Surviving, Learning and Growing During COVID-19 and Beyond

www.santecenter.com

May 2020

800.258.4250

Intensive Outpatient Treatment Program Team - Primary Therapists

Santé Center for Healing

(L-R) Jordan Wolfe , M.S., LCDC, LPC-Intern, Supervised by Dr. Jason Doorish LPC-S, CSAT; Ryan Holland , MS, NCC, LPC-Intern, Supervised by Michael Webb, LPC-S, Denny Taylor , MS, LPC

Confiding with Transparency

Step Five

“Admitted to God, to ourselves, and to another human being the exact nature of our wrongs.”

You can be forgiven for your flaws. You can also forgive others of theirs. Step Five is about letting go of ego and sharing our character defects and wrong doing with our higher power and another person. This is a way to learn and grow from past mistakes and to unburden oneself to someone who will not judge. Being able to face inwardly and process all of your wrongs is not an easy feat; you must have a strong support system to lean on, to confide in, and celebrate the cathartic freedom of bringing all of one’s wrongs to light. To practice transparency by acknowledging details of your wrong doings helps ease isolation’s hurts. Many working the steps for the first time experience the cumulative effects of active addiction’s years of isolation and loneliness.

“As the pain subsides, a healing tranquility takes its place. And when humility and serenity are so combined, something else of great moment is apt to occur.” Twelve Steps and Twelve Traditions, Alcoholics Anonymous World Services.

Posttraumatic Growth: Teaching Clients to Look for It

There is much said about Posttraumatic Stress Disorder and the way that our traumas can significantly harm us. In a season with collective experienced trauma, could we also pay attention to how some of our trauma experiences can grow us? Traumas can, like a forge, temper us, make us stronger and more resilient in the face of future stressors.¹ Post-traumatic growth (PTG) equips us with strength, increased awareness, and better coping skills than before the trauma. PTG is defined as positive psychological change experienced as a result of adversity and other challenges in order to rise to a higher level of functioning.²

What’s the difference between PTG and resilience? Are they indistinguishable? Resilience is when someone is able to bounce back after a trauma; the resilient person is able to more easily rebound after a trauma because the trauma didn’t affect them to point of questioning their core beliefs. PTG is when someone finds it is difficult to bounce back, but is still able to work to achieve growth after a trauma. Several factors can depend on how much or if someone experiences PTG.³ There is a PTG Inventory that is used to measure growth. It looks for positive responses in five areas:

Appreciation of life
Relationships with others
New possibilities in life
Personal strength
Spiritual change³

“I see Posttraumatic Growth every single day at Santé. It is something that I am honored to witness and point out to my clients,” says Ashley Whitted, M.S., LCDC, LPC-Intern, Supervised by Steve Tryling, LPC-S, LCDC, CSAT, Primary Therapist at Santé Center for Healing. The clients at Santé work with their Primary Therapists to learn their strength and adaptability to grow in ways they previously may have found impossible due to chronic or a specific trauma.

The COVID-19 pandemic and ensuing economic downturn has negatively affected many people’s mental health and is creating trauma experiences for a variety of individuals. A recent poll by the Kaiser Family Foundation (KFF) found that nearly half (45%) of adults in the United States reported that their mental health has been negatively impacted due to worry and stress over the virus.⁴ In the coming weeks and months, as people seek professional clinical help with their traumas and struggles, we look for the opportunity to help them see, experience and achieve PTG.

1. Ashley Whitted, M.S., LCDC, LPC-Intern, Supervised by Steve Tryling, LPC-S, LCDC, CSAT, Primary Therapist at Santé Center for Healing

2. Psychology Today. Adena Bank Lees, LCSW. (2019, April 18). “Posttraumatic Growth: There can be positive change after adversity.” Retrieved from https://www.psychologytoday.com/us/blog/surviving-thriving/201904/posttraumatic-growth on 2020, May 11.

3. APA. Lorna Collier (2016, November, Vol 47, No. 10, Page 48) “Growth After Trauma: Why some people more resilient than others – and can it be taught?” Retrieved from https://www.apa.org/monitor/2016/11/growth-trauma on 2020, May 11.

4. 1. KFF. Nirmita Panchal, Rabah Kamal, Kendal Orgera, Cynthia Cox, Rachel Garfield, Liz Hamel, Cailey Muñana, and Priya Chidambaram. The Implications of COVID-19 for Mental Health and Substance Use – Issue Brief – 9440. Retrieved from https://www.kff.org/coronavirus-covid-19/issue-brief/the-implications-of-covid-19-for-mental-health-and-substance-use/ on 2020, May 14

Santé’s intensive outpatient treatment program (IOP) provides real-world exposure, along with critical ongoing structure and support. Each client meets with their masters level primary therapist, who will identify and addr ess treatment goals, provide individual therapy and assist the client throughout their 16 valuable and formative weeks in IOP. During this time of COVID-19 Santé's IOP has gone vitural via Zoom. "We’ve had a seamless transition from in-person sessions which is a credit to both team members and flexibility from patients and their families," says Adam Karazuba, MSW, LMSW, Santé's Director of Outpatient Programming.

A study published by National Council on Alcoholism and Drug Dependence (NCADD) offers evidence that longer term treatment equates to better overall addiction recovery and quality of life results. A residential level of care needs to be a first step on a journey like Santé’s long-term, recovery continuum of care where can transition from a residential setting into a more “in life” treatment approach.

“Sante’s IOP and TL program provided a safe place for me to go after inpatient. After leaving a secure environment like inpatient trying to achieve sobriety “on my own” in the real world would have been too daunting without the support I had put in place. After putting so much effort into recovery during inpatient, it would have hurt me immensely to skip out on IOP and TL and risk a relapse. Even though I wanted to put the past behind me and continue on living my life as I was before I got sober, I knew this was impossible. Going to IOP and TL provided me the best opportunity possible to achieve long-term sobriety.” – Marni, Santé Alumni

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Impact of COVID-19 on Individuals with a Substance Use Disorder

Headlines scream continuously about COVID-19 – the number of cases, unemployment rates, vaccine progress, etc. Included in those headlines are stories focusing on the vulnerable populations affected by COVID-19. Among those in that population are people with a Substance Use Disorder (SUD). These individuals and their families, friends, colleagues and neighbors are a significant part of your readership/viewership/listeners; addiction now impacts 1 in 3 households in America, claims a life every four minutes, costs our country $442 billion each year, and is stealing a generation.¹

The impact of COVID-19 on individuals with a SUD can be seen in several different ways. One is directly on their health. Someone with SUD may have underlying health issues associated to their addiction that can make them especially susceptible to infection by the virus that causes COVID-19 and associated complications. Another is that due to the stigma that persistently follows individuals with SUD, those with the disease who develop COVID-19 may find it harder to get care. And those in recovery will also face unique challenges due to social distancing measures. The social isolation, stress and anxiety that many of us are feeling during this pandemic are risk factors for relapse.²

National statistics and facts about the impact of COVID-19 on those with a Substance Use Disorder:

At least 2 million persons in the United States have OUD [opioid use disorder], and more than 10 million misuse opioids; these individuals may be at increased risk for the most adverse consequences of COVID-19.²
In 2018, an estimated 21.2 million people aged 12 or older needed substance use treatment. This number translates to about 1 in 13 people who needed treatment.³ It is vital to fight the stigma that is largely based on the erroneous but persistent belief—widespread even among health care workers—that addiction is the result of weak character and poor choices, whereas science has clearly shown it to be a disorder arising from alterations in brain circuitry.²
Social support is crucial for persons trying to recover from SUD, whereas social isolation is a risk factor for relapse. Even though the social distancing measures being implemented nationwide are important for reducing disease transmission, they may be especially difficult for persons in recovery because they limit access to meetings of peer-support groups or other sources of social connection.² Relapse rates for drug use are similar to rates for other chronic medical illnesses. If people stop following their medical treatment plan, they are likely to relapse.⁴

“During this unprecedented season of the COVID-19 pandemic we have seen that more and more people are reaching out for help with their addiction and mental health struggles,” says Sam Slaton MEd, LPC-S MBA, MHSM, Chief Operating Officer at Santé Center for Healing. “The disease of addiction will not slow down and will always be something that we must diligently fight while keeping the health, safety, and long-term recovery of this vulnerable population our highest priority.”

1 Facing Addiction (now part of National Council on Alcohol & Drug Dependence)

2. Volkow ND. Collision of the COVID-19 and Addiction Epidemics. Ann Intern Med. 2020; [Epub ahead of print 2 April 2020]. doi: https://doi.org/10.7326/M20-1212

3. Key substance use and mental health indicators in the United States: Results from the 2018 National Survey on Drug Use and Health (HHS Publication No. PEP19‑5068, NSDUH Series H‑54)

4. NIDA. (2018, July 20). Drugs, Brains, and Behavior: The Science of Addiction. Retrieved from https://www.drugabuse.gov/publications/drugs-brains-behavior-science-addiction on 2020, May 5

Carl Goldman, Diamond Princess Cruise COVID-19 Survivor, sat down for an interview with Santé's own Lisa Marie Shaughnessy, Regional Marketing Specialist. Though Carl is not affiliated with Santé, he was eager to provide insights on what therapists could expect other COVID survivors to discuss. Click here to hear Carl share how he and his family and friends were impacted by COVID-19.

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August 7, 2020

Spectrum of Sexuality Summit

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August 12-14. 2020

Maintaing Proper Boundaries

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All dates are subject to change due to COVID-19. We will keep you updated.

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