Latest / Conversations with Cumberland Heights / Addiction Recovery Clinical Services with Tami-Jo Stevenson | Episode 34

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Addiction Recovery Clinical Services with Tami-Jo Stevenson | Episode 34 · Conversations with Cumberland Heights

0:00
Okay. Tammy Jo. Yeah.
0:03
Welcome to the show. We've already started.
0:04
Oh, we just we just go.
0:06
So I knew it was a natural at this.
0:09
So, Introduce yourself, tell us who you are.
0:13
Okay. What do you do for work?
0:15
So I'm TV Joe Stephenson.
0:17
I'm the vice president
0:18
of clinical services at I Watch Recovery Center in Kent, Connecticut.
0:22
And I'm also a person in long term recovery.
0:25
I oversee
0:27
the clinical, team at High Watch.
0:31
We are really big into, bringing in the best
0:37
possible, modalities and trainings that we can to train the staff.
0:41
But in doing so, we also,
0:44
a part of our facility is a wonderful lecture hall.
0:47
So when we bring somebody in to train, the clinicians,
0:51
we invite the community, provide them a really a nice lunch
0:54
because I think, it's great
0:58
that we have really well-trained clinical staff.
1:01
But if we don't have anybody to refer out to in the community
1:05
when people leave, you know, there could be a really big drop off.
1:08
So I think, providing the training, to the community around you,
1:13
to the referral sources that you will be sending people out to for therapy,
1:17
you want them to be able to, you know, have a seamless transition
1:21
in the modalities that you've been it smart working with and stuff like that.
1:25
So it's smart and supportive people
1:27
that are coming to high watch, especially being in Kent.
1:30
Yes. Yeah.
1:31
I mean I mean people are going,
1:32
you know, when they leave all over and all over the state, but,
1:37
you know, trainings for a clinician,
1:39
you know, a lot of times when we're referring people out,
1:41
they're going to private practice, clinicians and things like that,
1:44
and trainings and training in a modality is thousands of dollars, you know.
1:50
So thank you for saying that.
1:51
Yes, it is very expensive and it takes years to get the other.
1:56
Yes. Trainings. Like what?
1:58
Like you just go for a three day thing and you're like, man, I'm so glad I went.
2:01
Now I'm an expert, correct? Yes.
2:03
So I am, a somatic experience practitioner,
2:07
which is Peter Levine studies.
2:09
It took me three years,
2:11
to get to the advanced level, thousands of dollars.
2:16
You have to travel to do these things.
2:18
It's an I mean, it's a yes.
2:21
It's not only a financial investment.
2:23
There's an emotional mental invest.
2:26
I mean, it's yes, it's it's no, small feat.
2:31
Right?
2:31
Are you I can't remember, are you an LPC?
2:34
I am an LCA.
2:35
Okay. Yeah. Licensed clinical social worker.
2:37
Yep. And I'm a somatic experience practitioner.
2:40
And now because we have brought in, Richard Schwartz, all of the clinicians,
2:45
including myself for level one, I trained, we have level two coming in.
2:49
What ifs is, internal family systems. Yeah.
2:52
So it's parts work, being able to
2:55
identify managers, firefighters, exiles,
2:59
it has of all the modalities we've done
3:02
and we have trained with in and psychodrama.
3:05
She has experience.
3:06
Yes. All these amazing things.
3:08
And we use all of them.
3:10
We integrate a piece of all of them.
3:12
Ifs is something that in our facility,
3:17
just immediately change the language we use.
3:20
We started
3:20
speaking in parts language like it's just some the all the clinicians started
3:24
creating their own groups using the ifs and workshops and things like that.
3:28
It's amazing.
3:29
Probably, because I'm systems MFT, world Marriage, family therapy,
3:34
but I believe I guess correct me if I'm Wrong is along the narrative vein.
3:39
Yes. Externalizing. Right.
3:41
Yeah.
3:42
You're identifying the different parts that we have created
3:45
that protect an exile in us.
3:47
And so it is about, you know, peeling back some of the layers on,
3:51
those parts in order to eventually in the way connection
3:54
and become more self led in the way, sort of the nuts and bolts which I love.
3:59
We just go right into the nuts, but the nuts and bolts of that or that
4:02
the mechanisms of change are easier to externalize
4:07
along a growth trajectory than maybe a more traditional psychodynamic,
4:12
you know, totally insight driven process.
4:15
Yeah.
4:15
Yeah, I heard, so it did
4:19
these talks with various experts, and she did a talk with Bessel.
4:24
And one of the things that I love that he said, and I,
4:27
I didn't know I was craving to hear it, but when he said it, I was like,
4:31
you know, as he said that people need to stop being loyal to a teacher.
4:36
He said, we've created all of these modalities.
4:39
Now you guys need to go take it and do something with it.
4:42
And I have done, you know, what I found is through training with, teigan.
4:48
For several years, you know,
4:49
I've been training with him for four years now, probably.
4:52
And the ifs and the somatic experience is that
4:57
the integration of them is
5:00
really where I want to be because there is not one. Yes.
5:05
I can do a session where I can do like ifs from beginning to end,
5:09
but as I go through a session, I may find that,
5:12
you know, taking this part and then putting it in a chair
5:16
and doing a back and forth dialog and then doubling,
5:20
that comes from psychodrama, you know, like eight.
5:22
It is all blending them together.
5:25
And then also the clinician needing
5:28
to learn how to go with their gut, you know, because you know why?
5:31
I know you're a badass clinician.
5:35
Tell me
5:37
you're like, I knew this is what this is going to be.
5:38
I know I love podcasts is
5:43
I was taught and believe in my experience that good clinicians are good thinkers.
5:47
Yeah. And
5:50
for me, what that means
5:51
is that a good clinician is reflexive to the person.
5:57
Yes. Constellation problem context that's in front of them.
6:02
When I went to school for my master's degree, one of my preconceived notions
6:07
is that I was going to become an expert in one thing.
6:12
And what I was challenged
6:14
to understand is actually
6:16
you need to be multidisciplinary a Swiss army knife.
6:20
Yes, yes of sorts.
6:22
And you can match those modalities or interventions
6:25
based on to who you are, the things that, that draw you in.
6:29
If that's ifs, if that's psychodrama, if that's,
6:34
you know, structured family therapy, whatever it is, that's fine.
6:38
But remaining rigid is not going to be
6:44
as effective with real patients in your practice.
6:48
So as a leader of a clinical team, a large clinical team,
6:53
I'm sure there's a myriad of different levels in terms of where
6:57
people are, number of years working, I guess is what I'm saying. Yep.
7:01
We have interns through you know, all the way.
7:04
So to vary experience, can you unpack anything that comes to mind
7:07
just about mean you're you're challenging everybody to grow on a regular basis.
7:12
So do you see this as a challenge that that young clinicians have?
7:17
And how does how arch address that or how do you address that as a leader?
7:20
I think that,
7:26
When you were starting in school.
7:31
Whether it's LPC, you know, all that type of stuff, they
7:34
we have to be taught the ethics, we have to be taught boundaries.
7:38
You know, those things of course, are critically important.
7:42
What I find is then working in the actual field
7:47
and specifically substance use and co-occurring,
7:51
that then we are needing to dial some of that back.
7:55
It's like you want to start with a strong foundation in it.
7:58
And then as they grow as clinicians,
8:02
you want them to be able to, discern when it is
8:06
they can start to rely more on their gut and say, in this instance,
8:12
this boundary is not helpful, you know, and that there is a self-disclosure
8:16
that is going to be useful here to this person as a tool, as a tool.
8:20
Exactly. Maybe not every time.
8:22
And learning when and how and why.
8:25
Yes. Yes, exactly.
8:27
So that's what I think is like I want to be moving forward
8:32
with, taking down
8:35
some of the older sterile boundaries that I don't
8:39
feel are necessary and can really be a barrier
8:43
to making a therapeutic alliance in a safe environment.
8:46
Correct? Yeah.
8:47
With some revision in supervision.
8:50
Yeah, exactly.
8:50
All those things in the community
8:53
of other clinicians that are participating in said supervision is like
8:56
we were just talking with Kelly Skaggs, you know, working in a treatment center,
9:01
cutting your teeth might be one of the best places to do to grow.
9:05
Yeah, absolutely.
9:06
Because you can't, and I have to use a, like, term loosely,
9:10
but you can't do too much wrong because they're in a safe environment.
9:15
They have multiple people.
9:16
You can check in with multiple people.
9:19
I think one of the real dangers that I see right now is,
9:23
people that are coming right out of school
9:26
and going into private practice, I would really prefer that
9:30
there was some type of legislation that was being put in place
9:34
that people couldn't go right into private practice.
9:36
I think, operating in a silo,
9:40
can be really dangerous
9:41
for the clinician themselves and for the person.
9:45
But in a group setting in a, in a, residential treatment,
9:48
when you have a whole team of people that you can run your stuff by
9:52
and check in on and people are eyes on each other and things like that
9:56
and eyes on your guest, so, you know, hey, how are they doing in real life?
10:01
This is what I'm seeing here.
10:02
How are they doing in relapse prevention group?
10:04
And, you know, being able to, cross-reference
10:08
the their presentation with each other is really important to me.
10:12
Know what?
10:14
I'm going to rewind a little bit.
10:16
Yeah. Go.
10:18
I'll save you the sound effects that I.
10:21
You have that later
10:23
I. Oh, we could do that. Yeah we will.
10:25
Yeah I,
10:27
I'm curious what does for those that don't know
10:31
because sometimes a lot of often people that are watching
10:34
this show, don't know how treatment works.
10:37
So a VP of clinical, what do you do every day?
10:42
Answer emails.
10:46
This is true.
10:47
Yeah, yeah, it's a lot of emails, you know.
10:49
So as a VP of clinical, one of the things is
10:53
you do have to have your eye on everything.
10:57
Where what I learned coming into this department
11:00
is that when you are overseeing clinical
11:04
like for example, clinical has to oversee,
11:10
not oversee. That's the wrong word.
11:12
Has to have an eye, an eye on what may be happening down in nursing,
11:17
you know, where is nursing doesn't necessarily
11:20
have to have an eye on what's happening in clinical.
11:23
Clinical has to have an eye on what's happening in admissions, you know, there.
11:27
So there is a.
11:31
A dabble of clinical
11:33
in each part of things that isn't always reciprocal.
11:37
And this is also me speaking.
11:39
Have I worked in nursing and, you know, can I speak freely about their experience?
11:44
No. But, so one of the things is being able
11:48
to identify what the guest experiences across
11:53
all of the departments from the moment that they're walking in, feeling
11:57
welcomed, how are we removing any barriers that they are finding to treatment,
12:02
being able to, intervene on the desire to leave AMA?
12:08
I mean, you know, people come in there, detox in 24.
12:10
I was like, this isn't for me. I'm out of here.
12:13
And, you know, how are we, being able to employ
12:17
the things that we have learned by office is a great tool for, you know, hey,
12:21
is there a part of you that wants to be here,
12:24
you know, being able to, employ the clinicians
12:28
with the things that can help in each phase of the treatment.
12:31
So, really making sure that we get the, guest welcomed experiencing
12:36
all that kind of stuff clinically, it is about making sure that people are
12:41
trained, getting the right supervision, that we're providing programing
12:45
that is useful.
12:46
To the guest, in a variety of programing, like I can't tell you.
12:51
I think that's one thing that, you know, we have a program director, Matt Hughes,
12:56
and he is wonderful at really advocating to make sure
13:00
that there is options every single day that people get to try different things,
13:05
do different things, expanding group times to be able to allow
13:09
for more processing after they do the ropes course or, you know, those
13:15
the hikes and then, that kind of stuff rather than sort of, on.
13:20
Yep yep yep yep. Hi.
13:22
In every single day, keeping it interesting, those types of things. So,
13:28
from my place, my view is to make sure that the clinicians are taken care of.
13:34
So they have all the right tools for,
13:37
to be able to take care of themselves as well as take care of the guests.
13:41
So are they getting support when, you know, every once in a while
13:44
you get loaded with a caseload that can be really challenging.
13:47
So it's like, do we have eyes on that clinician to make sure that, you know,
13:51
they're getting the right support,
13:52
that they need to be able to continue to provide the best service?
13:56
And then it is also about being out here,
13:59
going to different conferences, you know, meeting
14:02
people, talking about the modalities, learning about the different tools.
14:04
There's, you know, all the AI that's coming forward and wearables
14:09
and this app and that app and, really trying to identify
14:13
what is the best and to be able to tell people about what we do at high watch.
14:17
So it, it covers
14:20
so many things that while also being a human being in your own life.
14:24
So you're not busy at all. Yeah, yeah.
14:26
You know. Yeah, yeah.
14:27
But everybody is in their own, piece I
14:31
so if you could find the email solution for me, that would be.
14:35
And then I would be golden, you know.
14:37
Oh, man. Yeah.
14:39
Oh I'm saying I think for me, I'll just say personally, for me,
14:42
stepping into just a personal role is,
14:47
having to have that sort of eye on everything, means that you are
14:54
having to find the right people that you trust.
14:56
So if there is an email that goes by that I didn't see that
15:00
I am not the sole person who's responsible for catching everything that you know,
15:05
everyone says and that, working with others
15:09
that are just as talented and if not more,
15:13
in a lot of cases, to be able to really provide the best service possible.
15:17
Yeah, it's wise.
15:19
I am curious
15:22
what you think about you mentioned at AMA.
15:25
Yeah.
15:25
People leaving leaving early earlier than might be what recommended.
15:29
Yeah.
15:33
Maybe unpack that a little bit for folks that don't know what we're talking about.
15:36
And then I'm just curious, how does your team think about that?
15:41
How do you work to prevent that
15:43
and then just support people where they are.
15:51
Each instance comes with its
15:55
own experience.
15:56
Right.
16:00
I'll, I'll just share a personal experience I have with you.
16:03
That was sort of a game
16:06
changer for me was that, we had somebody who wanted
16:10
to leave AMA against medical advice, meaning leaving treatment early.
16:13
They still have insurance benefits.
16:15
They still have family support. They don't.
16:17
They need longer time in treatment. And,
16:22
they said, you know, some girl wants to leave ami blah, blah, blah.
16:26
Can you talk to her? And I thought,
16:29
no, I'm so tired of giving the speech.
16:32
You know, like I'm so tired of, like doing the thing because
16:36
it is going to battle against the disease, you know, and,
16:39
that's the toughest thing that I think that we do every single day.
16:44
We know what it sounds like, we know when we're talking to it.
16:47
And yet it is extremely difficult to penetrate.
16:50
And so I was like, oh, man, you know, I'm tired of giving this speech.
16:54
And, but of course I'm going to do it, you know?
16:56
And, the girl comes down, I talk to her,
17:00
we say all the things I say all the things that I have to say.
17:03
And she leaves and she's still going to leave treatment early.
17:08
And I see her walking down the hallway, and I know that her
17:12
disease is telling her, like,
17:14
she bought it, you know, not,
17:16
you know, just having no idea that it's like, I, I didn't buy it.
17:20
And but I also have to meet you where you're at and that kind of stuff.
17:24
And I was driving home that day, and I came
17:29
up to the top of this spot, and I just remember
17:31
being in my car and I was thinking about, you know, having to do the thing.
17:35
And for me, and like I said, I'm a person in recovery.
17:37
So it was just my experience is, I thought about that moment.
17:42
And for me, what I heard was a message from my higher power, which just
17:47
is a new thought in my own voice, a thought that I never had.
17:50
It just kind of comes and planted in there.
17:52
And the thought said, you're not doing it for them.
17:56
You're doing it for the people who love them.
18:00
And all of a
18:02
sudden, like, it unlocked a reserve in me that I was like, oh,
18:07
if that's the case, like, I'm not doing it for them.
18:10
I'm doing it for the family who loves them.
18:12
I'm doing it for the people that they're going to encounter on the road
18:14
that didn't have a say in whether or not they were going to face a drunk driver,
18:19
you know, like I'm doing it for all those people.
18:21
I have been given this gift to be in front of these people
18:24
and to have the ability to speak from my own experience,
18:28
why would I ever look at that gift as a chore that I would have to do?
18:32
And so,
18:35
a long answer to your question and less more personal, less technical
18:40
than the thing is, every single person is their own unique experience.
18:48
So if I can meet that individual with their fears, their difficulties,
18:52
their barriers to being able to be and if I can, in the most loving and kind
18:58
way, remove those barriers in any way that I can to be helpful,
19:02
to allow them to stay because their disease is going to throw
19:06
everything is the reason that they have to leave.
19:08
So really meeting the individual where they're at.
19:11
And then at the end, I also have to say is
19:14
I am going to put in every barrier possible because,
19:18
as much as I am a clinician and our code of ethics teach us about,
19:21
client centered care, I am of course good with that.
19:26
But what I am not good with is disease centered care.
19:29
And so I am going to do the most I can to try and interrupt that process.
19:34
And then if I am unable to at the end, I have to tell them
19:40
that we are here for them
19:41
and that if they need us, please come back and they will be welcomed.
19:46
Like that is what I feel like is the most important thing.
19:49
They could not leave feeling like if they mess up like they can't
19:53
show their face again, they can't return because I know what's going to happen
19:57
when you leave against medical advice, you know?
20:00
So at the end of the day, I need to make sure that, you know, okay, I hear you.
20:04
You got to go this way.
20:06
You got to do know that when you need us, we are here.
20:08
And I think that that's something that a lot of times people can forget about.
20:11
You know, what you're reminding me of is this dynamic sometimes that we all
20:15
are guilty of in terms of our respective organizations.
20:22
I'm curious your thoughts on it, but
20:24
sometimes I think
20:28
in an inpatient residential center,
20:30
we have the attitude that guests, clients, patients
20:35
shouldn't be where they are.
20:38
Here's what I mean.
20:39
Maybe they are caught stealing something from the kitchen.
20:44
Or they are showing up chronically late.
20:50
It doesn't matter.
20:52
But sometimes we get in this mindset that folks that come in
20:58
experiencing addiction should know how to follow directions.
21:01
Yeah of course you should understand
21:04
that these are our policies.
21:07
You know what I mean.
21:08
And it's always a helpful.
21:10
You just reminded me of it.
21:12
It's helpful to recognize like these are people who are in the grip of addiction.
21:18
Yeah.
21:19
Who are not the best versions of themselves.
21:21
And our programs should be reflexive to that behavior.
21:24
And for instance not to kick somebody out
21:27
because of that, but embrace them with compassion and love,
21:33
so that they can grow, hopefully through that behavior.
21:36
Yeah. And emerge on the other side.
21:38
One of the things that we did for the staff is we had, we took part
21:43
in, Judy Crane's, trauma
21:48
modalities, not travel modalities, but, you know, the
21:53
the thing.
21:53
Sorry, I can't think of it right now, but, we did that and that, really.
21:57
And we trained everybody from the driver to nursing to kitchen staff to clinicians
22:01
like everybody.
22:02
And that was something that created an empathy across campus
22:07
and an understanding of the underlying behaviors for what people are doing.
22:11
When you just said those things.
22:12
Oh, stealing from the kitchen, I'm like, well, obviously
22:15
they didn't have enough food as a child.
22:17
You know, it is being able to see underneath the behavior that it is,
22:22
just that we are needing to
22:26
have the knowledge that to not take it personal, you know, and then be,
22:31
what's underneath there that I can help you with so these things don't end up
22:35
being, you know, but if it's like, if you want extra food, great.
22:40
I want you to have all the food that you could ever want.
22:42
And so that's what I'm going to set up for you.
22:44
We are also going to make sure that you're not,
22:46
drawing mice into the dorms, things like that.
22:49
But you know, you know, those types of things.
22:51
But, it's about being able, across campus wide,
22:56
everyone that is encountering these people to know
22:59
that there are reasons for every behavior that they're doing.
23:03
And how can we help, moderate those without
23:07
impacting the community as a whole?
23:09
Because there does come a point when,
23:14
the greater guest experience does get impacted.
23:17
And that's what we are trying to, see if we can intervene in that space.
23:22
So it doesn't become so problematic. Yeah.
23:26
Tammy, Joe, thank you for doing this. Yeah.
23:27
You're welcome.
23:28
I'm glad I just bamboozled you downstairs this morning.
23:30
Yeah, but I appreciate it.
23:32
Totally jumped on it.
23:34
Yeah. Because of your love of podcast.
23:35
That's right. Genuinely.
23:37
We appreciate you spending time.
23:38
We love. Hi.
23:40
Watch. Hi. Watch. Really? Is a sister.
23:41
One of our sister programs? Absolutely. We believe it.
23:45
If you're interested in learning more about Tammy Jo or Hai Watch
23:48
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23:51
We'll see you next time.