Latest / The Inspired Stories Podcast / Creating Safe Spaces: A Trauma-Informed Approach to Mental Health Treatment, with Dr. Ryan Drzewiecki | Healthcare Series

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Creating Safe Spaces: A Trauma-Informed Approach to Mental Health Treatment, with Dr. Ryan Drzewiecki | Healthcare Series · The Inspired Stories Podcast

0:04
Welcome to another edition of Inspired Stories, where leaders
0:07
share their experiences so we can learn from their successes,
0:10
how they've overcome adversity, and explore current challenges
0:13
they're facing. Welcome to another edition of
0:18
the Inspired Stories podcast, where leaders share their
0:21
experiences so we can learn from their successes and be inspired
0:25
by how they've overcome adversity.
0:27
My name is Anthony Kotaspodi and today's guest is Doctor Ryan
0:31
Druzwicki, Chief Clinical Officer of Sierra Tucson, the
0:35
premier residential treatment Center for drug and alcohol
0:38
addiction and behavioral health located on a serene 160 acre
0:43
campus in Tucson, AZ. Their team of experienced
0:47
professionals provide integrative evidence based care
0:51
to all adults of all genders to achieve lasting recovery from
0:55
addiction and mental illness. Ryan is a licensed psychologist
1:00
and has degrees from Northwestern University and the
1:03
Arizona School of Professional Psychology.
1:06
We'll hear about how his career started in special education and
1:09
group home administration and morphed into treatment for
1:13
population struggling with substance use and mental health
1:16
issues. Now before we get into all that
1:19
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AD back benefitsagency.com. Now back to our guest today, the
1:51
Chief Clinical Officer of Sierra Tucson, Doctor Ryan Druzwicki.
1:56
I appreciate you making the time to Share your story today.
1:58
I appreciate the opportunity to come on.
2:00
Thank you so much for having me, Anthony.
2:03
Yeah, so let's get into it. Before we talk about Sierra
2:07
Tucson, tell us a little bit about your own path.
2:10
There's a number of waypoints in your career.
2:13
Give us a little tour. Absolutely.
2:18
That's a great question. I, I think I always knew I was
2:21
headed into behavioral health, but for some reason I, I, I
2:25
fought it for a little bit. I, I came out of undergrad with
2:28
an English degree, but fell right away into special
2:32
education and working with autism and just found that I was
2:38
really, I found that it was really passionate about it.
2:41
So I worked, I used to work 5 or 6 years between special
2:46
education. I worked a bit with applied
2:49
behavior analysis and ran, ran a group home for a little bit and
2:54
decided it was time to go back to school and get my doctorate.
2:58
So I got my doctorate, ended up, you know, very involved with,
3:03
with substance abuse and substance abuse treatment.
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Did my my internship and my post doc at Hazelden and have stayed
3:13
close to residential treatment and and outpatient treatment
3:17
ever since. Help us understand what a group
3:21
home is. So the group home I was working
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at was a therapeutic group home. We had actually a very small
3:31
number of clients with intense behavioral health needs.
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So these were people that really certainly couldn't live it at
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home and couldn't live in any lower level of care.
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So that we were staffed, we were staffed pretty significantly.
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I, I remember at one point we had like five staff for three
3:50
residents and just worked with them on daily living and, and
3:55
conflict resolution and, you know, living successfully while
3:59
they were going to treatment and attending schools during the
4:03
day. And so how is it that you found
4:09
your way to Sierra Tucson? That is a good question.
4:15
After I graduated with my doctorate, I bounced around a
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little bit. I ended up in Colorado for
4:23
several years at at All Points N Lodge, which was great.
4:28
It was a wonderful opportunity and a wonderful organization.
4:34
And we were there through COVID, which was a particular challenge
4:39
because most of our family is here in Arizona.
4:41
So, you know, it was that it was that time when like, you know,
4:46
my kids daycare, if, if, if somebody would get COVID, the
4:49
place would shut down for two weeks and my wife and I were
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really struggling. So we put out some feelers and
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I, I had always known of Sierra Tucson and known of its
5:00
reputation. And by chance they had a, they
5:04
had an opening and we were excited to get down here and get
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back a little bit closer to family.
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And I was excited to to join a great program with as much
5:14
history as Sierra Tucson. So Sierra Tucson is known
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outside of even the that state, that region there, it's got a
5:23
reputation that precedes it. Yeah, Sierra Tucson is a great
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treatment Center for both addiction and mental health.
5:31
We just celebrated our 40th anniversary, so we've been
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around for a very long time. And yeah, we tend to, you know,
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do very well on, you know, the news, the Newsweek polls.
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And I think we're very, very highly rated.
5:46
We have a great program here. So in your own words, tell us
5:50
what services you provide there at Sierra Tucson.
5:54
Sure. So Sierra Tucson, we offer a
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variety of of levels of care for behavioral health.
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So we have a small inpatient unit.
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Most of what we're known for is our residential program and we
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also have PHP and IOP services. So residents often come to us,
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they stay for, you know, maybe 30 days in residential and you
6:19
know, 4 to 8 weeks at at lower levels of care and have the
6:23
opportunity to really work on whatever is going on for them,
6:27
whether it be addiction, trauma, you know, relational or
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developmental trauma, mood and anxiety and those sort of
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presenting problems. What does life after Sierra
6:40
Tucson typically look like for a patient?
6:43
Is there some kind of a a step down program?
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Is there like ongoing support available for them once they
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leave the facility? Yeah, we, I, I love to say that
6:53
that residential treatment is about getting to the starting
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line and not the finish line. You know, when you go away for
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30 days, it's not to have everything magically healed and,
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and, and configured and ready to go.
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It's to really figure out what the rest of, of life is going to
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look like. You know, one major piece of, of
7:12
any program like this is talking about the next steps.
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So from a 30 day residential program, you know, we expect
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people to kind of step down gradually.
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The next kind of level of care is partial hospitalization,
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which is doing maybe 20 hours of programming and, and living
7:29
independently. And then below that is IOP,
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which is 9 or 10 hours of programming and, and then on to,
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you know, outpatient where you might see your therapist, you
7:40
know, once a week or what have you.
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And we also prepare people to say, you know what, what has to
7:45
change in your life? What are some of the, the
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day-to-day changes 'cause I think, you know, the thing about
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recovery of any sort is it's tricky.
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It's, it's terribly simple and terribly complex at the same
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time. Yeah, a lot of ways we, we know
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what we have to do. But it's it's really hard to
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make some of those little challenges or some of those
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little changes or some of those bigger changes in life to be
8:06
able to deal with adversity well and to be able to deal as well
8:11
when we're when we are struggling and when we're having
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a difficult time. Talk to me about how you would
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describe your approach or approaches to treatment.
8:25
Sure, we really love to take a trauma informed approach here.
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I think it's that that framework is a great lens through which to
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see mental health rather than thinking, you know, we treat X
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number of different diagnosis. We say, you know, we treat
8:45
people, you know, knowing that that they've probably had a
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history of trauma. What happens when you've had bad
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things happened to you in the past, when you've had, you know,
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different traumas of, of different sorts is, you know, it
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gets harder to stay in your window of tolerance.
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It gets harder for you, your brain and your body to function
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normally and feel safe and feel secure and really, you know,
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blossom. I think the, you know, the more
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difficult things that have happened, the easier it is to
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get this regulated and to get really emotional and for anxiety
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or mood or different behaviors to kind of start to take over.
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So we like to frame our job for everybody who comes through our
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door as broadening your window of tolerance, kind of building
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resilience, building strength, building a good platform, and
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then simultaneously working on knowing that you know, you, you
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will get upset, you will get dysregulated, you will fall
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apart at times. And how do we utilize all the
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resources around us to get ourselves back to a good place
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when that happens? So we, you know, that's kind of
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our general approach regardless of presenting problem.
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But then you know, the, the wonderful thing about Sierra
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Tucson is we're, we're a fairly large treatment center.
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We have all sorts of different therapeutic modalities and
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medical interventions. We have fantastic doctors and
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nurses and we can offer a lot of more specific interventions.
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We also focus a lot on the power of community and the power of
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the milieu. You know, we'd like to tell
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people all the time, I mean, you come here or a program like this
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and you're surrounded by absolutely amazing A+ providers
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and therapists, but you only have us for a very short time.
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What we really want you to do is learn how to rely on each other,
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build relationships, rebuild relationships, you know, learn
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how to repair the relationships in your life that may have gone
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off track and also just understand that every
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relationship has its ebbs and flows.
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You know, we in, in, in therapy speak, we talk about rupture and
10:48
repair. Any good relationship, you're
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going to have arguments, you're going to have fights, you're
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going to have times when you're supporting each other better and
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sometimes when you're supporting each other worse.
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So what do we do when our close relationships and the people we
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rely on aren't there for us or when we're in conflict?
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So that community approach and that social approach and that
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relational approach is, is really fundamental to how we do
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what we do as well. You mentioned having different
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modalities that you utilize there.
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Can you maybe tell us about a couple of maybe your favorites?
11:21
Sure. On the therapy side, we offer,
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you know, a lot of different therapies.
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You know, EMDR is very, very popular these days.
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Somatic experiencing is a really, really great framework
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that kind of informed some of our trauma informed lens.
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We pull, we pull a fair amount from internal family systems.
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The idea of no bad parts. You know, a lot of times when
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people come to treatment, they, you know, that part of them that
11:52
wants to use drugs or that part of them that's having these
11:55
suicidal thoughts or the part of them that's getting depressed or
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anxious, You know, it's easy to say, oh, I hate that part of
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myself. And we like to talk about like
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that, that part of yourself is there and it's there to protect
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you. And in, in the right
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circumstances, in the right scenarios, you know, it those,
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those parts of us can, can do our can do their job pretty
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well, but we're here to learn more skills.
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So those are some of the fun kind of therapeutic modalities
12:19
that we have. And then we've got other great
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programs as well. We have TMS, we have ketamine
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assisted psychotherapy. We have a lot of integrative
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options as well, massage and Craniosacral and Reiki and just
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a whole lot of different opportunities to try different
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things and and see what works for our clients while they're
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here. When I ask about ketamine
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assisted treatment, read a lot of promising things about it got
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some bad press recently because you know, Matthew Perry, you
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know, is passing away from an overdose that was unobserved or
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what's the word not outside of treatment.
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It was a more of a recreational use case.
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But tell me what you're seeing in in a practical sense from use
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in a in a safe controlled setting.
13:19
I think, well, certainly the advantage of a safe controlled
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setting is we can do all the right legwork at first to make
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sure somebody's appropriate for ketamine, both to rule out any
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medical Contra interdictions. And you know, as well, I think
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we tend to lean away from it when people have had a history
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of substance use 'cause I think you do.
13:40
I think ketamine can be an amazing experience.
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I'm a, you know, a big fan of the, the treatment, but I think
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it's easy to get over reliant on it as well.
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So we really screen out for some of those, you know, both those
13:53
addictive patterns and we try to make sure that we understand
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what people are looking for for from treatment and make sure
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that they understand what good, effective, holistic, integrative
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treatment looks like. If we get a sense that somebody
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wants to do ketamine because they think, oh, I'm going to do
14:10
ketamine and everything's going to be better, we're probably
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going to say, let's let's put the brakes on this a little bit.
14:15
And you know, maybe it's not the right thing for you right now,
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maybe it's not the right time. So we have a very, very careful
14:22
and selective screening process for it and we make sure that a,
14:26
we, we pick the right people and B, we, we monitor throughout to
14:30
make sure that it continues to be beneficial.
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You know, we also make make it pretty clear that, you know,
14:36
ketamine as recommended is not a long term solution.
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It's not you do it every so often for the rest of your life.
14:44
Usually it's a very prescribed number of sessions.
14:49
I'm curious if your interest or your research has expanded into
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nearby areas. And there's been a lot of talk
14:57
about MDMA assisted therapy or psychedelic mushrooms being
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involved in that, both of which are not legal in most places.
15:07
Is that something that you and sort of looked into or you know,
15:11
at least kind of kept up on the the discussion that's going on?
15:14
It's not something I've looked into a great deal.
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I think I've worked enough in substance abuse and there's
15:20
always that sense of hesitancy around around some of those
15:24
interventions. So it's not something that I've
15:26
personally looked into a lot, but I'm certainly intrigued by
15:29
it. And I think it's, it's going to
15:31
be very interesting to see how these things unfold in the
15:34
upcoming years and what turns out to really have a good solid
15:37
evidence base to support it and what and what tends to not work
15:42
as well. And then what we can determine
15:44
about the difference. You know, why would one approach
15:47
work where as a very similar approach might not?
15:49
So it is something I'm I'm interested in learning more
15:53
about, but not something I've dove into too much at this
15:56
point. I want to talk again about
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internal family systems that you brought up because I hear the
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name and I think, oh, like sort of the family dynamic that I
16:06
have at home with my wife and kids or that I had, you know,
16:08
with my parents and my siblings growing up.
16:10
But as I hear you talk about it, that's not what it is at all.
16:14
Correct me if I'm wrong. It's more about, hey, there's
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sort of these different pieces and parts of me, right?
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Sometimes I'm confused and, and angry, sometimes I'm nervous,
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sometimes I'm confident or playful.
16:27
And like these are all sort of different parts of the same
16:30
person. And rather than getting angry or
16:33
frustrated with the, you know, existence of sort of these
16:35
lesser parts of me, as I'm going to call them, sort of embracing
16:39
and understanding that they're, they're for a purpose.
16:41
Is it? Did I hear you correctly with
16:43
that? Yeah, I think that's a great
16:45
explanation of it. Kind of the strict IFS
16:52
philosophy is, you know, they they kind of label some of the
16:55
different parts. They'll say everybody has
16:58
exiles. Exiles are these parts of our
17:00
self where we have like a deep shame.
17:03
And you know, we sort of try our best not to have that exile part
17:09
of our self come out. We also have protectors and
17:13
firefighters and managers who try to, you know, keep us from
17:18
going to that place of, of, of, you know, experiencing that
17:22
exile or that shame or that try to protect us from those sorts
17:26
of things. Or so it's a really interesting
17:29
framework in that sense. You know, we, we tend to take a
17:32
little bit of a looser approach that really mirrors the way that
17:34
you describe it, which is to say, you know, whether whether
17:37
you want to use those specific terms or not, I think it is fair
17:40
to say that everybody has all these different distinct parts.
17:44
One of my favorite quick little exercises I used to do with with
17:48
patients when I was doing a lot more direct care was to talk
17:51
about like who's who's on your, who's on your board, who comes
17:55
to the table in your, in your boardroom?
17:57
And let's try to think about like, what are some of these
17:59
component pieces of your mind? A lot of people, you know, we'll
18:04
talk about like, Oh, I hear, I hear the voice of my father in
18:08
my head when, whenever I'm making a decision or, you know,
18:12
I, I see that boss that I had 10 years ago and I still hear that
18:16
voice in my ear. So I always found that that was,
18:19
that was a lot of fun just to say to people who's on the board
18:22
and, and what role do they play? And are there any parts of
18:25
yourself that you want to bring to the table?
18:27
And are there any parts of yourself that you know in this,
18:31
in this boardroom, you want to maybe ask them to, to take a
18:35
seat and, and, and be a little bit more quiet and a little bit
18:38
more observant. So that was always a fun, fun
18:40
kind of activity and a fun way to think about how our minds
18:43
work and all these different pieces and voices and and
18:47
figures that live on in our in our head.
18:52
You know, as I've gotten older, I've certainly done my fair
18:54
share of personal development work, read a lot of books,
18:58
talked to a lot of people who are smarter than I am, who have
19:01
been, you know, able to kind of open my eyes and ears to things.
19:04
And this discussion I'll put into that category as well.
19:08
And I, and I, I, I can't help but think like, wow, this would
19:11
have been like a really helpful foundation to have understanding
19:16
some of these things when I was younger.
19:18
Are there ways to teach these things to younger kids?
19:23
You know, I've got two boys who are 8 and 10 and, you know, like
19:26
every parent with kids that age, like, am I doing the right
19:29
things? Like, you know, how how can I be
19:31
helping to sort of set them up for success going forward?
19:36
What would you say to that? I would say I love that question
19:39
because I think that's a question that we we should
19:42
really be asking ourselves as a, as a society.
19:44
How do we help our kids develop the right tools and skills and
19:49
understanding of mental health to to prepare them for success?
19:54
Because I think it's fair to say that, you know, even in the
19:58
past, you know, 20 years that I've been working in the field,
20:02
it's been such a dramatic shift towards, you know, people
20:06
feeling a lot less stable, I think a lot more severe mental
20:11
health symptomology. So I think it's very worthwhile
20:14
to hammer out a good curriculum for kids in school and talk
20:19
about. You know, mental health and help
20:21
them to conceptualize, you know, mental health.
20:25
I really like, you know, some of the pieces we've already talked
20:27
about are things that I think would be a great fundamental
20:31
understanding for everybody to say, you know, just to talk
20:35
about the internal family systems and the no bad parts,
20:38
those parts of yourself you don't like, they're there for a
20:41
reason. They're there to help you.
20:43
I also, you know, I, I really like normalizing mental health.
20:46
I think, you know, we talk a lot about destigmatizing and I would
20:50
love to just eradicate the stigma entirely.
20:53
I think it's natural to struggle.
20:55
I think it's normal to go through periods of depression or
20:59
anxiety. And if as a society we can
21:02
embrace that in our self and if we can support each other when
21:06
other people are struggling, I think it would go a really long
21:08
way. I worry that we've reached a
21:10
point where people who struggle with, you know, depression or
21:14
anxiety or what have you feel like there's something
21:16
dreadfully wrong with me. And my thought has always been,
21:19
no, this is, this is a tough world to live in.
21:22
There's so much stress. There's yeah, these days.
21:25
There's financial stress, there's political stress,
21:28
there's, there's health related stress and, and the list just
21:31
goes on and on. I think it's completely normal
21:35
and natural. And I would love to to really
21:37
honor and celebrate the people who are struggling and say
21:40
that's perfectly normal. And what can we do to help you
21:42
and support you? I like that sort of really
21:46
flipping the script on its head. Not something to be shameful
21:50
over hype from, but in your words, celebrate it.
21:53
Let's put a spotlight on it. And hey, yeah, this is a human
21:57
part of the human experience. And how, as another human being,
22:00
can I help you through this? Absolutely.
22:03
Yeah. So, you know, I studied a little
22:07
bit, practice a little bit somatic experiencing.
22:10
And so like at a very basic level, I've, I've tried that
22:13
with my kids. You know, if they're upset or
22:19
it's, it's easier to talk to them when they're feeling good
22:22
and they're celebrating, you know, something that you know,
22:24
that they're excited about. And I'm like, you know, how does
22:27
that feel? Oh, it feels good.
22:29
I'm like, OK, where in your body can you feel it?
22:32
What? I don't know, like, yeah, I
22:34
don't, I don't know how to explain that any better to an 8
22:36
or 10 year old or how to, you know, how to pursue that
22:38
conversation. I don't know if you have any
22:40
suggestions for me or if maybe like I'm just a little bit too
22:43
early to the table with them. I don't think it's ever too
22:47
early to the table to introduce some of those ideas and
22:51
concepts. I I would say it's, it's tough
22:53
with kids and I've seen that with my own kids as well.
22:56
It feels like you're fishing sometimes.
22:57
I'll say, you know, how was school?
23:00
They'll say fine, even at 4:00 and 6:00, you still get the
23:03
fine. And I'll say, how did you feel?
23:07
How, what, how did you, what did you experience?
23:09
What was it like for you? What do you think about when you
23:12
think about school? And I, I don't know that I'm
23:15
getting, you know, solid well thought out answers, but I think
23:18
you plant the seed for them to recognize that we experience, we
23:24
experience our lives in a lot of different ways.
23:28
You know, I think some of the talking about what do you feel
23:32
in your body and where do you feel it came from?
23:34
Recognizing that a lot of people, if you say, what are you
23:38
feeling? They have no idea.
23:40
But some people experience the world through feelings, some
23:44
people experience it through images or sensations, and some
23:47
people through bodily sensations.
23:50
So I think that language or just having these conversations just
23:53
opens people up to recognize, oh, there there's a lot of
23:56
different ways that I might be experiencing the world.
23:58
There's a lot of different ways that my emotional reaction to
24:02
the world may be registering in my body.
24:06
You know, there's two things that I've tried and had some
24:09
success with in terms of getting my kids to kind of open up about
24:13
their day. You know what you're talking
24:14
about because I get the same thing with my like I was school
24:18
today. Fine.
24:18
What'd you do? You know, nothing.
24:20
I don't remember. And so for a while, this first
24:23
one worked, and then it stopped. It was like, oh, well, yeah.
24:27
So I heard you guys were, you know, making clay sculptures.
24:31
What? We didn't do that.
24:33
Yeah. In our class, you guys were
24:34
making clay sculptures. Well, Dad, we were.
24:36
We we colored today. Oh, that's right.
24:39
And everything had to be in green, right?
24:41
No, I used red and green and yellow because I was making a
24:45
Santa Claus thing. And so if I said something that
24:49
was incorrect, they really loved the process of correcting me.
24:53
And so I was able to kind of start a dialogue.
24:56
I, I've done that enough where they see through that.
24:58
And so the only other thing I have found success with, and I
25:02
would love to hear if you've got any other suggestions, is I wait
25:07
for them. And most of the time when they
25:11
want to talk is when it's bedtime.
25:13
Because one, it's a little bit of a stalling tactic.
25:16
But two, it's the part of the day where they're coming down.
25:20
They're the most calm and relaxed and they're they're more
25:24
apt to be open and just share on their own without me asking all
25:29
these prying and proving questions.
25:32
Yeah, I love that. I, I think that that's the right
25:34
answer probably is, you know, you do ask the question
25:38
sometimes so that they know that you're open, but just let them,
25:42
you know that, that lets them know that, that you are safe to
25:44
come to when they do need to talk about something.
25:46
I, I, I think that that's the, the only official solution to
25:51
the problem. I, I tried, my wife and I were
25:56
trying for a while just to say like, what was the best part of
25:58
your day? What was the scariest part of
26:00
your day? What was the angriest part of
26:02
your day? But then we were, you know,
26:04
overanalyzing that. And we're like, is it, is it
26:07
good? Is it healthy to have them think
26:09
about their day in that way? Do we want them to be like
26:11
ranking their day? Are we getting them to focus on
26:13
the negative? Is that going to call their
26:15
attention to the bad stuff? I don't know.
26:20
Yeah, sometimes we overthink things so.
26:22
Oh yes, very much so. I I overthink everything so.
26:25
So, Doctor D, tell me, what does your role as a chief clinical
26:30
officer look like? What?
26:32
What is? What do you do?
26:34
As a chief clinical officer, I oversee all of the different
26:39
therapy departments here. We have a lot of different
26:44
subdivisions there. We've got primary therapists,
26:47
specialty therapists, residential therapists, equine
26:50
and experiential and, and I would say day-to-day my job
26:56
looks very different. I think it's how do I need to
26:59
support the team right now? You know, I, my, my biggest
27:04
guiding principle is, is trauma informed leadership.
27:08
I want everybody to feel safe. I want to feel like I'm being
27:12
transparent. I want to be good at
27:14
communication. I want to be good at
27:16
collaboration. And that's, that's already, you
27:20
know, multiple full time jobs there, but sort of balancing
27:23
like what, what do I need to do today to try to make sure that
27:27
the people feel safe 'cause I think in a, in particular, in a
27:31
setting like this, I'm sure in every setting, but I think our
27:34
job with our residents is to create a safe trauma informed
27:38
environment for, for healing. And if we don't have that for
27:41
staff, we'll never have it with the residents.
27:44
So I, it's funny, we just, we just promoted a new clinical
27:51
director, which is fantastic. And we've been sitting down the
27:55
last week or two and kind of saying, what is this job?
27:59
What is this job breakdown into? Because we want to figure out
28:03
what is this new person really good at?
28:05
Where do we want to stick her in?
28:06
What, what duties do we want to follow to her?
28:08
And how do we reallocate all the other duties?
28:10
And turns out we had, we had two whiteboards full of probably 100
28:15
different duties in terms of the clinical leadership things that
28:18
we do here. So day-to-day I, I try to just,
28:23
I look at some of the big projects I've got and then I
28:25
look up at that board and I say, what is there anything that I'm
28:28
missing? Is there anything that I'm not
28:29
doing? Is there anything that's fallen
28:31
by the wayside where I need to spend a little time or
28:34
attention? You know, a lot of folks I
28:37
talked to Ryan still talk about it being a pretty tight labor
28:40
market. You know, whether you're hiring
28:43
sort of at the high, higher end, the demand or lower end of the
28:46
pay scale. I'm curious on your side what
28:50
you've seen and you know, maybe some different creative things
28:54
that you've tried to recruit and retain folks that you have found
28:58
to be successful. Recruiting can be a challenge.
29:03
We're a little distance away from Tucson, so it's A at least
29:08
1/2 hour for, for people in terms of a commute, often times
29:13
an hour for people that live, say in central or or South
29:16
Tucson. So recruiting's a challenge.
29:19
I, I think that we can be successful through, through
29:23
reputation and word of mouth. I think we have, you know, a
29:28
decent reputation in that way. And we get a lot of people that
29:32
come in and say, you know, I've just, I've just heard about you.
29:35
And so I thought I'd give it a shot.
29:36
I where we really invest most of our energy is in the retention.
29:42
And that's something that is critical to me.
29:45
I think in a, in a residential facility, you often see that
29:50
therapists come in at the associate licensure level
29:55
because they need to get clinical supervision, they need
29:58
supervised work hours. You know, a facility like this
30:01
is a great place for a therapist in training.
30:05
But a lot of times once a therapist gets their independent
30:08
license, they're going to want to go hang their shingle and
30:11
start private practice. So our whole, one of our major
30:15
priorities is how do we hang on to our independently licensed
30:18
therapists And you know, that involves to me, I think that you
30:23
know, the trauma informed leadership, making sure people
30:25
feel heard and seen and respected and valued.
30:28
We like to pour on trainings and training opportunities.
30:32
That's a great thing about Sierra Tucson as we have a great
30:35
budget for our staff. If they want to go to an IFS
30:38
training, we can do that. We trained everybody in somatic
30:42
experiencing last year and we did EMDR the year before that.
30:46
So training is valuable and, and making sure that people feel
30:50
valued and feel utilized and feel heard and respected.
30:53
And so we've managed to really shift the numbers.
30:57
I think when I started here, give or take, I think we had two
31:01
independently licensed therapists and now we've got to
31:05
have, I mean, close to a dozen people like either right there
31:10
or they've submitted their, their paperwork for it.
31:12
So, and then our associate license therapist, we put so
31:15
much time and effort into training that our associate
31:17
license therapists are rock solid.
31:19
It's fantastic, you know, fantastic clinicians and and
31:24
really talented at what they do. How would you sort of
31:28
characterize the breakdown either by number of percentage
31:31
wise of and and I don't know what the different categories
31:35
are sort of your licensed therapist, your associate
31:37
licensed therapist, clinicians, so.
31:41
How would I? Like, yeah, like what?
31:45
Like how many of them do you have or like percentage
31:48
breakdown? I'm just kind of curious to
31:49
better understand like, you know, here's the the number of
31:52
people who are providing therapy and here's the number of other
31:55
kind of support people that are necessary to do all the other
31:59
things. Sure.
32:00
Within my department, we've got, we've got about 15 primary
32:06
therapists. We have 6 or 7 specialty
32:10
therapists. We have a great group of
32:13
therapists in training our our residential therapists and
32:17
there's say about 15 of of those.
32:21
They run a lot of our groups and do a lot of support as well.
32:24
Our equine and experiential teams are about 5 therapists
32:28
apiece. We also have, of course, a
32:30
couple therapists at all of our outpatient locations.
32:33
So we've got a really, yeah, we, we've got the ability to have
32:39
our residents have a lot of good, you know, clinical touches
32:44
with a therapist throughout the week.
32:48
Ryan, you've got a special interest in organization,
32:52
efficiency, company culture, morale, effective leadership.
32:59
Talk to us a little bit about how you approach these things.
33:03
Yeah, I think that we've talked a bit about, you know, the, the
33:09
trauma informed approach and that's that's my big thing for,
33:13
for morale is making sure that people feel safe.
33:16
And I always said rather than try to guess or rather than try
33:20
to break down what are all the components of trauma informed
33:24
leadership? You know, the number one most
33:25
important thing is to have good systems for, for getting that
33:29
feedback. You know, meeting with staff
33:32
regularly, getting their input, having them have different
33:36
opportunities to provide feedback, making sure that
33:40
everybody understands that their feedback is welcome.
33:43
That's really critical. We also really try to celebrate
33:48
that this is a place where we we celebrate failure.
33:52
You know, this is a very difficult field.
33:55
And you know, people are going to have a group that goes
33:59
poorly. People are going to have an
34:00
individual therapy session that just goes completely off the
34:04
rails. And we want people to be feel OK
34:08
to come to leadership and say, I just, I just had a terrible
34:13
group and not fear that there's going to be retribution or not
34:16
fear that we're going to say, well, we'll have to write you up
34:19
for that. You know, we, we create that
34:21
good environment of learning and that good environment of, you
34:24
know, just celebrating that any mistake is a learning
34:27
opportunity. So that's, that's really big for
34:32
us on the organizational effectiveness side.
34:35
I'm, I've, I've always been a big picture person.
34:37
So I just love throwing out big ideas.
34:43
And then I have learned to figure out what it looks like to
34:47
operationalize those 'cause, you know, having a great idea is, is
34:52
one thing and being able to put it into play is a very, very
34:57
different thing. I remember I was a handful of
35:02
years ago, I was on a, a wonderful executive leadership
35:06
team with maybe three other people.
35:09
And each of us was, we were just idea people and we'd throw out
35:14
all these brilliant ideas all the time and then scratch our
35:16
heads around why, why did none of this ever happen?
35:20
So I took in this, I took a course in lean, I took, I took
35:27
the Google data analytics certificate course.
35:31
I took a couple different kind of strategic leadership things
35:37
and, and just learn how to take an idea, you know, break it into
35:42
action items, break it into steps and, and start to
35:45
operationalize it. And that was, I think, a big,
35:48
big leap forward in terms of my career or my my ability as a
35:52
leader. You know, I've, I would put
35:56
myself in that category of big idea guy too.
35:59
And one thing I, I had to learn over time the hard way, you
36:03
know, I have all these ideas and I would keep, then I come up
36:06
with them and I immediately direct my team to start working
36:09
on them and, you know, sort of divide up some duties.
36:12
And then, you know, a couple weeks later, I'm coming up with
36:14
the next big idea. And so I, you know, I'm having
36:15
them shift gears again. And it's like, well, this isn't
36:19
good. Like they're going to get
36:19
whiplash from this. And so I kind of had to impose a
36:23
process upon myself. And I'm curious if you've ever
36:25
tried this, which is you have a great idea.
36:28
I mean, you want to share it, right?
36:30
You want to put it into action. So the first thing I do and, and
36:33
this kind of sounds a little bit like what you were saying is
36:36
like I, I, I have to put it down into words.
36:38
Like, I have to sort of script it out.
36:40
Like here's the idea, here's what the different steps would
36:43
look like, the different roles. And that process of just writing
36:48
it out. Sometimes I'll find out that
36:52
that really wasn't such a good idea because there's some, you
36:54
know, pretty big gaping holes there.
36:55
Or if I get to the end of that and it still feels like a good
36:58
idea, then I make myself sit on it for a week.
37:02
And if I come and I and I set a timer on my calendar so I, I
37:05
don't forget it and I come back to it.
37:06
And if it still feels like the the same great idea it was a
37:10
week ago, OK, then I can start thinking about the next steps to
37:14
to put it into action. I love that maybe I should put
37:17
that into play 'cause I definitely have that same
37:19
experience, like one big idea, the next big idea and you know,
37:23
I'm sure my team is like, why don't we give this one a minute
37:26
to see if it really sinks in For sure.
37:30
I think for me, what I, I think I had a good success in, in some
37:37
setting, I, I think what I'm, what I'm learning or really
37:39
developing right now is the, the selling the idea piece.
37:44
I, I think I always just had this idea in my head that, you
37:47
know, if I had a great idea, I'd get everybody's buy in right
37:50
away. And change management is so much
37:53
about getting everybody on board, getting all the right
37:55
stakeholders on board. And I think I, you know, haven't
37:59
always put the, the time and energy into that step that, that
38:03
I needed to. So in doing that, I think some
38:07
of these some of these big ideas become a lot more actionable.
38:13
I think you hit on something really important there that that
38:15
buy in from other team members and a process that I've tried
38:19
and would love to hear if you have tried something similar is
38:25
I sort of go through my thought process with them.
38:28
Hey, here was the problem that I had in mind.
38:30
Here was the idea I had on maybe how we could solve it.
38:34
What do you think of that rather than here's what we're going to
38:39
do kind of a thing like, let them give me some feedback
38:42
first. Yeah.
38:44
Absolutely. It's it's, it's a gentler way of
38:48
sort of rolling it into people's.
38:50
Minds, Yeah. Yeah.
38:53
It also helps to yeah, I certainly let other people feel
38:58
like they're part of the creative process.
39:00
I think that's another thing that I've where I've another,
39:03
another, another mistake I can tend to make.
39:05
I'll have the idea, I'll write out the 22 step action plan to
39:09
do it and then I'll try to sell that.
39:12
Whereas instead, you know, maybe start with the idea, help, have
39:16
other people contribute to the action plan so that there's some
39:18
buy in and that tends to go a lot better.
39:22
And it'll make the idea ultimately better.
39:24
Oh yeah? Oh, absolutely.
39:26
Ryan, talk to me about your thoughts on technology related
39:31
addiction. Oh, that's a fun question.
39:36
Couple years ago I was doing a lot of presenting on technology
39:41
and and technology addiction or compulsion as it, as it were.
39:47
I have a lot of interest. I, I think it's sort of the
39:49
unheralded addiction or compulsion of our age.
39:53
I think between Netflix and the Internet and and cell phones and
39:59
video games, I think a lot of people are really over utilizing
40:05
technology for emotion regulation.
40:08
And I might be one of the worst, honestly.
40:11
I am so attached to my my phone and go to such great lengths to
40:16
try to create some distance, literal physical distance
40:20
between me and my phone. But I think, like so many
40:23
things, you know it. These sorts of things create
40:27
distractions and it can be healthy in small doses.
40:30
You know, there's nothing wrong with, you know, binging a show
40:33
on Netflix every now and again or playing those video games or
40:36
what have you. But I know that, you know, it
40:39
can be, you can slip into where that becomes a person's soul
40:45
means or primary means of kind of self regulating.
40:50
And I think that that's super problematic.
40:52
We always want people to have a lot of different tools at their
40:56
disposal to just manage their mood and manage their anxiety
41:00
and manage themselves. Is that something that actually
41:04
gets dealt with there at Sierra Tucson?
41:06
I mean, are you admitting and and treating people specifically
41:10
for technology related addiction or do you maybe just see like
41:14
the folks that come to you that like maybe that's just like a
41:16
small part of what's going? On absolutely.
41:22
I think it's, it's a big piece of what we're doing with a lot
41:27
of our residents. It's tends not to be.
41:31
And I think this is true for the the industry in a sense.
41:35
It tends not to be the presenting problem or the the
41:38
reason why they show up because insurance doesn't really
41:42
recognize that as something that would necessitate this level of
41:46
care. But you'll find that, you know,
41:50
most of our residents and staff struggle with overuse of
41:55
technology. And then furthermore, you know,
41:58
when you take people from their home and you put them in this
42:02
environment and you take away some of their other coping
42:04
strategies, some sometimes that technology use gets even worse.
42:10
Do you have any recommendations? I mean, you talked about and,
42:13
and I'm guilty of this too. Just last night, a long day, I
42:16
was exhausted, just wanted to go right to bed after I got the
42:19
kids down and I go and I lay down in bed and I'm really
42:23
tired, just happy to be closing my eyes.
42:26
And I, I feel my arm reaching for my phone and I don't have
42:31
anything specific I'm looking for.
42:32
Was it an e-mail that I needed that not a phone call I needed
42:36
to make, not a text message I was waiting on.
42:39
It was just, I, I just, I just wanted to open it up and see if
42:42
anything had happened. So, and I'm sure a lot of people
42:45
can relate, you know, they're listening to this.
42:47
So you have any suggestions, any coping tools?
42:49
You, you talked about how you, you know, try to create like a
42:52
physical distance between you and your phone sometimes.
42:55
I think I, I don't know that I have the ground breaking advice.
43:01
I, I do just try to really monitor what I'm doing and, you
43:08
know, when I'm at home, I try to put it down in a specific place
43:12
and leave it there at least until the kids are in bed.
43:16
And, you know, if I'm, if I'm noticing that I'm struggling
43:19
with it at work and I'm going into a meeting where I know I'm
43:23
going to be distracted, I will take my phone out and put it on
43:26
a table centrally and I'll say, hey, I'm, I'm putting my phone
43:31
down here if anybody else wants to do it because I want to make
43:33
sure that I can focus and pay attention.
43:35
One thing that I heard that actually, I think it did work
43:40
for me. You know, they, they, they say
43:44
that, you know, some of the, just the, the bright colors and
43:48
the flashiness and the icons is really visually appealing and in
43:52
some ways, you know, appealing to our, our, our, our brain and
43:55
our mind. So if you you can actually go
43:57
into your accessibility options and turn off the color and that
44:01
makes checking your phone a lot less reinforcing.
44:05
Interesting, I hadn't heard that there's a setting where you can
44:08
do that. Yeah, I think I for for an
44:11
iPhone, I know at least it's under accessibility options and
44:14
you can just turn it to grayscale and then when you look
44:17
at it, you don't see all the big fancy colorful icons and and all
44:21
that. I wonder if we did that on our
44:23
iPad if my kids would bug me less about wanting to play video
44:26
games on it. It's possible.
44:29
That is, I'm making a note of that right now.
44:32
Yeah, it's, it's worth a try. Beyond that, I think it's just,
44:36
yeah, I try to overanalyze it as I do everything.
44:39
Like when I find myself reaching from my phone on autopilot, it's
44:43
like, well, what am I? What, what is it that I'm trying
44:46
to accomplish here? Am I just trying to zone out?
44:49
And if so, why am I trying to zone out?
44:51
Is there something I'm trying to avoid thinking about?
44:53
Or am I just bored or, you know what?
44:56
What am I doing and what else could I do in this in this
44:59
scenario? So moving away from sort of the
45:03
technology addiction piece and thinking about, you know, a
45:08
family member maybe looks like they might be experiencing some
45:12
addiction issues or maybe some other mental health issues.
45:16
What are kind of some warning signs that folks should look for
45:21
that say this person's in the danger zone, they need some
45:24
help? I think first and foremost, just
45:29
trusting your gut is critical. I think if you if you know
45:34
somebody and you start to get a little concerned, it's
45:37
absolutely worth trying to start the conversation.
45:40
And of course, often times if you confront somebody in that
45:43
way, they're going to deny it. But I think you can open the
45:47
door for the conversation and just say you just, you don't
45:52
seem like yourself. And if you ever want to talk,
45:56
I'll be here. Absolutely.
45:58
So I think that's the first thing to do in terms of just
46:02
starting the conversation. And then, you know, if it's a
46:06
family member and you're genuinely concerned, I, I, I
46:10
think it's important to have the difficult conversations and to
46:14
say, you know, I'm really seeing you drinking a lot lately.
46:19
I really see you very, very depressed and withdrawn.
46:23
Like I, I really think this is a problem.
46:25
And I, I really want to figure out what it takes to, to help
46:28
you and what that looks like for you.
46:30
One of the things that I say all the time and when I do our, our
46:34
new hire orientation is, you know, it doesn't matter how many
46:37
fancy letters you have after your name, if you're in a, if
46:41
you're in a room full of people, the last person to know if
46:44
you're doing poorly is yourself. Everybody else around you can
46:47
see you more clearly than you can.
46:48
So I, I think that that's something that I always tell
46:53
people is, you know, got to, you know, listen to the people
46:56
around you for sure. Do interventions work?
47:01
You know, I see them on TV shows and movies.
47:03
I've heard some people talk about, you know, kind of a group
47:05
of friends or family come together and surprise somebody
47:08
and hey, you've got a problem. We're taking you to treatment
47:10
right now. Does that your experience?
47:13
Does that kind of thing work? Absolutely can work, I think.
47:17
I think you could argue it either way.
47:18
I think, you know, sometimes in a treatment center like this,
47:22
when you get somebody who's coming in the door and is has 0%
47:26
willingness to be there and is only there because of ultimatum,
47:30
that can be difficult. But those cases people also
47:35
often can, you know, really have that moment be a wake up call.
47:41
I think it's, I think the moment of intervention is less
47:45
important than the family continuing to support that
47:48
person and continuing to share their, their messages and their
47:52
love and their concern for their loved 1.
47:55
So I think, you know, an intervention is certainly not
47:59
guaranteed to work, but it, it really can it, it can really do
48:04
wonderful things. And I've heard countless
48:06
residents say, boy, when I stepped in this door, no part of
48:10
me wanted to be here. But my family kept in touch.
48:14
They kept letting me know that they supported me.
48:16
And slowly I started to realize that there really was a problem.
48:21
And then one day it hit me that there was a giant problem.
48:24
And I'm so happy that my family, you know, forced me to be here
48:27
because if they didn't, I would still be out on the streets
48:30
doing what it was that I used to be doing.
48:32
So yeah, I definitely, you know, I, I wouldn't get scared away
48:37
by, by the thought that the intervention might not work.
48:42
Ryan, what's a serious challenge that you've had to overcome
48:46
either personally or professionally?
48:48
How did you get through that and maybe some lessons that you
48:51
learned going through? Yeah, I think for me, I always
49:01
knew I wanted to do leadership and I got onto the leadership
49:06
track fairly early in my career. But I think just that entire
49:12
journey has been very eye opening because professional
49:16
development as a leader, it really requires a lot of
49:20
personal development. Like I had to realize
49:23
periodically throughout my career like, oh, I, I really
49:27
have some some big deficiencies here that I need to work on.
49:33
I guess one example was I, I had done some leadership early on in
49:40
my career. I was actually chief program
49:43
officer before I went to, to grad school for an outpatient
49:47
clinic. And my imposter syndrome reared
49:50
up so, so mightily and, and hit me so hard, 'cause I was, I was
49:56
young, I was really smart. So I helped to get this place
50:00
started. I wrote out all the policies and
50:02
procedures. We, we made it work.
50:04
We launched. And then all of a sudden, I
50:06
mean, I hired all these people around me and I'm early 20s, in
50:11
their 30s and 40s. And I'm like, Oh my God, I don't
50:15
know a thing about anything that I'm doing right now.
50:17
And I'm surrounded by. After you've done all the work
50:21
now, now you're doubting yourself now.
50:22
I'm doubting myself and you know, it's a, it's a trap,
50:26
right? Because the second I started
50:28
doubting myself, I, you know, it absolutely became a self
50:32
fulfilling prophecy. I was full of insecurity.
50:35
I was, you know, suspicious and distrustful of everybody around
50:40
me. I was hiding.
50:41
I didn't want them to see who I really was.
50:43
And of course they they saw all of that, you know, And so that
50:48
was, I think, a really big wake up call for me.
50:52
And then after grad school, I came out and, you know, I had
50:55
this new self-confidence. I knew that I knew what I was
50:57
doing. And I think my first job after
51:02
grad school was where I was like, well, I'm a doctor.
51:05
Everybody should immediately respect me and know that I, that
51:09
I know what I'm talking about. And I didn't realize it kind of
51:12
like we talked about earlier, so much of leadership.
51:15
It's not about having the best idea in the room at all.
51:17
It's about selling it. It's about connecting.
51:20
It's about, you know, networking and, and, and building
51:24
relationships. So I think that was another big
51:28
wake up call for me. And I think even currently I'm
51:33
realizing like I think some of my strengths, I think I'm great
51:37
at communication and collaboration and building
51:40
bridges. Got that whole middle child
51:43
thing right. But I've noticed when I get
51:45
stressed out, that's the first thing that goes out the out the
51:48
door. And that's not the first thing
51:50
that should go out the door. So I'm trying to be very mindful
51:52
of that right now with my leadership, which is, you know,
51:56
if I get stressed out or things get tight or things get tense, I
51:59
still need to really put in the time to maintain, you know,
52:04
relationships across departments and maintain relationships with,
52:09
with different stakeholders and, and be connected.
52:13
Whether it's something that you might employ yourself or
52:17
techniques that you teach to your residents, your your
52:20
patients. I'm curious, you already
52:23
mentioned one or two kind of quick exercises.
52:26
Do you have some more that you can share with the audience that
52:30
you know might be helpful things for them to try when they're
52:33
feeling stressed, overwhelmed, sad, anxious, depressed?
52:37
Yeah, I think one of the one of the interesting things, I think
52:45
if you're feeling really dysregulated, if you're feeling,
52:49
you know, like things are falling apart and you're really
52:51
struggling, sometimes the best thing to do is almost you.
52:55
You almost have to trick yourself into snapping out of it
52:58
rather than trying to dive down the rabbit hole and
53:02
psychoanalyze yourself and figure out what's wrong, what's
53:05
wrong, Why am I feeling this way?
53:06
Like, you know, we always say to people, number one, you know,
53:10
one of the best things you can do is get a change of scenery.
53:13
If you're sitting in your office and things feel dreadful and and
53:17
work seems overwhelming and you're feeling super anxious,
53:20
like go for a walk outside. That is, that can really almost
53:25
just trick your brain that the change of scenery can can be
53:28
really powerful. You know, going, going out and
53:31
getting something to eat, really changing up your routine.
53:35
You know, breathing can be, can be super effective as well.
53:39
But a lot of times it's just these physical interventions
53:43
that can really snap you back into a place where where you can
53:48
then think more meaningfully about what was going on for you
53:51
and what got you so upset. You know, I, that really
53:55
resonates with me because I, I find sometimes that I'll get
53:58
stuck in my head on something, right?
54:00
Like you said, I'll psychoanalyze it.
54:02
And I, I figured the more that I think about it, eventually I'll
54:05
figure it out, right? And, and, you know, then release
54:09
me from the, the stress of this worry that I have.
54:12
But I've often found that exactly what you're talking
54:15
about is a much better approach if rather than dwelling on it
54:19
and sort of stewing in it, right?
54:20
I, I get up and I do something physical, I go for a walk
54:25
outside, I, you know, fold some laundry.
54:28
I, you know, just something to sort of shift my mind into
54:32
another gear. And it's, it's one of the more
54:36
effective strategies I've found. The, the other thing personally
54:39
that I find that works really well is just having
54:42
conversations with people. Get out of here and get back to
54:46
here. Right.
54:47
Absolutely. Yeah, Yeah.
54:50
I think one of the questions that I encourage therapists to
54:55
be considering when they're doing their work is how far down
54:58
the rabbit hole is appropriate to go here.
55:01
So I think sometimes we, yeah, we or, or we guide our clients
55:05
to just analyze, analyze, analyze.
55:08
And sometimes, you know, getting up and getting out is, is much
55:13
more helpful. I'm thinking of like a long time
55:16
ago when I was doing my clinical work, I had a client who was in
55:20
distress and we were, you know, just sort of going out like, you
55:23
know, what's good? Like she was in, in the session,
55:25
she was getting very stressed and tense.
55:28
And I was falling into that trap of what's happening for you
55:31
right now? What are you aware of?
55:32
What are you feeling or thinking or seeing?
55:34
What is this about? And then all of a sudden I was
55:37
like, wait, wait, let's, let's go for a walk, right?
55:39
And sure enough, after 2 minutes on a walk, then we were able to
55:43
talk about what was happening for her.
55:45
But in that moment, I was doing nothing and being of no help to
55:48
her. So.
55:50
Ryan, any particular mentors, books, or other professional
55:56
experiences that have been helpful for you and your
55:59
professional development? I've had some great mentors
56:04
along the way. I think what got me into
56:08
leadership in the 1st place was a guy, Matt Pierce out here who
56:13
was my supervisor at, you know, one of my earliest jobs post
56:19
post undergrad. And Matt's whole trick was, you
56:23
know, I would go into his office and say, what do I do?
56:25
And he would say, what do you think you should do?
56:28
And then I'd say it and he'd say, that sounds like a great
56:32
idea. And, and that was it.
56:34
Like that was it. But I needed that so much at
56:37
that time. I, I was like, maybe I do have
56:40
good ideas, maybe I do know how to, how to do this work.
56:44
And it was so, so powerful me, so powerful for me.
56:47
And I think it propelled me from, like I said, I, I kind of
56:52
got an English degree, did not, didn't know what I wanted to do.
56:56
And, and it propelled me right away to no, I want to do
56:59
leadership and I want to work in behavioral health and I know
57:01
that I'm good at it. So Matt was fantastic.
57:04
And then when I was at Hazelton, I worked with Fran Williams, who
57:09
was just a brilliant psychologist and brilliant
57:13
supervisor. And Fran's trick was amazing
57:20
too. Fran, she just always focused on
57:25
the positive. So I was a fairly new therapist.
57:29
I had no idea what I was doing. I was probably a pretty bad
57:33
therapist, but I would tell her about what was going on and she
57:37
would. There's that imposter syndrome
57:39
again. Yeah, well, I think it was
57:41
accurate, though, at that time. She would find something in
57:45
there that was really good and just focus on like, wow, it
57:47
sounds like you did this really well.
57:50
And there was a part of my brain that was like, you know, but
57:52
what about everything else? But through that, her way of
57:57
calling attention to those things, it made me, it
57:59
reinforced it. It made me want to do it more.
58:02
And I leaned into the things I was doing well.
58:04
And I went from, yeah, I mean, at the beginning of, of, of that
58:09
internship year, having all the imposter syndrome in the world
58:12
and being a very socially anxious therapist to really
58:19
finding my stride and really being able to finally say, hey,
58:23
I can actually, I can, I can be good at this.
58:26
So that was phenomenal. And I, I think I, I asked myself
58:30
all the time, what would Fran do?
58:32
As I'm working with a lot of young therapists as well.
58:35
You know, sometimes people early on in their career, you want to
58:38
be like, ah, you know, you're doing this wrong, you're doing
58:41
this wrong, you're doing this wrong.
58:42
And I try to go back to that place of, you know, what, what,
58:44
what would Fran do? And is that is that appropriate
58:47
for this? And I wonder how many people
58:49
right now are saying, what would Doctor Dee do?
58:52
I, I hope some of them, I, I hope I can have that same impact
58:55
that Fran had on, on me. I think that's a lot of what you
58:59
know, got me into into working in treatment centers as well as
59:03
like I would love to be a Fran even if just for one person, if
59:08
I can have that kind of impact, that would be fantastic.
59:13
Ryan, I've got just one more question for you.
59:15
But before I ask it, I want to do 2 things.
59:17
Everybody listening today, I know you love today's content.
59:20
Please hit the like share subscribe button on your
59:22
favorite podcast app. And Doctor DI also want to let
59:26
people know the best way to get in touch with you.
59:27
What would that be? I think LinkedIn is a is a
59:31
pretty good way to to shoot me a message.
59:33
So it's Ryan Druzwicki. Should be easy to find.
59:38
And we'll have a link to that as well as the spelling of Ryan's
59:42
last name in there. So it makes it easy on
59:44
everybody. But Ryan, last question for you.
59:46
I'm kind of curious to hear your thoughts on what you think the
59:50
big changes are that are coming to your field in the next couple
59:54
of years. Oh, I like that question.
59:59
The big changes. It'll be interesting to see
1:00:05
honestly I I think. I think that we're coming to a
1:00:11
real realization about the limitations of the current
1:00:16
model. And, and I think that we're at a
1:00:19
breaking point. And I don't quite know what the
1:00:22
future looks like, but I know that I know that the acuity of
1:00:27
mental health is skyrocketing. I know that a lot more people
1:00:33
are struggling and a lot more people are struggling with more
1:00:37
significant or more severe symptomology.
1:00:41
And, you know, within kind of the managed care system, there's
1:00:45
a lot of frustration that the system of these levels of care
1:00:51
from inpatient to residential to partial to IOP just isn't quite
1:00:57
sufficient. You know, and I think I'm not,
1:01:02
I'm not anti insurance by any means.
1:01:04
I think there's some really good goals that the insurance
1:01:09
companies have. But there's a disconnect where,
1:01:12
you know, there there certainly is kind of a disconnect between,
1:01:15
you know, what the payers are seeing and how they're trying to
1:01:18
regulate the industry, what the treatment centers are seeing,
1:01:21
what the different providers are seeing.
1:01:22
So something's going to have to give and I think we're going to
1:01:25
have to rethink about what does effective treatment look like
1:01:30
and how does it need to evolve to meet the needs of of society.
1:01:35
I think as things get well, seems like more and more tense
1:01:40
and more and more stressful 'cause I think that that's a
1:01:42
really big piece of the spike in acuity is post COVID.
1:01:48
You know, there's still, there's still those anxieties about
1:01:50
COVID and our, and our safety and our health and, and our, and
1:01:55
our freedom and the role of the government.
1:01:57
There's all these, you know, there's political tension post
1:02:01
election, whether the next couple of years going to look
1:02:03
like for everybody. And there's, there's all sorts
1:02:06
of financial stress. And I, I just think, I think
1:02:10
that we're all just a little, you know, a hair away from being
1:02:14
dysregulated most of the time. And so a lot of that's going to
1:02:18
look like prevention. To your earlier question, how do
1:02:21
we teach our kids to be fluent in mental health and talk about
1:02:23
their mental health? So prevention's a big piece.
1:02:27
And then how can the treatment system evolve to really
1:02:31
meaningfully support the people that are struggling?
1:02:34
And how do we then build structures and, and means of
1:02:39
people maintaining their, their mental health maybe when they're
1:02:43
not in acute crisis, but how can we build community?
1:02:46
How can we build natural systems of support for people to
1:02:51
continue to do well when they're, when they're, you know,
1:02:55
not actively in treatment? So.
1:02:59
So that kind of leads to a few follow up questions I want to
1:03:03
ask because I'm in the camp that believes that mental health is
1:03:08
in, generally speaking, a worse place for the country or maybe
1:03:14
the world as a whole. But that's sort of anecdotal,
1:03:19
right? That's sort of like what I'm
1:03:21
hearing, what I'm seeing, what other people are saying.
1:03:24
I wonder, is there like hard evidence?
1:03:27
Is there data that says yes, like we've seen a huge uptick in
1:03:32
mental health issues? I imagine there is, I don't know
1:03:36
it offhand, but I can say that I, I think that the industry's
1:03:40
evolving already. When you look at the sorts of
1:03:46
presenting problems that you see at the inpatient level of care,
1:03:49
there's a much higher acuity now the residential level of care
1:03:53
is, it's an entirely different landscape than it was 10 years
1:03:57
ago. The clients that we used to
1:04:00
refer up to inpatient now aren't eligible for that level of care.
1:04:07
So I you know, and, and same thing all the way down the line
1:04:10
with the, with the levels of care for behavioral health we're
1:04:14
certainly seeing in terms of our client population and our and
1:04:17
our client mix just to dramatically more acuity, more
1:04:23
self harm, considerably more suicidality.
1:04:27
And it's interesting as well, too.
1:04:32
And this is a whole nother can of worms.
1:04:35
But through the rise of social media and through so many
1:04:39
different people having a platform on social media, the
1:04:43
public's perception of mental health and the public's
1:04:46
understanding of mental health syndromes and disorders and
1:04:49
diagnosis is changing so rapidly.
1:04:52
It's, it's, I think it's fascinating to me that the
1:04:55
public has really driven a drastically different definition
1:04:58
of autism and autism spectrum disorders.
1:05:01
They've really redefined ADHD. We're talking in very different
1:05:06
ways about about, you know, neurodiversity, that those
1:05:12
aren't terms that were, you know, in the latest DSM, but
1:05:15
we've changed the language in the dialogue around around
1:05:19
mental health. And so that's been a very
1:05:22
interesting evolution just since the rise of social media.
1:05:27
It's an interesting perspective because one of the questions I
1:05:30
wanted to ask is what do you think the contributing factors
1:05:34
are to the decline in mental health?
1:05:37
And I mean, you kind of touched on some of them.
1:05:40
You know, maybe COVID was sort of, you know, pulling really
1:05:43
hard at a thread that, you know, we didn't realize how loose it
1:05:47
was. And that's led to even, you
1:05:50
know, worse and more stresses over financial concerns.
1:05:55
You know, political tensions objectively really seem to be at
1:06:00
a peak, at least in my my, my lifetime.
1:06:04
I was going to say social media itself and the devices, you
1:06:08
know, sort of disconnecting us from safe, real human
1:06:12
connection. But your perspective there on
1:06:15
social media, kind of shining a different light on it and
1:06:20
bringing a different kind of attention to it in a way that I
1:06:24
think I hear what you're saying is the public is sort of
1:06:26
redefining what mental health means.
1:06:28
Oh, I I think that they absolutely are.
1:06:30
And is that good or bad? Both yes yeah, I guess is the
1:06:34
answer. I I think it's to the extent to
1:06:37
which it normalizes mental health and celebrates people who
1:06:42
who feel, you know different or, you know, embraces or welcomes
1:06:47
people who have been struggling. I I love it.
1:06:49
I also, you know, I worry at the same time though, that it's a
1:06:53
lot of people are over pathologizing themselves or
1:06:56
labeling themselves or, you know, in in the way that the the
1:07:00
language that we use to talk about mental health can be.
1:07:05
I mean, it can be beneficial for some and it can be harmful for
1:07:07
others. So, yeah, I think it's
1:07:09
fascinating that the public has really taken the power away from
1:07:13
the experts. And I bet you like the top 10
1:07:16
things that are talked about on TikTok right now.
1:07:18
I bet none of them are in the DSM, but they will be because,
1:07:22
you know, we've got to, we've got to adapt to meet what the
1:07:24
public is telling us about their mental health.
1:07:27
That's fascinating. That's wild.
1:07:30
I'd never thought about it that way.
1:07:31
Well, Ryan, Doctor DI, want to be the first one to thank you
1:07:34
for sharing both your time and your story with us today.
1:07:37
I really appreciate it. Yeah, thank you so much for
1:07:39
having me on. It was really great to talk to
1:07:41
you and this was a it was a lot of fun.
1:07:43
Folks, that's a wrap on another episode of the Inspired Stories
1:07:46
podcast. Thanks for learning with us
1:07:48
today.