A wise Mind Presented by Sabino Recovery S1 EP 11


In this episode of A Wise Mind presented by Sabino Recovery, host Sam Zimmer is back with two of the Sabino Recovery Continuing Care Team, Shea Smith, Continuing Care Coordinator and Andrea Hovden-Hall, Continuing Care Manager. They discuss the importance of Continuing Care as part of Sabino’s treatment model and highlight some of the work we do at Sabino Recovery to make your transition back out of treatment and into your life in recovery as smooth as possible. Visit our staff page to view Andrea’s and Shea’s full bios.

Sam: [00:00:00] Welcome back to a Wise Mind podcast presented by Sabino Recovery. I’m your host, Sam, and today we have the privilege of being joined by our Continuing Care Dream team. Andee and Shaa. Hey guys.

Andee: Hey Sam.

Shea: Hey Sam.

Sam: How’s it going? So I’m especially excited for this episode cuz I work very closely with Andee and Shea as, as part of our outreach team. Today we’re gonna be talking about what you guys do in the continuing care. And why it’s so important. I think a good place for us to start would be for both of y’all to just tell us a little bit about yourself and, and how you began working in this field. Andee, do you wanna start?

Andee: Sure. I’d be happy to. Um, well, what brought me to to mental health was actually my son’s, um, addiction to heroin. Uh, what started out as a class at the community college just kinda snowballed into a career. It all started out wanting to know why he used, which I learned a lot of [00:01:00] times there isn’t a why there’s just an is. And he also had friends that struggled with substance use disorders and between the different treatments he went to and his friends, I saw that a lot of people didn’t have support, you know, um, families couldn’t manage it after an extended period of time and, and I understand that. And so I really wanted to step into a role where I could be a support for other people who didn’t have that support.

Sam: Hmm. Yeah. That’s awesome. some, some hands-on experience, if you will. Um, couldn’t be any near or dear to your heart, it sounds like.

Andee: Exactly. Yeah. That’s, that’s one reason why I’m so passionate about it.

Sam: That’s awesome. What about you, Shea?

Shea: Well, I am Shea. I’ve been with Sabino for a little over a year in the behavioral health field for about five years. Um, what got me into this field is my best friend passed away, uh, seven years ago. She was hiking in the Catalina Mountain. And I was only 19. I was just a baby and I really didn’t [00:02:00] know anything about trauma, grief, any of that. And I had never spent any time in like the trauma and addiction treatment space. So I was really, really interested in working with people that have been through trauma, whether it be acute, complex, whatever. And here I am. I really, really enjoy working in a space like this.

Sam: That’s so awesome. And when I was going through treatment, it was hard for me to take advice or listen to people who hadn’t like been through what I’ve been through because, you know, you can, you can read books, you can, you know, learn online about what the best practices are and how to deal with certain situations, but there’s no substitute for like, experiencing it yourself.

Shea: Exactly.

Sam: You know, we’re very lucky to have you guys here. You know, obviously there’s a lot of personal experience and a lot of passion.

When people talk about continuing care, like you guys are, we call y’all continuing care managers. Other treatment centers might call them case managers, just so that our listeners can kind of know what we’re talking about. But what, what would you guys say? [00:03:00] Like how would you describe what continuing care is? I know it’s a pretty general question, but Yeah.

Andee: It’s um, pretty broad. Yeah. But continuing care is essentially case management, but the idea is to work with residents here at Sabino to help develop a plan that’s gonna springboard them from here to getting back home.

They’re laying the foundation while they’re here. You know, I kind of look at it like the three little pigs, you know, out there when things are going rough. And it was a hard time. It was like being a straw house. The wind blew and it flows, you know, it’s gone. You know, here at Sabino, you know, we help them build, they start building a woodhouse to where there’s firmness. But it still weighs in the wind. And the idea with the continuing care plan is to help them so when they get home, they can build that brick house. And so if things get tough and the wind comes, maybe they lose a few shingles. But the whole house isn’t gonna come tumbling down.

Sam: I love that metaphor. That’s awesome. So obviously it’s very important. [00:04:00] Why is it so important?

Shea: That’s a great question. Continuing care to us, it’s so important because we try and make Sabino a really safe, secure bubble. And that’s so that our residents can do the hard deep work while they’re here and they’re safe, and we wanna make sure that they can go home and they can keep that safety and that security.

And unfortunately, they’re not gonna go home to a safe, secure bubble like they have while they’re here with us. So the importance of the continuing care plan is making sure that they can continue to do the work, the hard work that they’ve been doing while they’ve been here, and just take it home with them.

They take the skills home with them. They know what they need to do to be healthy every day when they wake up, they have a plan, they have a routine. They know what self-care activities will keep them out of bed, away from alcohol, away from whatever vice they might have. Andee, do you have anything you wanna add about why continuing care is so important?

Andee: I mean, the importance of continuing [00:05:00] care really is because when somebody enters recovery, whether it’s for mental health or substance use, it’s really a lifestyle change, you know, and with continuing care, helping them develop, they develop the skills here, but taking them home can be difficult and being able to, you know, continue with that.

So with the, you know, strong continuing care plan, it helps integrate them back into life. But a new lifestyle. Which, which is hard change is hard. You know. So with a good plan, hopefully it makes the change a little easier.

Sam: And I think a lot of people think that, you know, coming to a place like Sabino is, is the magic pill that’s just gonna fix them. I know the admissions department is, is very good about kind of, um, nixing that whole notion on the front end, right? You know, bringing up the conversation of continuing care in the entire process, not just their time in residential. Just so that we can all be on the same page from the get go. Because going back to your analogy, you know they’re only building the foundation here and we do a great job of that, but there’s a certain amount of buy-in and commitment and follow through that [00:06:00] needs to to be there and a willingness to, you know, see that through, you know, when they go home. Cuz it’s not, like you said, Shea gonna be the same bubble that they’re in here.

You guys put up the guardrails to make it bubble-ish but if somebody’s gonna go home without any kind of plan, they’re still in a somewhat fragile state, it’s gonna be hard for them to, to land on their feet most of the time. So as far as like what you guys do specifically here, maybe you can talk a little bit more about our continuing care program. And I know you guys meet with our residents very frequently, so you can talk about, you know, how frequent that is, and then also what takes place in those sessions throughout their stay.

Shea: Yeah, so we meet with residents once a week for about 30 minutes. Sometimes it’ll be more, especially closer to discharge just to make sure everything’s in place and that very first appointment um, I know both Andee and I really want to bring home how important continuing care is. So we will often [00:07:00] talk about the analogy of if you get knee surgery, your physical therapist isn’t just gonna send you on your way. they are gonna do physical therapy and rehab for months and months after. So that’s kind of what we share that continuing care is going to be, not just 35, 45, 60 days.

Um, and then we do some psychoeducation with them. We explain relapse prevention, the stages of change, and we also wanna make sure that they have everything set up so that when they leave, all they have to do is show up. And what I mean by that is we will, um, make appointments for them. We will set up phone calls for them, and we will make sure when they go home, they have a therapist, a psychiatrist, if they are on any psychotropic medications, and then anything else that is given to us as a clinical recommendation from their providers.

Andee: Yeah. Well, we talk about the recommendations. Usually it’s about two weeks after [00:08:00] someone comes to Sabino, before we have recommendations. And I mean, some people are really lucky. They come to Sabino and they already have a team or some people come to us and they don’t. So we’ll, that’s when, you know we work with you, Sam, and your, um, colleagues in regards to identifying resources and providers. We wanna make sure that we use smart goals when we develop a plan.

Is it specific? Is it measurable? Is it attainable? Is it realistic? And is it time sensitive? And we wanna make sure that we hit those points when we develop a plan because that kind of puts them in that bubble it, it’s another foundation. If we can hit all those points and they follow through, they really have a good chance of success. Because evidence tells us the longer person’s in some sort of structured treatment programming, the more beneficial it is and the stronger the outcomes.

Sam: A hundred percent. Yeah. My own experience, I went to three 30 day programs before I ended up going to a transitional, that last stint in rehab I did aftercare. [00:09:00] I did continuing care. I went to a six month transitional, and it was because, like you said, every additional day you’re in a treatment environment, your chances for positive long-term outcome just skyrocket. So, I mean, that’s really what we’re trying to accomplish here. When we talk about continuing care, and I’m, I’m glad you brought up the collaboration between the outreach team because we get people from all over the country and it would be, It’s impossible for the two of you to know every resource across the country and you know, not just every resource, but the good ones. The ones that we would send our family members to. Right. Which our Sabino residents are when they come to our program, or at least that’s how we treat them. So every week we have a Zoom call, our whole outreach team and the continuing care team so that you guys can bounce ideas off of us.

You might say, Hey Sam, I need x, Y, and Z transitional living psychiatrist therapists in Carbondale, Colorado, or you know, in Salt Lake City or Park City, Utah. And you know, myself and the other outreach representatives in other parts of the country, their job is to vet those programs [00:10:00] and those individuals to make sure that we’re sending our family members, our Sabino residents here to the best possible people.

So, you know, there, there’s a lot of time and intention that goes into the process. And one thing that I actually wanted to bring up, cuz we had our call right before this meeting. Andee was talking about one of our residents here who, who really wanted to extend, but we as a program felt that their financial resources would be better served going towards continuing care.

And when I heard that, I was just like, yeah, you know, this is why I work at Sabino, because many other treatment centers would be thrilled for an extension, right? to have somebody here for another two weeks, and I’m just really happy to be at a place where, We look at it less like a business, you know, from a financial standpoint and more of like, what’s the best thing for this person, you know? How, how is, how can we allocate these resources to produce the best, positive, long-term outcome? Because that’s really what our goal is here.

Andee: Yeah. We , we, we want them to come back for like our alumni events, [00:11:00] right? Yes. But we don’t want them to come back. We want to get it right the first time.

Sam: Sure. Yeah. 100%. Yeah. We’ll, I think we’re having Tara on, who is our alumni coordinator next time, so we’ll do a little foreshadowing there at the end. But you guys work really closely with Tara and obviously Continuing Care bleeds into some of our alumni programming too. So as far as like what happens in that first meeting, just so that somebody, you know, maybe one of our listeners doesn’t know, what to expect when they’re coming into their first continuing care meeting. You guys are kind of coming up with a list, from my understanding of things that they might need that are clinical recommendations. Is there. Anything that you put on that list that is maybe not so clinical, maybe more like, you know, interest, hobbies? Is that stuff that you guys will set up for folks as well?

Andee: Yeah, we will, you know, that first meeting is really a, a rapport building because they, it can be very uncomfortable, you know, new environment, new people, new [00:12:00] bed, you know, a lot for someone to get used to. So we really try and make it a rapport building, but we do talk about, Recommendations could be how we get our recommendations, how we work with you and vet the programs.

Because when they come to Sabino I like to think, you know, yes they’re coming to treatment, but really when by the time they leave, they realize they’ve had an experience and they’ve become accustomed to a certain level of care. And we wanna make sure that that care continues when they discharge. So we share what maybe, you know, recommendations could be, but we also have things on the plan beyond the clinical.

We talk about self-care, like you mentioned. You know, what do you do for self-care? You know, we talk about hobbies. people have hobbies and they forget. Community is a big important part of it too. We talk about triggers, managing triggers. It’s a whole plan for the whole person, body, mind, and spirit is what it really comes down to.

Shea: Yeah, I would say usually the first meeting, like Andee said, is spent building that rapport. I also really just like to get to [00:13:00] know the residents that are sitting in my office. I ask them what they like to do now, and more often than not, they’ll say, I don’t know.

They’ll say, I have lost my way. I’ve been completely involved in my children’s life, and now they’re out of the house and I have no idea what I like. Don’t know how to take care of myself. I used to read 25 years ago, I don’t know if I still like reading. So I really like, and some people will disagree with me, but I really like that on the weekends we have a little bit of downtime for the residents and we do that so that residents can process all of the hard work they’re doing over the week, but then they can also kind of figure out if they have any interests outside of therapy. We have an art room. It’s beautiful. We have a beautiful music room with a full piano. We have multiple electric guitars. We have an internet cafe with a library full of a ton of books. So that downtime, I like to encourage residents to spend that figuring out what they like now, now that they have [00:14:00] time that’s devoted all to themselves.

And then the next appointment, I’ll say, so what’d you do? That’s, that was your homework. What did you do that you enjoyed that you could potentially bring home with you?

Sam: Yeah, yeah. For me it was getting back in the gym. which was, was, and we have a, we have a gym here on site and we take our folks off campus, just across the street to CrossFit twice a week.

So if it was me sitting in your chair, you might be looking for like, a personal trainer back home where I where I grew up in San Diego or something like that. Or if somebody wanted to join like a book club or you know, an art group, whatever the case may be, that’s something that you guys would help with too.

Andee: Yeah. And sometimes, you know, because we do have a residents for such a short time, sometimes they don’t know, so we might recommend a life coach. . . Yeah. You know, someone that can support them and help them find their passions, find their bliss that they may either have lost or maybe never had. Because of the trauma they’ve worked with their whole life.

Sam: So what are some things that can happen if somebody [00:15:00] is stubborn and does not want to follow recommendations and maybe goes home with, well, they’re going home with the continuing care plan, but maybe is not going, is not gonna follow through with that. Obviously, you know, there are negative side effects that. Associated with that? What are some of those?

Shea: Yeah, I mean, relapse, but in every sense of the word, not relapse with drugs or alcohol. Relapse can happen with depression. Um, if you don’t have a plan, if you don’t have a community, if you don’t have like consistent things on your schedule, after you leave a place where every day is scheduled for you and you’re going home just to be alone with your thoughts, it’s gonna be really hard.

Um, so we really like to make sure at the very, very least, residents are doing something on their continuing care plan. They’re doing something to get back into the community. They’re doing something for their mental health every week, just because a lot of people don’t realize how hard it is to go home, especially if you live alone, and then even if you don’t, if you have your husband, your children, [00:16:00] you can’t go from just taking care of yourself for 35, 45, 60, however many days you’re and you’re your sole focus and, um, then going home and not taking care of yourself. So

Andee: one thing we always try to drive home is a person has to put their recovery first and that’s not being selfish. Because if we don’t put our recovery first, all those things that we have lost or on the verge of losing, we may lose, you know, if that week that you think. I don’t need to see Jane. I’m doing okay. that’s probably a week. You do need to see Jane. because you’re not putting your recovery first. Yes. And that’s how we stay well, right?

Sam: . , so it’s just as much about like the actual clinical side of treatment, right. Outpatient treatment as it is the structure and routine that continuing care provides too. I know for me, if I fall off my routine and I, my sleep schedule starts to get out of whack, then that’s, that’s. It’s danger time. So yeah. So that’s another benefit of continuing care is just keeping somebody engaged and, and busy. [00:17:00] Right. So that they have less time to, to even think about those, those negative things that can happen if they don’t do that.

Andee: And that’s in the plan too. We talk about what are some signs of relapse, what are some red flags? You know, we all tend to engage in certain behaviors and feel certain emotions yeah, that can let us know that we’re not doing well. Right? So we cover those as well.

Sam: And that’s a good segue. The next question I have here is, you know, what are some of like the tools, strategies, knowledge that you guys will cover and teach to your folks during continuing care that are maybe less like formal bullet points on their plan, but just good general knowledge to, to have and be equipped with going home.

Andee: Well, we talk about triggers, you know, what do triggers look like? because the ugly thing about triggers is sometimes we don’t know what they are until they’re right in front of us. you know, so how, how are we gonna manage those? What are some things that you can do? Some people don’t realize that the sense of smell is one of the strongest triggers, you know, that’s why on at Sabino, we are a fragrance free community because someone may get a whiff of vanilla sugar [00:18:00] and you know, it gives them a trauma response.

So we talk about, you know, triggers, what do those look like? What are some things you can do? We talk about grounding techniques, we talk about breathing. We have an amazing breath work practitioner here, Amy, that I always recommend going to because if you can get your breathing under control, everything else kind of starts to simmer down a little.

you know, so we talk about things that, that they can do for them in the self-care. What do you do for you that makes you feel good? And if that’s spending time with the kids, then that’s self-care. You know. So what, what does it mean for you?

Shea: I actually recently had a resident who requested to meet with me for, um, an hour instead of 30 minutes. And we spent that time going over all of her responsibilities for when she went home, and we very loosely just set up a weekly schedule for her. And so that was a really great tool for her to leave with and know like, okay, Monday I’m gonna go to the park. Wednesday, [00:19:00] I’m gonna go to the farmer’s market. Thursday I’m gonna go to therapy. And even that alone, like it doesn’t seem like that big of a deal, but that routine regulates our nervous system when we know what’s coming the next day, when we know what to expect. And I mean, that’s trauma-informed care is overcommunication and knowing what’s coming next.

Sam: Yeah, I, I, obviously it’s all important, but I can, I think sometimes those little details are, are even more important. Maybe not more important than having and going to see a therapist, psychiatrist, but. Still just very important because it, it, again, it’s, it’s that routine, right? if I don’t know what I’m doing today, then I, who knows what I’m gonna get up to.

Shea: You can do anything you want.

Sam: Exactly. Exactly. And that can be dangerous.

So another thing I wanted to ta kind of talk about was the, you know, like community and like social groups, right? Um, that’s something that’s really important and. You know, if it’s one of our substance abuse primary folks, you know, you can throw a rock anywhere around the country and find a 12 step meeting .

But for some of our folks it’s harder because trauma support groups and, you know, depression, anxiety, [00:20:00] support groups are a little bit fewer and, and further between, which is where the outreach team comes in handy and finding those places. But I also know that you guys help Tara out with our weekly alumni Zoom call. which can be a great way for our residents to continue that feeling of, of community, and you know, holding each other accountable and stuff like that. Is that kind of what takes place on those calls?

Andee: Yeah. Shea, you wanna share a little bit about the calls?

Shea: Yeah. I will say I love this job. That is definitely my favorite part about this job. is seeing alumni. on the call every week. We have some people that have never missed one. We have some people that come once a year, and either way, whether they’re doing well, whether not they’re not doing well. It is wonderful to see that community because being at Sabino is an experience that we are very privileged to be a part of, and I just, I feel really grateful to be able to be on that call and see the support that the alumni give [00:21:00] each other. It is definitely like a support group. I, I’d say probably the best one that we can recommend because it’s people that have been through what they’ve been through,

Andee: they know what it’s like to be at Sabino and they also know what it’s like to have to leave Exactly. And not be able to see Robin G , you know, not be able to go sit in the branding room and just have a cup of coffee with someone.

Sam: Yeah. It’s nice to see some familiar faces.

Shea: Exactly. Yeah. Exactly.

Sam: And that’s just one aspect of our alumni program. And, and like I said, we we’re gonna have Tara on here next to go through, you know, her whole alumni program that she’s built out over the last couple years, which, you know, we’re really excited about and is picking up steam.

But yeah, it’s, thank you guys so much for, for joining us today. Or joining me today rather. And hopefully our listeners know a little bit more about, you know, the full scope of our program and, and what you guys do in continuing care. Because I really do think that that part of our program and of most [00:22:00] programs is kind of, kind of goes understated it.

It really just can’t be overstated how important continuing care is. So I just wanted to take this opportunity to thank you guys for what you do for our residents and thank you for coming on the podcast.

Andee: Yeah, thank you.

Shea: Thank you. Thanks for having us.

Sam: Yeah, absolutely. Thanks. And to our listeners, thank you for listening to a Wise Mind podcast presented by Sabino Recovery.

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