ATCPCC 2013 – John O’Neil on Understanding

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Today we would like to share with you a video from our annual ATCPCC 2013, Addiction Treatment Centers and Professional Consortium. Here in our guest lecture video series is John O’Neil speaking about Understanding. We have a transcript of the lecture for you to follow:

Hi. My name is John O’Neil. I am the Manager and Director of the Addiction Services at the Menninger Clinic in Houston, Texas. I’m a clinical social worker and a licensed addiction specialist, specializing in chemicals and sexual addiction. I’ve been working with the Menninger Clinic for around ten years altogether. I want to talk a little bit about how we look at treatment at Menninger. At Menninger, we spend a lot of time really trying to understand our patients. We see a significant number of patients who come in who have been to a lot of places. They’ve been to a lot of different treatment settings and everything else, and it’s not as if treatment has failed them. What has failed them is the understanding of what’s really going on. Most of the people we see have a significant psychiatric problem, personality issues, trauma issues, and unfortunately for them, it hasn’t been investigated or they haven’t developed an understanding of what that means for them.

We spend a lot of time, initially, trying to understand that. Our team approach, which consists of a psychiatrist, a psychologist, a clinical social worker, a clinical nurse, an addictions counselor, a rehab specialist, a registered die, so on and on and on, really is a comprehensive approach.

At the end of the day when they’re trying to understand themselves, they don’t just have opinions. They have a lot of information. They have tests and they have tools and they have screens and they have interviews and they have family histories and all kinds of things that put together a picture that helps them understand what’s going on. And I’ll tell a story, a little story. It’s kind of, I think, a funny story. We were working with a young man years ago who really didn’t understand what was going on, continued to relapse, using alcohol, using drugs, sex, gambling, all kinds of things, and so we did a full assessment and we tried to understand what was going on. Well, what we found was that he was struggling with bipolar, significant, strong indicators, everything was really pointing to bipolar. So we sat down to meet with him and met with his family and met with him, and we said, what we’ve found is that you struggle with something called bipolar. And he looked at us and said, “Bipolar? But I like girls.” and so we had to then explain what we meant by bipolar. It was flooring to him, and that’s kind of an extreme example, but for an 18-year-old that had no idea what this was all about, he just thought, you know, that this was normal. It was normal to have these mood swings.

So our team spends this time really educating and spending time and helping them understand that this isn’t just a character flaw. This isn’t about will power. This isn’t about only motivation. There’s something much more significant underneath it.

So after we get to a place where we understand and they understand and the family understands, we have an opportunity then to develop a treatment plan that makes sense, a treatment plan that might untangle, unbundle, some of the medications they were on. You know, if you’re taking a medication for a disorder you don’t have, it doesn’t help, or if you’re taking an addictive medication thinking it’s treating something that it isn’t, it doesn’t help. So we unbundle that, and at that point, we can put together a treatment plan that makes sense for them, and that treatment plan, of course, involves the family. We spend a significant amount of time educating them on the brain, and once we understand what’s going on in their brain, then at times we’ll use neuropsychological testing. We may use functional MRI’s. We may use all kinds of different tools to really understand what’s happening in their brain, and that helps them a lot. It’s amazing what you find when you start to help people understand how their brain has changed, how addiction has altered their brain, how depression has altered their brain, and it’s a relief for many people to understand that this isn’t a character flaw. And it’s also amazing when families understand that, hey. It’s not my 20-year-old who’s just been lazy and irresponsible. My 20-year-old has a real illness, a real problem. I think every day we continue to fight the stigma with the families and with the patients that we work with when we say to them, this isn’t about your willpower or your motivation or your desire. This is far deeper and far more painful. And so to that extent, that’s how our treatment gets developed.

We have eight different addiction specialists on each of our – on our entire campus, but each of our units has an addiction specialist that are all masters prepared, and the reason why we have masters prepared addictions counselors is because of the combination of the mental health problems and the addiction. Sixty to 70 percent of our patients have co-occurring disorder and we know that and the depths of the disorders for so many of our patients are so extreme and so painful and traumatic that if we don’t have that understanding and specialty, we won’t treat them well. And so we’ve learned over the years that we need to have people that get it from our clinical staff.

So the Menninger Clinic is in Houston, Texas. Of course, we used to be in Topeka, Kansas until 2003. This last year, one year ago, we built a brand-new campus. It’s a beautiful campus. It is very accommodating for patients. It’s very comfortable from, you know, a facility standpoint. It may be very uncomfortable from a treatment standpoint as we start to dig into things, but we try to balance it out. You can reach us on the Menningerclinic.edu website, if you are interested in any kind of information. Again, I can be reached as well at that website or you can contact me through my email.

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