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Inspiring Success on the Road to Recovery

Wednesday, October 4, 2017

The Power and Promise of Integrated Health Care

Terros Health inspires change for life by combining primary and behavioral health care

By DeEtte Person

Physical and mental health conditions used to be treated in silos. As a result, patients would see a doctor for one condition while another condition may have gone unnoticed. Today, that is beginning to change with organizations like Terros Health adopting behaviorally-led, integrated, whole health/whole person model of care.

The model is exactly what it implies – caring for the body and mind as one

The whole health/whole person model changes the paradigm of care by helping physicians and other clinicians uncover a patient’s source of pain and evaluate alternatives to prescription drugs like cognitive behavioral therapy and mindfulness-based stress reduction. Patients and physicians work in partnership to treat not just a single ailment, but toward overall better health, physically and mentally. If there are signs of mental health issues or addictions of any kind, those can be dealt with in the earliest stages before they take a greater toll on a person’s physical health. 

Behaviorally-led whole health/whole person care 

This was true for Nicole, her husband Martin and their children who receive primary and behavioral health services through Terros Health at 27th Avenue Integrated Care. Nicole, was the first family member to seek out Terros Health to address grief due to the death of her and Martin’s 3-year-old son. The counseling she received helped and she began to go to Terros Health for her primary health care, as well. 
Nicole encouraged Martin to give behaviorally-led integrated care a try. Today, the mental health care Martin receives has helped stabilize his depression and anxiety. He also receives excellent medical care for his diabetes. Their 20-year-old son Eric receives care from Terros Health’s behavioral health professionals. And, both Eric and 16-year-old daughter Mishelle are seeing primary care providers at Terros Health. Their older brother, Quinn, says he plans to reach out for his medical care. 
For Nicole, she values the convenience of having all aspects of the family’s health care managed from a single location, including prescription refills. Without Terros Health and its integrated approach, she feels her family wouldn’t be doing nearly as well. 
This success story is typical when integrated health care is implemented. By treating the whole person and weaving behavioral health into primary health care, even conditions such as diabetes and high blood pressure can have better outcomes. 

Terros Health primary integrated care services include same-day or ongoing medical services including physical exams, chronic disease management, nutritional coaching, immunizations, lab work and prescription pick-up, all in one centralized location.

Treating the mind, as well as the body

The “whole health” approach also provides support for body, mind and soul when there is a mental health issue. Terros Health treatment programs are designed to be culturally-responsive and to coordinate with your overall health care plan. The health care team will support you every step of the way as you make choices — positive changes — that will put you on the path to true health and wellness for life. This includes counseling, treatment groups, crises services, psychiatric evaluations and medication management. 

Karen experienced the whole health approach first-hand. As a child, Karen experienced sexual trauma in her family and again, at 19, when she was in the United States Naval Reserve (Women's Reserve). Since then, she has struggled with nightmares, anxiety and depression. Karen tried to reduce her painful symptoms of post-traumatic stress (PTS) with alcohol, a common way to try coping with PTS.

While working as an early childhood educator in Hong Kong from 2008 through 2012 — in that busy and crowded metropolis – Karen’s PTS symptoms became overwhelming. She was unable to continue working and returned home to Phoenix. But her symptoms didn’t lessen.

A Terros Health crisis counselor recognized Karen had a bi-polar disorder, in addition to the alcohol use and PTS. She was referred to the Terros Health McDowell LADDER (Life-Affirming Dual Diagnosis Education and Recovery) program, located at the McDowell Integrated Care center, which helps people with co-occurring serious mental illness and addiction challenges by providing therapeutic behavioral health treatment and counseling that focuses on symptom reduction and management. Karen credits her progress to the support and education she received that makes it possible to deal with two of her issues at the same time. Today, she’s looking forward to returning to a position in early childhood education or becoming a peer support counselor to help others with similar challenges.

Optimizing health by treating addictions

Part of whole person care is regaining wellness by reducing alcohol, tobacco and other drug use, as well as risky sexual behaviors. Change can come in many forms — embracing new ideas, hobbies and healthy habits. At Terros Health, this involves counseling, detoxification, treatment and recovery support. In addition, one of the keys to success is engaging in life-affirming enrichment programs, such as life skills trainings and arts and cultural activities for youth and adults. 

Robert knows well the success that can come from the support of integrated health care.
Robert stands well over six feet tall, and has the powerful physique of a body builder. Yet, inside his muscular body is a frightened little boy who experienced beatings no child should ever have to endure. When he was four years old his father, an alcoholic, drug user, biker and drug dealer, repeatedly beat him so severely he left permanent scars on Robert’s forehead. When his mother and father split up, things did not get any better for Robert. His mother’s new partner also was an alcoholic, and harshly disciplined Robert for things like not quickly memorizing multiplication tables in first grade. 

In high school, Robert was free to rebel and rebelled badly, skipping school and using alcohol and pot. He dropped out of school and became, by his own definition, a “lazy pothead.” In his early twenties, things got little better for Robert. He got married, had a good job in a mill and limited his drug and alcohol use to weekends. But after four or five years, the marriage broke up because Robert started “using” more than just on weekends. Finally, the law caught up to him and he was sentenced to seven years in prison.

Robert remarried after he got out of prison, but he still needed treatment. He made the decision to become part of Terros Health’s Maverick House. There, he confronted his alcohol and drug addiction. And perhaps most importantly – for the first time – he came to terms with the violence he experienced as a child.

The day Robert graduated from treatment at Maverick House was the day he also decided to keep his recovery going by living at Maverick House Sober Living. At Sober Living, he has a healthy environment of 27 caring men committed to supporting each other and living positive lives without alcohol or drugs. Robert’s wife lives nearby and they have a positive relationship. But, Robert’s home — for now — is Sober Living, because that is where he has the structure and the fellowship of men committed to supporting each other in recovery.

Integrated care can provide key to treating an epidemic

Integrated health care creates healthy communities by providing welcoming “one stop shops” for the needs of a person’s mind and body. In turn, this leads to what is known in health care circles as the Triple Aim – an excellent customer experience, quality care outcomes and controlled health care costs.

A patient’s integrated health care team will include a primary medical care provider and may include mental health care providers, community health workers, a case manager, wellness/prevention coach and counselors. All elements of care are coordinated across the broader health care system including specialty care, hospitals, home health care, community services and other supports. The team works together to anticipate patients’ needs, communicate findings and to ensure no aspect slips through the cracks.

A good example of how integrated health care can heal an individual, family and even community is when it comes to the opioid epidemic. This dangerous class of drugs includes prescription pain relievers such as oxycodone and hydrocodone. You might have been prescribed these after a surgery, even one as minor as wisdom teeth removal. But did you know this same class of drugs also includes heroin? On the street, heroin is cheaper – hence the revival of heroin addiction, overdose and death. 
Opioids are destroying lives in cities and states throughout the nation. Arizona is no exception. Sadly, two people in our state died every day from prescription opioid or heroin overdoses last year. All told, opioid overdoses claimed the lives of 790 Arizonans in 2016 – a 74 percent increase since 2012.

If you or anyone in your family has been prescribed these medications, talk to your physician about precautions to take. Following an integrated health model like that adopted by Terros Health can help doctors identify the signs of drug use and abuse in their early stages – signs such as drowsiness or sedation, slurred speech, uncharacteristic problems with attention and memory and constricted pupils. 

If you would like experience to experience the transformative power of integrated health care, or if you need mental health or addiction care services, please call Terros Health at 602-685-6000. www.terros.org

DeEtte Person is a freelance writer living in Scottsdale, Arizona

Recovery Month and Unknown Soldiers

By Tracy Smith

This recovery month was a bit strange for me. You see last year my calendar was full of events and rallies that I often traveled to and attended. This year I took a backseat and instead, in a different role of advocacy, I worked long hours with clients and organizations to place speakers throughout the country to inspire change.

I missed the PRO-ACT walk and the SAMHSA Press Club and Luncheon, and other key events that I would have really liked to attend— but the conversations, emails and voice mails I received reminded me there are all different positions in a marching army of advocacy. I realized from listening to these calls and messages — that the impact of my new role — to sit quietly and put new captains out front — was not only the right strategy — it was exactly as all was meant to be and incredibly satisfying. 

Yes, I realized, I'm exactly where I'm supposed to be.

It also made me reflect and realize advocacy can be done in so many different ways. There are individuals quietly writing letters and making phone calls who you never see on social media but they're out there and they care. There are socially responsible businesses that donate and support important causes and host speakers to educate their audiences. There are individuals writing and developing new training to assist those in recovery. In a remote part of the country, in a quiet community there are meetings around a kitchen table discussing better supports and programs for individuals. There are counselors who go late into the night motivating another on a call they chose to answer. So many quiet foot soldiers we may never ever see or hear are doing amazing work along side loud captains who are very visible.

To our army marching along, loud or quiet, known or unknown — I want to thank you all for your efforts to promote recovery and understanding! Remember, we are all in this together — to inspire change!

Tracy Smith is a Public Speaker. She is the Founder and Owner of a national speaker bureau dedicated to inspiring change. Her agency, Speakers for Change, offers a roster of social responsibility. If you would like to hear more about solutions to the current opioid and prescription drug epidemic from impactful speakers who understand the power of their words and want to inspire change, please contact tracy@speakersforchange.org

Drug-sniffing dog helps families learn if loved ones are using drugs

Amy Halm believes the road to recovery starts with discovery.

Halm is a K-9 handler by trade.

She started Desert Drug Dog roughly 8 years ago in Chandler after adopting a retired narcotics police dog. It’s a unique business that offers sniffing snouts in a private and discrete manner.
"I would love to lose this job because there's no need, but there is a big need," Halm said. 

We put Amy and handler Hannah Arendall to the test.
Cottons balls soaked with the scent of drugs across an 800 square foot apartment were hidden. Amy then took Caela, a Belgian Malinois, across the apartment. In 20 minutes, all three drug scents were found.
“People actually get so creative that they take apart machines," said Arendall.

Halm brings dogs like Caela to homes, shelters, schools and recovery centers.

Both Scottsdale Recovery and Community Bridges utilize Halm’s business. Unfortunately, Halm is also going to homes where the users are often teens.
She had the following advice for parents: "Help them learn coping skills because what I see are people are using drugs because they don't know how else to cope with things in their life."
She also recommended that parents visit online and in-person resources to seek out help. (source ABC 15 Arizona, Chris Gros)

About Desert Drug Dog

A confidential drug detection service working with schools, treatment centers, businesses, and families throughout Arizona.

Their professionally trained teams work with schools, treatment centers, businesses and private parties throughout the state of Arizona, providing you with one more tool in your toolbox to prevent, detect and deter the use and abuse of drugs. 

To learn more about how Desert Drug Dog can support your current efforts to maintain a drug-free environment call 602-908-2042 and visit http://desertdrugdog.com/

Valley Hospital's New Freedom Care Outpatient Program

Freedom Care offers comprehensive, evidence-based treatment for those experiencing substance use, abuse or dependence, depression, military sexual trauma, combat-induced PTSD/trauma, military-related chronic pain or co-occurring mental health and substance abuse disorders.

These programs include PHP and IOP Program for First Responders, Active Duty Service Members, Retirees and Veterans

The PHP is daily, Monday-Friday from 9:00 a.m.-2:00 p.m. and IOP is offered thee days a week from 9:00 a.m. until noon. Additional Adult Programs are available. To learn more call or text Kenny Flack (Freedom Care Community Liaison) at 602-292-6757 for any questions on how to enroll.

Valley Hospital is built on three core principles: outstanding care, compassionate people and unparalleled service. Valley Hospital is located in Phoenix at 3550 E. Pinchot Ave. www.valleyhospital-phoenix.com.

6 Things to Do Before Your Kid Comes Home from Treatment

By Mary Ann Badenoch

The day has finally arrived to welcome your child is back from residential treatment. You may be cautiously optimistic for the homecoming — or worried how it will go. You may not feel ready for your child to come home yet, remembering those feelings of walking on eggshells when they were last home struggling with their addiction. These feelings are completely normal and you may even be experiencing them simultaneously.
You and your child are about to enter a new phase in a long process of recovery. It will involve sacrifice for the family, and it’s best to talk about what this will mean for everyone and plan for it. While you cannot control what will happen (your child is ultimately responsible for their own recovery), you can be proactive and better prepared to be supportive in your child’s recovery.

1. Time for a housecleaning.
Take all substances and paraphernalia out of your home. Secure all alcohol or remove it completely. Lock the medicine cabinet and dispose of any old or unused prescriptions. Search your child’s room for drugs, alcohol and paraphernalia — and then search it again.

2. Naloxone as a prevention measure.
If your child’s substance use included opioids (heroin and pain medications like Vicodin, OxyContin and Percocet), have you obtained a Naloxone kit? Naloxone (brand name Narcan) can reverse an overdose, potentially saving a life. It’s never the wrong choice to be safe. In many states, chain drugstores, as well as some independent drugstores, are providing naloxone through their pharmacies without requiring a prescription. Is the kit easily accessible in your home? Have you learned how to use the Naloxone kit?

3. Make the aftercare plan a priority.
The first step is to fully understand what the treatment facility is recommending for the next steps and clarify anything that is unclear or concerning to you. Hopefully, you and your family were part of developing this “aftercare,” “discharge,” “continuing care” or “stepdown” plan — the plan for those next steps after treatment.
Aftercare plans may include the following:

  • Family counseling
  • An outpatient program
  • Recovery support groups
  • Psychiatric appointments
  • Ongoing psychiatric medications, and/or medication-assisted treatment

Things to consider

Is your child going to need a ride to and from an outpatient program, counseling or support groups? Since this is vital to their recovery, if transportation is needed, make arrangements ahead of time with your employer or hire someone to drive them to appointments, programs or meetings. You may need to make plans to take time off from work to attend family meetings which are a part of your child’s aftercare program. Continued involvement matters.

Your child may need help in finding healthy friends and activities, given many of their friends are likely still using substances.

If your child is living in sober housing, an Intensive Outpatient Program (IOP) or whatever the step down plan is, become familiar with the requirements and rules for this type of living community.

Even though your son or daughter is the one receiving treatment, the rest of the family will greatly benefit from regular counseling and support groups of their own. This can be a difficult time of transition and it’s critical everyone is supported, has help coping and addressing any issues that come up.

4. Try CRAFT skills to improve communications in your family.
Community Reinforcement and Family Training, or CRAFT, is a scientifically proven approach to help parents with skills to stay involved in their child’s recovery in a positive, ongoing way. CRAFT provides families with tools to better understand your child’s reasons for substance use, ways to improve communication and to reward non-using behaviors while discouraging substance use. Equally important are the tools around self-care to handle negative emotions like anger, guilt, depression, and to address feelings of isolation.

5. Develop a contract and recovery plan
You’ll want to establish some boundaries and rules with your child. Some families find it helpful to develop a contract including both positive reinforcement or rewards for good behavior and consequences when they push boundaries or break the rules.
In addition to a contract that simply states what is expected, create a Recovery Plan. A Recovery Plan is for both you and child to put down in writing what you both agree to do (or not do) to help support and maintain continued recovery and personal growth.
Plan to sit down during a calm time soon after they get home to develop a plan as a family. Here are some questions to ask your child as you develop your plan:
How can I be helpful?
What would be stressful or unhelpful for you?
Can we agree on what will be discussed and what won’t?
Can we talk about how we will communicate with each other in both easy and difficult situations?
Would you prefer to keep your treatment and recovery private from others outside our family?
If you are willing to talk about it, with whom and how much information will you provide?

Are there upcoming family gatherings where alcohol will be served that might be too difficult or be triggers? Decide as a family if you will decline an invite or attend with a plan in mind to protect your child’s recovery first. Can you think of fun activities to do together as a family? After all, your son or daughter may need to stay away from the friends they were hanging around before they went to treatment.

6. Take it one day — perhaps one minute — at a time.
The first few weeks and months of recovery will probably be the hardest. Your son or daughter will most likely go through periods of emotional ups and downs. They may be angry at times (at him/herself, at you, at others, or just angry), sad at other times, or even may seem manipulative or distant.

Other times they may be grateful and more like the person you used to know — savor those moments! Be sure to point out any and all positives, and offer hope and compassion. There isn’t a “one size fits all” road map to recovery.

Never give up. There is hope.

Stigma within a Stigma

 By Renee Sieradski, EA

My husband was diagnosed with bipolar disorder after we had been married for 8 years. When I told others I found their reactions unsettling. Most had a deer in headlights look. Why the surprised and embarrassed response?
"The stigma of mental illness" is what I read online.

The dictionary defines stigma as "bad reputation, shameful, mark of disgrace." But I would reason, “My husband became ill, he didn't choose to have the disorder, so I couldn't understand why my friends didn't want me to talk about it. His father and brother had the same diagnosis. It would seem it was in his genes. So why would he be in disgrace?

Soon after his diagnosis, we found that medications weren’t working. The psychiatrists tried every medication on the list. Nothing fixed his suffering. He was given a special term, refractory bipolar, meaning he didn't respond to conventional methods. Then, something I had never heard of was suggested to us- ECT shock treatment

We went ahead with the treatment.  When I told my friends their jaws dropped in horror, with comments such as, "I didn't know they did that anymore". I discovered here was another stigma for receiving this treatment.

Since the initial course of shock treatment in 2010, he has had 4 series of maintenance ECT treatments. As I write this article, he is currently undergoing a series of ECT's. So, I am again reminded of the surprised reactions I received years ago.

We are stigmatized for talking about having mental illnesses and stigmatized for receiving the necessary treatment for these illnesses.

I've decided if someone asks where he is, why he's missing from church or social events, I will simply say he is having therapy to help with depression. Unfortunately saying the words depression or the blues is easier for society to handle.

What exactly does “pennies on the dollar” refer to? 

Pennies on the dollar is a reference to the IRS Offer in Compromise program. It allows eligible tax debtors to pay the IRS an amount of money that is less than what they owe in order to wipe out the entire tax liability.

In advertising, you’ll hear companies talk about settling for 20%, 10%, or even less. These ads, and the sales people you talk to on the phone, are trying to sell you an Offer in Compromise service package. Many of their web sites even have interactive calculators where you type in how much you owe the IRS, and it’ll spit out a, “You may only have to pay $xxx” message.

The phrase “pennies on the dollar” was actually determined several years ago by the IRS to be a form of deceptive advertising. They explicitly instruct licensed practitioners the use of this phrase is a violation of ethics. However, since the IRS doesn’t have jurisdiction over firms market these services, it comes into the FTC’s purview to look out for these deceptive marketing practices.

Sales people are trying to convince taxpayers that what you settle for is some fixed percentage of your tax debt. However, this is blatantly incorrect. There is absolutely no provision in the tax code for allowing a taxpayer to pay a set percentage of their tax liability and calling it good. It has never existed, and most likely never will.

Instead, the amount of your Offer in Compromise settlement is calculated using a very, very strict formula…and the formula is NOT a secret — it’s available on a worksheet in IRS publication 656B.
Based on this formula, if you have equity in assets that exceeds your tax debt, you simply don’t qualify. Period. End of story. For most individuals, the common thing is going to be equity in a homee or rental properties, equity in a collection of classic cars, stamps, coins, guns, art, etc. If the value of ANY of those assets is greater than your tax debt, you do not qualify for the Offer in Compromise program and cannot settle for “pennies on the dollar” – there is no way around this.
In the same vein, if you are a high-income earner, it’s also highly unlikely you will qualify for the Offer in Compromise program. The reason for this is the IRS only allows certain amounts of money every month as “eligible expenses” for housing, cars, food, etc. If your lifestyle exceeds these amounts, the IRS doesn’t care — they will only allow you to claim the National Standard expenses.

Any monthly income over those amounts goes into your offer amount.
In these circumstances, you may qualify for a period of up to 12 months to make a “lifestyle adjustment” and reduce your living expenses to come into line with IRS standards. This will often involve selling luxury homes and getting rid of toys such as cars or boats. Keep in mind these items are all covered by your tax lien, so any proceeds from the sale of these items technically is owned by the IRS, and should be paid to them. A good tax representative, such as a Federally Licensed EA, can assist you with structuring these sales so both you and the IRS get something out of it.

Beware of anybody promising your tax debt can be settled for some fixed percentage of the debt. That’s not the way it works, and it never has. Anybody trying to sell you on that idea is selling you swampland in Florida, and you should seek assistance elsewhere.

Renee Sieradski is a Tax Specialist, for information and to set up a consultation visit www.tax-intervention.com or call 602-687-9768.

Two Days Ago

By Barbara Nicholson-Brown

I was going to begin this piece about the magic of recovery month we celebrated just a few weeks ago. And suddenly life as we knew it drastically changed— again. We learned of the mass shooting in Las Vegas just two days ago.

For all of us it is a most horrific and incomprehensible act. I can’t even imagine how undeniably painful this time is for the victims, their friends and families.

May our prayers and hearts filled with compassion reach each and every one who has been shattered and affected. I am, like all of us, at a loss for words.

Thank You to the first responder's, doctors, nurses, paramedics, concert-goers who helped each other, the unknown heroes who may have saved lives

And it is difficult to seque into another topic, but I will do my best.

Recovery Month

As founder of the Art of Recovery Expo, I want to thank each and every supporter of this year’s event. The recovery community came out strong and proud.

As I look back to 2005, when Bill and I thought a public event was needed, and to see how it has grown, locally and nationally, is powerful.

We have witnessed tremendous growth in awareness and advocacy, reduction in stigma and more people are seeking help.

While looking for addiction treatment might appear easier with the click of a mouse, the Expo continues to be a unique avenue where people can meet the professionals face to face. And that in itself is something that I am proud of. There were many serendipitous moments on September 16th.

A special note of gratitude to our leading sponsors, CBI., Inc., Terros, Calvary Healing Center, Mercy Maricopa Integrated Care, Mercy Care Plan and Holistic Recovery Center.

Our Bronze Sponsors, Decision Point Center, Dr. Phil Path to Recovery, The River Source, Intensive Treatment Systems, Crossroads, Inc., KFNX News Talk Radio, NCADD, PCS- Psychological Counseling Services, Scottsdale Recovery Center and Teen Challenge of Arizona.

And for making this event the success it was, my gratitude to Austin Eubanks, Stephanie Siete, Jim Kreitler, Gary Hees, David Seymour, Angie Geren, Gwen Henderson, SAMSHA and many many more.

My heart is full.

Continue to be safe! Stay on this wonderful road of recovery with us.