Ep49 Addiction Treatment Magical Process of Group Work

Ep49 Addiction Treatment Magical Process of Group Work

Chris Langley: Hi, welcome to Addiction Recovery Place Podcast, the podcast championing addiction treatment professionals around the world. I'm your host Chris Langley. And I'm very pleased to introduce today's guest Kylee Cline.

Kylee is a Licensed Counselor located in North Dakota and has just recently qualified in her role and is starting her journey with her new career at the Heartview Foundation. Welcome to Addiction Recovery Place Podcast, Kylee. It's great to have you with us today.

Kylee Cline: Hello. Thanks for having me.

Chris Langley: Now, very excited to hear about your new career and your work and what you're doing in your state. can you tell us about yourself and your journey to becoming a licensed addiction counsellor, please?

Kylee Cline: Yes, so I grew up, closely with the addiction world, which is unfortunate, but I feel like a lot of people are touched with addiction one way or another. I have family members who have struggled with substance use disorders, so it is something that is very intertwined in my life. I had went to college for something else, and that wasn't a good fit for me. I took a year off, decided what I wanted to do, and then addiction counseling just fell into my lap, within that year. And I'm like, okay, let me look into it, and I just fell in love with it ever since. and throughout my time, my training and everything, it was really difficult, but I think I've definitely found my calling, and I found it really fruitful to be here.

Chris Langley: Yeah, what is it that you most enjoy about your role?

Kylee Cline: honestly, I think doing group work. I really enjoy having groups. like I said, I, do three groups. I have an outpatient group that meets three times a week, and I do two aftercare groups, on top of individual caseload that I have as well. But, really do enjoy seeing people. The group process and seeing how everyone works together.

Everyone is able to relate to one another, give feedback to each other. And I sit back and watch that magical process happen in front of me. I used to be really scared of the group process until I was in my training and then I did my training and it's just a really magical process.

So I love being part of the group process.

Chris Langley: Yeah, most definitely. Where did you do your training?

Kylee Cline: I did my training November of 2019. 23 through of 24, June of July of 24. So it's about, it's 960 clinical hours of supervision. we do those 960 hours. and however long that takes you to do it. and for me, it was a little over six months of doing it. So yeah, it's a long process.

Chris Langley: But you did it in six months.

Kylee Cline: Yes.

Chris Langley: Wow.

Kylee Cline: six months.

Chris Langley: firstly, congratulations. that's, that's one heck of an achievement. It really is. And it seems like you certainly found your calling in this, in this career. So, well done on that. I just want to talk about the Heartview Foundation, Kylee.

So what are some of the services that you provide to your facility?

Kylee Cline: so at the agency, for the addiction process, we have a residential program. have, We have three slash four facilities located across the state. we have two here in Bismarck with a CanDo location and a Dickinson location that offer residential. we have outpatient that is offered in Bismarck location, which is stuff that I provide. day treatment, which is also outpatient, but day treatment is five days a week. aftercare services and then also individual services. We offer Medica assisted treatment, opioid treatment program. we also have case management, peer support specialists on staff. we have a wide variety and range of people who are here to support our clientele.

Chris Langley: Yeah, it certainly sounds like you've got all the bases covered with your staff team. That's amazing.

Kylee Cline: Yeah.

Chris Langley: has the service been around for?

Kylee Cline: we just celebrated 60 years. this past, this past, I think it was in. Gosh, I want to say in October was our 60 year anniversary, actually. yep, it's been in place for 60 years.

Chris Langley: that's amazing. That really is 60 years is one heck of an achievement. so can you tell us about some of your team members and some of their roles, their skill sets and what your team members do?

Kylee Cline: Yeah, so like I said, I, I have, three groups and individuals and everything like that. And my direct supervisor actually runs the opioid treatment program. so she's the director of the OTP program. So underneath her are, some of the case managers, The nurses for the OTP program, some of the like front desk people, stuff like that.

And so she really oversees the department of OTP, and then a couple other addiction counselors. and so she really is pretty awesome in that aspect. I think anyways, I'm biased. and then we have, some of the other directors of day treatment, outpatient directors, and they do a really good job of if we have questions about anything, being able to go to them and like, staff with them and be like, Hey, I'm having trouble with this client or what do you think we should do in this situation?

and the other addiction counselors are really, amazing too. we have people who are dual licensed in mental health and addiction counseling. And so sometimes being able to bounce things off of them and be like, Hey, can you come and lecture in my group for an hour on something to do with mental health?

And they're willing and able to come in for an hour of their time, maybe once or twice a month and come and talk to my group, which, is, it's a really nice work environment. Culture here where people are just willing to help out one another, if I'm sick or something comes up, like people are willing to just jump in and help, which is really amazing to see, within the agency.

Chris Langley: Yeah, it sounds pretty incredible place to work. It sounds like you've got a lot of support around you and the, work with dual diagnosis clients as well. It's just it's so important. It really is. And then that sounds great. So, how do you receive referrals and how are you funded?

Kylee Cline: so our, the way we receive referrals is we. How our clients come into us is we have a walk in clinic type thing. And it's four days a week. So Monday through Thursday, we have a walk in clinic. And so people can come on their own free will they can come with a court order, PO order. And a drug court order. and so we have two different types of clientele, right? So like a court order, drug order, CPS, whatever it is, or people come just like on their own volition wanting to get help. that is also really nice to see, the different, levels of motivation and stuff like that. and we receive different funding from like the state, the federal government, stuff like that, because we're like a privately run business. so that is also nice, like I said, because like we have to, our opioid treatment program, the OTP program is like a federally run program.

And so we have like certain things we need to run by through them. We also have insurance. And so there's things that we have to be in, regulation with so that insurance covers stuff. And yeah, there's different entities that we also have to by.

Chris Langley: Yeah, you've just mentioned the word insurance, Kylee. Would you say that's one of the biggest challenges that you experience or are learning about as you work?

Kylee Cline: yes. and I think what I struggle with the most, and I would say personally, me, I think the difference in I guess state to state and also just like North Dakota and how we struggle with insurance with our clients, and depending on what they will and will not cover. because I've been in trainings before with other people from different states and some states follow the ASAM criteria.

So if you say like someone needs to continue in residential or continue a different at this level of care, they'll like, Oh, okay. the expert, you're the addiction counselor, we'll follow your recommendation. some North Dakota insurances don't follow that. They follow, a different, interqual or something like that. And so they don't follow the ASAM criteria. So they're like, okay, in 30 days, in residential, you're good to go and we won't cover anything past that. And That is extremely frustrating because especially some clients who are like really fresh and brand new into recovery or depending on the substance that they're using, like sometimes withdrawal happens for a full week and you're not even in group sometimes.

And so it's you're not really working with the clients. It's just detox at that point. I'm not doing treatment. And so I think that's something that I really struggle with. And then they come into the outpatient group and then it's we're starting fresh and brand new and people are different levels, which is fine.

Like it's okay to have different levels of motivation and different times of having sobriety. But, I think that I find that the most difficult is, insurance kickbacks as well. And then that makes it difficult for clients to want to engage in treatment because treatment's not free. And treatment could be extensive, is then people, are recommended a higher level of care, say day treatment, outpatient, if they can't afford it, then they are like, okay, can only do individuals or I have to discontinue treatment because I can't afford it.

Chris Langley: So 30 days is the normal insurance kind of level of care. Is that right? Am I right in thinking that?

Kylee Cline: For residential, it's 28 30 days. Unless we are able to prove, that they need longer, but usually they will extend it for two or three days more. like I said, like when I was in my, residential rotation in my training, I think that's something that I found very, frustrating because like I say, it's not just addiction that we're talking about with our clients.

Sometimes it's hard because. you have them in residential for 30 days or whatever, but we're trying to help them with housing, with employment, with all this stuff, and you're working that entire time to help them set this up, but sometimes it's not set up in that time frame, and what are you going to do, send someone back on the streets? so that's something that is also just really frustrating.

Chris Langley: Yeah, so you help with housing as well. You help with other things in some in your clients lives as well. You refer them on to other agencies. Yeah.

Kylee Cline: Yeah, and that's something that our case managers do really well. A lot of our case managers are, work magic. they do stuff with help applying for housing, with a job service, so that they can get connected with jobs. we work closely related with the Abused Adult Resource Center.

one of our local gyms like, set up like a free six month, Like gym membership for our clients and stuff. we have a really good like community, like organization and, stuff like that. And so our, like I said, our case managers are just amazing as well. And so they do their jobs very effectively and, sing high praises for our case managers as well.

Chris Langley: Yeah, most definitely. so some of your clients get free gym membership for six months just because of your community.

what.

Kylee Cline: while they're a client here, they can, get a gym membership for six months, as long as they go for a minimum of four times a month. and if they're wanting to do things for wellness, then they can go to one of our gyms. And so it's pretty, cool.

Chris Langley: That's, amazing. That's great to hear. That really is. Kylee, you mentioned earlier that obviously your work can be called towards, clients and you obviously drug test, you do drug testing at your facility. Yeah. So have you ever met someone who's tested positive for say fentanyl and is genuinely surprised at the test result?

The reason I'm asking this cause I've had other guests on the podcast who have stated that some street marijuana is found to have fentanyl. Is this something you've come across at all or any of your clients?

Kylee Cline: Yes. unfortunately, I have had this discussion with other clients many times as well. and also at a previous job I've had as well. I worked at a halfway house. I see it when people are using disposable vapes. and they're just like, Oh, it's a vape. there's nothing in there. But people can put methamphetamine into disposable vapes.

They can put fentanyl. can put anything anywhere, right? And even like when fentanyl first started coming on the line, who are longtime methamphetamine users were all of a sudden popping hot for fentanyl. And they're like, I've never used fentanyl. And I'm like, where are you getting your meth from?

And It's you don't think about it cause you're so deep in your addiction. You're not going to like the best, most clean, So there are testing strips that I've heard of clients using where they can test like the potency of their breath. It's whatever drug they're using, and a lot of people who I've heard that are testing it, like a lot of the methamphetamine is already laced with fentanyl. which is really unfortunate, but I have heard of it, yes, where people will like, use marijuana, Or vapes or a different drug and it's laced with something else. And they're like, I had no idea. And I'm like, sometimes the risk of you using is you're not totally sure what you're using or what it's cut with or what it's laced with.

I'm like, that's the risk that you put yourself in,

Chris Langley: Yeah. The mu Yeah, there must be a huge shock to the, to your clients as well, to realize the extra massive risk that they put their lives at for Yeah, it's really tragic. It really is. So how is North Dakota coping with the opioid crisis?

Kylee Cline: Yeah, we, so our, director, main facilitator, right now, he will send out some like statistics like at the end of the year, end of the, Pay period or whatever and he'll just about like how the numbers have increased or decreased or whatever So we have been seeing a little bit of a decrease which is really good I know that Like I said, like we have the opioid treatment program right now here in Bismarck and one of our other facilities over in Dickinson.

We're gonna try opening one up as well but again, there's like that stigma in the community of like we don't want quote unquote those people around here and it's you could have a neighbor addicted to something and you don't know. but it's like we have these wonderful programs that are trying to circumvene that. with like the OTP, MAT services. we have people, we have NARCAN everywhere. We offer, we have NARCAN training for our, for our, staff members, we make sure that everyone is trained in NARCAN and knows how to use it. like I have a box of NARCAN in my office just in case, and we have it, we offer it to clients as well.

like we have it in our nurses station at the front desk and be like, okay, you need it, even if you don't need it and you might want to give it to a friend, like we offer it to clients as well for free. Just in case. and so that's something that we really, try to push as well as, people might be using, so be educated on how to use it.

Chris Langley: Yeah. That's great to hear that you, can supply Narcan as well. That's, that's great. So there's no issues with your state around Narcan or anything like that? No.

Kylee Cline: No, yeah, we push really hard for, especially with the opioid crisis is like, just educating people on like the signs of an overdose. And if someone is passed out, and you can't wake them up, there's no harm to giving Narcan. And if it's not working, then you know, obviously call 911, but you can dose Narcan, do CPR, and then just wait for authorities to arrive.

Chris Langley: Yeah, that's real vital stuff.

Kylee Cline: And

oh

sorry,

Chris Langley: no.

Kylee Cline: I was gonna say something too is like we have the, not the bystander law, but, I can't remember what it's called, but if you are like a group using together, right? And that's a big thing is like people like, if our buddy overdoses, I don't want to call and get in trouble because I'm using. if you call the police, then like you won't get charged with that. Like any drug charges because you called and basically saved this person's life. So it's I can't remember what the law is called, but basically the person who called won't get charged with anything because you're saving this person's life. Also, it's the good Samaritan law, I think is what it's called.

Chris Langley: That sounds pretty progressive. I've,

yeah, I've heard,

Kylee Cline: really nice. Yeah.

Chris Langley: states dealing with a different, I've never come across a law like That, that's great to hear that North Dakota has actually got that in statute. It really is. you, you, mentioned a word earlier, Kylee, you mentioned stigma.

And why do you think stigma has such a negative effect on people who want to enter treatment for their addiction? It's,

Kylee Cline: There's a lot of shame. attached to it, right? it's something that I talk a lot about with my groups and my clients. I think to a lot of people who are involved in treatment, it's not their first rodeo, right? It's not their first time. And, even if it is, it's like this deep ingrained of okay, I have to go to treatment, I have to, be at work for very long.

I have to tell people what's going on. And, I educate my clients and be like, you don't have to straight up lie to people, but at the same time, it's really no one's business what you're going through, right? it's like any other medical condition, right? if you're going through like a cancer treatment or anything else, like you can just tell people like, I'm going through a medical condition right now.

I just need some time off. I'm like, it's like a need to know basis, right? And so I think that's something as well that people struggle with is there's still like this Yeah, like the shame stigma attachment to it of like you're inherently a bad person if you're struggling with a substance use disorder, which is just not the case, right?

as addiction professionals, we know that it's just not the case that people struggling with substance use disorders are struggling with many other things and addiction is just like the symptom of that.

Chris Langley: it's great to hear that you speak about this in groups so openly as well, Kylee. So I think clients need to acknowledge this as well that there is no shame or stigma around This this is, she said, it's a, condition almost. It's a, Addiction is so that's really good. So how do you find that clients react when you explain this to me?

Do you ever see any light bulb moments with them?

Kylee Cline: I'm not sure if it's a light bulb moment, but I definitely them feeling understood, to where it's oh, someone gets it,

Chris Langley: Yep.

Kylee Cline: right? Where I feel I say, like sometimes even in the addiction world, it's still this okay, if you're not, fully into it. If you're not, there's just some of this yes, there needs to be accountability in your life.

But at the same time is like I said, like addiction is not the problem. Addiction is the symptom of a lot of the problems that you're dealing with. And so it's okay, let's, talk about the issues at hand. yes, like you're coping with it with your addiction, but, there's other sub lying issues, whether it's family problems, financial problems, mental health, all of this other stuff that's going on, right? And we want to prevent you, basically, from going back into your using And whatever, like these destructive habits. and so that, I guess that's what I try and focus on with my clients instead of looking backwards and it's okay, here's all the bad stuff you've done, let's focus on that.

And all that kind of stuff. I'm not a fan personally of that kind of approach. it is important to look back and be like, okay, like I have messed up. Here's what didn't go good. But now in the present, what can I do to avoid that?

Chris Langley: Yeah, most definitely. I'm just going to ask you, just about your, member of NAADAC, which is obviously where we met. But can you tell me what are the benefits of being a member and why someone who's considering a career in counseling become a member of this organization?

Kylee Cline: Yeah. so I think obviously the first one is like you said, we, met through it. And so I think like having a community on there and it's not just, not just for people in one state to connect. I think it's the whole country or for all addiction professionals to be able to meet each other.

And so I think that's a really neat opportunity to what's going on in other states or what's going on with other addiction professionals and see like what other people are working on or what they're going through and ask questions. I always find that really interesting because, there's Sometimes it's easy to stay in your own bubble, even within your own agency, right?

And be like, okay, this is what we're doing and this is what's working for us. It's it's always nice and fresh, get new ideas and new stuff. That's what's going on. so I find that really nice. The second one is doing the free trainings. we have. so many CEs that we need, continuing education credits that you need to meet. but I always find them very fruitful. I love all of the people that they have as guest people to educate. and so I really enjoy the training. So anytime I have time, Free time in my schedule and I see a topic that I really like. I also like that you can go back and watch trainings, in the past because they record them and you can still get the CEs because of it.

those are things that I really enjoy.

Chris Langley: Yeah, so you would recommend someone who's considering a career to look at and make that membership. Yeah,

Kylee Cline: Yeah.

Chris Langley: Excellent. thank you for that. last couple of questions, Kylee. I ask all my guests this because I get such a wide range and varied answers, but can you tell me what your opinion of harm reduction is and how it can play such a role in recovery?

Kylee Cline: Yes. I guess I have mixed emotions about it. just because I feel Like I said, like there needs to be some sort of accountability, right? Because for so long clients have themselves as accountability and we see how far that brings you. and that's something that we talk about again in, in group.

And clients have said to me too, they're like, yeah, like I can't hold myself accountable. Like I need something. But I also understand, harm reduction means, meeting clients where they're at, right? And something that like I always remind myself, is if I'm gonna look at it as a different type of a disease, so sometimes I'm like, okay, if I'm going to compare it to diabetes, for example, all of a sudden I get a diabetes diagnosis at the age of 25 and I have to make all these lifestyle changes, the doctor's okay, here's your diagnosis of diabetes, you need to exercise more, cut all this food out of your diet, blah blah blah blah blah, here's a list of 20 things to do. Am I gonna all those 20 things within the first week of doing it? Probably not. Maybe one or two. Okay? So same thing for addiction. Again, a disease, medical term, right? Things that people are struggling with. why do we hold people at a higher standard for addiction treatment? Again, it's a It kind of ties in.

It's that stigma of, it's your moral feeling. You should just quit and you're done. it's a bio psychosocial disease where it's, there's a lot that needs to change in order for people to like genuinely be in recovery. if you give them this big list of things that needs to get done, can't expect you to have it all done in 30 days, 60 days, 90 days, right?

It's going to be a long process for that to get done. So how harm reduction comes in is, say a client comes in using four different substances and they only want to quit two of them, it's not really for me to say, okay you need to quit all four of them in order to be successful. If they're not willing to do that, how successful are they going to be?

Cause they're going to have this like dissonance, right? Be like, I don't want to, right? Then you're going to meet resistance and you're not going to have a lot of effective work being done. So I guess that's where I'm at, where it's okay, I understand like having to meet the clients where they're at and, working with them in a way that. are ready to work on, but at the same time there's like this, okay, you need to meet me somewhere, right? I can only meet so far but you need to meet me, right? Because I, it's your treatment, not mine, So you need to meet me somewhere.

Chris Langley: What a great answer.

Kylee Cline: Oh, thank you.

Chris Langley: That really was. That was a great answer. so much for that. That explained it beautifully. Last question really, Kylee, do you have a message for anyone who's listening to this podcast who is going through an addiction?

Kylee Cline: I will say, not be scared, do not be afraid. What you are going through is very difficult, and to not feel or scared, because I know it is scary, but help is out there and people care about you, whether it feels like it or not, And yeah, like I said, help is out there and you are deserving of recovery.

You are deserving to be healthy and you are deserving of a substance free life. there's so much out there that provides you that love, comfort, and happiness that doesn't have to tie you to substance use. and you are deserving of that kind of life. be courageous and take that next step of being free.

Chris Langley: I love that. Be courageous.

Kylee Cline: Yeah.

Chris Langley: That's beautiful. It really is. can you tell our listeners how to best contact you and to find your service online, Kylee?

Kylee Cline: Like I said, I work for an agency. The agency is the Heartview Foundation. our website is heartview.org. and like I said, if anyone needs any services, like I said, we have our walk in services in Bismarck. just need to come in to the walk in services Monday through Thursdays, and you can come in for an evaluation.

An evaluating counselor will evaluate you, see what level of care is appropriate, and yeah, like I say, I do outpatient and aftercare, so if that's what people are appropriate for, and individuals, so if that's what people are appropriate for, then I could be a counselor.

Chris Langley: Kylee, it's been a real privilege to talk to you today. You've really, found your calling with your career choice. There's no question about that. And, and thank you so much for your time today. I really appreciate it.

Kylee Cline: Of course.

Chris Langley: Thank you.

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