*Fast forward past 5 minute prep time to watch episode

We venture down some of the elements that clinical teams come across as they provide quality addiction treatment.

Topics:

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