Shaping Addiction Recovery: Rethinking Relapse, Outcomes, and Support

Johan Sorensen, Founder of Portobello Behavioural Health, joined Abdullah Boulad for a thoughtful conversation on how early disruption and emotional overwhelm can shape behaviour long before they are fully understood. Drawing on personal experience, the discussion reflects on how unhealthy patterns can become normalized, how boundaries are crossed gradually rather than suddenly, and how awareness often emerges quietly as a sense that something no longer feels right.

The episode also expands the conversation beyond narrow ideas of recovery. It examines how outcomes are measured, why abstinence alone is not enough, and how connection, kindness, and accessible support play a central role in lasting change. 

Tune in for a conversation that offers a grounded, human understanding of recovery as a process shaped by environment, relationships, and care.

Johan Sorensen has spent more than 25 years working in mental health care. Over that time, he has set up and led treatment facilities and programmes across the UK, the Middle East, and the United States. Trained initially as a therapist, Johan has worked across every stage of service delivery, from direct clinical work to programme development and leadership. He has also served on charitable boards and consulted with the media on issues related to mental health and addiction. He later founded Portobello Behavioural Health to focus on personalised, practical solutions that support individuals, families, and organisations throughout the full continuum of care.

00:00:00 – Early Life and Family Pressure
00:01:03 – Meet Johan Sorenson
00:03:03 – First Exposure to Addiction and Family History
00:07:08 – Father’s Addiction and Family Impact
00:10:16 – Parents’ Divorce and Substance Escalation
00:12:49 – The Moment That Broke the Spell
00:14:48 – AA, Kindness, and Early Recovery
00:17:14 – Residential Treatment and Group Work
00:20:51 – Genetics and Talking to His Kids
00:23:54 – One-Size Doesn’t Fit All in Recovery
00:26:30 – 12-Step Reflections and Compassionate Care
00:29:13 – Why Relapse Rates Are Misleading
00:32:08 – What Works and What Doesn’t in Treatment
00:35:07 – Regulation, Policy, and Political Gaps
00:39:34 – Behavioral Health Coaching as a Bridge
00:41:09 – Learning from Global Models of Care
00:48:16 – The Referral Fee Controversy
00:57:29 – Founding Portobello and Individualized Coaching
01:08:10 – Cultural Sensitivity and Client Dependency
01:25:09 – Connection Heals

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Transcript

Johan Sorensen 00:00:00  We moved to England from Norway. That was a fairly difficult move. The sort of eldest son was always expected to go into the family business. I mean, I sat in board meetings at ten, angry with school, angry with my mother, angry with everyone, socially conscious. Felt weird. If I drank, that just went away. And that was great. Yeah, I couldn't control it. So at 20, I was in a sort of heap of trouble, heap of debt, surrounded by some some pretty dangerous people and way over my head.

Abdullah Bullard 00:00:27  Relapse rates are so high. Yeah. What can policymakers do to support sobriety and mental health?

Johan Sorensen 00:00:35  Behavioral health coaching I love for several reasons. If you're a 15 year old and you're taking drugs and your ADHD hooking you up with a 22 year old who goes to the skate park with you, I bet you'll do a better job than I will in terms of connecting.

Abdullah Bullard 00:00:51  What happened exactly? To get into treatment.

Johan Sorensen 00:00:54  I did lots of stuff I'm not proud of.

Johan Sorensen 00:00:57  I'd stepped over a boundary, I wasn't ever wanting to step over.

Abdullah Bullard 00:01:03  Welcome to the Living a Life and Balanced podcast. My name is Abdullah Bullard, and I'm the founder and CEO of the Balance Rehab Clinic. My guest today is Johan Sorensen, founder of Portobello Health, new owner of the historic Cardinal Clinic and one of the most forward thinking figures in addiction recovery today. In this episode, Johan shares his personal journey from growing up in a privileged family marked by addiction to battling his own struggles with substance use as a teenager in the UK. He opens up about the moment that made him get clean, and how the pain became the foundation for his career in the recovery field. We explore the complex causes of addiction, the cracks in the industry and Johan's vision for the future of mental healthcare, including the potential role of AI. I. I hope you will enjoy. Johan, what motivated you to do what you do today?

Johan Sorensen 00:02:04  Probably a combination of personal experience, lived experience of getting into recovery. And my trajectory was to be in shipping, which is the Norwegian part of my family getting sober at 20, realizing that shipping in Norway and being in recovery was going to be difficult.

Johan Sorensen 00:02:29  And then the other side of my family are in addiction treatment. So maybe a lack of imagination. Yeah, following sort of family footsteps and sitting in a rehab thinking I could thinking, this is amazing, I love this, but I could possibly do it better. So those are probably the reasons for it.

Abdullah Bullard 00:02:57  What is the history or what was the history till you had to go to rehab yourself?

Johan Sorensen 00:03:03  Started drinking young, you know, started smoking and then drinking young. My father was alcoholic. So, you know, ready availability. I remember the first time I, you know, had a drink. So not everyone does. But I remember that feeling great. And so by the age of. You know we moved to England from Norway. That was a fairly difficult move. And so by the age of 14 regularly drinking and taking drugs. 16 I'd say I was dependent in some form. my, my mother and aunt are both in the field. So my aunt is an interventionist. She was the first interventionist in Europe.

Johan Sorensen 00:03:53  So My. My mother is a sort of fierce addictions therapist. and I'd been to family programs when I was about 14 in, in, in a place called Farm Place, where I learned a lot about addiction and it being sort of a family disease. And I remember sitting there thinking, oh, I'm here to talk about the effects of of my father's drinking, but I'd be hungover and thinking, oh, this isn't going to end well.

Abdullah Bullard 00:04:26  You were at this gathering because of your father's, process.

Johan Sorensen 00:04:31  Yeah. So my father was still drinking? Yes. but my aunt worked at, at Farm Place and my mother went in for codependency. So I went along to the family program, you know, on a Sunday we would sit there and I identified as much with the patients who were in the talking about their drinking or using, as I did with the other family members. So I think from that age I thought, oh, this, this. This could not end well. And I went to Albertine, which is support group for children of, of.

Johan Sorensen 00:05:08  You know, alcoholics and drug addicts. And yes. so I always sort of had an awareness and I knew pretty much say this was going to be problematic. And I think I also knew they would probably need to stop at some point, which was helpful. But that knowledge alone isn't enough to then regulate the behavior. Yes. so I, you know, I kept at it and I, you know, I'm lucky I was only 20 years old, and I had a family who knew what to do. They knew how to intervene. They knew how to sort of handle the situation, to leverage me into treatment. Well, actually, I went just to a 12 step meeting. I went to treatment later.

Abdullah Bullard 00:05:50  You spent quite some time between 14 and 20 to get the first support or help in your case.

Johan Sorensen 00:05:57  Yeah, I mean, it was offered, but I knew if you accepted the help, you'd need to stop. So, I wasn't ready to stop. It was, you know, it was a sort of anaesthetic and social lubricant and confidence booster and all of those sort of things.

Johan Sorensen 00:06:17  my life got quite dangerous and quite exciting all in one. I wasn't very good at knowing where where that line existed. So at 20, I was in a sort of heap of trouble heap of debt. I was surrounded by some some pretty dangerous people and way over my head and and essentially living rough. And I thought, this is, this is not whilst at university. And I thought, yes, I'd made these sort of weird justifications. That is fine, because I can go into uni, I can have a shower at the gym and my friends got some clothes. So? So it's weird how you end up thinking, well, this is okay. And then one day you wake up and you think, actually, this is not okay. so yeah, it was brief and unspectacular, but, but it was enough.

Abdullah Bullard 00:07:08  You you mentioned your father was also into, alcohol addiction. can you tell us a little bit about him? How did he get into it and had this effect on you as well?

Johan Sorensen 00:07:22  so he was in many ways brilliant.

Johan Sorensen 00:07:24  I mean, he was he was very clever, very, very funny. also sort of quite sensitive looking back. He was quite sensitive, but found himself, I think, in a job he didn't want to in the family business, which was. I don't think he ever wanted to do that. We were living in Oslo, which is quite a conformist sort of society, and he was not particularly conformist. So I think there's a number of things which made him unhappy. He drank from a young age and a sort of bon vivant sort of life and soul of the party way, the effect. So he was a brilliant man, but, you know, pretty terrible husband. And, you know, as a father, he was just mainly absent. I mean, it was mainly that he was either preoccupied working or out. So, you know, not catastrophic, but not very present. and my mother was very distressed. He he was unfaithful and, you know, didn't carry the load within the family.

Johan Sorensen 00:08:32  So I saw the effect of my mother more than him having a direct effect on me. I'm also very similar to him. So I think I think there was a sort of recognition that if, you know, this is certainly how I could turn out if things went in a different path. So, you know. That was him.

Abdullah Bullard 00:08:55  Yes. It sounds to me like he grew up very privileged, and and he could take over the family business, but found himself in something he was not not feeling comfortable in.

Johan Sorensen 00:09:10  No. And I think it's a, you know, reasonably confident his father didn't drink because his father drank too much and, you know, sort of trickled down and family history. Yeah. And certainly we were always expected, you know, the sort of eldest son was always expected to go into the family visit. I mean, I sat in board meetings at ten. It was sort of very clear that, what was going to happen. All I remember was there was white noise machine.

Johan Sorensen 00:09:41  I mean, I can't remember the board meeting, but I was watching this white noise machine thinking, this that's okay. So that's probably too early to be inducted into any sort of, board meetings.

Abdullah Bullard 00:09:54  Was this also expected from you to to be involved in that business?

Johan Sorensen 00:09:58  Oh, yeah. Yeah. So I have my great uncle's name. I've still got the name plaque which was taken off his door, which was going to go on my, you know. That was and I don't even know if anyone said it, but it was very clear that was that was expected.

Abdullah Bullard 00:10:16  Were you free to decide whether you, you go that path or not.

Johan Sorensen 00:10:22  Well so so we ended up move. My parents got divorced. I moved to England. He stayed in Norway. and the rift in that divorce was massive. So, I guess my grandfather expected me to carry on. And then my father's life unravelled. The business started unraveling. So, So I think no one was particularly interested in what I was going to do with my life at that point.

Johan Sorensen 00:10:50  There were other priorities.

Abdullah Bullard 00:10:53  How old were you when your parents got divorced?

Johan Sorensen 00:10:55  14?

Abdullah Bullard 00:10:56  14. So this was the time when when you started drinking?

Johan Sorensen 00:11:01  Yeah. So at 14, moved from Norway to England, which is quite a big change. Yes. And I looked older than my age so I could get to pubs so I could buy alcohol. And I was pretty angry. I was sort of angry about everything. So yeah, definitely the drinking sort of took off at that point. Okay. Quickly found other stuff.

Abdullah Bullard 00:11:26  So you know like emotional emotional regulation or what the interstate is at that moment at the age of 14. Certainly you had difficulties maybe to, to judge what, how how to control that.

Johan Sorensen 00:11:43  Yeah. I couldn't control it. Yeah. and I drank to blackout. I mean, I figured out you drink a lot quickly. You blackout. And that was great. So there wasn't much sense of trying to control it.

Abdullah Bullard 00:11:55  What relief did it give you?

Johan Sorensen 00:11:58  you know, I think I was anxious.

Johan Sorensen 00:12:01  I didn't really know. I sounded a bit like the Swedish chef of the Muppet Show. I was pretty self-conscious. I didn't want to conform. I hated wearing a school uniform. they had sort of rules in the education system we didn't have in Norway, where I'd been taught sort of critical thinking, you know, questioning everything. Don't take anything for granted, that sort of thing. And that didn't work well in the English system, which was all about rote learning. And, you know, so I was, you know, angry with school, angry with my mother, angry. Angry with everyone, socially conscious, felt weird. And actually, you know, if I drank, that just went away and that was great. So I don't think it was deeper than that. Just a meditator.

Abdullah Bullard 00:12:49  Yeah. What happened exactly? To get into treatment.

Johan Sorensen 00:12:53  So I did lots of stuff I'm not proud of. During my drinking, I got involved in not great stuff. but the thing that tipped me over was I had this amazing girlfriend who I'd been dating for three years or something.

Johan Sorensen 00:13:13  She was amazing, really nice. And one night I was, I was unfaithful. So, I mean. And by that, I kissed someone else. Okay. And that was like my last moral tipping point. That was because my father had been unfaithful. I'd seen the effect on my mother. And and that was it. I thought, this is sort of the last thing. The one thing I. I never intentionally hurt people as close to. I was sort of fiercely loyal. And I thought, this is the person I care about most in the world, and then I end up doing this. So. So that was it, you know, again, unspectacular, just as a realization that I'd stepped over a boundary. I wasn't ever wanting to step over.

Abdullah Bullard 00:14:04  I saw yourself being your father.

Johan Sorensen 00:14:06  Yeah, I think so. I mean, I wish I could say I was that enlightened, that I saw it quite as consciously as that, but I don't. I think I just thought, yeah, I'm, I'm turning into something I recognize as not great and someone I don't want to be.

Johan Sorensen 00:14:20  I didn't handle it well. I just then never contacted this person again and disappeared off the face of the planet and got clean. So, you know, not the most functional way of getting clean, but yeah, it's funny how it can just be a random thing that tips you over the edge.

Abdullah Bullard 00:14:40  What did you do then? So was it your own motivation then to change and who helped you to do that change?

Johan Sorensen 00:14:48  So I sort of wasn't particularly welcome at home. So at that point I was also in trouble in London. So I moved back in with my mother in Surrey. So she helped me by that happening. And, and I just I went, I went to an AA meeting and I did that because I remember from being in that rehab as a family member that that's what you did. If you had a problem, you enter AA. So I sort of looked up, there was an AA meeting. I went along and I was the youngest by maybe 30 years. I mean, it was just, you know, I think it was a Tuesday lunchtime.

Johan Sorensen 00:15:30  I had lots of sort of blue rinse older ladies drank gin and, and I mean, I had sort of I had a, I had hair. It was weird. I had, you know, lots of piercings. And I was compulsively going to the gym. So I sort of big and odd looking, and they were just really nice. And that was the thing. So I was used to pushing everyone away and looking, looking and acting in a slightly frightening way. And they were like, oh, would you like a cup of tea? And, you know, tell us about it. And it was just that, that sort of instance of kindness to a stranger, which at that point felt so unfamiliar. Yeah. And that was it. I thought, you know, I feel accepted, wanted in the room and people interested. And they thought it was fascinating for me. Tell me about cocaine, which is because they're used to gin. so I just. Yeah, I just felt cared about, like, so mum cared about me, all of that.

Johan Sorensen 00:16:36  But if you're a family member, you just think of it as bad and conflictual. It was just these random strangers who are just nice and would had no money, so they'd buy me a cup of tea and a tea cake. I'd never had a tea cake. It was brilliant.

Abdullah Bullard 00:16:50  Kind of. The strangers had no agenda for, you.

Johan Sorensen 00:16:52  Know.

Abdullah Bullard 00:16:53  Nothing. You would have accept them more than a family member. Yeah. To help? Yeah.

Johan Sorensen 00:16:58  That was just so nice to come and pick me up. It's great. I mean it was so different from how I'd experienced life in the couple of years prior to that. or how I, you know, interacted with society.

Abdullah Bullard 00:17:14  Very then also at some point in the residential program.

Johan Sorensen 00:17:18  Yes. Yes. So I remained clean and in recovery, moved back to London. but I was quite mad, so I was sort of working. I worked as a bouncer, and I was studying, and and I didn't know how to manage relationships very well.

Johan Sorensen 00:17:44  And after about two years, I felt like I was going to relapse. I was so stressed and looking back, probably anxious, I wouldn't have known it was anxiety, but I was stressed, I was anxious. not really knowing how to manage life particularly well. And I thought I'm gonna, I'm gonna relapse. So I went to a place called Western Counselling Services. Western Counselling Services is. I mean it was a small yellow room and it was yellow because of the amount of smoke in the room. Okay. And it was baba kebab shop and, and they were everyone was pretty much a Greek or Portuguese heroin addict. You know, hard guys. There were tough guys. It's me and this Belgian guy. and I said, I need to come in. I'm clean. They were really confused. Like, you don't come in to rehab, clean us. I don't know about if I'm. If I don't come in, you know, I'll relapse. It's cheaper to do it this way. So.

Johan Sorensen 00:18:52  So I went in, I think I was the first person to go. So I went in under codependency because I weren't quite sure. They didn't really know what that was, but we made it up as we went along. And again, it was great because it was just a bunch of people talking and, you know, confronting and talking. And so it didn't really matter if I'd used or not. That wasn't the point. I mean, they were a bit confused. I was like, you know, relationships are hard. And a lot of them were like, no, no, we're getting clean to, you know, find girls. Yeah. I was like, oh yeah, no they're dangerous. Like, don't go anywhere. So, it was great. I was going for six weeks. I stayed for nine months. Wow. In there, I figured out that I don't need to, you know, fill my tax returns. I don't need to really do life. I can just sit and talk about myself in group.

Johan Sorensen 00:19:43  It was brilliant. I loved it, but again, I was thinking I could probably do something a bit better.

Abdullah Bullard 00:19:50  Yeah, I was paying for that.

Johan Sorensen 00:19:52  Well, it was mainly the state. So I had, benefits. I had housing benefits, I had some Social Security stuff and I think my mother made up the balance, but okay, I imagine it was not particularly expensive.

Abdullah Bullard 00:20:09  And after nine months, you you were healed. You. What happened next?

Johan Sorensen 00:20:15  Well, so the nine months fulfilled a sort of academic year. So then then I had to leave and go back to university. So I finished off, finished off that degree. My brother had also gone into this particular center. So he two weeks after I got clean, I decided to to 12 step my brother, you know, tell him he had a problem and he did. He was not able to just do it through going to the room. So he'd been to this rehab, so I knew it worked for him. So that's why I went there.

Johan Sorensen 00:20:43  Then I went back to university and while in the rehab decided, yeah, I want to, I want to train.

Abdullah Bullard 00:20:51  Do you think there is like a genetic aspect for a predisposition for for addiction or being more likely to fall into it?

Johan Sorensen 00:21:01  Yes. I think we know enough to know there is a predisposition. I don't think we know enough to have nailed that down firmly. And I think it's a lot more complicated. And in and of itself, I don't believe it's enough. You can have a genetic predisposition in the same way. I you know, the way I process any number of things is different than anyone else I'm around. So I suspect the way I react is genetically factored in. And if you look at certain populations, you see higher incidence. There's probably a genetic factor. You need other things. But yeah, I think I think, you know, for example, my children are aware of my history. My wife's in recovery. We've had the chat. Look, your your reaction to substances, you know, could be problematic and something you need to be aware of.

Johan Sorensen 00:21:52  So yeah, I think it's factor.

Abdullah Bullard 00:21:55  How do you adjust now having your own family, your own children with your history and your father's history and the other extended family history? How do you how present are you and how conscious are you around that topic when it comes growing up, your your children?

Johan Sorensen 00:22:16  Oh, all of my many children have known from sort of my history. You know, in an age appropriate way from a young age, not least, have they never seen me drink, but they also know I work in this field. So we've had this sort of chat that there's a long history. you're probably at more risk than some other people. It doesn't predetermined, but, you know, keeping an open dialogue with them about drug and alcohol use. and I know that if any of my children encounter a problem, that they do come and talk to us about it. so, yeah, quite good at having that chat. I mean, and for me, there's also a history of mental health issues.

Johan Sorensen 00:23:03  So, so actually for me, I, I tend to tell them to stay away from cannabis more than just about anything else. it's sort of controversial amongst their friends, but rather they took cocaine than cannabis. so, so far none of them have encountered any major issues. and and when things have been problematic, they've felt able to come and speak about it.

Abdullah Bullard 00:23:30  I mean, addiction doesn't come alone, right? So it's not about just getting sober and then life can continue or be flourishing in it. It comes definitely with a variety of mental health issues.

Johan Sorensen 00:23:48  yeah. Gone are the days pretty much where someone had just one thing going on, I think.

Abdullah Bullard 00:23:54  Yeah. What is your understanding today of addiction and addiction recovery in general?

Johan Sorensen 00:23:59  So my understanding of addiction would be that I guess when I first came into the field, I'd subscribed to a disease model, a traditional 12 step view of it. Today, I'm certain we don't know. So today, I'm certain that there are many competing theories, and the truth lies somewhere.

Johan Sorensen 00:24:22  I believe in the middle of all of those theories. So whether you're looking at a disease model or are you looking at, or maybe not the moral construct model, I'd probably reject that one. But if you're looking at, attachment theory or you know that it's as a result of trauma or Johann Hari's sort of connection theory, I'd say it can be any number of that on an individual basis. And the danger in saying, I know what it is, is someone will prove you wrong. So I think the longer I'm around, the more I can accept how little I know. So I think there can be, but not necessarily a genetic factor. Trauma can definitely pay, you know, part of it. But our understanding of trauma is now so diffuse, it's really hard to know whether, you know, unless things are perfect, you've got trauma, right. So you could say trauma underlies all of it. Yeah. but some people just drink themselves or use themselves into addiction. You have, something happen? You laid off work.

Johan Sorensen 00:25:34  I've seen people with no history, you know, of problematic use, laid off work, get divorced, start drinking, drink til it's a problem. They're addicted. They stop drinking and they're fine. So there's enough disproving my previous theories for me to be certain about it. But I think the skill is working with someone to figure out what led them to this particular place on an individualized basis. That's how you can help treatment plan out of that, right?

Abdullah Bullard 00:26:11  Yeah, there is certainly not one size fits all, in that in that concept, a concept when you were in, in, in treatment program, you went through the 12th step. Can you explain what this is and how do you see it today?

Johan Sorensen 00:26:30  So? So it's funny, the treatment program I went to shouldn't have worked. If you look at if you if you look at current theory, it was really tough. It was confrontational 12 step model. So a lot of it was about breaking down the ego in, in, you know, in a pretty brutal way.

Johan Sorensen 00:26:54  very little of it was about increasing self-worth or shame reduction. If anything, you'd say, you know, you probably got a large amount of shame through it. So it was a very traditional 12 step confrontational model, but some of the people delivering it were clearly incredibly caring, compassionate individuals. So more than the methodology they were using people. It was the people who were delivering it. One of them was called Aileen. Who's this? I mean, he's still around this this Welsh counselor, and he was amazing. And he would be confrontational. But you felt nothing but love and care coming out of this person. So again, I don't I don't think it was the modality that made the difference. They did certain things which were clever around helping people be honest and taking responsibility, stuff which the old school did quite well. But it wasn't the methodology. It was, you know, a group of people. So it helped having a community of people who sort of bonded with over over your commonalities and then just a few really wise, maybe wise and caring professionals within that system.

Abdullah Bullard 00:28:16  That makes absolutely sense. It's the experience at the end and not really a systematic model which should work with everyone.

Johan Sorensen 00:28:23  I know, but it's very annoying. It's very hard to do outcome studies on that. So that's the frustrating bit is you look at the data and the theory and it doesn't necessarily match the actual practice or outcomes. So it shouldn't work if you took a modern theory that shouldn't have worked. I happen to know that. And that was 28 years ago. A lot of the people I was in treatment with are still clean, so it shouldn't work. But actually a lot of people are still clean. So something happened outside of the sort of theoretical framework. Yes. That worked. So again, it just leads to think, you know, until we understand the problem and have a sort of more unified way of viewing it, then understanding the outcomes is particularly difficult.

Abdullah Bullard 00:29:13  So relapse rates are so high. Yeah. In coming out of a rehab because whatever the underlying cause has not been resolved or the environment.

Abdullah Bullard 00:29:27  what's your opinion on that? How do you see relapse rates and rehabs around the world? I know you, you you you have insights more than anyone else.

Johan Sorensen 00:29:39  I don't think the recovery rates are really any better than they ever have been. So if you look at, if you took the sort of recidivism rate in a sociological framework, that we don't seem to have made much of an impact on that. And I don't think that's necessarily down to the treatment centers or the individuals or society, because we're not measuring it properly. And again, unless we define what the problem is. So if you are abstinent after a year, but you're suicidal, Is that a positive outcome? I mean, I'd I'd say not. No. If you're, you know, you've been clean for a year, but you're you're violent. Your family. Is that a positive outcome? Would it be better actually. So until we can measure it properly, I don't think abstinence is necessarily in and of itself. It's one of many goals.

Johan Sorensen 00:30:37  Yes, but until we sort of measure it properly, it's hard to define it. I don't I think we are much closer to being able to meld philosophical sort of framework. So I went to something early in the year where they had harm reduction and abstinence on a panel, and there was almost no disagreement. There was a recognition that this is all part of a continuum. That, to me is good news because people go through, you know, whether it's mental health or addiction, there's often not a linear process. And at times we've excluded people in need because they don't fit in with what we think they should be doing. So if you can bring them together, I think the death rates go down, which is important because someone who's dead is not going to be a successful outcome no matter how you measure it. Never, never. so I think sort of tying things to outcome more will help us. But average amount of treatment episodes is for, I think before you hit a successful one and that's remained fairly static.

Johan Sorensen 00:31:47  so I don't know if we're doing any better. I mean there's, there's not more provision. Government beds have gone down, private provisions gone up. So I'd like to think we're smarter and, and we're doing it better, but the data isn't necessarily suggesting that yet.

Abdullah Bullard 00:32:08  Or what? What is, in your opinion, working well and what is not working well from a practical perspective.

Johan Sorensen 00:32:16  I mean, I think some things have worked for a long time. And whether you're looking at 12 step engagement or, you know, and that that's very sort of, Western centric or even sort of white, Judeo centric. If you if you look at black populations in America, more of them will get cleaned through the church than they will by going to 12 step meetings. other parts of the world, you know, organized religion could possibly get just as good outcomes as other ones. So what's working is I think we are able to find community more easily now than we were before. If you want to find like minded people, you have the internet.

Johan Sorensen 00:33:01  And I think that works well until it stops you from actually connecting with the community. So it's a sort of mixed bag. Yeah. I think there's real promise in some of the stuff AI will deliver. I think we're less judgmental generally around addiction and mental health, more welcoming to people. and that that's resulted in people seeking help earlier, which is sort of pretty crucial. So I think we're doing that. Well, we're talking more, what are we not doing? Well, so, you know, 25 years ago, the addiction treatment industry would have a representative body in the UK which could, you know, advocate for treatment providers, but actually it was European wide. So we had a European wide body which could try to regulate standards. So everyone had the right standards, ethically directed treatment. You could, you know, go to the EU or the British government and advocate that's gone. The Federation of Drug and Alcohol Professionals pretty much gone, so there's probably less people engaged outside of a narrow commercial focus than there used to be.

Johan Sorensen 00:34:26  And I think that's that's not great. understanding of trauma and attachment and underlying causes and co-occurring is better. And that means hopefully we've got that. But it's a real mixed bag. It's sort of some pretty sharp commercialism coming up against better understanding of what we're dealing with. So, you know, we'll wait and see which one sort of wins out. There's much more of a separation of, private sector versus public sector before those interacted better than they do now. if we can get that to work better, that would be helpful.

Abdullah Bullard 00:35:07  A lot of topics AI and the political side. But maybe let's dive into the political, discussion. What what can, policymakers do to prevent, or to support, sobriety and mental health and society.

Johan Sorensen 00:35:28  A much easier in a dictatorship. so most of, most, most of the data would suggest that if, if you make an investment into particularly if you look at the sort of prison system, if you make an investment, a heavy investment and there are great programs within prison, you'd see a tremendous outcome after seven years.

Johan Sorensen 00:35:54  your return on investment would be tremendous in terms of increased productivity, engagement in the workforce, less recidivism. But of course, our government terms are about four years. Yeah. So whenever you sit with a policymaker and say, look, please spend billions on on prisoners, and the next government will see the returns that never goes well. Whereas if you go and I'm not saying it because I'm a fan of dictatorships, I'm not. But if you go to a country where they have a very long term view, you can put forward policy decisions which will probably have a better impact long term. Or if you go somewhere which is very coalition based, you can get longer strategies. At the moment, everything is I mean, more now than ever. Everything is incredibly short term and it's just about how you get through this current election cycle and having public health policy dictated over a four year term, I think is really problematic because public health is a chronic long term problem. So what can they do? I think they can regulate more.

Johan Sorensen 00:37:07  I don't think you know. I'm sorry. I'd say I don't think we're regulated enough. Okay. I think, I mean, we have the CQC, which doesn't take all my boxes for what I think it should do. It does in one way, but it doesn't, particularly around the delivery of services. It certainly doesn't round. Financial modelling. So, I think we could do with more regulation. And unless we can prove that we can self-regulate, that should probably happen externally. And that provides more scrutiny, more emphasis on outcomes. And that's got to be better ultimately for a client. So that's that's one thing. And it's not for a lack of willing politicians. I've met countless politicians who'd love to be engaged.

Abdullah Bullard 00:37:52  And but the pressure also to decide and the time limited time frame.

Johan Sorensen 00:37:59  Yeah. Look, it's not you know, it's not a popular constituency. The drug addicted has never been a sexy topic for anyone to run on office for. Yes. I mean, I think there's more understanding now than before, but if you're looking at, you know, prisoners, homelessness, the mentally ill or the or the addicted saying we'll be compassionate and put funding towards that is a hard sell.

Abdullah Bullard 00:38:25  So funding a big topic, but funding which lasts longer than a specific period, a long term plan for it.

Johan Sorensen 00:38:34  Yeah. And I think you can also be smart. Look, the NHS has so many problems. If you I think there are lots of interventions you could put in place which would cost less than is currently delivered in the public system. but it requires creativity, openness. There's plenty of vested interest in people keeping bureaucracy within those entrenched systems. So, your ability to change the way social work, outreach, engagement, I can train up. you know, I could go into prison. Say, if you want to be a coach, a behavioral coach, you need no qualifications for that. What you need is life experiences. And having gotten through that. Yeah. there's an abundance of that in in the prison services. You could go in there. You could say to people, look, take those experiences for good. You'll get paid a salary. You can go into your communities and engage in a positive way.

Johan Sorensen 00:39:34  Brilliant. Good for the prison service, good for recidivism. But it would take a large capital injection. It would take political will. Similarly, within the NHS, we, the case management we offer privately is cheaper than the cost of delivering it within social services and the NHS. Yeah, but the systems are built such that sort of untangling that ball is hard and the cost of, you know, the cost of the public system currently contracts into private systems for addiction care and other care, which are backed by private equity groups. There, you know, there's a there's a massive conflict within private healthcare generally, and I accept that. But but when the public system is so bereft of its own provision that it has to contract with private equity, there's an obvious tension. And it's not to say the provision is bad, but, you know, you and I both know that if you're if you're a shareholder that conflicts with wanting to get people well on a fundamental level, right? So, you know, all of those structural issues are difficult.

Johan Sorensen 00:40:51  If you go to, other countries where that's not the case, you can actually see organically grown systems which function really well that of.

Abdullah Bullard 00:41:05  Countries do function well.

Johan Sorensen 00:41:09  oh. I mean, whether I'd say Lebanon is an example of it functioning well is is another question, as you can imagine. But for example, there or I've seen it in the West Bank, I saw it in Iran where you have a lack of historical structures. So they approach a problem, say, okay, the problem is drugs and the creation of systems just from people's imagination without ideological battles. So in Lebanon they had this incredible harm reduction service. And I was I was running an abstinence service, and I was used to being in the UK and fight, you know, we'd fight ideologically about it. I went to the lady who ran the Harm Reduction Service and said, well, look, if people aren't ready for this, can they come there? And if people you know are sick of using, you know, a harm reduction.

Johan Sorensen 00:42:03  And she had no preconception. She was like, yeah, great. Totally makes sense. And it was the first time in my career I'd heard her. And you can create a system from that. similarly, in the West Bank, they ended up, you know, one of the services ended up doing sort of assertive outreach, a dating service, which was, you know, it's a small community. So, you know, said, you know, everyone here knows who's taking drugs. And if they want to be in a relationship, we have to essentially sell it to the community and say they're fine. So it's a sort of dating service business ownership model. And these are created just from people wanting to do good without, without all the structures in place that need dismantling. So I think there's brilliance out there. It's as much dismantling.

Abdullah Bullard 00:42:57  You have to have had the history of leading rehabs and building in different countries. Can can you tell us a little more about what have you done? How did you get into into this industry and and what what were the steps you have been doing till today?

Johan Sorensen 00:43:17  I trained as a counselor at Promis, which is in Kent.

Johan Sorensen 00:43:22  Yeah. I think very quickly I thought I quite enjoyed marketing, and I think maybe that's to do with sort of how I was brought up. I thought I was interested in the business side and the marketing side alongside the clinical. I mean, I loved working with clients, but I was frustrated when marketing wasn't done properly. So really quickly moved into dual sort of clinical and business side of it. then I worked a farm place, which was nice. That was where my aunt had been part of setting it up in in the 70s, so that was great. and then people started going to Arizona for for trauma and sex addiction. And I thought, well, we should do that here. I mean, you shouldn't have to fly. I get very annoyed when people have to fly somewhere else in the world to do something because there should be provision. So. with a guy called Don Surratt, we set up Lightworks, which is now owned by The Priory. So we did that, and then I had the opportunity to go to the Middle East.

Johan Sorensen 00:44:30  Someone I knew wanted to set up centers. I actually wanted to set up centers all in the Mena region. And at that time, people were talking about the sort of Middle East market, and it drove me nuts because none of them had ever been to the Middle East. None of them spoke like. I was like, how do you know whether this is sort of culturally, okay. Like, how do you know that this treatment modality will fit into this population. So I agreed to go. So I moved between Beirut and Jeddah to set up services in Beirut and Jeddah. Then there was a little war with Israel. So I got involved with doing sort of trauma work, in southern Lebanon. And I was also on the board of something called the coalition for Outcome Based Benefits. It's a very sexy title. we then rebranded to C4. so I've always believed in needing to be involved in more than just commercial practice. That sort of keeps you. I mean, I'm an atheist, but it sort of keeps you spiritually pure, which, I mean, that's sort of an oxymoron, but whatever.

Johan Sorensen 00:45:37  So I'd been involved with these charities looking at all of that. So we got involved with not just setting up the rehabs there, but got involved with dealing with trauma and systems of care within that was particularly the sort of Levantine region. So West Bank. bit in Gaza, bit in Lebanon. and then Saudi and seeing how, you know, in my ignorance, seeing how fundamentally different it would be trying to create a system in Lebanon from Saudi. You know, I, I didn't I was just ignorant European. So that was fascinating. And through this board, we were doing stuff with, Native American reservations in the US, some stuff with Maori populations. So it's sort of, that helped me understand that no one has the answer because it's so specific, not just to the individual, but to the culture you're dealing with, with the history you're dealing with, with the structures in place. so in order to do that, then I did some stuff in Qatar, which again, very different from the others back to England, Try to take on the referral agents.

Johan Sorensen 00:46:56  That wasn't fun. And then met my now wife, who's American. So I ended up in New York, and there wasn't really a center in New York, which was weird. Yeah, there wasn't a sort of private primary rehab, so I got involved with setting up a rehab there. Moved to Nashville. Nashville is where all the biggest behavioral health care companies are centered in the US. and it's just fun. Nashville's great. So spend some time there. Then came back here to Portobello and bought a psychiatric hospital. That was not part of the plan. That's. That was spontaneous.

Abdullah Bullard 00:47:41  Yeah. That's beyond any any other clinician or any anyone with recovery background would do in the industry. So I think you have had a lot of impact on others and and how to do things here.

Johan Sorensen 00:47:57  I mean, it's super fascinating. I don't know whether I've had impact both. You know, if you if you well, you will know if you sit there and you've got a gem and you've got some answers and then you look to somewhere else.

Johan Sorensen 00:48:10  I mean, the beauty is to try to spread that. And how how can I maximize the impact, right.

Abdullah Bullard 00:48:16  Let's talk a little bit about integrity in the industry. And particularly you mentioned something you took down the.

Johan Sorensen 00:48:24  Took on took I wish I put them down.

Abdullah Bullard 00:48:27  You took on the referral agents.

Johan Sorensen 00:48:30  Yes.

Abdullah Bullard 00:48:31  What was the problem there and what what happened.

Johan Sorensen 00:48:35  So sometime in the early 2000, people, some people clocked on that they could essentially sell patients into treatment. So this is the concept that you go to a treatment center and you say, right, I'll send you a patient, private pay patient for 20,000, but you have to give me 10%. very quickly, I mean, so on. And you know, the ethics I can talk about. But very quickly I realized that this was a terrible idea for the treatment industry because essentially it was a race to the bottom. so tried to get people together to say, let's not do this. If no one engages in this practice, then it goes away.

Johan Sorensen 00:49:24  Right. It's it's a marketplace. And if everyone refuses to participate, don't think it's started by people with ill intention. It was just an idea someone had that caught on that. Oh, I can make some money by selling in. Patients in in the US, that's human trafficking law violation and a federal crime. But we got no legislation in Europe around it, so I failed. The industry didn't take it on. Some of the centres said, yes, we're not going to engage. Other centers did. And the problem from the treatment center side was there was a marketing industry within treatment at that time. But of course, if you're relying on your patient flow just through paying cash for your patients, you don't need to market. Yeah. You also don't need to improve outcomes, nor do you need to innovate. All you need to do is generate enough money to pay for your patients. And that happened. So the marketing side got decimated. You can go to the US and there's business development in behavioral healthcare conferences, sort of thousands of people involved in marketing.

Johan Sorensen 00:50:41  And here they're sort of four. Yeah. Yeah yeah. Which which for an industry worth the amount we are. Is a nonsense, and it's purely because it went down this route also treatment center. You know, inevitably what happened is people would say, okay, I'll pay you 10%. And then slowly it would move to 15%, 20%, 30%. And the margins of of people who weren't well backed put them out of business. So good operators went out of business. so yeah, I was, I was cross about it on the other side. It was felt ethically, completely wrong. I mean, I there's no way I could with certainty say that I would pick, you know, if you had two centers, one would pay me £5,000, one would pay me nothing. It would be impossible for me to tell you that I had an unbiased view of where someone should go. Yes. And in addition, no one was being open or honest about it. It wasn't, you know, the therapist in the office or the referral agent weren't telling people looking for help that they were being paid.

Johan Sorensen 00:51:53  I mean, it was all. You know, all under the table.

Abdullah Bullard 00:51:58  Does it still happening today?

Johan Sorensen 00:51:59  Yeah. Yeah. There are still referral. Yeah. So, the advert and me and some others have tried hard to find out how we can get in and change it. and and there is plenty of value in offering people advice about where to get help. I mean, so important because. Charged person looking for the advice. Right. So it's the same as other sort of.

Abdullah Bullard 00:52:26  Being transparent about it.

Johan Sorensen 00:52:27  Yeah. Well being transparent.

Abdullah Bullard 00:52:28  Who's paying for it knows about it then it's transparency.

Johan Sorensen 00:52:32  Yeah. But charge the family.

Abdullah Bullard 00:52:34  Yes.

Johan Sorensen 00:52:35  If the family is looking for advice like any other service, pay for the advice. Of course they're not going to pay £5,000. Yeah. So you go to the institution because they're going to pay £5,000. So that's. Yes. Obviously be transparent I would say. You know, my discussions with people engaged in this is there's not enough money in charging patients or families for it.

Johan Sorensen 00:53:01  finally, the Advertising Standards Agency has become interested and they are now, they're now, you know, cracking down on it, which is great. And,

Abdullah Bullard 00:53:14  I know it's not it's not done because we had also a case recently. someone contacted a psychiatrist clinic from from the Middle East, contacted us and wanted to refer a client. they said, yeah, but do you collaborate with the local doctors that they work also during the treatment program? He said, yeah, they can join. We can we can update them about about the progress of, of of the patient. Of course we we do this with anyone from around the world? yeah. And then how much do you pay them? So, yeah, usually, no, we don't pay anything. then I ask. Yeah. Is it then considered as a referral fee? No, no, no, we don't take any referral fees. It's just a consulting fee.

Johan Sorensen 00:54:00  A consulting.

Abdullah Bullard 00:54:01  Firm. I said yeah, I'm sorry. We don't we don't pay consulting fees or, to external doctors who are not part of our team.

Abdullah Bullard 00:54:10  And, is it then, depending on the decision, if the client would come to us and. No, no, no, the client would decide by himself. The client did not end up coming to our place. So, but it needs certainly integrity and also by, by, from everyone involved to to be on the right path long term. But there is there is one other thing which I, I feel in the advertisement Industry when when we look at the discrepancy between North America and and Europe. European centres are legit licensed, are not allowed to do marketing or online advertisement. Whereas North American centres, they they have access to everything they can advertise in Europe even. And and the European centres cannot advertise anywhere. So because they need this type of legit script, which is only US based and and I found this also a bit unfair to the local European centres.

Johan Sorensen 00:55:25  Yeah. I think, you know, it's it's incredibly problematic. We bought it on ourselves. So you know this practice along with the sort of insurance fraud which took place and shadowing sites on Google in the US Meant that we joined online gambling as the two industries which weren't allowed to advertise on Google, which is not illustrious company.

Johan Sorensen 00:55:49  And there's been changes to bringing in legit script. The fact we don't have it here massively disadvantages that now I think around SEO and that it's not my area of expertise, but with the introduction of AI, I actually think what will end up happening is physical centres will end up dominating it, which will, I think, level the playing field around that much more. So at the moment you can't really see where anything is even if there is a center. So I think the sort of, I think the weight it's going to put on physical location centers through ChatGPT and some of the others will change that, trying to get into legit script being broke and sort of bought over here or speaking to Google has been difficult. And the answer coming back is, well, you're still not clean enough in industry to legitimize it over here because legislatively, if you get it wrong in the States, you go to prison here, there's no consequences. So I agree it's unfair. I agree we as an industry could do more to change it, to make it fairer.

Johan Sorensen 00:57:03  But we have no representative body. We don't meet, you know. How do we.

Abdullah Bullard 00:57:07  Yeah. It's not unified.

Johan Sorensen 00:57:09  It's not.

Abdullah Bullard 00:57:10  Your country. Every law is different.

Johan Sorensen 00:57:13  Yeah. And you know, some of the bigger players who have generally been involved in sort of patient brokering and stuff are cleaning up their act. So there's, you know, really hopeful moves towards that happening. You know, it's great. and hopefully we'll get there. Yeah. Yeah.

Abdullah Bullard 00:57:29  Good. Hopefully today you run. You have been running in the last years. Portobello. tell us more about that. What work do you do? What type of clients do you do you serve?

Johan Sorensen 00:57:43  So Portobello again was set up mainly because I was cross. it seems to be a theme. So, so behavioral health coaching is, I love for several reasons. It's a great way of getting into the industry. Currently, if you want to train to be a therapist, I mean, you're likely to need to be fairly wealthy to afford the time and money to train.

Johan Sorensen 00:58:06  So you're looking at sort of middle aged, mid-career white people seems to be, you know, by far the most nothing wrong with that. But it's hardly a way of getting representative professionals into the field. So coaching is a great way of entering either as you train as the therapist or again, you don't need dumb barriers of qualification levels into it. you can we can train coaches really easily, cheaply. but it's a short training. You're doing it as an unqualified person. Am I seeing from the States? Was over here. You were getting coaches who are charging, you know, £200 an hour. Now, that's more than twice what a nurse with seven years training has got. And that that what ends up happening is we delegitimize the whole area of activity by it being rapacious. You know, it's you're shooting yourself in the foot. So Portobello was set up mainly because I was cross about that. I thought if I come back to England and I set up behavioral health coaching and dominate it, if you dominate it, you can start setting standards and pricing.

Johan Sorensen 00:59:16  Yeah. So that's the reason for doing the coaching and I love it. I mean it's it's a really if you're a 15 year old and you're taking drugs and your ADHD, seeing whether sitting in a room with a middle aged guy like me in a therapy session for 50 minutes versus me hooking you up with a 22 year old who goes to skate park with you. I bet he'll do a better job than I will in terms of connecting and possibly affecting change. So. So I love doing that. Case management again was about that was again, it's happened in the States for a long time. I've always worked between here and the States and, there is value. Like I said, in families having advice about what to do. So case management is one form of that. People call us and we'll figure out treatment plans. Our job is to know what all the services are, who all the professionals are, and match people in with the right thing. And we charge the family for that. There's no yeah, I don't.

Johan Sorensen 01:00:17  If you offered me a ticket to Mallorca, I wouldn't take it. So our research is far back and we get paid by people looking for help. So Portobello does therapy. We're a great therapist. We do case management, we do coaching.

Abdullah Bullard 01:00:29  And you serve clients locally? Global? Oh.

Johan Sorensen 01:00:35  global. It's global. And so treatment, the in-patient treatment bit, the bit that you specialise in or others specialise in. We know how to do that. It's great. The front end and the back end. We do not do great support of bellows about doing those bits. It's staying clean and treatments easy. You're in treatment. So it's ensuring that the biopsychosocial post treatment bit works and you've got a niche it out. If you have if you have, you know, a 23 year old, posh cocaine addict in treatment and you say, well, just go back to London, go to meetings. Now, if she goes to the wrong meeting, she may never go again. Yep. So the trick is knowing exactly which meeting or who to hook.

Johan Sorensen 01:01:27  It's like manipulate the situation to the advantage. So? So that's my sort of passion part about that.

Abdullah Bullard 01:01:36  To connect the right person and to create the right motivation in in them.

Johan Sorensen 01:01:41  Right. Yeah. So hopefully you get better outcomes if you if you're able to provide a longer continuum. One year of engagement really changes the relapse rates. And it's not that you need to be in treatment for a year, but you know, points of contacts for a year make a difference. So that's no we treat we we're we're global. I mean most of them are English.

Abdullah Bullard 01:02:02  But if I, if I yeah if I understand it correctly I mean we as the balance we offer the residential program where you step in is in the preface let's call it it can be an intervention phase. It can be supporting the whole family, not just that person to be then also in treatment and and the beyond that let's say the aftercare support for mid longer term. Yes. To create a successful outcome.

Johan Sorensen 01:02:33  Yes, but crucially, it needs to.

Johan Sorensen 01:02:36  So the engagement needs to happen between the provider.

Abdullah Bullard 01:02:41  And the families.

Johan Sorensen 01:02:42  Well, no. So so it's the planning of the continuing care needs to happen. Early treatment. Yeah. Because what generally happens often is the family or the system around them. You know, once the person's in treatment they're like great problem fixed. So actually explaining to people you you need to think about this in terms of in in a long term care. So the best successes are when we are working with treatment providers from early doors, you know, as soon as someone's in treatment, you're starting to build a biopsychosocial picture about what people need on the outside. Get people used to that idea, but it's great. Yeah, yeah.

Abdullah Bullard 01:03:26  No sense. Sounds as a as a crucial, Important service for families to to have a long term successful outcome. and, you you mentioned this young posh client. So you work with many high net worth individual clients or have been in the past also. How do you see the differences there? Are there different needs, different techniques, different ways of communication? what's the difference to normal treatment? You would you would offer to to someone else.

Johan Sorensen 01:04:06  So I'm tempted to say less than you think. I so we're not a particularly I mean, we're cheap in the marketplace, so we're not particularly. And everyone charge the same. So you're not charged more if you're a sheikh than if you're if you're a teacher next door. a round that and understand a true understanding of the lifestyle and pressures and needs of the person coming in is important. It's also important to understand that if you have a doctor come in, so it's not unique to someone who's a high net worth individual. You need to understand the pressures on a lawyer. You need to understand the pressures on whoever you have coming through the door. I think the thing that the area and I guess, you know, there's some personal experience and many of our friends is often actually the second generation of wealth or the third or whatever. It's creating meaning and purpose for people who don't need to work. You know, there's people who are self-made, and that's a very specific thing to tap into, whether you're treating entrepreneurs or successful business people.

Johan Sorensen 01:05:23  The generation beneath that, where there is not necessarily any motivation. Creating meaning and purpose. I don't care so much what the environment is. I care a lot about people being able to tap into the meaning and purpose without meaning and purpose. It's really hard to see why anyone would be successful. So for me, that's that's the crucial. And I have clients who want to go to the most expensive or the most. And I think that's great. You can go wherever you want to go. I think, you know, the balance has actually got great clinical integrity and an understanding of the clients, which is I'm not going to say I'm not going to be unfair and say it's unusual, but it's a bit unusual. so so it needs to be nice if someone went. But, you know, I've had billionaires go somewhere, which isn't nice. It doesn't need to be nice, but you have a choice. If you have, you know, if you have $1 billion, you have a choice of where you go.

Johan Sorensen 01:06:24  So, the crucial bit, I think, is the meaning and purpose, but it is, Again, not again. Individualised. Some people I know want to go somewhere so they feel exactly the same as everyone else. So individualizing it makes a difference. But the meaning and purpose and the systems around it, you know, trying to untangle family offices, being or if it's entertainment, being able to work with the agent is as important as working with whatever the talent is, being able to renegotiate contracts in order to incorporate self-care. Once you're back on set. All of those things are things I'm like, you do well, but if you're if you're going for that, those are the bits that matter.

Abdullah Bullard 01:07:17  I couldn't agree more. I mean.

Johan Sorensen 01:07:19  You know more about it than me.

Abdullah Bullard 01:07:21  The motivation, you know, the purpose and the motivation. that's that's what most people then may lack. And then also the, the social surrounding. But the for high networks and let's say people entrepreneurs and and certain positions.

Abdullah Bullard 01:07:37  There is also the the this discussion between individualized treatment versus group based treatment and so on. So not it doesn't. As we discussed before, it doesn't mean one size fits all. And and an individualized program or one client program. There is the individualization which can be much more tailored also to some of the cases you have been involved now lately in taking over.

Johan Sorensen 01:08:08  The first.

Abdullah Bullard 01:08:09  Year.

Johan Sorensen 01:08:10  You're one of the first people I came across. So when you were talking about individualized treatment by incorporating the group element. Yeah, but but the fact that that was fairly revolutionary is amazing, but it shows the understanding of that again. The bit I like is if you have a duchess coming in and you need a coach, for example, that coach needs to understand what that looks like. There used to be a time where any old person be chucked into a role without any understanding. So if you know, if you're going back to Saudi, that person that's going with them needs to understand that you don't go up and give mum a hug.

Johan Sorensen 01:08:52  You know, all of those things. Individualized means within a cultural and personalized context. Anyway, there you go.

Abdullah Bullard 01:08:59  No, it's much more complex than just we are talking about it right now. It's the cultural understanding. It's the presence, the core regulation. It's certainly the understanding of the disorder. It's not just the addiction, it's also the mental health side. It all this, I mean, needs proper training.

Johan Sorensen 01:09:18  And your ability not to be bought.

Abdullah Bullard 01:09:21  Yes.

Johan Sorensen 01:09:22  So so you know, that particular segment are used to paying. So one of the things I enjoy about charging a rack rate, which is low, means someone's life does not stand or fall on what this incredibly wealthy person is paying them. They can go work with an accountant for just as much, which is why I want to fix the pricing as much as possible for coaching. Because suddenly if like whether I keep this client pays my mortgage or not, you're compromised at that point. At that point, you're going to try whatever you can to keep them dependent on you.

Abdullah Bullard 01:10:00  It's it's very important because this is what creates also trust. If you have transparency when it comes to cost. Yeah. a lot a lot of clients we have they, they have this always this have this feeling of people want to take advantage of them 100% And and we had just recently a situation with the client. We referred to another specialist which is out of our team. And then just because it was like a celebrity, apparently, much more cost was was calculated. Yeah. And I was feeling bad because, I mean, how could you? This is exactly what we are as an organisation trying to protect. And, so, so we needed to step in and sort that out and correct. We did this so the client felt, felt felt, taken seriously and and protected from, from from outside.

Johan Sorensen 01:11:01  Increasing the trust in your organisation as well in the process.

Abdullah Bullard 01:11:04  Which is important because I always say it's a marathon. It's not a sprint. What we try to do is not, okay, let's let's get the most out of this client now.

Abdullah Bullard 01:11:14  But no, this client will have successful experience. He will be a referral to others. He will. He will speak to other potential clients to us. We stay in contact. It's a beautiful thing I can get is if a former client sent me a message just randomly and say how grateful he is because he is now a wonderful life and and that's the purpose.

Johan Sorensen 01:11:40  Yeah. Oh, it's where ethical care meets good business. And the two go together if you're in it for the long term. Right. Yeah. Sounds like you got that. Yeah. That's good.

Abdullah Bullard 01:11:50  Hopefully we try. Yeah. Can we discuss your latest venture?

Johan Sorensen 01:11:56  Sure. So, it's a psychiatric hospital now. and the reason for that is so in, in the UK, we've got psychiatric hospitals with amazing clinicians getting in trouble again here. Amazing clinicians. they're all backed by private equity And you end up with a sales cycle generally. So five year sales cycle. And the care can become more focused on increasing your margin and squeezing your costs.

Johan Sorensen 01:12:29  And I know that because I've sat in the system I've seen it. And I keep doing it alongside that. As someone who refers in, you know, there's a lot of people with dual diagnosis or just general mental health problems, trying to get someone in can be difficult. So, you know, enquiry lines shut down or a nurse on a ward doesn't want to take someone in on a Friday. My experience, there's there's more mental health crisis on a Friday night or a Saturday morning. Then there is during the week. And so we'd be left holding someone who desperately needed or you end up with an inappropriate referral. We're leveraging a psychiatric patient into rehab would, which would take them on a Saturday, but simply because they couldn't fit in there. So, Cardinal clinic, I knew the family who owned it for 48 years. They got into financial distress and we had, you know, maybe four days to decide whether to whether to buy it, which we did. So I partnered with Robin, who's the first guy I worked with that promised way back in the day.

Johan Sorensen 01:13:36  and so we have it, and it's super exciting. I mean, I'm not sure if I know what I'm doing. I don't know whether it was clever. I was sitting there the other day. It was quite stressful. I'm not going to sell it. I'm not being salaried from it. So I was like, oh, wait. Why am I like, why am I? I think being able to provide well, you'll understand this the psychiatric profile and we have comorbidity with addiction, but we don't do an addiction program. I think addiction programs are best done in an addiction center, but we'll take comorbidity along with psychiatric. It's such an individual Thing. And if your interest is in individualized care, there are sort of general rules with addiction which don't apply with your average mental health patient. So that's great because we can, you know, employ somatic therapies or we can we can do whatever because we're not we don't particularly care about the cost of the delivery of service. So the ability to take someone in seven days a week, 365 and then really use Portobello as case management planning.

Johan Sorensen 01:14:46  So real treatment planning is is great. I love it. It's a bit stressful but really enjoying it.

Abdullah Bullard 01:14:55  Yeah, I'm pretty sure it will be helpful for for a lot of people because the psychiatric purely psychiatric focused clinics, from our experience, because we try to refer clients who cannot afford our program or who ask us for some specialized centers, and we have difficulties to refer if it's more psychiatric oriented because the rehabs even they on the website. Okay. We we provide services and that on that field depression, anxiety, trauma and so on. It's not it's not what maybe they are focused at. so rehab for addiction and but psychiatric focus, that's what I, what we're lacking actually.

Johan Sorensen 01:15:41  So yeah. And it's quite expensive to deliver because you need lots of psychiatrists and psychologists are quite expensive and you need lots of nursing and nursing. Exactly. But you need it. You can't, you know, that's the you can take dual diagnosis into an addiction program, but it needs to be fairly heavily stacked, addiction wide, because the need for for psychiatry, clinical psychology and nursing is, is considerably more.

Abdullah Bullard 01:16:07  But the training of the staff is different as well. I mean, the nurses every single person needs to have a different kind of level of education. It's different. you can, I believe it's not comparable.

Johan Sorensen 01:16:23  It's different. But also the thing that's been interesting is, you know, our background is therapy, and we really believe in the delivery of various therapeutic models into this population. But the tolerance levels completely change in the population. So if someone's coming in for autistic burnout, their tolerance to group therapy is going to be vastly different than an eight year old with early onset dementia and depression. So being able to create a community group therapy environment is like super niche and interesting. And you've you know, that's where I guess you can show your skill or experience. So yeah, you're enjoying it.

Abdullah Bullard 01:17:03  It's good. When is the opening?

Johan Sorensen 01:17:05  Oh no. We open in July.

Abdullah Bullard 01:17:06  You open now in July. Yep.

Johan Sorensen 01:17:08  And so.

Abdullah Bullard 01:17:09  Great. So congratulation and, hopefully.

Johan Sorensen 01:17:13  Come and see it. I mean, if you.

Abdullah Bullard 01:17:15  Happy to happy to.

Johan Sorensen 01:17:17  As a visitor rather than a patient.

Abdullah Bullard 01:17:20  Come on. Yes, I feel well I'm balanced.

Johan Sorensen 01:17:24  and then the other thing that's been hard is once you're once, you don't need to be an acute care. There's nowhere there's no secondary. Yes. In the UK. Yes. So you're either stuck at a very high cost in acute because nowhere to go or you're sent back home prematurely. So you end up with a massive recidivism rate or a relapse rate. So we've implemented sort of, you know, secondary housing within the ground so people can, again, the continuum of care, you can stabilize an acute you can then go into, transitional living about five minutes walk from nursing.

Abdullah Bullard 01:18:05  Oh that's nice.

Johan Sorensen 01:18:06  So measuring the outcomes through that will be great. We'll look forward.

Abdullah Bullard 01:18:10  Yeah. Looking forward to see. To see that. Yeah. But will we not be out of business soon with AI? Oh.

Johan Sorensen 01:18:20  I mean, who knows? It is. It is. It is amazing.

Johan Sorensen 01:18:24  So one of the things we did was we took what we did. I did sort of anonymized cases, quite a large number. And our, our our case managers are great. They're really well trained, really experienced, very creative in coming up with treatment planning. So I took some of these cases, ran them through an AI program to get treatment recommendations, therapeutic interventions. You know, the the clinical basis for each of these things. And it was amazing. And and you know, obviously I had my clinical team do the same thing. They didn't come out with anything nearly as good as the AI modeling which won't The the data set is enormous. So the trick is, obviously our families don't want that delivered in the spreadsheet from ChatGPT. They want it delivered by someone who knows how to actually humanize that and put it into place. But the ability to get it right increases exponentially with AI, which I find really exciting. I think there's a resistance in our field to it, which is a mistake like that might go wrong.

Johan Sorensen 01:19:38  We, you know, in three years, we may all be dead because it's gone wrong. Fair enough. But I'm not going to change. You know, I'm not going to be able to impact that. I think, you know, I've been to conferences where people said, well, you know, there isn't the co regulation that you get. And I think that's nonsense. I think you've seen dysregulation or re regulation through interaction with computers for decades now. So I don't I don't buy any of that once you combine graphics with AI and large language models and you measured someone's regulatory system, it's going to dysregulated co regulate all of that. So I think it will be transformative. and I think we're much better off seeing where our part in that is than trying to fight this sort of wave coming down. How about you. What do you think?

Abdullah Bullard 01:20:32  I, I'm with you. I'm with you. The critiques you mentioned is purely based on what AI is today. It's a 2D version of what it can be.

Abdullah Bullard 01:20:44  Once it's a version which is like a robot, or in our world can interact with us, that's different. If someone can show compassion and and interact with me, it will help a lot of people in the future. fairly quicker than the waiting list we have right now in many countries.

Johan Sorensen 01:21:09  Yeah. Can you imagine the delivery of AI to Burkina Faso? You know what? Like the cost of delivery is going to be like. There are so many permutations where this can improve mental health. The biggest barrier is going to be us as a mental health industry for it to be implemented. Yeah. So I think I think it's exciting and we need to see where we fit in it.

Abdullah Bullard 01:21:31  We are agile. We work around it. but I certainly already see it in my children. I mean, there are like between 11 and 16 right now, and they already refer to ChatGPT or similar tools for any live questions and or any conflict at school. They they ask. I mean, they mention it. Then to us we talk about it, there is an open conversation about it.

Abdullah Bullard 01:21:55  And I'm fascinated how quick this has become a reality in our children's life.

Johan Sorensen 01:22:03  There are opportunities for for us as well. Within this, I was just talking to my clinical director, and we've had our first person seeking help because they've become dependent. So they this person, it's a sort of variance of OCD. They check every decision which accept and have become completely reliant on it. So there you go. It's another stream of business.

Abdullah Bullard 01:22:25  We know it, no, but we will see where, where, where it goes. I mean, as with everything, as with social media, a social media healthy, healthy thing to to get to and and get information from. No, I mean then I.

Johan Sorensen 01:22:41  Am much more concerned about that one than I am.

Abdullah Bullard 01:22:43  I agree, I agree, John, what do you personally do to stay in balance in your stressful life?

Johan Sorensen 01:22:53  Yeah. So I sort of knew this answer was coming up but almost nothing you know, and I could sit here and lie about that and say, you know, I eat great, and I sleep lot, and it's just not true.

Johan Sorensen 01:23:12  So. And why and why is that one? I have five children. PVH looks after hundreds of clients, sometimes at a very high risk. I've got a new business that's a start up. You know what a start ups like? I do various, you know, other charitable stuff. My wife has this incredible, you know, she works on amazing things. That requires me to, you know, carry her bags or make sure the kids get fed. So, And I love working. So I'm terrible at looking after myself. I do very little to keep balance. I probably should, but I'm not good at it. I have a massage once a week that's organized by my wife, I'm not sure, but which I love. I mean, I'm very grateful for that sort of one of the highlights. And I try whenever I can to watch my kids play football when they're playing a match, or I have another child who acts, and if she's in a play, but this is that's about it.

Johan Sorensen 01:24:19  There is, you know, it's not much balance.

Abdullah Bullard 01:24:23  Right? Yeah. To some sort, your children keep you young and your wife cares about you. Do you have a support system in that way?

Johan Sorensen 01:24:32  Yeah. Look, I've got great friends around me, and I've, you know, great friends, great colleagues and field, I work like, mad and sleep very little. And I, you know, I do lots of stuff I'd never recommend to clients. And once the start up phase is finished, it'll be easier.

Abdullah Bullard 01:24:49  Different. But then I now officially invite you to Majorca to one of our facilities and get some rest. I would love, love.

Johan Sorensen 01:24:57  Nothing more.

Abdullah Bullard 01:24:59  Is there something you would you would like to share with anyone out there as something helpful in their lives.

Johan Sorensen 01:25:09  Something helpful in their lives? Yes. Oh, gosh.

Abdullah Bullard 01:25:12  What they can do, what they can implement.

Johan Sorensen 01:25:14  I mean, I think that is about, you know, find people to connect with. I mean, I know that's sort of glib, but the most helpful thing at times, you know, and I can get stressed, anxious and depressed.

Johan Sorensen 01:25:27  The thing I need is lifeline human beings. So find authentic human beings who, when you're in trouble and it really doesn't need to be a professional, it can be whoever. Make sure you got some numbers you can call when you feel incredibly low or distressed.

Abdullah Bullard 01:25:47  Like how can they? How can they connect? What can they do?

Johan Sorensen 01:25:52  Like, put your phone away, go sit by a fire and talk to someone about how you're feeling. Or ask awesome how their life is. Or you know, if you want to be present, find a young child, put your phone away, get down on their level and just interact with the child on on their terms. It will drive you nuts for about ten minutes and then suddenly you're connected and present. So, you know, it's it's, the brave, you know, the bravery involved in vulnerability. you know, which I struggle with. I'm like a Norwegian. We are not we are not famously vulnerable. But how I feel best is if I sit down with someone and I take the time and I really tell them what's going on in life, and often that is actually a social contact rather than, you know, a therapist.

Johan Sorensen 01:26:40  For me, I'm a terrible therapy recipient. I have to do experiential therapy to really get to where I need to go. but I can also do it by sitting down with someone I care about or who I know cares about me, and telling them honesty. This is going on in my life. That feels great having a cry, which I'm horribly bad at doing. I can sometimes watch like a Disney movie and that will get me through it, but like, find a way of releasing some of those feelings. Connect with something. yeah. See, this is not my strong point, but those have been my.

Abdullah Bullard 01:27:18  My was already very.

Johan Sorensen 01:27:19  Emergency points of advice.

Abdullah Bullard 01:27:21  Yeah. Thank you very much. Thank you for all the work you have been doing. in the industry, for all the people who have been getting the right treatment. showing integrity and and, I have a lot of respect to you. I enjoyed very much our conversation to the today. I know you are very busy. Taking the time here is very valuable to us.

Abdullah Bullard 01:27:49  Thank you very much, Johan.

Johan Sorensen 01:27:51  Thank you very much. It's been great. Really loved it. Thanks.