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A Wise Mind Presented by Sabino Recovery S1 Ep2

In this episode of A Wise Mind Presented by Sabino Recovery, host Sam Zimmer and Chief Medical Officer, Dr. Aaron Wilson talk about what Sabino Recovery did to keep all residents safe and healthy during this tough period. They also shed light on the challenges that the pandemic presented for people at all stages of their recovery journey and what Sabino did to combat and address many of the negative trends affecting the world of recovery.

Episode Transcript:

Sam Zimmer: All right. Welcome back to a wise mind presented by Sabino Recovery. My name is Sam Zimmer, and today I’m joined by our Chief Medical Officer, Dr. Aaron Wilson. How are you, Dr. Wilson?

Dr. Aaron Wilson: I’m good. Thanks for having me.

Sam Zimmer: Of course, of course, today we have a couple of topics. Um, one of ’em actually, we were just talking about is COVID. Obviously the last two years have kind of gone by, in a blur. We were talking about how those first few months though sounded like or seemed like they were going by pretty slow, but it definitely had an effect on the world of recovery and specifically on Sabino Recovery in our day-to-day lives, dealing with residents and stuff like that. How did COVID kind of effect our treatment center and the residents here?

Dr. Aaron Wilson: Yeah. You know, I think on kind of a global stage, if you will, I mean, it has had huge impacts just on recovery in general, right. I think people right out of the gate lost the foundation that recovery’s built on, which is a connection with other people, going to groups, and belonging to the community.

And I think there was this huge gap that immediately became evident. Then very quickly, a lot of treatment centers, ourselves included, looked at ways that we could reconnect people. Right? A lot of people went towards virtual services. A lot of outpatient clinics started doing virtual IOPS and PHPs, and those types of things. Pretty quickly, people that were not tech-savvy immediately had to become tech-savvy and figure out how that all worked.

And so I think that was the first big movement I think, here at, you know, Sabino Recovery. We immediately had to, you know, pivot the way we did things. Of course, infection control became the absolute top priority and everything revolved around that, just to make sure that people felt safe coming here, that our residents were safe while they were here. That they still had a good experience. And we can talk a little bit about how we maintained that. We still had a, a lot of people coming in for treatment, honestly, even more at times, just because they had lost that, that sense of community where they came from.

Sam Zimmer: Yeah, definitely. And actually at the time of COVID. When I first started at Sabino Recovery around two years ago, I was in admissions. So we were all kind of holding our breath. Are people still gonna come here or, you know, are they scared to travel? But it actually, like you said, at times was even more so because of all of the effects of COVID.

Dr. Aaron Wilson: Right. I mean, people’s mental health started to deteriorate very quickly when they couldn’t leave their house. And, you know, a lot of times in those kinds of situations, when you’re isolating, you turn to some of those maladaptive coping mechanisms that we treat here. So, um, it was kind of a double-edged sword, which was interesting.

Sam Zimmer: What were some of the protocols that we had to put in place, like COVID-specific, and maybe some that we’re still doing right now, cuz obviously we’re not quite out of the woods yet with the COVID situation? Right?

Dr. Aaron Wilson: So immediately outta the gate, we, you know, turned to the CDC. We turned to the state for, any kinda recommendations on the guidelines that we followed.

Um, there are a lot of people who can attest to this. It was a little bit of a moving target. Those, those guidelines shifted pretty quickly. So we literally had our team constantly watching those guidelines just to make sure that we had the up-to-the-minute version of the way that we were doing that.

And so we implemented those infection control protocols, you know, social distancing, masking, and really maintaining all of that while people were here. We also had to very quickly implement, when it was available, testing protocols before people come into treatment just to prevent anybody from bringing it in.
We also had to do the same thing for our staff to make sure people aren’t, you know, coming down with COVID locally and bringing it in and infecting our residents here. So we really quickly had to adapt and follow those guidelines. And just make sure that we were following them to a T here. Um, some of the unique challenges with that, you know, I think were just social distancing, wearing masks, and feeling like you’re still connected in your process group and still able to fully engage in treatment.

Our, clinical director, Shara, did a fantastic job of just making sure people still felt like they were being heard. They were able to communicate effectively. Um, we also moved because we’re in Tucson, Arizona, and we have beautiful weather. Move some of our activities outdoors, anything we could do to still allow people to connect, but keep them safe.

Sam Zimmer: Finding that balance was key because, you know, you can imagine being in a talk therapy appointment with your therapist and having both parties wearing a mask, there’s a lot that can be lost in terms of, you know, non-verbal communication. And how effective that can be. I think we did a pretty good job of, you know, making sure that everyone’s safe, but also, like you said, making sure they feel comfortable and fostering those relationships that they build while they’re here and all that stuff.

One thing that you kind of touched on was the technical stuff that came out of COVID. There was a lot more Zoom for like outpatient services and continuing care. But since I have you here, I did want to kind of get your opinion on that. Do you think that in the world of recovery, whether it’s substance abuse or mental health-related that the programs that offer Zoom, do you view that as a positive or more of a negative? And I know it can kind of be both, but…

Dr. Aaron Wilson: Yeah, I think it’d be, it can be a little bit of both, you know, it’s interesting before COVID telehealth and telemedicine. I mean, it was, it was definitely talked about a lot of people were implementing it primarily for difficult-to-reach areas or people that lacked access to care. Like if you live in the middle of nowhere and you couldn’t get to a psychiatrist if you had to cut that down, making it more convenient and still being able to do it, and then COVID entered the room. And all of a sudden telehealth was like the main platform that people did, any sort of healthcare appointments, even physical medicine switched a little bit to that.
So I think it’s, we’ve watched this evolution of when it first came out. I would be on these Zoom calls with colleagues and they’d say, well, we’re doing it. We don’t really love it, but it’s just what we have to do right now. We can’t wait to go back to in person, you know, the pandemic went on, you know, further and further and longer and longer then eventually people just became very used to that.

For a lot of patients, to be honest, they almost prefer that we’ve been sitting here watching to see like, hey, is everybody just gonna come piling back into the the outpatient clinic? And for a lot of people, just like working from home, have realized, hey, this is actually a little bit better than I thought it was gonna be.
I can access my therapist. I can access my, my psychiatrist in the privacy of my own home. I think once we all got past, you know, kind of the awkwardness of Zoom and the awkwardness of just being on a monitor. People have gotten used to that and are a lot more comfortable with it now.

Sam Zimmer: Yeah. And too, you know, another positive of, of those, the Zoom Boom, as I like to call it, during the whole COVID era is, um, you know, recovery models, like 12 Steps. You know, I know people who have moved here from California, where I’m from and they have their old home group that they never were able to go to. But now, almost every Zoom meeting or every, excuse me, AA meeting, you can attend on Zoom. So, I think it does have a lot of positives.

Dr. Aaron Wilson: Oh yeah. Stay connected to people where you’re from, people you’re comfortable with, there’s there’s no substitute for that. Yeah. So it’s valuable for being able to maintain that, even if it’s just in the interim while you find a new community or, you know, recovery community get connected with.

Sam Zimmer: Absolutely. So in terms of like, you know, the behavioral health treatment, substance abuse, the industry at large. Have you seen any trends as a result of the pandemic? I know we touched on probably an uptick in some of those issues, but is that something that has been measured to your knowledge? Is that something that, that you can attest to? Has it gotten a lot worse?

Dr. Aaron Wilson: You know, there’s a lot of ongoing research. Studies on the data usually lag a little bit behind because they’re gathering it, processing it, and those types of things.

So I don’t have up-to-the-minute statistics. I mean, just anecdotally we’ve seen, you know, huge uptakes of course, and relapse is based on, you know, like we said, isolation and not being connected. I think that we are figuring out how to navigate that a little bit better. So we’re hoping that the data will, of course, come down, you know, just in the kind in the pure mental health space, as far as like depression, anxiety, trauma, isolation, I would just say as a general rule, isolation’s not good for anybody who struggles with any mental health issues.
And so I think we’ve seen upticks in, you know, depression making that, you know, exacerbating your depression. Anxiety’s gone up. I will tell you that, you know, Fear of coming down with COVID has not made anybody’s generalized anxiety or panic any better. Um, so it has really provided a lot of fuel to fire a lot of those things.
So we’ve seen huge upticks in that. Um, but again, I think it kind of piggybacks to the, you know, the treatment options for a lot of people with the talk therapies and all these different platforms that are coming out, we’re seeing a lot more people access those just because it’s accessible to them and in a platform that they’re used to.

Sam Zimmer: Yeah. There’s a lot of great stuff out there. There’s an organization that, um, It’s a nationwide company that will, they will put groups together of folks all over the country based on their specific issues. So, you know, it’s specific to that person, those issues that they’re dealing with and, you know, the United States there’s no, I mean, they even do like you know, HIV positive groups, right. You know, substance abuse groups, all kinds of mental health disorders. So it has become a lot more accessible and a lot more people can find really quality outpatient treatment.

Dr. Aaron Wilson: Yeah. I think, I think pairing people up with relevant, you know, other folks who have relevant struggles yeah.You know, that, that can resonate with them. It really just, you get a lot more traction when you feel like somebody else’s story hits home for you and how they’ve dealt with that might even, you know, be, be an option for you too.

Sam Zimmer: Yeah. So not all bad things. We have found some new ways of doing things. And as far as here on campus, have there been any things that have resulted in like protocols and procedures that have been born out of necessity during COVID that we’ve kind of been like, hey, that’s a pretty good idea. I think we’re gonna, you know, stick with that and, and kind of make that part of our everyday Sabino life, even post COVID.

Dr. Aaron Wilson: Yeah. I would think that we, specifically as a leadership team, it has enhanced our ability to collaborate when we’re not all on campus. Right. So Zoom meetings and those types of things. It kind of expanded our network of people that we’re collaborating with to manage patients.

We were probably better able to hop on Zoom calls and discuss cases with your outpatient therapist or your outpatient psychiatrist. So I think it has definitely done that. I think it has catapulted that to a level that we’re, we’re very happy to stay at. Um, we, of course, as the CDC and everybody gives us guidance, have lessened some of the restrictions just to get back to the, you know, there’s just no substitute for being in a process group without a mask on and being close to other people, mirror neurons and all the things that we know so much about. I think that there’s no substitute for that, you know, but it is really fine-tuned infection, control processes, you know, hand sanitizers, you know, cleaning surfaces constantly.

We will continue those. It’s what we did before, but I would say it’s just even more amplified now. And I think what we will find is it’s just best practices. Just to continue a lot of that stuff, because like you said, I think at the beginning it’s, we’re, we’re not completely out of the woods.

I think we will continue to monitor that. But if we keep these practices in place, if there was a new variant or something came down the pike, we would just wanna make sure that we were prepared and it wasn’t this huge shock to our system. Like it was for everybody at the beginning.

Sam Zimmer: Yeah. And then for like an incoming resident say, you know, I have a brother who’s coming to Sabino or needs treatment somewhere else, but specifically for our treatment center, what are some things that that person would have to do in terms of like getting tested? Like what does that kind of look like right now?

Dr. Aaron Wilson: Yeah. So our intake does a, our intake team does a great job of, of pre-screening asking, you know, questions, you know, pertinent to, do you have any symptoms? Have you been exposed to those types of things? That’s all that happens before you come here. We also have people get tested before they come to Sabino.

Um, while people are here, generally, I can tell you, because we’re, we’re sitting here having this conversation, it doesn’t feel like it did during the depths of the COVID pandemic. It feels a lot more in quotes, normal. Um, I would say that if anybody does have any symptoms, of course, we monitor that closely.
We have a fantastic nursing team. We can do testing here. Um, we can quarantine here if we, if we had to, that’s not really an issue these days, but of course we, we watch it very, very closely. I meet with our director of nursing pretty much every other day, just to keep our finger on the pulse of that. Um, and then again, we do pay really close attention to rates in the community. We have some off-campus outings that we do just to get people involved in the community. A lot of really fun stuff that they get to go do for team building. Um, we keep a close eye on those rates in the community just to make sure we don’t expose people unnecessarily.

Sam Zimmer: Yeah, we’re really lucky, especially in our specific location, not just in Tucson, but the part of Tucson we’re in, the north end of our property, as you know, backs up to the Sabino recreation area, which is some of the best hiking in Arizona. We try to get those, our residents out there as much as we can.

Dr. Aaron Wilson: It’s like working at a national park. We’re spoiled.

Sam Zimmer: Driving up the hill every day, looking at the mountains. Definitely spoiled.

Dr. Aaron Wilson: You just have to remind yourself you work here.

Sam Zimmer: I know, right. I take it for granted too. Absolutely. But, um, but yeah, no, I think this is a, a very pertinent topic and something that, you know, can be scary.

But, um, after talking to you, I, I have to say that I’m a little bit more optimistic. I think, you know, when, when you hear the word COVID, you, you get scared and you think of bad things, but it’s nice to know how much positive has actually kind of come out of this situation. And, you know, in terms of how we’re gonna move forward, too, implementing all those cool new changes that we’ve made.

Dr. Aaron Wilson: Absolutely.

Sam Zimmer: So I know we’ve obviously addressed substance abuse and the fact that COVID has had on that kind of population, um, obviously we’re a trauma center here, so we see more than just substance use. I wanted to get your take on, you know, what kinds of traumas has COVID caused for some of the people that have come to our treatment center and what are some of the things that we’ve sort of kind of pivoted to we’d be able to offer them in programming and, you know, treat them effectively.

Dr. Aaron Wilson: Yeah, no that’s a great question. I think, you know, you mentioned trauma. I think a lot of people throughout COVID have had just, you know, really, really difficult experiences, whether they had COVID themselves, you know, got very sick, ended up in an ICU.

How do they process that? Where the flip side is, you know, a lot of people lost, loved ones that were very close to them, you know, friends, family, and because of the unique nature of this infectious pandemic, weren’t even able to grieve in real-time, weren’t able to be at the hospital and do all the things that humans are just accustomed to doing, to, to process through those feelings.

And so there’s a lot of these really complicated grief responses that we’re seeing. Um, you know, we’ve also, we’ve also worked quite a bit with, with first responders, right? So doctors and, and nurses and the people that were on the front lines, respiratory therapists, people that were really there helping those, those people while they had COVID and they experienced just, you know, some of the worst things you can imagine in healthcare.
And so helping all of those different people and their unique experiences with COVID has been a huge focus for us. We saw it kind of developing and evolving while people were coming at the beginning. And now we’re just seeing some of the aftermath and, you know, to your question about how we, how we pivot and how we treat those folks, it’s really, we’ve implemented an increase in grief processing, a lot of trauma processing.
We try to put anybody who’s had some of those unique experiences together with other people that can share those experiences. And so it is a huge focus for us now, I think it will be a big focus in the years to come as well. Um, you know, the other thing that we’re seeing is just because people’s lives became so much smaller than they were before.

A lot of this is helping people get back out into the world and get reintroduced into society and start to work, you know, outside of their homes, you start to see this uptick in anxiety and all these things that there’s a lot of moving parts on it.

Sam Zimmer: Yeah, no, I’m glad you mentioned that too, because you know, obviously we touched on it, the last podcast with Shara, but I, myself am in recovery and I can’t even imagine if I was going through like the early stages of trying to get sober during the pandemic, I would not know what to do. It must have been so confusing and just, you know, that feeling of helplessness that somebody already has when they’re in that position. And then, during COVID times it’s like, well, what resources can I tap into to get some relief from this stuff? So I was hoping that maybe you could speak to that too. Like for somebody who is newly figuring out that they need help with some of this stuff, whether it’s trauma, mental health, substance use, and they’re, you know, navigating the COVID world, what are some things they can do? What are some places they can reach out to, to kind of get some relief?

Dr. Aaron Wilson: No, it’s a, it’s a great point. Talking to your, to your doctor at home and in your hometown, talking to your therapist, if you have one. Get connected to, to those people to help you navigate the system, I think. You know, for all the great things the system offers, it’s not inherently intuitive to navigate when you’re first in it. Right. And so I think getting connected with somebody who’s either in recovery, who can maybe provide some resources, getting connected with your primary care physician or your therapist, can maybe point you in the right direction. I think it’s also pretty invaluable to be able to reach out to an intake department at a place like Sabino Recovery, just to say whether or not, you go to Sabino for treatment, just say, hey, here’s where I’m at. This is the help I need. Or I don’t know what help I need. Can you point me in the right direction and give me some resources, whether it’s in your community, wherever you come from, or potentially coming in here.

And the nice thing is, if you do end up in a place like a Sabino Recovery, it’s really nice to have professionals and continuing care teams who, while you’re doing the deep, meaningful work and you’re processing through everything, you have a team of professionals that are helping you navigate the path when you get out.

Yeah, because doing the work here is a huge part of it. But here we are such huge advocates of this is a part of it, but what are we gonna do to help you sustain? Right. How do you sustain that change? What has worked for you here? Let’s set you up with those professionals in your community. We want it to be a warm handoff. We kind of look at it as kind of passing the torch to that next professional. So they can give you a soft landing when you get back home.

Sam Zimmer: Right. And that’s what I love about our team so much. It does, it starts at intake, right. And you know, every one of the folks on our intake team has some kind of relationship either through family members or personal experience to trauma or substance abuse or both. So they get it. And when somebody calls, it’s not, it’s not ‘okay, when are you coming to Sabino?’ It’s, ‘what is going on with you?’ And how best can I help you? And if it’s not a good fit here, let’s find the right place for you. And then you’d mention continuing care too. If someone does end up coming to Sabino. They have somebody in their corner who is a professional and has all of those contacts. So that it’s not just on them. Like you said, the system isn’t, it’s not intuitive to just navigate it as, you know, a novice. Right. For somebody who’s just starting off, there’s a team of individuals who are gonna help that person find whatever step-down level of care is appropriate for them. And they don’t have to stress out about it.

Dr. Aaron Wilson: Right. Well, and I think, no it’s, and I think it’s so important that when you, the continuing care team it’s not just, Hey, we looked on Google. We found this beautiful website in your community because as we all know, you can have a website but it’s, it’s places that our team and other teams that we’re affiliated with have vetted. We want to send you to a team that is like-minded. We want to send you to a team who is not just in it for the bottom line, that they, they really care about you.

And you know yourself and a lot of our, our outreach team, we’re always out in the communities building those relationships and just vetting those programs to make sure that they’re on the same page.

Sam Zimmer: Yep. Yeah. There’s no substitute for stepping foot on campus at a program to really see what it’s about and meeting people and just making sure that somewhere where I would send a family member to.

Dr. Aaron Wilson: Right. That’s the ultimate endorsement.

Sam Zimmer: Yeah, exactly. And that’s really what it comes down to. We’re not gonna refer any of the folks that come through Sabino. I mean, it, it basically is a family. We’re a very small facility. You know, everyone who comes through our doors we’re gonna have a relationship with, so we wanna make sure we’re sending them to somebody, you know, where we’d send our, our son, our daughter. Our mother, our father. So I’m very proud that we have such a solid team. Including yourself. Thank you so much.

Dr. Aaron Wilson: No, it’s been a pleasure. Thanks for your time.

Sam Zimmer: Yeah. And to our listeners. Thank you for listening to A Wise Mind podcast, presented by Sabino Recovery. To listen to more episodes, just search A Wise Mind, presented by Sabino Recovery, in your chosen podcast platform. We discuss topics that can be difficult to process on A Wise Mind. There is no shame in seeking help. For resources or to find someone to talk to, please visit the links in the description below.