Episode 25

all right hello again everybody and welcome back to another exciting episode of finding peaks so exciting um i missed you guys yeah it’s been a minute i don’t miss you guys yeah absolutely i miss the viewers i don’t like taking this week off it makes me feel left out so i like to come back with just a ton of energy absolutely i can feel it it’s permeating the room yeah good yeah have you noticed our new mugs new mugs everybody yeah these are pretty big deal all right relatively funny jason friesma chief clinical officer joining us today chief operating officer clint nicholson both lpc’s licensed professional counselors kind of a big deal philosopher anyways


uh in that regard um so today we want to talk a little bit about this notion of holistic care and to launch into this i i think i reviewed it in our in our last or the last episode that i was on that you know uh peak’s mission is to save lives but our vision at peak’s recovery is to disrupt an industry through quality of care and uh to the point of holistic care i think i intend today to disrupt this notion this internet word that is on so many addiction treatment center websites uh in that regard and it’s a challenging word for a variety of different reasons and you know charitably speaking to it i think it’s important to treat the whole individual mind body and soul to approach the individual as an individual and not as an object like all other people within any given setting addiction treatment mental health or otherwise but it’s to me just an internet word it doesn’t have a lot of oomph within side behavioral health addiction treatment mental health centers and so forth so i think we’ll start uh off the bat here with a a firm definition of what we’re talking about and i think clinton yeah oh yeah going first going first this is this is new territory for me so um so what i learned in grad school is the idea of holistic treatment or holistic therapy comes from the idea that people do not exist in a void right like we are our symptoms our issues our triggers do not happen outside of an environment but they happen within an environment and oftentimes because of the environment so there’s this idea that when you are delivering services and providing clinical therapy that you have to treat the person within a context rather than outside of a context so you can’t just simply say oh you’re experiencing this one symptom we’ll just get rid of the symptom and then you’ll be tre and then you’ll be cured it’s the idea that the symptom actually has a trigger within an environment so we have to look at the trigger outside of the symptom and the context in which that trigger occurs and then also the context in which why in which ways the environment impacts the perception of the trigger and so it starts to get pretty big pretty quickly and i think the initial i mean so counselors work under this holistic model of therapy versus the medical model of therapy and i think that and it sounds great right like there’s this really wonderful power and energy behind it that oh yeah we’re going to do this holistically and we’re going to treat the whole person and it’s going to be a mind-body soul thing and also how do we do that right like because you’re still in therapy right you’re still in treatment and i i i guess i from from my perspective um i wonder how well we’ve actually integrated holistic therapy and how much we’ve really pushed and developed intervention strategies that support this idea that we treat people holistically so i think that there’s a lot of it’s become more of an internet word a buzzword than an actual practice in a lot of ways and it’s something that people can just say that oh i do that but you don’t actually do that so you believe that you do that but doing it is something different right and and i mean going back to the last episode that i was on as well too with christian and uh you know going over utilization review i’ve never heard an insurance company turn to a treatment center and say are you providing holistic care you know they’re focused on biomedical conditions and all of these other sort of words that we use you know to promote um continuation within treatment episodes but the word holistic uh you know and i’m of course making a terrible joke here about how insurances aren’t talking about or speaking to such strategies in that regard um so you know from your perspective jason i believe too it is a buzzword and just kind of curious you know from maybe the first time you heard it to where we’re at is sort of an industry um best charitable reading of the word yeah that’s a great question i i think the piece that um i would be really curious about or that i would ask families to to challenge uh programs that say they’re holistic is just ask a program to define what that means like what does that word mean because i i do think of uh as as you were talking clinton i think of like food labels saying all natural and it might be full of sugar right but it’s natural sugar so it’s all natural well that that doesn’t say it’s all natural doesn’t mean it’s necessarily healthy and i think saying something is holistic doesn’t necessarily mean that that treatment is good like what is holistic mean and i think that’s what we’re referring to as well that there isn’t kind of a general agreed-upon definition of what holistic care is so it’s just really easy to drop it on a website or on a commercial or something and say we offer holistic care okay how yeah in what way yeah and that’s the key right there yeah it’s it’s not the it’s not the what we do it’s the how do we do it like how do you actually provide holistic care and in what way in what ways do your does your specific treatment or curriculum or program actually genuinely and authentically address the sort of whole person because it’s great to think like oh well you know we talk about the mind we talk about the body and then we talk about the soul but that’s still just talking right like there’s nothing it’s understanding that the person is dynamic but the treatment has not necessarily reflecting the fact that the person is dynamic so i think that we’ve gone we got the idea right and then we never actually developed anything to to give it some real gusto so yeah um maybe even just poor philosophy at the end of the day


already but the vast majority of addiction treatment services are also and mental health services are rendered in a group setting and whether it’s residential treatment or partial hospitalization i mean that’s four to six hours of therapy inside a group setting you know downward pressure from insurance in that regard if even if it’s in intensive outpatient iop setting in that regard that’s three hours you know with anywhere from you know in the state of colorado i think the limit is 12 that you can have at any given time in a group but let’s say there’s eight to 12 people in a group and the vast majority of treatment is being provided through that modality then it just seems a little silly to be calling things holistic at that point because you know now we’re now we’re treating a group and though each individual is dynamic within that group it’s not clear to me how we arrive at a holistic approach or how we could insert um holistic care within such a setting over the course of 35 to 40 hours of therapeutic interventions throughout a week i mean i think that there’s a maybe a bit of irony to to what holistic means at least from my perspective it’s actually i think the best type of holistic treatment is to actually take people out of treatment and put them back in the world right to me that’s where the only way you can be holistic is if you go back if you you go outside of the sort of confines of that of that therapeutic safety and you go back into the world in which whatever condition that’s presenting is actually occurring because if you’re not in that world then i don’t know that you can be holistic i think that you can speak holistically and you can i don’t i don’t know like philosophize about it like um maybe really effectively but unless again it’s where if you’re that’s but that’s really speaking and doing therapy within the void right it’s not allowing people to experience and engage within the context that they’re actually that they actually are going to need to be practicing whatever they’re learning


and so i do feel like there is this maybe irony in this discussion that we’re kind of looking down our nose a little at this word called holistic and then i think about the services we offer at peaks and i’m not trying to necessarily make it a commercial about that but the things that we offer are our people are pretty remarkable from from the medical perspective um not just with medication but with tms the transcranial magnetic stimulation um is pretty innovative and cutting edge and uh you know from from an outside of the medical realm perspective like i’m watching it really have fast and dramatic impact on people’s mind and um the other thing that that we certainly offer is a lot of um ability for people to use their bodies at at peaks whether it’s through hiking or through uh crossfit or through um mma that were that we’ve recently added all in the context of building a community as well of people who are recovering and encouraging one another and then you throw on top of that this family our family programming that we’re offering three hours a week to our families outside of um care just over zoom to families all over the country to deal with kind of the you know at least some of the support systems and and possibly even um some stressors and to help families kind of reintegrate their loved one back into their their life like i think we do a pretty decent job of engaging people in this holistic way um and yet we are resistant to using that word because the word is somewhat meaningless in a lot of ways i don’t know right that was my thinking about it no i think that you’re right i think that it’s um i think about the mma portion right like that so we offer uh in our women’s program we offer them mma so they can go and do mixed martial arts and engage again in their bodies in uh as a as a means of sort of expression and processing but also it it there’s a level of social empowerment that’s involved in that as well and a sort of challenging of social norms that helps to begin to actualize individuals in a way that they when they go back into the environment actually changes the way in which they perceive the environment and it changes the way in which they interact with the environment so that becomes a very holistic a holistic intervention strategy even though it’s something that is not necessarily like cbt right or motivational interviewing but there’s a there is a actual behavioral cognitive behavioral transition that does take place in within a holistic setting and so i think that that’s actually a pretty good example of holistic treatment but it feels to just say oh yeah we just do holistic therapy seems so much more empty yeah and so maybe it’s just the word that is kind of played you know and it’s time to to come up with new concepts because um in the end it’s it’s not just about changing the individual but it’s about teaching the individual how to change the world around them as well so yeah one of the um i was doing some googling uh earlier today at work and i actually ran into an uh an abstract of a research paper that was talking about um you know treatment modalities and efficacy of treatment and so forth and it said one of the value propositions that adds to a treatment episode or that creates greater benefits for the individual participating in treatment was these enhanced features so one of the things of course that we do at peaks to ensure that an individual has the opportunity to arrive at treatment we so long as they’re local within the area of course we will go you know pick them up from their sober home in the absence of transportation and support them coming over and within this article that was an enhanced feature of treatment that promotes the individual’s wellness and supports them receiving those therapeutic interventions in a way that they otherwise wouldn’t receive um but holistic can’t mean enhanced right or is it or are we just playing on words here because in these articles they’re not talking about holistic care they’re talking about what feels like more ancillary features that provides or offers up a more extended view of care but you know if if these enhance you know if treatment is here and enhanced features bring us to here it still feels like we’re still inside this concept of holistic care sure holistic feels much bigger than yeah no i i think you say that in in my in the way that i perceive the world is somewhat pragmatic and i think that maybe that’s i think holistic care is actually very pragmatic you know we have that that word holistic is just like so ah like spiritual like i don’t know it seems like amorphous it’s kind of hard to like wrap your head around and in reality it’s like holistic care is like oh you need a ride right so we can do that right like let’s do that for you because it’s a barrier and we’re gonna so we’re gonna help you get through this barrier that’s in your like legitimately just in your life and so um maybe there is it’s uh maybe we’ve lost the pragmatism behind what it means to be right a holistic therapy a holistic care provider yeah so i mean because at the same time like a you know i i think anybody reading a website that says holistic care is thinking oh they’re going to provide transportation to iot and that’s a part of this right yeah right you guys are going to get us a bus pass that’s what that means yeah you know um and it’s not to take away from you know there are excellent treatment centers using this language on their website and so forth and i think they mean to say something like we care for the individual so much that we are going to think about and open the door to all of the things that are important to them mind body and soul you know spirituality really and the soul aspect of things and um you know one thing at a time we’re going to kind of you know work backwards and see what’s going on with the individual and what’s causing the frustrations and i think you know again too we’re dancing around the language of holistic care here with new language or or different language but there’s an essence to it that i feel like is just missing here and pragmatism you know the pragmatic approach about it is probably the truth of it right at the end of the day according to me yes we’re never gonna maybe achieve this concept of holistic care because we learned it in grad school maybe and then the industry or the profession or whatever just never you know came up with a pragmatic approach to make that a real thing that we could actually anchor into and rely on though um and you know uh and i guess ultimately too we’re talking about it because family members get on sites and they read those things and we’re trying to disrupt an industry and really just have the family i guess at the end of this really just ask good quest what does that mean yeah that you guys stated this and my daughter presents or you know son or whoever presents all of this uh these you know symptoms and how is this possibly going to be treated because i was listening to that finding peaks episode and brandon said 35 to 40 hours in a group setting kind of pulls on the notion of holistic care so yeah and it’s hard to and how do we disrupt the industry on that because certainly the thing that pops into my head when somebody says holistic i’m thinking incense yeah and uh the yoga yoga or the sunrise and the garden of gods in the background some sort of uh bell or chimes or whatever and like i and i think all those things are are awesome if they are directional and they are saying this but this is informing our mindfulness practice and and these are behavioral interventions that can help ground people um that’s what i think is probably the intention of the word back in the day right um and now you know and i do think so people may put these things out there without having that underlying intentionality around it and and i think to me if we want to get holistic back as a word there’s there should be some reasons and some intentionality to explain around that not just throwing stuff out there and calling it holistic do you guys think that it maybe came from or was brought into the literature of grad school because there were you know therapists or outpatient centers or whatever the case uh is as far as the facility or hospital is concerned that we’re just like doing everything under the gestalt lens or just stating we’re going to you know dr yalam it or we’re just going to have these single approaches to care and maybe we thought no we need to break away from these you know very direct services and really approach it through or maybe it’s more of just an intervention strategy right that we’re going to use cbt and dbt and mi and in uh you know trauma services and all these sort of things to promote the wellness of the individual i mean maybe that’s the well i mean this so the origin of the whole holistic movement it was really just something it was in response to them to the medical model which did sort of treat people at within a void right it’s like i identify a symptom i’m going to prescribe you a medication to alleviate that symptom and then that’s the treatment right rather than actually saying so what in the environment might actually be causing that symptom that we need to change the environment and not just treat the symptom right so i think that that’s where it all kind of initiated it was in response to the medical model and then i think it just got super incense-y like and it became something a um that was a great big idea and wrapped around the idea of person-centered therapy it’s like oh so we’re person-centered and we’re gonna be holistic so sit down on your chair and let’s talk and we’re gonna fix it and that that’s not the same thing so i think it the idea was there everything was great and then again we just lost the idea of well where’s the follow-through right yeah well it’s it’s it’s fascinating right if it was sort of a rejection of the pragmatic approach of the medical model right because then what we then we fully and embraced abstinence-based you know approaches to care which in and of itself is not holistic it is just a single path for individuals in that regard and then when we as an industry came forward and said well maybe there’s some efficacy of medication-assisted treatment for example and we said no you know abstinence-based so it seems like out of that though it was necessary to leave the pragmatic model of medical in the way that it was being viewed and to come up with this holistic way the therapeutic interventions there started rejecting the potential for new ideas and holistic care in the direction of those medications and i just think that’s a fascinating aspect about this as well too so treatment centers who insist on abstinence approach or who refuse to use matte as a treatment uh intervention or as a you know a pharma pharmacological approach i think i got all the words in there letters letters syllables thank you english major uh in there who turn around and only promote abstinence and refuse to do that then would be violating a holistic approach to care in that regard because it’s not about the individual it’s about our personal treatment philosophy as well too so just highlighting i think in a way when we talk about disrupting an industry uh family systems who are you know dealing with you know the the fallout of opioid abuse and in that regard call a treatment saying think it’s holistic and get there and they just rip you know the individual off the drugs and their craving states are through the roof doesn’t feel very nurturing from a holistic approach i think you’ve converted to a holistic point of view absolutely yeah the innocence intervention is over


well i think again what you end up what ends up happening is you get people really good at being sober in one setting like in one specific context and as soon as they leave that context it’s game over or at least the odds become very very very low that they’re going to be successful so yeah so if we had to kind of you know kind of as a going out credit here you know kind of maybe redefine what it means for us and being charitable to the word and maybe providing some influence to the industry to you know lean into it and take seriously what they might be stating on their sites like what do you think treatment settings that are holistic look like


friesma yeah thank you for that um well i think it’s what we are as i mentioned earlier we are trying to create at peaks which where we have medical at the table and saying this is how we can see the brain and this is how the brain works and this is what this individual needs to treat their brain not just not just medications but other medical interventions and i think that’s growing like that’s that’s going to be really innovative um and then a clinical voice saying this is these are the clinical interventions that are going to be best and then and then people uh that can intervene on this is how we build community and this is how we meet practical needs like like recovery coaches um i think could be so uh incredibly powerful and but all of these things being directional and collaborative i think that sounds pretty holistic from my ears yeah what do you think clinton um i just i think you got to get up off the chair you know and you got to get out there into the world and actually practice like there has to be a moment where these things go into action in real time and real space and um we you stop talking about it and you start actually doing it so just programs that have that momentum forward of like this is it’s you’re gonna be safe here but also we need to figure out how to make you safe out there and so the program is designed to do that and and provides that whole spectrum of care that’s what i would look for well i know i’m just playing on words here but it it feels like again too that holistic for me at least falls better under like enhanced care or more to samsha’s you know point of view as well too that we’re talking about integrated care and that you are integrating as many different features of care that can support the individuals within a milieu at any given time um to uh everybody’s benefit and certainly each and every individual within it um so challenge accepted on integrated care i still i’m not feeling too many fluffies about the word holistic in that regard you guys know it’s been something that uh i’ve just detested wholeheartedly being on websites and so forth so just grateful we can have a discussion about it if anything for families you know watching out there and taking a look at this thinking why are we talking about this in the first place again to disrupt an industry the greatest power to do this is family members and the reason we talk about these buzzwords and the internet words as we’re talking about it is because i know at the end of the day especially in working the admissions line that people are desperate for change in their lives and the family system is suffering and the individual who’s addicted to drugs and alcohol are going through their mental states is also suffering at the same time and we read words like holistic and to me you know the way that i think about families in those moments you it can kind of feel like you know putty and the power then is in the addiction treatment center saying to tell you how it is and so my hope with this is that when you read that on a website i don’t care where it’s at if the treatment center is great bad or otherwise that you just ask what that means and how they’re actually going to implement that and i bet the more and more families start asking the question the word’s going to go away from the internet is my belief about it because i think what we’ve recognized here is that it’s kind of hollow it has meaning certainly but at the same time it kind of lacks meaning at um all in all so thanks for sticking with us thanks for talking about this internet word uh holistic again um until next time on finding peaks episode um finding peaks at peaksrecovery.com questions thoughts concerns ideas or uh here’s the definition of holistic you guys missed them you guys missed the mark you don’t know what you’re talking about that’s what that email address is good for uh find us on the twitters the facebook the social medias they’re all over the place um we love you guys we appreciate you and thanks for joining us again we’ll see you next time take care