Spotlight On: The Addictions Team

Mental illness and addiction are cousins. They’re related. For those who are addicted or dealing with mental illness, they share a similar bone structure and can often trace their lineage back to the same type of pain.

Adult & Child Health has always known this and has always offered support to addicted people. However, the opioid crisis hit addictions treatment in Indiana hard. The addictions team at Adult & Child Health was no exception. It forced this service line to make a decision in the face of such a heavy burden: to strengthen or to snap. They chose to strengthen.

How Adult & Child Health is serving those who are addicted

In 2017, the addictions team rebuilt, according to Lyndsey White, assistant director of outpatient and addictions. She would know, because she was the one who built it. Hired this past May, Lyndsey worked closely with Tara Elsner, director of outpatient and addictions, to develop the best team and service structure possible. Adult & Child Health hired nine licensed clinical addictions counselors, It also created a working relationship with every service line that could offer substance abuse assistance.

The opioid crisis put a strain on addictions from day one, but the team’s passion leaves Lyndsey helpful. “We could have 100 providers and still not reach everybody. But that’s our goal,” she said. “The cooperation and relationships between [the team] is so inspiring … just to see people that work so well together and want to pick up and help out.”

Licensed Clinical Addiction Counselors are now stationed in all Adult & Child Health offices. They’re also fully integrated into the A&C continuum of care.

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How addicted clients find Adult & Child Health

Clients enter addictions treatment a few different ways. The Department of Child Services refers addicted clients, or it’s a stipulation for probation. Adult & Child Health services are voluntary and self-referrals are common. A call to the Call Center (1-877-882-5122) or a visit to Open Access can get them on the right track.

“I know it sounds so simple, but really it’s not,” Lyndsey said. “For someone to make that decision to ask for help takes a level of courage I couldn’t even imagine.”

Adult & Child Health also screens people who come through Open Access for mental health or physical health issues for substance abuse disorders. From there, the access screener can refer them to any necessary service.

It’s common for mental illness to spark and feed substance abuse disorder and vice versa. Because of this, it’s important for this team to employ dually licensed clinicians. They often treat the two at the same time as well as teach how these illnesses affect one another.

How does it work?

The level of care will always depend on the client. The addictions team currently has three different tiers of group support. The highest support level is the Intensive Outpatient Program. This group meets three times a week for three hours for up to 16 weeks. This is often in conjunction with Medically Assisted Treatment, where doctors from Adult & Child Health’s primary care clinics oversee the client’s physical health.

There are many physical side effects from using and withdrawing from substances, which is why treating health complications in tandem with other supports makes sense. Part of MAT can also involve receiving Vivitrol treatment.

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“We’re very fortunate that all of our staff now are trained at providing Vivitrol in the injectable form, which is a preferred method to help combat the opioid epidemic,” Lyndsey said.

Vivitrol, a brand name for the substance Naltrexone, blocks an opioid high’s effects for up to 30 days. All these support layers  exemplify the Matrix Model, which signifies the use of multiple support layers and applies multiple strategies and techniques to fully equip people to stay sober.

The group tries to wrap the client in support. So many factors feed substance abuse. The addictions team addresses as many of them as possible, so addicted clients achieve as much success as possible.

Other care levels for addicted clients

The next tier down is the Living in Balance group, which is less intensive. They meet for two hours two days a week. Many DCS referrals feel comfortable here. It’s modeled for someone who functions at a higher level and can fit into a full-time work schedule.

The Brief Intensive group is for people whose substance use is teetering on the verge of disorder. For two hours one day a week, participants learn more about long-term substance abuse complications and how to combat the compulsion early. Motivational interviewing plays a big role in this type of treatment.

Building avoidance skills before physical and mental dependence forms helps participants succeed. Everything the clients learn in each of these groups is evidence-based and considered to be best practice within the industry.

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Each group includes individual therapy and/or family therapy and skills development sessions. Group treatment has the most success evidence. Individual treatment is also available for those who have social anxiety or who simply aren’t comfortable. The addictions team and Open Access can create tailored treatment plans depending on clients’ circumstances.

This is how Adult & Child Health embodies the idea of a continuum of care. Health care in general, but especially among addicted clients, sticks better when they address all aspects of wellness simultaneously by collaborating professionals.

What’s new about the program

Lyndsey lauded Medically Assisted Treatment, which is new to Adult & Child Health. Two primary care clinics that launched in 2016 made this possible.

“Integrated health is kind of revolutionary in how you do treatment in general,” she said. “In the population that we’re treating, that suffers from substance abuse disorder, it’s night and day. There are some serious medical complexities for those who have long-standing issues with chemical abuse [and alcoholism.]”

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Addictions continues to expand into different spaces to provide treatment. “Something I am so unbelievably excited about, is our adolescent substance abuse treatment program, which has been a community request for [a long time],” Lyndsey said.

This group, now in operation, is designed for 14-to 18-year-olds and uses the Matrix Model. This group meets at Adult & Child Health’s 8320 Madison Ave. location for two hours, two days a week. It addresses the full scope of combating addiction. It also focuses on relapse prevention training and developing intervention skills to build coping abilities.

How families can help addicted clients

Lyndsey said family inclusion in the healing process is incredibly helpful. She added, however, that treatment plans often overlook it. “The supports around people suffering from addiction are what helps them every second of every day,” she said.

While the current program includes working with a client’s identified family, she hopes the future brings more family inclusion opportunities. Other future dreams involve giving back to the community during recovery month. She also wants ongoing dialogue between the addictions team and the rest of the agency.

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“If someone has a question concerning addictions, I want them to feel comfortable asking it. I want to make sure that everybody has access to our team and their expertise so everybody feels like they can get answers,” she said.

Lyndsey advises curious case workers as well as community members who are looking to overcome their addiction: “Don’t be afraid to reach out.”

This is an updated version of an article that originally published Jan. 17, 2018.

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