

so i i would say that concept really helps to get to a place of not leading by fear it's not something that um is easy and it it certainly isn't something that comes natural as a parent you know you get scared like wow that's i have the answer and it's not that um but allowing them to walk that path and establishing that connection and that communication and that kind nist which i think is actually an extension of love like expression of kindness is an extension of love of course you're a parent of course you love your child of course you're married of course you love your person but um expressing kindness is an extension of that and

that's where i you know establishing that

helps us get to a place of him understanding where our intentions are yeah i thought that's great for sure and then in working with it's so difficult too because ultimately what happens in that and i think you defined it quite well is i think as families too we're actually called to do our own work yeah and really do that because what you spoke so eloquently to was not being triggered when my son presents a behavior that i don't agree with and just staying tried and true throughout that and extending kindness even a step further which is so difficult in family systems when you're met with a behavior that you just adamantly disagree with and so i just think that's so cool can we extend silence in the midst of chaos extend kindness in the midst of chaos i think that was just explained better than i've heard it explained probably ever so i really really love that thank you yeah so one of the activities that i do with families is establishing personal values and i think you know unless you've been through um like therapy school degree stuff you don't necessarily like in engineering school they don't you know have you sit down and identify your personal values so you know sometimes you just don't even know your intentions of living and identifying those values then understanding that your values are yours and your person has different values your spouse has different values your friends have different values they may overlap but um your values are yours and that's how you show up to life that's how you lead in conversation in relationship and then that can then extend to how to set boundaries with somebody because it then boundaries become about protecting your values and your intentions as opposed to manipulating outcomes which i certainly was guilty of setting boundaries and manipulating outcomes i want to ask you one question because it's just coming up when you're when you've been talking this whole time you know the the old or kind of what we would consider the archaic version of interventions yeah how do you feel about that system and the way that it's set up were they sit down and they bring everything that this person loves front and center and they wage it against them and they say and i've seen there's some efficacy to interventions in certain scenarios but what you so um eloquently explain what that's can be counterproductive could you explain that a little bit yes i disagree with that just personally i feel like it's very shame driven and shame-based i understand that at times the fear of somebody dying is at the forefront of that kind of intervention um and so i'm not going to say that there's never a place for that um because sometimes you have to pluck somebody out of a scenario that is imminently dangerous um but i like to say that with connection comes relationship comes influence so connection equals relationship equals influence and that influence you know when recovery professionals tell families that um you know you can't choose recovery for your person that is a hundred percent true but what i disagree with is that there isn't a follow-up of there can be influence and there absolutely can be but the influence can only come if relationship and connection is occurring at the same time and that's really hard to to go to a mom and say that you don't have connection or influence of course you have connection and influence with your child um but is it that's where the love and expression of kindness kind of comes in is the expression of connection and um relationship influenceable or influencing um so yeah i think that that's

influence is way better than a shameful approach to forcing recovery which you can't force i mean you can force treatment i guess right but you yeah um for a day exactly until they walk out yeah and then which we haven't experienced that um yeah or a week and it usually goes a week but um yeah but you can't force a mindset shift and the understanding when families can really understand stages of change and what their role can be in those stages if someone's in pre-contemplation

you can do a lot of planning and you can do a lot of connection um and a lot of acknowledgement of where they're at to create that connection but there's not you can't force something you can't force it and you can't extend that kindness if you're not connected right ultimately and then you lose it all anyway right and that's i think sometimes where people get really comfortable on the streets it's like well my family had this intervention i didn't agree now i don't have a family anymore and now i've been on the streets for 15 years and so i wonder if that's a microcosm of some of you yeah definitely and so interesting with the example i gave of my son ending up on an airplane he didn't tell us ahead of time and we said like we could have helped this go a little smoother um and you know he was like i was afraid to tell you so even in that length of time that we had really worked on um that connection and kindness with him he still was afraid of our reaction but i will say that our reaction in that that moment when it could have gone a very different direction and then subsequently with him establishing himself in a new city and independently a hundred percent i believe that if he were struggling he would reach out to us and ask for help i i know it i know 100 and i couldn't have said that a year ago and he's been in recovery for 15 months so over a year um but i i couldn't say that a year ago that he would have reached out to us so it's it takes time and it takes work and um you know one thing that i think is super important for families to understand is yes you didn't cause this and you didn't um you know in most instances in many instances um didn't cause this and you didn't ask to be put here but again going back to that radical acceptance you're here and um so you've got a couple different ways of approaching it um and one is more compassionate and more connecting and more able to produce an outcome of influence than the other um so you know kind of stepping back for a second and doing that hard work is um i think the payoff is great yeah well i i think it takes a tremendous amount of courage too yeah because i do think shame is such an easy lever to grab and just whether it's name calling or you're never going to measure up or even a shame-based intervention like that's an easy lever to grab and you know i think rene brown says it really well that shame can create short-term change but it doesn't create long-term change yeah like you can you can shame people into some course correction sometimes but not sustained and not at that internal change that's a that's a really exterior motivator um in the in the couple minutes we have remaining will you just at least to talk about um the curriculum you've compiled um and put together in in that four week class uh process and and the journey you take families on yeah yeah um so real quick i i want to address shame because families also oh yeah carry a whole lot of shame and and the day again the day was not a good day for me that i had to look at myself and and realize the shame that i carried um and you know the career that i was in i i kept everybody at arm's length friends family you know other people in my profession because i was embarrassed um about how we ended up in the situation that we are in so um i think sometimes reactions of families are also shame driven um because if we put it somewhere else we don't have to we don't have to address it ourselves um but the curriculum i just wanted to get that in there we could spend another year yeah you're not wrong yeah yeah right like you're exactly yeah the family that control when you when any if you're shaming somebody it's your own [ __ ] absolutely i'm feeling like i'm a bad parent so i need you to get your stuff together yeah and that's hard that's hard to admit too yeah it really is yeah but we all have it every parent i've ever met self-included has a i'm a bad dad i'm a bad mom chain buttons yeah absolutely yeah um so the curriculum yeah yeah the curriculum awkward and good segue um it starts with it's actually very intentional um in the way i move through the concept so it starts with um identifying values and really understanding personal personally where you are in your stage of change and i will say um you know speaking to someone recently at peaks actually and um about the fact that i believe my son was in a further stage of change one time i remember when i first learned about stages of change i was not in the stage of change he was because i was pretty angry and had kind of had it and um so i it was interesting for me to kind of go through an exercise of learning for the first time that there are stages of change so identifying values understanding where you are in this and what you can put in your pockets in the moment and what you can absorb and what you can change right now going through exercises about creating safe spaces and what that looks like what does it mean to create safe spaces what does it feel like how can you change small things in your conversations that do create safe space and kind of open up lines of communication then i go through understanding stages of change what your role can be in those stages because it cycles um you know and it doesn't just have to do with addiction it has to do with everything any time you need to make a change lose weight just move anything change your career you go through those stages so understanding those and understanding the why behind the behavior how not to take it personally how the behavior is actually about something much deeper um not substance use um and then i go into what i call tools of the toolbox like things you already know how to do just need to practice it in different ways which is good communication skills listening with empathy open asking open-ended questions being able to sit with somebody and not give your input asking for green light moments looking for green light moments understanding change talk so just being able to be present and reading people a little bit better sitting with empathy understanding what empathy means and then the last step which a lot of people think should be the first step but it's very purposeful why i have it be the last step is establishing healthy boundaries agreements and understanding the importance of self-care so my purpose for having boundaries last um usually people are like i want to do boundaries now um but my purpose for having boundaries last is if you don't actually you you're if you do all these other steps you're establishing boundaries um without knowing without stating it um but if you don't do these steps first your boundaries are probably not going to be as effective um and are going to be driven by your need for an outcome as opposed to your need to protect yourself and your own heart and your spirit yeah i get why they would want to be first too it's like you know i'm pissed i got some stuff make some rules

yeah and there's time for rules actually in my course i talk about rules being really only if if you're dealing with a minor or if you're a spouse and you have minors in the home because there has to be some hard rules when you're talking about children um and you know or if you're if you're a family who has a 17 year old that's not 18 yet and you're financially liable for something that they could do potentially and they're sneaking out of the house there has to be a rule around that um because you know you can be in serious trouble so most definitely well elise i i appreciate you coming on your your story informs your passion and uh your your dedicated work on creating a curriculum and um and i haven't said it but you've partnered with us um to help enhance our family program um and i think it's a wonderful opportunity for people to walk through with uh grace and with uh values and with dignity uh a process that sometimes lacks all of those things um so thank you for being on here and thanks as always chris thank you thank you thank you so much absolutely um so that's it for this episode uh feel free to join us on facebook and instagram and twitter and uh apple podcast and anywhere you get your podcast probably thank you

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Episode 23 Behind The Care: What is Utilization Review? Watch Now https://youtu.be/LpqvRGrD2E4 Listen Now Episode 23 We look under the hood of addiction treatment services and what Utilization Review (UR) is, and why it is so important for families to be knowledgeable about it.

Topics:

What Utilization review is and how it is beneficial to families and individuals seeking addiction treatment

Levels of care within addiction treatment and how the process of utilization review makes sure the individual gets the recommended level of care (LOC) treatment stay through the insurance coverage

The reasons why insurance companies sometimes won’t support, or provide coverage for the length of stay recommended by treatment providers

How Utilization Review is saving lives

Select Quotes Time in treatment saves lives, and time in treatment comes through good utilization review, and good utilization review simply means leaving no stone left unturned, understanding fully what an insurance company’s criteria is, looking at a client's clinical presentation before making that request and advocating on behalf of the client. And if that means reaching out to the provider's office to get more information, or if that means I have to go in and look through years of cases to find a similar case where they were able to give us more time, and also fighting on the phone for these clients. Of course, it’s diplomatic, but at the end of the day we are on the phone and we are pulling for every single day possible leaving no inches on the field because one extra day in treatment can be the difference between life and death. We fully understand that and we take it with a huge responsibility. Christian Pantoja, Founder & Executive Director of Pantoja Consulting LLC Episode Transcripts Episode 23 Transcript all right everybody welcome back to another finding peaks episode uh here on a beautiful day in colorado we're doing a little bit of experimental mode today inviting guests through google meetings today clinton and jason are not with me as promised we're trying to expand upon and build upon you know the foundation of recovery journeys what it means to not only go through those journeys but also to kind of peer through the lens of administrative protocols and procedures um that support patient care at the end of the day that are often not talked about so we're really hopeful in this episode um to invite families into the discussions to hear kind of about the the under the hood aspects of addiction treatment centers and um you know kind of a backdrop to this is that one of our you know one of the challenges in addiction treatment that we hear often you know is that you know addiction treatment is expensive or addiction treatment centers are charging a great deal of money for patient care and it is true that that is abused um you know within our industry on some you know varying occasions but um for the most part to provide quality of care really takes an incredible team an incredible amount of resources and quality professionals and so i want to invite uh christian pantoja uh on to our uh finding peaks episode today he is the ceo um and founder of pantoja consulting um which is a utilization review firm and he also is the ceo and founder of uh good for you billing so christian welcome to finding peaks thank you so much brandon i'm stoked to be here seen some episodes uh i love you guys so excited to be here thank you yeah wonderful so to kick things off um before family starts scrolling through the social media to find some other video to talk about hold still families like this is important i think you're going to learn a lot about today's through today's episode about how some of the underhood aspects of addiction treatment culture work so to kick things off um we're we are we're going to shy away from billing conversations today and really focus in on this concept of utilization review or you are for short and to start this off christian you know kind of kind of fill us in on you know a couple of minutes about how and what utilization review is yeah so utilization review is basically the practice of a provider's office reaching out to an insurance company to request authorization to provide their services utilization review typically takes place at the front end of a treatment episode so it usually starts with that phone call to the insurance company a provider's office will have had already assessed a client and they've already determined which level of care they feel would be most beneficial to help this client increase their functioning and decrease their symptoms once that assessment has taken place we reach out to the insurance company on behalf of the provider and we advocate for that level of care request what's interesting about these level of care requests is that every insurance company has criteria that must be met in order for them to deem the level of care medically necessary so understanding the different elements of that criteria and kind of putting the pieces together from the client's clinical presentation to the insurance companies value system is where a lot of the fun takes place but there's also a lot of complications in there that a lot of providers miss as well and uh in thinking about what you everything that you had just stated in regards to level of care i just want to talk to the families really quick about you know levels of care and relationship we're talking about detox residential treatment inpatient uh partial hospitalization php and iop and so forth down the ladder um so from from your pers your professional perspective christian um i just want to you know families are calling addiction treatment centers and you know getting an admissions team that's talking about you know curriculum and insights into care and so forth um but they're not super familiar about the backdrop of processes that are actually going to support their loved one as they advance through these levels of care and so just curious from your professional lens what is it about utilization review that you've seen as a process that is beneficial to ensure that each individual is moving through those levels of care accordingly certainly so like you mentioned there are multiple levels of care the first of which in substance use treatment typically starting with detox moving into residential your partial hospitalization stay iop and then perhaps some long-term routine outpatient but from a process standpoint i believe that typically in any field you have a level of due diligence that is pretty universal whereas with utilization review that due diligence varies across the board so you might have one provider's office where you're speaking with their admissions department and everything sounds great let's bring them on in but perhaps some questions to ask are what are your typical lengths of stay what does your utilization review process look like because those those levels of varying due diligence sometimes do cut short the treatment episode for somebody's loved one so for instance that process looks like we receive information from the facility some updated clinical documentation which is typically reflected in the patient's medical record and then once that information is received it's the job of the utilization review specialist the ur specialist to call the insurance company and request the be it detox or residential or maybe even a continuance in a level of care such as detox maybe they're four days in and we need an additional three days which is pretty consistent by the way having to call an insurance company just about every three to six days is consistent amongst most levels of care certainly inpatient ones but once that information is received we make that phone call but before making that phone call we need to first understand that there is this element of historical data that we need to tap into ourselves which simply means the facility has a level of care that they would like to request be it detox or whatever it is we have information to support that request it's our job as utilization review experts to look at the information and make sure that it's actually going to meet the insurance companies medical necessity criteria because our job doesn't end at simply making the phone call and reading off what's in front of the form anybody could do that so our job is to actually look at the information and ask ourselves is this a viable fit for authorization if it's not a viable fit our job's not over at that point we have to go back to the provider's office and we ask clarifying questions perhaps we'll say hey this is a cigna policy or a blue cross blue shield policy for instance blue cross blue shield requires um three out of five stressors within the client's psycho-social life so their personal life and then we might ask the therapist are there any of these three stressors present so once we've done that clarifying bit of information and we know that the clinical picture that we have in front of us is the accurate one and it's best represented then we can go ahead and make that call throughout that call the insurance company will ask us a lot of questions these calls can take anywhere from 20 minutes to an hour and a half where they're basically asking questions to see if our request is medically necessary but they're looking at it through the lens of could this client be fit into a lower less expensive level of care and still increase their functioning it's our job to speak to reasonable foreseeability to be able to state that any therapeutic entry attempt into a lower level of care would exacerbate this client's condition thus preventing them from being able to improve and likely leading to another admission so understanding that's important and then another element to understand too is that these are publicly traded companies so they answer to shareholders that's a good thing to remember when you're understanding why it is that the insurance companies have these cost containment measures their for-profit companies so they clearly need to make a bottom line and as more people opt to go to treatment clearly their cost containment measures are going to increase so it's our job as utilization review to understand the different trends that are happening in our field and to make sure that the provider's documentation are not even the documentation but to make sure that the provider's level of care request is supported by the documentation before calling it in once you have that information set in stone calling in the request itself is a little bit of an art form quite honestly you're basically making a level of care request while being able to state that should you not authorize this this will likely cost you more money blue cross blue shield but you want to do that in a rather diplomatic sense as well so understanding where the client currently sits today and how that fits into the insurance company's clinical criteria is of the most important certainly and that information um is constantly changing so it's not something that you can sit into and automate and get comfortable what worked in 2014 doesn't work in 2021 certainly right i'm actually seeing level of care criteria shift down the way so perhaps a client that used to meet for residential in 2017 an insurance company's criteria might say today that that same clinical presentation can be best served at php or iop yeah and i i appreciate that it's always just such a pleasure hearing you wrap uh utilization review practices um because um you know from my position as ceo of you know peaks recovery centers it is um something that's constantly being explored constantly being updated and changed in the background you know and following all of that really requires you know a a a quality lens to see all of that through you know before i got to know you in this industry and in this uh you know field certainly christian um there would be episodes where you know individuals would come into treatment and i would see them getting you know their authorization denied by the insurance carrier or we hear and i know families watching this can think about it or know this to be true for themselves that you know they got johnny into an addiction treatment center and then eight days later the addiction treatment center removed him under this kind of notion that the insurance company dropped them from um or wasn't willing to pay for treatment moving forward now for me when i hear those things i take a lot of responsibility for that an addiction treatment center mental health or otherwise has to have its ducks in a row to be able to help the family system navigate that insurance aspect of things by checking all of the boxes along the way so we've heard a lot of positive features for how utilization review has to go for it to go well but when you hear people getting dropped off you know in a sense seven to eight days into treatment episodes that we're planning on being there for 30 60 90 days you know what do you find in your experiences are negatively happening within those operations and and what's being missed that we can share with the family system so that you know in in relationship to you know one of my visions for peaks recovery centers is to disrupt this industry and to do that in a way really is to empower families to have this access to information to call back you know the addiction treatment center and say hey this doesn't make sense to me because johnny's been using you know intravenous heroin for the past four years and it makes no sense to me for how we've arrived at no medical necessity um in that regard so just kind of curious how you might see you know as a thought experiment kind of how negatively or what negatively would have happened that would have led to an individual only getting you know a few days in a treatment episode where they were promised you know 30 60 90 days sure i actually really appreciate you bringing that up brandon thank you for that question because it's pretty frequent that i find myself saying that from my from my position where i sit i genuinely believe the greatest issue i see on a day-to-day basis is clients who are meeting their insurance companies criteria but the provider is unable to for some reason accurately relay that client's clinical presentation onto a paper or into an electronic medical record system that accurately supports their level of care request so the client's actually meeting but the documentation isn't necessarily stating that so where's the disconnect and there's a few variables that i've identified over my time that can kind of uh relieve some of those short links to stay the first of which is making sure that we are assessing clients appropriately far too often are we going through our questionnaires that end up becoming information that we send to the insurance company we're going through these assessments in a rather passive way letting clients kind of dictate the flow of the assessments at some point in assessments things have to be done within an open-ended questioning manner and sometimes they have to be done within a closed-ended questioning manner so for instance um understanding that this is one of if not the most manipulative patient demographics in all of healthcare is very important right so for instance when i go into a urgent care because i broke my arm let's say the provider will take an x-ray it'll show a break in my bone the break in the bone shows that the cast is medically necessary whereas we don't have that in our field we don't have a lot of biometric data showing that someone has cravings to use so within that there's this element of creative licensure that has to be utilized by our team when getting this information back from the clients outside of that certainly making sure that you're having the correct person calling the reviews i personally see it as a cost to have clinicians calling in reviews to the insurance company for a few reasons nothing against clinicians but clinicians go to school for a lot of different reasons but at no point do they ever receive education on what cigna deems is medically necessary for residential care that's a really important part of treatment you have a lot of clinicians in the industry in the country rendering services for a level of care that they don't really know what meets and what doesn't meet with our pair sources so making sure and then another thing when they call in their own reviews frequently they kind of want to highlight the good elements of their work which is certainly not the place to be done on a utilization review when we're trying to discuss why this person needs more treatment so i always suggest having a somebody else calling the reviews that is specifically an expert at utilization review if they're a clinician that's great but their main understanding needs to be of what insurance companies deem to be medically necessary and then also being able to take the information in front of you and painting a clinical picture because the insurance company asks questions in a rather rapid-fire way and you have the answers in front of you but just simply reading them off from the medical record can certainly get you into trouble a quick example is um frequently i see in medical records that a client is resistant towards an intervention or perhaps towards a therapist or towards a day of service resistance towards treatment to an insurance company means that there's no need for treatment that the treatment as efficacious as it might be it's not going to work out because you have an unwilling um component being the patient so we flip that word into um ambivalent because ambivalence towards treatment speaks to a low readiness for change it speaks to limited insight into illness and it certainly speaks to the need for continued stay at a level of care so somehow a change in terms like that and understanding those through just engaging with insurance companies um over a long period of time gives us the understanding to to change the wording a bit without actually changing the nature of the clinical requests and certainly of the details that are accurate and truly represented within the milieu so i would say it's a plethora of things you don't want your clinicians calling in your reviews if you don't need to and certainly i would suggest if it's on the clinician's caseload it might not be the best person to call in another element of that is that you want to be diplomatic within these conversations and the insurance companies as they're trying to fit your patients clinical presentation into a less expensive lower level of care at times they come up with statements that can be rather offensive if heard through certain people um and certainly responding in annoyance or in anger diminishes your ability to persuade so at times i feel as though if it's going to be a clinician perhaps somebody that um doesn't have that client on their caseload and as i had mentioned previously certainly somebody that has a great understanding of medical necessity criteria and how it varies from pair to pair

yeah and and i'm i'm hoping that uh you know families for this episode are still tuned in at this point because this is all fascinating stuff um and especially for me but something that the family system should be aware of of how complex these discussions that are taking place you know an addiction treatment center says yes bring johnny into treatment but what happens in the background are these types of things and it's these quality aspects of care that are going to ensure longevity namely a continuum of care so that your loved one can achieve you know experiencing a full addiction treatment center's curriculum being able to go through it to work on grief and loss relationships and so forth as they go through it but we have to constantly identify these metrics with the insurance companies and you you mentioned it slightly but um it it i i guess just as a this is probably just a very direct and straightforward question with a with an easy answer but it sounds like we're speaking to a insurance companies differently we can't use things like the american society of addiction medicine manual a-sam criteria to advance a single narrative across insurers it sounds like in that regard that when we talk to united healthcare blue cross blue shield and cigna we're having very different conversations because their cost criteria looks um significantly different at times is that correct absolutely so certainly the old acm criteria or the acm criteria is helpful to have documented but if you are just simply using dimensions one through six of the asam criteria um to assess a client and then expect to get full continuums for 30 days of residential whatever it is that treatment centers are promising up front you're going to you're going to find yourself ill-equipped for reviews because certainly there are some insurance companies that are still using dimensions one through six and asking in that format um but a lot of insurance companies are very creative they want to know for instance speak to me where in the asam criteria or through dimensions one through six you're going to be able to answer uh blue cross blue shield or cygnus question as to what are the current barriers to a lower level of care why can't this client be served at php you have an asam form filled out you're not going to be able to answer that question so certainly you want all the components from asam within the information that you're looking at because you're looking at post-acute withdrawals and biomedical conditions and all of that information is there but insurance companies are becoming very creative on how they're able to tell whether or not truly your service request is medically necessary and of course their own criteria at times can be rather arbitrary one insurance company might deem it necessary to give someone 30 days of treatment whereas another might deem it necessary to do 15 which tells us that it's not streamlined and there is some level of um that this is arbitrary but um even at that you still want to make sure that you have a thorough understanding of things outside of dimensions one through six such as those barriers to discharge a full scope of somebody's personal psychosocial stressors impacting their daily functioning their past treatment history there's much more outside of that and even though if you were to call an insurance company and ask them what kind of information you need to be successful on these reviews they would certainly just point to something that's rather canned as just a general progress note adapt note a nursing note but um it goes much past that it's uh multiple things and it's funny that you mention this too because i genuinely know and believe that you can have the same client assessed by two different people ethically done with true information in each of those assessments however one assessment can show for access to residential treatment whereas the other assessment would literally throw the client into a php or an iop level of care it's the same person struggling with the same issues but a facility's willingness to get curious roll up their sleeves makes all the difference in the world yeah yeah absolutely man and and again too man it's all just music to my ears love love you uh uh spit in the ur game and and hopefully too this is being well received um by the family systems because this is such an important aspect to getting dates of service authorized that allow for the individual to move through greater lengths to stay within addiction treatment episodes that gives us more time to penetrate those craving states to introduce therapeutic interventions you know that soften you know the the the feeling of of needles that seemingly when you take away drugs and alcohol that they're experiencing the sensitivity to the world and allowing more time for medical teams to manage medications to get those things right so that when the lower of level of care has come they're prepared for it and are um in a great position to achieve recovery on a day-to-day basis moving forward and so um you know and i certainly prompted you a little bit about this you know prior to the episode and coming into this but peak's mission each and every day is to save lives and our vision for saving lives is to disrupt an industry through quality of care in working with what professionals like you in our industry certainly allow for that quality of care platform and foundation so that we can move forward and disrupt an industry so in that regard you know to not just make it you know bullet points and talking points about utilization review how can we um what would be your answer to how utilization review um as sort of this sort of textbook tone thing operating in the background is contributing to our not just our mission here at peaks but for all families involved in addiction treatment episodes how is utilization review saving lives because time and treatment stay saves lives and time and treatment comes through good utilization review and good utilization review simply means leaving no stone unturned understanding fully an insurance company's criteria looking at a client's criteria or looking at a client's clinical presentation before making that request and advocating on behalf of the client and if that means reaching out to the provider's office getting more information if that means that i have to go in and look through years of cases to find a similar case where they were able to give us more time and for some reason they're not giving it to us now and i'm able to cite precedent as to why did it take place here and not here whatever it takes in that regard and then also fighting on the phone for the for these clients of course it's diplomatic but at the end of the day we're on the phone and we're pulling for every single day possible so leaving no inches on the field so to speak um because one extra day in treatment could be the difference between life and death and we fully understand that and we take it with a big responsibility so um you know i always say that at the end of the day i sleep better at night my dinner tastes better at night knowing that i did everything i could have possibly done to get these clients the treatment that they deserve and that typically comes in the form of collaborating deeper with um the clinicians and the therapists and not taking the easy way out because we could take the easy way out and families quite honestly can call their insurance companies and it would just note that it wasn't medically necessary so again leaving no stone unturned in that regard getting very curious keeping up with trends because time and treatment is what saves lives and time and treatment typically comes through a utilization review department and in conjunction with the other departments that work well

beautiful man and again to i've i'm hoping that family systems in the coming years can be just as giddy about utilization review and some of these background under the hood features of addiction treatment behavioral health centers and so forth and i know you and your team at panto consulting and good for you billing have certainly expanded your services across the nation to provide services on the west coast certainly here in the state of colorado on the northeast side of the country as well and i just uh just with with gratitude thank you for taking your unique services and expanding it in a way that continues to save lives and impact treatment episodes for individuals and families and their loved ones moving through care so you know kind of going out here as a as an episode i just want to invite addiction treatment centers that may be struggling in getting lengths to stay solidified for their patient demographic um to reach out to christian directly by email christian at pantoja consulting dot com again he's their chief executive officer as well too can provide billing services for your company through good for you billing services as well too with the deepest respect i have only met two individuals on this planet that can speak to insurance uh episodes efficacy length of stay in the way that christian can and of those two people he is one of them and so i highly recommend him um and his uh business for your billing purposes and utilization review needs families please excuse me for pitching it but i think it's important like i said to disrupt an industry to spread these quality of care aspects across our industry so that your loved one can receive greater lengths to stay uh in treatment and uh before i take us out on this outro uh christian anything else for uh the family uh viewers professionals in this field that you wanna leave us with yeah keep disrupting the industry because it's only driving positive change holding these insurance companies just liable to the lengths of stay that we should be seeing and that our patient demographic quite honestly deserves to have in treatment um continuing to disrupt the process and provide education to everybody as as peaks recovery does and thank you for the kind words you guys have been quite honestly our biggest muse not to do this back scratching for all the families here but um brandon and chris and and bobby and everybody over there your guys's curiosity about the field and an unwillingness to just settle at the status quo because you truly are in the business of saving lives it has inspired us in so many ways so um thank you and uh keep doing what you're doing absolutely and continued success on your end with a new baby in your life and the beautiful scenery and backdrop behind you in seattle washington man looking forward to the next time to be able to have you on here again to talk further about some of these underhood strategies that take place within addiction treatment and behavioral health in general so with that as we do here on our outro here at finding peaks recovery questions thought concerned and so forth please email us directly findingpeakspeaksrecovery.com we want to continue to bring new uh information invite guests on in the future um check us out on the instagram podcast um gosh facebook i forget what all the kids are on these days the twitter all of these sort of platforms look for us out there and signing off here uh ceo of peaks recovery centers looking forward to seeing everybody on the next uh episodes in the coming weeks and until next time love you take care

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Episode 22 Types of Therapy Used in Addiction Treatment Watch Now https://youtu.be/xs5KbB-uzyY Listen Now Episode 22 Our team dives into the range of modalities (types of therapy) that are used within addiction treatment in order to successfully promote healing, growth, and foundations.

Topics:

Why it is important to use a range of modalities (types of therapies) within the beginning of treatment The art of having a range of modalities as a clinician in order to truly better the needs of a client What CBT (cognitive behavioral therapy) and what MI (motivational interviewing) is and where to properly insert those modalities What our leader therapists favorite types of therapies are to use for individuals

Select Quotes At the core of all of this is the relationship with our clients. I can have the best tools and know CBT, DBT, and all of that, but if I don't have that connection with the client, none of that matters. That is the part that is hard to measure and you can't really see it, it’s felt. That is the magic sauce that connects all of this Clinton Nicholson, MA, LPC, LAC Episode Transcripts Episode 22 Transcript all right i think we are starting here another great episode of finding peaks recovery center as your host nailed that introduction that's a soft launch right here it was great it was powerful really yeah just playing with a few different intros like that oh we've we've we've just started yeah oh oh you just came into our lives that's surprised look yeah yeah so anyways let us know finding funny peeks at peaksrecovery.com if that works for you the viewers right likely not jason told me to do it sitting here today with the friend colleague chief operating officer clint nicholson everybody pleasure and chief clinical officer jason friesma everybody welcome back to the show we were intending to do a show today with the doctors about medication assisted treatment but that's coming to you now in the future because they got a little bit busy today so here we are so we're going to talk about treatment modalities today cognitive behavioral therapy motivational interviewing when to insert it when not to do it um kind of as an introduction to this you know because i like to build on a little story every time i approach absolutely stay awake this time going back uh we did a podcast long long time ago with a special friend of ours uh dr steven alardy who's a professor at university in kansas i believe is the university that he's working at and he does a lot of research on depressive uh disorders major depressive episodes and so forth um check him out online he's got a lot of great videos but he did a little podcast session with us and i think he was talking about how to resolve a major depressive or disorder as a single diagnosis code said in that regard using strictly cognitive behavioral therapy it takes up to 90 days to resolve the issue in individual therapy sessions as an intervention okay so taking a step back from that data sounds powerful but in a 45-day stabilization model such as peaks recovery centers or a 90-day recovery program over time we are dealing with very complex individuals substance use disorder major depressive major depressive episodes psychosis mania a lot of varying diagnosis for the individuals that we treat at any given time so it doesn't feel reasonable just to launch into a cognitive behavioral therapy and that's all we're going to do you know at a center like ours or within any early short-term recovery episode in that regard so just curious about mainly where to start with this but also yeah but also too how do we because families are you know all of the addiction treatment centers websites are saying evidence of evidence-based practices well if it takes 90 days just to do nine you know a major depressive clean that up a little bit then what are we doing with all the other diagnosis doesn't seem to really fit into what we're trying to do in stabilization phases so maybe just as a broad approach to this why why don't we just use a single approach to therapy through the first 45 days at peaks like cognitive behavioral therapy yeah i think that's fair and i and i refer back to some of our other podcasts that we've done where people come into peaks and probably enter any residential program at a different place everybody um has varying degrees of motivation and a wider range of symptoms that they're dealing with and so if somebody comes into our program and really they aren't even sure if they would like to be sober or if they'd like to make changes to their life at all jumping straight into cbt cbt does require a little bit of buy-in from somebody they need to kind of be interested and motivated to change and so if somebody isn't quite yet motivated to make some changes other approaches like motivational interviewing as you might suspect um would be a better approach in those instances and and those modality that modality particularly is designed to help um clients move from that starting line of like maybe i want to change maybe i don't or i don't want to change and get them to okay i'm ready to change does that make sense yeah okay yeah i think um people are complex you know like even a single diagnosis like um like major depressive disorder like that has many so many factors to it that i even think that cbt in a 90-day model would be really difficult to completely um resolve like a major depressive episode i think the idea of being eclectic in your approach is probably i mean if you think about complexity and then being eclectic is going to allow you to be able to meet all of the different needs at different times because like jason said like in one moment you may have somebody who's highly motivated to to move forward and make these changes and a more um sort of i don't know confrontational approach like cbt might be really effective but if you have somebody who's still on the fence to go in there and say hey well you know actually your thought patterns are not are this but they need to be or should be or could perhaps look like this they're going to be like what the hell are you talking about you know they're not even going to be able to hear you so being able to i mean my personal approach i like to go in with a little bit of mi and then slide in with the cbt and then you do a little bit of solution focused on top of that you get a nice little sandwich there as far as treatment modalities go but you have to first and foremost meet the client where they are and if you're not paying attention to that then no matter what treatment approach you have no matter what intervention strategies you're using you're going to miss the mark so well i think what's interesting i don't know about your program um but the program that we both work in no no the master's program the master's program sorry i'm aware of that the program we both work but i do think you know we were trained to pick one modality absolutely as clinicians and to stick with it and the word you know to take an amalgamation of these different tools and combine them having an eclectic approach um was pretty heretical actually to a master's program right and then you enter the real world with real people and you can if you only have a hammer the world looks like a nail isn't that the same and like you have to have a lot of other tools on the tool belt i think um in order to approach clients in a sophisticated way yeah absolutely i remember being in grad school thinking that oh i'm never going to use cbt i'm an existential therapist that lasted about three days so i'm pulling the gestalt yeah

so cognitive behavioral therapy to me is you're sitting in a room as a therapeutic intervention individual has one reality seemingly not a true reality in this moment the practitioner has an alternative reality and that's more aligned with the world for the way that it is and the goal then is through that rapport building mechanism to help them see the better framework of reality and to move and lean into that um is that accurate yeah i mean i think i think that's a good representation of it for the most part like basically people have cognitive distortions they aren't thinking as clearly as maybe they could and um and there are a variety of techniques in cbt to begin to uh challenge and or reframe thinking yeah that's pretty much it yeah it's a it's a lens it's just somewhat distorted right like there's just a i don't know a smudge on the lens and you're there to sort of say well what if you wipe this much away then what then what does the world look like so and you're so you're not only are you highlighting that hey you might have a smudge on your lens you're also presenting them with alternatives to what the world may look like without that much yeah and and i know one of your big um beliefs and i believe rightfully so is that to do good clinical work is to engage with your own clinical work in that regard because when i think about a practitioner who's not well themselves their alternative reality could be in a sense a liability um in that regard if they're not working on themselves inaccurate seen in that way too does is that um or what i'm stating about that seemingly true within cognitive behavioral therapy oh yeah absolutely i think it's true right if you're kind of carrying your own cognitive distortions into a therapy session it can be hard to help other people out with that clinton mentioned solution focused which really entails helping uh clients come up with solutions that they can come upon themselves and i i find that clinicians that haven't done their own work just get use that as an opportunity to say solution focus is focusing on my solutions for you right absolutely feels a lot more like parenting or telling right yeah just telling people and like the bob newhart video just like stop it like it it requires more nuance than that quite frequently to help people change behavior yeah i mean sometimes yeah sometimes occasionally the bob new heart approach works which is just well you feel sad you should stop that i do think too that cbt in the in the a big reason you know that dr elardi uses it and that it is an evidence-based model because it is a pretty um regimented and structured model and so when we're using eclectic approaches like that's hard to do a clinical study on and so when people are doing clinical studies you have to kind of get into that lane and stick to the parameters of that lane and so that is why that appears a lot i think in in studies and so in practice like that is definitely a tool that is important to pull out from the toolbox but we have the ability to to get out of that just that modality too and be able to use other tools um clinically as needed that makes sense to like yeah yeah i mean it's um i don't know the more options you have then the more opportunity you have to address what's actually happening in the moment you know i think that if you're too focused on trying to i don't know like force a modality into the moment you you miss things like you um i've seen that a lot with especially like newer clinicians who are focused on who use a lot of worksheets and handouts and stuff i think that they you kind of come in with an agenda of like oh my goal is to get through this worksheet and so as you're going through that worksheet somebody may make a comment that you're going to miss because your whole focus is just like i just need to get back to this worksheet so and i think that that can happen if you're too focused on one specific clinical modality i think the ability to um to know when it's appropriate to pull which evidence-based practice is actually the sort of art of being a therapist like that's the art of being a good counselor is knowing when to pull what tool out and um and then being able to use it really effectively so because there's so many good i mean there's a there's a time and a place for everything you know cbt is an amazing modality when it's time to use cbt right solution focus like jason said like it's not really solution focused if you're just giving people answers or if you're telling them what to do like that's not a solution that's a tell yeah so i think that there are um it really comes down to sort of the skill of the clinician and really being able to pay attention to the moment and really hear and recognize what the needs of the client are in that moment in order um i think that that is really actually what the whole i don't know that like i said that's the art of being a therapist that's where it really comes into play yeah so and then so taking one step back to ping that mi language that motivational interviewing um as a therapeutic intervention modality however we seek to to put it in this framework um is that the most tactful sort of maybe first time approach that is often taken or um or is there something a little bit more preliminary to motivate motivational interviewing that's what motivational interviewing in and of itself is actually a person-centered it's an offshoot of person-centered therapy yeah and so all that means all person-centered means too is that like you hold the person in unconditional positive regard and you build a rapport with them and and then um and then the therapeutic journey goes from there so like it's kind of implied within am i med i think motivational interviewing is where you meet people where they are um and so to me that is the first tool i usually pull out of the toolbox unless they're well down the path of like taking action and and doing a lot more introspection and other things and are available for that but you know helping somebody walk through the ambivalence of like do i want to change or do i not want to change that's just where motivational interviewing is a really natural tool to pull out in my opinion yeah yeah i mean i think it's a good place to start it's some people sit in it a little bit longer than others it's i don't tend to stay in that space for very long um because i i mean i believe that counseling is about change right like that's the goal is to change and so to sit in space and um but you have to get that buy-in first like jason said you have to wreck it you have to be able to recognize and understand well what is the person's actual willingness to make this change and so from that point once you've identified that then you can start moving on into these other different modalities you know you have cbt you have trauma informed care which is again another sort of person-centered approach that really focuses on building safety and rapport and relationships i mean you have uh you know even relapse prevention strategies uh dbt um act i mean they're all of these different you know modalities that you can start to pull from once you know where that person is and at that point that's when you start to to pull pull out of your toolbox and start implementing these different strategies based on where that individual is in the moment and then but and certainly like when i'm working with our clinical team at the core of all of this honestly is our relationship with our client yeah right like i can have the best tools and know cbt in and out and dbt and all that but if i don't have the relationship if i don't have that connection with a client none of that matters to be honest with you like um if i don't have that buy-in right and and that is the part i think um that's hard to measure and you can't really see it um it it is felt which i know you guys love like it's a it's a feeling it's a feeling it's a explain that yeah i know i know it's confusing that'll be a different episode i'll be in that seat but like i do think uh but i think that's the magic sauce that connects all of us absolutely and allows uh you know and i i was thinking too back to the cbt thing like i find cbt to kind of be a front door approach with clients like you it's it's has a high face value like you it's clear what you're doing it's clear what you're asking a client to do and it's clear where you're trying to take the session and some clients love that and it's really great others put walls right there and you have to find another tool and i know we joked about gestalt but pull your addiction out of your body put it on this chair let's talk to it and see what it's saying to you it sounds it can sound ridiculous to people who don't like that but like to other people it's this freedom of to have a conversation over here with my addiction and that is an entire dif entirely different modality absolutely yeah no but i i mean yeah to jason's point i mean a lot of i like to tell a lot of new counselors that you know about 95 of being a good counselor is actually just being like a decent human being you know being a good listener being emotionally present not judging them and that really like takes the win out of their sales because they just spent 50 grand on a master's degree so but really it is like it's about being a decent person because that relationship that initial connection that trust is the foundation of everything and if you don't have that if you can't make that connection if you can't show up genuinely and authentically as a human being in those moments like jason said you can have all the shiny new tools in the world but i mean if you don't have a house to work on then what's the point right yeah right when you said a really important word which was authentically because when i talk to new counselors i say that as well but i also say and it's so important that you be yourself yeah right that authenticity like you can't fake rapport clients no smell it a mile away right the younger the the keener the sense of smell

exactly yeah absolutely so as a and and of course there's dbt dialectical behavioral therapy so there's a variety of acronyms there's a variety of different ways that we can go about this um but as an as an early sort of stabilization therapeutic intervention what are like the top three that are used most often i think we've discussed two of them i mean i actually think it's mi cbt and dbt okay i think those are the three yeah truthfully okay then what is dialectical behavioral therapy so that is really about um helping people get out of the extremes of emotions and and finding um uh and not being driven by emotion dbt is super helpful um when people well it's almost a training for helping people manage and regulate their emotions because obviously in the case of substance use and even in the case of mental health issues the emotions are regulated by other things and so when people begin to get healthy emotions can can be overwhelming or some a lot of times people just walk in with overwhelmed emotions and being taught um distress tolerance and emotional regulation um and and kind of how to access the wise mind if you will the part of the brain where i can just kind of observe what's happening and not be so reactive to it um i think that's a really fundamental part of a stabilization process yeah i mean my three are a little i i like to focus i guess i consider dvt a form of mindfulness so um so i i would think that mindfulness would actually be a primary uh i do think that cbt is a primary mi is the primary but i would also say that solution focused at least for me personally is i'm pretty solution focused guy because in the end we're looking for solutions so it's a matter of being able to get to that place of safety where you can start to explore those and actually make some headway but you do have to have buy-in and as part of the foundational process of it so um but yeah those would be my go-to's for and i think it's going to be different for every counselor to be quite honest you know but mi is almost always going to be a part of it because again if you don't know where the person is in their journey then how in the heck are you going to meet him there so now i'm thinking of this clinical sort of ninja right slicing somebody with a little mi and then when it gets you know a little bit outside of where mi needs to is taking it then you know maybe hit it with the cbt or uh the dbt in that regard and just you know kind of as you go you're offering the therapeutic intervention these modalities um in real time and the practitioner success is their ability to know when to pull those out within the tool right right absolutely yeah uh in this regard so uh as we kind of come to a conclusion here because what's happening with these evidence-based practices is they set up you know the group setting and they put the practitioner in the middle of it and then they get all of these people to show up to it and then they just drive through it it sounds like though there's an outcome and an opportunity to say these are evidence-based practices i don't think those evidence-based trials are intending to say now just go out and do cbt for the next 90 days i think all they're trying to point at in a real strict sense of things is that when you use it it does work and but the trials are just going to strictly focus on the cbt is that and accurate i think that's exactly yeah what we're trying to say yeah cool cool yeah because on the admissions line you know at peaks and working and people can't say well what evidence-based modalities do you and i think they're thinking about it in this strict tone of like johnny's got major depressive disorders so i better hear you guys hitting him with the cbt but if we can't engage with rapport and if we can't move past ambivalence you know through mi then cbt dbt these therapies seem right way out in the distance absolutely if somebody comes in they say i'm depressed and you say no you're not then that's i mean you can try that but it's probably not going to work that's yeah yeah you're looking through the wrong lens yeah you're perfectly happy so no that's that's bad cbt yeah yeah absolutely good you can do that you can say that over and over again for 90 days and it wouldn't work so awesome well i honestly when we started this didn't think talking about these modalities would be so much fun but i had a great time and um really appreciate you guys investment and getting everybody access to this information with a little bit greater understanding hopefully about how these work how it's happening in real time and that when we think about trials and studies and those sorts of things they're just pointing at its efficacy not that it needs to be delivered in that time constrained setting as well too there's a lot of other complexities that we could talk about with trials and for how we've arrived at these evidence-based practices but for a future episode in that regard so uh love you guys love you too good question i think we motivationally interviewed you like you shifted a little bit yeah he just said he came in expecting it to be a little dull and boring and we tipped the scales to being an engaging that's that clinical magic that's what that master's degree is about you don't you don't know what's happening to you you just walk away a little bit better each and every quinn and i are really hosting this but yeah right we just let you think

all right thanks again for joining us here on another finding peaks episode it's great as always to be in the social share it's great to be joined by two wonderful great uh professionals in this industry great friends of mine as well too uh until next time check us out on the instagram the facebooks the podcasts the twitters i don't know if we do twitter i don't even know if anything

findingpeakspeaksrecovery.com please give us your ideas your thoughts instagram things you would love to hear us talk about in the future and uh until next time thanks for joining us

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Episode 21 A Remarkable Recovery Story Watch Now https://youtu.be/k5U5lF1lha4 Listen Now Episode 21 A very special guest, and long-time employee of Peaks, bravely shares her inspiring recovery story in order to give hope to others who struggle with addiction.

Topics:

Jason talks about his early clinician days, all while meeting Angela during those days, who was in her early days of recovery.

Angela talks a little about what her mindset was back before she started her recovery journey, and the hardships she walked through.

Angela talks about what her life looks like now as an admissions specialist, helping families through getting their loved one into treatment.

Select Quotes What I have learned in my recovery is that the most important thing to me is leading with my heart. I want to help people, I want to care about people, I know what it is like to be at the bottom. What I remember from people who tried to help me was that care. For me I just wanted to be in any kind of avenue in the treatment industry. Angela Lopez, Admissions Specialist Episode Transcripts Episode 21 Transcript good afternoon everybody and welcome to the finding peaks recovery show i have two great friends here angela lopez who's a personal friend of mine and also a professional that works with peaks recovery and then my man mr j freeze happy to be here today happy to have this group together really excited about the topic of conversation today which is we're just gonna open it up with big hearts big smiles and kick it over to my man jay but what i'm gonna say really quickly is these two have had a relationship um a clinical relationship before they had a personal relationship and so we just kind of wanted to start today's video talking about some of those early stages of angela's recovery or even before she um ended up getting sober this time in some of his early stages as a new clinician coming out of school and working with someone like angela so we're just going to get this thing going um and talk with jason first and just what was that experience like or what is the experience like to see a professional a person in recovery with integrity who has helped a tremendous amount of people not only get well get clean to be a connector in the community seeing where you saw her initially and then getting to see her now what is what is that like for you

and great question chris i think you know we were talking before the show started as we do and i was really reflecting on the day angela tracked me down which was what five years five years ago probably four and a half or five years ago um and i had known her like you said from even many years before that when i had less gray hair and i had more hair i apparently dressed terribly but um

but i do think uh that day um it was i remember i was downstairs at our center um in our women's program that at the time and um angela tracked me down and i hadn't talked to you i don't know how long what like 10 years maybe 10 years probably um but you'd really made a huge impression on me and so when you looked me up um i was eager to see you and um and honestly it's one of the most rewarding things of being a counselor at times is when people kind of track me down down the road and are like uh i'm doing well on my journey even if you know even if it didn't have its stumbles along the way um but i just remember you walked in and um you're this beautiful little girl that could barely walk and um and i i obviously knew right away you were doing well because your presence and and who you were um and i remember even on that day angela like i was hoping that one day you would work with us and were you working at a different program at the time i can't remember i wasn't quite yet but soon after you and i met then i started working in treatment at a different program yeah at an entry level technician job but i think through my experience with you um but also feeling um that you cared for me back then and you never pushed me away or said you're doing this wrong you just met me where i was and i think that that along with other people in my recovery journey made the most impact that oh i know how to care for people and i think that that's kind of what sparked my interest in wanting to work in treatment that um if there's anything i knew how to do it was care about somebody yet how like i mean share how we met like do you want to talk about that so we met when i was i believe i was 17 years old 17 or 16. and at the time it was very early on in my addiction so i'd only been using for maybe a year or two at the time um i also struggled with eating disorders i had terrible relationships with men so i was just kind of all over the map i wouldn't listen to my parents my mom lived out here in colorado my dad lived in vegas and so i definitely used that dynamic to my advantage to get what i wanted and which really put me in a position of not being able to accept help because there was a way out so my mom contacted you and i started seeing jason individually who do i talk to you okay talk to me yeah um i started seeing you individually yeah and i think at the time i was nowhere near ready even admitting that i had any kind of problem um i was in a relationship that was unhealthy at the time uh him and i were using together and so again i had a way out from looking at my problems so you tried your best um and you're good i gave

yeah you know and i had wonderful family support i just wasn't willing to look at my own problems so you know your recommendation time after time was you need to go in inpatient yeah and i was just not having it i think i even remember you bringing my parents into our session and sitting us all down and saying this is what's happening and as soon as i saw everybody i was out i left the office i was like nope not doing this yeah i left and um yeah that's that's how we first met and then i think from there we lost contact i went back to vegas and that's really where um you know i really dove deep into my addiction from there that makes sense yeah and i love that too because we're talking trauma informed before it was cool right there and that's that's what i saw there is and i think you know there was a tremendous amount of intensity in the field 10 years ago to say let's lock her away and throw away the key and let's tell her the decision she's making is wrong and let's draw a hard line in the sand and let's make sure she loses everything just to get her into treatment but what you did and what she spoke to was you just let her know that she has a seat here no matter what and whenever you're ready i'm gonna be here and i just i tend to believe it's through a lot of interactions like that that recoveries are built and it becomes safe so i just wanted to say that it's just it was trauma informed before it was cool yeah yeah and i think that that was impactful to me because at the time i didn't really have anything um i didn't really care about anything in my life that i was scared of losing so i was comfortable having nothing and i think that the part that was hard for me was letting somebody care for me because had i let that happen there's endless amount of people that would have i i just couldn't see that in myself that i was deserving of that yet um so i think that that maybe um is why i remembered you even years and years later was that feeling that like oh he cared for me when i didn't even give a [ __ ] about myself yeah yeah and planning that a little teary if you keep talking like that it's really powerful um

and it is it is weird to me because like i i do remember it like it was last week like when you were over there and and uh and then we'll talk about kind of then how did you how did you get sober you don't i know we've talked you probably talked about that in here a little bit before but like how did you get sober and then i i do want to ask some other questions about now then too sure so what happened from there i went back to vegas and my life just took a dive i was in a relationship um that was very unhealthy so between you know the codependent dynamic that we had i'm not sure what came first really my addiction to him or the addiction to drugs and so eventually i found heroin and um i had tried to get sober i you know a couple years in i was like all right i give i i have enough like let's try this and you know i attempted sobriety it didn't stick i attempted again i went to treatment didn't stick it in the same time i was dealing with an eating disorder so you know if it wasn't one it was the other and at the time i just felt like there's really no hope for me so you know i tried um and then when i was 19 years old my ex-boyfriend he he passed away from from an overdose and i think that that's what made me um realize that i wasn't invincible and also made me feel like i had nothing left to live for so you know i started doing speed balls after that and i went to california for a while to try to get sober but ended up down on skid row because that's where i could find drugs i mean so you know i was using down there and a bunch of places in between you know to i went to memphis tennessee i went to out here in colorado to try to get sober to california and i just tried to get away from essentially myself and it wasn't sticking so the last time i went to treatment my story is that i went to treatment 10 times before i finally got sober and that's definitely not everybody's experience and i never hope for anybody to go through that but for me that's what it took and i and i'm grateful for that but number 10 i went to treatment and i week in i was like okay i'm gonna use and once it was in my mind i was like okay this is what i'm doing and so i left a weekend and i used and it was the worst 24 hours of my life um i didn't use any of the substances that i had convinced myself i was addicted to uh you know up until then i blamed it on the drugs i was using or you know if you tried heroin then you would be addicted too and in that 24 hours i didn't use anything i was addicted to and i could not stop so i was convinced at that time that okay this is me that's the problem you know it's not the driving it's not my family it's not my parents it's me and i called the treatment center and i asked them if i could come back and i think that that was the first moment that i ever trusted anything bigger than myself and i ever showed a bit of humility and i asked to come back and they let me and that made the biggest difference all the other programs i had gotten kicked out of or when i relapsed they said you weren't welcome back and so when they welcomed me back um i went back but not only did they let me come back they were grateful that i was alive and they were grateful that i was not giving up on myself and from then i just decided to take suggestions and you know everything didn't happen at once i didn't become a healthy normal individual as soon as i stopped using drugs i had trauma to work through i had depression anxiety wow i had no idea that you run skid row so i go every every well the last two years um and when i go and visit places inner cities urban areas i like to run from where i'm at today where i've been and always to come back to where i want to be and it's a really spiritual thing and so i'll do these runs through skid row and you know i just i miss all of that when i meet you because i meet the professional and i meet the person sitting in our lobby who is convicted to be the best mother on earth and will do anything for her child and her recovery and that's how i came to know angela was this great integris woman in recovery great mother great values

big hearts and so to hear a story like that it kind of makes me sad because you're right you are worth so much more than that but oftentimes our stories our pain our shame whatever it is lead us to a place where we're isolated and all alone and disconnected but it is just so rewarding to see your recovery intention today in the way that you live your life which is attractive to each and every person you have the opportunity to come into contact with i mean it is truly something that people want more in their lives today is your resolve and your energy and your compassion and your love so much so that i didn't mention it on the front end but angela started out as what we call now a cca client care aid and i think it was probably a house manager back then and she was a graveyard overnight manager and she took a weekend yeah that's where i started just her best shift the best shift ever she took a three dollar pay cut and came to peak's recovery um tell me about that experience of taking that pay cut why did you do it how'd you do it yeah so i was working at another program and you know initially

what i've learned i guess in my recovery is that the most important thing to me is leading with my heart and you know i just want to help people i want to care about people i know what it's like to be at the bottom and what i remember from people that tried to help me is that um that care so for me i just wanted to be in any kind of avenue in the treatment you know industry so i started off as a technician with a corporate program so i was making a little bit more but eventually i didn't feel any heart i didn't feel useful um i felt like i just handed out cigarettes and that was it so i was like okay this is just not for me and it was like okay this is three dollars more but at what cost and the cost was at me not feeling useful and really feeling drained by helping people and that's never my hope so you know i knew of peace because of jason and i when i had come to see him so i was like you know what i believe in that program and um i printed off my resume and i walked into the office and um rachel tap she interviewed me in that moment and you know the only shift they had available was overnight on the weekends to me that was small compared to the three dollars and the pay cut because it was something that was meaningful to me so what my wife looked like at the time i was a single mom already of my daughter who was one and a half so there's no daycare on the weekends so i would work 12 hours overnight and then i would pick her up from pueblo where my sister lived drive back try to take a nap while my one and a half year old is tearing up the house and then drop her off and go back to work for 12 hours and then monday morning then she would be able to go to school and i would be able to sleep and so that that's what my life looked like and then you know from there i think um what made the biggest difference for me professionally is just acting out of integrity and putting my heart first even in what i do um as a job so i think from there i was able to work my way up through the company yeah it's a really beautiful thing and then i think we do mean to actually lose you back to the almost almost and then we're like no no we'll just let's just pay her that three bucks she's worth all of it and now angela is an admission specialist she brings people in on the front end of treatment and if my sons god forbid would ever have to go to treatment i can't think of somebody that i would want them to get on the phone with other than you because you're going to lead with that heart you're going to make them feel safe you're going to tell them that they're valuable even when they don't believe it and that's the type of people that i want in and around my recovery circle in and around our treatment program and in our communities and can you talk a little bit about what that admissions job has kind of changed for you professionally what is it like to really have those families on the front end a lot of times very vulnerable i mean the work that you do is so precious and has to be so precise and the family often times is like clay yeah and sometimes people do poorly with that clay yeah and i think you do just a magnificent job um filled with integrity and so what what has that been like for you transitioning from like client-centered to more centered yeah so i think for me what i remind the families that i am working with is that we all have the same goal nobody wants to live their life you know doing drugs and living in this burden of mental health and so nobody wants to be there and there's no right way to get to recovery i think that a lot of the tension between families comes because one person thinks there's a right way and typically the client is like no that's not the right way to support me which is there's probably truth in that somewhere so i think that that's the biggest thing i remember is that okay we all have the same goal here and how do we get there and then also making them um you know feel like they're not alone in this um i think even if i don't tell them specifically i want them to feel that that you know there's they've been hurting their loved one has been hurting and there's a solution for that and so i think that that's just always my hope is every time i take the call is that okay make them feel like they are not alone and i think that that makes the world of difference um is for somebody to feel like they have somebody to support them yeah and then that you can relate to and i love the way that you can relate with families and people and even if it's not necessarily your story you do a really cool job of allowing them to see their story in yours and i think that's a really cool unique professional and personal trait that you have is really highlighting a story that might be a bit different but enabling that story or enabling them to see their story in that so that relatability and that safety right away i just think you do such a phenomenal job with that because when you were telling your story i never was on skid row but damn i felt like i connected with that you know really really well and so i just really appreciate you coming on here today and really just talking about some of those things that are near and dear to your heart in your recovery process that is so intimate to you and your family and i've just really got a tremendous amount of gratitude for who you are what you're about and what you do on a daily basis and i couldn't celebrate you more both personally professionally and you're amazing mother an amazing professional amazing person and that bright light just exudes off of you so thank you so much for coming in today jason as always chief clinical officer admission specialist cheerleader

it's been it's been awesome opportunity having you all on today um i appreciate you coming on and spending some time on this sorry about the technical difficulties that's what people with big hearts do they don't pay attention to wires sometimes it goes a loop thank you so much please find us on spotify facebook instagram wherever you get your podcast we love you big hearts big smiles peaks recovery let's go

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Episode 20 The Effects of Covid-19 Watch Now https://youtu.be/K_9wHqVTi-0 Listen Now Episode 20 Our team talks about how COVID-19 has affected recovery journeys, the overall mental health of individuals, and how treatment centers provide care.

Topics:

How COVID required treatment centers to shift tremendously and how Peaks Recovery adapted
How COVID gave treatment providers a chance to better their quality of care and grow in ways they weren’t aware of in the beginning.
How Peaks saw a shift in the dynamic of calls/clients due to the isolation COVID brought forth

Select Quotes For any addiction treatment center that was paying attention during that time there were incredible opportunities to learn more and grow as an institution and 100% forced that growth almost immediately. Brandon Burns Episode Transcripts Episode 20 Transcript here we are again good to be back good to be in the hot seat the host seat another finding peaks episode here so today we're bringing forward uh because the viewers the people on the other side of this camera have been interested in i know this world talks about covet all the time and for very good reasons but the viewers have been interested in what does that look like i think within addiction treatment culture and also too what are those sort of dynamics the features of it that we're starting to see maybe starting to take place you know within current programming and to just talk about that a little bit so excuse me viewers for having my phone out here but we've got some data on this and so what took place during addiction treatment um as the height of covid was taking place was there was a lot of movement to telehealth practices to create that distance uh and so forth an addiction treatment culture but the data is in and so what it kind of looked like within addiction treatment culture was 85 percent of all treatment was delivered face-to-face and telehealth sort of a back and forth 82 of all treatment was delivered face-to-face still an inpatient program and 69 of all treatment was delivered telehealth only uh during the pandemic or certainly during the height of all of the lockdowns and so forth what's interesting about the data is that uh 91 satisfaction with face-to-face and telehealth uh 85 satisfaction with face-to-face only and 76 satisfaction with telehealth only which lets us know that in some way telehealth wasn't totally satisfying to our patient demographic so i'll just read a few quotes here from that survey i very much need to be at in-person groups these telehealth stuff has been very hard for me especially when people are in the group and they never reveal their faces this other comment is very straightforward zoom sucks

it really put a damper on my recovery i didn't like the zoom meetings it wasn't like in person meetings going from regular person meetings where there were bonds and physical embraces with other fellow addicts to the zoom meetings made me feel more isolated and depressed uh the zoom sessions are still challenging because we can't hear everything people say so technology issues there and finally zoom meetings are a great in a pinch however i don't get the same benefits as i would from in-person meetings so my takeaway from the reading of that is that first and foremost there's a big part of recovery journeys is about interdependence right connection and so forth and um where am i going with this so having some interdependence and connecting features it seems like we got a bit away from that in telehealth strategies and i know at pink's we had a ton of challenges because we didn't have internet and all these sort of features about it but you know kind of going back and reviewing namely what it was like for us jason at that time what was your experience about being an inpatient program at that time and what we saw from the patient demographic because we couldn't bring in outside services we couldn't bring them off campus and all these sort of features and i definitely want to recognize that i think it caused something it definitely caused something it's interesting listening to you talk because i when i go back in that period of time first of all one of my first reactions was i felt a lot of frustration frankly with um some of the national organizing bodies in our field that we got no direction for how to proceed in a pandemic and like i remember even like five or six years ago when we were writing our uh policies around for the joint commission you know i think we probably had a pandemic response page or something and uh it did no good like we had a completely paragraph yeah yeah and i remember there was a day uh where um i think one of our clients like this is way early on like just when the pandemic was beginning where the we had a client with a fever and like we just we sent all clinicians home and we're like we're gonna we're gonna go all online it was just a very reactive period i think the world was afraid it didn't we didn't know how to adjust and cope to it and then we had no direction i think um from anybody frankly and and so we were making it up on the fly and um i think it took us uh right around i don't know 15 minutes to figure out that going all zoom was going to be a huge mistake

trying to manage a room none of us were trained on how to do teletherapy either and there wasn't a class and at least my master's program about how to do uh telehealth courses when i did my master's program there wasn't internet that wasn't yeah it was carrier pigeons but we couldn't even figure that out um but i do think you know overall what we ended up doing at peaks is we created a couple different clinical teams actually that would come in for seven days and then be off for seven days and i'm not sure that was the best plan either however uh from that model we started to figure a thing out where the clients were on our campus and we got to put on these seven day kind of intensives as each team came in uh we we did kind of an intensive week where seven days in a row they had the same clinicians and then those clinicians were off and the next crew came on and so from that actually uh we birthed some remnants of that as our current curriculum honestly that we we found that really taking a topic instead of having one group a week for the course of their stay but how about taking a week and actually having a topic for a week created a level of depth to the topic and the continuity and a real cohesion uh amongst the clients so that they had um one topic to work on i don't know if that answered your question only brandon but like i that was my recollection of it it was rough um and we learned some things from it yeah put it in a sentence um and thank you for uh yielding that question because it was pretty open-ended and abroad yeah you did great there was one question yeah really things were greatly frustrated during that time but i think what's uh unique about this as well too you know clint you weren't with us in that inpatient model but you were working for an opioid treatment program known as otp models that exist out there as a clinic and so i think that adds some you know flavor and perspective as well too to what that dynamic was like for those operations and sort of curious in an entirely different setting in that regard what that looked like for you guys in that going through that yeah it was um much different i mean uh the outpatient world um we went essentially overnight we went 100 telehealth at least with the counseling component of the programming we also had the medical component where people would come in daily for medication and rather than you know a small campus of people we were serving across the three clinics around like maybe 1200 people so the risk of transmission and the fear and the uh was incredible and we were limited you can only bring like 10 people into a facility at a time and that included staff members so we had these huge lines of people around buildings um it was a it was chaotic in a different way uh and logistically was um challenging for sure but to jason's point earlier like there you know i was at the time in charge of um you know quality assurance and documentation and so basically got kind of pegged um along with the other leadership numbers to to create a telehealth program out of out of thin air basically because there was even though i went to school and graduated at a later date than jason there was still no telehealth training it's kind of always been some a fringe kind of thing that um again overnight had to become the forefront method for communication and delivery of services so uh i remember going to training after training we would just find random trainings wherever we could plug yourself in um try to get some insight into what the um the world was doing not only from a clinical perspective but also from a medical perspective because those clinics have both components so it it was um it was intense and uh but it was effective you know and it worked and we were able to nail something down and again like um take different pieces of that and build better programming overall yeah and i think the biggest thing that i learned from that was it actually forced a different level of communication like um now at peaks we use uh like google chat right um or a lot of people were using at the time um we were using a microsoft platform but they're the sort of like chat message culture that where everything became very much real-time um access to individuals within interdisciplinary teams actually improved in those moments so i think that the actual that the cohesion within the um within staff became much much much better like the everything became real time there was not nearly as much lag and there was uh it kind of forced everybody to really talk to one another so for that i think that's the one thing that i took out of it that i think we will just never go away at least you know you you talking about that clinton i we have three different campuses right we have our men's campus or women's and then our administrative campus and i hadn't thought of this but we used to really feel very separate before code like everything felt so separate but now it is nothing to have meetings with people in person and on video and so though i think the clinical challenges are there i do think our meetings and the quality of the meetings are the same virtually or um in person which i think is another interesting shift like to even comprehend having video meetings it just wasn't a thing and i think we're all much more tech savvy now i mean it just kind of you've had to become tech savvy and now even though we're not uh we do focus almost really on the in-person exchange for clinical services and medical services at the residential level i think that we know how to utilize these technological these these technical components in order to actually accentuate rather than replace the sort of programming that we have and um yeah i mean you guys have three campuses and at the time i was working for three clinics in three different cities so being able to communicate to every single clinician at the same time with the most recent up-to-date information i think that now um that same sort of practice happens at peaks and i think it and just keeps again everything is all about right now you know there's no lag and i think that the quality of care for the client has greatly improved and benefited because of it yeah absolutely i mean if for any addiction treatment center that was paying attention during that time there was incredible opportunities to learn more and grow as an institution and i think 100 percent it forced that growth almost immediately i remember just sitting myself in my dinner table at uh at my house at night time trying to figure out how to use gmf and you know it software and the sort of thing to connect ipads to put into patient rooms and that sort of thing and keep people separated and distanced and you know so in that regard it was real time learning how to do things with limited resources to be able to pull it off and so you know sort of invigorating in hindsight and certainly propelled uh you know our company forward i'm sure many addiction treatment cultures forward at that point as well too but also thinking about you know so logistically the industry should have gotten better in a variety of different ways but there is you know at the same time with all the social distancing the public health orders that limited people and travel and all that sort of stuff created a lot of isolation for individuals and overworking particularly for our company and supporting our admissions department over the past seven weeks or so i hear it a lot on the phones that i was a sort of normal drinker i felt like prior to the pandemic i got isolated and then just me sitting in my home with that bottle it became my next friend my best friend in fact in that regard and so in many ways that lack of interdependence and that isolation caused significant issues for individuals who otherwise may have just been on normie style journeys in that regard but mental health acuity seemingly went up and certainly addiction i think went up as a natural result of that especially in alcoholism so i've heard it on the phone certainly brought people into the center you know who've had that story and then you know now in your guys experiences and hearing you know in group settings and individual settings what does that kind of look like that we can share with the viewers of what this has caused through that clinical lens yeah there developed a new demographic of client that i hadn't seen before and it were there particularly service workers right that got laid off um and then got unemployment checks that were i had a lot of people come to me and say i made more money on unemployment um than i had ever made in my life and i was sitting alone sitting at home alone and then there's an app that i don't really care to advertise where they could order liquor delivered to their house every day and it created a perfect storm of really young service industry alcoholics and we have started to see them uh come to peaks where to your point maybe you know maybe they push some boundaries with how much they drink but being at home and being isolated and then having access to an entire liquor store through their phone that would be delivered and having more money than they've ever had with no really other way to spend it um it created this this demographic of people that were really isolated alone and not to mention i mean the overdoses are through the roof last year right i think that that data is in and clear um and suicides are up dramatically as well that isolation piece um is certainly a hidden uh component of this pandemic that you know we feel we're still we are still feeling the reverberations of that i think absolutely and i think it goes to that idea um you know that the opposite of addiction is connection correct yeah so this this in this lack of connection um triggered or pushed over the edge people that were maybe already teetering or feeling slightly disconnected or maybe i don't know if you're like me work is a huge connection you know like i that's all i do because you know you know that very well yeah you guys are my best friends yeah this is your social time right now yeah flower right here this is the best 15 minutes of my week

but i think that losing it it shows i think as a society how important it is for us to stay connected to one another and when we don't feel connected we have this void that sort of forms and we're gonna fill that void of however we can and at the time there when you can't leave your house i mean you what else are you gonna do netflix will only take you so far so when i think it i mean it is an interesting point because yeah on the flip side of that you know we are you know my experience during the pandemic too is that like i saw my family and then i saw my work family and that is it i didn't see my extended family for months and months i didn't see my friends you know like we just we all got very isolated and to your point like fortunately we worked in an industry that needed to keep showing up and being on campus and like what a grace that was honestly because you know when i've had these clients come in and are like i was at home getting a 600 a week check

um part of me is like yeah that had been me i don't know how to cope with that that's crazy and even being you know watching people you know having our whole clinical staff work from home right like starting off you know people are they they look okay in the beginning because i i mean you're you're doing video calls all day long you know i always made a real effort to always do face-to-face calls like make sure like hey turn your camera on i want to see you um i just think it's important for us to be able to connect and see one another um but there is a sort of steady grade of that a decline of mental health in general because i think even that virtual connection it's better than nothing but it's no replacement and i think that kind of speaks to the data that you mentioned at the very top of this that the that need for actual interaction and connection even within a physical place even if you're not touching there's just some sort of like energetic mumbo jumbo that's happening that actually helps us stay healthy and stay i don't know human yeah yeah when it never

i have never read in any textbook in our field where an entire population is going through a shared trauma right clinicians clients like some of those walls of like it started to come down that we were all kind of in it absolutely and we were all kind of this wasn't like i'm counting i'm providing this counseling it's like well we're all kind of trying to survive right and i remember too like if clients wanted to leave during that time i'm like can i explain to you what the outside world is like you are you have more social connection in here you have more freedom in here you have a basketball hoop yeah you have all these things you can do in here you go home you don't have any of this good for retention brandon but yeah right yeah so uh well i think i think this is great because it ties into the initial data that i was talking it was well to hear that that fallout and that negativity as an experience it wasn't all negative but certainly and certainly individuals experienced telehealth in a positive aspect but what they lost was that connecting piece of it what inpatient programs lost at the same time was the ability to bring outside sources and connecting you know pieces into treatment in that regard and as well too as the pandemic continues to thrive in a variety of ways with the delta variant delta plus the lambda variance and all these sort of things what is happening that i want to be clear with the world about in front of us is that addiction treatment centers aren't armed with public health orders or any of this sort of piece at this time and so the general propensity for somebody who comes in and tests positive for covid is that they are going to be removed from the treatment setting and not able to access care and with that signing off thanks for joining us again here at finding peeks um find us on the socials the facebooks the instagrams the podcast please be sure to email us findingpeakspeaksrecovery.com for more insights and questions again to this covid piece that we're doing here today is because of the viewers you called on us to speak to it a little bit so we are always going to deliver you know answers moving forward on for the questions that you have so thanks again for joining us love you all stay safe until next time you

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Episode 19 The Benefits of Gender Separate Treatment Watch Now https://youtu.be/1Lu-G3YrstU Listen Now Episode 19 With a special guest, our team dives into the importance of gender-separate treatment while endeavoring down the road to recovery.

Topics:

Chris speaks on an example in his recovery where he didn’t grow the way he thought he could because he was distracted due to mixed genders in the program.
One of our team members speaks on why it is important for her to work specifically with women and recovery
Chris speaks on his passion behind helping men through recovery and the holistic approach Peaks Recovery takes in order to do so.
How having gender-separate treatment has allowed Peaks to establish a curriculum best

Select Quotes We are able to customize the curriculum for the genders as well because people have different needs. Jason Friesema, MA, LPC, LAC Chief Clinical Officer Episode Transcripts Episode 19 Transcript p.p1 {margin: 0.0px 0.0px 0.0px 0.0px; font: 12.0px Helvetica; color: #000000} p.p2 {margin: 0.0px 0.0px 0.0px 0.0px; font: 12.0px Helvetica; color: #000000; min-height: 14.0px} hello and welcome to another episode of finding peeks i'm jason friesma this is chris burns president and founder of peak's recovery hello hello and kate nelson uh what is your title i just teamly team lead of our women's program at peaks sure yeah professional counselor so we are here today to talk about uh gender-based treatment and gender-specific treatment and um i thought it would be a really interesting discussion to kind of talk about chris the the origins of peak's recovery and and starting this off as a men's program and and just yeah just walk us through that process and then incorporating women into it absolutely thank you jason yeah thank you kate for being here it's nice to have a female on i'm going to point that out right now

finally so i'm really excited to have that in there and it really matters and kate's someone who guides and directs our our newer women's program doing a phenomenal job over there building a great culture so grateful to have her on thank you for being here um when i opened up peaks recovery you know i was i was a very new professional yeah i was very new compared comparatively to the people that we were bringing in to hire but i can remember um i can remember sitting in treatment in 2008 and i remember going to present my timeline and i remember there was a a female in the group and i was 22 years old and i had consequently fallen in love in six days as you do as i do yeah that's all right yeah and i'm going through my timeline and this is very vulnerable information this is like the deepest this is my story and i'm going through and i get to a year where there's a little pain and shame and i skip it and i move on to current time and i let that thing unfold um and naturally i didn't get what i should have got out of that programming in that curriculum and so right why did you let it skip why did you let it get because of shame and embarrassment because there was a female that i was attracted to in the group who i wasn't willing to express that type of vulnerability with yeah and that was very clear to me um that gender specific treatment at that time for me would have been the best option because i would have been able to be more vulnerable and i think oftentimes we talk about counterbalancing adversity and that connection that has to be there in order to counterbalance it and i just think that's difficult sometimes when you start mixing genders i think it's kind of inappropriate in a way in the clinical setting at least yeah so when i open up triple peaks recovery i was like i know one thing it's got to be gender specific yeah it's because we have to have a natural kind of ebb and flow to the clinical process and so when we open up triple peaks it was just that specific to men and even bigger than that specific to young adult men um and very quickly we learned um in the community that the the females were under resourced there wasn't a lot of programs that they could plug into and so a referral source at the time was like you gotta open up a women's program and i said absolutely so we opened up with serenity peaks recovery in 2015. and it was gender specific a 10 bed program and we were able to build those cultures separately with women and men over here and just to kind of hit on the gender thing that's however you identify and i think that's really important to mention in today's day and age however you identify we treat that specifically yeah um and that's important to anchor into and and to align with in 2021 and when we were able to open up serenity peaks recovery center i think it even spoke more highly to me because it was a specific women's environment and the stuff that they were unpacking in a group process they would have never unpacked if there were other men involved or people that they had attraction to or stuff that they were going to withhold and so i think of much more functional group process certainly the most efficacious is when it's gender specific when chris i remember when we when we opened serenity peaks we had it we had two different suites in the same office building on different floors of the building and um upstairs was the men's program and downstairs was the women's program and i remember

very immediately we started to see the differences between the two programs almost immediately and pretty quickly we figured out to put it in a nutshell we figured out that a lot of the men's work is about helping them open up and kind of helping them excavate some of their feelings and identify what is going on for them and for the women it was all about containment because they had a ton of access to how they were doing what they were feeling and they needed a way to help kind of wrap their arms around it and settle down and i just remember chris you had your you had an office on both levels that were that was like one was literally above the other we joked about putting a staircase up to it but i know i remember you being like this is different down here yeah i've never seen anything like this before um so kate i i did want to go over to you as well um with pique specifically just due to the business culture that we walked through during covet we unfortunately had to shut our women's program down for a few months because um well we had to spread our clients out obviously and and really consolidate what we were doing but uh i'm really proud that we were able to relaunch it again here a couple months ago um and what what has been your process yourself kind of transitioning professionally from the men's program and kind of helping us start the women's program again that's a good question um you're right about the different skills with men it is so much more about you know trying to get them to finally lean into feelings they've been avoiding for so long and then to transition back over to women um it was a change for me for sure um and i was also my heart was broken when it was first closed so to go back and be back in that environment was just really exciting that we were able to do that something that is really close to my heart and why i love working so much with men and women but specifically women is finding safety in their bodies and yoga mindfulness breathing all that is just my passion because it has worked so well in my life to manage things i've been struggling with anxiety and such health issues and so to be able to give them a space where they can get connected and feel safe in their body and regulate it and realize i can't have these big emotions but also i can move through them and find skills and tools is what is really exciting for me about the women's program so can you talk specifically about what that looks like like when you when you run a yoga um class at peaks how are you how are you incorporating that and how are you incorporating how are you connecting their body and their mind and their emotions how are you doing that so i usually try to stick with the theme you know we have different themes throughout the week for our curriculum and if it is around shame or something like that usually i will do a meditation in line with that like maybe having them visualize their shame or something like that and give them some different visualization exercises to try to sit with it and kind of allow the emotions to come in like waves and i'll talk them through that like this emotion that's coming up notice it explore it observe it as if you're observing a human experience and then i integrate maybe readings about shame or peaceful music that will help to sort of regulate that parasympathetic nervous system and stuff like that so yeah it's my faith yeah it was a great description it was a great description like waves yeah it's been described to me in therapy too just let those thoughts kind of pass like waves yes don't hold on to them let's just let them go let's not judge them i think that's really really cool way to kind of do yoga and connect that mind body and spirit and i think you know chris what i was thinking when you talked about your experience in treatment too the safety of the communities both the men's and the women's program when they when they aren't necessarily distracted by the by the tension that i think comes when when the men and women are on the same campus um just yesterday uh i'd had a i'd had a pretty intense session with one of our uh women clients and um and the women's group was letting out right as i was wrapping up with this client and the entire group just went outside and sat in the shade on the lawn there uh all of them yeah and uh and kate sat there and i sat there and morgan was there and we just sat and hung up clients for like half an hour before we went to our clinical meeting and um and that's just that stuff doesn't necessarily happen i think if when we begin to blend uh blend the genders truthfully and the other thing i was thinking too is nobody has a cell phone out of course right and uh that matters as well but chris i wanted you to talk about your experience today with with the men at the mma yeah that's really cool um so each thursday and i mentioned in here before but we've been doing uh an hour of crossfit followed by an hour of cert we call it circle accountability group um with me and it's really really connecting so we get in there and we get a good sweat and we get vulnerable and we go talk about it and it's just this really cool connecting environment for example i'm thinking of a of a mature adult that it's his last week here at peaks and all he's done each week he's probably closer to 60 years old and all he's done each week and gone into crossfit is he's gone on the assault bike and he's just sat there in his first week it was like

in today the whole hour he moved and he grooved and i'm telling you i come out of that mma gym and we're walking around and punching and he's got a smile on his face ear to ear and behind his eyes says i have hope and that's what it's about it's so much bigger than a workout i could care less about a workout but seeing these young adults and these mature adults speak lives and speak life into themselves through overcoming something that they didn't think was possible and i think crossfit similar to recovery gives us tangible opportunities for growth and to experience what i think is really important i think the big book hits on is that spiritual experience this idea that i can have fun and these lights can turn on and i can be connected and i can be fulfilled and resourced i have hope and so that's what i see a lot of times in that crossfit gym just as much as on campus as week one they come in there they're a fish out of water they don't want to touch a weight maybe they have some shame around the gym and i'm running around just gassing them up let's go and get everybody really really excited we're all ending with gratitude a tremendous amount of gratitude and hope and that's the coolest thing is just watching someone from week one to week six because they didn't come to peaks to be a better athlete but they're leaving a better athlete because it's it's physical it's emotional it's mental and it's spiritual yeah and it has to hit all of those and i think a good recovering individual is okay at each one of them um we're not trying to be the best at anything and we're not trying to be the best crossfitters the best mma guys we're just looking to get in there and see if we can be the best versions of ourself through coming together as we instead of me myself and i and so it's been a really cool process to be a part of the last couple of months since the pandemic has loosened up a bit i'm hopeful to get another day scheduled as well because it's just so functional and so spiritual for those people for myself included so well what is it what does that group look like though if the genders were mixed in there oh man that'd be horrible yeah because they're great people but it's it's distraction right it takes me off of my primary purpose which is right here right now it's really difficult to be present in a group process in a workout when i have a different gender sitting across me that i may or may not be attracted to and i grew up right i showed up in treatment because i can't be the authentic version of myself right that's why i'm here because it wasn't safe enough and then that puts me right back in that position it's not trauma informed right it's not trauma-informed care because i go right back into the position to try and save face and tell this story that's not actually the true version of myself and so it would be very difficult we'd be having to pull people from this wing and this wing and we would never get an authentic process as a result so i'm grateful it's gender specific outside of our female staff that's there which i think is great i also think of avoidance like if they had a male in there what a great opportunity to focus on his stuff and worry about him and you know fall into patterns of codependency and my focus becomes this person and now i don't have to look at myself i think those are the two biggest things distraction and avoidance which would just sabotage their whole experience absolutely and i do think there's some efficacy to having mixed genders but i tend to believe that best case scenario is outpatient level of care yeah you know that's when we're going to kind of we're going to live into our recovery and not define it we're going to live into it and that's a different step and i think you really have um both genders in that because that's kind of how it works certainly in primary care uh gender specific is the way to go right in my experience yeah i i think that makes a ton of sense and then um professionally for you kay what what is it like to be uh to work in the men's program as a woman i'm curious about dude that too because you're talking about that yeah um yeah you know it's different i am more conscious of my words and my actions and body language and just all of the things because it is a different dynamic for them and i and i recognize that and i appreciate that um and then at the same rate i think because they've struggled with women in their life in various avenues i get to provide maybe a healthy sounding board that they haven't experienced which is a really great feeling to have boundaries and also see i can helpfully connect with a female so that's that's probably the coolest part about it um but you do have to engage in a different way to be mindful yeah you know yeah for you chris that's huge i actually had an experience in the women's program and just being really boundaried yeah and how like affirming that feels too you know it's important anymore i've been in the women's program been in group and be like nice legs chris i'm like inappropriate just absolutely we're not doing that and you have to do it right away and that's something as a young professional that was difficult so i'm great that we i'm grateful we started with men and then kind of leaned into the women because they they have a tendency to catch you off guard yeah and you need to make sure that you're professional in all accounts and so being diverse and working with both programs can be huge the last thing i wanted to to talk about is um running a gender specific program and having both genders that's been hard for us to be honest with you we have very separate campuses they're like six miles apart or something like that like and it and it puts this stretch on our in our on our team right um but but we found that it's really worth that stretch and worth um having two different campuses even though it does put that that strain on us and and like from a business perspective chris what's that been like to have two different campuses in two different yeah i think to your point it it's for safety yeah it's for it's it's client-centered and it puts the client first yeah because on the business side quite frankly we've crunched the numbers and it would be much more beneficial from a business perspective to have everybody on one campus look at all the treatment centers around the country yeah everybody's got everybody in one hub yeah it is not cost effective first to have another two acre campus with a full team but it's beneficial for the client and the clients families that we serve and we think that it's the best opportunity for recovery and so as long as i'm here in front of peak's recovery we're going to choose what's best for recovery for the client and let the chips fall where they might and that's kind of the way that i see it is there's no amount of money that can make sense of mixed genders and primary care treatment it's just not efficacious we can't get people into aftercare i mean the whole process blows up so as much as it's not financially great um it's recovery oriented yeah i'm grateful for that it really trauma informed and that was a lot to overcome i think especially in this last year but it's been amazing to kind of have it all uh as it was yeah even better than ever better than ever i would actually say i think that's exactly right yeah because the other thing is too i know i just said the other thing was the last thing this might be the last thing but we have been able to really customize our curriculum um for the genders as well because people well we started this whole thing with that people have different needs yeah um and what can you just speak maybe to what modifications you made because because we we had our men's program and wrote up a curriculum about it and then we added the women's program and what what changes did you make on that so i think kind of what you said before where women have kind of word vomited for lack of a better term a lot of this stuff in therapeutic settings so long and it's almost like they need a different way to um explore it and so i think we give them a lot more experiential and art and activities and movement to try to have them see it from a different lens um so that's different and some you know we try it with the men but because of that resistance and like it's so new and uncomfortable it doesn't always land well um another thing is really diving into like uh domestic violence and unhealthy relationships because that seems to be something that a lot of our clients come in with but that's something that a lot of the women continue to find themselves back with because when you don't feel good about yourself we accept the love we believe we deserve right and so they end up with these really toxic relationships and that becomes this cycle of the person and the feelings and the addiction and so we really dive into a lot of that unhealthy toxic relationship stuff with them awesome i think you summarized that uh brilliantly um and so we we are at a time for this episode i really appreciate this uh discussion i think it really um illustrates why we do and how we do what we do really well and so with that uh that does wrap up this episode of finding peeks follow us on instagram facebook and apple podcast youtube all of it snapchat i don't know if we're on snapchat but anyway that's it peace thanks awesome

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Episode 18 Trauma Treatment - Medical vs. Behavioral Watch Now https://youtu.be/_iT2ielQ84U Listen Now Episode 18 We discuss both similarities and differences between medical and clinical trauma approaches within addiction treatment.

Topics:

What happened when both medical and behavioral treatment joined and the patterns that started to emerge. The relationship between the physiological and the psychological effects of trauma The direction of medical to clinical Why building resilience in early recovery is so important

Select Quotes In stabilization and in this early recovery process we have to take the time to empower, encourage, and guide them to build resilience so they can do that deeper work. Or we relegate them to simply giving up. How many people go to the gym in January and do this big workout and are so sore that they never go back. That's exactly the risk we run by going too quickly before clients build enough resilience to tolerate that deeper work, that is why we don't do it at the beginning. Alan Cook, MA, LPC, LAC Episode Transcripts Episode 18 Transcript so we had what i think is a new and insightful conversation last episode about trauma in particular trauma-informed care and i think allen brings a new perspective uh in that regard that i think is worth engaging the audience in and a little bit after the episode yesterday we kept going forward with trauma-informed language and so forth and there were a couple of topics that we touched upon that i thought would be important just to continue to discuss with you all as well moving forward so uh in that regard one of the things that was brought up was sort of this collision course in time that you've experienced and been witness to about you know sort of clinical and medical interventions taking place you know in my minimal reading of addiction treatment in its history one of those collisions was the bringing in of insurance benefit plans that started dictating care in the early 70s in that regard and i think that's where we can probably maybe start as to where we see these clinical and medical interventions sort of colliding in that way and so i guess the question is uh what did that look like for you and what have you seen in time alan that this collision course has been on a path of and then in relationship to trauma specifically through that lens how did that take place in your eyes wow that's a big question yeah so compacted great uh well what comes up for me as you're talking is what i said toward the end of our last conversation that i think that when medical and behavioral joined they had not a lot of language in common except trauma and so that became the basis for the collaboration that we built we've built an entire system based on this notion of trauma being the common element between medical and clinical and and that's a great idea except

except that physical trauma is actually a physical stress to the body and that seems pretty clear i mean you hurt yourself you're trying that's a trauma in the medical world emotional trauma is a stress that happens emotionally but also requires perception physical trauma doesn't require perception it's simply your body reacts to it and it's a physical response emotional trauma requires perception a person has to perceive that they were traumatized and i think that that's that's gotten us off into the weeds a little bit absolutely that we've made some assumptions that trauma is trauma and all trauma isn't the same there's a pretty specific difference and we've also started to really look at ways that trauma is physical right i think we've really we've created a trajectory of trauma and trauma therapy even within the behavioral health world that treats emotional trauma as a physical trauma and not to say that trauma doesn't present itself in the body or present physiologically however we again it's just sort of reinforcing what you're saying that we've really looked at trauma as a sort of physical thing and we've really continued to lean into that even today but the physical trauma usually resolves itself right usually resolves itself the emotional trauma that requires perception often then gets encapsulated and that's why i said that that in the last episode that i really prefer to work with guilt and shame because i believe that the moment what encapsulates emotional trauma past the physical aspect of it the physical trauma gets resolved the emotional piece you know we talk in terms of big t little t trauma trauma then gets encapsulated in well what i'll call history but what history gives it is guilt and shame that the moment that an emotional trauma is perceived as trauma what happens the very next theme is that it gets encapsulated in judgment and shame so so it sounds like i guess i'm just not entirely uh this is all great and it's important i feel the direction i feel the energy of brewing here about it but there seems to be that subjective emotional feature tied to it and then so because we're talking about the collision of of medical and clinical so what what is that bridge as far as that collision goes that we're sort of concerned about here now was there an over step maybe on the medical side to call that something physical um a sort of brain state that has taken form in that regard or how should how can we you know think about it in terms of that actual collision taking place like what's the problem here

that's a good question i'm not sure what the thinking was what the outcome has been is that the medical community views emotional trauma as you said still as a physical ailment and treats it as such we apply medication to it we we absolutely and i think into a certain degree clinically we do as well we treat it as a sort of like terminal trauma to the body but we it's a terminal trauma to like the emotional mind right that's what i think clinically how we approach it as well it looks um they i think that you know it goes back to like you were saying this building for behavioral health and insurance i think that we had to look for you know the the behavioral health model or the wellness model is really does not overlap well necessarily with the medical model you are looking at a tension between subjective and objective and medical does not do subjective extremely well and and the behavioral health world doesn't do objective very well you know so trying to find that common ground and it really it was up to behavioral health to adopt the medical language in order to be able to sort of justify services and payment and again i think that that continues to um and this is you know i'm a huge proponent of the interdisciplinary medical model in conjunction with behavioral health model however what what happens is you start like alan was trying to was saying is that the medical model starts to inform or at least or almost dictate the trajectory of the behavioral health approaches and the behavioral health intervention strategies so as an unlicensed registered psychotherapist it's a mouthful and means nearly nothing here in colorado other than a 300 fee every year in that regard i'm aware minimally of somatic experience and it seems like within that therapeutic intervention the trauma modality that it is correct me if i'm wrong here i think it's stating something right that emotional space that traumatic event that we're calling encapsulated in time here is then sort of pushed into the body it seems like we're really trying to draw a hard physiological approach that it's in us maybe even all over us in that regard and so one is my reading of somatic experience correct and two is that seems to be the connecting piece between like the clinical and medical bridge that there is some physical thing that is actually taking place absolutely i mean i think it's a perfect example of the way in which those two and i don't know that it's actually uh that's i have um my knowledge and experience with somatic experience i'm not a somatic experienced therapist so i i have limited understanding as well even as a clinician but and i think that there is some uh there is some obviously like evidence-based uh work behind it that shows that there is efficacy to that level of treatment but i think it's a perfect example of the way in which the medical model has really started to inform particularly the world of trauma and really and almost i don't want to say hijacked but certainly over-informed the actual approaches and treatment that would be sort of my personal perspective of it i think alan could probably speak to sc a little bit better than i can so well i do want to draw the correlation between se and emdr for example that emdr is designed to create bilateral stimulation it's to design to create if we were it's not exactly electricity but it's kind of like electricity that flows between the hemispheres the purpose of that for emdr is to begin to it's too big a word but dislodge the relationship thoughts and feelings that are stuck in that part of the brain so that they can be looked at discreetly se does the very same thing in the body it wants to move energy where energy has gotten congealed from the sense of i was hurt there so as he does work with physical trauma it actually bridges that gap pretty nicely because it wants to put energy into and move energy into those places where a person either a person's mind or their body has has felt traumatized has stored trauma in it and so like that electrical impulse we'll just call it energy if we want to be spiritual and woo wants to move that energy in the very same way the emdr wants to move that energy bilaterally right but it doesn't actually do anything to change the narrative though right like you're saying that we are not addressing perception which is that missing piece no it actually just gives us access to the information that's its point it is not designed by itself sometimes having access heals but it is actually just to open a door it's just to open a door to those rooms so it seems like then because we're moving in the language of correlation and now introducing cause-and-effect causal relationships here where there's certainly a correlative feature of trauma in which the energy is displaced in the body the mind or somewhere within this thing called the human body in that regard and then we trigger that it opens up the door so it feels like there's a cause and effect relationship between those therapeutic interventions for trauma that give us access to that so there's a cause and effect there but the correlative nature of why i or the cause and effect nature of why i use drugs and alcohol to sort of quell those things what does that look like you know in this regard i think we're i don't think i best stated that question but i think we're inching towards where we want to go here about these cause-and-effect relationships when somebody says i use because i have trauma you know um well now we've opened up that door it's it's still encapsulated maybe it's open it's not encapsulated anymore but it's gonna still be stuck in time right so i think a more gabor mate says it best we don't we don't use because we have trauma we don't use for any of those reasons we use because we're suffering absolutely that we don't feel good we fee and suffering is a big word absolutely so we use because we're suffering i think you make an interesting made an interesting point though that there is a it's still just a correlation right like the experience of pain and uh the idea of suffering it's not the reason specifically why people use but there is a core to live correlative relationship between the reason between suffering and the reason why people use i actually i would disagree a little bit with mates just because that sounds like cause and effect right i'm suffering i use yeah so okay so i think i think i think this is wonderful you know for the viewers and thinking about the cause and effect the correlative features the dive deep so we have what sounds like to me two different instances of an individual coming into treatment the first individual comes in and says i'm very aware and have access to what my trauma experiences are and we have another individual who comes in who goes i know i'm traumatized and maybe they disassociated from a violent event or something that took place in their life or something along those lines that sort of has it as a distance where it feels meaningful then to pull out of the tool kit emdr scp as experiences as therapeutic interventions and deliver though in this way and then there's this individual where it seems like maybe the balance in that isn't really required to approach with emdr and scp in that regard so but for both instances whether you do the deep dive pull the trauma out get those doors accessible and whether they're already accessible it sounds like we've done at that point the medical thing and insert now clinical behavioral health care right now we're working on that shame and guilt is that an accurate display of the balance there that's taking place yeah it sounds like pretty accurate yeah and i think that um i i think the one thing i would add to that or just the one caveat is that regardless of if those doors are open or those doors are closed you can actually still work on trauma which is i think at what allen's saying through the the lens of guilt and shame like i think in fact using guilt and shame it can be a good access point you don't always have to go the emdr s e route the deep dive isn't always necessary sometimes bringing a light and sort of loosening up the the sort of um the binds of shame and of shame and guilt will actually start to help access those uh those doors or open those doors sort of organically got you so it's not just directional right we can go the other way absolutely it also reminds me why we've gotten a little off track between medical and and behavioral in some ways because there's not a stigma to having physical trauma right unless it's profound in other words you can be stigmatized by having a tbi you can be stigmatized by some kind of physical trauma but for the most part our society does not stigmatize physical trauma but we have managed to stigmatize emotional trauma profoundly so it becomes really intransigent to treatment in some ways people want to avoid it or want to have very selective access to that in a way that you go into an emergency room and anybody can look at your physical trauma that's well depending on where it is but anybody can do that sorry yeah that's all right yeah yeah they have curtains but i think that's one of the one of the ways that by globalizing our approach to trauma we're doing somewhat of a disservice right because we forget that emotional trauma is held really differently and now our society holds it really differently right and it's become a more i don't know it's uh we've complicated it to a certain degree i think because of that yeah there's an extreme complication because of that and i think that's why we're discussing this with the viewers and why you know seemingly like these concepts of trauma and boundaries are just so influential and why i keep talking about it on behalf of the viewers you know that are out there because it is complex and it's greatly oversimplified and i think rightfully so by you know patients who inform families i'm relapsing because of this trauma stuff that's undealt with you know at the end of the day but it seems like in that regard that the cause and effect there's no cause and effect relationship that ties the use together and that what we want to say differently is i continue to experience shame and guilt from your behaviors for the experiences around the trauma and i've told myself a really big story you know that's not true at the end of the day and that piece seems the cause and effect relationship when that is nurtured or more closely to the cause and effect relationship when we start nurturing that shame story and those guild strategies it seems to reduce the propensity or the intensity toward use absolutely is that accurate yeah i think that's true absolutely so um so i i'm hearing the balance in all of this um so you know again too to stabilization models and approaches it seems like for somebody who has um not significant distress tolerance in early recovery journeys the deep dive can be quite dislodging and disruptive for that individual and so in a place like peaks is a stabilization model we're not going to go necessarily right at that right we're going to support those stories and it's through that shame and guilt approach that we're creating like you said the clinical to medical side of things right as a bi-directional aspect here of opening up those doors through that narrative and allowing the individual to see not only how big the story is but the actual impact that trauma as that door opens had on that story in that narrative absolutely

so a little bit as a as a prompt as we kind of head out here again let's just remind the viewers i do have stuff to say about this actually yeah yeah well if you have more to say about it let's do it well i just as i was listening to you i was i go back to this notion of resilience because the truth of what you're saying is that a client who comes into early stabilization has no resilience absolutely the substance they've been using would have compromised any resilience they previously had or replaced resilience yeah absolutely yeah well it certainly replaced it but not in an authentic strength building sort of way it's like putting a cast on your arm and expecting your arm to get stronger while it's in a cap absolutely as it atrophies yeah as it atrophies underneath so that's what happens to our resilience when we use it replaces it but it doesn't actually strengthen us at all it does the opposite so in early recovery our and in stabilization and this early process we have to take the time to to empower clients and encourage them and guide them to build resilience so they can do that deeper work or we relegate them to simply giving up how many people go to the gym in january and do this big workout and are so sore that they don't go the rest of the year that's exactly the risk we run by going too quickly before clients build enough resilience to tolerate that deeper work that's why we don't do it at the beginning what it doesn't feel is i think that there is a perceptual thing from a clinical side that doesn't feel as big right it doesn't feel as powerful it doesn't feel as heavy and deep and as emotional but the reality is that you have to build up to these things regardless you know as you're working on you know like re-strengthening that arm after it's been in a cast and working towards rebuilding those muscles and these small exercises that are helping to to sort of uh rebuild tissue and and connectivity and build muscle and you are still working on trauma you know you just don't you don't have to be in the emotional trenches in order to do that in fact sometimes that's the worst place to be especially when you have no resilience which is again what at that early stabilization time model or that early stabilization period of treatment where people are so absolutely and so what comes up for me here is certain things we're running out of times we don't want to bore the kids on the social media and so forth they're watching us uh in that regard but uh you know in in my time over the past five weeks or so i've been supporting our admissions team working admissions in this regard and it seems you know clear to me that as well too that when an individual is stating something like well they didn't work on my trauma and their last treatment episode was six months ago and they've been using ever since then in that regard and now looking for care it seems like we're sort of restarting the clock is that necessarily true uh in that regard can they have we moved again away and allowed for atrophy to take place as that cast metaphor goes by that six months of use in between making it still less accessible in the way that they're well if i go back to the physical exercise piece the truth is that if you have exercised and gained strength even if you stop exercising those muscles remember and get stronger faster so i think that's the same truth here that if somebody has made progress if they've gotten some recovery under their belt and or they've just gotten insight from earlier treatment even though they go back and use they still remember those things and can regain that ground faster than if they didn't do it the first time right still however you have to go back and start you to a certain degree you start from the beginning even though like alan said you will the the sort of uh trajectory or recovery or uh repair is much more as is much quicker right because there is a level of resilience there that's already been established there but you still start with the same weight absolutely yeah you still have to and it's gonna feel different especially if you've been into it if you've been to a facility or a treatment center where they're just where the deep dive is the process right it's going to feel different in a stabilization model where it's like where we're much more about creating that resilience and building those containment strategies and those coping strategies and starting to rebuild the muscle basically from the ground up because the muscle that you've gained while you're in um while you're in those deep dive models are is really uh can actually kind of surround those smaller more nuanced muscles that you need for the the fine movement the sort of uh those fine point um maneuvers that you need emotionally to actually be able to sort of rewrite your story and and really um and really get rid of those old narratives that don't work anymore absolutely well for the sake of time i mean this is fulfilled this has nurtured me in a big way and i hope it's nurtured the viewers on the other side um but a lot of questions still arise for me and i'm hopeful that as we continue to bring this information forward it's drawing a picture that is quite complex this this thing called addiction and mental health and trauma and all the variables of it is a complex picture that's really difficult to navigate especially within you know limited limited treatment episodes so certainly want to call in our past videos about direction of care how important it is post stabilization models to influence care beyond the walls of a treatment program such as ours or continue with iop and so forth and i feel passionate about continuing to bring on you know guests such as alan in the future as well that can continue to help promote the complexity as well as bring forward solutions because there is hope in all of this no doubt certainly we witness recovery all the time post-programming at peak so in finalizing this um finding peaks at peaksrecovery.com send us your questions concerns thoughts ideas we would love to engage with you at a much larger level about what's coming up for you throughout these videos or maybe bits of information you've missed in the past find us on the facebook the the gram spotify um check us out in the podcast and so forth and um until next time i think jason freeze and chris burns are up next um as host in that regard and i personally will see you in a few weeks and until next time take care

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Episode 17 Keys To Understanding Shame and Trauma Watch Now https://youtu.be/EVMebaHmYJc Listen Now Episode 17 With a special guest, we dive into the unique relationship between shame and trauma, and why both should be worked on cohesively and strategically to better the individual's growth.

Topics:

The relationship between shame and trauma and how one usually doesn’t come with the other
How our clinicians approach an individual who has trauma, and where they start.
How the industry is focused on “trauma-informed”, but should also have a heavy focus on shame

Select Quotes It is not that trauma that has caused them the problem, it is what they took away about themselves, what they believed about themselves, what they believed they lost, what they believed they disempowered about themselves, or what they had to protect themselves from; that’s important to release and relearn. Because most of the time our traumas happen sometime in history, that's the nature of trauma; it's in the past. And we forget that no matter when our trauma happened, we were different then, but we have anchored that trauma in that experience, especially childhood trauma. We were children, we were helpless, we didn't have a lot of skills. So we believe that trauma to be true today, even though our skills have changed. So I approach them from shame, because when somebody grows up, what they bring about that trauma is shame, ‘why couldn't I take care of myself, why couldn't I stop that, I must be a bad person'. If I can release the shame today then I can remind them that they have different skills today than they did back then, and link it differently. Alan Cook, MA, LPC, LAC Episode Transcripts Episode 17 Transcript all right welcome back to another awesome exciting it's awesome and exciting to me so i'm just going to keep saying it episode of finding peaks um i've come in my shortest of shorts today because the viewers were calling on a little bit more skin jokes aside it's warm out today here in colorado springs so i'm enjoying the warmth and letting my and opening up my legs to the sun here so i can get a little color so we all win yeah so hopefully the viewers are winning equally in this regard uh today so i'm joined again i'm brandon burns chief executive officer for peaks recovery centers joined by my friend colleague clinton nicholson uh lpclac therapist awesome awesome there you go we finally after 20 or so episodes however far we end we have a guest today and as promised the great alan cook lpc lac is joining us today um he's been just a tremendous asset not only to our programming our our currently our family programming but has also helped us out of the depths of um some really difficult times at the tail end of covet at least in the 2020 side of the covet experience so a little bit more about yourself please alan what more can i say i am i'm the chair of the addiction counselor examiner board at dora infamous as that might be absolutely i also have the dubious distinction of helping develop the competency competencies and all the classes that torture addiction counselors to become addiction counselors so which is where we met right in one of those torturous classes yeah one former instructor extraordinaire awesome yeah yeah well wonderful i've always greatly enjoyed my time discussions and energy with um with you uh alan uh you've provided a lot to me a lot of great insights for how this industry works how addiction works mental health and so forth and so uh today i just wanted to kind of go back through the reel and introduce your narrative around trauma and shame and as we were kind of talking about pre-episode here um there is this common notion it feels like from my experience where individuals leave treatment and recovery falls short on the other side maybe it's relapse something comes up in that regard and they say you know what had that prior center just worked on my trauma i probably would have been more successful and for me there's this cause and effect tone that they're sharing with us that trauma sort of or the absence of work on trauma is causing the relapse and i'm just curious about what your thoughts are when folks say that and if there is any relationship for you as far as cause and effect goes okay well i think that there is a cause and effect between shame and trauma first i and in my experience i think there is not shame without trauma i think trauma underlies most shame and in fact anchors it that um that people's response to being traumatized is almost always that they feel this sense of something went wrong with themselves or something's wrong with them or it couldn't have happened to them so i think that that there definitely is a cause and effect i think speaking more pointedly about folks leaving treatment and i'm gonna i'm gonna talk about the peaks experience a little bit because we're a and we tend to have a basic premise that we will identify trauma but that 45 days is not a particularly good amount of time to unpack it and resolve it and so as i've been at peaks for the last four and a half years i really have thought a lot about how what can we do what can we do in that period of time and i find honestly that at least the the clients that have come through peaks and and i suspect they're representational but i don't know for sure but they have an easier time talking about their shame than they do about their trauma that trauma has a great deal more stigma attached to it and that there's a belief that it goes deep and it takes forever to resolve and that it's earth shaking but shame doesn't seem to hold all that stigma so my sense is that in a in our program we do deal with trauma by talking about shame that it's simply changing the word and changing the language and what's interesting about that is that it really affects how clinicians think about it as well that a clinician i hear clinicians all the time when i do supervision oh well we we don't want to touch on trauma and then i'll talk about shame and say yeah yeah we can we can unpack that no no problem and and i just have a sense that since they they are almost one in the same and at least building blocks of each other that it is easiest to simply talk about face and resolve and integrate shame it takes the same cancer presence unconditional positive regard whichever we're doing and clearly it is at least in our minds easier to approach so why not yeah no my experience i think that checks out as well so because trauma does have this um sort of uh it feels really rooted and really grounded in like persona to a certain degree whereas shame feels a bit more fleeting a bit more or i guess maybe just easier to detach from so um while like you like you said they're they're closely related there is a there is a very nuanced difference between the two of them and so i'm wondering in your experience and and for the viewers if you could speak to what the approach in treatment looks like how how that might be different than if you're taking a going a straight head-on trauma we're gonna we're gonna tackle the deep-rooted stuff versus you know what we recognize that trauma exists and that shame is closely related to trauma but we're going to approach and and really work on the shame instead so what is uh from a clinical perspective what does that look like how might you explain that or share that with families so i think i'll talk about shame okay i think clinically shame is approached first by acceptance on the part of the clinician to hear whatever the client has to say and not to to judge it or to question it but to explore it and be curious about what it means that that that in itself gives the client a chance to openly unpack it openly talk about it and so that's a little different than shame because we don't clinically typically have a person jump right into their traumatic experience right so that demarks a fairly big difference between the approaches of the two that we do have somebody talk about their shame which is interesting to me because often people will talk about their trauma while they're talking about their shame in my experience but they won't have the same emphasis on the shame because they're not focused on that they're focused on um you know what they were thinking and feeling during that experience not so much about what happened to them right yeah and that makes a big difference absolutely yeah i think it um when you're going into the sort of what happens space it requires a lot more containment right there's a lot more preparation that has to go into that and actually how to emotionally how do i emotionally hold these memories while i'm going through them versus the shame gives you something adjacent to that that you can sort of uh hold that space a little bit more clearly within a little bit i know loose more loosely right like provides more room to breathe when you're addressing the shame yeah absolutely and added to that that when we're talking about shame at least the the way i approach it is to always stop start with how shame how we're living shame now what we believe today trauma is always anchored in the past and so clients think i have to unbe you know unearthed my entire history in order to work on trauma not so much with shame and the truth is that we resolve trauma in the present too but clients don't believe they do right but we know we we address shame in the present so it just makes it so much easier if there's an easy about either of these topics it just makes it so much easier to clinically approach absolutely the shame so the i think that's powerful in thinking about how we can do something um that's not such a deep dive in regards to the shame uh experiences but when it comes to trauma where do you see it beneficial to just get right into it and unearth it in a way or is or when is that valuable i guess in the sense of things right you know i'm so i i'm not going to be able to give you a clear answer because i almost always approach trauma through shame now because it just seems so logical to me so it's really rare that i unless a client walks in and they unpack that story in front of me i will tend to start what the you know the emotional things that that they believe impacted them about it right which is their shame i tend to approach most trauma through shame now absolutely because it just seems powerful and even when a client does come in and just starts to just shares all of their trauma with you i think it's still important to bring it back to the moment and say all right what was that what led you to want to share that with me you know it's like rather than continuing to go into that story bringing it back into the moment because that was a shame response right like so being able to help them identify that just by wanting to dive deep into it there is a shame attached to that so bringing it back into the present moment so this music's my ears so so how do me you know i'm i'm just curious and i'm sure the viewers are curious as well too but we hear this language from you know clients about you know trauma and needing to unpack and and all of that where do we think like this narrative came from the intensity about if we just unpack all this trauma you know you i think before the episode you talked about since what the beginning of dinosaurs that whatever your phrase was there for how long you've been in this industry you've been able to see in a really historical context how this industry has really unfolded in front of you and so how did we get into this position where we've just got this hyper-focused sort of feels like clinical culture around like we need to do this deep dive on trauma and we need to make that the thing well i'm gonna i'm gonna step out a little bit because i think that since we named everything as needing to be in our field trauma informed that clients have latched on to that oh well trauma must be the thing that's going to heal me and i think it's probably not true that trauma isn't the thing that if i somehow unpack it it's it's like this cancer inside me if i get it excised i'll suddenly be healed but i think we perpetuate that because everything is trauma-informed which i think is brilliant but we could easily make it shame informed i mean we chose trauma because that in at least in my memory that's the next shiny thing in the field so we we latched onto the word trauma we've written tons of books about it we we now have all this information about it and since i write core competencies i have to make sure everything's trauma informed so we have competencies for it and it's important well so with that said how do you a client who comes in expecting to have a pretty significant like experience like really working on their trauma and all of the sudden you bring this conversation or this sort of new language around shame how do you help them to correlate or connect um the shame to substance use like to kind of bring it back like what how do you because i think people can there again there's this narrative like i have trauma which is why i use drugs right or which is why i drink and but shame it's a little bit different right it doesn't that it doesn't that connection may not be as as uh apparent or um and maybe that's a good thing because the actual direct like i have trauma which is why i use drugs is probably not actually a thing but uh so i'm curious how do you it's really it's really pr not rocket science for me okay and it starts with saying well how do you know that that something's going on for you you know how do you know something's going awry for you and the client will describe that and i'll say well what what is a what is your thinking and feeling pattern that leads to that we'll talk about that for a while talk about the shame of that and then it's a really simple question after that where did you learn that and that touches on their trauma but from a third person point of view where'd you learn that they're thinking about what they learned not their trauma so i'm not unearthing their trauma but it's at their trauma they learned it and i don't care about the trauma at that point i care what they took away from the trauma i care what they believed about themselves as a result of the trauma and that's what's creating their shame and their current thinking right and then that lesson is essentially being manifesting through behavior right and so on one of those behaviors could be substance use right and then after all of that is unpacked i'll say that's a really powerful experience of learning something important from your trauma and then i'll use the word trauma after they're all done really let's just put it in a bottle and sell it yes yeah absolutely um always appreciating your your poignant and thought through answers and i'm always sort of captivated being in front of you sincerely about just your ability to quickly get to the situation and identify you know examples you know for which you're walking through and so you know what is one thing that we can leave you know families in that regard of so when because the families are hearing that same sort of experience my trauma was not worked on i relapsed as a result of that now what now what can we share about families about maybe how to um what what can we share with families differently about trauma than we would share as an individual session with a client in that regard to better inform them about how to appreciate you know what's happening if that makes sense it might not someday it kind of you always have you always have a way of talking i'll make a stab at it and we'll see how it goes yeah i would say to folks that it is not the trauma that has caused them the problem it is what they took away about themselves what they believed about themselves what they believed they lost or what they believed they disempowered about themselves or what they had to protect themselves from that's important to release and relearn because most of the time our traumas happen sometime in history that's the nature of trauma it's in the past and we forget that no matter when our trauma happened we were different then but we've anchored that trauma in that experience especially childhood trauma we were children we were helpless we didn't have a lot of skills so we believe about that trauma that it's true today even though our skills have changed so if i approach that from shame because when somebody grows up what they bring about that trauma is their shame well why couldn't i take care of myself why couldn't i stop that i must be a bad person if i can release the shame today then i can remind them that they have different skills today than they had then and link it differently absolutely yeah yeah i mean i'm captivated too yeah yeah and i will say the one the other thing i say to clients all the time is that guilt shame trauma are simply lessons encapsulated in judgment if we can release the judgment then we can simply learn the insight or the understanding or the the preference absolutely that is available to us and then we can start to rewrite the narrative right because we start trauma we start telling a story about ourselves you know and i think once you can when you look at shame in a way that it's a it's a sort of narrative it's a persona you've created and but that actually doesn't fit anymore you know the story no longer matches the skills and once you can kind of see you see that disparity or that uh discrepancy there you can really lean into it and start to actually build a new narrative start to tell a different story that isn't based on the the lessons learned in trauma but are actually grounded in the skills of the present and the person that actually is in front of you i agree it's it's powerful stuff and so it's just slightly nagging me a little bit to when is the appropriate time then for like an emdr or this semantic experience sort of intervention i mean both of you are welcome to field the question but you know i really just want to contrast because you know working the admissions line for you know here at peaks for the past three and a half weeks or so you know you just get these questions like johnny needs to work on his trauma so what are you guys going to do about this trauma they're quick to engage with what they know about these clinical interventions which is emdr and somatic experience and these sort of things so you know again you know when can we really tie in the appropriateness of those in your clinical experiences like where does that seemingly work best if if at all and i think it's okay to poke the bear to say maybe it should be limited and because it feels powerful to really approach this shame story in this way leave trauma in the past and let's talk about these experiences this judgment you're experiencing with these new skill sets you have that are no longer matching um i mean i can i'll take a step at it go for hit my mic um i think that it at least at the model let's let's take a 45 day model like peaks uh that is about stabilization not necessarily about the deep dive into trauma i think that at that point in time the the reality is that there are oftentimes skills that still need to be learned right and in order to be able to sort of contain and manage and manage the experience of processing trauma it it's not easy you know and it takes uh you need to be in a pretty clear and stable physical and mental state in order to be able to appropriately and safely and effectively address trauma so i would my recommendation clinically would be after 45 days of treatment you start to ex you start to explore that with the therapist on the outside you know that to me that feels like aftercare or at least like a long-term care plan because it's going to take a while you know and it's and it's going to be intense and it's but before you and before you go there though you have to you need to be stable you have to learn how to regulate you need to learn skills so that once you start down that path you don't relapse right or you don't fall backwards into old patterns and i would say it's both and i think that what the curriculum at peaks is brilliant at opening the doorway for stillness for mindfulness for turning off the midbrain the experience herself beginning to get access to the observer self exactly what emdr does it moves us out of that experience or into our observer and distracts us as simply essentially so that we can connect dots in ways we haven't connect them and we do yoga and we do meditation and we do exercise opening the door for realizing that the body holds experiences it as well and all of those are important and peaks absolutely sets the stage for all of that absolutely and in essence we're working on trauma yeah we've we are working on what gets in the way absolutely beautiful it's good to learn what's going on within the program absolutely and you're down with you guys and um you know again alan thank you so much for joining us today my pleasure certainly would love to continue future episodes with you and bring in more of that that knowledge um that you bring and always a pleasure always a pleasure as well too for all the viewers on the other side thanks for joining us today we hope that this was informative and impactful to you um we only know what we know in regards to what can be impactful for you so please email us finding peeks at peaksrecovery.com bring your thoughts and ideas and questions forward so that we can bring that into these episodes uh find us on the facebooks the instagrams the podcasts the twitters all of that sort of stuff to learn more about these episodes and what we're doing within the space of addiction treatment and mental health and thanks for joining us again and we'll see you next time

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Episode 16 How To Identify and Change Enabling Behaviors Watch Now https://youtu.be/kCyISsTm-6g Listen Now Episode 16 Peaks endeavors down what enabling a loved one may look like before, during, and after a treatment episode, and gives some input as to how to appropriately build boundaries or break co-dependency dynamics.

Topics:

We talk about what enabling an individual can look like before the family decides that treatment is the next step
We move forward into what enabling can look like while your loved one is in addiction treatment.
How codependency plays into family dynamics and addiction.
Lastly, we speak on what enabling can look like post addiction treatment
The balance between nurturing a loved one and not feeling like you're walking on pins and needles post-treatment.

Select Quotes No family member wants to watch their family member be in pain. So a lot of the time it is those little decisions to get somebody out of the immediate pain that is like enabling behaviors, but it gets them out of the immediate pain so it seems like the right thing to do at the moment. We’ll worry about recovery down the road, or we will set the new boundaries tomorrow, but tonight they need to get out whatever discomfort they are in, so I'm willing to do anything at that moment for them. But it’s that aggregated over time that leads to these really chaotic environments. Jason Friesema, MA, LPC, LAC, Chief You start to slip into this moment where you are enabling rather than empowering. Because healthy good support after a treatment episode or while someone is in active recovery is all about empowering them to continue down this journey. Enabling starts to take them further off that path rather than challenging them to figure out ways to maintain what they are doing, to figure out a way forward, to get themselves out of discomfort on their own. Clinton Nicholson, MA, LPC, LAC Chief Operations Officer Episode Transcripts Episode 16 Transcript [Music] all right welcome back to another episode of finding peaks joint i the last time we were doing this i did not introduce you guys uh oh no one knows who we are now yeah yeah so if you don't know by now i am i am brandon burns the host don't steal my thunder yeah okay chief operating officer clint nicholson everybody laclpc lpclac it's the order either way jason friesma lpclac chief clinical officer brandon burns full shot officer all right ba philosophy philosophy expert university in washington yeah basically i'm the most important so okay again just trying to bring a little energy into the episode you know appease the audience get everybody a little excited um we've commonly heard in this industry maybe we've been brought it up that the opposite of addiction is connection we're not going to go down that rabbit hole today but it is a phrase that i wanted to use to go down another rabbit hole that is the opposite of boundaries is enabling right we've been talking a little bit about boundaries and what it means to show up and bring forward boundaries on behalf of the individual get them directed into care those sorts of things but let's talk a little bit about enabling today and what that looks like so when we're not boundaried we're enabling and maybe we can think about this in three different phases what does enabling look like before treatment what does it look like during treatment what does it look like after treatment so the first question what does enabling look like prior to somebody admitting to care i i mean i i love that you asked a question and i i was waiting for four more to come chief clinical hit us with it i get it i get the question and it was so succinct um enabling before treatment frankly it it extends i was we were talking a little bit before the show that a lot of times it involves either money or resources or time of family um and really it's in the direction of allowing somebody to continue in their behaviors that are likely causing them a lot of harm and would lead to media and stay at peaks and i can't tell you how many parents i've talked to who have bought substances directly for their loved one or continue to provide their loved one cash money even though practically speaking they might say it's for rent or whatever but literally that money is going being diverted or i've also talked to a lot of families too who set boundaries and then when it comes time to kind of enforce the boundary they'll just set a new boundary uh and so that's what i've seen enabling look like a lot on the front end is just um a constant um well allowing a behavior allowing an addiction a lot of times by itself just implies that that the behavior given by a loved one um allows the addiction to keep advancing it's keeping the addiction actually moving forward rather than putting the boundary or helping us stop it i'll kick it over to you there chief yeah i think um i guess i see it in just slightly different terms but relatively uh with the with using jason's description i think before treatment um enabling is just chaos it's just chaos there's no nobody knows where they stand you know there's no direction there's no there's there's no ability to navigate situations whether that's physically emotionally um there there is just a complete absence of um clarity and a really again a complete absence of just direction yeah and i want to add um because a lot of times uh enabling a watch be really progressive um where there's just a slight boundary violation and a slight bounty violation a slight boundary violation and i'm at a heroin dealer's office or uh office house uh right picking up heroin right but it was the series of a thousand decisions before that to not hold boundaries in this incremental uh warping of one's values i think or distortion of that to just enable somebody just make it one more night or whatever um so that families suddenly look up hey austin i don't even know how we got here absolutely yeah there's a sort of like exponential quality too it's like it just it starts to gain its own momentum and before you know it it has its own weather pattern i mean you just you have it's the gravitational force around that the enabling that has created this this again this this world of chaos and where all of a sudden you you kind of look up and you're like holy crap what happened you know how did we even get here and i think that at that point is maybe when you get the first phone call it's that first moment of like where am i and how do i how do i figure out how to move forward from here yeah one of the things that we you know certainly see in those first phone calls or when families are bringing their enabling behavior forward and uh in this regard is um well i guess what i want to say about it more so to the point is that you wouldn't if it wasn't your loved one if a friend called any of us in this room if you said you know hey brandon send me a hundred bucks i'm gonna go buy some dope today to me like the boundary is like that's not loving that's not loving for me to give you that cash knowing where it's going to go so regardless of it being a loved one if we wouldn't do it for anybody else why are we doing it in these instances and so i just kind of want to i guess in my own words like reinforce what the boundary concept there is is that it's not a loving thing to do if it's not a loving thing to do in the direction of a friend then why would we consider it a loving thing to do for our loved ones no matter how much they're clawing at the door pounding on it in that regard so i think that actually speaks to some of the chaos that you experience because one thing that i think happens is you lose um perspective of your emotions and all of the sudden what feels like love is actually fear you know you think you're moving from the space of love but really you're you're so discombobulated that you've actually started to move from a place of fear and i think that that is one of the it's a huge trap that families fall into and they're unable to take that step backwards and sort of have that moment of like wait if i wouldn't do this for anybody else why why am i doing this now because they've sort of uh these they've just flipped those two emotions and so that uh between love and fear i mean that would kind of love it and that's why i continue to bring you guys on because you're the talent and i'm the host yeah yeah and clinton's i do i've talked about like three of them today so i feel like i'm good for the next we got all kinds of dealers going on yeah but i do think i think it's just a really great point too that um because i do think no family member wants to watch their loved one be in pain and so a lot of times it is those little decisions that get somebody out of the immediate pain that are likely enabling behaviors but it gets them out of the instant or immediate pain and so that just seems like the right thing to do in the moment and we'll worry about recovery down the road or we'll we'll set the new boundary tomorrow whatever but tonight they just need to get out of whatever discomfort they're in so i'm willing to do anything at that moment for them but it's that aggregated over time that just leads to these really chaotic environments absolutely we start and we continue to experience that and to kind of go into that second question we continue to experience that once clients are actually in treatment it's sort of uh the echo of that behavior once a client comes in and then all of a sudden they're calling and saying hey the bed's too hard the foods the food is uh i don't know too soggy the the people are mean to me and all of a sudden the parents are the families back in trying to rescue again they slip back into that sort of fear space and they even though they know and they've worked so hard to get family into treatment all of a sudden there's still this this sort of uh automatic response to rest to continue to rescue when once they hear that distress so you still see them moving from a place of fear particularly early on in the treatment episode well does doesn't it make sense too that like we tell families all the time that just because the substance used to stop doesn't mean that things are better like that a lot of the behavior of the person struggling with addiction has suddenly begun to change or shift like they'll be ongoing line they'll be ongoing deception or whatever and then on this meta level if you will the family is used to hearing hey i'm uncomfortable mom dad i'm uncomfortable oh we'll help you stop being uncomfortable what their tempurpedic beds aren't like soft enough well i'll have somebody yeah we'll we better get you out of there um and so you know for families oftentimes like teaching them in treatment like hey your loved one is safe i promise you that and they are uh cared for and we don't need you to rush and meet all of their needs right in fact actually it's counter productive to the whole process yeah so i think that that would be to summarize that the the answer of what is enabling look like in treatment it looks like rescuing i think that that would be the easiest way for me to put it so well i'm starting to feel a little invisible now because you stole my thunder on the second question so i'm no longer going to prompt you guys about what we're going to talk about we're just going to question like we laid out a little bit i laid it all out so you just went through it making me invisible and feeling less of a person so we can rescue you i guess yeah or enable yeah trying to build the concept maybe we insert at this point just so i can get some of my thunder back term like codependency how does that resonating now because it feels like what i what i want to capture maybe with that language it's just that from what you said from pre-treatment into treatment you can start to experience the bleed over of those emotional states and that codependent feature that is common within our industry and that codependent feature is a is a family system sickness right in a big way and you can start to see it sort of cross over in its variations as it's taking place but really just want to acknowledge that with family members the the reason there's this tone of sickness is because you're engaged with the addiction you are attached to it suffering in the process so worked up on the front end here that as it moves into treatment you continue forward in just a what feels like a new in a different way but it's the same sort of behaviors just compounding in different settings with a little bit tone of positivity because now it's in treatment rather than prior to treatment right so any thing we can add to that sort of codependent sort of sickness that's now traversing through as the individual moves forward what came to my mind as you were talking is you know a couple weeks ago i think we talked about like the neural pathways and and the reward centers and and how um people who are using drugs uh this pattern of behavior just becomes this trench and that this is what they automatically do and the family have the same thing their rewards look different it isn't drugs it's like oh my son is safe that that rewards me or like i did enough to keep him alive or keep keep him going this time or i'm you know maybe he'll be okay this time and so there is this same groove and so when when we have clients come in the loved ones are can still have that same like i wonder if they're okay or one like i have to constantly be in this and like we've talked to to couples that are like their relationship their loved one's addiction and like their their marriage is almost in tatters we're like what do we talk about right now because like you know our sun is starting to get better and what do we have to do yeah what do what do we actually do right we better just talk about watching and i hope the bed is comfortable yeah so like but if that makes sense like it has that same neural pathways that almost have to be rewired too and it doesn't happen automatically it takes some time and there's this recognition i think at some point where you know it the work again goes on both sides as far as the change in the transformation that you're looking for and when your loved one who is in treatment begins to change and transform that automatically requires the family the loved ones to start changing as well you know it's the way that the sort of relationships maintain what's called homeostasis right they're always trying to seek a balance and as one person in a family system changes it necessarily require requires that everybody else in that family system change to adapt and i a lot of times families and loved ones aren't aren't prepared for that they real they think that they're sending their loved one off to go make the change that they need to make and then every and then they come back to us whole and complete not realizing that their transformation is happening as well like their their time to heal and to and to sort of um grow into this new p into this sort of like new stage and their relationship has already started as well i think it kind of can come up as a pretty big surprise sometimes and it shows up it actually edits extreme and i haven't seen this a ton in my years but i have seen it where family members who are supportive of the recovery process have actually enabled a relapse on the back end to get back into the homeostasis that they were used to absolutely like they they were they almost relapsed in their enabling prior to a discharging client relapsing in their addiction if that makes sense like if you did it back in chaos yeah right like we did better when we were when we were doing that absolutely i know you better as a as an active alcoholic than i do as somebody who's trying to to live in a life of recovery so and it's it's it's an interesting thing to witness from the outside and like jason said which is so interesting that he i'm talking about feelings he's talking about the brain i know i don't know but uh i know we're all over the place so yeah i'm invisible [Laughter] but again you know we're like looking uh we're we we recognize or we start to see this sort of entrenchment of behaviors yeah yeah it i want to go on a tangent here but for the sake of time i'm gonna i'm gonna put it to bed maybe introduce it at the end here but so now we're transitioning out of you know treatment in that regard and i hear strongly and it's certainly true and certainly in our experiences at peaks recovery right that the family system has to be included in this we have to build them up in a way that's building up at the same time of the patient um so that everybody's informed about how this um goes about but i constantly hear and i want to use the word constant like when we go to refer families to like hey you know look now and make these connections you know reach out to families it's the sort of same behavior and feedback that we get from the the client who's relapsed in after pride treatment episodes of no no i've done that it doesn't work for me you know there is this experience that families have too of like the information i've been given the resources you've given aren't working for me but it seems like in a very strong way as well too that we are trying to um remove that and compel you to actually engage with it it's not about working for you in the sense that we're turning some knobs and this sort of feature and all of a sudden you know we get it as a family system you have to embrace the language the education the information we're giving you as families in this regard to really know how to strongly hold those boundaries and not enable the loved one post treatment um in this regard but now we get this you know again this bleed over into post-treatment and kind of from your guys's perspective now what does that post treatment enabling start to look like you know i heard the homeostasis and how it kind of just clicks back into place but being more clear from my host position and asking these questions what are we let's talk a little bit more about it right okay so obviously kind of a family enabling a literal relapses it would be another that'd be a pretty extreme um [Music] but if you go back to what i mentioned at the beginning of this would be this slow incremental uh relapses much more common whether it's um it you know what what somebody coming home may say is like listen i don't i don't want to go to my therapist anymore they're right i'm not getting a lot out of my iop or i'm not you know my support meetings are starting to go downhill and yeah i don't like the guys in my silver living yeah yeah and and an enabling behavior would kind of be to align with that rather than saying so then what are you gonna so therefore what are you gonna do to build your support right uh like enabling kind of would get in alignment with kind of a reduction in a return to the old behavior holding good boundaries doesn't have to be forceful or anything but you know boundaries i did want to make sure i mentioned too boundaries are for uh the person setting them to create a protection they aren't to change anybody else's behavior right so like when when a loved one is coming out of treatment the boundaries that the somebody a family member puts in place is to protect them not like i gotta set boundaries in order uh to make sure my loved one stays sober that's not a boundary um a boundary says listen if if you kind of follow your aftercare plan then you're welcome to do these things or we'll support you financially in these specific ways um but if you begin to violate those then our then our support ends that's boundary because it's saying that's where i end and that's where you get to begin because i do think that is a families can fall into that pattern too where i'm setting a boundary but it's really about i'm setting a boundary to control or manipulate you absolutely um do what i want you to do the boundaries say regardless of what you do this is what i'm willing to do on my side right you start to you slip from um you start to slip in this moment where you are enabling rather than empowering right i think that that's what you start to see because healthy good support after a treatment episode or while somebody is inactive in recovery is all about empowering them to continue on that journey as opposed to enabling starts to take them further off that path rather than challenging them or empowering them to figure out like ways like jason was saying to maintain what they're doing to figure out a way forward to get themselves out of the discomfort on their own or to find a way to get out of discomfort that doesn't allow them to fall back into those entrenched behaviors um yeah so i think that that's it it shows up like that i think a lot of ways where you start to see rather than empowering the patient or the client or the loved one you you slip back into the enabling behaviors yeah and so i where i know we're at the tail end of this episode but i do want to get this saying because i just think it's important to address or maybe some information or guidance that we can give to families in regards to there's something about this industry you know when we think about concepts like the the pm melody model and the language that she uses for example to describe what trauma is she says that trauma is anything less than nurturing and that could be a lot of things in this industry you know when we talk about grief and loss or relationships and these aspects of our curriculum you know trauma and so forth once the family knows or aware of sort of root causes of what you know is driving the intensity of the addiction or maybe the intensity of the use that led to the addiction um in this regard it's for me it sort of leaves them vulnerable or in a position to feel like they're walking on pins and needles like if i push too hard they'll relapse or anything less than nurturing gosh i should probably not do these things and i want to alleviate families a little bit from this concept that we're constantly walking on pins and needles and allow them to separate themselves a little bit from you know potential relapse episodes and that sort of thing and just curious if you guys have any language or guidance we can give in that regard because i think it's important because i was talking to the mom last week and it seems like she's doing everything she can to sort of like you know nurture fix resolve you know move the boundaries all over the place to nurture the situation because she's anticipating he's going to yell at me he's going to slam his door he's going to do these sort of things along the way and but i don't think that the goal here is to be that delicate or to walk in that sort of way yeah and i think i think you hit the nail on the head and actually um this came up with a family member that i was talking to just last week um who was talking about not wanting to parent uh their partner um and they were talking about their fear of like you know if i if i suspect you know a relapse or drinking i don't want to parent them or police them or follow them around but i don't know what to do and what i actually suggest was like well then why don't you ask your partner which what they would like for you to do and to have that conversation i get i see that because i think a lot of times boundaries uh that are put in place when the emotions are high so i'm going to talk about having low emotions again but like boundaries should be in place when emotions are low and anger isn't high old ways oftentimes i'm you're you're throwing boundaries out when you're angry or afraid or frustrated or whatever and really when somebody's kind of in in a residential setting or whatever that's a great time to have that conversation and partner with your loved one like what what would reach you uh if you are um having this concern and how can i say it in a way that will will least likely lead to uh defensiveness and most likely lead to um conversation so i think having a conversation beforehand not during would be what i would say to them i would i would say we have really getting families to see that nurturing has nothing to do with comforting you know like those two things are very different yeah to nurture somebody can feel really awkward it can feel it can be um hard it can be rough it can be very very very uncomfortable and i think that we often associate that in order to nurture the result that means that you feel good afterwards and that is not nurturing nurturing is much more dynamic than that nurturing is about love and keeping somebody alive you know not love and making somebody feel comfortable brilliant well i'm glad we could top the day off with that because i i felt like it was important to convey so um in exiting this thank you so much everybody for joining us today for allowing us to go a little bit over our natural timelines to convey just a bit more information about this boundaries enabling that topics are going to be an ongoing feature of our show in a variety of different ways we're looking forward to really coming up with a strong schedule in the month of august so that we can convey a new guest onto the show and bring forward some additional information to support families and and family systems um check us out on all the things the kids are doing these days instagram facebook youtube uh podcast and uh finding peaks at peaksrecovery.com if you've got questions thoughts ideas you want to throw our way uh certainly happy to engage with those questions thoughtfully and bring those topics up in future episodes to your all benefits so thanks again for being with us today and we'll see you again next time [Music]

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Episode 15 A Powerful Recovery Story Watch Now https://youtu.be/84prLsNCboU Listen Now Episode 15 One of our CCA’s shares his inspiring recovery story in order to give hope to others who struggle with addiction.

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He talks about his life before recovery and what struggles he walked through. 2. What ups and downs individuals can walk through while endeavoring down the road to recovery. 3. He speaks on what his recovery looks like today and the lessons he has learned along the way. 4. The group talks about the difference between accountability and shame

Select Quotes Helping others is huge for me. Because I was that guy that was homeless and didn’t have anything. And when someone lent a hand or tried to give me direction I thought that was really genuine. Giving back has been the most rewarding feeling and its something I was missing in my past attempts to get clean, honestly. Cody Fleck, Peaks Recovery CCA Episode Transcripts Episode 15 Transcript hello everybody and welcome to the peaks recovery center's talk show i am super excited to be here today we got some phenomenal guests with us to my right we got my good buddy cody fleck client care aide someone in long-term recovery as well and to my left we have our trustee steed clinic chief clinical officer jason friesema who is the first longest tenured employee with us right now and then beau right right what's the right now thing chris like today have news for me and so we wanted to do this in the most compassionate way possible as public as possible yeah no we love freeze my piece we love cody i'm really excited to get on here today it's my first time hosting i get to bring cody on and he's just got a really authentic powerful um and unique recovery story that i want him to share um briefly and we'll just kind of start there and get into and start conversating about it but i think cody's got some really good insight some good experience and now being on the professional side um some good ways to lean in with compassion love and care which is what we love to do at peak so yeah cody why don't you tell us a little bit about your experience kind of getting sober what that was like maybe your time in the military as well he did three years in the military and then as a professional a little bit you can track on all three of those yeah no problem um so yeah growing up uh it was it was kind of kind of tough for me um both my parents used so that became kind of like a normal normalcy for me um i uh used to deal with life anything that happened in my life that's what i turned to i joined the military when i was as a cavalry scout in in the u.s military um in the army and um i thought that would kind of take care of of my addiction and the problems i was having but that that was not the case at all i did in fact still find ways and means to use i want to backtrack a little bit i had gone to a rehab to my first rehab when i was program in baton rouge louisiana and i really didn't grasp anything that was going on most of the kids were a little older than me and it was a it was a weird uh a weird experience for me at that age to go through that but fast forward to uh while i was in the army i still drank i still used i wasn't using iv but i was still using pills and stuff that nature and yeah my time in the military was great i soon moved back to louisiana after getting stationed at 4 poke and that's kind of where my addiction kind of kicked back off again a little more intense at that time i started going home on the weekends hanging out with old friends again and yeah i started uh i started using just to cover up the pain of losing my father at a young age losing my mother short shortly after that to her addiction and incarceration so yeah i bounced bounced around a lot i went through i caught some charges and ended up having to get into the drug court program i found at that point in my life i found out what aa was really um and i knew that it worked but i didn't fully uh commit to changing in in the program um i about a year after that i started using again while on drug court and i basically kind of gave up at that point i uh opted to go to prison pretty much and spent a couple years involved in the judicial system in concordia louisiana and got out and i knew that i needed to make some major changes i wanted to get out of louisiana and i thought that moving would be my best bet and i thought again just like i did when i joined the army that moving to florida would solve all my issues um and i found out that wasn't that wasn't the case at all i moved to florida and that kind of started my journey in the treatment scene um going from rehab to rehab and all in all i i truly wanted to stop using i did not want that life i always knew that i could be better but i just didn't i just didn't know how i didn't know what i was missing at that point um and it's tough too because you grow up with it all around you and i think because i relate to that having both mother and father addicted and all around you is this idea that if i can just get a little bit better than this i'll do okay yeah and so there's really no way out of that and there's it's not this idea that i can like yourself i tried to go check into the military at 18 and squash my addiction only for it to pop back out the side right and same with you so it's it's not a thing that you can suppress and i just love the way you describe addiction because you said i do it to treat the pain and and i've just said this at nauseam lately just because of dr gabor mate and all this stuff it's not why the addiction it's why the pain you just really described that really eloquently man and thank you i love the way that you move through that but go ahead and continue with the treatment yeah so i mean i i've i've i've been through a number of different treatments um and they they were great i did learn some things some some not so great um but uh yeah so i did i did learn something from each treatment center um and yeah bouncing from treatment to treatment trying to trying to solve my my problem which was which was the use and the and why why i used um ultimately my time in florida was coming to an end i met a guy and came out to colorado springs um again trying to trying to run for my issues um and yeah i found myself arrested again here um after about with uh some some some a few nights of drug use um and yeah that that's kind of that's kind of where uh my how my journey ended as far as my use and february 26 of 2019 was the last day i used and i still can remember that's legit man yeah i still can remember the the the feeling of uh of what what just happened and and where i was at at that point and uh i remember getting offered drugs um not two hours after uh arrested in el paso county and that was the first time uh i you know denied anything um so yeah it was it was a it was a really powerful moment for me and i knew that it wasn't just uh oh uh like i'm never gonna do this because i'm i'm here um it was like i just i just don't want this anymore so yeah that that light just clicks and you're like i'm done yeah yeah that's beautiful talk to me a little bit about what the last two and a half years in recovery's both been personally and professionally yep um so a year ago i found peaks i was yeah it's a day away from a year ago i started working for peaks and prior to prior to work prior to getting the job at peaks i i got out and hit the ground running i knew that i needed to make some major changes and go to any lengths to to keep on this path i got committed to ca here um met some really good really good guys who i'm still friends with to this day stayed connected with them and i just started going through the steps going through the process working my butt off to to really change my life and make sure that i never had to go back to that started working for peaks a year ago and that's where it opened my eyes to to a lot more than just you know ca and aaa and in the program i found out that there there's many ways to to stay on this path i found out that they actually had staff at treatment centers that that truly cared about about the client and put their best interest ahead of had head of their own sometimes you know and um it's just been a blessing to [Music] be able to work for this work for this company uh work for the people i work with my co-workers it's like a family it truly is a family and and yeah i mean just opened my eyes to to a different side of the treatment scene because like i said you know i've been i've been involved with treatment for for a long time um and you know some of some of those times weren't weren't the best uh experiences um but yeah i mean peaks is uh peaks is really uh it's really different in a lot of ways and uh you know from the staff that is there with the clients day in and day out uh from the medical side from the clinical side from from now iop um and which which is great because i really feel like staying involved with with the people and the in the company that helped you get clean is is really important so yeah that's great man and you've certainly found a lane at peaks that you're really really good at and cody is kind of i describe him and another guy sylvan up there and our detox is kind of like the front ground triage infantry soldiers i mean the people walk in in the worst conditions of their life life more often than not and this guy walks right up and is happy to wrap his arm around him and say let's go it doesn't matter he can hold space for those individuals just as good or better than anybody i've ever met and like i told you today on that feed like you're made for this i mean it shows in the work that you get to do on a daily basis and so we're just as lucky to have you yeah to be a part of that for sure and just like cody and jason pointed this out a couple weeks ago when we were doing a show he said you didn't believe in treatment the reason i didn't believe in treatment was because of all the bad actors and that's what cody saw down in florida is if you go to so many programs and you're around so many programs and you learn that this is this is actually not efficacious it's not putting clients first and then you find yourself an a.a saying things like this is the only way to get sober yeah and it really is i'm grateful that peaks can be that breath of fresh air because there's certainly been a couple breaths of fresh air for me over the last couple of years that have allowed peaks to adopt some really compassionate and trauma-informed uh pieces of care so yeah um grateful you're you're leaning into that now um i want to shift over to jay money yeah that was solid yeah i appreciate that dude you got a powerful story thank you powerful story let me ask cody one question switch over yeah i i appreciate the before story i really do and and i love the recovery part of your journey cody and then i i just wanted to ask you what brings you joy now like what what gets you up in the morning and brings a smile on your face and it doesn't have to be peaks by the way well peaks peaks is a is a big part of that um but also just uh finding myself again i used for so long that uh i didn't i didn't know who i was honestly i didn't know what i liked i didn't i didn't know what i didn't like i didn't know that was that was a big fear of mine uh getting clean is like what what am i supposed to do now you know um i spent my days using um so um uh like a part of this is is is from the program but uh just helping others helping others is huge for me um because i was that guy that uh you know was homeless and and didn't have um and you know whenever someone you know lent a hand or tried to give me direction i i thought that was really really genuine um so yeah just just helping giving back uh you know working out staying fit um what do we do this morning yeah crossfit tell them what we did this morning we had what 15 guys in early recovery doing a 20-minute am rep with 15 excuse me five pull-ups 10 push-ups 15 air squats as many times as possible in 20 minutes it was a great it was great to see yeah beautiful thing and they love that that's something they look forward to and that's something you know i look forward to at work and and on my own time um but yeah man just giving back is this the most it's been the most rewarding feeling and it's something that i was missing in my past attempts to to get clean honestly um because those times that i was clean and in the past were kind of just like you would uh say dry drunk or or someone without any any happiness in their life so yeah man that's definitely been a huge factor of what brings me joy that's awesome yeah and a great question too because i always tell you i'm like we want to touch our passion every day yeah whatever that is yeah great question great response so we don't have a tremendous amount of time left but i'm going to shift it over to jason and just kind of keep going on the the same tongue that we've been on and you know treatment providers i used to be a treatment i used to run a program in prescott arizona that maybe i shouldn't have been out in front of you know i was very new in the field i was only a few years i was hungry i treated people well i cared a lot but i wasn't in a good position to be in there and so i think sometimes in those early recovery processes specifically back in 2008 and 2009 for me where i think i'm showing up being accountable or helping become helping the group become accountable i'm actually introducing some shame and that is the last thing that i want to do today and i think the last thing we should be trying to do is treatment providers so and it's a delicate dance sometimes and so i just want to chat with you a little bit about what is the difference between accountability and shame and and how do you how do you differentiate those yeah and i think if i were to say it in a sentence i would say accountability is about behaviors and shame is about character of a person right if you if if i'm confronting somebody about their behaviors i'm holding them in high regard while i'm doing it i'm holding them up and saying you're valuable you're valuable enough for me to say hey these behaviors are out of line shame is saying wear a sign that says i'm an addict and go sit on the street corner you know what i mean like that's shame you do that that is i mean there is a history of that in this field and fortunately we are moving away from it but i think um people that have walked through addiction don't need to be told uh what a piece of garbage they are they are feeling that they need to be told you have a lot of value and we can build you up in this way and then some of your behaviors probably need some correction along the way because it isn't like you just remove drugs and alcohol and everything else like all my other behaviors fall right in line i've stopped lying i treat people right i make my bed i i i live on a schedule those things like those things have to be taught and and they don't come naturally just with the removal of the substance and like doing this longer term work and and um and cody did a great job describing it too like working out and all that bringing finding joy just in uh kind of getting acquainted with yourself again i think that's what that's what matters and so i that's my short answer to your question yes i think that's a really great answer because what we're doing is we're pulling out of the only resource that was around in yeah which is alcoholic synonymous is a great resource absolutely but even so much so when i got sober in 2008 i heard stories and things like just sit down shut up listen you'll talk when you get a year and at the time i was one of those people that was resilient to that type of treatment but there's a tremendous amount of people that aren't and you can't fight shame with shame so i just think that's really really valuable to grow up and out of that aaa culture especially if we're treatment providers yeah um so you bring up a great point and explain that really really well and i just think we can all get better on a daily basis with respect to compassion love care and decompressing shame because most people are walking into your credit like there's not a single person that's beating themselves up worse than the person walking in the door and when they get to sit with somebody like cody who understands what it feels like to be in shame i mean we can dismiss that right away and that's that's how in the last almost seven years with people like yourself and cody how we've been able to develop to adopt and carry out this idea that nobody cares what you know until they know that you care and so it's because of special individuals like you guys so um thank you so much for coming on cody matt's been great having you on pleasure love to have you on again here in the next six weeks or so jay trusty steed baby love y'all so that's it for the peaks recovery centers talk show founded september 14 people find us wherever you find your podcast instagram facebook let's go probably are watching it right now on that so make it beautiful and blessed [Music] peace

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Episode 14 Is Leaving Treatment Early The Right Decision? Watch Now https://youtu.be/O5xBuEoY-Cw Listen Now Episode 14 Our team gives insight into what the professionals and the families can do when their loved one’s want to leave treatment AMA (against medical advice), or early.

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Our team talks about what we do as a team if your loved one is expressing they want to leave treatment early or AMA (against medical advice).
We explain how craving states can be directly tied to the feelings individuals feel when they want to leave AMA (against medical advice).
When to trust the professionals and when to trust your loved one when they want to leave the treatment program early; what yellow and reg flags to be aware of.

Select Quotes The data is clear, 1 year of recovery time leads to a 50% reduction in relapse, but there still is a 50% potential of relapse in just one year. This leads to the direction of the 2-year outcome of 85% reduction in relapse rate. So the more time that goes on is informing us, but it also brings forward this opportunity of the direction of care and we’ve got to take it seriously. Brandon Burns - CEO Episode Transcripts Episode 14 Transcript all right welcome to another episode of finding peaks i'm excited to be back i've been out of the host seat for a little bit jason freeze must been here hopefully not boring the crowd too much um in that regard yeah really academic discussions while i was here mainly mainly academic you know we've had chris burns i think matt a few others come to the show recently so hopefully that creates a little flavor and variety for the crowd a little bit differently than what i bring here but so here i am again and the topic for today um that i would like to bring forward is uh amas against medical advice discharges that is uh i think if i'm reading the data accurately here from samsha and nida and some of these institutes that about nine to 12 percent of patients who enter addiction treatment centers detox residential services even aftercare programming ama within a very short time period inside addiction treatment cultures and that happens for a variety of different reasons but i think the thing that we want to do is help prepare families for what that moment looks like and what to be prepared for one step back is a little backdrop to this that i think is important that i want to acknowledge among the 14 country there are bad treatment centers and we're not going to pick on anybody but i just want to be honest about that as an approach that it is true that from time to time your loved one will find themselves in a position where the treatment is just bad what i want to say about that before we dive into the questions is that if that is the case it doesn't mean no more treatment it means we've got to find the next place and keep treatment directional and that is the first strategy so let's say that johnny's in treatment he's now reaching out to you the family member and saying i am in the worst possible place i've been lied to this is not what i expected and i want to get out of here what is our best first advice in that moment because we want to keep things directional in that regard what would you guys offer up clinically as a solution in that instance to motivate it does johnny go to the home first or are we think you know what is our best first step forward here well i think you bring up a really good point in that if there's 14 000 which i believe you if there's 14 000 drug and alcohol treatment centers in the country some of those are going to be not great um you know who you are we know you're watching but i do think overall if a treatment center if it's a parent's belief or a loved one's belief that their loved one is in a center that is uh competent and doing a good job with their loved one certainly we do look to families quite frequently to set up and establish boundaries if you if you basically communicating as succinctly as possible with their loved one if you leave early this is going to be our response and i and very rarely is it the appropriate response to be well you'll just your loved one just gets to come back into their same situation whatever that might be whether it's returning to their apartment to their home or whatever or going to a parent's home uh leaving treatment early is not a setup for success um for the most part and so we really do work on when we're working on retention um with families it i would be looking for an increase in communication from the treatment center that like uh so if a family member were to get a call uh from maybe a loved one at peaks that and maybe it's uh not in front of a counselor or whatever just on kind of a regular call saying that they would like to leave early my first suggestion would be to loop in the treatment team like confirm with a counselor a case manager um that this is what either the plan is or are you guys aware of this and how do we proceed um because oftentimes uh we talk it peaks about there are times and we've talked even on this show that there are times and peaks where we uh increase the discomfort within peaks as a way to kind of uh prompt change and to make somebody a little bit uncomfortable to to prompt them forward and those are sometimes the the times when clients call and want to um want to leave a little early and so just at that point it's just important for parents or family members to hold a boundary and just say well that's interesting uh it sounds like you're uncomfortable but we suggest you stay i always challenge families to offer some empathy because it's a feeling and that's what i notoriously catch grief for here on the show um but like to offer empathy like it just sounds like you're having a hard time there and that that is difficult and i want to affirm that um and then offer the the boundary with that that like but we're not gonna support you leaving early pretty less words the better i like to i like to tell families like that should be right about a two-minute conversation honestly like you can deliver empathy and a boundary probably in will clinton i think you in like four seconds uh you're very you have a lot of brevity with you it's so subtle you don't even notice it yeah exactly like i just see it yeah yeah no i think i for me and my perspective i guess having that conversation even earlier um like way early on in the treatment process recognizing that what we at least at our level of care right which which is a stabilization level of care like this is an almost inevitable moment because because we are existing within the realm of the craving state right all of our treatment is happening within these sort of peaks and valleys rises and falls of the craving state and which will be activated and can be activated actually pretty almost predictably um so right off the bat educating families and actually i'm a big believer in educating the client as well like hey you're going to experience these feelings like you're going to have this moment where you want can't get out of here fast enough and you're going to use any excuse in the book to do it and i guarantee you it's not because the sheets aren't a high enough threat count you know it's because your your brain is telling you you need to go use substances right like that you are uncomfortable because we have created an environment that that has a level of discomfort in it and the best way for you to respond to that is to go use the substances which are the best coping mechanism that you've found so i think being able to have that conversation with the clients and then also preparing the families like hey these are these are things that just happen so sort of normalizing that process taking some of the fears taking some of the anxiety away from it making it actually developing a plan really really early on as far as all right so what happens when um so what happens when your loved one calls and they are screaming for that they're horrible they're miserable this is the worst experience of their life and they want you to come pick them up like what is that let's actually role play that let's actually have that conversation now so that when it happens in the moment we're not you know all kind of taken aback and trying to scramble and getting caught up in this sort of emotional impulse that is really just reflecting the craving state that that the client is experiencing so um so i guess that would be if you talk about that that best first step that that would be where i would start yeah and i one of the things well for me it's important just to state that i think that the craving state is the thing that is driving the this food is no longer good and i don't need to be here my tempur-pedic mattress here at peaks no longer comfortable not enough pillows all that it's the pointing to the negative features of it prompts to me that we're just experiencing somebody going through craving and trying to take that power back in some way and move themselves in the appropriate direction what i'm curious about maybe because i'm not a clinician and in philosophy we were told never to make up metaphors but you guys are seemingly more brilliant at metaphors than i could be so i'm going to try and bridge this a little bit introduce my own metaphor because i we in a way you know families don't know what it's like to have that craving state at least in relation to drugs and alcohol if you're not addicted right so what i'm what i'm thinking of here is you know uh being hungry or anger right when we're hungry and we've all been around people who are hungry right and a little bit angry along the way there's sort of a there's no way to really like engage with them positively when they're in that moment until we get them food and satiate that aspect so i'm curious if we can draw some sort of energy towards the family system or some sort of metaphor like that that would allow people to make it helpful to see that the person actually isn't like fully suffering they're experiencing discomfort they're craving something in this hanger moment food but some way that we can sort of connect them to those feelings so that they can know that it's not at the level of like dying because sometimes if not all the time when somebody's trying to leave ama the expression they're you know what they're leaving them with is like this is horrible like worst ever worst possible situation i could be in um in that regard we know it's not the case but sometimes families right it starts pulling on the heartstrings you hear your loved one engaged in that negative energy and you want to alleviate it and you know soften the suffering but if we can help families see maybe a little bit that it's just not that bad and it's just something to walk through in a few moments you know maybe we can provide some additional support in that regard to alleviate that that heart string tension so i don't know if hanger's the right thing you know again i'm not a metaphor guy but something we can help people i mean it's not but it's we'll use it okay it's really interesting that you've asked me for a metaphor and then i'm like i just can only think of like some concrete things i would say to people okay let's do concrete then uh that feels really challenging in my part and i and i think the the first thing i would like to mention is that like that craving state really what's happened kind of overall when somebody is using drugs is like drugs and alcohol are such an effective coping mechanism that all of the other coping mechanisms have atrophied there we go we're getting into muscle metaphor then uh so like they they don't it's like they've only used one muscle in their entire body and all the other muscles uh are still there but they're just very weak and so when clients come up against this discomfort the only muscle they have to grab the only muscle that has worked is to go honestly relieve that by getting high and to your point the way to do that then is to make your support system seem like the problem and honestly this this has kind of echoes into kind of ongoing recovery too like you know when people have been sober three or four months and maybe are in more of a outpatient type setting um you know i do talk to families about like hey if your loved one starts if they start to seem like they're pushing their sponsor away or pushing uh their loved ones away or their new support system away that's an indication that they're slipping back into that same behavior of like i'm beginning to make i'm beginning to take my internal problems and externalize them a little bit and then the the honestly the nice thing is is that in my experience of working with people that are like you know what i i'm leaving today i'm going to call my family they're going to give me an airline ticket or whatever i'm going to i just have to get out of here this place thank you all so much by the way it's usually pretty polite because i do think uh clients that we work with feel pretty cared for you guys are great um but i'm good i've got this figured out um i've watched the families hold boundaries usually there's this transition into okay i need to use my other muscles pretty quickly and really um that's just such an important piece of this process and and it's hard you know i have kids too and it's hard uh at any time if my kids are having a hard time whether it's at school or work or whatever everything in me does want to rescue them it's how we're kind of wired um well especially families that have like codependency or enmeshment or other sort of like difficult family system structures i mean those you know those are just triggered uh exponentially so it's not only because you're knowing that your fan that your loved one is struggling they're not there in front of you you know the rest of the family system is a bit disregulated because they are absent and so i think that it kind of uh to a certain degree can actually amplify or highlight other issues that are going on within the family system so um and i think one way that i that i can think about to sort of at least mitigate some of that tension is to really encourage families to act to really look into where they are sending their family members right like get some like hard facts before they go right like do a virtual tour you know walk have somebody walk you around the grounds you know like actually um explore beyond the website you know talk to their primary clinician you know reach out to um you reach out to uh you know one thing that we do at peaks is when a client's in detox i mean we immediately we're calling that family every single day you know we're just initiating that contact but that's not not every facility will do that so sometimes that's gonna be um it's gonna that's gonna have to happen on the part of the family but i think that that will help to draw some clarity around what's real and what's not real if that makes sense yeah and so at peaks maybe a little vulnerable here share our outcome data because that's another thing to think about when you call a treatment center are they pursuing outcome data and are their outcomes improving over time which i'm proud of the fact that our outcomes are improving over time and we are getting close to a 60 success rate 30 days post treatment um as a as a baseline number just kind of represent what's going on here but our anybody who's left ama a couple days into treatment episode those success rates are lower than nine percent um post 30 days leaving ama and really the picture i just want to set for families there is that the the likelihood of success when a client calls to ama and says i've got this unless there's an anomaly happening there it is entirely not true and immediately going to move towards relapse as an episode um so we're talking about we're having a conversation about this because individuals lives are on the line in that moment and when we lose you know focus along the way or lose trust between us and the treatment center and so forth it puts people in a pretty vulnerable situation so we've been kind of teetering along the question a little bit here the the final question i want to ask is you know how does how can we you know and i think in ways we've said it but how can we identify and let a family know when to trust the treatment center and when to trust the individual calling who's amane in that regard and i think that's a difficult balance between are they actually in a good setting i think you've pointed at do more than just talk to the admissions team admissions team people are there to bring people in they're excited about it that's what their job is and sometimes admissions people don't work for a good setting that's behind them in that regard so you know maybe it's looking more into the treatment center on the front end maybe it's more about how are you going to communicate with me when my loved one gets there but ultimately what further you know advice maybe can we give to help you know maybe three bullet points where we can give families to think about okay i actually think the treatment center's doing the right thing here okay i actually hear johnny pointing at things that are really problematic and how to identify that i think that's interesting you asked that question because i know when you and i talked years ago about building the peaks website i said we have to have like a robust staff company page with our names and credentials and all of that because i do think you know the 14 000 programs i think a way to tell if a program is less than above bar is that they don't have a really they're not proud of their staff because probably their staff rotates um or they may be involved in unethical things so staff don't want to be on a company page either like to me that's a big thing and if you know with peaks now in this finding peaks like we have a catalog of the leadership of this program talking openly about what we do and if you can watch that and you're like okay you know i might not agree with everything these guys say and they may be a little dull at times but i can at least they seem like they at least seem like they're real people with real names and real credentials after them and i think that part really matters and in that we live in our entire time right now like our trusted sources what do we trust like that's that's the case in news that's the case across the board in a lot of things and so this is kind of an ongoing thing but i think where there's if you can find the right people and if you have access to a clinical team if you if you have access to who is working specifically and directly with your loved one and if they can answer your questions transparently um and if you have good access to them like we really push you know multiple contacts with family per week uh at peaks because um this is a whole family recovery process and so um if that's not happening for your loved one then that's a yellow flag i would say maybe not a red flag but a yellow flag i've said too quinn you i left you only with one wow the most powerful good one yeah no i think i may have two actually but i think another yellow flag would be a lack of family programming so programs that don't invite the families in are i don't know i would just uh you know addiction is a family disease and it has to be addressed on the family system level and if if the program isn't designed to do that as part of this just primary function then there's i i would question uh maybe not the integrity but the efficacy of the program um and the other thing i think it just kind of a broader terms is just transparency you know if you never speak to somebody beyond the admissions line or beyond like the administrative line then there's that is a that that is a red flag to me like you should be speaking to clinical people to medical people to case management you should be um to leadership you know you should have access and have uh a pretty um comfortable way and a pretty easy way in which to communicate with them so i think that that for me is going to be the sign or the best indicator of a program that is actually on the up and up and is really invested in interested in the not only in the and the client getting better but in the family getting better in the process as well absolutely and i heard some yellow flags i don't know if we touched on a red flag or maybe it was the family system a true red flag is if they're flying or offering a plane ticket to your loved one red flag like don't do it it is one of the most unethical things to do and it goes against the grain of state laws um insurance benefit plans there's it's a huge red flag and it's nonsense in this industry and it needs to go away so i'm going to be a little passionate about that red flag in that regard but i i also think you know what you guys have said a lot about the website and the staff and the access to those are really important components and also too outcomes grow over time and we know this in our experience from going back you know several years ago when our outcomes weren't that great historically to where they're at today they're growing over time because we're creating direction of care you have to implement a curriculum you have to be able to guide somebody through their recovery journey through their emotions through the medical side of things and so many companies operate from process groups and process-based therapy in that regard and though that's valuable in certain settings and in certain instances it seems to fall well short of what is intended here and how we get into this direction of more positive outcomes for the family system and for the individual participating in treatment so i also want to highlight if you call a program and they don't have a curriculum we'll call that a yellow flag too in that regard because they're not investing in a dusty rose flag dusty road yeah like the pants like the pants yeah a dusty a dusty red back in that regard but when the outcomes start trending in the direction of not positive that tells the program and informs them that something's wrong with the curriculum in the direction of care and curriculums in that regard are meant to be adjusted over time and that's how we know as a company culture we're moving in the right direction because we see it inching positively and when we where we see amas you know we're not a perfect program of course we see amas that are our you know responsibility in that regard we could have done better you know we respond to that we address it in a curriculum we address it as an interdisciplinary team and so that to me also is a is an important indication for which you can ask treatment centers on the front and what that looks like and as clinician if you're talking to an admissions person and they can't convey that curriculum get a chief clinical officer on the phone or a chief operating officer who is a clinician who can account for the curriculum and what it looks like for your loved one um so before i i take us out with my enthusiastic exit strategy here do you guys want to sprinkle anything else on there inspired by i think we covered it no i i guess um just maybe a reiteration that treatment is tough you know like it's a tough process and there's you are literally retraining the brain and the majority or a good portion of the time that a loved one is in treatment they're going to be in some level of survival mode um which is very uncomfortable and will trigger some pretty pretty strong emotional reactions some pretty strong behavioral reactions and i think that if you are aligned with a facility or a treatment center that is supporting you as a family on all fronts you know by by through transparency access to clinicians access to leadership access to medical people whatever the case may be um that that is going to be the best way to support the the client through this because it's it's inevitable it's going to be uncomfortable you know so um yeah i guess that's what i would say all right so to reestablish the acronym on our way out here ama is against medical advice we're telling the individual this is not uh we don't believe this is appropriate for you as a direction of care and because we believe you know at the end of the day that their life is in jeopardy but there is a balance here between the individual being correct and the treatment center being correct and hopefully over time we can continue to educate and update on this uh important topic as well too about direction of care so in closing uh questions thoughts concerns ideas please send it to finding peeks at peaksrecovery.com uh look us up on the gram the facebook the the cram the kids whatever they're looking snapchat snapchat i don't know if we're on a snapchat i don't know if we do that but um app store podcast itunes love you all thanks so much for joining us and we'll see you again next time [Music]

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Episode 13 Supporting The Direction of Care Watch Now https://youtu.be/Tc9fZd9ssHI Listen Now Episode 13 Our team discusses why it is important for families and individuals to lean into what level of care the addiction treatment professionals are recommending, because a direction of care is an essential part of a successful recovery.

Topics:

The importance of the progression of addiction treatment and recovery
The length of time someone is in recovery and within addiction treatment can truly make a difference
How families can best support the direction of care

Select Quotes The data is clear, 1 year of recovery time leads to a 50% reduction in relapse, but there still is a 50% potential of relapse in just one year. This leads to the direction of the 2-year outcome of 85% reduction in relapse rate. So the more time that goes on is informing us, but it also brings forward this opportunity of the direction of care and we’ve got to take it seriously. Brandon Burns - CEO Episode Transcripts Episode 13 Transcript [Music] well here we are back for another exciting episode of finding peaks i'm excited to be here again today hosting after i think you tried to steal the show last time yeah tried no chris i was host chris you right it doesn't matter to the viewers um welcome back i'm excited to be with my pals my colleagues here jason friesma chief clinical officer clint nicholson chief operating officer at peaks recovery centers and the topic that i want to bring to the forefront today is direction of care the continuum in this regard and one of the things that i'm energized in talking about this it seems like in the addiction treatment space that this industry has lost a little bit of its edge it seems like at times um clients are informing direction of care and not taking clinical recommendations medical recommendations and that sort of thing and it feels like it's uh disruptive to outcomes now sitting in the parent seat in this regard when um and certainly in the harm reduction principle sort of way when somebody chooses to do something even if it's against the grain of the clinical recommendation at least they're doing something and i think you know families and treatment centers and cultures really lean into that that at least there's some direction about that care but for me i feel like it's important for this industry to sort of bring back that energy a little bit and sort of take back that power because we are the professionals um in the way that we understand addiction so uh just curious in that regard jason will start with you what is your experience around like resistance to the direction of care and what do you see through that so i mean here's what i think you're asking brandon is like the direction of care um not just being directional but not skipping steps along the path is that kind of what you're talking about too yeah not asking your questions yeah questions back at me not not skipping steps but taking seriously so sometimes you get it you know of course individuals get into addiction treatment they spend 90 days in it and they're exhausted with clinical care or whatever the case might be and they want something fresh and new or believe they have the tools and assets to do something otherwise but it seems like there's an ignoring of clinical recommendations as they happen great question i have a metaphor uh just for clinton yeah for me yeah for you uh because i know how you love metaphor i do um when noah my son was going to that is his real name by the way he's not a client right um when he the summer before he's going to kindergarten he actually broke his leg his tibia and um and he had to get a cast all the way up uh to well his hip really and he had to kind of get around on it and then um the doctor said he'd figure out how to get around without it without uh any help and he did he didn't need crutches he was too small for that he just started figuring it out and clumped her wrong and then he got a cast down to his knee and then he got a walking cast and then he got a brace and then off and i often have thought about that when considering your question because you know the cast all the way up to the hip was that hey the the joint above and the joint below the broken bone needed to be stabilized and then that provided some stability for the bone but then you know after a while they could lower the cast down to his knee but the the bone still needed some support but not as much it didn't need to lock the joint above it um and then eventually you know the walking cast the bone could sustain a little more pressure as people were walking or as noah was walking um but it still needed that support and and i often think about that as a process uh you know and i apply to what we do right when when when noah's leg broke i didn't ask the orthopedic surgeon like can we just go from the the hip cast to the walking cast or like yeah can we just put an ace bandage around it after we get it aligned and just see how it does and then if that doesn't work come back for this like you know i we i went to an expert and then i wanted to rely on the expert all the way through the process and i and i often think about that in in our field like it's your point like you know we we have a field we're well read in it well studied in it and we have watched um people be able to progress through a process of detox and doing residential care and and then uh on down through php and iop and even outpatient treatment and and when people follow that process especially if they take their time and follow the process maybe even over a year and do that entire arc of care um usually they're pretty stable coming out the other side and and that progression uh is in place for a reason and and and the earlier levels of care just like the cast on my son provide a bunch of stability and sometimes it feels like i know when when no it is cast on like it seemed like his leg was healed underneath it and in fact he reported no pain thought he was gonna be okay and like and i remember asking the surgeon for sure like can you know are we sure we can't take it off quiet and he's like no i don't it's not stable and like i can understand the frustration of that um but recognizing that we can't always we aren't always the best judges and and of ourselves and sometimes we do have to rely on experts uh to trust us along the path i don't know if that answers your question or not but uh seemed like it did yeah no great metaphor as clinical culture often does presents strong metaphors it was kind of an allegory too so there's a little bit yeah oh that's all right english major yeah thank you for that no i think that that's really i actually beautifully said um and the problem with addiction is you can't take an x-ray of an addiction right like there's no way to have this sort of like quantifiable like look here's the break you know this is where everything went wrong and then this is exactly how we're gonna fix it and then this is the whole process of what that looks like it's there's no way to capture that and i think because there's so much misinformation stigma shame around guilt around addiction and and also a level of disruption that is so systemic within a family system um that the typical response is to go the path of least resistance and actually go backwards right we'll start with the brace we'll see if the brace works and then if when the leg breaks more we'll go ahead and then we'll do we'll do something up to the knee and then when the the break gets even worse well maybe let's try the brace again and see if we can go back to the brace there's this it's this really um it's counter-intuitive in so many levels but this but it is very unique to what we do here in addiction and that there are regardless of because the expertise that people have to rely on is through personal experience and not through something that can be shown on a graph or in a picture it it's that much harder to relay the importance of what it means to go through these sort of steps and processes of of treatment yeah and i'll add too sorry but i'll add that the the process of starting with too low of an intervention like that has great risk absolutely um and i also talked to families too i call it calluses conform or like okay they start to hear the language but they're not immersed in a high enough level of care and so there's a loss of i don't know like there's other that creates other things to work through when they begin to learn the light when clients begin to learn the language of recovery but they're not entering into recovery that's more of a barrier actually it creates an inhibitive process and clients get really good at telling their parents how much pain they're not in right like oh no i don't feel any pain right now like my leg is totally healed like and they get real again good with the language good with the lingo and meanwhile and the parents or the family hear this and they want to go and advocate for their family member which of course they do you know they it's it's a a scary and um you know there's a lot of unknowns a lot of variables that are that are unpredictable when you're talking about addiction treatment so of course they're going to go and advocate and trying to get the least amount of um uh you know negativity or resistance in their life you know take that path of least resistance uh in the meantime the the damage is just increasing and increasing and increasing and eventually you know you're going to lose the leg yeah and that's the ultimate and that's and that's unfortunately you get to that point where you're like you're like gangrenous at that and and we have to step in and and try to to not only um get people through the treatment that they should have had initially but undo all of the damage that has happened in the process yeah i would like to mark real quick that this is the first time gangrenous has been used right on a peaks episode but absolutely check that box interesting direction of metaphors yeah yeah or allegories whichever this yeah yeah and and i and i certainly don't want to insist on care has to stop it start at the top and then end over here at some point i think going back to your track metaphor you know in the past as well too that people are doing different things and entering treatment episodes at different times and i'm thinking you know more strongly certainly about you know maybe somebody who's been using you know drugs and alcohol in an addictive way for multiple years it seems like an error to state well i'm going to go to detox and then i'm going to go do this iop thing and also too as a direction of care when we think about you know coming off of a stabilization model and let's say you complete a residential treatment program and the next recommendation is iop i mean it's intensive outpatient for a reason the intensity we're trying to get ahead of is that craving state that's operating within it and we might feel good as an individual coming out of residential care feel like we have a little bit of stability but you know in the wellness way of things that makes sense but we like you said aren't able to sort of pry open the brain look in there and be like no your craving state's still active and still going absolutely and the data is clear you know one year of recovery time leads to a 50 reduction in relapse but there is still a 50 potential right of relapse just in within one year which i think informs the direction to toward the two-year outcome of 85 percent right reduction in re-lapse rate so the more that time goes on is informing this but it to me it it it really brings forward this opportunity of direction and care and we've got to take it seriously and it's interesting like you said too in the medical lens like we lean into the professionals in any other arena of you know cancer or broken bones or these sort of things we're not like i'll do that approach and then i'm just gonna skip it move out to over here you know we really take it seriously and i think that subjective state is really hard to compete with and i can only imagine as a family member too your loved one finishes 30 45 days of programming says i feel great and i'm not going to take these recommendations but i'll do this next thing maybe go to meetings and have a sponsor that can be reassuring but in that regard how can we empower families to hold a boundary to that to say that i really want us as a family system to really lean into what the experts are stating love what you're stating about that but can we do that and also what the experts are doing and you know how do we go about that as a as a boundary with families i actually think you said it really well brandon and i think that that literally is the conversation to have with people of of like you know i i love you and you're making a compelling argument about why you should leave treatment early um but i need to kind of set that part of me aside and just trust the experts right you know because i you know i going all the way back to my metaphor again about noah like i didn't like having him limp around in the cast like that's not fun as a parent to watch my son struggling in this way and and you know there certainly was a part of me that thought about taking a song cutting the cast off myself because it's getting itchy and stinky frankly and like um and i really think uh but but learning just doing that piece saying i i love you like using affirmative and and uh empathetic statements like i i hear what you're saying and i know this must be difficult um but we're going to rely on on the professionals because we would do that if in any other situation if you're battling cancer if you're battling any other thing we would just be relying on the experts not and but supporting you when you went through the hard times of it and emotionally difficulty in great fashion jason leads into the emotional component of it right and i think that that makes why i'm here exactly so i'm going to take up my token as well and so i actually the other part of what you said brandon i think is equally as important which is that quantifiable data as well like looking at these like all right let's look at outcomes you know like we have some numbers to go by we can't crack open the head take a picture of the craving state yet it could happen you never know the brain is the last frontier tune in next week but i think that being able to show people like hey yeah at one year of sobriety it's a 50 50 still but you have to get to that year mark just to get to 50 50. you know like what you've done is however many more days left on its math is what you do to get that yeah a lot more than 300 so yeah account for and a meeting here and there a sponsor even completing your step work in a is there's there's so much one of the things that we do in treatment is is walk people through like an actual day in their life like a schedule like what does your day look like and when you go through it kind of hour by hour minute by minute you realize how much time there is in the day and within that time frame and all of that space there that's where the cravings start to take on so if you add up not just the days that you that you need to account for for extra support but that but the hours and the minutes that that actually accumulate over time you're in such a without that increased support or that sort of step down level of care your your risk just gets so much higher and that ability to really work within uh the sort of limitations of your craving state just diminish considerably yeah i i one of the and aren't certainly in our experiences and we've been talking about this week too but one of the feels like the major challenges isn't keeping somebody occupied in treatment during the group session or the individual session it's all of the in between moments that a lot of frustrations and craving state you know we see come about and boredom and this sort of stuff and can i have this and i want my phone and then all these things in between in a continuum of care also is not just about going to treatment and fulfilling those group and individual session obligation i think they're an important component of this but all those other incremental things of peer recovery coaches sponsors meetings you know healthy activities there's a great not-for-profit in you know denver for example sober af um that we were talking about earlier in relation to our iop program and you know sort of working with them to where we're creating you know incremental moments in time that support these craving states and provide that community immersion aspect that's so important as well too so certainly don't want the viewers to think like this is just treatment focused and oriented but we have to account in many ways for all of those in-between moments and sober living home is another great opportunity for that um as well too that's not treatment oriented so um i think it really is starting to interrupt it really is about building a life around recovery yeah and you cannot do that in 45 days you know that stabilization period is just that it's for stabilization but as you tear down into these other levels of care what you get are those is that ability to start building a life within a community building a life of recovery building a um sort of action i guess it would actually be rebuilding yourself within this new way of living and that's that's why it's so important to follow those directions of care and to follow those recommendations yeah and it seems like as well too in regards to addiction i mean some certainly with you know opioid numbers you can become addicted on the first go of it intravenous heroin quite addictive and so forth um in that regard but other otherwise i think more generally speaking addictions form the same way in time and then they're reinforced in time and that energy that it took to get there is sort of a new required energy on the other side that has to be constantly reinforced and so i think about okay well you know we hear you know clients say well meetings don't work for me i mean how about we just look at it through like a lens of we have a craving state and we're normally craving to the you know heroin or craving to pot or craving to whatever the substance is now we have cravings and we're inserting you know the meetings we're inserting iop groups we're inserting peer recovery coach we're in suiting you know psychiatric media um you know evaluations meetings with doctors and so forth but it's that replacement phase that i think is important from because we can't look under the hood but conceptually what what i believe is happening in my light reading as a philosophy major here is that what what is happening there is we are growing new neural pathways we're reinforcing a new way that the brain is considering what that craving state means and over time we still get craving states but it reinforces now for the individual meeting or i need support and that sort of thing in time and i think all of these connecting pieces between the medical lens of craving state to the wellness model are important things to tie together you know conceptually for you know the viewers and anybody pursuing treatment in that regard and um you know sort of as we get to the tail end of this uh have i inspired any additional thoughts you know through this language or things that you might want to drop on yeah the only other thing that i i think everybody's alluding to but i just wanted to put put a i don't know just speak it is that you know at detox and at a stabilization level of care like we provide literally the schedule and frankly some of the meaning and directionality um for our clients and then uh i think clients get comfortable and they feel like they can make it but like we've been doing in the background all of the little things yeah the making of of the food and whatever else it might be and so it is a precipitous drop off if a client goes just back home and doesn't have any sort of structure around them they go from zero hours of free time a week to 168 hours of free time a week and it's a huge drop-off and so building in significant steps down to where smaller successes can occur where i just have to manage my evenings i can man okay i can how do i spend these three hours and how do i do that and how do i successfully find my meaning and direction and and walk through any craving states that come up building achievable bites and then building on that like now i just have to go three nights a week to iop and yeah but i can build the rest of my life around that but it it just doesn't happen right uh overnight i completely agree and i think that it's um just to sort of reiterate i guess coming back to where you started with this for both clients and for families to really take that to heart and when there is a recommendation for another level of care or there is a direction of care that is laid out by somebody who is a professional who's been through this process however many times it's intentional you know it is there is true meaning behind it because the reality is you're rebuilding a human being you know you're completely rebuilding yourself and to do that to think that that can happen within a 30 or 45 day program which i think has been the narrative out there for quite for for decades really you know people family send their loved one in and they expect them to come out cured and ready to go it's it's just not how life works you know there's nothing realistic about that so um really taking to heart that we're we're doing this so they don't lose the leg right like that well in and i guess i uh you know as we as we wrap up here i do want to give you know some family some hope right because it's certainly hyperbolic to state like get energized hold the boundary and the client will just go through care you know in that regard but there's going to be resistance along the way so when that resistance happens it seems opportunistic to go okay it sounds like you want to come home live in the basement do that you're going to get a job and do all those things and everybody feels good in that moment because there is recovery time and we're communicating better through family programming and that sort of thing but it feels good in that moment for families to uphold a boundary in a way to say something like okay i'm going to allow for this to happen but the moment it stops happening in this direction then here's the other plan and do you agree to this plan it seems like we're in a good position to negotiate at that time and then if relapse occurs or it gets really you know the individual gets really disregulated in whatever fashion mental health or otherwise that now families can you know return to that moment and say remember when we did this together you know and kind of just opened a you know feedback or maybe is there a better way to go about that or is that kind of consistent with meeting that resistance where it's at well when you're talking brandon all i thought of is going back to the broken leg thing again if you if somebody goes to physical therapy then after and your kid comes someone's like it just hurts really bad and like i get sore and it's exhausting like as a parent you're like that sounds really hard and how do we support you i'll get you some advil prop your leg up you know get you dinner or whatever but you're going tomorrow right because like we want your leg to heal right like so there's i think there's tons of ways to align support and still with kindness and hold the boundary yeah and and if we we can kind of switch it out like this feels like one of the only fields where like yeah where you blame the intervention right right like damn the physical therapist is messing everything up yeah no they're doing their job it's going to hurt like you broke your leg physical therapy is going to hurt i'm sorry right yeah yeah that's what i thought of yeah i think i tend to have a slightly less gentle approach in general um i think that there's the conversation of you know the the kid wants to come home they want to be in the basement they want to get a job they want to start their life back over they want to get back on track and i think the families want the exact same thing and the path to do that is not to go there yet it's to take this journey instead is to realize that this is a process and meeting you where you are and recognizing that that's what you want and that's your ultimate goal that's all of our ultimate goal right so however all we disagree on is the timing exactly yeah yeah so patience is the hardest thing to really reinforce but if you can that's what it really takes it takes time and so continually reinforcing the fact that everybody has the same goals everybody wants the same thing everybody has the same end game however the path to getting there is not going to be easy right yeah yeah absolutely so i it's a fascinating industry to work in there are extraordinary challenges there are the subjective experiences of the individual the objective sort of framework of professionalism in the direction of those subjective behaviors thoughts craving states and so forth and you know in this regard i just really want uh to also empower families with this knowledge and education to know that direction of care is so important and if there are bad treatment experiences i get it not all treatment is going to be the same for everybody and treatment providers you know even ourselves that time are going to make mistakes along the way but that can't be the reason for stopping the direction of care if this place is not good let's find that next place if that next place isn't ideal let's look for a place that is ideal let's keep the conversation going let's energize recovery thanks for being with us today check us out on the youtubes the instagrams um email us at findingpeaks peaksrecovery.com if you want us to talk about something uh other than what we've been generally talking about um i think we got the spotify and the facebooks and trying to read all these things on the screen over here that you guys can find us on in that regard uh jason friesma will be the host next week bringing on something maybe a lot of emotions bring your tissues so we can cry together or your palms it doesn't matter but get excited more exciting episodes to come and thanks for being with us [Music] thanks

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Episode 12 Growths of Peaks Recovery Watch Now https://youtu.be/OtPba8MyuXg Listen Now Episode 12 Our Founder Chris Burns opens up about some of the personal journeys he has endeavored, alongside the growth of Peaks Recovery.

Topics:

Our founder talks about what Peaks Recovery looked like in the beginning and how it was more based on the 12 Steps
Walking side by side with clients throughout recovery by simply sitting down with them at a coffee date, giving them the opportunity to connect.
Chris talks about his “Why”

Select Quotes My “Why” is, was, and will always be to walk with people in the early stages of recovery, to experience hope change, and growth, and that’s what I will continue to do. It’s not in front of people either, which is what I used to think it was. I used to think I had to be way out in front of the race, I had to be waving the checkered flag, and I just think for so much of my early recovery it was about being right rather than helpful. I am just really trying to be hopeful now and sit side by side with clients. Side by side with staff. Side by side with my family. Side by side with and in alignment with the world. I have found that is such a better path to navigate. Chris Burns - President & Founder Episode Transcripts Episode 12 Transcript [Music] all right welcome back to another episode of finding peaks uh very excited to be here today uh on this new day yeah different episode um as promised over the many episodes we've done so far we're gonna start bringing guests on uh moving forward and creating different um hosts within the process and uh so to my left here today is um president founder of peaks recovery centers christopher burns and hello everybody welcome thank you good energy also uh my brother too just in case or just to create awareness around that we got the burns last night brother don't let the hairline fool you i am younger yeah 14 months 14 months and then to my right here of course as you all know our chief clinical officer jason friesma step brother step brother born in the fire so um well excited to have you here today chris with us um uh and in the future i think you're gonna bring a great deal of energy in a variety of different ways to not only these episodes but i think the recovery journey and engaging the audience with that we are the original we're the ogs right at peaks recovery centers we were there in the beginning certainly you created it invited us into the process and so i think today it would just be uh fun and interesting and insightful to kind of look at the past where we started what we thought recovery was as a journey back then where we've come today and um you know what it looks like and what are those differences and then what have been those interesting challenges and in betweens and and so forth so um so yeah i feel like we got to start here with your energy nice grateful to be here in your both of your presents i've watched this is episode nine all right i think we're over that are we yeah i know i get why you get it wrong man yeah because the last one i watched i think yeah whatever no grateful to be here i've loved watching you guys collaborate and bounce ideas off of each other and um i think it's been really informative in a lot of aspects and so grateful to be here and spread some positive energy some recovery oriented energy which i have a ton of but i want to start with this mental healthy shirt that i got and i got it from a past client he texts me was here a while back and he texted me said hey i wanted to send you something which what size shirt do you wear and so we sent this through and it's a just a really cool thing it's um men's health as well as rhone athletic gear doing a collaboration for men's mental health month as well as pride month and then mental health awareness was last month so just really inviting all men um to engage in their mental health and to take that seriously and um i think that's probably one of the bigger things that's changed about peaks over the last seven years is really this opportunity to go from where i started it in 2014 which was a really heavy emphasis on a 12-step foundation and approach to care um you know we had great therapists but we were really missing kind of insights into curriculum trauma-informed care and things like that but we had that heavy emphasis on connection in the community with the 12-step way of life and you know i believed in that wholeheartedly and i still believe in a lot of the safety and connectivity that the 12-step way of life provides certainly there's a lot of great things in there um but i think to set in that and to build a model of care out of that is to say that from that one day in 1935 in akron ohio when alcoholics anonymous was formed that we haven't learned anything moving forward because most certainly alcoholics anonymous hasn't changed at all they've been tried and true over the last nearly 100 years and so i had a heavy belief system on that and we that's what we wrapped peaks around on this idea that nobody cares what you know until they know that you care with a heavy emphasis on community integration um and really why wouldn't we because the resources weren't there and we had really good results throughout those first years first few years of peak's recovery wouldn't you say chris that you started i would i think i've told you this before but i think you kind of started peaks you started a treatment center and you didn't believe in treatment yeah that's a great point um i can remember sitting in treatment at 20 21 and 22 and then sitting there in those trauma weeks and i'm just like i'm just not finding it sat with a young adult the other day at 20 years like i just can't find my inner child i'm like i can relate yeah because i didn't believe in the efficacy behind treatment behind clinical modalities because my life had been saved repaired and reformed through the 12 steps of alcoholics anonymous but what i learned through that was it's just a very close-minded approach to helping people but it was so much to me and it was such a breath of fresh air you know when i walked into alcoholics anonymous in 2008 devoid of a healthy family system i walked in and these people told me we love you we care about you and we believe in you and i can remember some of those men in the front end of my recovery breathing life into me that otherwise wasn't there and so i was just so convicted with that approach so when we opened peaks recovery centers i opened up the treatment part because i knew that was the resourceful piece that was going to keep the company going and keep it so we can continue to do circles can continue to integrate into the 12-step way of life and quite frankly and candidly it wasn't until i did a deep dive into my own personal story into my own past and really started to dismiss or explore some of that intensity that i still held with some of those rough edges in the early stages of peaks so current time i tend to believe it's it's more of a both and proposition i still believe because the 12 steps has the most people in it and they've helped the most people i tend to believe that that's the greatest resource we can integrate in into the community however i also believe that should be met with a professional involved and you should be walking the steps with the professional with the support of the community but the community today is so much more of an adjunct to what we do and not the primary purpose and not the primary source or the curriculum in which clients walk today so it wasn't until i was able to have that personal experience started peaks with my overall personal experience and peaks has kind of moved in that direction with the help of some great clinicians and some great leaders and really me doing my work because when i did my work i was like you guys have been right all of these years this is awesome yeah you know and and the reason i wasn't open to that early on was because of trauma and and how i define that in my life today is i'm looking for hard edges right 12 steps is the only way meeting every day for the rest of your life where you'll die have to do this counseling every day until it's over and really a more recovering space that i'm learning and beginning to lean into today is this is this kind of gray area in the middle where i can take it i can leave it it's functional it's healthy it's boundaried and it's safe you know and so i tend to believe and really have a heavy emphasis on trauma-informed care now i believe that the medical profession needs to be trauma-informed i think teachers need to be trauma-informed i think the world needs to be trauma-informed and if we begin to become trauma-informed we can understand things like craving states and we can begin to dismiss this addiction thing and so it's such a more hopeful view whereas when i open peaks recovery in 2014 i might have said it's a.a the rest of your life or you'll die or you won't have a good shot or you won't be able to experience happiness in the way that you would in the center of that room and today i just don't believe that hard edge i believe there needs to be some recovery space in there for people to navigate and find their true self um and that's what trauma is is it's that unalignment of the true self and obviously that that treatment or that healing and recovery is bringing that back in alignment so i don't think 2014 chris would recognize this guy no he'd be honest with you yeah it's it's been he would say who's this skinny guy sitting here who's that skinny guy right he's talking about plants but i'm really grateful to be in this space and to have grown in my recovery because it's really helped me grow as a professional and see things a bit more clearly and it's been awesome and it's really helped me too on the ground level you know i'm sitting with guys today that are in grief week or in family week or in identity week are um you know really doing these deep dives down to a place that i was unwilling to go for a long time and now i get to just lock arms with them and say man i remember when i was going through that two weeks ago or i remember six months ago i was right where you were just keep fighting keep supporting keep locking arms and so i've been able to really support my friends and family and then folks in recovery in a really new and refreshing way that i didn't know was possible so yeah and you get i mean you spend a great deal of time not only communicating with families on the front end of programming but certainly meeting with each and every client throughout their treatment episodes sitting down having coffee with them and i think um you know something that i would like to draw your energy toward and introduce to the audience in a big way is what are what are those moments like being in you know on coffee dates with you know men or or women in early recovery and um you know maybe walk us through some of those uh challenges and sort of how you guide that as a process yeah i mean it's a great question and really a unique experience um when i first got sober in 2008 my first sponsor larry smith was like you're getting coffee with this guy i was like what what are you talking about what am i getting coffee with this guy i don't want to get coffee with guys right i'm 22 years old i don't get coffee with guys not then anyway and he said chris you need to just trust the process so i sat down and had a cup of coffee and in that cup of coffee at 90 days sober for the first time in my life i realized what i was put on this earth to do and so it was so profound in that moment and what i was put on this earth to do was stay sober and help other alcoholics to achieve sobriety i knew that on that day just through this intimate connection with another guy that i had i had never met before and so i carried that with me in the peaks and throughout the early stages of my recovery and even now and when i get the opportunity to sit down with a young adult a mature adult it it is so rewarding for me and so impactful i assume for the client because here is somebody who's sat in the seat they've sat in walked through a painful journey of trauma exploration and healing set tough boundaries had difficult conversations overcome adversity been met with a tremendous amount of pain and shame of which we've been able to overcome and so it really is is inspiring for the client and very connecting and it goes back to that idea in 2014 that nobody cares what you know them till they know that you care and i really want to show these clients that i care and i tell them things like hey i love you man and i don't need to know you to tell you i love you man i love people that are working towards mental clarity and mental health i just really engage and align with that fight and so i have the most spiritual of experiences and i sit with guys that tell me horrific stories of pain and shame but then we're able to sit there and lock arms and have a smile as well and be hopeful for the recovery process so a lot of times these guys and girls young women mature women in our women's program they think they're coming in and they're going to get this this great energy of which they will and they may get a lot from it but i'm leaving that moment so much more filled up um so much more recovery oriented than before that um and they give me feedback too you know on different things and i can grow in certain areas you know i was sitting with a kid the other day and i was talking to him a bit about um diet and food and energy and how it fills up your body and how bad food gives the inflammation and the recovery process and how really treating the whole person and he looked at me clear as day he said man i would have thought you were just a plant-based guy i would have had no idea you would eat all that horrible stuff i was like i'm like man so i left that and i was like man there's an opportunity for growth for so many years with diet exercise it had these hard edges right and so in those opportunities that i get to sit with clients i do two a day five days a week um it really is both in like he gets an opportunity to connect with the president of the company who kind of somewhat runs the show and then i get an opportunity to get a breath of fresh air from some young new recovery which is really invigorating so it's it's a really it's a really cool experience yeah and as the company's grown i mean it it just feels like you know we talked about in the past episodes jason you know our whys and our in our how and our what and so forth and as the company has grown you know i feel like both of you in this room are the ambassadors of ry at peaks recovery centers and in that really incredible way i feel like you guys continue to fulfill that promise that we engaged with in 2014 and certainly have allowed me opportunities you know through that business lens to cater to the company culture and the what and how aspect of things but um you know i think we can experience and feel your energy and the why in all of this but to state it firmly and really ground it you know what is your why i mean it is was and always has been to walk with people in the early stages of recovery in order to experience hope change and growth um and that's what i'll continue to do and it's not it's not out in front of these people either which is what i used to think it was um i used to think that i had to be way out in front of the race i had to be waving the checkered flag follow me and i just think for so much of my earlier recovery it was more about being right than being helpful and so i'm just really trying to be helpful now and set side by side with these guys side by side with staff side by side with my family side by side and in alignment with the world and i just have found that there's such a much better path to navigate for me considering where i came from um in my life so will you have well go for it please i was just gonna add um chris like when i met you back in when i came and joined peaks you did this thing that i've never heard of called circle with clients um and it wasn't clinical space like in fact i think we all had to leave the room when you would do circle uh yeah and probably needed to leave the room just because it wasn't a very clinical environment but um i am really curious uh because i have sat in on a few since then but how has your circle changed over the last seven years so cert maybe explain circle in its background and then like how you approach it differently yeah i mean great great question great point um circle when i first got involved in circle was back in prescott arizona now mind you prescott arizona has more treatment centers per capita than anywhere else in the world and so you have a lot of inexperienced operators myself included running treatment centers that they probably otherwise shouldn't be running quite frankly there's no education there's no insight there's no clinical acumen there's no and so they would allow these circles to happen and it very much is kind of old school aaa it's calling you out it's accountability and at the same time i could probably say um somewhat shaming you know we would go in there and we would uh we would unpack things in a group setting that maybe otherwise would have been unpacked individually but at the end of them it was just really this connecting opportunity to come together as one but the circles that i saw in the past were kind of very shaming and even when i opened peaks i tried to the best i could be devoid of shame but i'm sure there was hard edges in there because i came from a 12-step approach which says suit up show up shut up oftentimes yeah and that's the premise they stand on and so i would go into these circles suit up show up shut up right and we would go around and we would accountable we would check in from an accountability perspective honesty what are you being dishonest about so right away i would tell a client you're dishonest yeah right away shame on chair yeah i don't know if anybody's ever told you you're a liar but you're a liar yeah right so just we understand today and even then i'm sure you did that this is not helpful shame on shame does nothing but drive more shame and more pain and so as we've been able to grow or as i've been able to grow as a professional and in my recovery and the recovery field has grown we've been able to you know i was in circle just uh this morning and just had a really cool opportunity to check in with people ask open-ended questions don't do use statements and just really have changed that part of it and brought it into a much more functional comforting and safe space i have a tremendous experience on my personal trauma and the recovery they're from and i have a lot of experience on this recovery journey and so i just try and combine those two things and see if i can't align with clients and we can't make some magic happen whereas before it was kind of that other analogy where i was out in front and i'm like this is the way shut up and follow me so just a huge shift and a shift that i'm hopeful that the field is paying attention to because we don't need people to stand on the table naked anymore yeah that's not helpful yeah so so i know that never happened at peaks never happened it's a metaphor total metaphor total metaphor yeah i know that good absolutely well um you know it's certainly um exciting to have you in the room and be thinking about these uh things and um hopefully too the viewers can uh also i mean there's just no doubt to me that they're going to be energized by your energy and so forth but this you you provide an incredible amount of hope and i think you know in parting ways here at the end of this episode i'm curious about what you think are some of the major you know maybe put down you know one or two of what you believe are some of the major challenges moving forward but also in the brilliant way that you always do tied up with hope um as we exit this episode yeah thank you it's been really cool being in here and it's it's almost like i've never been here before it's kind of what it feels like really yeah i mean it's like anyway um it's we're facing a lot of challenges right we have a polarized world out there um you know depending on what side you're on really doesn't matter you're going to find chris burns and peaks recovery riding right up the middle because i want to be most helpful to most people right but we have to really let down our guard and move into a space of love and compassion because that's the bridge of which we all need to travel to help this mental health catastrophe and not only it was a mental health catastrophe before 2021 and before 2020 we had big issues and so my my big calling um to the community to the world to the people is like give a smile give a handshake give a hug wrap your arms around somebody in need create opportunity don't draw lines in the sand that's people don't like to see that be inviting be comforting and i have found that it's through that love and that compassion you can really connect right i've sat with people that love president trump i've sat with people that loved president biden i've sat with people and the constant is recovery compassion love because it's the only that's the only language we can speak today in order to get this thing right in my opinion we have to dismiss the hard edges create the openness and opportunity and understand that everybody is a unique individual and unto themselves and we should allow them to explore that and i think that's the problem with the world currently is that we have a traumatized population who are living out their trauma on the people they care about unfortunately creating more mental health catastrophes and generational shame pain and trauma down the way so love your neighbor i'm all about it big hearts big smiles well beautiful i have i have nothing to to add to that uh impactful um energy that you just left us with in that regard so we'll just uh call this the exit at this time chris thank you so much for being here excited to have you in this seat in the future hosting it bringing in your own uh guests and so forth and energizing that uh ever important recovery side of this journey uh for all the viewers out there check us out on instagram facebook all the social media youtube um we got what podcasts all sorts of ways to discover these opportunities along the way and certainly feel free to reach out to us at finding peaks at peaksrecovery.com if you have questions thoughts concerns things you'd love chris to speak on in the future myself to speak on jason clinton whoever's hosting um and we love you all so very much and look forward to the next episode until next time you

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Episode 10

Two Important Pillars of Trauma Work

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https://youtu.be/wNzNpaGJ458

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Episode 10 We dig deep into two very important aspects of trauma; establishing the awareness of where the trauma stems from, and then identifying how the trauma is affecting you in the present.

Topics:

We each dive into what trauma is and what it looks like from an individual standpoint.
Jason and Clinton get to the "why" and "what" of trauma
Exploring the deep relationship between trauma and shame

Select Quotes

In my opinion, it's hard to change things that we aren’t truly conscious or aware of. Trauma can still have an effect without ever coming becoming conscious, so I think it can also be difficult in the here and now to work on things that haven’t at least been brought forward to some degree in the consciousness. Jason Friesema, MA, LPC, LAC - Chief Clinical Officer

Episode Transcripts

Episode 10 Transcript

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Episode 9 Early Recovery Concepts Inpatient Programs Should Focus On Watch Now https://youtu.be/OYXuNCQWcLw Listen Now Episode 9 We discuss why addiction treatment in the early stages requires a narrow focus and sophisticated direction, and the approaches residential inpatient programs should envelop in order to properly carve a clear path towards a successful recovery.

Topics:

Why it is so important to implement a mindfulness approach to care in the early stages of recovery, especially within inpatient rehab.
What is “The Pink Cloud” in the world of addiction recovery? And what are the unique ways a residential program breaks through the “pink cloud” state of recovery, and do it in a way that allows them to reground on the other side without totally disrupting other progress?
How our program reinforces these approaches

Select Quotes You cannot walk the path of recovery if you aren’t grounded. So grounding becomes the primary focus. It's not just immediately diving into this bundle of issues and trying to untangling them. It's about first making sure your present, let's make sure what your emotions are, that you know how to actually navigate those emotions to the degree that is going to allow you to walk through these issues, rather than just throwing it all out there, and saying go. If you don’t know how to ground yourself, no matter how much work you do in a 45-day residential program, as soon as you walk off that campus, you’re at risk. There is no way to know how to walk and live a sober life without presence and intention. Clinton Nicholson, MA, LPC, LAC - Chief Operations Officer It's tempting to see a huge cluster of problems and feel like we need to tackle all these things and to make our 45-day residential program be able to treat this huge bundle of issues, and really that’s almost a mindless approach to care in this meta way. And being able to boil it down to taking a more bite-sized methodical, mindful approach to treatment planning through a residential program really allows for this stabilization to occur, and to address some specific things in a clear way. But really being able to build a system for clients, a path for clients, to know that they can walk. Regardless of the disruption that comes up. They will know how to walk through disruption and self-soothe on the other side of that.

Jason Friesema, MA, LPC, LAC - Chief Clinical Officer Episode Transcripts Episode 9 Transcript [Music] all right welcome back to another exciting episode of finding peaks i'm joined here again as we've been doing uh with friend and colleague jason friesma chief clinical officer for peaks recovery and uh clinton nicholson chief operating officer for peaks recovery centers so so grateful to have you guys continuing to follow us to join us for this uh uh new episode and hopefully the episodes are building up and becoming meaningful for you and your loved ones and uh helping you expand on conversations uh in your own household and so forth and you know educating and giving insights into the recovery journey and you know really what it takes to get somebody well at the end of the day and peaks is working on a mission or a project that sort of narrows the focus of addiction treatment through the lens of stabilization but before we begin defining terms like stabilization and what it means we wanted to sort of narrow in and focus on what residential treatment is like the tension we experience as a staff within it and how we move towards you know engaging individuals within um early concepts of recovery uh when you survey the vast arena of addiction treatment spaces you'll find on all of our websites that we're talking about things you know where we work to resolve trauma or we work to resolve addiction or we um use dbt or you know buddhist mindfulness you know based practices to engage individuals in recovery and though we speak broadly about these things within website infrastructure there's a much more sophisticated and narrow approach that we kind of want to tune in and focus on today so um you know with that it'as my experience at you know peaks that especially when individuals are leaving that the detox episode sort of like this grandiose experience of they are everywhere but at our treatment center they're out in a future opportunity or they could be doing this they could be doing that but it seems to take them out of the present and remove the focus away from internal recovery and sort of starts to externalize the process and i think one of the ways that we go about treating that is kind of through this lens of mindfulness and kind of just wanted to open up the discussion to um you two as the trained clinical staff who's constantly engaged with this about what do we mean by a mindfulness-based approach to care and why is it so important in that early part of a recovery journey and i i i always start with jason you always do you're the friend and colleague though i'm just the ceo i think the viewers are really depending on you to kick this off absolutely yeah to go with tradition yeah so the question was what is mindfulness or how do we approach that i i why is it such a why is it such an important tool in early recovery when we think about engaging them and getting them focused on their internal selves in the early part of the process especially within residential programming i would argue i guess the reason it's so important i think it's kind of a cornerstone i would say a tool to for clients to put on their tool belt to help them walk through the myriad of problems that they begin to face in early recovery um i kind of think about mindfulness and think about its antonym of mindlessness like just kind of not being able to think about what is happening in the here and now and being able to helping helping clients figure out how to settle in and acknowledge where they are is a key component to the recovery process because oftentimes people coming out of a detox setting are either really miserable and thinking about how to end their misery usually through returning to to substance misuse or um they're on what a.a calls the pink cloud which is just feeling like i have four days sober thank you peaks and i'm ready to go i'm just i know i'm never gonna use again and so that is certainly an issue and and oftentimes um you mentioned trauma kind of in your intro and lead in there and um trauma is a pretty it's a stuck emotion if you will and and it is difficult to resolve and it requires an element of learning how to be mindful learning how to deal with one's trauma from the present because trauma tends to be kind of stuck in the past and so teaching and learning mindfulness is a key component to learning how the process of dealing with trauma even before you begin to actually try to deal with your trauma and so it's an early recovery skill that i that i think is critically important and now i'll kick it over to the just the ceo of peaks one of these days we'll be friends so yeah good luck so mindfulness and early recovery um i think that there is an element of uh recovery that often is kind of overlooked that's particularly in the residential level um which is these sort of pragmatic skills about um that help the uh that actually help the brain to start to restructure itself and those are done through mindfulness-based tactics right um and they can be as simple as a a very uh a rigid schedule right or a predictable routine or um engaging in um integrating fitness and um and meditation and like very intentionally into the program not as some sort of uh like optional like experience that people can have but actually it's part of the programming itself because like jason was saying you know in order to really do the work that you need to do to to be successful in recovery you have to be present you know you have to be here right now and in this moment in order i think so many of us even people who aren't in recovery live sort of outside of this moment and so they are really unable to kind of nail down the things that they need to to work through because you're always sort of working around issues rather than actually working through those issues um i think that uh yeah that's those are my thoughts i'm gonna stop there okay yeah yeah okay i wanted to add what you say well you said too because i do think you know from a clinician perspective or even from a uh maybe more of a marketing lens too like it it's tempting to kind of see a huge cluster of problems and feel like we need to tackle all of these things and to make our uh residential program 30 or 45 day program be able to treat this huge uh bundle of issues basically this huge thing and really um that's almost a mindless approach to doing residential care in this meta way um and being able to boil it down to to taking more bite-sized uh methodical mindful approach to treatment planning through a residential program um really allows for this stabilization to occur and to address some specific things in a clear way but really to begin to build um a system for clients a path for clients to know that they can walk regardless of the disruption that comes in whether it's a trigger or depression is coming back or my anxiety is spiking or my spouse won't stop yelling at me i can i know how to walk through a disruption and and self-suit on the other side of that yeah exactly i mean you cannot really walk the path of recovery if you're not grounded you know and so grounding becomes what the primary focus is it's not just immediately diving into the this bundle of issues and trying to untangle them it's about those first let's just make sure you're here let's just make sure you're present and let's make sure that you you know what your emotions are that you know how to actually uh navigate those emotions to a degree that's going to allow you to work through these issues rather than just kind of throw it all out there and say go you know it doesn't necessarily if you don't know how to ground yourself then no matter how much work you do in the residential program in the 30 to 45 days as soon as you walk off that campus you're you've you're at risk yeah because there's no way to learn how to to know how to walk uh and live a sober life with presence and intention yeah so yeah and it seems to be the case that there's this brute force i'm gonna do it right when we think about the pink cloud component of it but and i don't know where that's come from where that we have to embrace this soul sort of autonomy then i gotta do it on my own i just have to make a decision a forceful decision not to use anymore but the science of addiction is quite clear that the physiological brain state that we or addiction is just that a physiological brain state that is exist and is depending on for how long you've been using drugs and alcohol it is now permanent right within the brain as a craving state and so when we're on the pink cloud we're not triggered we're not associating you know any potential future opportunities that might disrupt the present moment that we're in but i think it's really important to remind them how quickly they can be disrupted in any given process so you know within residential models such as ours i think it's really important to go about that kind of you know poke the bear a little bit to to get them to see that they aren't so grounded and that things aren't on this you know pink cloud and so within you know the limited time frame that we have whether through it's a whether it's through a mindfulness lens or so forth um what are the unique ways we can have families sort of engaged with what it looks like in an addiction treatment center for how we are sort of um poking the bear getting them a little elevated and re bringing them back down to the ground escalating the situation a little bit again bringing them down because we're really not doing our job if we aren't creating or exposing that tension that actually uh exists in their lives so as i generally do ask a question followed by a a statement a statement another in that regard the question is how do we how do we break through that pink cloud and do it in a way that allows them to reground on the other side without totally disrupting their progress well you know interestingly the pink clouded itself i mean first of all labeling it being able to say hey this is a predictable part of a recovery journey and i'm not trying to be the bearer of bad news but it doesn't last it doesn't last yeah um and i always a i align with people like i fully believe that's your intention like it that statement feels very true inside of you that you will never use it again and i want to acknowledge that um but you also you know and then i just describe either you know and i can intend to lift my car with my full intention and i won't be able to you know just just saying that that there's translating that intention into a how i think is the key part um acknowledging that that will take work or a process and and and if that doesn't work i'll i i have another metaphor i'll use is you know you can say you're gonna save ten thousand dollars or you're gonna say i'm gonna do what it takes to save ten thousand dollars and i'll i'll go with i'll do what it takes to save ten thousand dollars like acknowledge that there's a process and it's gonna take some work and some planning and um and you may run into some difficulties along the way that that usually helps people kind of begin to round a corner to say okay i and then i say ride it too by the way i'm glad you have that in that intention let's use that as momentum to kind of walk through this let's get as far as you can while you're feeling like you're never going to use again uh because that is kind of some fertile ground to get some momentum um to build some of the tools that we had talked about when they're when maybe some of those other baggage or whatever is with them isn't weighing them down at that moment we can use that as momentum in a path what are your thoughts i have actually been called the pink cloud popper because i have a pretty dry first of all sense of humor and my approach to treatment is rather disruptive so i and i like jason said i enjoy singing seeing the pink cloud because there's a moment there to agitate because there's a moment there to bring a dose of reality and recognizing that hey so the reason why you feel like this this experience is coming from this is the first time you've been sober for multiple days and feel good physically and i don't know how long and you pair that with a safe environment full of people who are completely dedicated to your well-being you are completely safe there are no there's no trigger as far as the sort of external world is concerned and so that immediately forms a bubble and the reality is that in about two weeks you're gonna try to leave treatment because you're gonna be so frustrated and it's gonna that you're actually gonna wanna get the heck out of here and there's this disbelief obviously i think with when people hear that but the reality is that it's uh treatment goes in cycles you know it really does like there are times when you feel really grounded in the process and there are times when you feel like this is so heavy i want to get the heck out of here and that's what it should feel like like that's what the that sort of tension brings about because you need to be able to navigate both of those parts you need to be able to navigate when you feel good and then you need to be able to navigate when you're ready to run and um i mean even as something as basic as our curriculum is designed like that it's designed to to really sort of like escalate somebody and then ground them and then escalate them with the topics of the day and then ground them again um so you go through this process and i think that it's again i totally agree with jason that it is fertile ground it's fertile territory and also it's not real and it's going to go away pretty fast so yeah yeah and sorry sorry dad burst your bubble so to speak so yeah that's not gonna last you got more to say jump in well i i just was gonna one of one of clinton's famous quotes is uh yeah that's not a thing like he it's like his line yeah that's not a thing yeah yeah so whatever this whole like i'm never gonna use again yeah i mean that that's a moment of like yeah that's not a thing like you you would use within minutes if you left here right now right like you feel really good in this moment which is great also it's not gonna last because you're an addict because like you said brandon like there is physiologically that person is still in the craving state like they have not worked through the neurological processes necessary in order to even begin to have the skills uh to manage triggers and cope with these sort of um external uh agitators that as soon as they walk out of treatment they're gonna experience right right and uh the verbiage that's coming up for me i think we talked about a pre-episode here but uh distress tolerance is really the name of the game and it and it's at least my non-clinical experience you know in surveying the patient demographic that comes through our program that it seems like they're they're quick to take the things that cause stress in their lives and tear them down it might be you know it might be a marriage it might be the place they live it might be the place they work in a lot of instances it's almost everything it feels like that is causing you know distress in their lives um in that regard and i guess you know sort of as we kind of go down the the end of this episode here um how how is it i mean it i i don't get to be in the group settings i don't get to be in the individual sessions but how are we allowing that how are we giving them that space to really hone in on say it's a marital issue that they wish to tear down um how are we bringing them into that because they're escalating within it and kind of what is the process i suppose look like for increasing that distress tolerance and that sort of wave that you're bringing them through like what buttons it up you know and uh yeah i'm the unbuttoner yeah you know to me and i'm going to let clinton really take that question directly but you know the alternative is distress avoidance right like just try to shrink your life so small uh if if you get your substances shrink your life so small to be as limiting in distress as possible um and so you know really clint and i when we sat and began planning out some of the curriculum um we really i really thought through a lot of the unbuttoning like creating the distress and and beginning to excavate some of the things that people are avoiding or want to avoid or getting to some of the causal issues leading to the substance use um and then really relied on clinton and his kind of expertise in bent to say okay and this is how i can see buttoning that up so i'm gonna i'm gonna let him kind of take that the how question for that how well uh like i said earlier i think recovery is actually really quite pragmatic it's about um being able to so easy yeah it's super easy like you just got to do it yeah i don't know what to do [Laughter] uh i think that there is a practical quality to it though it's not magical like it's actually work you know so in my experience the way to ground people is through work like you actually have to do some work you have to live what you have to experience life in recovery which is very basic it's very normal it doesn't feel exciting it doesn't actually feel um there's no thrill about it you know it's act and so that's one way is to actually really start engaging people in just this sort of basic life of recovery and and really reinforcing that um you know a day in the life of recovery is just a day doing laundry you know it's a day mowing the lawn it's a day going to the grocery store you know and being able to sort of reiterate that and allow them to experience that in a way that is actually fulfilling the other hand the other way to do that is somatically actually getting into the body and really grounding people either through yoga or through other various exercises through actually going on hikes you know there's a there's a way to sort of ground the mind through the body that uh we also lean into pretty heavily um because the reality is like you're i mean i don't know if i personally believe in resolution to trauma i don't know if i actually believe that that's a thing but i do believe that you can re you can work around your trauma you can recognize that it's there see how it's impacting you in your day-to-day life and then change that impact you know um very easily and very pragmatically of course yeah we can flag that for another episode by the way because that may be a another episode for sure super easy guys yeah well and and bringing this uh um to its uh natural end here i i all of this resonates with me i sit in front of clients you know a lot of times and they say stuff about how this is boring and i think this industry has done a major misstep from those attitudes of boring because recovery is boring just living sometimes you're going to find yourself an absolute boredom it's just a part of life and when you get to our websites we say we do all these things because we're trying to sort of do a dance at the end of the day but the dance is too big and it should be narrowed and it should be focused and so over the course of coming episodes certainly we want to continue to bring forward that narrow focus and how it can be helpful to individuals engaged in early recovery processes and then expand from there where we can start doing a greater dance beyond the walls of a residential addiction treatment facility so speaking of boredom if you're bored today this afternoon check us out on spotify the itunes store um wow find us somewhere go to our website uh our program is not boring by the way like that's not a thing let's just throw that out there that it's very exciting full of thrills and wow yeah it's pretty and uh email us questions comments ideas concerns at finding peaks at peaksrecovery.com send us your comments in social media and so forth we'd love to build upon questions and ideas that you guys have thank you so much again for joining us until next time

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Episode 8 Navigating Harm Reduction Watch Now https://youtu.be/Wo0_e_vgpx8 Listen Now Episode 8 We dive deeper into what the Harm Reduction Principal may look like in a real life example, as well as why this new emerging model can a hard topic to navigate.

**And for our viewers, plus note, that as Peaks Recovery continues to endeavor down sensitive subjects, we want to caution our viewers that our goal for these conversations is to only bring deeper insights into addiction treatment topics that may seem new, complex, misunderstood, or even frustrating. But we believe that as our industry grows to understand how to better treat addiction, not only do we want to provide better understanding around it, but it is also our duty to appropriately grow along aside it in order to arrive at better outcomes for the individual, and for the family systems that are suffering through this process.

Topics:

Brandon asks what their thoughts are on The Big Book and what contrasts can we take from it as we move towards a better understanding of what addiction is.
How we believe the addiction industry is still in its infancy and early on in the process of truly understanding addiction.
Responsibility and sustainability concepts within Harm Reduction

Select Quotes There are no two addictions that are the same, so there is no one equation that you can just plug an addict into and expect only positive outcomes. So we get into this more open and understanding world where different intervention strategies are geared towards improving the overall wellness and quality of life for the individual rather than focusing on these hard definitions of what it means to be in recovery or what it means to be sober. Clinton Nicholson, MA, LPC, NCC - Chief Operations Officer Episode Transcripts Episode 8 Transcript [Music] all right welcome back to another episode of finding peaks excited to be here again today with our chief clinical officer jason friesma and our chief operating officer clinton nicholson welcome back fellas to another episode i've been talking a lot about what episode we're on and apparently the feedback is that i've lost count significantly so i'm no longer going to state what episode we're in because i actually don't know maybe just a sign in the title just like episode chair episode yeah we're a work in progress bear with us that's pretty clear yeah super clear yeah so today i want to that this industry you know going all the way back what to introduced from there forward started with a strong abstinence approach to care and this industry at least that in the way that i'm experiencing certainly i'm sure you guys are experiencing the same is softening around the edges of abstinence and moving towards a harm reduction model to determine outcomes and a story comes to mind about a past patient who was in our care several years ago the mom continues to reach out to us on a yearly basis just excited and ecstatic about how well her son's doing but she talks in a way that isn't really engaging with the abstinence-based concepts and so just introducing this story namely the individual came into our program abusing heroin intravenously left our program has since not used interventions in our uh how do i be iv i'm gonna let's go to iv there to make this more more uh convenient for the conversation not using iv heroin but is holding down his relationships has a baby in his life you know holding down a job showing up as a family member not stealing from mom or anything like this anymore but is drinking actively drinking and she states it's not an issue that you know at parties or whatever the situation is family gatherings that he's accountable showing up in all the ways that she sees you know um positively in the adulting sense of things um but has removed the heroine and so in this regard this story is revealing a harm reduction principle namely the major problem has gone away but use in some way continues and so i guess with my what feels like a poor introduction of a story there utilizing that story um and and coming from this large abstinence-based approach where are you guys at on this topic and before i ask too many questions i'm just going to rest it there okay jason oh yeah i mean this is this is a an emerging debate or an emerging discussion probably to have because i do think uh in a lot of ways creating very rigid success models i've actually called it worshipping at the altar of sobriety time when somebody's perfectly sober from all substances um and that's the only measure of success it creates an issue where if somebody then does have some sort of slip whether it's a beer or a joint or whatever and it isn't a return to iv heroin use from a pure abstinence-based model they've relapsed and they're at zero days of sobriety just like they were the day they last had a needle in their arm and i think that rigid model of thinking takes away any nuance and it and it says all relapses are the same all lapses are the same all drug use is the same and it just turns out that um that isn't always helpful it it and don't get me wrong it has been helpful at times to think in that way and it can be helpful to take away ambiguity and that is certainly the easiest way to take away ambiguity is just to say all drugs are bad any use of any drug is a relapse it's very black and white there's an easy way to measure success in that but i think we can be a little more nuanced maybe in our description of what is success like is this by all measures this mother that you just described would say that her son has successfully uh recovered from iv heroin use now he's chosen to continue to use alcohol i don't know how he's using it it doesn't really matter the mom is saying that he's functional his life is going okay um that would seem like a success and i it would also seem a little risky potentially too clinton over to you over to me wow right yeah well um i mean i think that the big book was very much uh sort of um from its time right like it's a representative of its time which was in a pretty conservative um not super sophisticated scientifically um era and it really rests a lot on the moral model of um of addiction and the belief that you know there is an element of um willpower and that there is a sort of uh a defect within a person that makes them an addict and because they have that defect they're an addict across the board right like it doesn't give you any room for um again like jason said for nuance or for differentiation or for the idea that you know just because you are a heroin addict physiologically does not mean that you are an actual alcoholic you know like those are two different things but from a moral standpoint or that old sort of the older models and that and that abstinence-based model specifically all substances are the same you know like addiction as addiction is addiction is addiction but the reality is that addiction is really when you talk about like the dsm-5 it's a it's about how is it negatively your substance use negatively impacting your life right there has to be that component to it um and this the um client that you were talking about it sounds like you know the substance that he was using that was messing with his life and disrupting him and creating turmoil and chaos that was eliminated and now there's another substance that he's using that does not have that same effect so therefore he would not be diagnosable under as an alcoholic you know so for me it um the abstinence-based ideology is one of over simplicity and i think that it lacks uh a certain i think that it really does steep itself in shame as opposed to wellness which is what the the more um harm reduction models look at yeah absolutely i think sorry interruptions um but i do think like looking at where aa came from right like there is no predecessor to it absolutely nobody could get well and it was this grassroots movement in ohio if i remember right where people started to be able to stay sober and then tried to figure out how they were staying sober and this was to me just a great honestly a great description of how they managed to stay sober um and to your point it isn't a time capsule um but it probably needs to reform like any idea from the look at sigmund freud and say all of his ideas are absolutely true and we can't change any of them right absolutely everything is about uh the id and the ego and the superego and there's no other way to conceptualize how people think absolutely it was foundational and important and we do use a lot of concepts from sigmund freud and he needed to make those um do that writing and then we've grown a ton from it well i think actually in addiction it's one of those fields that didn't grow right it found one model that worked pretty well for a lot of people and then because there's so much stigma and misinformation around addiction and there was this sort of moralistic component uh that was kind of wrapped around it socially once once we found one decent way that helped a few people like we just kind of stopped as within that field looking for other alternatives and looking for different ways and really even exploring what is addiction like what is actually what does addiction actually mean and i think that we're still kind of playing catch up to other fields that would have like you know looking at like psychology as an example you know where they were able to sort of bust through those early ideologies and recognize very quick very quickly that there is more to the story and i think that we're still pretty early on in that process especially because the fact that we're having this conversation and harm reduction is in a lot of circles still considered pretty controversial well it is weird even sitting here i'm uncomfortable i'm going to be honest with you because i know certainly how i've been trained and how i've operated for a fair amount of my career it's it's been much easier to make this black and white issue absolutely to be honest with you like to just fall into that same pattern of thinking but really with the addition of like mat treatment like using medication to help people remain sober and and to be able to kind of regain control of their lives like it we have to begin to learn how to explore things that are uncomfortable even even acknowledge that uh perhaps the the lane of this absence-based model uh is actually maybe even a trap that we find ourselves in rather than even even a path forward at times so absolutely and the way that i see it the the new the the new language of a moral defect is the science of the physiological brain state that we call craving uh right now so i think you know i can i can just feel the tension building on the other side of the camera as it is for us too with families being like no you're not telling me right now that johnny has an iv heroin issue and he's gonna go and start drinking i think there's an important notion here to consider that if the craving state is iv drug use and the end of it i guess one step back i always have clients you know walking around you know our treatment center saying i can do this on pot do what are we talking about here and what i hear or the way that i translate that is that i have this thing called ib craving state and i'm just going to replace that state with pot i mean no wonder the abstinence culture has thrived so much because that's an error in thinking that it's not going to satiate the craving state which leads back to the relapse of this craving state and so what i think is really important here that i would certainly love for families to hear us out loud as we talk about this and i think it's worth more of a discussion here right now is when we think about the trade-offs let's say we can actually do some other drug or alcohol in the future that is this over here and remove this craving state it seems like when i think about drug use or alcohol or you know use anything of those sorts that there are these two words that i always use with clients in our care responsibility and sustainability right so when we're talking about okay well i'm going to use meth it i mean right when it comes out of the mouth it doesn't feel very responsible and we know it's not sustainable in our experiences due to um the likelihood that you will begin to crave that and develop an addiction yeah there are very few like weekend meth users right that's just not really a thing you know um you know cocaine there's some there's drugs out there that each time we say them it doesn't feel like we can get into responsible and sustainable lanes now with you know pot becoming legalized or at least decriminalized across the country it's a common go-to piece and we can get into it but alcohol is the other one there both of them have components of responsibility and sustainability at least in the general public sphere of things but what does it look like maybe to think about responsibility and sustainability here because it's not you know 10 bong rips throughout a day that makes this no okay to do yeah i think you're bringing up that craving state really resonated with me brandon and i really think um if somebody's using pot uh in lieu of heroin um i just don't see that really working right like i i think it makes the itch worse it doesn't scratch the itch it worsens the edge um and so i think there's a function of time a lot often right like deal with the craving walk through whatever is driving it and then maybe down the road um what would it look like to reintroduce some of these marijuana back in and then i frequently in in the new approach which is more uncomfortable i want to acknowledge that it's like well how will you know if marijuana if you want to do it and how will you know if you're losing control of it or how you know if it does seem to be leading you back to uh a place where you don't want to be into a craving state or into being triggered and so um and i and i don't want to just detract from that but like i do think some of our unwillingness to talk about um harm reduction is on our field that like this is a harder nuanced conversation it's easier to sit and tell a client don't do drugs they're bad avoid all that don't go to a bar really easy very telly very parental um and in the end shame based i think maybe not shame based but aspects of it are shame based for sure which really complicates treatment because a lot of actual addiction treatment is based in trying to eliminate shame correct so there is this contradiction that immediate intention that actually is created within that model and the treatment of that of addiction so um and but i mean jason's totally right this is as soon as you say the words harm reduction you have cracked open a pandora's box of gray like it is just there so all of a sudden it really is based on each individual has a unique addiction there and therefore has a unique recovery and our job as clinicians or as medical providers or is to actually try to figure out what that is you know so rather than giving one answer for all of the questions we actually have to really dig in and figure out who these people are what their needs are what the motivating problems and factors are how to actually eliminate that craving state and and then help them to to figure out their own path to what their future of recovery looks like and that is i mean i'm tired just thinking about it but at the same time that's the response that's the most responsible way to move forward it might and that's an opinion without a doubt and that's that opinion in no way shape or form is promoting um you know substance use for people who are in early treatment you know or early in recovery that's i think the antithesis of what we're actually trying to say um so there is there are edges and there are boundaries but they are they they don't feel familiar and they don't feel and they don't feel nearly as solid so yeah and the concept of at least in the medical sense of um neuroplasticity brain neuroplasticity is of the brain of course but in and without diving too deep into the science i mean the basic premise of it is right that new neural pathways can form and i think that's the brilliance of the time component that if you have this craving state the more distance you have from it and the more neural pathways that are developed in front of it um or on the other side of it you have what seems like a new opportunity to explore different things in a way that was limiting in this case absolutely so i think absolutely even though we're in a gray area time is really important and distance from the original craving state is absolutely needed um in this guard uh or in that regard in uh particular so uh and just real fast i mean that that reiterates the idea that recovery is not just sobriety like those are two very different things like not using substances is not the same as recovery uh recovery is about changing all of those aspects of your life the the social aspects the interpersonal aspects the intra-personal aspects managing and creating a life that in which you function completely differently which is reflected in the new and the way that your brain is functioning right because of neuroplasticity that transformation is somehow made permanent and more meaningful and you actually do live a different life i think that's a great point i mean i i do think of people that i've met along the way who maybe have been sober for years and years and years and go to three aaa meetings a day and are no more pleasant to be around when than when they were drinking yeah they're sober but they're not in any sort of recovery yeah that's a thing yeah and so it brings me to a future topic medication assisted treatment programming that um we'll definitely play out in a future uh episode but one of the things that dr volkow with nida the national institute on drug abuse came out many years ago in regards to suboxone this is around i think 2006 or so and felt as if this was a cure to craving states so there's tension on the mat side of things that i'm looking forward to talking to but just kind of leave the viewers with as a tail end of this conversation um that's limiting in our thought about this that we can apply an a drug objectively to all subjective craving states for intravenous opioid users and in relationship to suboxone that for me doesn't seem reasonable that it can't be the silver bullet that we depend on as an industry moving forward it's something within the tool kit that we can utilize um in all of this but i don't feel like suboxone in general or you know supplicate and the like are accounting for the subjective experience of craving states and this is why we get such a separation from the young adult being entirely not successful on mat programming where you get you know middle-aged 33 years old or higher largely seemingly becoming successful on those protocols so i don't know exactly what my question is here but i feel like it seemed like you were doing an outro yeah yeah maybe maybe it's an outro here um well you're kind of reiterating the idea that um you know silver bullet responses regardless of what they are whether they're based in a medication model or whether they're based in an abstinence model there is no silver bullet the real the real work and the real repair is done over time and it's uh actually done within the brain you know that's where the majority of the repair work is and it takes time it takes dedication it takes treatment it takes counseling it takes um several different dynamics and variable variables are involved in actually healing the brain so the silver bullet mentality in general and i think this goes for either abstinence-based or for harm reduction models is i think that's maybe what we actually need to walk away from yeah absolutely it's crazy because inside of me as we talk about this i i want to like put the disclaimer out there that like people don't walk out of peaks with the recommendation of like start smoking marijuana right i would explore your path absolutely not uh have your wife pick you up with a six-pack and see how it goes like that because of that time element people aren't walking out after a stabilization program right and right into that like there's a there's that element see and that's my own discomfort with this whole conversation but i feel like i need to say it yeah and it is a part of this outro that i that you rightfully pointed out i'm cautioning both sides of the the polar sides of the conversation that this isn't pure harm reduction this isn't pure abstinence that we have to sort of live in this gray area to arrive at better outcomes for the individual for the family systems that are suffering throughout this process and so um hopefully we've been able to provide a little bit of insights into the tension in this relationship you could probably experience it in just us discussing out loud that there is tension in this um uh topic and that definitely the goal isn't to just you know turn around and start using you know drugs and alcohol by any means in this regard it's it's sensitive but it's something worth talking about and this industry does need to talk about it and i'm excited that we're able to deliver small pieces of it today so thanks again for joining us here at the finding peaks and we look forward to the next episode with you all thank you thanks

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Episode 7 Introduction To Harm Reduction Watch Now https://youtu.be/0xR3fVSveT4 Listen Now Episode 7 We begin to open up some delicate topics around different treatment approaches such as Abstinence, versus newer principles that are emerging within recovery, called Harm Reduction.

Topics:

We discuss a bit of history and background into where “The Big Book” and “AA” came from
We explain what the Harm Reduction Model is vs. what the Abstinence Model looks like
Though the Harm Reduction Model is still under development within the recovery industry, and not quite understood, we discuss some of the pros and cons of both models.

Select Quotes There are no two addictions that are the same, so there is no one equation that you can just plug an addict into and expect only positive outcomes. So we get into this more open and understanding world where different intervention strategies are geared towards improving the overall wellness and quality of life for the individual rather than focusing on these hard definitions of what it means to be in recovery or what it means to be sober. Clinton Nicholson, MA, LPC, NCC - Chief Operations Officer Episode Transcripts Episode 7 Transcript [Music] all right welcome back to another episode of finding peaks um brandon burns host uh ceo of peaks recovery centers joined here today again uh with my friend here jason friesma chief clinical officer and my other friend uh clint nicholson chief operating officer and a backup friend yeah i'll take it yeah yeah yeah it's a heavy hitting episode before we yeah dive into these yeah all right feelers aside um again welcome back uh so today we are gonna try and start a series of episodes about or the differences between the grayness of delivering services that are abstinence-based as approach but also starting to inform the idea and talk about it self-harm or self-harm excuse me harm reduction principles would be the opposite absolutely harm reduction principles um and the approach to care and what that looks like so within this industry it's a seemingly contentious topic because of all of the grayness that exists within it and say when it's right to follow the abstinence lens or when it's right to you know say you have a heroin addiction for example to allow for time uh a year or two to pass before starting to entertain maybe what it would be like to have a drink um and uh so we're gonna start i think from the ground up as an important aspect of this to create some definitions around this and as we go through this um because it's a heavy hitting topic we would love to hear questions feedback comments concerns and anything that we can help bridge any gaps that might be experienced on the on the user's end in that regard so going back now i think to 1935 1938 again and there somewhere where the big book was written that informed the room's individual wellness and abstinence um jason t us off history how did we get here okay uh how did we get here so historically um well really back in the 1930s there was really no treatment for substance use there was treatment of the symptoms of having other medical problems and so really people ended up in the hospital for a month got out went right back out on the street no resources of course uh no real social work uh options no real uh possibilities and so um from that history uh developed the the aaa model and the founding fathers of aaa in writing the a.a big book and really um from that came this this really uh well the 12 traditions and the 12 steps from aaa which really encouraged people to begin to work a recovery process and somewhere along the way there uh came coins uh i don't actually know the history of the coin um to be honest with you and where they where that entered into the aaa process but where um a metric of measurement was how long somebody was free from their well from drinking and uh and then down the road even further after that came from drinking and drug use and uh and that was uh this token became um something critically important to strive for to gain 30 days of sobriety uh to gain two months and three months and six months and nine months and a year and then 18 months and then every year after that and celebrating that indicating that i have not taken any drink and had or had any drug in this amount of time and on top of that then our profession formed or began to treat uh substance use kind of following a similar model where where the entire goal of substance use treatment was to get somebody clean and sober and a measurement of success with that would be for the rest of their life never used another drug what's really nice about that model is it's really pretty black or white uh black and white um you're either you're either doing it or you're not doing it you're either putting heroin alcohol math coke into your body or you're not and if you're not you're successful and if you are you're not successful and you have to start over uh with going down the journey of getting your coins and and again it creates the unintended consequence of that or the maybe the intended consequences it's really clear black and white if you use again you're off track and you have to start over and if you don't use you're being successful however that black and white thinking it does create a little bit a a thing that weaves its way into the a culture is um coming out of uh alcoholism you have to admit that you are an alcoholic you have to say i am an alcoholic and my life is unmanageable and um in saying i am an alcoholic it began it began what we now know with with the emerging research on shane it's a little bit well shaming to say i am and then putting anything after that that that is less than uh kind to oneself that's a little bit of a shame message that that i am this and so the undependent consequence i guess of of kind of having an abstinence-based uh thinking or mentality is that well i am this and i need to accept that and since i am this it's kind of this unchangeable part of me that i'm an alcoholic today and in 10 years i'll be an alcoholic whether or not i have anything to drink and again it it it served it has served and is serving a huge and important role in lane coming from nothing this has been incredibly useful and helpful in um gaining sobriety uh or for people to gain sobriety and gain in and work a program that helped them step out of using um i would say two out of that tradition well came the 12 traditions which really talked about this aaa thing nobody can profit from it nobody runs it the meetings are self-supportive um and it really built uh this amazing community of people that attended a meetings and and began to get sober um so it's to me like when i look at aaa honestly as an outsider it's this really interesting contrast that like there are there's this aspect of aaa that does set up um this like all or nothing mentality but on top of that there's this amazing community and culture that that brings people up and brings people within and nurtures them through through early recovery and so i don't know there's just this contrast there and and i find that to be really interesting and curious but anyway that's where that's where kind of this where an abstinence-based model came from it it came from a grassroots uh up origin has a grassroots origin story and it came from uh people getting together in community and holding each other accountable to stay sober yeah one of the things that i've seen or that seems to be commonplace within our industry uh especially within the past few years though it's softening is there what manifested out of that is that there is this sort of moral deficit that's having and we haven't generally coined it as in the science scientific terms as a craving state that's driving those um addictive behaviors um full stop and then so when we think about somebody who's using opioids then you have the um you know the invention and brought to market suboxone and sublicate and all of these other components to it but there was this immediate rejection from an abstinence-based culture it felt like especially you know coming out of the rooms that oh well now you're just using another substance and it seems to bring back that sort of shaming component of it that you're different and it's not the same and true recovery looks like this but and this is also where we're trying to balance for the viewer here the transition about the education of abstinence and then how we get to something called a harm reduction model in all of this and how do we do it amicably and how do we preserve both because both are important in approaches to recovery journeys but it's no longer true in the sense of things at least for me it feels like that one way is the only way and so in sort of lightly bridging that gap from what you described brilliantly there and thank you for the absent side of things let's start with sort of a ground-up definition of what um harm reduction looks like well i think um yeah great description of abstinence-based and i you know when we talk about the 12-step model and aaa and the big book and anc and all of those uh different organizations i think it's it really is a story of unintended consequences because the other part of um what happened with aaa is it what it is it's about addicts helping addicts right peers helping peers and because that was the only treatment for so long that actually helped to start shape addiction treatment in general where addiction treatment became very very different from mental health treatment so we're uh in to be uh you know to be perceived as an effective addiction counselor uh the it was really about are you an addict or in recovery or not versus do you have a degree and have you been trained in these skills and then these foundational these mental health foundational principles um and so there was a big disparity between the mental health world and the addiction treatment world and now that disparity is definitely being that bridge is being closed very very quickly because i think there's an awareness now that we've uh as our understanding of addiction is more sophisticated and our approaches to mental health become more sophisticated i think that we ended up with something that looks more like the harm reduction model which takes into account this a much more much more of a mental health approach to addiction treatment which is this idea that you need to meet your client where they are like so wherever a person is in their willingness and ability to change that is actually where you meet the person and then that is where you develop the intervention strategies to support that person versus in an abstinence-based model it's either you're going to quit everything or you're not going to be a client or you're not going to be successful versus in a in the harm reduction model it's much more of a spectrum where it recognizes that i may be an alcoholic and i but i may not be ready to quit drinking however i want to do something to make this less impactful on my life to make less of a negative impact on my life and so that's where harm reduction comes in and it's uh a good example of the harm reduction model is like a needle exchange for iv opiate users or methamphetamine users it's the this idea that you know these addicts may not be ready to quit their substance at the same time there are ways and interventions and strategies that we can support them we can support families and we can support most overall the community by providing them with clean needles by mitigating the amount of like bacterial infection and infectious diseases that spread within the community to help eliminate some of the burden on the on the medical field and trying to limit the amount of emergency room visits that people have to go into so it's a much more it takes a much more broad spectrum approach and it really does focus on the idea of in any form of mental health treatment you have to start with where the client is in their readiness and willingness to change and if you start above that it's the options or opportunity for success are greatly decreased or diminished but i think the the word i would put in there with the needle exchange is you meet people where they are that's like the definition of empathy right it's saying i acknowledge that this is where you are and you don't need you know to put the drugs down to receive some care and some compassion um we'll just we'll be right here with you right and and really it kind of when you were talking about um the history of good substance use counselors had to kind of come from an addiction background in their personal life really what studies have found what's way more predictive is the empathy the capacity for empathy of the clinician not what their background is and what what's behind them and and i think that's the link uh that you're talking about without harm reduction absolutely and i think the irony is you would expect the empathy to be greater from to go from addict to addict however what i think a lot of times happens is it becomes sympathy right because that addict who's in recovery looks down upon that other person and recognizes that they're in pain and that feels as though they have the path to give them to to get better versus actually meeting the client where they are and saying all right what is your we need to create a path together you know like your path is going to be different than my path is going to be different than this next person's path in this next person's path you know that is the complication of uh their of addiction there are no two addictions that are alike and so there's not one equation that's going to help uh add it that you can just kind of plug an addict into and expect a positive outcome so we get into this more open gray world of um different intervention strategies that are much more geared towards improving the the overall wellness and um quality of life of the individual rather than focusing on these sort of hard definitions of what it means to be in recovery or what it means to be in sober absolutely and just putting on my ceo hat here and building a little bit of tension into the conversation about this is about how this industry behaved in this transition it out of the gates out of the late 80s started charging people an insurance company thousands and thousands of dollars for treatment through the aaa model and so it created this unnecessary tension between something that was by itself peer-driven sophisticated in its approach and free from the very beginning and so it started to make treatment look kind of silly because we're just charging money for something that is available to anybody and everybody with a willingness to change right in that regard and so this industry you know when you when you go to other it's still happening today when you go to people's websites they'll say something like we're providing a holistic model of care here but we're abstinent space that is not holistic i mean full stop and it doesn't allow for an industry that really needs to through a treatment through the science of things to approach the individual and meet them strictly where they're at and it puts this unnecessary pressure i think on family systems and i think in my experience of it that's kind of put them on their toes like if johnny comes home and flinches in the wrong way then it's all for nothing and it's not successful and it's created this really unfortunate black and white language that i think distances us from the individual who's really struggling um in a really significant way and so i just wanted to you know sort of bring that in and up up front center to honor the traditions the 12 steps the rooms and the meetings that this industry did something really inappropriate and it missed a great opportunity to work with those programs and then also do something more significant along the lines of the harm reduction model in meeting people where they're at and then utilize its strength as an industry to help bridge those gaps and ensure different conversations and insights into um you know the suffering that comes about through addiction but i love the mental health piece as well to it so um and just curious too in your guys's time here within this industry you know what aspects of working within addiction treatment have you seen you know maybe inconsistencies as an abstinence-based approach or you know the thriving of a harm reduction approach or missteps within a harm reduction approach as we you know bridge as an industry um or anything maybe more to that we can we know what the industry's done wrong here or maybe even the better question is what do we see it doing right now well i i think the issue is that there's this there are camps right right like yeah i mean i've done this for so long like i've been asked hundreds of times if i'm an addict by clients coming in and uh i have kind of a lengthy response i give to that when i'm feeling a little more curt or angry i i say this is the only field where that's asked like i don't my colleagues who do domestic violence treatment aren't asked if they beat their wives like it's literally the only spot where it's asked like it's like a litmus test like the only way you have anything valuable for me is whether if you have a similar experience to me um and to me that is that that model of like um well that's less charitable because i think what people were asking is like i need empathy i need somebody to just sit with me in this like i need help and i need hope um and so once i learned how to deliver that message like i could quickly move beyond like whether what my own personal history is or not so um that that's always been a weird tension for me i don't know if that answers your question brandon but yeah i think i think that's a a really interesting point and um you know there's as far as my experience has primari primarily been in the harm reduction field actually so i've worked in uh medication assisted treatment for a really long time and had a lot of exposure with that and i think that that's a whole another topic that we'll address at some other point um but i so the the what i like about the harm reduction model personally is that it actually because it's a spectrum it includes abstinence it recognizes that there is a moment in time where abstinence is not only important but it's vital to the success and the well-being and the stability of the individual it just doesn't insist upon it right away it doesn't and say that this is the only place where we're going to start and then this is where we're going to end up it recognizes that the journey is going to be wild and crazy and they're going to be relapses and they're going to be complications and they're going to be triggers and there and there's going to be maybe multiple treatment episodes in order for somebody to really grasp what's going on but what it does by by having that openness and that ability ability to sort of expand and and be more creative in its navigation it really does what jason talked about at the very beginning it decreases that shame like it doesn't reiterate this idea that if i do these 12 steps and i'm sober for 90 days and then i relapse i have failed in my treatment it doesn't have that option it realizes that things life is more complicated than success and failure and that failure is an opportunity for growth so i really so for me that's what the most exciting aspect of harm reduction is i i think as far as what the industry or the harm reduction field may be missing is their ability to communicate that message effectively yeah i just think that it's been i don't know that people really recognize and understand what harm reduction actually means and how it how it impacts and helps people i think that it a lot of times people just feel like it's an excuse to you're just allowing people to still use drugs so you're not helping them at all and not really um kind of changing or adapting people's lenses to better understand exactly what it means to be in recovery and what it means to be helped yeah absolutely and i like and i love the idea too the concept of you know it having different starting points i think we talked about it several hours ago episodes ago we also talked about being on a track and everybody kind of doing their own thing directionally focused of course but i think you know when i run into you know clients as well too when we're talking about things like the 12 steps you know secular folks are going to have a resistance to especially steps two and three and finding higher powers and that sort of thing but i feel like you know not often talked about but the bridge in there is the harm reduction principle allows us to see the steps not in so much black and whiteness but as opportunities for exploration into different things whether you know it's a buddhist mindset or a buddhist approach to care um uh the dharma um in that regard and so it feels like when we start sort of you know bringing them together you know contextually and then and in practice we're actually getting a lot more out of both flavors and i think that's a really exciting piece and that this industry if it can move from the camps and start bringing its tents closer together and stand outside and start a fire together we probably get a lot closer to something meaningful and help bridge this gap in a really significant way and you know for me personally that's just something i i would love to see embraced in this industry and it's also something that um and why this conversation is so important right now um and as we go through these next few episodes so um you know with that said any any closing words before we get a little bit more uh vocal about this and insert ourselves and be vulnerable in the topic well i think the only thing i wanted to add after what you just said is you you mentioned the camps and really it's way more of a venn diagram if we can get out of our camps there's a lot more like especially initially like helping people get out of their immediate suffering like who doesn't want to do that like there's a lot more common ground there and it's pretty fertile i would say yeah yeah again i think for me as a clinician it's exciting to to see the opportunity for what this could mean for the field of addiction and how this really expands our expands the ability and capacity for us to be able to help people not only more effectively but more of them so i'm really for me it's exciting to be a part of this conversation and it is yeah moving forward i anticipate the vulnerability will be um tough to navigate at times and there may be some i don't know some very hot topics that get brought up and people might feel burns but i just for me i think the the important thing is that having this conversation regardless is all about helping people it's all about being able to provide a level of care and treatment that helps addicts live better lives absolutely so as we move forward um we just want to recognize there is an absolute sensitivity to this uh topic but it's a sensitivity um that's worth exploring and all of this so if we say things in you know our future episodes and so forth that are discomforting or did you mean to say that um please ask questions send your comments and so forth so that um we can continue to support the discussion and make clear what we're trying to say about these things moving forward so thanks again for joining us if you've only joined us by video in the past um i'm hoping to get into spotify download our podcast um you can go to peak's site as well too to find our video and podcast sessions and so forth there's just plenty of ways to listen to us in that regard and so find us and thanks for being with us and we'll see you soon

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Episode 6 The Value of Boundaries Watch Now https://youtu.be/-8tECXEYUds *Fast forward past 5 minute prep time to watch episode

Listen Now Episode 6 We discuss the complexities of boundaries and how establishing them within the recovery process is pivotal for yourself and your loved one.

Topics:

Our interpretation of the complexion of boundaries
A similar metaphor that can help explain boundaries and how close or far you can hold loved ones in your life.
We recognize how hard it can be to hold these boundaries, but we speak on how important it is to hold those boundaries for yourself and your loved one.
Establishing boundaries doesn’t mean you don’t love your family member.

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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.

Topics:

The delicate dance between intensity and relief.
The variabilities of “Dual Diagnosis”
What success can look like outside of “the length of treatment”.

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Episode 4 A Diverse & Authentic Clinical Team Watch Now https://youtu.be/4BzwTSCCAS8 *Fast forward past 5 minute prep time to watch episode

Listen Now Episode 4 We discuss the importance of having a strong clinical team that is diverse in their strengths and approaches, but above all, has the ability to show up as their authentic self.

Topics:

How many clinicians may have the same credentials, but each may have unique approaches and skillsets in how they support their clients. Dissolving the tension between the individual struggling with addiction and the family members
The importance of appropriately matching a treatment program’s curriculum to the skillsets of each individual clinician, AND making sure the clinicians are willing to be immersed into the culture.
How in order to be a great and impactful clinician, it requires some crucial and extra fundamental pieces (outside of licenses and credentials) to actually be able to support and show up for clients.

Select Quotes In order to do this work, you have to your own work. You have to work on yourself and have a high degree of self-awareness, appropriately placed boundaries, along with an openness. In order to be open to impacting people you also get to be open to being impacted by people, it goes both ways. Jason Friesema MA, LPC, LAC, - Chief Clinical Officer In addiction treatment, authenticity in a counselor is absolutely the most essential. A lot of our clients have experienced treatment and counseling in the past, so they know the language, the “clinical jargon”, they can read a counselor who is not being genuine like that. So they need to be able to show up as their true self. Clinton Nicholson, MA, LPC, NCC - Chief Operations Officer Episode Transcripts Episode 4 Transcript [Music] welcome to another episode of finding peaks i believe this is uh episode four i was told yeah yeah it's again because i was told the prior episode was the third and i actually stated it was the fourth so welcome to the fourth episode here maths hard yes yeah math is difficult so just want to start uh today with uh we have some title changes in the room here at uh peaks recovery centers jason friesma is now our chief clinical officer oh and the crowd goes wild thank you for a while and introducing the new chief operating officer of peaks recovery centers clint nicholson everybody clinton yes also a therapist clap i would slow class i would also like to introduce also a therapist i'd also like to introduce clinton's cowboy boots uh also making an appearance today right here yeah i recently purchased a truck and they came with the truck nice congratulations on that and i have a really big deal obligated to wear them by dodge so as across that off the list as these episodes roll along we're getting feedback and some of that feedback so far has been that uh we're a little we're seemingly a little too uptight um in these sessions so we're really trying to explore not doing that here so expect bad jokes so let's expect bad jokes moving forward always difficult at least for me in doing this show because there's a seriousness to addiction treatment certainly and individuals are suffering of course across america from the disease of addiction and so um it's not always you know i haven't personally known how to approach it myself or how serious to be on camera because it is serious to us and certainly each and every day we come at you know and to work with the seriousness and getting people well but uh certainly want people to appreciate watching us and not be so serious yeah do you guys like to comment on that i'm feeling a little nervous today i agree okay um i'm hopeful that you've scripted some jokes i have no jokes okay so we'll jump right into it okay yeah so last week uh clinton said something was a little passive i don't know if everybody caught it in the third episode but i think he said something along the lines of i'm not excellent i'm maybe great at the family side of things that's uh that's a quote yeah okay okay yeah but something along those lines exposes the reality of addiction treatment centers and in that you know i think taking one step back you know peaks started with 36 beds six years ago and we have 36 beds today the thing that has changed at peaks recovery centers is we went from 12 staff members to 75 staff members and 67 of those i believe today are full-time staff members here so so we're advancing this enormous team around these 36 beds over the past six years and i just wanted to talk about through the lens of the clinical lens about the importance of having a team i mean in essence you're both lpcs of course you're in lac you're about to you know get your lac after taking the test recently equal licensures should mean equal skill sets right right but they don't it turns out turns out they don't do that so yeah and actually you know clinton and i uh since you're bringing us up specifically we we're very different in our approaches um i like to dig in uh emotionally and clinton likes to make fun of me for that and clinton likes to put things together and look forward with clients and so uh actually it complements our styles quite well actually it turns out that turns into just working really well together and and the other thing is having a wide variety of clinicians in a wide variety of skill levels gives us the opportunity to to have clients that are drawn to various clinicians and various things that clinicians say in various clinical approaches so and and the other thing that's different is that i'm funny and clinton uh thinks he's funny yeah that checks out that does absolutely yeah that absolutely checks out yeah so to elaborate in a slightly more um intelligent way than jason so yeah like like you said jason our our styles do differ again you like to do feelings things yeah and i do less of that i do more pragmatic practical solution-focused stuff that's based in kind of integration and you know one of the interesting things is that because we have these two different styles we were actually we've actually started to model our programming around that you know we our clients get to come in and they get to really dig deep like jason said and really um gain a tremendous amount of emotional insight and then they also on the sort of the second half of that programming is they get to actually land that in something that's more practical and skills based and experiential so this is just an example one example of how you can utilize these different skill sets from counselors and knowing your counselor's strengths and also being very transparent and uh about you know like i said family is not my specialty it's just it just isn't i i have other areas that i focus in and um that i excel in so those are the those are those the places that i'm going to lean into clinically yeah i mean for me i just think it's it's relevant and important for treatment centers across america to be honest about their approaches to care and through that honesty match the curriculum to the skill sets of the clinicians and not just you know unnecessarily force clinicians without those skill sets to run you know groups or individual sessions you know leading to you know less quality in in the environment of care and here in colorado springs you know we've got what a little more than a million people now i mean i feel like since i've moved here there's like a quarter million people have at least moved here but um you know we go we put an indeed out you know indeed out there to attract clinical firepower into our organization and just kind of even in a population of over a million people now just kind of talk through our experiences of the difficulty in actually locating the talent that can fit the needs of not only our patient demographic but that is informed through the curriculum that you know we've built out here at peaks well certainly just culturally at peaks we really do work to well being a clinician at peaks let me just put it that way uh somebody who works for us it's a pretty immersive experience honestly we don't just see clients for an hour a week in an office and then kind of get about our business we we walk with clients we play disc golf on our campus with clients we play cornhole while we're talking about various things so we really or we even share meals with them or or have coffee at times as well just to [Music] offer that support and in that path like that is also hard work for clinicians at times because uh that that is what causes us to go above and beyond and and i think it's the essence of what we do and that isn't really trained in school it's the extra special sauce i guess if you will that that i think our clients always feel supported and heard and that there is always somebody available to talk to you mentioned how the growth of our staff part of that is there's always someone awake and around for somebody to have a conversation with i just this week had a client who was who told me that at 3 am he woke up and couldn't fall back asleep and went out and had an hour-long conversation uh with our client care uh person and so i just really that matters having that availability and having kind of this real-time ability to be supported and cared for yeah i mean we really the expectation for our counselors is um there's a level of vulnerability that you have to be able to achieve with your clients in order to be to again to sort of like fit into the peaks culture you know it's uh we really strive for that community feeling and i mean there are primary counselors and clients are assigned to a primary counselor but the reality is that every counselor there is every client is there for every client and throughout the day different clients will pull different counselors and sit down with them talk with them um and again i think it kind of speaks back to you know different levels of different types of strengths and different types of styles you know because our counselors run groups with everybody and we're again we're fully immersive the clients start to learn what that style is and what that type of counseling approach is and they will start to gravitate you know and it gives them the opportunity if um you know if somebody's looking for you know really struggled and a grief and loss week and is really needs to process that they can find jason you know and if somebody is getting ready to discharge and they're freaking out about what is the actual pr practical side of sobriety look like they can seek me out so i keep touching my microphones banging in the control room yeah yeah so yeah this is just about my flaws today this is me being vulnerable everybody so yeah so you're doing great so you got you are you're doing great thank you so you guys have the the fancy credentials lpclac behind your name and i think one of the things almost almost lac behind us wow yeah the things that i want to pull from that is it seems like just just having the degree doesn't inform the skill sets or the ability to show up for individuals especially in a complex patient demographic environment that you know we operate within so what do you think is one of the most crucial like fundamental pieces to becoming you know a great clinician or a clinician that can inspire such a complex patient demographic including family systems and so forth i'll give a cliche sentence which is in order to do this work you have to do the work you're on work you have to do your own work you have to work on yourself and and have a high degree of self-awareness along with appropriately placed boundaries along with an openness to in order to be open to impacting people you also get to be open to being impacted by people it goes both ways you can't kind of be unidirectional in that way and that is the part that makes peaks so rewarding honestly and so challenging both i think in my experience particularly with addiction treatment authenticity in a counselor is just the absolutely most essential i mean a lot of our clients this is not their first rodeo right they've been through this process they've experienced uh counseling and treatment in the past and they can just i mean they know the language they know the the sort of like clinical jargon and they can read a counselor who is not being genuine like that you know so being able to show up as your true self not showing up as your counselor self which again requires that you're doing your work you know and it requires yet again to be vulnerable and being open to the idea like jason said of this sort of reciprocated exchange of of insight this this reciprocated exchange of kind of growth and exploration so yeah absolutely there's a there's a great deal of addiction treatment centers out there that you know state that they have similar services to us that they can stabilize and they can provide a continuation of care and all of this sort of stuff but the differences in departments by comparison are quite extraordinary at times i mean at peaks we employ a full 24 7 medical team to have two providers on psychiatrists and an md at any given time to support our patient demographic that is generally less than a census of assistants that can be made available to our patients and the supporting residential staff certainly our client care aids and you know never mind all the administrative support that goes on i mean how fundamentally important is it you know we've grown from the very beginning jason um at peak's recovery not having all of these things on the side what have we what have we learned along the way in bringing in these departments and um you know building them up with the intentionality and intensity that they offer the patient demographic how much is that supporting the clinical approach to care well to your point um the ability to staff our program well and with a lot of uh qualified and trained people not just clinical but across all departments does really i think give us the ability to really become excellent within our department and then kind of go the extra mile within that department rather than kind of spreading thin we get to spread deep i just made that up that's brilliant yeah i actually really like that thank you it should be a good shirt yeah next week available on our website yeah that was something yeah that was a t-shirt creation yeah absolutely yeah absolutely only four episodes how do i follow that right so next question um i i think you know i've worked up for a lot of treatments uh treatment centers and just different uh behavioral health centers and the the level of staff to us when i you know when i first came in i was just kind of like flabbergasted about like how much how much staff and how much support and how many people are really involved in the the sort of like whole peaks programming and um i realized very quickly that what we have the ability to do is truly wrap around people and give them a level of safety and support and acceptance that for a huge number of our clients they've never experienced before and it's powerful it's absolutely powerful and it's transformative which um you just don't see a lot of other places you just don't see that in other places yeah i think that you know just the other day we had a one of our patients uh was disrupted in a medical meeting and immediately wanted to leave and in my head i just thought somebody's gonna wrap their arms around him quite quickly and the beautiful thing about having all of this staff to support these individuals is that though this individual can be immediately attended to whether through on-call staff or whatever's going on that all the other patients on this side aren't there their quality of care isn't going down at the same time so i like this idea of building depth within departments by having departments in support of it rather than stretching departments then um you know which you know felt like kind of our humble beginnings you know and so to be able to advance these levels of care and towards and in the direction of patient care i think has just been a wonderful experience that i just want you know families out there to be cognizant of as you shop for addiction treatment services how crucial it is to have these dynamics within a company culture and also too to have maybe through the lens of humility to be as a ceo to be sitting here with you know other chief officers of our company culture be able to state openly like i'm not that's not my specialty and that's not my category and when we recognize that honestly as addiction treatment centers or any really medical setting um you know we can then move out into you know to the indeed ads and really pull in the talent necessary to fill those gaps in the direction of patient care so well i think you know candidly clinton since you are new i know you and i've wrestled with how many staff do we need and why why do we have so many like i've listened to you do it and push back on you that like this you're right we could actually stretch ourselves thinner and we could yeah um but it is really uh our staffing levels that give us some opportunity and time to have the between groups and the between sessions conversations um that really all the planned stuff is so critically important but a lot of the change happens uh in the margins well i'm lucky for you even though i'm an operations guy i'm also a clinician so i'm able to sort of see that um see both sides of that because operationally i mean if that that single lens tells a completely different story and i think that that's what a lot of uh programs are built around you know but by being able to sort of bring operational and clinical components together um i mean that just kind of describes peaks in a nutshell you know there's just this beaut this amazing blend of of focus and uh it has created an organization and a culture and programming that is extremely unique and very powerful so yeah absolutely well i again i appreciate the opportunity to present episode four the real episode four yeah that's episode eight episode four join us next week for episode four looking forward to episode five to continue to bring you content hopefully our humor or lack thereof is not in the way of you hearing the important information we uh desire to deliver to everybody today i'm just gonna give one more here please comment with the boots in focus we look forward to your comments um please give us questions so that we can provide answers and insights into the addiction treatment space and from here in colorado springs signing off until next time

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Episode 3 Healing Family Shame and Blame Watch Now https://youtu.be/9-P0kV811Ww *Fast forward past 5 minute prep time to watch episode

Listen Now Episode 3 We break down what family blame and shame may look like, and how both the individual struggling with addiction and the family can begin to heal.

Topics:

When family members or an individual experience shame because a loved one is struggling with addiction
Dissolving the tension between the individual struggling with addiction and the family members
Building awareness around what trauma, discomfort, and shame truly are, and how to properly move forward from excusatory blame to healing within.

Select Quotes Oftentimes family members in our program are looking to their family members to heal their wounds. With that blame comes to the need for, let’s say, an angry parent, to acknowledge the pain they caused, for the healing to occur. That's the drive inside. But what I focus on in therapy is whether or not your angry family acknowledges your pain, you get to heal. He/she is not your healer, you’re your own healer. Doesn’t mean healing can’t come in those areas, but they aren’t the source of healing. Jason Friesema MA, LPC, LAC, - Chief Clinical Officer When I hear families express this amount of shame, to me, it speaks to the idea that addiction is somehow based on morality, or a lack thereof. So being able to inform families what addiction really is and where it comes from; isn’t a lack of morality or somehow a reflection of who you are, who you are as a parent, or as a spouse. Giving them the education on addiction being really a biopsychosocial disease that is motivated by so many factors, and trying to own that behavior for your family member doesn't serve them or serve the family. Clinton Nicholson, MA, LPC, NCC - Chief Operations Officer Episode Transcripts Episode 3 Transcript welcome back to another episode of finding peaks excited to have friend clinton jason back joining us for what are we on now our 34th episode yeah it's always a pleasure it's your friend clinton and then jason and then jason yeah got it kind of a friend i think that checks out so yeah yeah thanks for having us absolutely good to have you guys back thanks for the coffee yeah we're trying to humor it up a little bit based on some reviews that we're a little too serious in the first few episodes so so that's the socks socks there we go all right whimsical not comedians counselors host okay thank you all right thanks for the clarification all right diving into this today um one of the things that came to mind over the past week and just thinking about you know kind of what we do each and every day is putting a little bit of focus uh back on the families uh oftentimes when i'm talking to families and certainly i'm sure it's the case when you guys are as well too that um they often describe situations you know about their loved one going into treatment and so forth as if they could have done better as parents uh if i had just done things a little bit differently um things could have been better you know i didn't have the playbook to parenthood you know that sort of stuff and um with that i think before we you know dive fully into the topic you know let's introduce what shame is from a therapeutic lens um find it go go all right so typically the best way to probably just talk about it is the difference between guilt and shame and sort of there's a subtle difference there so guilt would be defined as the idea that i did something bad right it's identifying that i i as an individual um had did a behavior that i perceive as bad versus shame is the basically internalizing guilt and saying that because i did something bad i am bad right so guilt i did something bad shame i am bad so that would be the probably the best way to differentiate it unless jason has years of experience on me so given his age and everything so yeah thanks for that yeah absolutely years and years decades really yeah um i the only thing i would add to what you said is guilt's a pretty important emotion that we feel because like it's helpful it's like corrective says you've done something outside of your values and stopped doing it shame on the other hand usually leads to an ongoing narrative and self-fulfilling prophecy uh and a spiral down yeah i would say so absolutely that's what i'd add yeah grief motivates growth and shame uh is a barrier to growth yeah there you go gotcha absolutely so when a family then and so you're you're talking to them and they're describing the situation as um not in the sense that they did the bad thing but that they are experiencing that i am a bad family member that i sort of caused what's happening to you know my loved one who's in care right now what do we what would you say to that family member in that moment i've had some of those conversations not surprisingly certainly what i what i have said honestly is um particularly when people are first coming into treatment like i i recognize that they're i'll say to them i recognize you're feeling that way and really now is not the time to like stop and like reflect on your entire parenting history because really we're in this crisis and and now you've done the right thing by reaching out and calling us and i'm grateful that you did that and likely you got here as soon as you could so we're glad you're here and that's usually how i start that call just just trying to say listen i think everybody's probably doing the best they can and making the best decisions they can and it can be hard to make a phone call about a loved one particularly who's struggling with addiction or other mental health things oftentimes from the best and most genuine intent parents try to solve their their loved ones problems on their own or so do spouses all through genuine intent and so i work really hard not to pile on shame at all people tend to walk around with plenty of it all the time anyway and so really just normalizing that experience that kind of you got here as quick as you could yeah yeah i think um also to really ex you know when i hear families really express this amount of shame it to me it kind of speaks to the idea that addiction is somehow based in morality or a lack thereof so being able to inform families what addiction really is and where it comes from that it isn't a lack of morality or anything that could have been necessarily that you could have done differently or is it in somehow a reflection of who you are as a parent or who you are as a spouse but um you know giving them the education on addiction being really a biopsychosocial disease that is um motivated by so many factors that just that trying to identify that one specific thing or to own that behavior of your family member is just it really doesn't serve them or serve the family so and for in in in my conversations with families it's the there's a rooted tension in there that i sort of want to bring forward here it you know it sounds like when the addict is behaving in the way that they do to seek their drugs and alcohol and all the behaviors that fall out from that the lying the stealing all the potential of it oftentimes families are in a position to point at all of that sort of negatively because it is as you said outside of a value system maybe it's the family's values maybe it's at the individual level but that constant sort of pointing and that negativity and that experience on be you know on that on the addiction side the the individual who is addicted at that time probably starts to really start seeing it not as guilt but shame like i'm just a terrible person only a terrible person could hear all this negativity with such fluency and so they start to point back at the family you're the problem you didn't do that for me this is why i act and behave and so how do we start to you know dissolve that tension because it's neither person should be experiencing shame but shame is resulting from it and i and i guess what i'm really getting at here is just how do we dissolve that tension that existing how do we stop the finger pointing at the family members so that we can appreciate that hey nobody had a playbook to do this right nobody had a playbook for how to do addiction right and nobody had a playbook for how to be a parent or to be the best possible parent that would create a situation in which it didn't lead to addiction so um i think it's important to dissolve that experience and remove it because it seems to be a fighting match by the time they arrive at our doorstep yeah fair and i'll just continue to reference brene brown well which is good because she's a shame expert it turns out and and certainly what what brene brown says is that the the solution for shame is empathy and and that's kind of what it requires on a variety of on multiple layers of what you just described like a loved one needs empathy for their family the family requires some empathy for their loved one but a lot of times the the empathy starts with the with the relationship with clinicians and other staff and other clients just really being able to sit in the dark with another person just sit with them in in the spot where they are struggling and usually that helps resolve some of the empathy and really can can help a person distinguish between their guilt and uh the shame that's a big question so i guess my approach would be something [Music] you know when families have that tension there's you know that finger pointing is serving some sort of purpose within the family right like it actually is serving a function and typically it's um to some degree part of it's holding that family up and becoming part of that family's identity so being able to sort of i one highlight the fact that hey by the way there's finger pointing going on and that's that's not serving anybody but also what is that finger pointing actually doing for you guys as a family how is it serving your or helping your family function even though in or dysfunction basically so i guess that would be my approach and then i think building empathy into that and you know families are such a complex organism and i mean they're certainly not a specialty of mine but um i think being able to unpack that and unwind that just takes a tremendous amount of time and um being able to give families even that information that hey this is going to be a process and as one person changes in the family everybody else in the family is going to have to change as well like to to say that just the i'm sending my kid off and so change them and make them better that's actually not how it works like they're going to go and start their work and process of change and as they come back everybody's going to also have to change around them to a stat to re-establish some sort of homeostasis so let's say that i've experienced trauma in my family or discomfort surrounding my family and in some way that discomfort led to me wanting to numb that a bit with drugs and alcohol or whatever the situation might be how do we guide the person in treatment or or what can we tell families about that guidance that because i what we don't want at the end of the day is some excusatory lens right for stating well i was traumatized or mom didn't do the right thing or you know brother did x y and z and that's why i do drugs and alcohol how do we get away from seeing the tension for what it is and then move away from it to the degree that we stop excusing bad behaviors or poor behavior is probably a better word there um in relationship to that that makes sense so i can restate that if that's well so it sounds like excusing and justifying at the same time yeah i feel like sometimes people get into addiction treatment centers and they're not fully aware of what is trauma and they're not fully aware of how they were shamed and they're not fully aware of what discomfort they're carrying and then you know we'll sit in a in a group individual session all of a sudden they're like oh my gosh yeah that happened in my life and then it sort of has a um an energy to it where they turn and say your fault you know sort of as an experience and but even if somebody caused something to the individual that caused discomfort that led to the desire for numbiness it can't continue forward in an excusatory sort of fashion so how how as clinicians do we help the individual see okay we've identified issues and problems but we can't live in those problems and we can't change the past and we can't use the past as a mechanism for excusing the behaviors that are outside of our value system currently i think in some ways to me in some ways it comes down to um boundaries like i like to bring clients back around to boundaries because oftentimes when an individual has gone through a trauma or whatever their boundaries are either really diffuse or really rigid in various places and helping somebody understand how to set boundaries to protect themselves which to me isn't the same as blame like you know if if a family member has a loved one that is actively harming them or will likely lead them back out to drug use or uh will affect their their mental health then that person it doesn't matter the blame or attributing blame to it it just matters setting up the healthy boundary and what where that boundary needs to be in order for this in order to sustain the recovery process and whatever that might look like that because that's what i look look at like that because i do think trauma distorts boundaries often times for people wow right clinton yeah i think that you get again we talk about this sort of like shame cycle right and that um you know on one hand you have the the person who's struggling with addiction pointing the finger at the family saying because you were because of my family was like this or my experiences were like this that i do this now and then the family points and says well if you weren't doing what you were doing then our family wouldn't be like this right so you get in sort of this you get caught into this um this sort of like big thinking error where everybody starts to blame everyone and being able to pull people apart from that and actually just sort of own the fact that look everything the system has been sick you know like we actually have a family that is ill and within that we have all developed um habits that are part of this family disease and being able to sort of go in then as for as individuals and start to work on their on that kind of finding that cure and then looping that family back together over time is i'm i think that that's uh it's a really simple way of explaining it again a complex process but in order to get out of that cycle of blame and justification uh you really have to pull things apart and then acknowledge that look we're all sick you know and it's not one person's fault you know but the way that we exist together is actually the sickness so when i think to add to what you're saying too i think oftentimes family members in our program are then looking to their family to heal the wounds right with that blame comes the so then you need with that blame comes the need for let's say a angry parent to acknowledge the pain they caused for the healing to occur that's the drive inside of people but you know what i focus on in therapy is that like whether or not let's say your angry father acknowledges the damage they cause like you get to heal from it he's not your healer you're your healer and because i do think that that definitely happens particularly in um child to parent relationships is the children often are looking to their parents for that healing or that affirmation or whatever and and teaching clients again not to blame and not but also not to try to get healing from from the source of the problem yeah doesn't mean healing can't come in those areas but they're not the healer yeah yeah absolutely yeah i think the it's it's a it's a challenge for families uh going through this and by the time they arrive at peaks it's it's a fairly broken family system in general especially those who've gone you know through the ringer and i think um just want to pass our love and appreciation of families who are all you know going through uh addiction right now within their own family system whether there's mental health association with it and so forth and just remind them that care is directional and that at the beginning of you know somebody coming into a program like ours it there's a tenacity to it an attention about it that is certainly our jobs you know each and every day to resolve and support them on and just to know that you're loved at the end of the day and that we care for you collectively as much as we care for the individual who's in our program um and um on behalf of our team here at peaks uh signing off i think again for our fourth episode here and uh just ecstatic to be here and appreciate the opportunity to continue to deliver this education and information and hope you all enjoy it until next time

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Episode 2 Balancing Facility, Family, and Client Responsibilities Watch Now https://youtu.be/lwNUMrCWXks *Fast forward past 5 minute prep time to watch episode

Listen Now Episode 2 We discuss a few of the responsibilities that the facility, family, and client can balance together in order to motivate change along the recovery journey.

Topics:

Creating a safe environment for individuals to allow them to properly learn how to better regulate their triggers, discomforts, and life challanges.
Engaging with the family to hold boundaries when their loved one is experiencing these discomforts.
Prepping the client for the realistic process of recovery.

Select Quotes Removal of a substance does not mean recovery, in fact, it's merely a beginning of a much longer journey. Jason Friesema MA, LPC, LAC, - Clinical Specialist and Therapist First and foremost we're there to provide safety, but the point of providing safety for clients is to allow them to experience discomfort in a way that is stable and secure enough for them to work through that and develop the skills needed to face life on life's terms. Clinton Nicholson, MA, LPC, NCC - Clinical Operations Specialist Episode Transcripts Episode 2 Transcript all right here we are again for our second episode of finding peaks uh talk show and my name is brandon burns and i'm joined here again by my colleagues and friends uh clinton nicholson and jason friesma welcome back to the show guys thanks brandon thank you for having me so good to be here it's a pleasure yeah glad to glad to see your more authentic selves are showing up in the second episode every show is a journey there we go and we're on it um so coming into this episode uh over the past week um you know really surveying company culture and the ins and outs of what we do each and every day um uh the the milieu fluctuates throughout each and every day in attitudes about what's in front of them it could be the meal that's in front of them it could be mainly the needs or the things that we need to provide to patient care to make this go well but what i often find in delivering the services and building up a program to make things well for the individual so they can focus on themselves in their internal recovery process that we end up finding a lot of distractions along the way sometimes our cooking by you know from our chef isn't at the level in which they would expect to see it at sometimes the pillow is just a little bit too rough and different from home and distracts them from the recovery process and all of these things um seemingly get in the way of recovery at times even when they're seemingly very small situations and so really just wanted to you know create a discussion around um you know for the viewers and for families you know what are the actual responsibilities of a treatment center and what do treatment centers need to do to you know bring clients in front of their recovery journey and reduce those distractions you know along the way so you know from my position certainly i want to provide a nutritious meal to our patient demographic but at the same time we're not a restaurant and that's not why we're in business to create the best possible five-star meal in that regard so though it's important to deliver those things i just kind of wanted to walk through maybe your thoughts around the purpose of treatment maybe how to reduce those distractions but really how does a treatment center properly engage the client in care well the big question good lead in uh it's almost like when i i think it's it's important for a treatment center to provide for the basic safety of clients and to create um some space for them to feel safe and be safe from the things that were around them but the things you listed like uh food not being up to par or um the pillow's a little too firm it's almost like those are maybe distractions from uh somebody being on a on a recovery journey oftentimes during clinical process or doing a counseling process or recovery process clients are uncomfortable and they'll take that internal discomfort uh emotional internal discomfort and then uh project it on to other things and uh really zero in on those things now it doesn't mean that the client isn't experiencing these complaints uh with all sincerity uh and i do think it's the the treatment organization and the clinical team's job almost to to bring the focus back on like okay your pillow's uncomfortable how are you uncomfortable yeah see that's a compliment yeah yeah you're welcome absolutely yeah no i agree i think that um first and foremost we're there to provide safety and but the point of providing safety for the clients is actually so that we can then disrupt them right so that we can then create uh allow them to experience discomfort in a way that is where they feel stable and secure and safe enough to work through that and process through that so if we were to sit there and and work to try to put out every fire or quell every every sort of um little nagging issue that somebody comes up with then we're actually not really preparing the client to go back out into the world and deal with disruption because that's what life is it's just constant the sort of constant state of being disrupted and um when you're in active addiction part of that the role of the addiction and the role of the substance use is to sort of uh kind of nullify that or numb that out and now we want clients to to actually embrace that again to to sort of walk back into being awake and being and feeling disrupted and feeling um sort of disjointed in their life and so being able to like jason said help people uh become aware of you know well yeah yeah the pillow is uncomfortable so why are you uncomfortable again that's bringing that awareness back inside of them and um allows them to sort of move through that and develop the skills needed to sort of uh kind of face life on life storms yeah i think one of the major considerations is to create that environment of safety um you know especially in influencing the business and growing it out you know one of the things i always talk to families about when i get the opportunity to get them on the phone is that you know over the course of you know therapy we talk about what triggers you to use drugs and alcohol i'm driving down the you know the road i get a phone call from a friend they say let's go to the movie and i think oh when i go to the movies it triggers me to want to smoke pot or you know shoot over whatever it is that makes that a more enticing environment but if we've been using drugs and alcohol for a period of five to ten years we're talking about not just going to the movies triggering you know usage of pot we're potentially talking about hundreds if not thousands of potential triggers and it seems though that the intention of the treatment center is to provide a safety or space of safety for the individual coming in one of the benefits of coming in and sort of not checking all boxes along the way is that we actually get to trigger them in the process and get to see their real world experiences sort of take place in front of us and then get to you know work with them through that well yeah i'll push back just a little i don't like we don't maybe intentionally trigger right clients like we don't i don't think it's healthy to like set the jack daniels bottle on the middle of the group and be like okay everybody you know everybody smell it and what comes up for you um because the the the triggers are internal right most of those like the the movie analogy that you made like that makes a lot of sense but what is it about that nostalgia feeling or that like sense of comfort or getting out of your house or whatever it is um in any length of time um in in setting the right tone in a treatment center like all those things are going to come up clients are going to feel triggered through no effort of our own that's just going to come up and and we do hopefully at peaks provide a good um well prompted times like pushing people into discomfort and and when is the pillows discomfort not about the pillow when is it about your own discomfort or what what is increasing your fear making you want to be in control of everything over here um those are kind of those prompts i just want to clarify that that that you know like just being sober for 30 days and being in in a recovery program is going to provide all of its own triggers and prompts uh necessary for good clinical growth yeah i agree i think that um generally speaking like again life is a ball of triggers right so yeah um and in a recovery environment the one thing that i would actually say that's maybe a little bit different than jason is so one of the sort of phenomenon of the recovery journey or especially in uh like a residential level of care is this idea or experience of the pink cloud where for the first time in maybe years in your life you're sober you have clarity again you feel safe because we've done our job as a facility and as a program to help you feel safe to help you build community to feel supported to have access to people that care about you and listen to you and want to be there to support you and then all of a sudden there's this like overwhelming feeling of like i'm great you know like everything is good i feel fantastic you know i'm ready to go do this and we're talking like we're on day 14 of their actual recovery and so being able to um clinically kind of predict that and also develop strategies clinical strategies that are intentionally built to sort of disrupt that process and sort of that that sort of false sense of security or at least um that uh a sense of security that is much more fragile than it feels or is perceived i do think is really important i think that um you know my personal belief is that if it's not messy it's not recovery you know and sometimes we do need to go in there it's not like we're purposefully giving people like you know really crappy pillows you know or like only feeding them taco bell or something like that but we're doing something yeah yeah no offense taco bell is not a sponsor so um yeah uh but you know being able to provide you know like not too long ago we did uh you have this sort of experiential interventions of like something like capture the flag where all of a sudden something that is a fairly benign game that kids play becomes this like extreme life experience where you have competition and conflict and communication issues and feelings of insecurity come up i mean so you really you know to speak to jason's point again you don't really have to do a whole lot right like because it will sort of come up naturally but at the same time to some degree treatment has to be designed towards uh to to provide a little bit of discomfort or at least motivate that to the degree that people can continue to grow and not get stuck in a false sense of safety yeah yeah absolutely and i think you know facilities purpose and goal is to provide quality care and create that safety environment but it seems like discomfort's a really important piece of the process and at times uh through challenging uh you know clients in that regard that um that's what creates sort of the clinical fervor and motivation for change right yeah absolutely and i think so it is this balance right that that we do provide this safe space for there to be this disruption and then helping clients see that they can resolve it hopefully on their own that they can learn to regulate their emotions in that way and and tolerate some distress in their life and not decompensate i often find that when i'm working with clients like they'll they'll have a feeling good or bad happy sad mad glad whatever it is and in some ways their their process is usually i have i'm feeling a feeling i need to do something about it usually that alone can be triggering like i am feeling happy i need to celebrate that or i'm feeling afraid so i need to do something about that and sometimes it's just about helping people slow down and and let emotions resolve on their own and i think providing that safety uh when capture the flag stimulates some sort of response in people helping them have that response and then also resolve it and get to the other side and provide that that net where we can kind of catch them and help them be safe and regulate that on their own absolutely so sounds like through creating a safe environment we are also creating discomfort along the way and so now johnny who's in programming experiencing discomfort whatever that discomfort is and having a difficult time engaging in therapy wants to pick up the phone call mom dad family member somebody say pick me up this isn't working i'm irritated i'm frustrated this isn't meeting my needs what should we be telling the families in this regard like what is their responsibility in this process when they get that phone call and not just under you know that strict criteria but what are they doing in the background to for themselves in the direction of their loved ones care and how can a facility support that well preparing the family that johnny's going to call and say you know in a few weeks when the he falls off the pink cloud or is his little bubble burst a little bit like he's going to get uncomfortable we can predict that and just like i said a minute ago when the clients kind of have a feeling and they think they need to do something about it they've oftentimes trained family members that hey i'm feeling uncomfortable you need to do something about it and really helping people disconnect from that and it is why you know we we do tend to kind of make sure that we we really manage phone calls to families well and in contact with families um because usually there needs to be some healing space for the family as well but we can tell families like you your job is just kind of hold firm and honestly get into your own recovery journey whatever that might look like uh and through whatever means necessary whether it's counseling or other community or church type support meetings and that sort of thing so um because if we can predict that if we if we can sit here and talk about it then we certainly know it's going to happen and then if a family knows that hey in three weeks like you might get a call that they're just regulated and they'll be they'll complain about um you know the the bread was too crunchy today at breakfast and so i'm i gotta go uh the family's gonna be prepared to be like um cool and how about if you don't leave yeah right yeah i mean this is the family guru over here so he's the he's the guy to ask yeah absolutely uh no i i think jason's spot on it there's a tremendous amount of preparation and communication that has to go on outside of the actual residential world or outside the actual facilities that the actual client is working in i mean just as much work is happening on the outside as there is on the inside and really engaging families and prepping them to hold these boundaries that are like jason spoke to can be really malleable because of the the relationship the disease the sort of dynamics that have occurred throughout the the client's active addiction where there's a sort of rescue moment that step where the you know the parent feels and uh he hears the sort of call of their child to be saved and you know there's that's the instinct is to go and save them and so being able to sort of dial that down or um help families kind of push against that instinct or that um is it requires a lot of work you know like that's a very intentional thing that has to happen so um and then for myself i also like to prepare the clients for the fact that hey by the way in about two weeks the bread's gonna feel it's gonna taste really crusty yeah you know like you're gonna have this moment in your treatment arc where you're gonna wanna leave and you're gonna have so let's explore all of the different reasons why you would think that you might want to leave you know whether it's your own families i have kids i've got bills to pay i've got a job i've you know i don't like crusty bread whatever it is you know sort of prepping them as well to be able to acknowledge these moments when they happen before they do yeah yeah and you know i one of the families who whose loved one recently went through peak's recovery you know on the phone with her right as he's entering treatment she says i just don't know what i'm gonna do not having my phone blown up all the time with him being angry at me or him asking for money for drugs or for him asking for money to for some strange story that took place in his life or you know whatever the case is and it seems like in a way they become sort of wrapped around the trauma of addiction in that regard um maybe for a lack of better words that i you guys can better inform me well i'll use the words okay the kids addicted to drugs the family's addicted to the kid being addicted to drugs it's a very similar process right absolutely powerlessness unmanageability yeah all those same kind of processes occur um and so recovery is also really important to break that absolutely and getting some sobriety time and detox time if you will from the drama yeah yeah absolutely yeah addiction is a disease that permeates all levels of family all levels of relationships i mean it's something that you know just the the person who is engaging in substance use is not the only person that is struggling with addiction at that point so i think being able to wrap around families and wrap around uh loved ones that have been struggling with this disease and treating it just like they are experiencing the same level of crisis as um as their loved one i think that that's really vital and really important yeah yeah and out of those experiences of intensity i think just you know reminding families too that they're a part of this healing journey directionally they're getting their healing in the background just as much and should put you know a solid amount of energy into that process as well too whether supported by our staff at a place like you know peaks recovery centers or beyond the walls through al-anon and these sorts of things um i think are quite promising so um so yeah in that regard i know we're getting close to the edge of our time here but just one more aspect of this is what should we be telling families about the patient's responsibility in this what do they need to be focused on going you know through the recovery process be mindful of because to me care is directional so what i'm stating here is that um what i'm trying to state is that oftentimes you hear post recovery oh the treatment program didn't work for me that you know spaghetti meal didn't work for me and that's why i left whatever the case might be that there's a challenge in there that the facility could have done better certainly maybe in those moments but what is it maybe that the client or the patient's missing in that moment because a big part of this is their volitional participation and staying focused and directional to resolve uh the current state that they're in so what do we got to you know sort of educate the the patient demographic on here about their responsibility throughout this process wow i guess i would say piggybacks a little what clinton was saying is just being able to predict and describe the process that that a removal of a substance does not mean recovery in fact it's merely the beginning of a much longer journey and being able to say you know you're not going to get sober and in two weeks everything's fine with your family and your life's coming back together and your court issues are now over and everything is great like the there's a lot to be committed to as far as like kind of a longer term process in a journey i would just say predicting a journey my nice little counselor speak you know clean it up for me i think um you know like the removal of a substance the only sure thing that that's going to do is trigger the desire to use substances right so if you get to the why really quick exactly i mean so if you um and then the majority especially in early recovery that addict mind that addict brain i mean on a physiological level is just going to do anything possible say anything possible attached to anything possible to make sure that that that drive is is satiated you know and so uh just being really upfront about that and really real very realistic about that it's you know hey by the way you're an addict so you're going to experience cravings because you have a pretty strong addiction and your brain is going to tell you as you get more and more uncomfortable that the only way i can do this is by getting out of here to go use and whatever means necessary uh all the and again that's when all of a sudden the bread is crusty the pillows are uh are lumpy you know the the uh i don't know you know the the steak wasn't cooked perfectly medium today you know whatever the case may be all your brain is going to going to attach to anything and we're going to be here to stand by you while you ride that out because that's the most important part is that in those moments you stay still with us and that you allow us to support you yeah absolutely and i think day in and day out you know at peaks you know whether it's 24 you know hours of a stabilized you know client that we sort of rinse wash repeat throughout each and every day to inform the patient of why they're experiencing that distress or walk through that with them to reach back out to the family to walk them through their distress and so forth and you know if anything i think here just leaving you know the the viewers of the show with the fact that um you know addiction is a complex process with many moving parts and in addiction treatment centers i think there are these three really crucial components of it what the facility does what the family is doing in the background and what the patient is doing within their care and um yeah i just appreciate you guys chiming in on this and um thanks for joining us for our second episode ever uh at the finding peaks talk show and we look forward to uh next week's episode and we'll see you all soon

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Episode 1 The Courageous Phone Call Watch Now https://youtu.be/J2oFOFr23IU Listen Now Episode 1 We explore a few topics we frequently discuss with families during those first initial phone calls to our addiction treatment center.

Topics:

Families asking for a specific length of stay treatment (30,45,60, or 90-day treatment program).
Families forwardly expressing the mental health disorders their loved one has been diagnosed with.
Families or individuals stating their prior treatment location or program didn't work.

Select Quotes It's becoming increasingly common knowledge that going somewhere for 28 days and then going back out to the same environment, doesn't tend to work very well. However, allowing someone to start at a high level of care and working their way down to lower levels of care usually can provide a longer length of support and accountability for an individual. Jason Friesema MA, LPC, LAC, - Clinical Specialist and Therapist I believe the idea of substance abuse or addiction somehow being different than a mental health diagnosis is the first fallacy. We should explain to families that addiction is a mental health diagnosis; they are one and the same. To be able to say that we are going to start working on one and not the other is not accurate. The whole person is what we start with. We are going to meet the person where they are and that's where we know where to go. Clinton Nicholson, MA, LPC, NCC - Clinical Operations Specialist Episode Transcripts Episode 1 Transcript Peaks Recovery Centers here in colorado springs colorado and i'm joined today by my two fellow colleagues jason friesema one of the therapists in our program and additionally clint nicholson also a therapist within our programming so hopefully to bring your two brilliant clinical minds together to help answer some of these questions that i have top of mind today so thanks for being here glad to be thank you for having us yeah yeah we all know i forced you guys to be here you can do that yeah give the capacity as the chief executive officer okay yeah all right i feel good about this stuff so far it's good yeah so recently i've had the opportunity to join the admissions department to support them as we've built additional team members or added team members to the team in that regard and so i've been able to engage in front-end phone calls coming into peak's recovery centers and one of the things that um i'm just fascinated by and answering these phone calls is that the phone calls aren't generally addressing major issues on the forefront of treatment you know that my son's suffering from addiction or these sorts of things it's it's often i'm looking for treatment that lasts for 90 days or 60 days or 45 days or that doesn't mean a whole lot in my experience in working in addiction treatment and sort of just curious from that clinical lens what that means to you all or maybe what is trying to be expressed in that moment okay good question i mean i might i suspect people are trying to express that they're desperate for help and as much help as they can get and certainly in addiction treatment i think it's been pretty well demonstrated that the longer somebody is in some form of care some level of care the more likely they are to remain sober for the long term now that doesn't mean that people need to be in say a detox level of care for 60 days or 90 days or even residential level of care but i do i do think i think what parents are asking for is like this is i think they're saying this is really bad and we need a lot of help that's my guess i i agree with that i also think it speaks to the um the sort of lack of understanding and knowledge about what actual addiction treatment is you know these ideas that you know the fact that they're hanging on to time frame rather than to a con to content or to actual programming just i think it does it comes from a place of fear but it also comes from a place of just not understanding and a sort of lack of education generally speaking about what what we do in addiction treatment and what that actual sort of programming looks like for their loved one so i think it kind of speaks to both of those sides yeah well i think brandon we've talked before like the 28 day model it's not like that was a clinically based length of stay for residential care that was fairly arbitrary designation for a treatment episode if you will and certainly i think it's becoming increasingly common knowledge that just going somewhere for 28 days and then going back out to the same environment that doesn't tend to work very well however um allowing somebody to kind of start at a high level of care and then work their way down to lowers levels of care usually can provide kind of a longer length of support and accountability for individuals i mean i think that's those steps of care though like that's we have access to that information and that knowledge because we're part of the industry i think for families though it's just this yeah we know that 28 days doesn't work so well that means you know if it's 90 days you know where there's that much more opportunity for whatever is going on to work but there's still this idea of i will send my loved one off to this sort of this this magical space where they will get healed and they will come back the person that i remember them or the person that i want them to be or the person that they want to be the reality is that that's just that's not what the process looks like you know there is this sort of um uh these these sort of levels of intensity and this sort of gradual building back into the community that a person has to go through while they're in the treatment process and the reality is that 28 days that's really just a pretty long detox right like it but it's the recovery hasn't even truly begun at that point it's really um at that point it's just a matter of i'm not using substances in this moment but i haven't actually started a recovery program yeah and certainly in our experiences working within addiction treatment you know one of the things that comes to the phone next is this array or a history of of this array of diagnoses my son or daughter suffers from severe alcoholism and major depressive disorder and type 2 by you know bipolar disorder um the nature of addiction is itself is quite complex but then it has all of these mental health components alongside of it so what can we tell families you know maybe about the order are we starting with substance use disorder first those craving states first before we can even peel into depressive states um or working on those mental health states but what can we tell families in that regard about the order of that process and the most efficacious approach to you know sort of calming those diagnoses concerns over what is a fairly short episode within treatment so for example one of the things i think we've talked about at least at some point you know cognitive behavioral therapy as a practice in the direction of curing a major depressive episode and the evidence of it it can actually do a lot of good over a period of three to four months but johnny's only interested in treatment for 30 days and we need three to four months just for the major depressive disorder but he has this severe addiction on top of it um it seems wildly inappropriate to think that we can resolve all of that within these limited time frames even a so where do we start i mean that's a great question and obviously there there tends to be at times with a fair amount of people there needs to be some sort of medical evaluation and intervention uh with with medication i am always a little bit suspect when people walk in with not suspect that's the wrong word but when people walk in with kind of a laundry list of diagnoses you know to me as a as a counselor and just how my brain works i kind of set that aside and then i just try to meet the person where they are and and often times sets if you will are adjusted even just weeks into a treatment episode because either new things emerge or the the mood dysregulation was in a large part due to the substance misuse and or vice versa or other issues that begin to pop up now that the the effects from the drugs are wearing off and and you know really i think i i think your question too is like how do we address these things with families other and i think it's learning about an entire client or per person i want to say actually learning who they are and what is driving the addiction and mental health stuff with with the background of our clinical knowledge that some of these things are probably going to require medication some of these things can be dealt with in therapy and then some of these things some of these symptoms and traits might even resolve themselves just with some sobriety and healthy nutrition and and good sleep hygiene well i'm going to take this a slightly different direction i think we do yes we do yes i think the idea of um as of substance abuse um or addiction somehow being different than a mental health diagnosis is the first fallacy yeah so really actually starting there and explaining to families that you know addiction is a mental health diagnosis like they are one and the same to be able to to say that we're going to start working on this one but not this one is not actually real like you're the whole person is what we start with like like jason mentioned you're gonna meet the person where they are and then that's where we just that's how that's where we know we're going to go um so really i think educating uh you know families in particular as far as like look there is no real difference between these two types of treatment and i think the industry is kind of uh over time has sort of wisened up to that that the the way that we treat um besides pharmacologically the way that we treat addiction from a behavioral health component and the way that we treat mental health from a behavioral health component are really similar there's not nearly as much distinction as we thought at the same time it doesn't change the fact that in 28 days we're only going to be able to get so far in 90 days we're only going to be able to get so far and i think it actually helps to frame in um in a more realistic pers um more realistic terms this idea that you just like you can't cure or get rid of depression in 90 days the same is true for addiction so i actually think by drawing those two more closely together it helps to sort of get rid of some of the i don't know the myths that have come up regarding what addiction is what addiction treatment look like looks like the time frames that that exists in so well i think to your point in in those first few weeks or even couple months i think a fair amount of the work is about helping people get some symptom relief and then truthfully i'll just be the the therapist here like give them some hope that like things are progressing and there's a way to keep progressing and there's there's a way to continue to experience greater relief and greater adjustment to life and and more and more ability to function or more ability to connect with others or or more ability to well just feel comfortable in one's own skin and so i just i think it's such a it's such a process and and and these diagnosis sets in and diagnosis sets aren't even perfect like they're they're the best description we have and there's overlap and there's uh differential diagnosis and how do we distinguish all of that and that in good diagnostic work is important but it isn't um complete it's not a complete picture of a person absolutely yeah so you know for the sake of uh time for this show maybe we can only cover three bullet points today but one of the major things that i you know heard a lot in my time being back on the admissions line was that you know johnny or sally's past treatment episode it didn't work um and the frustration about that and it seems like behind the veil there's you know some sort of excusatory lens going on for a different episode but at the same time what do you hear as clinicians when you hear you know the clients now in front of you you know for the first time walking you through sort of what has brought them to peak's recovery and then they say something like the last treatment center didn't work for me yeah and i think i used to really maintain a very similar mindset to that and i the more i do this work the more i really sense that what is didn't work what does that mean actually a lot of people who have been to six seven eight treatment they actually have a lot of knowledge right they actually i sometimes even joke that they could probably even facilitate groups or do an education on something and oftentimes i'll ask them to do that so it isn't like it it didn't work like there's some knowledge in there but there's there's just a component either missing um because that's a little bit of maybe even some shaming talk that something didn't work i i've never seen somebody that's gone through a couple rehabs that can't at least have a little that hope that i was just talking about that that's like okay i got i got some traction but something fell apart or like i just need a little more help to figure out what happened yeah i i agree with part of what you said as far as what i hear is there's a an expectation that wasn't met not that a treatment didn't work but there was an expectation that wasn't met in treatment um again i think that there's this idea that the treatment is the is the actual recovery like the actual programming is what's going to bring the change and it's not like the it's just um it's the spark right that's all it is but if there's no kindling there then it's there's no fire who's gonna start you know and we end up uh and then i guess you just need to blowing a lot of smoke right so i think that with clients who have done have been through this process over and over again and with families who have this idea or this perception of things not working a great place to start is what is your expectation for treatment and us being really clear about what we are offering and what we are doing and what what these outcomes are actually going to look like rather than sort of i don't know kind of feeding into this idea that again we're going to be able to sprinkle some magic recovery powder and and people will leave ready to go you know right yeah and so you know for me in closing it's a it's a reality that we have to have this time extension within treatment it takes a long time to quell those craving states i think the you know studies point out a 50 reduction in relapse after year one in uh 85 chance of success after year two and by year five i think it's less than five percent chance that you're relapsing in the process so but we don't have five years in addiction treatment nor is you know united healthcare as a as a payer gonna pay for things like that and so there's a lot of challenges to get from day one today you know to year five in that regard so to me it sounds like one of the most important features of addiction treatment for anybody who calls and says 30 60 90 days whatsoever it's not just about day 90 it's on what is now taking place on day 91 has to have this intentionality about it but at the same time it's complex because it feels that patients pull the you know the parachute core day 30 and feel like they got it and then don't do any of the work thereafter so you know kind of in closing here what can we you know maybe insist upon or share with families about uh about these time frames and to really put intentionality into thinking about this in much longer terms and then creating expectations about what we can do in 30 days but what the expectation will look like you know a couple years from now so what sorry what do we tell them in that regard how do we yeah how do we frame that to families exactly i think well a learning how to set measured expectations uh um and to me some of that language too is around how do we how do we help families well meet meet their loved one where they are too and and then to me you know it's it's our job at peaks it's our job to provide our care and then all the time when i'm meeting with clients i'm thinking about what how do i help empower our case management team to make sure that as the client transitions from one system and into the next system that that's seamless and uh robust enough to to help people maintain their uh sobriety from substances and any big relapses in mental health so i think just helping to cast a vision of the next couple steps and that it's going to take work like this doesn't it just doesn't go away uh even with sobriety like this this does have take some work yeah i think i actually speak to something that you had mentioned a little bit earlier jason this idea of the tiered levels of care and and actually educating families on what that is you know that recovery is a process you know treatment is a process and this is what the process looks like and at this moment you're here in the process and after after you're done with our program which is this 30-45 day program then you will be here in the pro in the process and then after that you'll be here in the process so really um breaking it down into realistic terms into and what the reality of recovery looks like you know that it's not um you know it's not just hope right there's a combination of hope and uh life skills and behavior and community and um and there's all of these different levels of intensity and so really uh really driving that home that this is especially when they're at peaks they're at the beginning of the process not at the end of the process and i think a lot of families are so exhausted by the time they even get to the starting uh get to the starting line that they're just praying that it's the end but being able for us to really educate and provide them with the level of support that says hey no you we're actually at the beginning you know so but we we're to tell you we're going to help you see what that end looks like and we're going to help your loved one get to that process but right now this is where we are absolutely well for a first time show here i feel like that was a rather successful discussion certainly entry level and i'm sure we could expand on this for hours but i appreciate everybody joining us today and it's our intention moving forward out of this beta phase to really explore topics and ideas within addiction treatment and bring that education to families and their loved ones as they you know seek addiction treatment or mental health services and so on behalf of peaks recovery centers and my colleagues here clinton and jason wish you all well and signing off

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