HELP - My Loved One Needs More care!

Where Do I Take My Child or Loved One Who Needs More Care?

What if we tried all the meds and weekly treatments, and it's no longer enough?

In this episode, Heleen Woest sits down with Larisa Klein, MA, an Advanced Treatment Placement Specialist, to unpack one of the most terrifying moments a family can face: realizing their child or loved one needs more care than outpatient therapy can provide.

IOP. PHP. Residential. Detox.
The options feel overwhelming, and the stakes couldn’t be higher.

Larisa’s entire role is guiding families and clinicians through that wall. She has personally visited and vetted programs across the country. She isn’t guessing. She knows.

In this episode, we cover:

• What a Treatment Placement Specialist actually does — and why their help is free
• The difference between IOP, PHP, residential care, and detox
• How to know which level of care someone truly needs
• Why 41% of people with co‑occurring disorders receive no treatment
• How the Stages of Change model affects timing (and why pushing too hard backfires)
• What real trauma‑informed care looks like, beyond surface behavior
• When outpatient wrap‑around teams aren’t enough
  
  Connect with Larisa Klein, MA
  Advanced Treatment Placement Specialist
  Larisa.Klein@AcadiaHealthcare.com

• Visit Heleen's Blog to learn more about this topic and the research behind it: https://www.lifesolutions.io/blog/
  
  
• Watch the video version of this episode on YouTube:  https://www.youtube.com/@heleenwoest/videos
  
  
• Explore upcoming topics that are dropping soon on The Missing Piece: https://www.lifesolutions.io/podcast/

Transcript

When Weekly Therapy Hits A Wall

SPEAKER_03 0:00

Today 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. A 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. And 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. Here is what I have come to believe. It 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. I 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. She 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. If 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. Let's get started. Welcome

Meet The Treatment Placement Specialist

SPEAKER_03 1:27

to the Mitting Feed, Cracking Therapy for Applicator. I'm your host, Colleen Boost, and I'm a licensed professional counsellor. Today I have Larissa Klein with me. She's a counsellor and also a treatment placement specialist. Her whole job is helping families and clinicians navigate the higher levels of mental health and addiction care. She 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. She 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. She is not guessing. She is an expert and she knows what she's doing. Aurosa, welcome. Thank you, Halloween. It's so nice to meet you. I love having you. Yeah. Well, uh, can you describe in plain language what a treatment placement specialist actually does? Uh, and where do you come into the story for a shrugging family?

SPEAKER_01 2:30

Just sort of out of you. Yeah, absolutely. The way that I came into becoming a treatment placement specialist is really kind of a calling in my life, I think. Um over the last 20 years, I've focused on mental health, behavioral health, psychology, the brain, why we do the things we do. Yeah, you know, that was always a question when I was going into school, you know. Um, things kind of went a little sideways when I was quite young and I wanted to kind of get into the business realm. Okay. So 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.

SPEAKER_00 3:16

Okay.

SPEAKER_01 3:17

And I loved it. I mean, it was like an immediate, this could be a career. I remember sitting in an office similar to this with a group of people. I had a team and I like loved it. You know, I was like, this is so fun. And you know who I am now, but so I got got to like fulfill the role and the dream of being a businesswoman too.

SPEAKER_03 3:40

Oh wow.

SPEAKER_01 3:41

So that was a big piece of this too.

SPEAKER_03 3:43

Business and counseling that actually do go well together, don't they?

SPEAKER_01 3:47

Yeah. Yeah. I 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. So there's a clinical aspect and a business aspect. And 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. So when I found out about the treatment placement specialist role, I was like, hmm, this is kind of interesting. Uh and I I pursued that and it was really fun to learn more about it. I am employed by an organization, and I will say through the whole podcast, these are all my views. These are not the views of my employer. People can probably find out who I work for just by searching. So I just want to put that disclaimer out there to protect both them and myself. Absolutely. And just so everyone knows that we're, you know, we're gonna maintain all HIPAA compliant.

SPEAKER_03 4:46

Yeah, 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. And I was like, what? You do what? There 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? And you're really still just taking a chance, you still don't know where they're going. And definitely has happened to me in the past where I hoped the place was good. I heard some good things about it. I don't really know. Uh, and I tell the clients, I really don't know myself, but I guess try it and it was horrible experiences, you know. Yeah, 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? Because I care about my clients. I want them to land in a good place.

SPEAKER_01 5:45

Yeah, I mean, we get into this role and we realize that we're helping people, we want to continue to help them. We do not want to harm. No, right? That is not our nature. No, and when that happens or if that happens, it it does happen, you know, unfortunately. Um, we want we want to either a make it better or prevent it from happening again. You 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. How do they operate? And that builds the relationship and it also builds trust and rapport. And 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.

SPEAKER_03 6:41

And just I think me and you are going on a road trip.

SPEAKER_01 6:43

Yeah, because I want to see more of these places. Yeah, 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.

SPEAKER_03 7:00

Yeah, no, I didn't even think that that's probably a possibility, right? And 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. Yeah, yeah, wow. You

Levels Of Care And Why They Exist

SPEAKER_03 7:15

can just maybe walk us through the different levels of care. And 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. And um, so what is the difference between, you know, IOP, PHP, all this stuff. Yeah, um, all the acronyms. Yes, all the acronyms. If you can just sort of in a nutshell tell us what that's all about. Sure, sure.

SPEAKER_01 7:38

Yeah, 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? And that's kind of how we do treatment. Okay, right. Yeah, that's sure. We create a treatment plan and we follow that plan, right? And like I said earlier, it's good to have a plan. Yes, yeah. That's very good. So 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. I'm talking decades ago, um, when there was abuse. This was you know very early on. Yeah, there were lots of things happening um where people were staying in facilities for months and months and months, right? So the level system kind of came into play to help identify how to do this better. And I think, you know, as a as a culture, as a society, we do try to get better by educating ourselves. So 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? Yeah, 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? So the mental health programming and services and levels of care um are come from the level of care utilization system. And 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. And then there's like recovery support, all of those things. That's the level of care utilization system or locus or addiction. We use the American Society of Addiction Medicine or ASAM criteria, yeah, right. And so some people may have heard about this. Of course, if we're if if the audience here is a clinician, this is all rudimentary for you. But at the different levels of care are kind of dictated by these systems, right? So 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.

SPEAKER_03 9:59

Okay.

SPEAKER_01 10:00

And then level one is outpatient, and then there's uh residence recovery, which is RR.

unknown 10:05

Okay.

SPEAKER_01 10:06

So those are the two differences. You know, mental health has one and and then addiction has one. Okay. And then for a residential level of care, um, that's a that's that's the primary realm that I work in. So that's very well, it's it's very hard to a lot of folks feel like, oh, I know about residential programs. But we get inpatient residential intertwined with the terminology with clients. That's what I find the most difficult to entwine, unravel with clients.

unknown 10:37

Okay.

Inpatient Vs Residential Safety And Agency

SPEAKER_01 10:38

Inpatient acute care behavioral health is very different than a residential treatment center.

unknown 10:46

Okay.

SPEAKER_01 10:47

Inpatient, yeah. So inpatient treatment is is really because there's a risk of harm. The criteria for an inpatient behavioral health hospital is a client that is suicidal with an intent plan and means to carry out the plan. Or homicidal, yes, meaning that they're going to hurt someone else. Yeah, they have means, they have intent, they're going to do this. Yes. Um, there's or there's a very real possibility that they could do it. And then there's also gradually disabled functioning.

SPEAKER_03 11:21

Okay.

SPEAKER_01 11:22

Okay, so those are the three main criteria for inpatient. All right. And what happens is clients will admit into those programs for psychosis as well as suicidal ideation most often. And then very regularly, but not quite as often as the homicidal ideation piece. Okay. Okay. And there are two different ways to go to those programs. There's a way to go voluntarily and there's a way to go involuntarily. Yes, right. So the legal system has place, you know, pieces in place in each state.

unknown 11:55

Yes.

SPEAKER_01 11:55

In different states, we have we have them different. So the states regulate your mental health capabilities and rights individually. Okay. Okay. So that's inpatient. And that's what a lot of people get muddied in with residential treatment. Residential treatment centers are voluntary. At a residential treatment center, you can leave whenever you want to leave. You don't have to stay there. Very important information, I think. Yeah. Yeah. The 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. It just goes to your patient automatically. Right. Yeah. So 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. There are safety protocols, and that is regulated by various organizations in our country. Um, and they adhere to those regulations for those services, right? Yeah. And so they have a regulation piece in place. So 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. If you don't need or want to take insurance, then you don't have to do that. And 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. So I tell people all the time, this is kind of you're in the driver's seat here. If they've been in an inpatient setting, they don't have a lot of autonomy or agency. They can't leave a room or a space on their own. Yes. Right? And that can feel very confining and trapped, even trapped. Yeah. And trauma and trapped do not mix.

SPEAKER_03 13:38

No, they do not.

SPEAKER_01 13:40

Yeah. So residential treatment is a phenomenal level of care that can be incredibly helpful for so many people. Typically, residential has group therapy, both process and psychoeducation groups, as well as now experiential groups, like equine assisted therapy or a ropes course. What 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. At some of these programs, there are psychological testing that's offered. And I'm really leaning into the mental health side in my brain right now. So I just want to put that caveat out there. If 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. Aha moments happen in treatment.

SPEAKER_03 14:33

I can see that. It 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. Exactly. And it's uncomfortable for people with addiction and mental health, uh, mental disorders, is to to sit. They're mostly running from that thing, and the running makes it worse. So having a moment in time at a place like that where the focus is on what's happening with you is actually pretty amazing. I can see that they could be huge epiphanies and breakthroughs at a place like that. Yeah.

SPEAKER_01 15:02

That's kind of the goal. Yeah, that's why we would recommend this for a client. Is you know, if you're in an individual session with your therapist once weekly or twice monthly, right? Bi-weekly, and you have some aha moments, triple that. And wouldn't it be awesome if we just had a retreat center that we could go to? Well, those exist too. Retreat centers exist as well. Yeah, they do. Absolutely. Tell me more about that. Yeah. Well, I just found out about one actually. Um, that you know, you can go for a weekend and do an intensive. I 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. Oh wow. Now those aren't, you know, they may not have trained therapists at the level that a residential program has, though.

SPEAKER_03 15:52

Yeah. So so residential is always professional people.

SPEAKER_01 15:57

Yes, you you would be seeing licensed psychiatrists. You'd see a licensed medical practitioner, um, both on the pharmaceutical side and also the integrative medicine side, too, right? In some programs, um, like natural medicine chiropractors, massage therapists. Yes. Yeah. So at a residential level of care, like I said, there's individual therapy, group therapy, experiential therapy that's happening. There are some integrative practices that can happen. Sound baths are now a thing, yoga is a thing. But then there's also the amenities that you get in residential treatment too.

unknown 16:33

Okay.

SPEAKER_01 16:34

Olympic-sized swimming pools, you know, hot tubs, ropes, courses. Um, you know, they might use goats for their therapy instead of horses. Who knows? But yeah, those are some pieces of something. Yeah, honeys, yeah, you know, having animals around, using music, using the arts. That is a whole so so crucial. So, so therapeutic. Yeah. Um, so those are the things that you can do.

PHP And IOP Returning To Life

SPEAKER_01 17:01

There's also like we don't want to leave out these incredibly important other pieces, which is PHP. Okay. Partial hospitalization program is what that stands for. And that's an intense level of care that's usually around 20 to 25 hours a week. So if you think about it, that's a part-time job. Yeah, right. Really? So typically people will need to take some time away. Um, that's typically group therapy, individual therapy, and medication management. And those exist in our communities and people can go to them. Sometimes they have to have boarding with those if they're coming out of addiction treatment and they need sober living. There's something called BPHP now, which is boarded partial hospitalization program. Okay. So they have sober living attached to their program. So they're living in a sober living community or a home, and they're integrating back into life after getting treatment. That can happen for mental health as well. There are boarded mental health PHPs as well.

SPEAKER_04 18:02

Wow.

SPEAKER_01 18:03

And then the intensive outpatient level of care, high-intensity outpatient treatment, is really around nine to ten hours a week. And those, you know, those programs are people are typically working and seeing their own individual therapists in those levels of care. They're not now seeing the program doctor, they're seeing their own doctor for their meds. So 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. Okay. So I do really endorse everyone is so unique. So 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. If 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. I 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. If they're apps, if you're absolutely concerned about their safety, then they need a higher level of care than that. So we need to do something quickly, right? We 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. This is no longer a safe environment for you to process this. And 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. But 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. And then outpatient is your continuing care support. But 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. And it's I find it to be helpful. A 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. So I really do want, you know, like I said at the beginning, this is all created because of abuse of the system. Yes, 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.

SPEAKER_03 21:12

That's what we're going to do. Absolutely.

Getting Clients Ready For Treatment

SPEAKER_03 21:15

Um, yeah, and and speaking of that, you know, getting them there, getting them ready. Um, maybe they're at one of the stages of change if they're just not not ready. So um tell us a little bit more about how do you work with therapists to help them get their clients there. What are some ideas that you have?

SPEAKER_01 21:34

Yeah. So yes, you sent me some of these questions beforehand, and you mentioned the trans theoretical or the stages of changes. Yeah, the stages of changes. And yeah, stages of changes. So I was looking through those, and I've used the terminology quite a bit myself. Um, of we're kind of in the pre contemplative stage right now. But to come alongside a therapist and help them support their client through this is. Is it's an honor to be able to do that for me personally. So I want to support the the practitioner and helping them present options. And so what I've done and how I how I've done it is kind of very um organic. You know, what are you thinking about? You know, you should you shared with me what's going on with your client. What are you thinking? And and then they'll tell me, well, I'm thinking an intensive outpatient level of care. And a lot of people do that because they're afraid to present the residential level of care. So coming back to the stages of change, we need to get a plan in place. And that's where I say there are definitely options to consider. So I look at three things first and foremost, clinically, what's going on with the client? Financially, what are what's within their means? And geographically, where are they willing to go? Are they willing to travel? Because in our state, there aren't a lot of options for certain types of treatment, like a residential mental health program. There can be services through the state that are offered. So when people come to me and they're, you know, professionals call me. My first and foremost question is where are they in this space? Do they want to pursue treatment? How can we work with them? Oftentimes they're already to that place. And so we're we're talking about options. We're we're running benefits, we're finding out, you know, they have an insurance plan that we work with at this program. This is the program. Let me tell you about it. Um, and this is the benefit of this program, this is how it feels there. There are programs that do um campus style treatment where it look looks and feels like a college campus.

SPEAKER_00 23:56

Oh wow.

SPEAKER_01 23:56

And then there are programs that do um treatment within residential settings. Like you could, you know, you're at a house in a neighborhood. Okay. You know, interesting. Yeah. There are neighbors around that are not in treatment. They live in their houses, you know. That's very interesting. Yeah. So and and different states have different rules around those things. In our state, we have both options. Um, and it's it is uh, you know, really important that we look at the treatment outcomes at those programs. It's important that we know the people that are providing services at those programs. So uh you gold standard best practice would be a residential level care transitions into a partial hospitalization program. Partial hospitalization transitions into intensive outpatient. But clients have lives, you know.

SPEAKER_03 24:48

Yeah, they want to get back to their lives. Yeah, it's difficult.

SPEAKER_01 24:52

And a lot of them skip those stages. Oh, yeah. And then they have to go backwards. So 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. If 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.

SPEAKER_03 25:22

Yes, that's the other part of it. Yeah. Is it the perfect world to now stay off the you know addictive substance or to really just focus in there? There's nothing that's challenging you, there's not a lot of dysregulation. Now you get home and everything's still waiting for you. Right. So very important.

SPEAKER_01 25:38

Yeah, I think. Yeah, 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.

Co-Occurring Disorders Detox And Dropout

SPEAKER_03 25:50

Okay, so I have this question. Um, you know, let's talk about addiction and comorbid disorders for a second. Um, 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. On top of that, 53% of people with illicit substance use disorder also carry a psychiatric diagnosis. Um, the dropout numbers are staggering. Roughly 30% drop out of psychosocial addiction treatment, and during detox specifically dropout can be as high as 43%. So, can you talk a little bit more about that?

SPEAKER_01 26:28

Yeah, absolutely. It's so important to incorporate mental health care into addiction treatment.

unknown 26:37

I believe that.

SPEAKER_01 26:38

And a lot of programs do that now. Oh, it's okay. It's very standard now.

SPEAKER_03 26:43

Okay, that's good to know.

SPEAKER_01 26:46

So for a detox center specifically, they're doing a either level 3.7 or 4 in the ASAM scale. Um, 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. So 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? Where they offer detox and they offer residential treatment, right? Yes. And they can maintain your medications, they can keep, you know, so it's nice to have that in one space. If it's not if it's not within the means, there's access barriers because of finances or what have you. There are a lot of folks that are needing detox who don't have the means.

SPEAKER_03 27:47

Yes, mental disorders and addiction and the two together really makes for um a situation where people main chances everything they do, yeah.

SPEAKER_01 27:56

Yeah, and it's it's very difficult to navigate those things. So 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. And 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. So 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. And 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. And 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. So that's helpful. That is fair. Um we can we need to know where they're at. And we also need to trust the client, but we need to be very skeptical, yes, too. Yes, because there's shame and stigma attached to substance use. Yes, so be very aware, you know, being very aware of that. So at a program that offers behavioral health care for depression, trauma, anxiety, bipolar disorder, maybe there's a thought disorder, maybe there's psychosis. Yeah, it's really, really helpful. It's much more uh likely that they won't relapse. It's much more likely that they'll get into long-term recovery if we have these supports in place. So 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.

SPEAKER_03 30:12

Yeah, no, for sure.

SPEAKER_01 30:14

So 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. And that's something that I talk to a lot of clients about. We've created this new terminology in our field called substance use primary or mental health primary, and that's really because of licensure. So 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. Yeah. If you are using substances and that's the primary thing that's bothering you and really altering your life, then your substance use primary. It'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. They'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. You'll see them on the website, right? So, and you'll also see that uh their treatment outcomes are listed on the website.

Programs For Licensed Professionals In Trouble

SPEAKER_01 31:31

So 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. Or maybe they work with professionals.

SPEAKER_03 31:49

Doctors, they are therapists, they're in trouble. They have an addiction and it can cost them the license, right? I love that there's centers like that. And 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? And that's super helpful.

SPEAKER_01 32:07

It is. Yeah, I mean, we have a great program locally here that has been in working with licensed professionals for decades. Healthcare professionals in particular. Particular. Okay. Yeah. I 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.

SPEAKER_03 32:42

Yeah. Exactly.

SPEAKER_01 32:43

I mean, so having the licensed professional monitoring program through the states is incredibly important and helpful. It is devastating, but it also ultimately brings clients to a new space. Right. There's also, you know, when you talk about those licensed professionals programs, um those monitoring boards vet out those programs. So 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. So it can be a great ally for you and support when you're working with with folks.

SPEAKER_03 33:23

Yeah, absolutely. I 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. And I'm worried, am I supposed to report here? What's supposed to happen? And 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? Can you help me out? Because um we feel overwhelmed sometimes with those kind of things. If you haven't worked with it before, it's just it's scary. And 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. Well, maybe we can start with Larissa, right?

SPEAKER_01 34:05

And she can help us out with some stuff. One 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. And 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? C-suite positions in various industries. And she has started a recovery uh career coaching business. Oh wow. So 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. Yes, she has to pivot. And she has uh uh transportable skills that would go into a different uh uh field. But sometimes don't know where to start even. And and we're you know, we're dealing with shame.

SPEAKER_03 35:07

So much shame, so much shame, so much shame and so much pain. I mean, we all know who are licensed and so what went into that yeah, so many hours, right? Yeah to just get it and then to hold on to it. And something like this happens, and it you can feel incredible shame, like you're saying, like a failure.

SPEAKER_01 35:25

And it's a trauma now, and it's a pivotal point in our lives that is part of our story. We have two options, right? We 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. Yeah, and like let's support people to go the positive direction. Recovery is possible. Yes. I work with people who are in recovery. I I work, I have family members who are in recovery, right?

SPEAKER_03 35:55

I know this is possible. There is hope. Trauma is treatable, and so many addictions have trauma behind them. Trauma is treatable, you know. But if you are going to a facility where they just treat the physical, uh, that's um so let's just say that. I've worked at June Gospel Mission for a while. Um, uh women and men sheltered, and there is this time, crucial time, when the body is absolutely working against us. The body needs to be, we have to start at the bottom of the bodies first, right? But then if we think that's all there is, that's it. So I'm not using anymore. We make a big mistake. I don't think there's anybody that can stop there. There'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. How about we try again and we do it different this time, right?

SPEAKER_01 36:50

Yes, yeah. And

Peer Mentors Aftercare And Family Support

SPEAKER_01 36:52

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. That is incredible. And how many of our therapists that are in private practice lean into the peer recovery mentor space?

SPEAKER_03 37:37

Not very many, not many, and it's super, super important.

SPEAKER_01 37:41

It's isolation. We found this out in the pandemic. Isolation breeds anxiety and depression and bipolar comes out, and we start to see major psychiatric symptoms coming out, and it's not good. When we live in isolation, it only breeds the negative. When 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. I know as a mom, I feel so much better when I start talking to other moms about what they're doing every day. Absolutely. If 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. Yes. And there are other people that can help support me through this process.

SPEAKER_00 38:29

Yeah.

SPEAKER_01 38:29

When I get home, I need that. Recovery coaches are also incredibly important. And reserving some funding to be able to have some of that is really important. Or a sober companion when you get home because the last seven times didn't work. Exactly. And you've spent so much money on treatment programs, but you're not really working on when you get home.

SPEAKER_03 38:52

Just a bird's eye view about what happened last time, why did we fail. Right. But also that aftercare, I think, is so essential.

SPEAKER_01 39:01

Incredibly crucial because that's what's going to get you to long-term recovery.

SPEAKER_02 39:04

Exactly.

SPEAKER_01 39:04

Like there's AA, NA, all different kinds of support, uh, structured support groups that I mean have proven track records that they work, right? It works. Um, doesn't work for everybody, and there are definitely different kinds, but there are definitely options with this recovery piece. There'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. That's hard. Yeah, it is. I mean, how? So 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. How 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? What do you want? And have a conversation instead of shying away from it.

SPEAKER_00 40:06

Yeah.

SPEAKER_01 40:07

And there are excellent groups, there are services available locally that are pretty accessible and attainable and not really that expensive, honestly. And 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. Yes. Right? So they're called craft groups. It stands for something, and I didn't look it up. So, but I do know the provider that that offers it. Lots of providers offer it. Um, 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. Yeah. And we're talking primarily about adults today, but children go back into the family because they're children. So, 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. Yeah. And that's not their responsibility. So looking as a therapist, supporting your clients to say your child needs help, and so do you. And 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? I always tell clients if you want to include your family, you have to sign a release of information. So we prep clients, we prep the families. If you need a way to get connected to the program, I'm a great conduit for you.

unknown 41:45

Yeah.

SPEAKER_03 41:46

And sometimes the families do not need to know. They sometimes a whole situation where it's not safe to do.

SPEAKER_01 41:52

Absolutely. And 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. Yes, they can. So, and that's that's a a a space that's built in because there is a safety issue. Yeah, right.

unknown 42:12

Yeah.

SPEAKER_01 42:12

Um, 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. And it's it's a family disease.

SPEAKER_03 42:24

Yeah, no, I love this. I 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. Yes, you're not all they are. Yeah, where are they at? Are they ready to go in? What will work for you? Are we do we have things afterwards in place? Otherwise, this might not work out, you know, all the things. Yeah, I love that. That's really excellent. This was just a wonderful conversation. There was I really enjoyed it. We just organically went with it. I'm like scrolling through my questions. I'm like, yeah, we covered all of them.

SPEAKER_01 42:57

You 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. So 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. Um,

Money Marketing Concerns And Next Steps

SPEAKER_01 43:17

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. We do a lot of social media marketing. Um 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. And we can't be everything, but there is definitely a piece, like you said, the missing piece of somebody that can help navigate this. And 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.

SPEAKER_03 44:04

Yeah, no, definitely. I love picking your brain up today. It's funny because it's really fun. It's really uh I feel like it's a very realistic way that you're thinking and that you're dealing with this. You come at it from all sides, look at all the pieces, which is it's super important. These are such hard things putting uh or helping people get into a facility where they can be treated. It's not an easy thing for therapists, for the family, having you on our side, somebody who actually knows the places. Um 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. Because 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. If it's if it costs a lot of money, I'm like, wait a minute, are you even gonna care for me? Is it is this just about the money? Do you even have good people on board? All of those questions that we can ask you, right? So say a little bit more just here um before we end off about that. That's interesting.

SPEAKER_01 45:07

Absolutely. So, yeah, I mean, there is an investment, and there are folks who say, I need to do this, I will make a way. I have family members that want to help me do this. Yes, so we don't want to exploit that. Exactly. We 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. There are very affordable treatment programs. Sometimes they don't pay anything out of pocket because they've already spent their out-of-pocket maximum on their policy.

SPEAKER_02 45:55

Yeah.

SPEAKER_01 45:56

So you never really know. And therapists can shy away from this because they don't want to get want to get into the money conversations. I'm happy to think I'm happy to do it. I'm happy to have that conversation. Yeah, yeah. I want to clinically consult with you, but that clinical consultation can turn into financial consultation. It 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. Do we need to start at an intensive outpatient level of care? All of those things are conversations that we're gonna have based on what's what's going on with your client at that time.

SPEAKER_03 46:29

Yeah, absolutely. Well, I really appreciate that. I feel like that part that you are you care about the person in front of you. You really want to see that they succeed. And uh it's not, I want to get you into this program because I I work for this place, right? It'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? And these managers are like, What is he doing? But then after a while they realize, oh, people keep coming back. They feel so they feel so cared for here. They 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. And 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. Yes, I have to make a living, yes, there's money involved, but what is ultimately best for you? What do you need? Right, and that's that's quite precious. So thank you for being that, Santa. Really appreciate that. So 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. I will drop information on how to reach Larissa and her team in the show notes below. Um, and again, thank you so much. I so appreciate having you today. Thank you, Larissa. Please subscribe to the Missing Peace podcast on YouTube, Spotify, Apple, Amazon, and other well-known platforms. And I will catch you guys next time. So keep looking for those missing pieces.