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Group therapy is a central component of nearly every addiction treatment program. In fact, the original AA format is similar to a group therapy session in that people share their struggles and triumphs in a supportive and confidential setting. Unfortunately, many people are wary of participating in group therapy.

This is perhaps understandable. After all, you have to discuss difficult personal topics with people you hardly know. Although it can seem intimidating at first, most people end up getting a lot out of group therapy sessions and even enjoying it. The following are ways in which group therapy is especially effective for overcoming addiction.

You see you’re not alone.

Addiction can be a terribly alienating experience. One reason is that it tends to lead to physical and social isolation. People with substance use issues often go to great lengths to hide the fact, which may lead to secretive or deceptive behavior. People often isolate themselves to protect their drinking or drug use time, blowing off plans with friends and family.

Addiction is alienating in a psychological way too. Many people who struggle with addiction feel like they’re uniquely burdened. They don’t see other people having the same problems they’re having. What’s even worse, many people who develop substance use disorders have also experienced challenges such as trauma, sexual abuse or assault, and childhood abuse or neglect. They often have a deep sense of shame as a result of these experiences and that shame drives their addictive behavior.

Part of the power of group therapy is that when you get a group of people who have had similar experiences together, they start sharing and they discover they’re not alone after all. Many people have suffered the same abuse and reacted in similar ways. Many people have done things they aren’t proud of as a result of their substance use. Discovering you’re not alone is liberating and it’s when shame starts to heal.

Groups provide social support.

There are mainly two reasons social support from the group can aid therapy. First, it helps keep you engaged. People tend to be a little more motivated to show up on time and participate when they know others in the group are depending on them. Greater engagement leads to greater outcomes.

Second, the group can provide moral and emotional support. A lot of what you have to do in recovery is hard to do on your own. For example, you may have trouble maintaining boundaries with family members or friends who still drink or use drugs.

Your group can support you and assure you that you’re on the right track. You also feel a sense of connection and belonging in the group that you might not get elsewhere. For many people, this sense of support helps them heal and find a greater sense of purpose.

You get different perspectives.

One of the great things about group therapy is that you get a lot of different perspectives on your problems. A drawback of individual therapy is that your therapist can only offer one different perspective. Sometimes you end up feeling like, “Well, that’s just your opinion.” In group, you can get a range of perspectives, including that of your therapist.

You are more likely to believe something about yourself when several people tell you the same thing, especially if it’s something you don’t really want to hear. However, diverse perspectives aren’t just about your behavior. They can open you up to different ways people see things in general.

For example, if you hate conflict, it might shock you to discover that some people in your group just see it as a normal and inevitable part of life and not something to be feared and avoided. That kind of insight can change your view of life outside of therapy.

Group is a better approximation of life.

When you’re in individual therapy, you are able to control the narrative about your life. You get to characterize other people’s words and actions and your therapist is left to speculate about how honest you’re being. In group, it’s much harder to control the narrative because your therapist can see how you interact with other people in real life.

For example, if you are overly defensive or critical, that will soon become apparent in the way you interact with the group. Since many of our social habits are fairly general, it doesn’t matter so much that the other people in the group aren’t actually family, friends, or coworkers.

You improve your social skills.

Related to the point above, group therapy is also a chance to practice new behaviors and social skills in a safe environment. Some therapeutic methods, like dialectical behavioral therapy, or DBT, incorporate group therapy for this specific reason. DBT was developed to help people with borderline personality disorder but is now used for all kinds of difficult conditions, including addiction. People with borderline personality disorder tend to have a lot of relationship problems because of how they interpret other people’s behavior.

Group therapy is an opportunity to put new social skills into use before you have to use them out in the world. It’s an especially good way of learning to hear constructive feedback without getting angry or defensive and give feedback without being mean or critical. Improving your social skills is one of the best ways to strengthen your relationships and reduce the amount of stress in your life.

It’s more cost-effective.

No one likes to hear that their therapy is cost-effective because it sounds like another way of saying “cheap.” However, according to the American Psychological Association, group therapy has been found by more than 50 clinical trials to be as effective as individual therapy for treating a range of conditions, including substance use disorders and common co-occurring mental health issues.

If you are in an intensive addiction treatment program, you are likely getting both individual and group therapy and group therapy increases the number of hours you can spend in therapy each week without a commensurate rise in cost.

Group therapy can help you see that you’re not alone, it can provide support, show you different perspectives, and help you increase your social skills, all for a lower cost than individual therapy. Although it’s normal to be hesitant at first, you will probably derive a lot of benefits from group therapy and feel good about the experience. Foundry Treatment Center’s vision was formed through personal experiences and continues to grow through the dedicated compassion of the Foundry team. We share a commitment to provide a comprehensive, whole-body treatment program that encourages each to seek their values and beliefs through innovative and evidence-based treatment modalities. For more information on how we can help you or a loved one, call us today at (844) 955-1066.

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We all want to feel like we have a hold on our addiction. We try to do everything right. We avoid people, places, and things, go to the meetings where we feel comfortable, and work through the steps with a sponsor. Unfortunately, no matter what we do, life is going to happen. We will be triggered, and we aren’t always going to be working our program perfectly. To avoid relapse, it's essential to learn the early warning signs that we might be closer to picking up than we’d like and how to walk through those signs in a healthy way.

When thinking of relapse, we often think of the part where we pick up and start using again, but just like everything else, there are phases we can look out for before we pick back up. Relapse begins with our emotions, then it becomes mental and, finally, physically, putting the substance into our bodies. These phases can be very gradual and hard to spot if you aren’t looking for them and adequately dealing with each stage as it comes.

Phase 1: Emotional

Emotional relapse often happens before we even consider picking up a substance. This phase can manifest in many different ways. We could notice that we are becoming angry by situations that generally wouldn’t bother us; it could be that you are noticing that you feel anxious more often than is typical. We could even begin to start eating and sleeping in ways that don’t feel healthy.

These could all be signs that you are beginning to slip down into emotional relapse, but the only way we can realize that we are slipping is by motoring our emotions. If you notice these, get connected to your support group. Verbalize the way you feel to people you trust. Consider meditation to quiet your mind and calm down or, physical exercise can be a healthy way to let out a lot of emotions.

Phase 2: Mental Relapse

Most people in recovery have two parts of their brains that are constantly at war. One part is the part of the brain that wants to remain sober and continue to lead your life in such a way that you can look back with pride and contentment at all of your achievements. On the other hand, there is also the part of the brain that misses the old life.

This part of our mind tends to forget all of the harm we caused others; all of the pain we put ourselves through and tends to focus on the good times. Everyone in recovery struggles with this, but when your thinking shift and the part of your brain looking back on those memories fondly takes the steering wheel, you’ve slipped into mental relapse.

If you notice mental relapse happening, it's time to fight harder than ever. Try and remember how dark active addiction was. “Play the tape forward’ and think about what your life would look if you went back into active addiction. Talk about it with your sponsor, your support group, your dog, your cat, anyone who will listen and listen to their suggestions and let them help you.

Phase 3: Physical Relapse

Physical Relapse is what most people probably imagine when they hear the word relapse. It is the action of actually consuming any form of mind-altering substance. Even just using one time can bring all of the old cravings back. Without help, often time, people find themselves exactly where they left off, which can be deadly. Our bodies aren’t used to consuming drugs and alcohol the way we used to, so it’s very easy to take too much and find yourself hospitalized or even dead.

If you find that you have physically relapsed, it’s not too late. It’s going to be easier to get help early on, rather than waiting until things get bad again. Don’t be afraid to reach out to people you trust. Going back to treatment might be the best option. It’s never a sign of weakness. You now are that much more educated about your disease and have better ideas of what to look out for.

Recovery is not something that everyone gets on the first try. Relapse is a part of many recovering addicts' stories, and if it happens, there is no shame in starting over. Of course, we want to save ourselves from being dragged through all of that pain and torment, if possible. The best way to avoid relapse is to be aware of these early warning signs and to take appropriate action when they come.

The most important thing to remember is that this a team sport and we all have to work together to have long and happy sober lives. Get a group of other sober people to walk through life with, avoid triggers, and always be aware of your mental health and keep pushing forward.

Steamboat Springs, located in the Rocky Mountains, provides a setting for the natural stimulation of mind and body, allowing for a return to our innate senses and a new foundation from which to build. Foundry Treatment Center’s vision was formed through personal experiences and continues to grow through the dedicated compassion of the Foundry team. We share a commitment to provide a comprehensive, whole-body treatment program that encourages each to seek their values and beliefs through innovative and evidence-based treatment modalities. For more information on how we can help you or a loved one, call us today at (844) 955-1066.

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We’ve all heard someone say something like, “He’s fried his brain,” referring to someone whose drug or alcohol use has gotten out of control. If you have struggled with substance use, or someone you love has, you’ve no doubt seen changes in personality and cognition and wondered “Is this permanent?” It’s a distressing thought.

So much of who we are – our thoughts, memories, skills, and personalities – is encoded in the roughly three pounds of neurons in our skulls. Drugs and alcohol obviously have some effect on our brains, which is why people use them in the first place, and too much can have a pretty bad effect.

The belief that alcohol kills brain cells is widespread, but it doesn’t appear to be true. However, some drugs like methamphetamine, cocaine, and MDMA do appear to kill brain cells. While losing a few neurons among billions is not a big deal, it does add up over time. Heavy substance use can cause cognitive impairment, personality change, and behavioral change. If you’re worried that you or someone you love might suffer permanent effects from substance use, here are some things to consider.

Some effects fade quickly.

Most of the psychoactive effects of drugs and alcohol are temporary but if you’re using them all the time, you may not notice. In order to know what effects are temporary and which are longer-lasting, you actually have to go through withdrawal and get completely sober. This may sound obvious but a lot of people forget what their baseline even is after a period of continued substance use.

For example, alcohol is a depressant. If you are a heavy drinker, you may have depressive symptoms that are mainly caused by your drinking. These may include depressed mood, poor concentration, and poor memory. It’s possible that your depressive symptoms will abate once the alcohol is out of your system.

However, you may also have an underlying mental health issue to deal with too. The main point is that substance use interferes with the normal functioning of the brain and the first step in assessing your degree of impairment is to get the drugs and alcohol out of your system.

Some effects may last a year or more.

Unfortunately, the direct effects of drugs and alcohol on your brain are only part of the picture. Another part consists of the adaptations your brain makes to counter the effects of drugs and alcohol over time – in other words, you build a tolerance.

In the case of alcohol, for example, your brain gradually makes less of the inhibitory neurotransmitter GABA and more of the excitatory neurotransmitter glutamate. This is why you may feel like you need alcohol to relax and why you may experience irritability, shakiness, and even seizures when you quit drinking.

The worst of these symptoms – acute withdrawal symptoms – typically only lasts a week or two but other symptoms may last weeks or months. These are sometimes referred to as post-acute withdrawal syndrome, or PAWS. These symptoms may include emotional numbness, inability to concentrate, lack of interest in pretty much everything, and depressed mood.

This is thought to be the result of your neurotransmitters slowly returning to pre-addiction levels. Another factor likely has to do with changes in the limbic system. After months or years of using drugs and alcohol, your brain has gotten used to artificially elevated levels of dopamine so getting excited about having a nice dinner or going to the beach is pretty hard. It may take more than a year for that baseline to reset.

Some structural changes may never fully go back to normal.

As noted above, drugs and alcohol mainly mess with the brain’s limbic system, which is involved in pleasure, reward, and goal-seeking behavior. There appear to be three main brain structures involved with addiction: the basal ganglia, the extended amygdala, and the prefrontal cortex.

Areas of the basal ganglia are involved with motivation, reward, and creating habits. The extended amygdala regulates the brain’s reaction to stress and negative emotions like anxiety and irritability. The prefrontal cortex is responsible for “executive” functions like planning, prioritizing, and organizing – or “go” functions – as well as self-control and emotional regulation – or “stop” functions.

When we say addiction “hijacks” the brain, what we mean is that the massively disproportionate reward of substances causes the basal ganglia to tell the prefrontal cortex to organize its efforts in a way that prioritizes getting drugs and alcohol. At the same time, it undermines the “stop” functions of the prefrontal cortex, which get weaker from disuse.

This is the main area of debate when it comes to whether the brain ever fully recovers from addiction. On one hand, you have this miscalibrated basal ganglia that only goes back to normal very slowly and on the other hand, you have this impaired “stop” function in the prefrontal cortex.

The latter is much more malleable, which is why treatment strategies tend to focus on tools to regulate emotions and control behavior. There is also good news in that the urge to use drugs and alcohol typically declines the longer you stay sober. Most people say their cravings get noticeably weaker after one year and five years sober.

The brain is much more adaptable than we used to think.

If you’re concerned about whether your brain can ever fully recover from addiction, there is plenty of room for optimism. It has only been in the past decade or so that neuroscientists have come to believe that the brain keeps making new neurons in adulthood. We’ve also known for a long time that the brain has significant powers of adaptation.

Even people who have had strokes or experienced traumatic head injuries are often able to regain most or all of their cognitive functions. New technologies like transcranial magnetic stimulation may help heal brains even faster. The key is that your brain will adapt to whatever you consistently ask it to do. Your concentration, willpower, and memory will get stronger the more you use them, even after years of substance use.

Steamboat Springs, located in the Rocky Mountains, provides a setting for the natural stimulation of mind and body, allowing for a return to our innate senses and a new foundation from which to build. Foundry Treatment Center’s vision was formed through personal experiences and continues to grow through the dedicated compassion of the Foundry team. We share a commitment to provide a comprehensive, whole-body treatment program that encourages each to seek their values and beliefs through innovative and evidence-based treatment modalities. For more information on how we can help you or a loved one, call us today at (844) 955-1066.

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We all get resentments toward people around us, and when we do, it can be hard to sit down and have those uncomfortable talks. Looking another person in the eyes and telling them what they are doing is bothering you or admitting that you haven't been acting in a way you are proud of can be hard to do if we don't have a plan to do it reasonably, and mutually. As uncomfortable as these talks are, they are worth it if they can save a relationship with a friend or family member.

We can do things to make these talks easier for the other person and us. So, here are some tips for handling these awkward talks productively and positively.

Before We Even Have the Conversation

These talks can be anxiety-inducing and overall just icky feeling, but it helps to take time and make sure our intentions are clear, and we know what the goal of the conversation is. Often we assume we know why the other person did what they did. Try and clear what you think from your mind so that when they tell you their side of the story and you can be ready to hear that instead of just assuming you know best and walking away without anything changing.

It can be helpful to set aside a time and place to have this problematic talk. When thinking of a location, it's useful if the area is not in public. You don't want to be distracted by people around you or be worried that others are listening in on you while you are vulnerable. When you invite the person, you want to make sure that you are clear that you want to have this talk. Otherwise, the other person may feel ambushed. You could tell them, "hey, ___ I've noticed a tension between us about ___, would you be able to meet at my house around 8 to clear the air?". Warning the other person gives them the opportunity to think about there perspective on the situation so that they can be ready to talk about what is bothering them. Often if you spring a hard conversation on someone with no warning, they will become defensive, and they may throw excuses out, so it's better if you give the other party time to process things.

Time to Have a Hard Talk

Bringing up the topic can be scary. We frequently fear how the other person will react and if they will still like us after we bring this up. Remember, we are looking for a solution to save the relationship. If you don't have this talk, the feelings you are having won't go away. They will only get worse. So the first thing you need to do is state what upset you. Try and use specific examples and make it clear how you felt in those examples.  Avoid using extremes such as "you always" or "you never." Have the mindset that you are going to fix this together.

You need to know the difference between what the other person's intentions were vs. how it impacted you. Likely, their plans were not to hurt. That doesn't change the fact that what they did DID hurt you. Giving the other person the benefit of the doubt can go along way in helping to resolve the conflict. It is still essential that you let them know that their actions did hurt you, but it's equally important to let them know that you are aware that they likely not their intention. A simple way of phrasing this is "when you did ___ it made me feel like ____, I don't think this was what you meant to do, but I need you to know how it made me feel so we can clear the air."

Listen to what they are saying.

After you explain the way you felt, you should ask for their version of the events. Listen to what they are saying, and after they've finished, acknowledge what they've said. "What I heard you say way ___."

Own your part. If the other party has said that you did something that made them feel bad, take ownership of that, acknowledge what was said, and apologize for your role in that conflict. Owning your part could be as simple as saying, "when you did ___, I was hurt, so I was defensive for a few days, and I see how that could add strain to our relationship. I should have been up-front with you that I was hurt at that moment." Even if they don't mention anything you did, it's not a bad idea to let them know that there are ways you could have handled the situation better. Identify a few examples of your part in this before you have the conversation.

Come to a Solution

Ask them for ideas and listen to what they say and don't interrupt them. When you tell them your ideas for a solution, make sure to use we/us rather than me/you. Promise to try harder in the future and move on.

These conversations don't always go the way we want them to go. If it starts to feel like an argument, don't be afraid to tell them that you don't feel comfortable talking to them when emotions are running this hot. You can reschedule and come back to it later.

Steamboat Springs, located in the Rocky Mountains, provides a setting for the natural stimulation of mind and body, allowing for a return to our innate senses and a new foundation from which to build. Foundry Treatment Center’s vision was formed through personal experiences and continues to grow through the dedicated compassion of the Foundry team. We share a commitment to provide a comprehensive, whole-body treatment program that encourages each to seek their values and beliefs through innovative and evidence-based treatment modalities. For more information on how we can help you or a loved one, call us today at 1-844-955-1066.

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At The Foundry Treatment Center Steamboat, a healthy lifestyle is an important part of complete recovery. The link between the body and the mind is powerful, and a healthy diet combined with regular exercise is an integral component of lasting recovery from Substance Use Disorder.

There is a common misconception that healthy food is bland and without flavor or excitement. Our goal is to shift how our clients define "healthy food" and shift their lifestyles towards sustainable nutrition. Serving bland, flavorless food would only set the stage for old eating habits and patterns to return down the line.

Check out this fabulous recipe to add to your menu tonight.

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Chimichurri Sauce:1 bunch parsley1 bunch cilantro1 tablespoon garlic, chopped1/2 cup olive oilSalt and pepper to taste2 lemons, juicedCombine all ingredients except for olive oil and lemon juice in a blender. Start to slowly add olive oil and lemon juice. Adjust seasoning to your liking.Asparagus:

2 bunch asparagus

1/2 stick butter

1 tablespoon lemon juice  

Combine ingredients together and wrap with foil. Cook in oven with steak.

Brown rice and quinoa:

1/2 cup quinoa*

1/2 cup brown rice*  

*Cook according to instructions on package

Steak:

1 flank steak seasoned how you likeCook steak in oven at 375 until desired doneness. Place rice blend on plate, top with the asparagus. Slice steak and cover with the chimichurri sauce. ENJOY!

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At The Foundry Treatment Center Steamboat, a healthy lifestyle is an important part of complete recovery. The link between the body and the mind is powerful, and a healthy diet combined with regular exercise is an integral component of lasting recovery from Substance Use Disorder.

There is a common misconception that healthy food is bland and without flavor or excitement. Our goal is to shift how our clients define "healthy food", and shift their lifestyles towards sustainable nutrition. Serving bland, flavorless food would only set the stage for old eating habits and patterns to return down the line.

Below is the recipe for Ginger-Garlic Chicken Salad

- One of the many healthy meals served to clients at the Foundry Treatment Center Steamboat.

Dressing:

½ cup sesame oil

2 tbsp fresh ginger paste

1 clove garlic

1 TBSP coconut aminos

½ tsp salt

½ tsp black pepper

1/3 cup onion-diced

2 TBSP honey

1 TBSP lemon juice

1/3 cup rice wine vinegar

*Mix all ingredients and mix in a blender or in a bowl with a whisk

Salad:

1 cup kale shredded

1 cup cabbage shredded

½ cup carrots shredded

½ tbsp toasted peanuts

1 cooked chicken breast

Instructions:

1) season and cook chicken

2) mix greens, carrots and dressing

3) top with nuts

4) slice chicken and place on salad

5) ENJOY

Scott Przymus is the Executive Chef at The Foundry Treatment Center Steamboat, a rehab and substance use disorder treatment center located in Steamboat Springs, Colorado.

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Compassion Fatigue and the Need for Trauma-Informed Legal Practice

When earning my doctorate at Florida State University, my faculty mentor asked me and a group of my peers to assist in preparing the first book on Compassion Fatigue. Dr. Charles Figley’s Compassion Fatigue: Coping with Secondary Traumatic Stress Disorder in Those Who Treat the Traumatized (1) was published in 1995. Since that time, compassion fatigue and helping helpers to maintain their health and job satisfaction has been a focus of my career. I have trained many groups of helping professionals to better understand the relationship between burnout and secondary trauma and to look inward at the emotional and physical cost of working with traumatized clients in stressful situations.  

Since 1995, recognition of the significant incidence of trauma in clients and families who seek assistance has magnified the importance of working within a trauma-informed culture where employee and organizational health, compassion fatigue, self-care, and honest organizational assessment are necessary. Over the years, I have wondered if other professions are starting to adopt similar trauma-informed practice.  

My son Patrick is an attorney. Since passing the Bar in 2012, he has specialized in Workers Compensation and Personal Injury law. We have had many conversations about the rewards and struggles of working with clients who have experienced significant workplace injuries or serious and life threatening accidents. We have talked about the difficulty of working with clients who often present as controlling, hypervigilant, and who frequently respond to the legal process with frustration, anxiety, and emotional dysregulation.  

A little over a year ago, Patrick and his family moved to Florida. As he prepared to take the Florida Bar, he began to consider the impact of his work with traumatized clients. As he identified the emotional cost that he and many of his peers have incurred as a result of their work as lawyers, he began to identify ways that he could assist other attorneys who have also struggled in this regard. As we discussed his desire to assist others (2), we researched trauma as an issue within the practice of law. It quickly became evident that lawyers, bar associations, and law school faculty were beginning to investigate the concept of Trauma-Informed practice (3,4,5).  

Based on our findings it is clear that working with traumatized clients can impact every area of legal specialization. Personal injury attorneys assist clients who have experienced life-altering automobile accidents or work-related injuries. Civil litigators assist victims of violent crimes. Family lawyers assist victims of domestic violence and abuse. Veterans attorneys assist service members with combat-related struggles. Judges and other officers of the court are exposed to cases where testimony and other evidence requires almost constant emersion in traumatic material.  Legal professionals in each specialty spend hours interacting with traumatized clients, listen to emotional stories of traumatic events and reviewing graphic photos and medical records.  

The potential impact of trauma on legal professionals is significant and multifaceted. First, traumatized clients often present symptoms that challenge the legal team and its efforts to successfully represent their concerns. Traumatized clients typically enter the legal process with a strong need to feel safe. As the legal process is unfamiliar and potentially threatening, traumatized clients often enter the relationship with a need to be hypervigilant, to feel heard and believed, and in control of the process. Failure to recognize this need can result in distrust, manipulation, and conflict between the client and the legal team.  

Second, trauma memories are often fluid and can change over time. A client's inconsistent accounting of what happened during the event can make case conceptualization, completion of a thorough and accurate assessment, and preparation for deposition or trial difficult. As members of the legal team become frustrated, they may avoid interacting with clients, which creates even greater conflict and increased efforts on the part of the client to regain control of the situation.  

As caseloads build with traumatized clients, team members become more vulnerable to stress, burnout, and secondary trauma from their daily work responsibilities and client interactions. As a result, professionals can experience reduced job satisfaction and increased emotional consequences. In all helping professions these struggles can result in increased turnover, the desire to leave the profession, and increased problems with mental health and addiction issues. Recent research on turnover rates in law firms found that 44% of new associates change firms within the first three years of practice. This turnover rate is estimated to cost firms over $9 billion annually (6). Large numbers of attorneys are also leaving the profession. A 2014 report (7) stated that 24% of attorneys who were licensed in 2000 were no longer practicing law in 2012.  

Addiction and mental health struggles are also evident in the legal profession. A 2016 survey (8) of 12,825 attorneys found that 20.6% screened positive for "hazardous, harmful, and potentially alcohol-dependent drinking." In this same survey, 28% of the respondents reported depression, 19% reported anxiety, and 23% reported significant levels of stress in the work environment. Issues associated with addiction and mental health struggles have implications that go beyond the attorney’s wellbeing. Attorney impairment is not a mitigating circumstance for failing to provide clients with appropriate representation (9).  

All of these issues are not directly associated with working with traumatized clients, but the importance of these growing concerns should be carefully considered!  

Recommendations for law firms and County, State and Federal courts:  1.   Accept the reality that trauma and frequent interaction with traumatized clients can harm outcomes, reduce work performance and job satisfaction of employees, and create emotional and behavioral consequences for employees and the organization as a whole. 2.   Work with a consultant to assess the impact of trauma, compassion fatigue, and organizational trauma on the overall health of the organization. 3.   Develop trauma-informed policies and procedures for working with all clients. 4.  Provide training for all employees on trauma, best practices for working with traumatized clients, and prevention of compassion fatigue, burnout, and secondary trauma. 5.  Provide resources for employees who are struggling with compassion fatigue, burnout, or secondary trauma, addiction and other mental health issues. These resources should include coaching, therapy, treatment and access to an Employee Assistance Program. It is also important to provide preventative opportunities for self-care, consistent utilization of PTO, etc.  

Recommendations for Law Schools: 1.    Provide training in trauma, best practices for working with traumatized clients, preventing and addressing compassion fatigue, burnout, and secondary trauma for all students.  2.    This training should be mandatory for all students regardless of the student's stated areas of interest.  

Recommendations for addiction professionals and other mental health professionals: 1.  It is critical to remember that working with attorneys and other legal professionals should include a thorough trauma assessment, assessment of compassion fatigue, and burnout.  2.   It is important to remember that Trauma-Integrated Legal Practice is relatively new concept in most legal practices, courts, and governmental legal environments. Trauma education, including education on compassion fatigue (i.e., burnout and secondary trauma) is critical for attorneys to accept the serious impact of trauma in their work environment.  3.   From this perspective, all addiction and mental health treatment should be trauma-informed and trauma-integrated. Working with attorneys and legal professionals should be seen from the same perspective of working with other helping professionals (i.e., medical professionals, first responders, therapists, etc.).  

Special Thanks to Patrick Barnes, Esq. for providing input and feedback on this blog post. · For more information on Trauma-Informed Legal Practice, go to Wave of Change Coaching and Consulting, LLC (www.waveofchangecoaching.com).  

Footnotes 1     Figley, C. R. (1995). Compassion Fatigue: Coping with Secondary Traumatic Stress Disorder In Those Who Treat the Traumatized. Brunner/Mazel. New York: NY. 2     https://www.waveofchangecoach.com/ 3     https://www.lawcare.org.uk/news/lawyers-and-vicarious-trauma 4 https://www.lsc-sf.org/wp-content/uploads/2015/10/Article_Establishing-a-Trauma-Informed-Lawyer- Client-Relationship.pdf 5 https://www.aals.org/wp-content/uploads/2015/06/Katz-Haldar.pdf 6 https://www.attorneyatwork.com/confronting-lawyer-turnover-in-law-firms/ 7     http://www.abajournal.com/magazine/article/after_the_jd_study_shows_many_leave_law_practice 8    Krill, P. R., Johnson, B. R., & Albert, L. (2016). The Prevalence of Substance Use and Other Mental Health Concerns Among American Attorneys. Journal of Addiction Medicine. January/February 2016, 10(1), 46-52. 9 https://www.lawpracticetoday.org/article/evaluating-impaired-attorneys/

Dr. Mike Barnes is the Chief Clinical Officer at the Foundry Treatment Center Steamboat, a rehab and substance use disorder treatment center located in Steamboat Springs, Colorado.

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The man who taught me to fly-fish said something our last time on the water together before he died that I have always remembered; “it’s all a big circle” he told me with a smile as I was bragging about the day I’d had fishing versus his.

Dr. Barnes was walking out of the Foundry office this morning as I was parking to go in and I laughed a little remembering those words, it’s all a big circle. I was walking into an office next door to Dr. Barnes, again. We had the same setup working together at CeDAR a few years back, and sharing/problem-solving/listening/laughing with him in the morning is well-practiced and something I have missed. I didn’t expect to work inside of this field again but here I am and I’m here with some remarkable people.

After a few laughs and a few problems discussed/solved Dr. Barnes told me again why New Years day is his favorite day of the year. He talked about intentional practices he has to plan for improvement and growth in the new year and forward as well as refocused efforts in certain areas of self-improvement. He talked to me about how this is a time to reset and refocus, to break cycles…..

Working inside of the treatment and recovery world we often find ourselves straddling a line. On one side, it’s all a big circle, things will repeat and on the other, there is breaking a cycle and changing trajectory. This duality is something that I want to hold walking into 2020.

This year marks my 13th in the field. Ten years into my sobriety I had never imagined that my vocation would be tied to my recovery until I found myself sitting in Scott Strode’s living room trying to write policy and conduct codes for what would ultimately become The Phoenix. Back then this whole scene was totally new, I knew nothing of treatment other than the county mandated programs I was ordered to attend a decade earlier. For me, recovery from my own addiction came through the rooms of a 12-step community. In those early days at The Phoenix, we thought it would be cool to try to extend the sober community outside of church basements and into gyms, races, climbing crags, etc. The five years I spent doing that taught me a great deal about recovery and a little about treatment. We embedded inside of several programs and even helped our friends at West Pines build a gym with a great climbing wall that integrated what we did into their treatment program. I started to learn more about treatment working with and inside of programs and saw how different programs approached the same goal. Much of my job at Phoenix ended up focused on these relationships and programs and through this, I was able to spend real time inside of most of the programs that were in Colorado in those days (Harmony, CeDAR, Jaywalker, Raleigh House, West Pines, Arapahoe House, Stout Street, Parker Valley, and AIM House) building programs to integrate fitness and putting together events. I made good friends inside of those programs and am so grateful for all that they taught me about why they did what they did. Most of those leaders have moved on, retiring or taking smaller or larger roles, a few have passed away. Their knowledge and insight persist and I am proud to do my best now to contribute.

After The Phoenix and through my time at CeDAR (University of Colorado Hospital) where Steve Millette showed me how much I still had to learn about this field, I started to work more nationally and gained exposure to what Treatment looks like throughout the country and internationally. One of the most brilliant psychologists I have known, LaTisha Bader, used to say that CeDAR in those days was like Camelot, as good as it got. My last day there was exactly three years ago today, 12/31.

Since leaving CeDAR I have learned even more about how treatment works nationally. Building approved provider lists for professional sports leagues and teams as well as labor unions and consulting inside of a handful of programs outside of Colorado has taught me a great deal, as has working with local and state governments and agencies that they support. I have had a chance to go onsite and assess well over 100 of the finest (and not so fine) programs in the country and learned something on every visit.

In 2020, it is my hope and intention to help the Foundry Steamboat Springs to become an even better treatment program. I never considered working for a program again but have been drawn to this place and these people. They have a genuine desire to help and provide healing as well as a team in place that is equipped to do just that. While our footprint is small, a men’s only program in the mountains of Colorado, the idea is huge; We will demonstrate that the best of services can be provided in-network with insurance. With enough money, anyone can get comprehensive treatment but the reality is that replicating these services in a program that is insurance-based has been near impossible. To do so takes work, a good deal of work. It also means accepting much lower margins than are traditionally seen in this field but we are convinced that it can be done and are off to a strong start doing so.

Hopefully, I have helped to elaborate on why I find myself holding those two contrasting ideas; It’s all a circle and dramatic change is possible. My hope is to draw on the knowledge and experience that exists collectively inside of the treatment world to help those we serve to find new and hope-filled lives.

I have already learned so much in this role as CEO and know that 2020 will both teach and humble me further as I look for these opportunities. May your 2020 see you both enjoying the circle and embracing the change.

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Ben Cort is the Chief Executive Officer at the Foundry Treatment Center Steamboat, a rehab and substance use disorder treatment center located in Steamboat Springs, Colorado.

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Season’s greetings from the Foundry clinical team! In a recent conversation with a friend, he asked me to pick my favorite holiday. I quickly responded, “New Year’s Day!” My answer comes from my annual practice of taking time to reflect on the past twelve months. Within that process, I stop to take stock of our program's wins, losses, and lessons learned.

What jumps out at me is how much our program has evolved and grown since the start of the year. Every aspect of our program has been assessed and updated:

• We have clarified our developmental model that more consistently allows clients to focus on addiction recovery, while simultaneously addressing issues of safety, autonomic nervous system dysregulation, and resolution of active trauma symptoms. Within this process, clients focus on connecting to others, trust, and attunement to needs that enhance their likelihood of embracing the fellowship of 12 step and other social support networks.
• We have expanded our trauma awareness and clinical focus to include work across the trauma continuum. This expansion allows us to help clients who are struggling with PTSD, Developmental/Complex Trauma, and the Primary and Secondary trauma that is experienced by family members.
• We have expanded our use of EMDR to include the DeTUR model for reducing the impact of addiction triggers and cravings. We have also introduced Brainspotting, somatic psychotherapy, and John Bruna’s Mindfulness in Recovery program.
• We made improvements to our Partial-Hospital (PHP), which has grown to include an 8 bed, community-based sober living unit, where participants live in a townhouse in Steamboat Springs and receive clinical services at the Ranch. Each participant is able to maintain their relationship with their primary therapist and continue to work on developmentally appropriate treatment plan objectives.
• We also improved the Equine Therapy Program so that it is now fully on-sight and provided to all participants in our Residential and PHP levels of care.

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2020 will be another year of growth and development for the Foundry clinical program. We are currently developing a 90-day trauma integrated addiction program and a new multidisciplinary family program. The 90 days program will provide participants with increased integration as they move through various levels of care and into increased community participation. The family program will incorporate onsite service, in conjunction with remote educational and clinical activities that will be provided via computer. This integrated family program will allow us to promote family healing for the families of all of our clients, whether they are in Steamboat Springs, the Front Range, or across the country!

We want to thank all of our friends and referral resources for their support and the confidence that you have shown in our staff and clinical program throughout 2019! We hope that 2020 is a great year for you and for everyone who gives so much to the clients and families that we serve!

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Check out the Heavyweight podcast featuring our very own Chief Operations Officer, Scott Kindel, as he shares his remarkable journey from addiction to recovery—including a valuable missing piece of his family's history. About the podcast: Heavyweight is a Gimlet Media production that explores a moment from a person's past that they wish they could change.

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Release date: October 23, 2019

Listen now ➝

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