Ep63 Addiction Treatment Propel life forward with joy and surf therapy

Ep63 Addiction Treatment Propel life forward with joy and surf therapy

Boom, boom, boom, boom, boom.

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, Kate O'Donnell who is the Client Wellness Director at Maui Recovery in Haena in the state of Hawaii, Maui Recovery. Offers many programs for people experiencing addiction, mental health, trauma, and other behavioral conditions, is also described as an elegant facility and most beautiful place in the world. And judging by the photos that I've seen, I can't really argue with this quote. So welcome to Addiction Recovery Place podcast.

Great, Kate, it's so good to have you with us today.

Thank you. It's very nice to be here.

Really appreciate it. And obviously you were very busy. So we're just gonna jump straight in. So can you tell us about yourself and your journey to working at Maui Recovery?

Sure. So my background is, as both a science educator and also in peer advocacy and counseling, so mostly within the labor sector. 17 years basically helping folks in everything from workplace discrimination to, transition life transitions after being laid off. due to I think some personal, let me see how I wanna say this, sorry.

I think addiction touches many of our lives in many different ways. it has certainly, touched mine. And to that I made a decision to make a little bit of a career shift and take both the science and the kind of advocacy, peer counseling piece, and really devoted towards addiction and mental health treatment instead.

So I. I thought I would try it out for, a few months, see how that resonated at Maui Recovery. I came here for Maui Recovery, ended up really falling in love with the program and the place and everything that we do here. And, that was a few years ago and I'm very lucky to, still be there now.

How did you find the shift from your old career to, now working in recovery?

So it's interesting. I think it's very, it's two things that may not sound like they have a lot to do. each other, but they're actually very similar. it comes to working with clients, I do a lot of our case management work, so that involves a lot of the trying to, help people with this major life transition as they go from treatment back into their lives.

In the same way that I was helping a lot of folks with major life transitions going from. being employed somewhere for a long time to, all of a sudden being unemployed, for example. And, in terms advocacy as well, really connecting people with resources that they need to help advocate for themselves and to the resources they need to navigate everything from complex medical systems to, you know, complex work systems, et cetera. really, I think another piece too is science applicability in when we understand what's going on in our brains and we understand that addiction is a disease. Not a choice.

I think it helps release some of the stigma that we often carry with addiction and opens us up for treatment more. And given, various personal experiences and experiences in my family, I felt really called to this work and felt like it was really what I should be doing and, that keeps being reinforced for me every day.

It. Sounds like a very natural progression

from what you've described. So that's wonderful to hear. Thank you for subscribing that. that's an amazing journey you've just told us. at Maui Recovery, I've been looking, you provide a very, extensive and comprehensive program for all of your clients.

Can you explain to us how your program works and what you offer the clients that come to your facility?

Absolutely. So we are a dual diagnosis program, meaning we treat addiction as well as mental health issues. And, a lot of folks are coming to us for both. it's very common to be using substances in order to self-medicate for other issues that we've got going on, example. But we do have people who are coming to us, Solely for mental health issues as well, without substance use disorders. really it's a very sort of holistic program, meaning all encompassing. I think. I like to think about it as that there are these sort of three main components. One of them is I. Really understanding the reasons why we're having these issues, what is going on behind our trauma, our mental health struggles, our addiction, and a lot of that comes through the individual therapy that we do with folks as well as group therapy.

I. We practice a lot of different types of modalities of therapy. Everything from cognitive behavioral therapy, dialectical behavioral therapy, mindfulness. We have, a pretty amazing clinical team that all comes with. Their own unique strengths and flavors so that the groups and the individual sessions are really varied.

And so while someone may have a primary therapist who work sees them more frequently, they're gonna be meeting with multiple different therapists so that they're getting these different approaches as well. while they're here and. We also though, I think that there's, the important then piece of connecting with, coping skills, with new ways of living our life once we leave, right?

And so those are the two main features you'll see at most dual diagnosis clinics, right? You've got the kind of the coping skills, the what's next, how do we deal with these things differently? As well as having a better understanding of why they're happening where I think Maui recovery really adds in this critical and not always available. Third element is reconnecting people with joy and reconnecting people with the reasons to be alive and be living, beautiful and substance free life. And a lot of that comes in the form of mindfulness therapy, but it's mindfulness therapy that's happening while they are snorkeling and hiking and surf therapy.

We do surf therapy weekly. We do equine therapy. And I think it's just really critical that, instead of just sitting in a room about the hard stuff, which is a critical part of treatment, don't get me wrong, we're also really reconnecting people with themselves and with nature eah We have art and music therapy too, and really just reminding people of how much joy that there can be in the world. And also, When we're in active addiction, when we're in, active mental health struggles, like going out on a hike and seeing beautiful scenery, usually not what we're doing right.

And maybe these are things that we to do, no longer are able to. And so reconnecting people to, with things that they really used to enjoy or new passions that they haven't had a chance to do, is a really important part of the program because it helps rekindle both that joy but also that hope for what's next.

Yeah, you mentioned surf. Surf therapy.

Yes.

That's, I've done quite a few of these podcasts, Kate, and I think you are the first person to ever to, can you tell us about that? That sounds really interesting. That sounds awesome.

absolutely. so surf therapy is, I think just like it sounds. We have an amazing surf instructor who, has a lot of experience working with people in addiction recovery, also people, of differing physical abilities. And regardless of age or, physical sort of ability level.

he'll get you out there on that sort of board and, it's not gonna, we're not talking about, the jaws, 50 foot waves here. We're talking about, the nice, baby ones. have paddle boards as well, and excuse me. it's just really, it can be really empowering to be in the ocean when you are so surrounded in this physical thing that is so much bigger than you, right? And then the exhilaration of catching that wave, the exhilaration of that little quick kind of adrenaline rush from getting on the board and having that board propel you forward. very both, I think, symbolic of, able to get on that board and propel forward in life, but also this.

It's hard, and then you get this amazing sense of achievement from doing it. And so I think it's both, in addition to physical, like all of the dopamine and the things that you're getting right from physical and out in the environment. You're also getting some really lovely. Ways of attacking a challenge and a thing that maybe you didn't necessarily think that you could do. And that can be a really nice metaphor for people's work with addiction and mental health as well. We have a lot of clients. We have clients, who are local.

We have clients, a lot of clients from the mainland as well. For some folks, surf therapy is if you're, you live here or from here, surfing is probably something that you either do or have done and haven't had a chance to do in a while. So it's really nice to reconnect with if you are from the mainland, maybe you haven't done it before and so it's a really thing to be able to that challenge to be able to overcome and learn.

It's a very unique experience. I can imagine someone,

someone coming, like you said, from the, mainland who's never experienced that, that awe of just being in the water and surfing. That's incredible. That's amazing. I did see that on your website. I'm glad you talked about that. Because that's something that I've never come across myself.

That's amazing.

It is also a lovely break from ruminative thinking, for example, like you were thinking about the wave and where it is coming. It is one of those. Inherently mindfulness practices, right? Where we can't be too caught in our heads. We have to be focused on the moment and what's going on around us, and that's just really good practice for us in general.

Yeah, most definitely. you, obviously you've gone into some great detail about your surf therapist. Can you tell us about some of the other colleagues that you have at Maui Recovery? Because you've, got a very extensive team there and it just looks fantastic. Can you just mention some of your team members?

Yeah, absolutely. So we are so lucky to have a really incredible team. everyone who works there, and this is not in any way sort of a biased exaggeration. Everyone who is there is just so dedicated to the work and to our clients and, keeps in touch with alumni after they leave. And this goes from everyone, from therapists and the clinical team, to the techs who are really the lifeblood of our program.

all of the techs who work there are just amazing. We have a number of alumni working on our staff as well, which I think speaks to the program at, multiple different levels of the organization. So people. I think the program touches a lot of folks and they want come and, stay and give back and, and so yeah, is amazing.

I think most people have if they're not in recovery themselves, they've had addiction, touch their lives in some way. There's a lot of empathy and on the staff in terms of people who get it, who don't judge, who are. Really just there to welcome folks with open arms and and treat people where they are and where they're coming from.

And. We're really lucky to have, pretty robust clinical team. Our clinicians, our therapists, attend all of the adventures, go out with folks, when they're doing, when they're hiking, when they're snorkeling, things like that as well. So in addition to our, therapy, adventure leaders, we have clinical staff there as well to help support clients while they're there.

something else I did wanna mention, Kate, you have a, an aftercare can you just tell us about this and how it works? 'cause it's, it's such an important component of recovery is to have that aftercare and, and it's really good to hear that you, you have such a robust program, but can you tell our audience about that please?

Absolutely. And, thank you for asking. 'cause this is my, especially my wheelhouse. so I, mainly director aftercare program and I work with clients one-on-one, for an hour every week with every client I. To really make sure that, starting the very week that they come in, they have a solid plan for what happens next.

It's one thing to be in treatment in a beautiful place with sweeping ocean views and sunshine and mountains, and it's another to then go from that back into our lives, regardless of whether they're here or elsewhere. Life is still life and comes with all of the stresses of it being so right. so it's really important to me and to the team to make sure that folks have a plan and when where possible, that can involve an aftercare program at a lower level of care, like A PHP and IOP, et cetera.

And we have someone on our team who has relationships with different. Other treatment facilities around the country. We don't offer IOP. So he helps us find places that are located near clients' homes where they might be able to seek further aftercare. I. But for folks who are not either, are not interested in that level of aftercare or just interested in going straight back into their lives, even for people who are gonna be pursuing, an outpatient program afterwards, I think it's really important that we get the fundamentals of care in place and that goes.

That goes from many levels, right? We, have some folks who come in who have great jobs, own their house, in terms of the basic case management essentials. They're set, don't have a sober community and they don't have, recovery meetings they can go to and maybe they don't have the therapist that they particularly trust or get along with.

And then we also, of course, have clients who are unhoused, are unemployed, need a lot of the, basics at that, foundational level of Maslow's hierarchy of needs, right? In order to, in terms of the, shelter and the medical care. And so that's where we start always, making sure that people are going to be set up as best as possible for when they reenter.

But that also includes things like, what sober activity groups are there in your area. Like, let's find the sober hiking group near you. Mm-hmm. Other ways that you can continue having joy in your life. And a really important factor for me too is the therapy and psychiatry. we have an amazing psychiatrist who works with us.

a lot of times people, will see him and say, oh my gosh, this is like one of the first times I've ever been fully understood, by a psychiatrist. Matthew Jenkins is his name. He's a, psychiatric np and he's incredible. it's very important that we can transfer that care. To someone else that they trust.

I've had actually had a client recently come in and I asked him, okay, he has a therapist. Great, how is that relationship? And he said, when I told her that I might relapse, she said that if I did, she would not be able to keep seeing me. And so after I relapsed, I just had to lie to her and.

I was like, okay. being able to be honest with our therapist is gonna be like the lowest bar importance, In terms of whether or not this provider is the right fit for you. And without, saying anything negative about her, every different person has different policies in their practice.

It's important that we, the clients have someone who can meet them where they are and has. Specialty in addiction in addition to any other mental health issues that they are experiencing. And so we have, I have a, protocol that I go through where, I have this database, we look up different therapists near them with all of the different filters of the types of therapy they practice, the types of issues they specialize in.

they take, we go through different bios, we read them and they select, three to five people who look of interest. and then help them write some questions for that three 15 minute consult. So the idea being that 15 minutes with someone, you're not gonna know if they're the perfect fit for you, but you will know if they're not a good fit. Mm. Get a good vibe in 15 minutes from someone, especially if you ask the right questions. One of those questions being. I don't plan on relapsing. If I did, what would you say? And making sure then that by the time they leave, they have an appointment with someone whom they have spoken with on the phone, Who they already have had contact with. So I. Whether it is, therapy appointments and IOP outpatient program or just, making sure that they have recovery meetings. And this extends to mental health as well, right? There are a lot of people, most people have heard of AA before. A lot of people don't necessarily realize that there are mental health support groups.

In addition for folks who don't have substance use issues or who want to have specific mental health support as well, and that have been. That have proved to be important for clients, so that they can continue to have that, peer support and continue to feel seen and validated by other people who get it, can just say, you know what, I don't necessarily have the answer for you right now, but I understand what you are going through, because that alone is really powerful.

Yeah, most definitely. Most definitely. something you said as well that really was quite, touching was you start the aftercare process on day one.

Yes.

you talk about aftercare on day one.

Yes.

that must be so reassuring to new people who are entering your facility. That must sound like wonderful.

I think it is. I think sometimes it can also be a little overwhelming because, " hmm. Okay, I just got here. What are you talking about?" But basically, I meet with every client within the first 24 hours of their arrival for, an assessment just to get a sense of, where they're at, why they're here.

And in that assessment, make sure to see, is there anything that is pressing that, they need to pay attention to, right? So that could be like housing, employment, a legal case. They need to get some things to a lawyer, et cetera. Just to get a sense of is there anything that we need to get on, now and is gonna, what is gonna be our focus going forward in terms of, that comprehensive aftercare?

It doesn't mean other things won't come up, but it's good to know too if we can get a jump on things and also. like some folks come in and they're, they have some severe dental issues, for example. Great, let's get that appointment on the calendar right away, because a lot of these things can be also distractions from us being able to focus on our recovery.

And so to whatever degree we can say, listen, gonna devote an hour a week to taking care of the legal stuff, or we're gonna devote an hour a week to taking care of whatever it is that your brain keeps wanting to, go and, and think about when it's time for you to be thinking about your own recovery getting better.

we have time for that. Don't worry about it. We'll address it. Because I think, life is life and it distracts us from, what we're doing. And it's really important, especially when we're healing, to just be able to be present with that.

Yeah, absolutely. you, touched on something earlier as well. you mentioned insurance and, one thing that I remember from our first meeting, Kate, was you said that you had a member of staff who deals with the, healthcare insurance, which must be a weight off all of your clients' shoulders.

'cause it's, as a British guy as well, he's getting to know their health insurance system. Over here. It's a little bit, it's a little bit different, but very complicated. But can you tell us about the member of staff that helps your clients with, the process of, insurance and claims and.

Absolutely. And it's not uncommon for rehabilitation facilities to have a utilization review person, but not everyone is able to, and we are so lucky to. And basically, is the woman who works with us. She's, she's just amazing and she Basically her role is to, she spends a significant amount of time talking with the insurance companies, case managers, and then talking with us to really advocate for the client getting the treatment that they need and deserve.

so there are plenty of times when an insurance Company might say up, the time is coming up, like we've covered enough. time to know, transition them out. we might be saying, actually, we're in the process of a referral to an IOP right now, but we need more time for aftercare planning.

Or actually, this person has just revealed this very significant. trauma event that happened with them that they haven't felt comfortable talking about before now, and we need some time to process this, et cetera. every case is individual. Mm-hmm. We can then our team is able to talk with her and she's able to take that information back to the insurance company and push back and say, actually need more time with.

This client for these reasons. and then, will let us know what type of documentation, what type of documentation is needed on our end for the insurance company saying, okay, they're asking for more information about this aftercare planning. Then I'll write up an additional summary or something.

Or they're asking for an additional, utilization review interview, which is the clinical assessment right

of where this client is at. She is a huge help to us in terms of knowing exactly what it is that insurance companies need to better understand a case to be able to provide that coverage, but then also to just really advocate on the client's behalf for them, so that they can get the coverage that they deserve.

it's unfortunately. A lot of insurance companies authorize about seven days at a time. So they may authorize a full 30 days, but they'll only authorize a week at a time. And that can be very stressful for clients. And we just try to assure them, listen, we don't have a crystal ball. don't know what's coming.

But, we believe, may be another authorization coming in any case, don't worry about it right now because A, gonna kick you out the second we find out, and B, we have someone on your side who is working on your behalf. Like they've got it. So your job is not to worry about that, it's to focus your treatment and your recovery.

Yeah. a big shout out to Jen then.

Yes, absolutely. Our hero!

it, oh, completely. that was, that's 'cause that's such a, it's an important part of, therapy just knowing that you're actually the ability to stay there. And if you are getting to a point where things are improving or you are making breakthroughs to have an insurance company suddenly rip it away from you, that must be devastating.

Yeah,

but it's good to know that you have a wonderful member of staff like Jen to take care of that for your clients. It really is. I always ask my guesses, Kate, 'cause stigma of addiction to me is something that comes up in all of my podcasts. I always, like to ask my guests what their views are and why stigma of addiction and mental health. It's still happening in this day and age. and why, why do you, think this is? Because things don't seem to be progressing too much with stigma, with dealing with stigma and for people entering treatment.

It's a really good question, about why the stigma is, I think, I think there's so much profound misunderstanding about addiction, right? I. The idea that it is, it is unequivocally all, medical, scientific consensus. It is a disease, right? American Medical Association, CDC, you ask any medical body, any, scientific and medical consensus, it is a disease and I think that.

the outside. For people who haven't experienced the disease or don't know about addiction, might look like something where someone's behaviors are causing this, not the things that are going on in their brain, and so they might think. it's, a choice or it's some, sort of weakness, right?

but know that it is, substance use, it changes the chemical structure of your brain, right? It alters your brain structures and functions. while we do have an amazing ability to, heal our brains over the long term, that's the long term, with substance use. we have physically altered, our brains get physically altered, right?

Pleasure circuits get overwhelmed way that can be chronic, even permanent. and because the brain is producing less dopamine, right? And we're needing then more of it, in order to receive that pleasure, producing less dopamine or reducing the structures that perceive dopamine, Basically, the is it is a chemical and physical experience and I think that there is just a huge amount of, education that is needed.

I grew up in the, dare era, in the United States that the era of just say No. and That messaging, this idea that. You, your, if your brain has been altered by substances to, need them in order to be able to have any sort of interest or pleasure in life, that you can just say no.

And that's also a safe thing to do, depending on the substance that you use. it really? I think, at least in my generation, it really. Was just so detrimental to the understanding of what addiction actually is made it seem like it was this condition, not a medical condition.

And with mental health as well. think that, the fact that same word depression is used for I feel depressed as in like I might be in a little bit of a slump 'cause I had a bad day. The fact that word in the English language is the same one as the word that describes the feeling a person is feeling right before they commit suicide.

That is a huge, gap people might think that they've felt when they've just felt. sad, I'm not trying to diminish in any way, sadness is not, the opposite of depression, as Andrew Solomon likes to say, is not, "the opposite of depression is not happiness, it's vitality."

And, which i, love and I think that there is this fundamental misunderstanding where if you haven't had cancer. know you haven't had cancer. If you have been able to drink alcohol and put it down you felt sad and then been happy again, you might think that you know what it is like to be, have a relationship with substances in a relationship with depression, when in fact you don't.

Right When in fact, in you've never experienced either of those diseases. And I think that can then lead to this profound misunderstanding. And so I think a lot of education really is needed around addiction. And I think that's part of the stigma. And I think also because of this stigma is this thing that self perpetuates, right?

We don't understand how many people. Addiction and mental health struggles touch when it's, it's, it touches everyone. every time I tell someone what I do, whether that is like in an Uber on the way to the airport or in the store at the grocery line, I'm not sure I have ever had someone not say, oh, my cousin, my mom, Yeah.

Yeah,

yeah, friend, We're afraid to talk about it because of professional consequences, personal consequences, et cetera. That it is this other thing out there and not something that all of us are touched by, gets perpetuated as well.

Yeah, that was one heck of an answer. Kate, thank you so much. That was amazing. That really was. you've absolutely. So succinct, then it really was. it's, nice we're able to have these conversations though I think now around it, it seems things seem to be moving somewhat, but not nearly quick enough, I think.

And I, hope that this changes. I really do. Um, one of the last questions I always ask my guest, Kate, is I get very interested in varied answers to this, but can you tell me what your opinion of harm reduction is and how it can play such a role in recovery?

Yes. So reduction. So there's sort of two pieces to this.

harm reduction is incredibly critical when it comes to preventing overdose mortality and additional, diseases from addiction. When we Do not offer people struggling with addiction, the resources to do things safely, all of a sudden comorbidities just are Go on the rise exponentially. The number of clients I've seen who, come in with Hep C or come in with, who've had a lot of issues with sepsis because of dirty needles that they've injected in muscularly, It's, it is a critical life saving. Evidence proven piece, right? That harm reduction, we are trying keep people alive and keep people from having diseases than they're already struggling with, right?

They're already struggling with, addiction disease. So let's not add more on top of that. harm reduction is, really critical in recovery. The one thing I will say about harm reduction is that I think sometimes. People who are in addiction hear that word and hear, oh, harm reduction is good. will do harm reduction by using a less dangerous substance like alcohol.

when unfortunately alcohol is one of the most dangerous substances to detox from, right? so that harm reduction is. really important in addiction treatment. I want to be very clear that I'm talking about, programs in which we are making it safer for people to, if they're unable to be abstinent, right?

they're in the thick of their disease. If abstinence and treatment is not working for them, is critical that we're able to make it safer. what I don't mean by harm reduction is, okay. I, was, a co a heroin addict and I have, I am in abstinence, I'm in recovery from heroin and addiction I'm just gonna use alcohol to cope instead. I recently had a client who that very case and, have seen it in many, cases where, you know, again, those, that circuitry that has been rewired in our brain may still be there and it may, swapping out one substance for another.

It can be a very, dangerous thing for us to do, and especially because there's such misunderstanding about alcohol and the dangers of alcohol and the dangers of detoxing from yeah. Of the two most dangerous substances to detox from, right? And we lose a lot of people that way. I just wanna be very clear when I say that harm addiction critical, critically important part of addiction recovery, not referring to someone switching out, one harmful Of course, for another.

of course. thank you for that, Kate. last question. Do you have a message for anyone who's listened to this podcast who's going through an addiction?

Yes, and is that you are not alone and that there is hope and that there is help, and that it doesn't matter how hopeless and how helpless it seems. many amazing and wonderful people have been in that exact same situation, not the exact same as you, because no one's the same, but in the situation of feeling like there is no possible way forward and maybe that they've al that, they've already tried everything that they can do, but there is hope and help out there and it is always worth reaching for it.

That's lovely. Thank you for that,

Kate. very last question. Can you tell our listeners how to contact you and. To find your service online.

Absolutely.

Absolutely. maui recovery.com is, the website. is, our phone number right there. I can also give you that phone number too. The phone number is (877) 522-4401. will be able to answer the phone whenever you call. And, we take insurance. we take insurance.

We, would love to, we are a great resource. If for some reason we're not the right fit for you, we will help refer you to somewhere else that is so please. Please reach out.

Amazing. Kate, thank you so much for your time today explaining to us about the amazing service that you are providing in Hawaii. It just sounds an incredible facility to be at and to work at and it just sounds amazing. So thank you so much for your time. I really appreciate it.

Yeah. Thank you very much.