Addiction Treatment

Harmony Foundation Upgrades Mental Health Services

Posted on by Christy Weeks
Mental Health Team

by Michael Rass

Harmony has provided addiction treatment at its Estes Park center in Colorado for half a century. In the beginning, Harmony was a place where alcoholic men could “dry out,” attend AA meetings, and then return home. Over the years, this first treatment approach was expanded to include group therapy sessions, the expertise of a physician, and a treatment protocol based on the Minnesota Model.

Beginning in 2008, Harmony expanded its detoxification facilities and revised its protocol to include Subutex detox methods for opioid addicts. More recently, Harmony added the HOPE Program which offers medication-assisted therapy using buprenorphine to clients with opioid use disorder.

Led by chief clinical officer Annie Peters, Harmony has now upgraded its dual diagnosis capabilities. Dr. Peters developed a roadmap for Harmony to become a dual-diagnosis capable facility serving clients with SUD and co-occurring mental health disorders. Dual diagnosis (also referred to as co-occurring disorders) is a term used for patients who experience a mental illness and a substance use disorder simultaneously. Harmony is now fully dual diagnosis capable.

This modern, evidence-based approach to addiction treatment acknowledges the important role mental health conditions play as drivers of substance use disorders. People may misuse drugs and alcohol because of mental health issues like trauma, depression, and anxiety. “If co-occurring conditions aren’t addressed, clients are more likely to relapse because they may be drawn to substance use to self-medicate those issues,” says Dr. Peters.

People with addiction may also have traumatic experiences as a result of their substance use. “When people are using substances, they may find themselves in dangerous, potentially traumatizing situations that cause further emotional pain, which then leads to more substance use,” says Peters. “This is a difficult cycle for people to pull themselves out of without help.”

Traumatic life experiences are extremely common among patients with substance use disorder. Many suffered adverse childhood experiences. “Studies of drug addicts repeatedly find extraordinarily high percentages of childhood trauma of various sorts, including physical, sexual, and emotional abuse,” writes Canadian physician Gabor Maté in his seminal addiction study In the Realm of Hungry Ghosts.

Because of this strong correlation, trauma-informed care is an important part of addiction treatment. All staff at Harmony have been trained in trauma-informed care. “When people come to treatment, they often have few coping skills to deal with traumatic memories and emotional pain,” says Peters. “Our primary goals are to help them feel safe in the world, manage emotions and situations without substances, and improve their self-esteem and quality of life.”

Trauma-informed dual-diagnosis care begins with a careful assessment. “Every client gets screened for mental health disorders,” says Harmony therapist Gretchen Leezer. “We identify the needs of the patient and establish which ones we can start working on immediately while they are at Harmony and what follow-up treatment they should get once they have been discharged.”

It’s important to address mental health issues as soon as possible, even if the main focus of treatment is the addiction. “When someone comes into addiction treatment with a long history of depression, anxiety, suicidal thoughts, or trauma, we want them to leave here with a roadmap for recovery from all of these difficulties,” says Peters.

Harmony mental health professional Uric Geer likens Harmony’s dual diagnosis approach to a Möbius strip which can be created by taking a paper strip, giving it a half-twist, and then joining the ends of the strip to form a loop. If one side reveals the SUD and the other the mental health disorder, then the twist makes both sides visible whereas a normal paper ring would keep the condition on the inside hidden from view. “If you only treat what’s visible on the outside—the substance use disorder—then an important part of the problem remains hidden and untreated,” says Geer.

The treatment team at Harmony works hard every day to address all relevant needs a client might have. “The culture at Harmony is simply amazing,” says Harmony psychologist Rob Leach. “The leadership has a great vision and the team as a whole is extremely dedicated. They put in great effort to meet clients where they are and develop individual treatment plans. There is great coordination of care. Really listening and meeting clients where they are, creates an atmosphere of trust and that’s crucial for their recovery.”

Beware the Early Signs of Alcoholism

Posted on by Christy Weeks
Early Signs of Alcoholism

by Michael Rass

Addiction can sneak up on you. You may be unaware of it, but you might be genetically predisposed to develop a substance use disorder (SUD) more easily than other people. The alcohol-related SUD listed in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) is termed alcohol use disorder (AUD), featuring eleven diagnostic criteria. The presence of six of those criteria indicates a severe AUD or an alcohol addiction.

Early Warning Signs

Several of the DSM-5 criteria can be regarded as early warning signs. Is alcohol taken in larger amounts or over a longer period than was intended? And has there been a persistent desire or unsuccessful efforts to cut down or control alcohol use?

Many alcoholics remember periods early on when they tried to slow down their drinking, only to find that it didn’t actually happen. According to the DSM-5, the presence of these two criteria already indicates a mild alcohol use disorder. If these early warning signs are ignored, the AUD is likely to escalate. More and more time could be spent on obtaining alcohol, drinking alcohol, or recovering from its effects, and “continued alcohol use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of alcohol” may ensue.

The Drinking Escalates

Continued, excessive alcohol use despite negative consequences is a serious red flag that should not be ignored. Take a step back and honestly ask yourself, why is this happening? Why are you drinking more than you should? For many recovering alcoholics the answer is that they were self-medicating emotional pain or intense stress.

Do you drink to reduce social anxiety? Are you suffering from an anxiety disorder or depression? Then you should not drink alcohol in an attempt to reduce the symptoms of those conditions. While drinking may initially suppress symptoms of mental health disorders, it will eventually make them worse. If you suffer from too much stress, you need to address the cause of that stress instead of fleeing into alcohol misuse.

Unfortunately, many users start to rationalize their excessive alcohol consumption at this point and deny any warning signs to themselves and to others. They keep on drinking even though it is beginning to cause serious problems in their relationships, for their professional career, and physical health. They start to experience craving, or a strong urge to use alcohol, as their alcohol use has begun to hijack the reward cycle of the brain. They need alcohol just to feel normal.

Recognize the Real Drivers

Stress (especially if caused by a traumatic experience) or any mood disorder, combined with frequent alcohol use and a possible genetic predisposition may now unleash a severe alcohol use disorder or alcohol addiction. Individuals may experience blackouts after heavy alcohol use. Uncontrolled, persistent drinking will eventually lead to tolerance—more and more alcohol is needed to achieve the same effect—and withdrawal symptoms will increase if alcohol consumption is discontinued.

Don’t let it get that far. Heed the warning signs. Be mindful of the real reasons you’re drinking excessive amounts of alcohol. Seek professional therapy for any mental health condition you might have and counseling for any trauma you may have suffered. Be aware of people with alcohol use disorder in your family and be extra-cautious if close relatives have an AUD. Engage in activities that relieve stress but don’t involve using addictive substances.

If you are unsure if you have developed a substance use disorder, seek an evaluation to assess your drinking behavior. Don’t despair and don’t drown in your addiction. Help is available and recovery is possible!

When Gray Drinking Leads to Long-Term Sobriety

Posted on by Christy Weeks
Gray Drinking

by: Michael Rass

Sobriety is no longer just the earnest goal of recovering alcoholics. As of late, it has also become the holy grail of so-called “gray area” drinkers.

According to former social drinker Amanda Kudo that gray area is the “place where you’re not a super-casual, once-in-a-while drinker, but you’re also not a hit-rockbottom, time-to-get-help drinker, either. You’re just there, somewhere in the middle, drinking in a way that is still deemed socially acceptable if not socially necessary.”

Or as health coach Jolene Park put it in her TED talk, “from the outside looking in, my drinking did not look problematic, but from the inside looking out, I knew, the way I was drinking was a problem for me.” Many people like Kuda and Park say they never had a real drinking problem, but they had a problem with drinking.
One of those “gray area” drinkers was British expat Ruby Warrington, currently living in Brooklyn, who— according to the New York Times—”spent her early career quaffing gratis cocktails at industry events, only to regret the groggy mornings.”

“After moving to New York in 2012, Ms. Warrington tried 12-step programs briefly but decided that ‘Ruby, alcoholic’ was not the person she saw in the mirror,” wrote Alex Williams in the Times feature about a new sobriety trend spreading across the nation. “Three years ago she started Club Soda NYC, an event series for other ‘sober curious,’ as she termed them: young professionals who were ‘kind-of-just-a-little-bit-addicted-to-booze.’”
Being “sober curious” has caught on and Warrington wrote a whole book about this latest health fad. “For these New Abstainers, sobriety is a thing to be, yes, toasted over $15 artisanal mocktails at alcohol-free nights at chic bars around the country, or at ‘sober-curious’ yoga retreats, or early-morning dance parties for those with no need to sleep off the previous night’s bender,” wrote Williams.

But there is a serious side to avoiding alcohol use, of course. It is after all an addictive substance without any health benefits that physicians would acknowledge. And while the sober-curious vogue may well be short-lived, reducing or giving up alcohol consumption is certainly laudable since it comes with all kinds of health benefits.
When Jolene Park described her alcohol use as knowing “the way I was drinking was a problem for me,” she was actually paraphrasing the first diagnostic criterion of alcohol use disorder (AUD) in the of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), which reads: “Alcohol is often taken in larger amounts or over a longer period than was intended.” And when she said in the same TED talk that she had no trouble stopping but couldn’t “stay stopped,” she was paraphrasing the second AUD criterion in the DSM-5. Two criteria (out of eleven) indicate a mild alcohol use disorder.

Park probably wasn’t aware of the DSM-5 criteria at the time but she read the warning signs correctly and realized that she was “kind-of-just-a-little-bit-addicted-to-booze.” She understood that her alcohol use could escalate further and made the right decision. She embraced sobriety.

She also realized that her alcohol use was a coping mechanism for her anxiety issues and designed a new coping strategy for herself based on connecting with nature and other people, exercise, and meditation. Park now shares this healthy approach to life with other people.

Amanda Kuda also realized that she needed to drink in order to relax. “But there was a bigger part of me that wanted to feel happy, joyful, vibrant, inspired, energized, motivated, fulfilled. Once I realized that alcohol was not only failing to contribute to those feelings, but was actually dragging me further and further away from them, I no longer wanted to drink.” Neither Park, Warrington, or Kuda sought detox or residential addiction treatment for their alcohol problem, and only Warrington briefly tried a 12step program. This low level of care for a mild or moderate alcohol use disorder may not be the right choice in all cases, though. Some patients might require an intensive outpatient program or even partial hospitalization. Only a careful assessment of the patient’s individual needs can determine the appropriate level of care.

Although none of the three “gray-drinking” women made use of a treatment program, they nevertheless realized a core principle of recovery. Stop using and change your life! Real recovery goes far beyond giving up substance misuse. It is a life-changing journey to long-term wellness that should make you feel happy, joyful, and inspired.

IF YOU OR A LOVED ONE IS STRUGGLING WITH SUBSTANCE USE DISORDER, OR YOU HAVE QUESTIONS ABOUT OUR PROGRAMS, CALL HARMONY TODAY AT 970.432.8075 TO GET THE HELP NEEDED AS SOON AS POSSIBLE

Harmony Fights Opioid Epidemic with HOPE

Posted on by Christy Weeks

More than two-thirds of drug overdose deaths in the United States in 2017 involved opioids, according to the Centers for Disease Control and Prevention, escalating an epidemic the CDC says “continues to worsen and evolve.” From 2016 to 2017, opioid-related overdose deaths increased 12 percent overall, surging among all age groups 15 and older.

The CDC report’s recommendations for curbing opioid-related overdose deaths include “increasing naloxone availability, expanding access to medication-assisted treatment, enhancing public health and public safety partnerships, and maximizing the ability of health systems to link persons to treatment and harm-reduction services.”

Naloxone is a medication often used by first responders because it can rapidly reverse opioid overdose. It is an opioid antagonist—it binds to opioid receptors and can reverse and block the effects of other opioids. It can quickly restore normal respiration to a person whose breathing has slowed or stopped as a result of overdosing with heroin or prescription opioid pain relievers.

Medication-assisted treatment (MAT) is used to decrease opioid use, opioid-related overdose deaths, criminal activity, and infectious disease transmission. Medications used for the treatment of opioid use disorder are buprenorphine (Suboxone, Subutex), methadone, and extended release naltrexone (Vivitrol). Some of these drugs are controversial in the recovery community because they are themselves opioids.

The National Institute on Drug Abuse, a US government research institute, clarifies that contrary to what some critics say, “methadone and buprenorphine DO NOT substitute one addiction for another. When someone is treated for an opioid addiction, the dosage of medication used does not get them high–it helps reduce opioid cravings and withdrawal. These medications restore balance to the brain circuits affected by addiction, allowing the patient’s brain to heal while working toward recovery.”

The use of these medications should always be combined with behavioral counseling with the ultimate aim of ceasing all substance misuse.

HOPE – Harmony’s Opioid Programming Experience

Harmony has provided all clients with medication-assisted treatment for many years. This combination of education, counseling, and the use of medication in early recovery is part of the Harmony philosophy. HOPE expands MAT to include medications that alter the physical response to opioids, reduce cravings, and give the patient time to heal from the psychological, social, and spiritual wounds of addiction.

“It’s important to remember that MAT is only a small part of the picture,” says Harmony’s medical director Christopher Reveley. “That is why we call it ‘medication-assisted’ treatment, because by itself it is not the treatment. Used alone it has a low probability of being successful.”

At Harmony, HOPE begins with thorough medical and psychological evaluations. Collaboration with the patient, members of the interdisciplinary team and, when appropriate, family and referral sources, determine the most effective treatment plan. All HOPE clients are invited to participate in weekly support groups led by a professional addiction counselor. These groups address the unique challenges of early opioid recovery, including uncomfortable physical and psychological symptoms, cravings, and strategies to avoid relapse. In this setting, clients support each other and are educated about the process of recovery.

Medication-assisted therapy may help stabilize the patient for these challenges in early recovery. “It gives people an opportunity to step out of the chaos of addiction and consider other ways of being,” says Dr. Reveley. “I never felt that buprenorphine was meant as a lifelong or even long-term solution.” Although there may be exceptions. It all depends on the individual needs of the patient. Reveley remembers a patient who had been on methadone for 46 years. “He tried to taper off a dozen times and relapsed to heroin use every single time. His family was initially very opposed to him being on methadone but eventually they told him ‘this is working, your life depends on it.’ So there are people on either end of the bell curve but in most cases buprenorphine is only a small but important part of the solution.”

Buprenorphine can be an important tool, especially in early recovery from opioid use disorder. The medication offers patients the opportunity to start living a “normal” life, far removed from the drug culture lifestyle they may have been immersed in while using heroin and other opioids. People are dying every day from opioid overdoses, especially in the age of the fentanyl scourge. Buprenorphine may provide the buffer that enables them to launch into sustained recovery. It is a buffer that can save people with addiction from a potentially lethal overdose.

Harmony has been treating addiction for 49 years and HOPE is now offered to all Harmony clients with opioid use disorders. The program involves enhanced medical, counseling, and case management services specifically tailored to meet these clients’ unique needs.

The Harmony care team works closely with clients who choose to include buprenorphine in their treatment strategy. This will typically involve full participation in HOPE and a recommendation for participation in Harmony’s Transitional Care Program (TCP), an intensive, 90 day intensive outpatient program coupled with monitored sober living and medication management by Harmony providers. When clinically indicated or to accommodate client preference, Harmony’s case managers may refer clients to other programs with similar services.

If you or someone you know is struggling with opioid use disorder and needs help, call Harmony at 970-432-8075 and one of our admissions specialists can discuss next steps.

The Insurance Dance with Recovery in Mind by Jim Geckler

Posted on by Christy Weeks
Collaboration

We recently received a Facebook post regarding frustration over Harmony’s handling of payments made through insurance. I wanted to use this opportunity to discuss questions and concerns about our partnerships with insurance partners and how we believe it helps benefit access to treatment.

First and foremost, insurance companies make it easier for us to cover some of the cost of treatment, a service that many of us do not plan for when the time requires it. When we consider our personal relationships with insurance partners, how many of us would be able to have yearly physicals, emergency procedures, or access to treatment? As a provider, Harmony works with our insurance partners to provide the appropriate level of care for the appropriate period of time.

Harmony has a 49 year history of providing a residential level of care; this is the highest level of care for people suffering from substance use disorder. We have a responsibility to our clients to stabilize them medically, assess their conditions, provide them with a diagnosis, work with them to create a foundation for sustained recovery, and construct a comprehensive continuing care plan which will support their recovery. The relationships we have fostered with insurance partners has allowed us to work collaboratively to support access to care along the continuum. Under the umbrella of the American Society of Addiction Medicine (ASAM), together, insurance companies and treatment providers alike are held to the highest standards of care for addiction treatment. This common language, reviewed in tandem with insurance providers determines what level of care an individual requires.

Sometimes there is disagreement.  For example, when Harmony feels that a client would be better served by remaining at a residential level of care and an insurance provider feels they would be successful at the next level.  Other times, a client would like to remain in treatment, however our expert clinical and medical staff believe they are ready to move toward self-management of their own recovery at a level of care which empowers them to practice the early skills of recovery they learned here. In most cases, to arrive at a decision to move a client to the next level of care, involves a conversation with our Medical Director and a physician reviewing the case for the insurance company. We work to keep people at the appropriate level of care indicated by our clinical staff recommendations based on the client’s progress.

Harmony has a dedicated utilization review team, clinical professionals who work with our insurance partners, staff, and clients to keep people at the level of care which will provide them the greatest opportunities for success. When it is determined that funding for residential care has ended, we work to inform the client as quickly as we are able. Unfortunately in this situation the determination for a shift in levels of care is immediate, funding ceases that day. In order to ease the transition for clients and families, Harmony is committed to absorbing the expense of an additional night’s stay for clients. This is not common practice and comes at a fair cost. For example, in the month of July, we provided $28,000 in housing and care at no additional expense to clients. We are able to continue to do this through the generosity of our donors. We recognize the challenge and frustration of learning at 4 pm that one no longer has financing for treatment, however we are dedicated to continue to support our clients during this transition period.

There is nothing magical about 28 days of treatment. We have heard the 28 day timeframe used for many years, growing in public awareness with the Sandra Bullock film. The reality is that proven success is driven by long term engagement in treatment within a full continuum of care, at multiple levels  increasing the opportunity  for self-management.

We will always remain committed to providing access to treatment whenever possible, using all means necessary to help individuals receive treatment that can build an early foundation of recovery.  This could look like something as short as a few days or as long as 4 months.  Either way, our partnerships with insurance and our recommendations for treatment will always be the focus in providing individualized care for clients.

Jim Geckler is the Chief Executive Officer for Harmony Foundation.

Ambassadors for Wellness & Recovery

Posted on by Christy Weeks
Business Dev

A Retrospective Look at the Importance of Business Development
by Gina de Peralta Thorne, MS

If you had asked me 20 years ago if I would be working in the field of addiction treatment I would have looked at you funny.  The idea of working with recovering addicts and alcoholics was never intended to be a part of my world.  I had family who suffered from addiction, but I didn’t know them and I never had any personal issues with alcohol or drugs.  My only exposure to AA was hearing about Adult Children of Alcoholics (ACOA’s)  Adult Children of Alcoholics (ACOA’s) from a mother who self- identified as an ACOA. 

So how did I end up being such a strong ambassador for recovery and wellness? I tell people, that I didn’t choose this career path, rather, it chose me.   My first time exposure to working with people in recovery was 10 years ago as Director of Business Development for a treatment program in Virginia.  I was so nervous, unsure how I could contribute to helping people live a life in sobriety?  I remember the first time an alumnus asked me if I was in recovery, I was uncomfortable to share that I wasn’t.  He stood for moment, looked at me and said, “That’s okay, and you’ll do.”   At the time, his response didn’t give me any tangible reassurance, but today, I understand.

With over a decade of ushering individuals and families into treatment, I know that it wasn’t pivotal for me to be in recovery to do this work.   I have been awed and inspired by what I have learned from working side by side with those in recovery. I have learned how to recognize my own character defects, practice the discipline of restitution, (making amends for my mistakes), find gratitude daily for all things in my life and recognize, “this too shall pass”.  I believe my role in this field has helped people find the connections and resources necessary to make their lives that much better and what an honor it is to be given this responsibility.

Today, the landscape of business development and marketing is challenging.  There are some big shifts in perception regarding our work.  Referrals are skeptical of our intentions, trust is questioned and our efforts to work collaboratively can be tested.  But I believe “doing the right thing” will win out every time.  We are “Ambassadors for Recovery”  charged with the responsibility  to help mentor and coach those new  to the field, teaching the ethical, transparent and collaborative approach to helping people get well. 

We are not about “heads in beds”,   or labeling our clients as insurance contracts. Our purpose is much greater.  We are the frontline of recovery for many of the families and individuals suffering.  Our role is vital and compelling. Never sell yourself short as being “just a marketer”. We are the connectors, the bridge to hope and opportunity and “we’ll do”!

Gina de Peralta Thorne, MS – Chief Marketing Officer with Harmony Foundation is a graduate from Florida State University with a degree in Health Education and Masters from University of West Florida in Health Education and Management. She has over two decades of experience working in the field of prevention, intervention, addiction treatment and recovery. Her background in health communications and health promotions has evolved in both the public and private sectors working in local, regional and national organizations, hospitals, and institutions of higher learning in Florida, New York, Ohio and Virginia. She has worked in marketing and business development for residential treatment programs in Virginia and Florida. A recent transplant to Colorado, Gina was Vice President of Marketing for Lakeview Health providing leadership and oversight to brand management, digital marketing communications, outreach support and alumni services. She is an industry leader speaking about Ethics, Recovery Oriented Systems of Care and Marketing and Business Development best practices. She is a member of the Treatment Professionals Alumni Services (TPAS) Board and an active member of the Addiction Treatment Marketing Organization (ATMO). Gina philosophically believes that change happens when others stretch across the divide and work together.

Caring for the Queer or Transgender Person in Recovery by Luca Pax

Posted on by Christy Weeks

The Center for American Progress reports that between 20-30% of transgender people struggle with addiction compared to an estimated 9% of the general population. This statistic is significant for those of us who are transgender, and for those of us who support transgender people in our lives. As family members and care providers, even if we have good intentions in caring for queer or transgender people in recovery, we may need to intentionally adjust our actions, in order to have a positive impact.

What can I do as a provider?

Ask, Affirm
When a transgender person shares an intimate part of their identity with you, honor and affirm their identity by using their correct name, pronouns, honorifics, and gendered or non-gendered terms when referring to them. If you ask someone their gender identity or pronouns, do so in a way that is not interrogative or invasive, but rooted in trust and relationship. Make it a normal practice to share your own gender pronouns, and to ask others’, so that transgender folks are not as singled out, or put into vulnerable situations.

Listen, Believe
If you are given the opportunity to learn more about the identities that your client holds, listen to their self-definition and believe what they share with you. Know that LGBTQIAP+ identities are valid and real, and that people who hold these identities deserve to be trusted in their self-knowledge. Remember that each individual is the expert on their own identity, and challenging or disrespecting a client about a marginalized identity contributes to their lack of safety.

Include, Support
As care providers, our first commitment is to do no harm. Keep this in mind for transgender clients when making room pairings and restroom designations in residential treatment. Consider using inclusive language in your policies and procedures, and in your new client paperwork. Making these changes may require us to deconstruct our own social conditioning about gender norms and stereotypes, in order to best respond to transgender clients’ assessment of their safety. We may also find ourselves in a position to educate, when confronted with discomfort that may arise for cisgender staff or clients.

What can I do as a friend or family member?

Your love and support matters! The 2012 Trans PULSE Project study shows that transgender people with a parent who is supportive of their identity experiences a decrease in attempted suicide rates from 57% to 4%. With a supportive parent, these subjects’ sense of self-esteem increases from 13% to 64%, and their overall life satisfaction increases from 33% to 72%.

Caring for our queer and trans family members in recovery means ensuring that our respect and love for them continues, unaffected by their transition or identities. We can lift some of their burden by explicitly supporting them in the choices they may make to transition or “come out” socially, legally, and/or medically.

As family and loved ones of transgender people in recovery, it is important for us to educate ourselves about what our loved one may be experiencing. It is equally important that we work to maintain clear and healthy boundaries, and that we prioritize our own self-care.

You may consider joining an Al-Anon or ACA group, and utilizing resources from organizations like PFLAG or Trans Youth Education & Support of Colorado (TYES). You may also consider picking up recommended reading like the WPATH Standards of Care, PFLAG’s Trans support publications, and publications by other addiction treatment providers.

For the transgender or queer person seeking recovery, I am here to reassure you that there is community who understands you. Whether you connect with other LGBTQIAP+ folks virtually, through social gatherings, or while receiving therapeutic care, recovering in relationship with others who love and support you is possible.

If you know the pain of isolation, you deserve to discover that freedom is available to you. Connection with people who have walked a similar path as you, and sharing honestly with others, can be your ticket to a life unbound by addiction, and rich in resources that affirm and sustain the health of your truest self.

There will be times when we, as queer or transgender people in recovery, feel very alone. Whether this is a result of an addiction, our environment, or the weight of simply being who we are in a world that often creates no space for us – know that there are people waiting to undertake this work and journey alongside you.

There are many tips online for how you can take small steps throughout your day to regulate and find relief (like 8 Mental Health Tips for Queer & Trans POC, and 5 Awesome, Immediate Self-Care Resources For When You Feel Like Actual Garbage).

You can also get connected to Queer Asterisk Therapeutic Services, a non-profit organization in Colorado run by queer and trans professional therapists and educators who provide queer-informed counseling services, community programming, and educational trainings to promote the inner wellness and social connectivity of queer and trans people. Follow us on Facebook, Instagram, and sign up for our monthly newsletter, to learn more!

Luca Pax (they/their/them), who is nonbinary transgender, holds a BA in Education and Peace Studies from Naropa University, and works as Director of Community Relations for Queer Asterisk Therapeutic Services.

Edited by RP Whitmore-Bard, Communications Specialist.

Queer Asterisk Therapeutic Services advocates for the importance of excellent individual and community-based mental health treatment for queer and trans folks. Our therapists and educators partner with healthcare providers to ensure that queer and trans clients receive the most inclusive, highest quality of care possible.
We have offices in Denver, Boulder, and Longmont, Colorado.

Reference our Etiquette Guide & Glossary of Terms to support your education.

Does Treatment Work? Why Outcomes Matter…

Posted on by Christy Weeks
Does Treatment Work

by Dr. Annie Peters: Harmony Foundation’s Chief Clinical Officer

Harmony has been helping people who are struggling with addiction to find recovery since 1969. While Harmony is well-known in Colorado for providing clients and families with support and quality services for many decades, reputation means little without demonstrating that people do, in fact, get better.

Defining what recovery is, and demonstrating that people who use Harmony’s services begin finding recovery, are essential components to the provision of ethical and effective care. Harmony’s mission is to provide the foundation for recovery from the diseases of drug and alcohol addiction. If clients leave treatment and begin re-developing lives of purpose, satisfaction, and rewarding relationships, we know we have helped to provide the foundation for a journey toward wellness.

Harmony contracts with an external research organization, OMNI Institute, to examine treatment outcomes regarding substance use, psychological well-being, and improvement in life satisfaction.
Data collection for the most recent outcomes study performed by OMNI began in March 2015, and the study was finalized in 2017. One hundred and forty eight (148) Harmony clients were assessed upon admission, at discharge, and at 1, 6, and 12 months post-discharge. The percentage of clients who responded at these time points were, respectively, 100%, 94%, 63%, 61%, and 64%. While results cannot be generalized to clients who were unable to be reached for follow up, a number of statistically significant findings can be reported and provide valuable information about the effectiveness of care provided at Harmony.

DEMOGRAPHICS

Understanding the people we serve helps us provide the highest quality of care by tailoring treatment interventions to the specific needs of our clients. In this study, the average age of clients was 38, with a range from 18-65. Sixty-four percent (64%) of clients identified as male, and 36% identified as female. All clients were asked to identify their “primary drug.” The majority of clients (74%) identified this as alcohol, followed by heroin (10%), methamphetamine (6%), other opiates/painkillers (5%), and marijuana (3%).

Clients under the age of 25 typically used more substances – the average number was four. The primary drug differed by age as well; clients under 25 identified heroin or alcohol (38% for each), followed by marijuana (13%).

REASONS FOR DRUG/ALCOHOL USE

Clients were asked about the reasons they used alcohol and drugs, and their responses help us understand how to help people better. Many clients (30%) said they used substances for “self-medication” or emotional pain/mental illness (28%). Other common answers were using for pleasure (22%), to escape reality (15%), habit (13%), or pain (5%).

PREVIOUS TREATMENT AND REASONS FOR SEEKING TREATMENT
About a third of clients had been to a detox treatment before, and about a third reported a prior treatment for substance use. Another third reported never having any treatment for drug or alcohol use.

About half of clients surveyed reported a prior diagnosis of a mental health disorder, with the most common diagnoses being depression (37%), anxiety (25%), ADHD (11%), PTSD (7%), and bipolar disorder (6%).

Most clients said that coming to treatment was a personal decision (71%). Other common reasons given for seeking treatment were a family situation, health reasons, a legal situation, or a job-related reason.

POST TREATMENT OUTCOMES

After leaving Harmony, clients were asked at 1, 6, and 12 months about their drug and alcohol use. They were asked whether they had been continuously abstinent from drugs/alcohol since discharge, and they were also asked if they had been clean/sober for the previous 30 days. As can be seen in the table below, over half of clients at one year post-discharge had been continuously abstinent since coming to Harmony, and 71% of them had been abstinent for the past 30 days.
Follow-up     %Abstinent for      %Continuously Abstinent
     Time            Past 30 Days                   since Discharge
1-month           77% (n=88)                            68% (n=91)
6-month           64% (n=90)                           57% (n=91)
12-month          71% (n=90)                            54% (n=95)

Abstinence since treatment is not the only outcome that demonstrates that clients are recovering and have improved their lives. In this study, we also wanted to determine how quality of life had improved for people who had come to Harmony. So all those surveyed were asked questions about relationships with family and friends, physical/emotional health, and other factors. Clients reported significant improvements over time in their family relationships, friendships, spiritual connection, physical health, emotional health. They also reported significant positive changes in their ability to handle finances and handling problems or conflicts, as well as improvements in self-respect. There were also significant reductions in arrests and other legal problems post-discharge, as well as improvements in employment status.

Because so many of our clients have co-occurring mental health issues, we also asked questions about symptoms of anxiety and depression. There were statistically significant reductions in symptoms such as hopelessness, fatigue, nervousness, restlessness, sadness, and feelings of worthlessness.

WHAT PREDICTS ABSTINENCE

In order to continuously improve Harmony’s services, we wanted to determine if there were factors that were associated with post-treatment abstinence. For example, do older clients have better abstinence rates than younger clients? Is primary drug related to abstinence rates, such that clients who primarily used alcohol do better than clients who primarily used heroin?

Interestingly, the only variable that predicted abstinence was the reduction in mental health symptoms during treatment. In other words, the more clients’ symptoms of depression and anxiety decreased during their time at Harmony, the more likely they were to remain abstinent after leaving treatment.

WHERE DO WE GO FROM HERE

One of the most compelling and recurrent themes in this study was the importance of mental health care and support. As mentioned above, self-medication of emotional pain and mental health issues were primary reasons clients reported for using drugs and alcohol. Half of our clients had co-occurring mental health diagnoses. And the single best predictor of post-treatment abstinence was the reduction in symptoms of depression and anxiety that clients reported during their treatment at Harmony. For the past few years, Harmony has worked to improve the quantity and quality of support provided for mental health issues. We have added mindfulness groups, a trauma coping skills group, and education groups on a variety of mental health topics. Clients can receive both addiction-specific counseling at Harmony and counseling specific to psychological issues. Given the results of this study, Harmony plans to continue enhancing the services provided to help people recover not just from chemical use, but from underlying emotional issues that can increase risk for relapse.

While the results of this study show that Harmony clients do, overall, have improved lives and decreased drug and alcohol use, we want to help more individuals and more families to recover, with more significant reductions in substance problems and more improvement in life functioning. Harmony is committed to continuous improvement in our services to provide even better care and help more people find their way to recovery. Studies such as this one remind us why this work is so important and why we need to always examine ourselves and find areas for improvement.

CLIENT FEEDBACK

At the end of each survey, clients were asked if they had any feedback about the Harmony experience. Common answers were that they appreciated the support provided by staff as well as the community they built with the other clients. While data can provide us with important feedback on who we serve and how we can continually do better at helping people find recovery, it is these comments that remind us why we do what we do at Harmony:

“I have come to better understand myself, my need to use, and what I am struggling with so that I won’t need to turn to drugs and alcohol to deal with my problems.”

“I’m really grateful to Harmony…it helped me a lot… I was in really bad shape. If I would have went somewhere else, I probably wouldn’t still be clean.”

“The staff here was absolutely amazing and seemed to truly care about me and my recovery. They were instrumental to my time here and truly helped me recognize qualities and worth in myself that make my sobriety worth fighting for.”

 

Listening to the Seen and the Unseen

Posted on by Christy Weeks

— Carol O’Dowd, MPA, M.Div, RP President, Colorado Association of Psychotherapists

Recovery, whether from addiction or a difficult situation, is aided by listening to the seen and the unseen. Often, how we listen causes us to not see what is in front of us. Have you ever walked into a familiar room to meet with family, friends or business associates and someone points to a new decoration or a piece of furniture in the room? You sat there wondering, “How did that get there?” Sometimes objects go for days being unseen. Our ancestors go unseen flowing as DNA in our veins while being powerful forces making us, us. Some of us grew up in households where we were trained to be addicted whether to alcohol or other substances. We learned to be pawns in a game with our unseen emotions.

Another option is to listen and notice the messages we hold and consciously choose which ones we want to play with instead of letting them play us. When the voice in our head is an old message from Mom, Dad or a memory of destructive family argument from long ago, we can create space between us and the message. We can take a moment to breathe in and hold in our fist the ghoul of anger, fear, frustration or the voice crying out “Go get a drink.” We can then set down the unseen emotion, unclasp our fist and release it. We can breathe out lovingkindness into our pain and sorrow. We can breathe in lovingkindness that we send to that space in our body where we held the destructive emotion. We can tell that portion of our body to relax. We can breathe out lovingkindness to the ghoul in front of us and tell it, “I do not need you right now. Please stay here. For the next 20 minutes I have a project to do a without you.”

Yes, those unseen emotions and old tapes can be so powerful, they keep returning. The practice is to listen carefully so that you can choose the ones you want to influence you. Seeing them as thoughts or emotions gone awry, you can put them inside a doll, rock, pencil holder or other object. Then pick them up and set them aside. If only for a moment, you can walk away without them. Although they may return, each time, they do so with less force. You can listen instead to acts of kindness from those in your past. In one moment you can listen to messages from the unseen to guide you to see more of the world right in front of you. You can consciously choose to spend time with people, animals and spirit beings who inspire you to live in a world of peace.

Go to www.coloradopsychotherapists.com for the mental health services offered by a wide diversity of mental health professionals.
Contact me at president@coloradopsychotherapists.com if you want to join a group that will be exploring the practice of deep listening on Sunday mornings starting in February.