WEBVTT
00:00:00.160 -->
00:00:10.080Today we are talking about one of the most frightening and overwhelming situations a family can face, which is what to do when weekly therapy just isn't enough anymore.
00:00:10.400 -->
00:00:18.079A client or a client's child or a spouse may need a higher level of care than I can provide in my office once a week.
00:00:18.239 -->
00:00:32.000And suddenly a family is standing in front of this giant, confusing wall of options, and they have no idea which door to walk through, how to pay for it, whether the place is any good, or whether they're about to make the biggest mistake of their lives.
00:00:32.640 -->
00:00:34.479Here is what I have come to believe.
00:00:34.719 -->
00:00:42.560It is almost impossible to find the right place for someone you love if you do not have someone like my guest today in your corner.
00:00:42.880 -->
00:00:53.280I genuinely believe that Larissa is one of the missing pieces in helping some of our clients get a loved one placed when they need more care than any of us can give them.
00:00:53.759 -->
00:01:03.759She is a person who knows the landscape, who has walked through these programs, and who can help a terrified family find the right fit instead of just the first available bed.
00:01:03.920 -->
00:01:13.680If you are a clinician who has ever felt stuck at that wall, or a parent laying awake wondering where on earth to turn to, this episode is for you.
00:01:13.840 -->
00:01:15.359Let's get started.
00:01:26.799 -->
00:01:30.640Welcome to the Mitting Feed, Cracking Therapy for Applicator.
00:01:31.359 -->
00:01:35.680I'm your host, Colleen Boost, and I'm a licensed professional counsellor.
00:01:36.079 -->
00:01:38.159Today I have Larissa Klein with me.
00:01:38.239 -->
00:01:42.560She's a counsellor and also a treatment placement specialist.
00:01:42.719 -->
00:01:48.799Her whole job is helping families and clinicians navigate the higher levels of mental health and addiction care.
00:01:49.120 -->
00:01:59.840She works with a national team that provides free personalized treatment, guidance, and referrals for people dealing with mental health concerns, substance use, eating disorders, and trauma.
00:02:00.079 -->
00:02:09.680She has years of experience in behavioral health care, and what I love about her work is that she has personally visited and vetted these programs.
00:02:09.919 -->
00:02:11.360She is not guessing.
00:02:11.520 -->
00:02:14.080She is an expert and she knows what she's doing.
00:02:14.400 -->
00:02:15.439Aurosa, welcome.
00:02:15.759 -->
00:02:16.800Thank you, Halloween.
00:02:16.879 -->
00:02:17.840It's so nice to meet you.
00:02:18.080 -->
00:02:19.199I love having you.
00:02:19.360 -->
00:02:20.000Yeah.
00:02:20.319 -->
00:02:25.919Well, uh, can you describe in plain language what a treatment placement specialist actually does?
00:02:26.080 -->
00:02:30.240Uh, and where do you come into the story for a shrugging family?
00:02:30.319 -->
00:02:31.439Just sort of out of you.
00:02:31.680 -->
00:02:32.719Yeah, absolutely.
00:02:32.960 -->
00:02:42.400The way that I came into becoming a treatment placement specialist is really kind of a calling in my life, I think.
00:02:42.879 -->
00:02:52.319Um over the last 20 years, I've focused on mental health, behavioral health, psychology, the brain, why we do the things we do.
00:02:52.479 -->
00:02:56.800Yeah, you know, that was always a question when I was going into school, you know.
00:02:57.439 -->
00:03:05.759Um, things kind of went a little sideways when I was quite young and I wanted to kind of get into the business realm.
00:03:06.080 -->
00:03:06.400Okay.
00:03:06.719 -->
00:03:16.400So I went into community outreach and business development after I graduated instead of going directly into practice or working as a therapist in a clinic.
00:03:16.639 -->
00:03:16.879Okay.
00:03:17.680 -->
00:03:18.560And I loved it.
00:03:18.719 -->
00:03:22.560I mean, it was like an immediate, this could be a career.
00:03:22.719 -->
00:03:27.360I remember sitting in an office similar to this with a group of people.
00:03:27.520 -->
00:03:31.120I had a team and I like loved it.
00:03:31.599 -->
00:03:33.360You know, I was like, this is so fun.
00:03:34.159 -->
00:03:40.800And you know who I am now, but so I got got to like fulfill the role and the dream of being a businesswoman too.
00:03:40.960 -->
00:03:41.520Oh wow.
00:03:41.680 -->
00:03:43.680So that was a big piece of this too.
00:03:43.919 -->
00:03:46.960Business and counseling that actually do go well together, don't they?
00:03:47.199 -->
00:03:47.599Yeah.
00:03:47.840 -->
00:03:48.159Yeah.
00:03:48.240 -->
00:03:56.319I mean, you have to have some some understanding of how to run your business and then how to get clients, and then what happens when you get the clients.
00:03:56.639 -->
00:03:59.120So there's a clinical aspect and a business aspect.
00:03:59.199 -->
00:04:10.960And I really went down the business development role and working within behavioral health hospitals is where I've spent the majority of my time, you know, uh, you know, help helping people in that way.
00:04:11.120 -->
00:04:17.199So when I found out about the treatment placement specialist role, I was like, hmm, this is kind of interesting.
00:04:18.000 -->
00:04:22.959Uh and I I pursued that and it was really fun to learn more about it.
00:04:23.279 -->
00:04:29.120I am employed by an organization, and I will say through the whole podcast, these are all my views.
00:04:29.199 -->
00:04:31.360These are not the views of my employer.
00:04:31.680 -->
00:04:35.279People can probably find out who I work for just by searching.
00:04:35.519 -->
00:04:40.079So I just want to put that disclaimer out there to protect both them and myself.
00:04:40.319 -->
00:04:40.800Absolutely.
00:04:41.040 -->
00:04:46.000And just so everyone knows that we're, you know, we're gonna maintain all HIPAA compliant.
00:04:46.639 -->
00:04:57.759Yeah, um, I specifically wanted you on here because um I know the first time I heard about you, you came to um have a little chat with us here at our group at Wakewing.
00:04:58.000 -->
00:04:59.439And I was like, what?
00:04:59.519 -->
00:05:00.319You do what?
00:05:00.560 -->
00:05:14.480There is somebody that can do that because it is so hard as therapist to try and navigate that, just getting into, I mean, even with the internet, even with AI, it is so difficult to help and figure this out with this, right?
00:05:14.560 -->
00:05:18.399And you're really still just taking a chance, you still don't know where they're going.
00:05:18.560 -->
00:05:22.720And definitely has happened to me in the past where I hoped the place was good.
00:05:22.800 -->
00:05:24.240I heard some good things about it.
00:05:24.319 -->
00:05:25.519I don't really know.
00:05:25.680 -->
00:05:31.439Uh, and I tell the clients, I really don't know myself, but I guess try it and it was horrible experiences, you know.
00:05:31.519 -->
00:05:41.040Yeah, so it's definitely, I feel so much more confident having you in my back pocket and I can just like pick up the phone and be Larissa, can you help me place this person?
00:05:41.120 -->
00:05:42.560Because I care about my clients.
00:05:42.720 -->
00:05:44.959I want them to land in a good place.
00:05:45.199 -->
00:05:51.360Yeah, I mean, we get into this role and we realize that we're helping people, we want to continue to help them.
00:05:51.519 -->
00:05:52.639We do not want to harm.
00:05:52.800 -->
00:05:53.439No, right?
00:05:53.519 -->
00:05:54.879That is not our nature.
00:05:55.120 -->
00:06:00.879No, and when that happens or if that happens, it it does happen, you know, unfortunately.
00:06:01.120 -->
00:06:05.839Um, we want we want to either a make it better or prevent it from happening again.
00:06:06.399 -->
00:06:18.240You know, I also really encourage all my therapists, the people that I work with, uh, that are the professionals in the room to visit programming and services that are that they're referring to.
00:06:18.399 -->
00:06:19.600How do they operate?
00:06:19.839 -->
00:06:25.680And that builds the relationship and it also builds trust and rapport.
00:06:26.000 -->
00:06:41.120And as a therapist, if you have a client that needs to step up to a higher level of care, wouldn't you like to know what the environment is, what the licensure is, how they interact with each other and what kind of experience they bring to the table.
00:06:41.360 -->
00:06:43.519And just I think me and you are going on a road trip.
00:06:43.600 -->
00:06:45.920Yeah, because I want to see more of these places.
00:06:46.240 -->
00:07:00.720Yeah, and most programs that are very well run and have a great reputation uh have professional immersion weekends or days that you can go and do and participate in.
00:07:00.959 -->
00:07:04.720Yeah, no, I didn't even think that that's probably a possibility, right?
00:07:04.879 -->
00:07:13.040And something maybe for other therapists to know as well is like um to reach out to Larissa and see if you really want to go see places and you can maybe look them up, you know.
00:07:13.199 -->
00:07:14.399Yeah, yeah, wow.
00:07:14.720 -->
00:07:18.720You can just maybe walk us through the different levels of care.
00:07:18.800 -->
00:07:26.800And you know, for someone who's never had to think about this, that was fascinating to me because I thought I knew a lot about this, but turns out I didn't.
00:07:27.040 -->
00:07:31.680And um, so what is the difference between, you know, IOP, PHP, all this stuff.
00:07:31.759 -->
00:07:33.120Yeah, um, all the acronyms.
00:07:33.279 -->
00:07:34.399Yes, all the acronyms.
00:07:34.560 -->
00:07:37.519If you can just sort of in a nutshell tell us what that's all about.
00:07:37.759 -->
00:07:38.639Sure, sure.
00:07:38.879 -->
00:07:50.399Yeah, so there is a level system within behavioral health, and there are in medical systems, there are tools that we use, there are labels that we put on spaces, right?
00:07:50.560 -->
00:07:52.000And that's kind of how we do treatment.
00:07:52.160 -->
00:07:52.639Okay, right.
00:07:52.720 -->
00:07:53.360Yeah, that's sure.
00:07:53.759 -->
00:07:56.560We create a treatment plan and we follow that plan, right?
00:07:56.720 -->
00:07:58.879And like I said earlier, it's good to have a plan.
00:07:59.120 -->
00:07:59.600Yes, yeah.
00:07:59.920 -->
00:08:00.560That's very good.
00:08:00.879 -->
00:08:13.920So in in this realm, um, I'll say it not everybody fits the criteria, and the criteria comes from a a need that the system had you know many years ago.
00:08:14.319 -->
00:08:18.000I'm talking decades ago, um, when there was abuse.
00:08:18.160 -->
00:08:20.319This was you know very early on.
00:08:20.560 -->
00:08:26.399Yeah, there were lots of things happening um where people were staying in facilities for months and months and months, right?
00:08:27.040 -->
00:08:32.720So the level system kind of came into play to help identify how to do this better.
00:08:32.960 -->
00:08:39.600And I think, you know, as a as a culture, as a society, we do try to get better by educating ourselves.
00:08:40.000 -->
00:08:50.879So I will place that as a caveat of this level system and this, you know, when we when we talk about levels, not everyone fits in these levels, right?
00:08:51.039 -->
00:09:01.440Yeah, the way that I would explain and answer that question is that there are a couple of levels that we lean into for both mental health and addiction, right?
00:09:02.080 -->
00:09:09.840So the mental health programming and services and levels of care um are come from the level of care utilization system.
00:09:10.159 -->
00:09:20.480And that really looks at the risk of harm, what's happening with their psychiatric symptoms, you know, based on their diagnoses, their medications, all of those things.
00:09:20.879 -->
00:09:24.879And then there's like recovery support, all of those things.
00:09:25.120 -->
00:09:29.120That's the level of care utilization system or locus or addiction.
00:09:29.360 -->
00:09:34.799We use the American Society of Addiction Medicine or ASAM criteria, yeah, right.
00:09:34.960 -->
00:09:37.120And so some people may have heard about this.
00:09:37.279 -->
00:09:42.159Of course, if we're if if the audience here is a clinician, this is all rudimentary for you.
00:09:42.399 -->
00:09:48.399But at the different levels of care are kind of dictated by these systems, right?
00:09:48.480 -->
00:09:59.759So the ASAM criteria has level four, which is inpatient, then level three, which is residential, level two, which is uh intensive outpatient or high intensity intensive outpatient.
00:09:59.919 -->
00:10:00.159Okay.
00:10:00.559 -->
00:10:05.759And then level one is outpatient, and then there's uh residence recovery, which is RR.
00:10:05.919 -->
00:10:06.240Okay.
00:10:06.480 -->
00:10:08.080So those are the two differences.
00:10:08.159 -->
00:10:11.360You know, mental health has one and and then addiction has one.
00:10:11.519 -->
00:10:11.840Okay.
00:10:12.320 -->
00:10:20.879And then for a residential level of care, um, that's a that's that's the primary realm that I work in.
00:10:21.120 -->
00:10:27.200So that's very well, it's it's very hard to a lot of folks feel like, oh, I know about residential programs.
00:10:27.600 -->
00:10:32.399But we get inpatient residential intertwined with the terminology with clients.
00:10:32.559 -->
00:10:37.840That's what I find the most difficult to entwine, unravel with clients.
00:10:37.919 -->
00:10:38.080Okay.
00:10:38.399 -->
00:10:45.759Inpatient acute care behavioral health is very different than a residential treatment center.
00:10:46.080 -->
00:10:46.399Okay.
00:10:47.200 -->
00:10:48.240Inpatient, yeah.
00:10:48.320 -->
00:10:53.039So inpatient treatment is is really because there's a risk of harm.
00:10:53.360 -->
00:11:03.279The criteria for an inpatient behavioral health hospital is a client that is suicidal with an intent plan and means to carry out the plan.
00:11:04.559 -->
00:11:08.720Or homicidal, yes, meaning that they're going to hurt someone else.
00:11:08.799 -->
00:11:12.799Yeah, they have means, they have intent, they're going to do this.
00:11:12.960 -->
00:11:13.440Yes.
00:11:13.600 -->
00:11:16.960Um, there's or there's a very real possibility that they could do it.
00:11:18.000 -->
00:11:21.200And then there's also gradually disabled functioning.
00:11:21.679 -->
00:11:22.000Okay.
00:11:22.159 -->
00:11:25.039Okay, so those are the three main criteria for inpatient.
00:11:25.200 -->
00:11:25.600All right.
00:11:25.919 -->
00:11:34.480And what happens is clients will admit into those programs for psychosis as well as suicidal ideation most often.
00:11:34.799 -->
00:11:39.679And then very regularly, but not quite as often as the homicidal ideation piece.
00:11:39.840 -->
00:11:40.000Okay.
00:11:40.159 -->
00:11:40.480Okay.
00:11:41.039 -->
00:11:44.399And there are two different ways to go to those programs.
00:11:44.559 -->
00:11:48.080There's a way to go voluntarily and there's a way to go involuntarily.
00:11:48.159 -->
00:11:48.639Yes, right.
00:11:50.559 -->
00:11:55.200So the legal system has place, you know, pieces in place in each state.
00:11:55.440 -->
00:11:55.759Yes.
00:11:55.919 -->
00:11:57.919In different states, we have we have them different.
00:11:58.159 -->
00:12:04.000So the states regulate your mental health capabilities and rights individually.
00:12:04.240 -->
00:12:04.559Okay.
00:12:04.720 -->
00:12:05.039Okay.
00:12:05.360 -->
00:12:06.799So that's inpatient.
00:12:06.960 -->
00:12:10.639And that's what a lot of people get muddied in with residential treatment.
00:12:10.879 -->
00:12:13.200Residential treatment centers are voluntary.
00:12:13.360 -->
00:12:16.480At a residential treatment center, you can leave whenever you want to leave.
00:12:17.519 -->
00:12:19.279You don't have to stay there.
00:12:19.600 -->
00:12:21.360Very important information, I think.
00:12:21.440 -->
00:12:21.679Yeah.
00:12:21.759 -->
00:12:22.000Yeah.
00:12:22.240 -->
00:12:29.120The only difference is that, you know, if you've endorsed that you're going to hurt someone or yourself, then that becomes a level one crisis stabilization.
00:12:29.360 -->
00:12:31.039It just goes to your patient automatically.
00:12:31.360 -->
00:12:31.519Right.
00:12:31.840 -->
00:12:32.000Yeah.
00:12:32.240 -->
00:12:41.919So with the residential treatment center, I always try to tell my clients and inform them that a residential level of care is really where you have a lot of agency.
00:12:42.080 -->
00:12:48.720There are safety protocols, and that is regulated by various organizations in our country.
00:12:49.039 -->
00:12:53.039Um, and they adhere to those regulations for those services, right?
00:12:53.279 -->
00:12:53.600Yeah.
00:12:53.840 -->
00:12:57.039And so they have a regulation piece in place.
00:12:57.360 -->
00:13:04.720So if you want to take insurance, you have to get Joint Commission accredited or CARF accredited if you're a residential treatment center in in many cases.
00:13:04.879 -->
00:13:08.240If you don't need or want to take insurance, then you don't have to do that.
00:13:08.480 -->
00:13:17.519And so there are pieces in place at programs and services at the residential level of care that keep people safe, but they also give them a lot more autonomy.
00:13:18.000 -->
00:13:22.559So I tell people all the time, this is kind of you're in the driver's seat here.
00:13:22.720 -->
00:13:27.279If they've been in an inpatient setting, they don't have a lot of autonomy or agency.
00:13:27.360 -->
00:13:30.399They can't leave a room or a space on their own.
00:13:30.559 -->
00:13:30.879Yes.
00:13:31.039 -->
00:13:31.360Right?
00:13:31.600 -->
00:13:35.840And that can feel very confining and trapped, even trapped.
00:13:35.919 -->
00:13:36.080Yeah.
00:13:36.320 -->
00:13:38.639And trauma and trapped do not mix.
00:13:38.879 -->
00:13:40.159No, they do not.
00:13:40.480 -->
00:13:40.799Yeah.
00:13:41.679 -->
00:13:47.919So residential treatment is a phenomenal level of care that can be incredibly helpful for so many people.
00:13:48.159 -->
00:13:59.440Typically, residential has group therapy, both process and psychoeducation groups, as well as now experiential groups, like equine assisted therapy or a ropes course.
00:13:59.679 -->
00:14:07.840What happens usually at the beginning of their stay is there's an evaluation completed, and then there's a treatment plan put together with their input.
00:14:08.000 -->
00:14:11.360At some of these programs, there are psychological testing that's offered.
00:14:11.519 -->
00:14:14.799And I'm really leaning into the mental health side in my brain right now.
00:14:14.879 -->
00:14:16.720So I just want to put that caveat out there.
00:14:16.879 -->
00:14:29.759If it's an addiction piece, you know, there are signs all over programs and services that are encouraging and help people realize like miracles do happen in treatment.
00:14:30.799 -->
00:14:33.039Aha moments happen in treatment.
00:14:33.279 -->
00:14:34.240I can see that.
00:14:34.399 -->
00:14:40.639It is a moment in time where you're taken away from all the things that distract all the craziness that's being part of your struggle.
00:14:40.799 -->
00:14:41.200Exactly.
00:14:41.360 -->
00:14:47.440And it's uncomfortable for people with addiction and mental health, uh, mental disorders, is to to sit.
00:14:47.600 -->
00:14:51.200They're mostly running from that thing, and the running makes it worse.
00:14:51.440 -->
00:14:57.919So having a moment in time at a place like that where the focus is on what's happening with you is actually pretty amazing.
00:14:58.080 -->
00:15:01.759I can see that they could be huge epiphanies and breakthroughs at a place like that.
00:15:01.840 -->
00:15:02.080Yeah.
00:15:02.320 -->
00:15:03.600That's kind of the goal.
00:15:03.759 -->
00:15:06.799Yeah, that's why we would recommend this for a client.
00:15:07.759 -->
00:15:14.960Is you know, if you're in an individual session with your therapist once weekly or twice monthly, right?
00:15:15.200 -->
00:15:19.759Bi-weekly, and you have some aha moments, triple that.
00:15:19.919 -->
00:15:23.440And wouldn't it be awesome if we just had a retreat center that we could go to?
00:15:23.840 -->
00:15:25.279Well, those exist too.
00:15:25.600 -->
00:15:27.200Retreat centers exist as well.
00:15:27.279 -->
00:15:28.159Yeah, they do.
00:15:28.320 -->
00:15:28.799Absolutely.
00:15:29.200 -->
00:15:30.000Tell me more about that.
00:15:30.240 -->
00:15:30.559Yeah.
00:15:30.799 -->
00:15:32.879Well, I just found out about one actually.
00:15:33.039 -->
00:15:36.559Um, that you know, you can go for a weekend and do an intensive.
00:15:36.879 -->
00:15:45.360I don't know very much about some of the retreat centers that um that are available because it's not really what I work in, but I just recently found out that we can do that.
00:15:45.519 -->
00:15:46.080Oh wow.
00:15:46.240 -->
00:15:52.240Now those aren't, you know, they may not have trained therapists at the level that a residential program has, though.
00:15:52.399 -->
00:15:52.639Yeah.
00:15:52.799 -->
00:15:56.639So so residential is always professional people.
00:15:57.200 -->
00:16:01.679Yes, you you would be seeing licensed psychiatrists.
00:16:02.000 -->
00:16:12.159You'd see a licensed medical practitioner, um, both on the pharmaceutical side and also the integrative medicine side, too, right?
00:16:12.240 -->
00:16:17.519In some programs, um, like natural medicine chiropractors, massage therapists.
00:16:17.679 -->
00:16:17.919Yes.
00:16:18.639 -->
00:16:18.879Yeah.
00:16:19.120 -->
00:16:24.960So at a residential level of care, like I said, there's individual therapy, group therapy, experiential therapy that's happening.
00:16:25.039 -->
00:16:27.519There are some integrative practices that can happen.
00:16:27.840 -->
00:16:30.240Sound baths are now a thing, yoga is a thing.
00:16:30.559 -->
00:16:33.679But then there's also the amenities that you get in residential treatment too.
00:16:33.919 -->
00:16:34.159Okay.
00:16:34.399 -->
00:16:40.159Olympic-sized swimming pools, you know, hot tubs, ropes, courses.
00:16:40.639 -->
00:16:45.679Um, you know, they might use goats for their therapy instead of horses.
00:16:45.840 -->
00:16:46.240Who knows?
00:16:46.320 -->
00:16:48.480But yeah, those are some pieces of something.
00:16:48.639 -->
00:16:54.320Yeah, honeys, yeah, you know, having animals around, using music, using the arts.
00:16:54.559 -->
00:16:56.320That is a whole so so crucial.
00:16:56.960 -->
00:16:58.399So, so therapeutic.
00:16:58.639 -->
00:16:58.960Yeah.
00:16:59.600 -->
00:17:01.039Um, so those are the things that you can do.
00:17:01.200 -->
00:17:06.720There's also like we don't want to leave out these incredibly important other pieces, which is PHP.
00:17:06.880 -->
00:17:07.200Okay.
00:17:07.599 -->
00:17:10.480Partial hospitalization program is what that stands for.
00:17:10.960 -->
00:17:15.920And that's an intense level of care that's usually around 20 to 25 hours a week.
00:17:16.079 -->
00:17:19.039So if you think about it, that's a part-time job.
00:17:19.200 -->
00:17:20.000Yeah, right.
00:17:20.240 -->
00:17:20.559Really?
00:17:21.039 -->
00:17:25.200So typically people will need to take some time away.
00:17:25.440 -->
00:17:30.799Um, that's typically group therapy, individual therapy, and medication management.
00:17:31.680 -->
00:17:35.200And those exist in our communities and people can go to them.
00:17:35.359 -->
00:17:42.079Sometimes they have to have boarding with those if they're coming out of addiction treatment and they need sober living.
00:17:42.400 -->
00:17:47.759There's something called BPHP now, which is boarded partial hospitalization program.
00:17:48.240 -->
00:17:48.400Okay.
00:17:48.559 -->
00:17:51.359So they have sober living attached to their program.
00:17:51.519 -->
00:17:58.160So they're living in a sober living community or a home, and they're integrating back into life after getting treatment.
00:17:58.240 -->
00:17:59.680That can happen for mental health as well.
00:17:59.759 -->
00:18:02.319There are boarded mental health PHPs as well.
00:18:02.559 -->
00:18:02.960Wow.
00:18:03.279 -->
00:18:13.519And then the intensive outpatient level of care, high-intensity outpatient treatment, is really around nine to ten hours a week.
00:18:14.240 -->
00:18:21.599And those, you know, those programs are people are typically working and seeing their own individual therapists in those levels of care.
00:18:21.680 -->
00:18:27.119They're not now seeing the program doctor, they're seeing their own doctor for their meds.
00:18:27.279 -->
00:18:37.839So they're transitioning away from the supports that was in the PHP and the residential level of care and starting to integrate back into the program, the services that they were receiving before or new services.
00:18:38.079 -->
00:18:38.319Okay.
00:18:38.799 -->
00:18:44.240So I do really endorse everyone is so unique.
00:18:44.400 -->
00:18:55.680So an individualized care plan that meets the needs of your client is what you need to put together with your placement specialists or with your treatment team that you created for this person.
00:18:56.000 -->
00:19:15.279If they are adamant that they cannot and will not sleep somewhere else, getting them to an intensive outpatient program first and helping them recognize the value of that, may it may fix the situation, may get them past this that piece of safety or the needs that they have in that moment.
00:19:15.680 -->
00:19:31.680I can't speak to specific issues, but a hypothetical would be if someone is starting to feel unsafe in in therapy, they're leaving your office and you're feeling a little iffy about how they're doing, get them into an intensive outpatient program.
00:19:32.000 -->
00:19:37.119If they're apps, if you're absolutely concerned about their safety, then they need a higher level of care than that.
00:19:37.519 -->
00:19:39.680So we need to do something quickly, right?
00:19:39.839 -->
00:19:47.920We need to consult, you know, do consultation with your team, and we need to come up with a plan and present it to the client.
00:19:48.400 -->
00:19:51.680This is no longer a safe environment for you to process this.
00:19:51.759 -->
00:20:01.440And the intensive outpatient program can step a client up to an inpatient level of care, a hospital, whatever, um, as well when that is a need.
00:20:01.680 -->
00:20:27.119But the typical, the way that I like to explain this to people is the hospital is for safety, residential is for processing and aha moments in a safe environment with agency, partial hospitalization programming is for reintegrating back into life, and then IOP is you're on your way back to life in a new way, doing life in a new way.
00:20:27.200 -->
00:20:31.039And then outpatient is your continuing care support.
00:20:31.200 -->
00:20:42.480But those levels of care help give us a picture and boundaries and guardrails to help us understand as professionals where a client needs to go and we.
00:20:43.359 -->
00:20:46.799And it's I find it to be helpful.
00:20:46.960 -->
00:20:53.039A lot of people find it that we're putting them in a box and labeling them, and I don't want to do that either.
00:20:53.359 -->
00:21:00.160So I really do want, you know, like I said at the beginning, this is all created because of abuse of the system.
00:21:00.400 -->
00:21:12.240Yes, so but it is it has helped identify levels of care and services that can be very useful and helpful and put a framework around clients to help them get better.
00:21:12.480 -->
00:21:13.599That's what we're going to do.
00:21:13.920 -->
00:21:14.880Absolutely.
00:21:15.119 -->
00:21:21.039Um, yeah, and and speaking of that, you know, getting them there, getting them ready.
00:21:21.279 -->
00:21:26.079Um, maybe they're at one of the stages of change if they're just not not ready.
00:21:26.640 -->
00:21:32.079So um tell us a little bit more about how do you work with therapists to help them get their clients there.
00:21:32.160 -->
00:21:34.079What are some ideas that you have?
00:21:34.400 -->
00:21:34.960Yeah.
00:21:35.279 -->
00:21:43.200So yes, you sent me some of these questions beforehand, and you mentioned the trans theoretical or the stages of changes.
00:21:43.359 -->
00:21:44.400Yeah, the stages of changes.
00:21:44.480 -->
00:21:45.759And yeah, stages of changes.
00:21:46.000 -->
00:21:49.920So I was looking through those, and I've used the terminology quite a bit myself.
00:21:50.000 -->
00:21:53.440Um, of we're kind of in the pre contemplative stage right now.
00:21:53.759 -->
00:21:59.759But to come alongside a therapist and help them support their client through this is.
00:22:00.240 -->
00:22:05.440Is it's an honor to be able to do that for me personally.
00:22:05.920 -->
00:22:12.400So I want to support the the practitioner and helping them present options.
00:22:13.200 -->
00:22:18.400And so what I've done and how I how I've done it is kind of very um organic.
00:22:18.640 -->
00:22:20.319You know, what are you thinking about?
00:22:20.640 -->
00:22:23.920You know, you should you shared with me what's going on with your client.
00:22:24.799 -->
00:22:26.160What are you thinking?
00:22:26.559 -->
00:22:30.400And and then they'll tell me, well, I'm thinking an intensive outpatient level of care.
00:22:30.559 -->
00:22:34.799And a lot of people do that because they're afraid to present the residential level of care.
00:22:35.200 -->
00:22:40.480So coming back to the stages of change, we need to get a plan in place.
00:22:41.519 -->
00:22:46.880And that's where I say there are definitely options to consider.
00:22:47.279 -->
00:22:51.359So I look at three things first and foremost, clinically, what's going on with the client?
00:22:52.000 -->
00:22:54.400Financially, what are what's within their means?
00:22:55.200 -->
00:22:58.720And geographically, where are they willing to go?
00:22:58.880 -->
00:23:00.400Are they willing to travel?
00:23:00.880 -->
00:23:10.480Because in our state, there aren't a lot of options for certain types of treatment, like a residential mental health program.
00:23:12.559 -->
00:23:16.640There can be services through the state that are offered.
00:23:16.960 -->
00:23:21.839So when people come to me and they're, you know, professionals call me.
00:23:22.079 -->
00:23:27.200My first and foremost question is where are they in this space?
00:23:27.599 -->
00:23:29.839Do they want to pursue treatment?
00:23:29.920 -->
00:23:31.039How can we work with them?
00:23:31.279 -->
00:23:33.119Oftentimes they're already to that place.
00:23:33.200 -->
00:23:35.039And so we're we're talking about options.
00:23:35.119 -->
00:23:41.920We're we're running benefits, we're finding out, you know, they have an insurance plan that we work with at this program.
00:23:42.400 -->
00:23:43.359This is the program.
00:23:43.440 -->
00:23:44.960Let me tell you about it.
00:23:45.200 -->
00:23:50.000Um, and this is the benefit of this program, this is how it feels there.
00:23:50.160 -->
00:23:55.839There are programs that do um campus style treatment where it look looks and feels like a college campus.
00:23:56.000 -->
00:23:56.559Oh wow.
00:23:56.720 -->
00:24:01.200And then there are programs that do um treatment within residential settings.
00:24:01.279 -->
00:24:05.599Like you could, you know, you're at a house in a neighborhood.
00:24:05.839 -->
00:24:06.000Okay.
00:24:06.400 -->
00:24:07.680You know, interesting.
00:24:07.839 -->
00:24:08.079Yeah.
00:24:08.240 -->
00:24:10.400There are neighbors around that are not in treatment.
00:24:10.480 -->
00:24:12.079They live in their houses, you know.
00:24:12.240 -->
00:24:13.200That's very interesting.
00:24:13.440 -->
00:24:13.839Yeah.
00:24:14.000 -->
00:24:17.279So and and different states have different rules around those things.
00:24:17.440 -->
00:24:19.920In our state, we have both options.
00:24:20.559 -->
00:24:28.880Um, and it's it is uh, you know, really important that we look at the treatment outcomes at those programs.
00:24:29.039 -->
00:24:33.759It's important that we know the people that are providing services at those programs.
00:24:34.400 -->
00:24:42.079So uh you gold standard best practice would be a residential level care transitions into a partial hospitalization program.
00:24:42.319 -->
00:24:45.519Partial hospitalization transitions into intensive outpatient.
00:24:45.759 -->
00:24:48.720But clients have lives, you know.
00:24:48.960 -->
00:24:51.039Yeah, they want to get back to their lives.
00:24:51.279 -->
00:24:52.400Yeah, it's difficult.
00:24:52.640 -->
00:24:54.559And a lot of them skip those stages.
00:24:54.799 -->
00:24:55.519Oh, yeah.
00:24:55.839 -->
00:24:58.240And then they have to go backwards.
00:24:58.559 -->
00:25:12.559So I really do encourage that when we have these conversations with clients that we tell them not to not to discourage, but to be completely honest and authentic and transparent.
00:25:12.799 -->
00:25:22.000If you're going to a residential level of care, you also need to consider going to the partial hospital and intensive outpatient program afterwards because you're in a bubble in residential care.
00:25:22.240 -->
00:25:23.680Yes, that's the other part of it.
00:25:23.839 -->
00:25:24.000Yeah.
00:25:24.160 -->
00:25:31.519Is it the perfect world to now stay off the you know addictive substance or to really just focus in there?
00:25:31.599 -->
00:25:34.400There's nothing that's challenging you, there's not a lot of dysregulation.
00:25:34.799 -->
00:25:36.880Now you get home and everything's still waiting for you.
00:25:37.039 -->
00:25:37.200Right.
00:25:37.519 -->
00:25:38.400So very important.
00:25:38.559 -->
00:25:39.039Yeah, I think.
00:25:39.279 -->
00:25:50.160Yeah, and some of the things that we have learned about how clients and people react, we need to take that into account in the future if they're going back to programs.
00:25:50.480 -->
00:25:51.759Okay, so I have this question.
00:25:51.920 -->
00:25:56.480Um, you know, let's talk about addiction and comorbid disorders for a second.
00:25:56.640 -->
00:26:06.000Um, the data shows that over 21 million adults have co-occurring mental illness and substance use disorder, and 41% of them receive no treatment at all.
00:26:06.160 -->
00:26:12.880On top of that, 53% of people with illicit substance use disorder also carry a psychiatric diagnosis.
00:26:13.039 -->
00:26:15.839Um, the dropout numbers are staggering.
00:26:16.000 -->
00:26:24.400Roughly 30% drop out of psychosocial addiction treatment, and during detox specifically dropout can be as high as 43%.
00:26:25.440 -->
00:26:27.759So, can you talk a little bit more about that?
00:26:28.240 -->
00:26:29.680Yeah, absolutely.
00:26:30.079 -->
00:26:37.039It's so important to incorporate mental health care into addiction treatment.
00:26:37.519 -->
00:26:38.240I believe that.
00:26:38.480 -->
00:26:40.799And a lot of programs do that now.
00:26:41.119 -->
00:26:42.240Oh, it's okay.
00:26:42.480 -->
00:26:43.680It's very standard now.
00:26:43.920 -->
00:26:45.599Okay, that's good to know.
00:26:46.079 -->
00:26:56.240So for a detox center specifically, they're doing a either level 3.7 or 4 in the ASAM scale.
00:26:56.400 -->
00:27:10.640Um, if they're doing a withdrawal management program that's medically managed or medically monitored, then that's typically somewhat, they're either doing it in a hospital or they're doing it at a residential or a detox program that's that's licensed for that.
00:27:11.759 -->
00:27:24.240So in withdrawal management, when you're finished with detox and you move into a residential level of care, it feels really fluid to go into that type of treatment program, right?
00:27:24.319 -->
00:27:27.440Where they offer detox and they offer residential treatment, right?
00:27:27.759 -->
00:27:28.240Yes.
00:27:28.480 -->
00:27:35.279And they can maintain your medications, they can keep, you know, so it's nice to have that in one space.
00:27:35.839 -->
00:27:42.720If it's not if it's not within the means, there's access barriers because of finances or what have you.
00:27:42.960 -->
00:27:47.680There are a lot of folks that are needing detox who don't have the means.
00:27:47.920 -->
00:27:56.640Yes, mental disorders and addiction and the two together really makes for um a situation where people main chances everything they do, yeah.
00:27:56.799 -->
00:28:01.359Yeah, and it's it's very difficult to navigate those things.
00:28:01.440 -->
00:28:13.759So I'm gonna lean into the fact that there are supports in place because of funding in our state and multiple states around us where you can access care.
00:28:14.160 -->
00:28:27.279And there are you there is withdrawal management and residential available for people on state insurance like Medicaid or the Oregon Health Plan, or Apple Care or uh uh within Washington State.
00:28:28.000 -->
00:28:42.240So what I find being, I'm gonna lean back into uh where my scope is, which is typically a detox and a residential level of care for a client combined.
00:28:42.880 -->
00:28:56.000And what I think um can be very helpful for a client, and we're talking, you know, potentially to therapists here, is really exploring how much they're using and whether or not detox is needed.
00:28:56.880 -->
00:29:08.240And you may not know that, and you can you can consult on that with an addiction professional or addiction medicine doctor, and you can also consult with me, and I have access to those folks, and it's free.
00:29:08.559 -->
00:29:09.200So that's helpful.
00:29:09.359 -->
00:29:09.920That is fair.
00:29:10.240 -->
00:29:12.000Um we can we need to know where they're at.
00:29:12.480 -->
00:29:17.359And we also need to trust the client, but we need to be very skeptical, yes, too.
00:29:17.519 -->
00:29:22.720Yes, because there's shame and stigma attached to substance use.
00:29:22.880 -->
00:29:26.400Yes, so be very aware, you know, being very aware of that.
00:29:26.880 -->
00:29:40.000So at a program that offers behavioral health care for depression, trauma, anxiety, bipolar disorder, maybe there's a thought disorder, maybe there's psychosis.
00:29:40.079 -->
00:29:42.559Yeah, it's really, really helpful.
00:29:42.799 -->
00:29:46.880It's much more uh likely that they won't relapse.
00:29:47.279 -->
00:29:51.920It's much more likely that they'll get into long-term recovery if we have these supports in place.
00:29:52.319 -->
00:30:12.319So at a treatment program, going through detox, then going into residential group therapy, individual therapy, seeing a provider for your meds, and then going to experiential therapy, all of those things combined over a let's say 30 to 45 day period is really the best option for your client.
00:30:12.559 -->
00:30:13.519Yeah, no, for sure.
00:30:14.000 -->
00:30:22.079So they need to go to individual therapy with a substance use counselor, and then you need to go to individual individual therapy with a master's prepared therapist or psychologist.
00:30:22.240 -->
00:30:24.480And that's something that I talk to a lot of clients about.
00:30:24.640 -->
00:30:32.160We've created this new terminology in our field called substance use primary or mental health primary, and that's really because of licensure.
00:30:32.319 -->
00:30:44.160So if you're going to a mental health primary program and you use substances to numb and support because you have trauma, that is uh that is uh definitely doable.
00:30:44.240 -->
00:30:44.720Yeah.
00:30:45.039 -->
00:30:53.359If you are using substances and that's the primary thing that's bothering you and really altering your life, then your substance use primary.
00:30:53.920 -->
00:31:03.200It's very common for you to go into a mental health program or into a substance use program now that has detox and mental health and their substance use primary.
00:31:03.359 -->
00:31:23.279They're doing sound baths, they're doing yoga, they're starting to get into using cognitive behavioral therapy, dialectical behavioral therapy, acceptance and commitment therapy, mindfulness, motivational interviewing, all of these different modalities are now very common in programs and services.
00:31:23.359 -->
00:31:25.039You'll see them on the website, right?
00:31:25.200 -->
00:31:30.799So, and you'll also see that uh their treatment outcomes are listed on the website.
00:31:31.039 -->
00:31:41.920So when you identify a program that seems to be really good, and maybe they have a specialty track now because tons of programs now work specifically with veterans and first responders.
00:31:42.480 -->
00:31:45.359Or maybe they work with professionals.
00:31:49.119 -->
00:31:52.319Doctors, they are therapists, they're in trouble.
00:31:52.480 -->
00:31:55.920They have an addiction and it can cost them the license, right?
00:31:56.160 -->
00:31:57.759I love that there's centers like that.
00:31:57.839 -->
00:32:05.759And I was so happy to find some of those because they hold, they work with the state, they work with the licensing board, they work with everything, right?
00:32:05.920 -->
00:32:07.359And that's super helpful.
00:32:07.680 -->
00:32:08.079It is.
00:32:08.240 -->
00:32:15.119Yeah, I mean, we have a great program locally here that has been in working with licensed professionals for decades.
00:32:15.440 -->
00:32:16.960Healthcare professionals in particular.
00:32:17.279 -->
00:32:17.920Particular.
00:32:18.079 -->
00:32:18.319Okay.
00:32:18.480 -->
00:32:18.720Yeah.
00:32:18.880 -->
00:32:42.000I mean, you can get into statistics and find the DEA has lots and lots of statistics around what happens with healthcare professionals and hospitals, and you're it's it is devastating that we have nurses and doctors and other professionals like pharmacists who have an addiction and they're putting them right back in the candy shop.
00:32:42.160 -->
00:32:42.480Yeah.
00:32:42.720 -->
00:32:43.440Exactly.
00:32:43.759 -->
00:32:53.440I mean, so having the licensed professional monitoring program through the states is incredibly important and helpful.
00:32:53.680 -->
00:32:58.480It is devastating, but it also ultimately brings clients to a new space.
00:32:58.720 -->
00:32:59.039Right.
00:32:59.279 -->
00:33:09.920There's also, you know, when you talk about those licensed professionals programs, um those monitoring boards vet out those programs.
00:33:10.079 -->
00:33:18.079So if you're a therapist working with professionals and you don't know about that type of option, it's very, you know, it is very helpful.
00:33:18.240 -->
00:33:23.440So it can be a great ally for you and support when you're working with with folks.
00:33:23.680 -->
00:33:24.640Yeah, absolutely.
00:33:24.799 -->
00:33:37.119I hope that you know, professionals and clients like listening to this um hear this because there was definitely a time that I had no idea until I had somebody come to me that's a professional and they have an addiction.
00:33:37.279 -->
00:33:39.440And I'm worried, am I supposed to report here?
00:33:39.519 -->
00:33:40.319What's supposed to happen?
00:33:40.400 -->
00:33:47.279And knowing that there's programs like that, knowing this you, Larissa, to pick up the phone and just say, I have this, what do I do with this?
00:33:47.440 -->
00:33:48.319Can you help me out?
00:33:48.559 -->
00:33:51.599Because um we feel overwhelmed sometimes with those kind of things.
00:33:51.680 -->
00:33:55.039If you haven't worked with it before, it's just it's scary.
00:33:55.200 -->
00:34:03.440And um, yes, we can consult with other therapists, but then many times I've seen that they like, I don't know, yeah, I don't know, call an attorney, do this, do that.
00:34:03.599 -->
00:34:05.599Well, maybe we can start with Larissa, right?
00:34:05.680 -->
00:34:07.359And she can help us out with some stuff.
00:34:07.599 -->
00:34:19.440One of the things that I like about being a uh a placement specialist is that I get to hear more and more and more about what people are doing to support the community of recovery.
00:34:19.599 -->
00:34:32.960And just this week I found out that there's someone that started a business who is a career coach and a high-level career coach working with executives that get really high-level jobs, right?
00:34:33.280 -->
00:34:36.639C-suite positions in various industries.
00:34:37.199 -->
00:34:42.639And she has started a recovery uh career coaching business.
00:34:42.800 -->
00:34:43.119Oh wow.
00:34:43.280 -->
00:34:52.159So when a nurse loses her license because she was addicted to substances and they're not going to give her license back, she has to pivot.
00:34:52.639 -->
00:34:54.320Yes, she has to pivot.
00:34:54.559 -->
00:35:00.719And she has uh uh transportable skills that would go into a different uh uh field.
00:35:01.199 -->
00:35:03.119But sometimes don't know where to start even.
00:35:03.599 -->
00:35:06.800And and we're you know, we're dealing with shame.
00:35:07.039 -->
00:35:10.880So much shame, so much shame, so much shame and so much pain.
00:35:11.199 -->
00:35:17.920I mean, we all know who are licensed and so what went into that yeah, so many hours, right?
00:35:18.000 -->
00:35:20.639Yeah to just get it and then to hold on to it.
00:35:20.719 -->
00:35:25.519And something like this happens, and it you can feel incredible shame, like you're saying, like a failure.
00:35:25.760 -->
00:35:31.440And it's a trauma now, and it's a pivotal point in our lives that is part of our story.
00:35:31.599 -->
00:35:33.519We have two options, right?
00:35:33.760 -->
00:35:42.079We can pursue a new opportunity and be able to tell that story and say, I came out of that, or we can go another direction.
00:35:42.159 -->
00:35:45.920Yeah, and like let's support people to go the positive direction.
00:35:46.079 -->
00:35:47.280Recovery is possible.
00:35:47.360 -->
00:35:47.760Yes.
00:35:47.920 -->
00:35:50.639I work with people who are in recovery.
00:35:51.199 -->
00:35:55.679I I work, I have family members who are in recovery, right?
00:35:55.840 -->
00:35:57.199I know this is possible.
00:35:57.360 -->
00:35:58.239There is hope.
00:35:58.400 -->
00:36:02.480Trauma is treatable, and so many addictions have trauma behind them.
00:36:02.719 -->
00:36:04.239Trauma is treatable, you know.
00:36:04.960 -->
00:36:11.599But if you are going to a facility where they just treat the physical, uh, that's um so let's just say that.
00:36:11.679 -->
00:36:14.559I've worked at June Gospel Mission for a while.
00:36:14.719 -->
00:36:22.239Um, uh women and men sheltered, and there is this time, crucial time, when the body is absolutely working against us.
00:36:22.559 -->
00:36:26.800The body needs to be, we have to start at the bottom of the bodies first, right?
00:36:27.440 -->
00:36:30.719But then if we think that's all there is, that's it.
00:36:30.880 -->
00:36:32.559So I'm not using anymore.
00:36:32.800 -->
00:36:33.920We make a big mistake.
00:36:34.079 -->
00:36:36.400I don't think there's anybody that can stop there.
00:36:36.480 -->
00:36:46.559There's so much more to do, you know, and then knowing that going into a different kind of program, saying, maybe the programs failed you, you know, maybe you just didn't have enough support.
00:36:46.719 -->
00:36:49.840How about we try again and we do it different this time, right?
00:36:50.000 -->
00:36:50.800Yes, yeah.
00:36:51.599 -->
00:37:30.960And I I want to mention not only is the mental health side of addiction treatment incredibly important, but the recovery mentor, getting a recovery mentor or a peer mentor for mental health is a conversation I wanted to start and have today because it just in the last 10 years, many states have adopted a peer recovery mentor program, and you can become certified, and you are essentially someone that has lived through and lives with a mental illness, and you can go through a certification and be paid to provide peer services now, which is incredible.
00:37:31.119 -->
00:37:31.840That is incredible.
00:37:32.000 -->
00:37:37.440And how many of our therapists that are in private practice lean into the peer recovery mentor space?
00:37:37.840 -->
00:37:40.960Not very many, not many, and it's super, super important.
00:37:41.440 -->
00:37:43.280It's isolation.
00:37:44.079 -->
00:37:46.559We found this out in the pandemic.
00:37:46.800 -->
00:37:57.360Isolation breeds anxiety and depression and bipolar comes out, and we start to see major psychiatric symptoms coming out, and it's not good.
00:37:57.519 -->
00:38:01.599When we live in isolation, it only breeds the negative.
00:38:01.840 -->
00:38:09.519When we start to open up, bring things into the light, talk to people about the fact that there are other people that are dealing with what you're dealing with.
00:38:09.679 -->
00:38:15.519I know as a mom, I feel so much better when I start talking to other moms about what they're doing every day.
00:38:15.760 -->
00:38:16.480Absolutely.
00:38:16.719 -->
00:38:25.360If I have depression, if I can talk about that and bring that into the light and not feel shame about it, recognize that other people are dealing with it too.
00:38:25.519 -->
00:38:25.760Yes.
00:38:26.000 -->
00:38:29.199And there are other people that can help support me through this process.
00:38:29.360 -->
00:38:29.679Yeah.
00:38:29.920 -->
00:38:32.079When I get home, I need that.
00:38:32.320 -->
00:38:35.599Recovery coaches are also incredibly important.
00:38:35.840 -->
00:38:40.880And reserving some funding to be able to have some of that is really important.
00:38:41.199 -->
00:38:46.400Or a sober companion when you get home because the last seven times didn't work.
00:38:46.639 -->
00:38:47.119Exactly.
00:38:47.280 -->
00:38:52.159And you've spent so much money on treatment programs, but you're not really working on when you get home.
00:38:52.480 -->
00:38:56.079Just a bird's eye view about what happened last time, why did we fail.
00:38:56.159 -->
00:38:56.400Right.
00:38:56.639 -->
00:39:00.800But also that aftercare, I think, is so essential.
00:39:01.119 -->
00:39:04.000Incredibly crucial because that's what's going to get you to long-term recovery.
00:39:04.159 -->
00:39:04.400Exactly.
00:39:04.559 -->
00:39:13.760Like there's AA, NA, all different kinds of support, uh, structured support groups that I mean have proven track records that they work, right?
00:39:14.000 -->
00:39:14.719It works.
00:39:14.880 -->
00:39:22.320Um, doesn't work for everybody, and there are definitely different kinds, but there are definitely options with this recovery piece.
00:39:22.800 -->
00:39:38.000There's also when I I talk a lot about this as well with the families that I work with, is when the loved one comes back into the family system after they've gone to treatment, they really need to incorporate back into a family system that was the same.
00:39:38.159 -->
00:39:38.880That's hard.
00:39:39.119 -->
00:39:40.000Yeah, it is.
00:39:40.159 -->
00:39:41.039I mean, how?
00:39:41.440 -->
00:39:51.440So we're gonna get rid of all of the wine in the house, and we may not drink at Christmas anymore, or we may not drink it every holiday because we want to support this person.
00:39:52.719 -->
00:40:01.280How about we as a family come together and address the fact that wine is going to be at the house and we want to know how we support you?
00:40:01.440 -->
00:40:02.800What do you want?
00:40:03.679 -->
00:40:06.800And have a conversation instead of shying away from it.
00:40:06.880 -->
00:40:07.039Yeah.
00:40:07.199 -->
00:40:18.400And there are excellent groups, there are services available locally that are pretty accessible and attainable and not really that expensive, honestly.
00:40:18.480 -->
00:40:23.599And it's such a great investment because that family member is a loved one that's going to be in your family for the rest of your life.
00:40:23.760 -->
00:40:24.000Yes.
00:40:24.159 -->
00:40:24.400Right?
00:40:24.800 -->
00:40:26.559So they're called craft groups.
00:40:26.800 -->
00:40:29.039It stands for something, and I didn't look it up.
00:40:29.119 -->
00:40:31.920So, but I do know the provider that that offers it.
00:40:32.159 -->
00:40:33.760Lots of providers offer it.
00:40:34.000 -->
00:40:46.880Um, but it is definitely helpful to have family therapy to change the family system or to make some changes in the family system that will support a person in recovery from addiction or with a mental illness.
00:40:46.960 -->
00:40:47.119Yeah.
00:40:47.280 -->
00:40:52.079And we're talking primarily about adults today, but children go back into the family because they're children.
00:40:52.320 -->
00:41:07.599So, in the same way, if you're going to a treatment program as a child or an adolescent and you're coming back home and there's still some of those same things in place, it can be really, really challenging for the kid to bring up, I need you to change.
00:41:09.840 -->
00:41:10.000Yeah.
00:41:10.159 -->
00:41:11.519And that's not their responsibility.
00:41:13.440 -->
00:41:19.760So looking as a therapist, supporting your clients to say your child needs help, and so do you.
00:41:19.920 -->
00:41:30.159And yes, family groups and family support is actually one of the things that I talk about the most every week is how are we supporting the family?
00:41:30.480 -->
00:41:36.079I always tell clients if you want to include your family, you have to sign a release of information.
00:41:36.559 -->
00:41:40.000So we prep clients, we prep the families.
00:41:40.079 -->
00:41:45.360If you need a way to get connected to the program, I'm a great conduit for you.
00:41:45.519 -->
00:41:45.679Yeah.
00:41:46.079 -->
00:41:48.000And sometimes the families do not need to know.
00:41:48.239 -->
00:41:52.559They sometimes a whole situation where it's not safe to do.
00:41:52.800 -->
00:41:53.360Absolutely.
00:41:53.760 -->
00:42:03.840And yeah, and for kids certain ages in certain states, you know, kids can get treatment at a therapy office at the age of 14 in our state without helping anyone.
00:42:04.159 -->
00:42:04.719Yes, they can.
00:42:05.519 -->
00:42:11.280So, and that's that's a a a space that's built in because there is a safety issue.
00:42:11.519 -->
00:42:12.159Yeah, right.
00:42:12.239 -->
00:42:12.559Yeah.
00:42:12.719 -->
00:42:22.079Um, but I think that there's definitely a space for families to understand and know um that they need to get the the support and help to be able to support that person.
00:42:22.159 -->
00:42:24.400And it's it's a family disease.
00:42:24.719 -->
00:42:26.079Yeah, no, I love this.
00:42:26.159 -->
00:42:33.280I love that that you don't just focus on let's get them in the center, but that you have the bigger picture, just you're looking at the whole thing.
00:42:33.440 -->
00:42:35.119Yes, you're not all they are.
00:42:35.199 -->
00:42:36.320Yeah, where are they at?
00:42:36.400 -->
00:42:37.519Are they ready to go in?
00:42:37.679 -->
00:42:38.639What will work for you?
00:42:38.800 -->
00:42:41.039Are we do we have things afterwards in place?
00:42:41.119 -->
00:42:43.760Otherwise, this might not work out, you know, all the things.
00:42:44.320 -->
00:42:45.199Yeah, I love that.
00:42:45.360 -->
00:42:46.960That's really excellent.
00:42:47.440 -->
00:42:50.880This was just a wonderful conversation.
00:42:50.960 -->
00:42:52.639There was I really enjoyed it.
00:42:52.880 -->
00:42:54.239We just organically went with it.
00:42:54.320 -->
00:42:55.840I'm like scrolling through my questions.
00:42:55.920 -->
00:42:57.599I'm like, yeah, we covered all of them.
00:42:57.840 -->
00:43:06.000You know, so I it's so great because I think about all these things through you know, through the work that I do and and every day.
00:43:06.079 -->
00:43:16.239So it's kind of fun to sit down and talk about it and be able to get it out, yeah, and let people know that we we exist, it's it's helpful.
00:43:16.559 -->
00:43:29.760Um, you know, and just the you know, the um probably the elephant in the room around uh this type of work is that there are treatment centers that are there to market.
00:43:30.159 -->
00:43:32.239We do a lot of social media marketing.
00:43:32.639 -->
00:43:45.119Um sometimes it can feel a little bit weird, and having somebody on your side is really important, it's very helpful both for the client, the family, and the professional.
00:43:45.519 -->
00:43:55.119And we can't be everything, but there is definitely a piece, like you said, the missing piece of somebody that can help navigate this.
00:43:55.280 -->
00:44:04.079And so it's been really fun to be able to talk about what I do, yeah, and not only what Do you know in this position, but also just how I think.
00:44:04.320 -->
00:44:05.599Yeah, no, definitely.
00:44:05.679 -->
00:44:07.199I love picking your brain up today.
00:44:07.280 -->
00:44:08.480It's funny because it's really fun.
00:44:08.960 -->
00:44:13.760It's really uh I feel like it's a very realistic way that you're thinking and that you're dealing with this.
00:44:13.840 -->
00:44:19.039You come at it from all sides, look at all the pieces, which is it's super important.
00:44:19.199 -->
00:44:24.880These are such hard things putting uh or helping people get into a facility where they can be treated.
00:44:25.280 -->
00:44:32.159It's not an easy thing for therapists, for the family, having you on our side, somebody who actually knows the places.
00:44:32.400 -->
00:44:42.719Um and it's something that you said once when you came to visit us here at the way when you said that your company even encourages you to just help people get whatever is the best for them.
00:44:42.880 -->
00:44:51.280Because you were just saying about the money thing, and definitely there is some well, myself, I can be skeptical of those kind of things, you know.
00:44:51.360 -->
00:44:55.440If it's if it costs a lot of money, I'm like, wait a minute, are you even gonna care for me?
00:44:55.599 -->
00:44:57.199Is it is this just about the money?
00:44:57.360 -->
00:44:59.360Do you even have good people on board?
00:44:59.519 -->
00:45:01.920All of those questions that we can ask you, right?
00:45:02.000 -->
00:45:06.079So say a little bit more just here um before we end off about that.
00:45:06.400 -->
00:45:07.119That's interesting.
00:45:07.519 -->
00:45:08.400Absolutely.
00:45:08.719 -->
00:45:15.280So, yeah, I mean, there is an investment, and there are folks who say, I need to do this, I will make a way.
00:45:15.920 -->
00:45:18.880I have family members that want to help me do this.
00:45:19.119 -->
00:45:24.079Yes, so we don't want to exploit that.
00:45:24.400 -->
00:45:25.039Exactly.
00:45:25.280 -->
00:45:48.639We want to find what works for them, yeah, and so the best thing to do is to um to really individualize the care, make sure that um it is a gonna be a good investment, and advocate when they do, when somebody does invest in treatment, if they're not having a good experience, we want to help them have a good experience.
00:45:48.800 -->
00:45:50.800There are very affordable treatment programs.
00:45:50.960 -->
00:45:55.760Sometimes they don't pay anything out of pocket because they've already spent their out-of-pocket maximum on their policy.
00:45:55.920 -->
00:45:56.079Yeah.
00:45:56.400 -->
00:45:57.440So you never really know.
00:45:57.519 -->
00:46:02.079And therapists can shy away from this because they don't want to get want to get into the money conversations.
00:46:02.719 -->
00:46:04.559I'm happy to think I'm happy to do it.
00:46:04.800 -->
00:46:06.079I'm happy to have that conversation.
00:46:06.320 -->
00:46:06.719Yeah, yeah.
00:46:06.880 -->
00:46:12.960I want to clinically consult with you, but that clinical consultation can turn into financial consultation.
00:46:13.440 -->
00:46:19.599It can also turn into do we need to put this person in a program that's close to home because they're a single mom and they have children.
00:46:20.159 -->
00:46:22.800Do we need to start at an intensive outpatient level of care?
00:46:22.960 -->
00:46:29.360All of those things are conversations that we're gonna have based on what's what's going on with your client at that time.
00:46:29.840 -->
00:46:30.800Yeah, absolutely.
00:46:30.960 -->
00:46:32.960Well, I really appreciate that.
00:46:33.199 -->
00:46:37.679I feel like that part that you are you care about the person in front of you.
00:46:37.920 -->
00:46:39.920You really want to see that they succeed.
00:46:40.079 -->
00:46:45.199And uh it's not, I want to get you into this program because I I work for this place, right?
00:46:45.280 -->
00:47:00.159It's not that you know what it made me think of um miracle at 34th Street, is that where the Santa works for Macy's, and then he says, he tells people, oh, don't buy this here, it's less expensive over there, right?
00:47:00.320 -->
00:47:03.760And these managers are like, What is he doing?
00:47:04.000 -->
00:47:06.880But then after a while they realize, oh, people keep coming back.
00:47:06.960 -->
00:47:09.519They feel so they feel so cared for here.
00:47:09.679 -->
00:47:15.039They feel like, oh, you really care about me, you don't just want me to buy this thing because it's gonna make you a lot of money, you know.
00:47:15.119 -->
00:47:25.840And I uh and so they keep coming back, which is I think um part of what I see in the whole um the way that you do it, you know, it's like I care about the person in front of me.
00:47:26.000 -->
00:47:31.280Yes, I have to make a living, yes, there's money involved, but what is ultimately best for you?
00:47:31.440 -->
00:47:32.159What do you need?
00:47:32.400 -->
00:47:34.480Right, and that's that's quite precious.
00:47:34.559 -->
00:47:36.079So thank you for being that, Santa.
00:47:36.480 -->
00:47:37.760Really appreciate that.
00:47:38.159 -->
00:47:46.639So for everyone listening, if you or someone you love is facing this wall, uh, you do not have a speaker out, and you don't have to do it alone.
00:47:46.800 -->
00:47:52.880I will drop information on how to reach Larissa and her team in the show notes below.
00:47:53.119 -->
00:47:56.079Um, and again, thank you so much.
00:47:56.239 -->
00:47:57.920I so appreciate having you today.
00:47:58.000 -->
00:47:58.960Thank you, Larissa.
00:47:59.679 -->
00:48:06.559Please subscribe to the Missing Peace podcast on YouTube, Spotify, Apple, Amazon, and other well-known platforms.
00:48:06.719 -->
00:48:08.800And I will catch you guys next time.
00:48:09.039 -->
00:48:11.199So keep looking for those missing pieces.
