Podcast Series: Colorado Center for Clinical Excellence with Josh Rudder

Gina:                     Hi everyone, welcome to the Harmony Foundation Podcast Series, and it’s my pleasure to be joined with Josh Rudder, who’s with the Colorado Center for Clinical Excellence. Welcome Josh.

Josh:                      Hi Gina, thanks.

Gina:                     It’s good to have you here.

Josh:                      Yeah, good to be here.

Gina:                     So, we’re really interested in hearing more about the center and what your specific work is, but before we do that, let’s talk a little bit about your background, and what got you into the field of behavioral health.

Josh:                      Yeah, good question. Kind of a long story, but I’ll try to keep it pithy. I experienced behavioral health first hand as a person finding my way in this world, and I guess long story short is, I found help where I didn’t think I would, and it changed my life, and somewhere along the way I was, “I wanna do this.”

And I followed a trail of breadcrumbs, one step after another, finally to a point where I could get some skills, where my skills could catch up with the intent, and my life is really improved dramatically and I just feel like I’m in the right place and so, I found myself here at the Colorado Center, working with people in recovery and addiction, and recovery from complex trauma and all sorts of difficult predicaments.

Gina:                     So you said, “Yes,” it sounds like you just kept saying, “Yes,” and it just kept moving you in the right direction?

Josh:                      Yeah, I did say, “Yes.” I had a friend who described it in his journey, of standing at the edge of the pool, and the pool had no water in it and he was gonna take a leap and trust that it would be filled. And somehow that struck a chord with me because I would say yes, and I had no evidence that this would actually work out, or I was doing the right thing. And sometimes there will be no evidence, and I had to trust and it’s working out really well.

Gina:                     I’m so glad. Well we’re certainly glad to have you part of the Harmony family. As we move into talking about the center, and what you all do, you’re one of nine providers within the center, correct?

Josh:                      Correct.

Gina:                     And you have this unique evidence-based approach that you do call FIT, feedback-informed treatment, and that was new for me, so I’m sure for some listeners it’s probably new for them as well. Can you describe what this FIT concept is about?

Josh:                      Yeah, absolutely, and I wanna say it’s not totally unique to us, there is a national and international body that practices, there’s a lot of evidence, there’s just nobody in our area. So, yeah, feedback-informed treatment is a thing that unifies our entire practice of individual clinicians, and no matter how we work the treatment process, no matter what our education background training is, this unifies us, and the feedback-informed treatment model is a way for us to measure outcomes and the alliance with the therapist, because all evidence, all results are local. So if all nine of us did the same treatment protocol, the results would be different, because it follows the therapist.

A lot of people know that, but how do we actually account for that? So we use ultra-brief measures that have been validated with a big enough sample size to really understand the affect, and we track how people are doing in therapy and then we track the alliance at the end of every session.

Gina:                     That’s fantastic, and it’s great because for somebody who’s looking for treatment, often times there’s this big question mark of, is this actually gonna work? You know, is this really gonna provide any kind of real value to me. But the fact that you are creating accountability for yourselves and building in this FIT model, you’re providing reassurance to your clients, to your patients, and letting them know that, we want you to be successful and here’s what we’re creating.  I wish we saw more of that happening, but I don’t think we do as much.

Josh:                      Yeah, and it makes sense, and I would say two things in response to that is that, the response that I’ve received and generally we receive is one of real interest and appreciation almost like fresh air, “Oh, we’re gonna do this together? Wow.” So that’s really cool. And then there’s also some trepidation as a provider. I’m gonna be asking somebody, and creating this culture of feedback, where I’m gonna be asking, “Am I doing okay? Am I doing well?”

And that can be really revealing.

Gina:                     A good thing though because it takes away some of that power differential too, so it helps the client feel like this is a collaborative effort, and that it’s not just about clinicians being up here, and the client being down here.

Well, it’s a really impressive model and I’m really taken by that. I also learned on your website that you have a multi-dimensional approach to treatment within the center. Can you talk a little bit about how does the practice work to streamline services for individuals seeking help? So if someone were calling in, because you’ve got this great approach with all these different clinicians that are doing different things, how do you all discern which clinician is the best clinician for that client?

Josh:                      Yeah, great question. I think the first thing that I appreciate about the model and the group itself, the Colorado Center, is that we actually meet weekly as a group. A lot of the group therapy-type of agencies will share resources but not take the time out of their day, out of seeing clients, out of seeing patients, out of running groups, whatever it is, to actually meet together. So we have a clinical meeting, we talk to each other, we understand. Even when we don’t want to.

So we know about each other, we know how we practice and, as much as we can, we know how the other people feel in the group, which is really important in treatment. So when someone calls in, we have somebody that’s dedicated each month that’s a clinician, that understands how to do intakes and also understands the rest of the group, so will do the phone screen, will schedule the intake, and generally will refer in-house as appropriate for the best potential fit.

And then having so many providers, if after a couple of sessions it’s not right, we see that in the feedback measures, then we can fire ourselves.

Gina:                     And re-direct them somewhere else.

Josh:                      And re-direct in a way that’s kind, warm, that’s in alignment with the person’s goals, and we’ll do it collaboratively of course. But we don’t wanna get to a point where we need this outcome, we need this client. We don’t wanna be invested in me only, having this result for this person.

Gina:                     That’s great, and that speaks to the ethics of the organization as far as looking at what’s the best need for the client, at the end of the day. Which not a lot of people are open to, but I certainly see where you’re coming from.

So this is your first visit to Harmony. What are your thoughts?

Josh:                      Yeah, I knew of Harmony, and kinda through the grapevine and being in the recovery world, especially. And so I had this preformed notion, and I kinda already held it as the gold standard.

Gina:                     Oh, thank you.

Josh:                      And so you had a high bar, and I think so far I can say honestly it’s lived up to that. My first impression is that it’s a warm inviting space. I know that’s something that I strive for, it’s probably why maybe I’m looking for that where I go. I also really appreciate how important that is in recovery and in this work, and needed, so I’m always looking for that. And it’s a lot of little things. And I just feel like you all have done the little things.

Gina:                     Thank you.

Josh:                      And through some of the questions I’ve asked, I’m getting that idea of constantly checking ourselves, kind of like we do, to see what else could we do, how’s this actually working. So I like that.

Gina:                     Thank you for that, and we appreciate it and we’re equally excited about building that rapport with the center as well.

Just quickly about your practice though, so can you talk a little bit about what you do in your practice and the type of client that you typically look to work with?

Josh:                      Yeah, so the type of client that I typically work with has experienced some dramatic events in their life, whether as a child or an adult, or both; they struggle often times with problematic substance use, or relapse, addiction and anywhere along the scale of contemplating, barely contemplating that this might be problematic, all the way to knowing that this is a problem and not being able to find ways to rectify it. So, anywhere from ages 15 up-

Gina:                     Both men and women?

Josh:                      Yeah, any gender identity, individuals, couples and I also do a lot of group work as well. All of my work is also informed by trauma-informed care guidelines, published by SAMHSA, I think that’s just really excellent guidance right now. We’re always trying to improve how we can better trauma-informed care, so that’s something that is near and dear to me. So I work from that model as well.

Gina:                     And you also cover substance abuse as well?

Josh:                      Yeah, so I thought I mentioned that! Yeah, substance abuse as well. That’s the primary focus.

Gina:                     Great. So if someone were wanting to access services today, and listening to this podcast, how could they get in touch with you all?

Josh:                      Yeah, so my suggestion is to go to the website, which is www.thecoloradocenter.com, and then call us at our main line, 303-547-3700, and probably will leave a message there. One of our intake or forward screen clinicians will reach out and begin that process. And we also, unlike a lot of places, we will publish a lot of information to our website, I think that’s really helpful. Actually a lot of information, including videos of all of us, with the idea that you can get a feel for how we might be, other than just the basic written information. So I think that’s helpful, as well.

Gina:                     Yes, very much so. People tend to go there first before they make their decision, so that’s great.

Josh:                      Yeah.

Gina:                     Well thank you so much for taking the time to visit with us at Harmony, and we look forward to working with you.

Josh:                      Yeah, thank you so much, I appreciate it.