December 3, 2015

“I Live at Lund” by Meagan Dewitt

Posted in Employees, Family Engagement, Residential tagged , , , at 11:32 am by Lund

Guest post by Meagan Dewitt, Family Engagement Specialist at Lund

The “I live at Lund…” project started a few months ago when my supervisor, Case Management Coordinator Amy Woodruff looked to staff for ideas for activities of what we could do when we had two days off of programming. I had an idea after seeing a video made by BuzzFeed titled “I’m Trans but…” (https://www.youtube.com/watch?v=-niyBo3hDpA) This video showed Trans people discussing stereotypes and assumptions that were not true to them and then had them discuss things that were true which people might not assume about them. I thought it would be really great if the women who live at Lund had an opportunity to address the stereotypes that they face when a person knows one thing about them, they live at Lund.

I didn’t think at that time that that email would lead to me standing in front of 97 gathered staff members at the All Staff Retreat but that is one of the great things about this agency. In the 11 months that I have worked here I have not only witnessed, but also experienced, the great respect that Lund has for the ideas and creativity of the people who work here. And while it is wonderful to work at an agency that has so much respect for the people who work there, it is even better that we work at an agency that values the voices of the families that we serves equally if not more than our own. Lund respects that the stories and experiences of the families we serve are always best told by the people who lived them rather than the people who served them.

The “I live at Lund” video allowed the women who live in our residential program to address the stereotypes and assumptions that people make about them and our program. It also gave them an opportunity to discuss other aspects of who they are and what they are proud of. Filming this video has been an incredibly rewarding experience. The women who participated were absolutely incredible. While I may have provided a space and a camera, they provided us with something that we could’ve never created ourselves, their voices, their truth, and a few very cute babies.

I am incredibly grateful that they have allowed me to share this publicly.

Click this link to watch the video on Lund’s Facebook page:

https://www.facebook.com/LundVT/videos/1086835311340252/

Residents at Lund shared their true selves in this video, proud of who they are and how hard they have worked.

Residents at Lund shared their true selves in this video, proud of who they are and how hard they have worked.

September 3, 2015

Treatment at Lund: A Closer Look

Posted in Program Spotlight, Residential, Substance Abuse and Mental Health Services tagged , , , , , , , at 4:07 pm by Lund

When you ask about treatment for substance abuse and mental health disorders at Lund, you might hear the following answer.  Lund’s treatment programs are family centered, strengths based, and trauma informed. Lund uses a variety of treatment techniques, approaches and models based on the needs of the client but all are informed by those three important tenets.   This sounds pretty logical and correlates with other things you might have heard about what sort of programs produce the best outcomes but what do these terms really mean?

Family Centered:

The focus of family centered treatment is creating and maintaining healthy connections to others, especially children and other family members.  Such treatment provides a full array of services to tackle the problems that women and their family members must overcome in order to reduce substance use and improve individual and family outcomes.   The goal of family centered treatment is to create a healthy family system with good structure, appropriate roles for each family member, and good communication that allows the family to function well as a unit while concurrently supporting the needs of each individual member.

Family-centered treatment includes both clinical treatment, and community support services addressing substance use, mental health, physical health, and developmental, social, economic, educational and environmental needs for women and their families.  This sort of treatment is highly individualized based on the needs of the family and changes as those needs change.  Participation and length of involvement can look different for each family member.

Women live with their child or children at Lund’s Glen Road facility while they receive treatment.  Not only do they work to address their substance abuse or mental health challenges but they learn parenting skills and are connected to Lund’s job training, education and other family support services.

Lund_outpatient

Relationships are key in Lund’s treatment approach

Strengths Based: 

The very simple definition of this approach is self evident in the phrase – emphasis and focus on a client’s strengths.  The idea is to identify what is going well, do more of it and then build on it.  The core belief of a strengths based approach is that everybody has strengths and has the capacity for growth and change. The focus is not on the deficits or perceived failures of the client but on positive future outcomes.

Trauma Informed:

Many women who come to Lund have suffered from trauma in their past due to substance use, domestic violence or other physical abuse, sexual abuse, childhood abuse or neglect, poverty, criminal activity or other complications of life as an addict.

A trauma informed treatment approach:

  • recognizes the widespread impact of trauma on every aspect of someone’s life
  • supports clinicians, social workers and others who work with the client to identify the signs and symptoms of trauma
  • integrates the knowledge about trauma into policies, procedures and practices at the organization
  • actively works to avoid re-traumatization

Safety, trust, transparency, peer support, empowerment and collaboration are key values at the forefront of trauma informed treatment.

Between July 1st, 2014 and June 30th, 2015, 67 women received treatment at our residential facility while living with their 74 children who also received developmentally appropriate services.  65 young parents, mostly mothers but 4 fathers were also treated, accessed our community based outpatient substance abuse treatment services.  81% of women discharging from our residential treatment and 75% of participants discharging from our community programs showed a decrease in frequency of use.  These percentages are higher than national averages.

Lund helps parents in recovery to change their lives and supports them as they seek to realize the hopes and dreams that they have for their children.  Our talented, compassionate and dedicated employees are constantly pursuing training and educational opportunities in their fields because they are committed to working towards the best possible outcomes for the women, children and families at Lund.

As one client says, “The reason I keep going is for my daughter. All my work is centered around her and giving her the life I didn’t have. The work that I do at here Lund is so I can continue to raise her. I learn and practice parenting skills so I can best meet her needs. I want to get back on my feet and have my own place with my daughter. I want to put my legal past behind me. I want to provide for her to the best of my abilities. Lund is helping me do all of that.”

August 5, 2015

Supported and Successful Transitions – Family Engagement at Lund

Posted in Family Education, Family Engagement, Program Spotlight, Residential tagged , , , , at 7:50 am by Lund

The topics of conversation around the table on Pinterest Tuesday at Lund’s recently formed alumni group wanders between questions about the project at hand – making bags from old T-shirts – milking cows, what to do with avocado oil and the animals at Six Flags Great Adventure in New Jersey.

The group is run by Lund’s Family Engagement Specialists Laura May Ackley and Meagan DeWitt and is for women who are about to transition, or recently have transitioned, from living at Lund’s Residential Treatment Facility into living in the community.

“The women who have been living in the residential program are always surrounded by a community of peers and providers,” says Meagan. “When they transition into the community they might still have providers coming to their home but their level of peer support drastically changes. Many women also discover that finding safe and sober peers, that can also relate to their experiences as a parent in the community can be difficult. The group allows them to remain connected to a peer group that shares the experience of having been at Lund’s residential program. It also allows women who are preparing to transition to connect with other women in the community.”

The group focuses on activities that teach and reinforce independent living and parenting skills. “The specific activities are chosen by the women in the group,” says Laura May.  “The women that are getting ready to transition want to learn about certain topics or the women already living in the community struggled with certain things in their transition and want to know more about it.” The recent shopping bag activity came as part of a four week long session on bargain shopping and was inspired specifically by one of the group participants expressing her frustration that no bags were available at the Farmers Market to carry home her purchases.   The previous week, Lund’s nutrition specialist, Jillian Kirby came to the group to dispense tips and tricks on how to get the best deals at the grocery store.

Making grocery bags from old T-shirts.  Find out how here: http://www.instructables.com/id/No-Sew-10-Minute-T-Shirt-Tote/

Making grocery bags from old T-shirts. Find out how here: http://www.instructables.com/id/No-Sew-10-Minute-T-Shirt-Tote/

“A lot of our topics have an underlying theme of living with financial restraints,” Meagan reports, “while we want to offer them information on resources or a given topic, we also want to encourage them to think out of the box and be creative with what they have. Lastly we like to have fun. Life with children can be chaotic especially after leaving a residential program. This is a place where for 75 minutes where they can laugh, play games and connect with others and relax.”

The alumni group is only part of the family engagement work that Laura May and Meagan do. The focus of their position is to strengthen family support systems for women in treatment. They do this by working with women before they leave Lund and for six months afterwards to help them reconnect, repair and redefine relationships with family members, friends and community organizations that will be supportive of and helpful to them.   They can help women manage the practical needs of independent living and parenting while in recovery and follow up with them to make sure that all the pieces are in place and that they and their children are thriving in the community. They travel all over Vermont to follow up with women who have returned to their hometowns or relocated elsewhere in Chittenden County.

The work is funded by the SAMHSA grant that Lund received in November of 2014 Both Meagan and Laura May’s are new positions but the need was not. Clients would frequently leave Lund doing really well and then start to struggle after a couple of months. Clients themselves would also often say that they wished they had something to hold on to after they left. “Before this position began there was limited availability for the providers whom a client has become so close to, to work with them after they leave,” states Meagan. “We can act as a transitional provider in the community who knows where they have come from and help them get where they want to go.” Life at Lund is very structured and women are constantly surrounded by supportive staff members and peers. Moving to living independently has the potential to be lonely and isolated. Family Engagement provides a coordinated and comprehensive approach to continued support after discharge.

Family engagement looks different for each client as it based on the needs of their particular family. It can be practical parenting support such as working with a mom to help her feel comfortable having her child sleep is his own bedroom after sharing a room with him at Lund since he was born or going with a mom to the grocery store to help them shop within their budget.   Laura May and Meagan also work with older children in a family who have not been living at Lund with their moms, perhaps helping a mom to write letters to an older child to get them ready for mom being a more regular part of their lives once she leaves Lund or connecting with the father to help find appropriate therapists for older children. Laura May and Meagan work closely with Lund’s case managers and clinicians to provide comprehensive, wraparound support to families and help them have the best possible chance for success when they leave Lund.

“Transitioning from a treatment facility to the community while maintaining sobriety and managing a family is difficult. Having a provider that you have already built a relationship with makes the transition feel more supported and more successful,” says Laura May.

 

 

 

June 25, 2015

‘Looking Toward Tomorrow’ – Kit Stone Award Winner 2015

Posted in 50 Joy Drive, Awards, Events, New Horizons Educational Program, Residential, Substance Abuse and Mental Health Services, Workforce Development Program tagged , , , , , , , at 12:03 pm by Lund

Smiles and surprises all around as the winner of this year’s Kit Stone Award was announced.  The recipient was completely surprised and had even been lovingly misled by a staff member in order to keep this wonderful achievement a secret. “Deb told me all week it was someone else,” said Chelsea Mitchell, 2015 honoree after she had recovered from hearing her name read out. “Oh my God, I was thinking, no way, no way, are you guys serious? I can’t believe this is happening. I was convinced it was someone else and I was getting ready to clap for her. I heard my name and was like ‘WHAT???’ Everyone had been telling me what a big deal it was and how its hard to get it. It’s amazing.  I think there’s a lot of people that do what I do so I was totally surprised and psyched.”

The Kit Stone Award is named after a former long time board member and supporter of Lund.  It is presented each year to a woman who meets the following criteria:

  • The young woman will recognize the value in using what you’ve been given to blossom in life.
  • The young woman will take the opportunities presented to her and make them work for herself, her family, her peers and her community.
  • The young woman will demonstrate a commitment to her education and/or vocational training.
  • The young woman will demonstrate compassion, kindness and goodwill for others.

Chelsea was nominated by a record 5 different staff members – Greeta Soderholm, Dinah Larsen, Deb Mayville, Jenny Labelle, and Amanda Johnson.

Chelsea currently lives at Lund’s transitional housing facility, Independence Place, with her almost 3 year old daughter.  She works in the front office with Deb, Jenny and Amanda at Lund’s Glen Road building as part of the Workforce Development program.  “I answer phones, greet people, do a lot of paperwork, copying, faxing, scanning, mail, spreadsheets.  I help the girls out with stuff and take donations in.  Wherever they need me to be, I’m there. I love it. I love helping people. I greet people and they tell me I always have a smile on my face.”

Before moving to Independence Place, Chelsea lived at Lund’s Residential treatment program for substance abuse and mental health disorders.  “I just banged the program right out. They were surprised I had such a short stay but it was good for me. My daughter came to live with me a month after I got there and I was so happy.”

Chelsea with members of the New Horizons staff and Honoring Ceremony speaker, Ryan Esbjerg.

Chelsea with members of the New Horizons staff and Honoring Ceremony speaker, Ryan Esbjerg.

In her nomination she was praised for her hard work, determination and constant commitment to doing the best thing for her daughter.  “She talks about her future, going back to school, taking the steps she needs to make, knowing things take time,” said Deb in her nomination. “What I see now in Chelsea is a woman who is determined to make the most out of her life for her daughter and herself. She’s strong, determined and presents a can do attitude. Even when she has a day when life is not easy she maintains a positive attitude, looking toward tomorrow and not concentrating on the negatives.”

“Chelsea came to Lund with a  huge uphill battle and had not been parenting her daughter for a great deal of time,” said Greeta who was Chelsea’s clinician and helped her take the important steps she needed to take before being able to come to Lund.   “Her addiction had taken a full grip on her and she had lost everything because of it. She worked so hard to do what she needed to do to get into treatment, and there were a great number of barriers. Chelsea took advantage of all Lund offered and demonstrated wonderful parenting capacities once the barriers were removed. She is getting back out in the workforce while also balancing all the busy aspects of being a single parent. She is out in the world, independent, and the future looks so much more bright for her as a result of all her hard work and dedication.”

Chelsea plans to pursue Personal Care Assistant Training through the VNA this summer and hopefully then move into a job in that field. “I’ll go to peoples’ homes, cook them dinner, do whatever they need me to do. I think I’ll be good at that. If I like it I’ll go from there and proceed to be a nurse. Right now I want to make sure I like it. It’s hard work but I’m a hard worker so I’m pretty excited,”  she said.  Though so doing would mean that she would have to leave her work placement at Lund.  “I’m debating on that at the moment.  I don’t want to go,” she admits.  “But when I leave Independence Place, I can come and sub as a residential counselor there or at Glen. I would love to work here someday. This is my ideal job.  I can start as a sub and go from there. I am 100% going to do that, no doubt in my mind. I wish I could do it now.”

Dinah’s tribute perhaps describes most succinctly the key to Chelsea’s success, “She took the opportunity given to her to take a deep breath and try to create a life that could be different and better for herself and her family.  She woke up every day with a smile on her face and a strong focus in her head to forge ahead when she easily could have given up.  She is kind, thoughtful, and a good friend to other people as well as a loving and nurturing mother to her daughter.”

Congratulations Chelsea on being the 2015 Kit Stone Award Winner.

March 31, 2015

Creating an alliance of respect – Community Health Centers of Burlington at Lund

Posted in Employees, Residential, Substance Abuse and Mental Health Services tagged , , , , , , , , , , at 12:26 pm by Lund

Monday afternoon in the medical office at Lund’s Glen Road Residential Treatment Center is a busy time. Nurse Practitioner Diana Clayton and Nurse Kaitlin Reese, from the Community Health Centers of Burlington (CHCB) come every week to set up a medical clinic for the women and children living at Lund.   Diana and Kaitlin provide routine preventative medical care for moms and children as well as treating acute issues that come up.   They meet every woman and child who move into the building and work with the Lund staff to begin a relationship of medical care.

This partnership was started by former CHCB Nurse Practitioner, Annika Hawkins, who was experienced in community outreach. She realized she was seeing so many patients from Lund that an onsite clinic would be beneficial and make things easier for everyone. “The women feel comfortable at Lund,” Kaitlin explains. “With a lot of mental health issues, there is difficulty trusting people. Lund is a safe haven for the women and so to have a provider come into that community helps them to feel that they can trust the provider too. They feel more comfortable coming into CHCB later on when they have met someone at Lund first. It takes time to establish a comfort level with someone and here we have time to do that.”

It is obviously more convenient for the women to receive medical care in the place where they live without having to pack up their children in the cold weather, negotiate public transport and work appointments around treatment groups and daycare schedules. The ultimate goal though is to encourage each family into going to appointment at CHCB’s Riverside Avenue location as they get closer to leaving Lund and preparing to live independently.

Medical care can be overwhelming and intimidating for women who have not had good experiences with medical providers in the past due to their struggles with substance abuse. “I find that now they are in treatment, many of these women have these chronic pain issues that they have never felt were taken seriously. It was seen as malingering or drug seeking before. This is the precedent we need to work from. We need to build up relationship of trust and an alliance of respect,” says Diana.

Kaitlin and Diana work closely with Jessilyn Dolan and Leslie Swayze, the medical team at Lund and Dr. Bill Grass, Lund’s Medical Director. Before each clinic they get an update from Jessilyn and Leslie about each client on the schedule that day and then before they leave they pass on the important items and updates from each visit that might need to be shared with the client’s larger team. “Jessilyn is the glue between us,” says Diana. “She doesn’t hesitate to get in touch with us to confirm the accuracy of what the clients are telling her or to find more information.”

Leslie Swayze, Diana Clayton and Kaitlin Reese onsite at Glen Road

Leslie Swayze, Diana Clayton and Kaitlin Reese onsite at Glen Road

This collaboration has already expanded since it began in June of 2014. . The first provider from CHCB came alone and now Diana and Kaitlin come together. Diana is a lactation consultant and has met with staff at Lund to see how she could be helpful in supporting breastfeeding. CHCB also brings in Psychiatric Nurse Practitioner, Anna Leavey, twice a month to meet with clients and provide additional mental health support.   CHCB reports that in the last eight months, Diana has seen 87 women and children onsite at Lund and that there have been 340 patient visits since the program began.

The docket is full every Monday afternoon and the exchange of information between the medical and treatment teams at Lund and providers at CHCB is lively and comprehensive. This is a successful, practical partnership that is working now and that has real benefits for the women and children in the future. “I think this is a really important role to play as the women grow into motherhood,” says Diana. “There is a huge opportunity to change the dynamic of the relationship between these women and their providers. It’s such an important example to set for their children.”

December 19, 2014

Spotlight on the Residential Counselors – Part 3

Posted in Employees, Residential, Substance Abuse and Mental Health Services tagged , at 5:05 pm by Lund

The residential counselors at Lund are on the front lines of looking after the women and children living at Glen Road in so many meaningful and important ways.  But they also take time to bring the fun to holidays, activities, meetings and sometimes, just to the every day.  Thank you to a wonderful team who put the well being, success and happiness of the residents at the forefront of everything they do.

IMG_0749 20141030_191706 counselors2 IMG_5781  IMG_7411

 

 

 

 

 

 

 

 

 

December 18, 2014

Spotlight on the Residential Counselors – Part 2

Posted in Employees, Residential, Substance Abuse and Mental Health Services tagged , , , , , , at 1:54 pm by Lund

One afternoon last week the dining room at Lund’s Glen Road Residential Treatment Center was alive with activity as residential counselors and residents were making paper snowflakes together to celebrate the season and make their rooms and common spaces look festive.  The counselor leading the activity was in and out of the room looking for more scissors and tape to make sure everyone had what they needed.  The residents were quick to ask whether they could take their creations away to hang where they wanted.  Everyone was engaged in completing the activity until it was time for transports to leave to bring the moms to childcare to pick up their children and transition everyone into dinner time and evening activities.  Upstairs in one of the counselor’s offices, two counselors were chatting with a resident who had her baby in the office with her lying in a bassinet happily listening to the goings on and gumming on a teething toy.  Further down the hall another counselor, with a toddler balanced on her hip, was discussing a problem with the washing machine in one of the pods with another resident.  This normal afternoon scene demonstrates the diversity of the requirements of the counselor’s jobs.  There is always something that needs to be done and it could be arts and crafts, parenting support, driving, companionship or even washing machine repair.  This team stays on their toes and does what needs to be done to support the moms and children living at the facility, whatever that might be.

When asked what their favorite part of their job was, celebrating holidays came to forefront for many of the counselors.  “I loved spending time with the few residents who were here over Thanksgiving,” said Audrey Rose. “It felt so special to spend the family day with them and relax with the clients who were present.”  Lauren Ozzella, Residential Shift Supervisor, seconded this appreciation for spending holidays with the clients, “One of my favorite memories is working at Lund on Mother’s Day. Since it can be a bittersweet day for some of our clients we do lots of fun things to make them feel special and appreciated. Last Mother’s Day was great; clients and staff alike had a great time! One of the mom’s actually wished me a Happy Mother’s Day as well. She explained that she believes that counselors are sort of like mothers to them and their children, too, and that she thinks that we also deserve to be appreciated on Mother’s Day. That was so unexpected and touching; it’s something that I will always remember.”

Keep reading to meet some more of Lund’s wonderful residential counselors.

Thomas  Natasha is extremely dedicated to that work that she does as a counselor.  She is a great support to our clients and to her team members alike and is always finding ways to make everyone laugh.

 

 

 

 

Ozzella Lauren  is a fantastic and strong leader on the team.  She is understanding, empathic, positive and motivating. Lauren takes charge and is confident in her abilities. She promotes team morale and cohesiveness.

 

 

 

Manchester J  Jessica is a great asset to the evening and weekend team.  She is straightforward, consistent and reliable.  Jessica is positive, happy and a great person to be around.

 

 

 

 

 

Daugreilh  Ashley  ensures that all runs smoothly on her shift and she is a strong advocate for her staff. Ashley balances compassion with boundary setting and limits with our clients.   She has a witty sense of humor that keeps us all in good spirits!

 

 

 

 

 

Campbell  Sarah has worked for several years as a counselor in the residential program and at IP. Currently Sarah works part-time as a daytime counselor while she completes her BSW/MSW program. Sarah has a huge heart, which is evident through the work that she does with our clients and their children.

 

 

 

 

 

Michaud  Katy makes anyone around her smile! She is positive, calm and has a can do attitude about everything. Nothing rattles Katy she is able to handle most anything that is thrown at her during her shift.

 

 

 

Mumford After working as an overnight counselor and then as a full-time evening counselor, Anna has recently transitioned into a part-time shift while she completes her MSW program. She is fun and creative and is always the first to volunteer to play with the toddlers in the play lab during dinner chores.

 

 

RiversMichaela is part of our weekend evening and overnight team. She is a great team player and always takes the initiative to get things done with a smile on her face. Michaela is kind and compassionate; she is a great support to our clients and does not shy away from challenges.

 

 

Rose Audrey has been working at Lund for two and a half years. She is well known in the counseling department for planning and facilitating our weekend trips and activities. She is kind, caring, patient and is very dedicated to her work.

 

 

JoyceDanielle always goes the extra mile and can be counted on to get things done. Danielle is thorough in everything she does and we never have to worry that something won’t get completed. Danielle is also very very funny. She has a great sense of humor which is appreciated in her work with staff and clients.

 

 

Screen shot 2014-12-16 at 2.09.46 PM  Heidi is the newest member of the counseling team, working weekend mornings. Heidi has great knowledge and skills and jumped into her new position with two feet. Heidi has very quickly become comfortable in her position and is already working with our clients with confidence.

December 16, 2014

Spotlight on the Residential Counselors – Part 1

Posted in Employees, Residential, Substance Abuse and Mental Health Services tagged , , , at 2:06 pm by Lund

Lund’s residential treatment program is the only place in Vermont where women can receive treatment for substance abuse or mental health issues while living with their children.  26 women pregnant or parenting women can live with one or two children up to age 5 at Lund’s Glen Road facility.  The program is staffed 24 hours a day to support these women and their families as they manage their own recovery, learn parenting and life skills and work towards self sufficiency.  The residential counselors who work daytime, evening, overnight and weekend shifts are an absolutely essential part of the program and provide all manner of support to the women and children from providing respite during the night, giving parenting support, planning family activities, doing chores, driving to appointments and helping moms deal with all the challenges that arise from parenting or pregnancy.    The counselors have been called the ‘glue that holds the program together.’

Last Friday the counselors held their holiday party sharing treats and exchanging ‘Secret Snowflake’ gifts.  It was unusual for so many of them to be in the same place at the same time as their shifts are often opposite and rarely can everyone be in a room at the same time as someone is usually needed on the residential floors or to accompany clients to appointments.   It was fun to see everyone celebrating and sharing the season together.  By necessity the  counselors work closely together and you can see it in the way they interact with each other.  It is clear that this is a passionate, dedicated and hard working team which of course is hugely beneficial to the families they work with.

Please read on for  ‘Meet the Counselors: Part 1’ and learn more about their work helping children and families to thrive.

JacksonJamie works the morning shift.  She is eager to be involved with resident’s treatment and is gracious in holding limits with them . Jamie is particularly enthusiastic for Saturday morning activities with clients.

 

 

Wood AAbi is hailed as having a perpetually positive attitude and has been commended for her calm and soothing presence during the morning rush.

 

 

 

 

PageKatelynn is a big fan of arts and crafts and she really enjoys engaging clients in art projects to make their time at Lund feel special. Katelynn in quietly determined with clients and supports consistently through challenging times.

 

 

 

ConroyKelsey is a fantastic team player and has worked all different shifts with consistency and reliability.  She is now working as a sub while she is in grad school. Kelsey presents herself with such a calm demeanor and radiates positivity throughout residents and staff member.

 

 

WhiteAlyse is happiest when playing with her toddler friends and always brings humor to any situation. Alyse is flexible and is able to handle any situation with ease that is thrown her way.

 

 

 

DeweyLaura is always helping out clients either one on one or in a group setting. Laura brings strength in play therapy to the evening team which is evident in her work with our kiddos! Laura is extremely patient and kind and is always willing to go the extra mile for any client.

 

 

 

 

WestBridgette’s passion for this job is evident in all the work she does. Team members describe Bridgette as committed and passionate and always able to make them laugh.

 

 

 

MbayuTeam members believe Francine has a solid “mom” presence for the women here and is always willing to lend a hand. Francine is appreciated for her hard work and her continual smile.

 

 

 

 

LeachDianne is always on the go doing something for other people. Dianne is always able to give great feedback to clients and really grow a bond with them.

 

 

 

Brot Liz is a team player and is often seen at L&D in her favorite spot overlooking Burlington. Liz brings strength in child development to the evening team and is able to help moms in any tricky situation. Liz often has a “can do” attitude that becomes contagious to other staff.

September 25, 2014

An Introduction to Medication Assisted Treatment and the Hub and Spoke System

Posted in Residential, Substance Abuse and Mental Health Services tagged , , , , , at 7:08 am by Lund

What is medication assisted treatment ?

Medication assisted treatment (MAT)is the use of medications, in combination with counseling and behavioral therapies, to provide a whole-patient approach to the treatment of opiate addiction. Research shows that when treating substance use disorders, a combination of medication and behavioral therapies is most successful. Medication assisted treatment is clinically driven with a focus on individualized patient care.” SAMSHA, www.dpt.samsha.gov. MAT is most effective in those who have suffered from continual relapses.

What medications are commonly used in MAT?

The medications most commonly used by clients at Lund’s residential treatment facility are methadone and buprenorphine. According to the Vermont Department of Health, the majority of MAT patients receive buprenorphine prescribed by a physician in a medical office setting. methadone, unlike buprenorphine, is a highly regulated addiction treatment medication and is only provided in specialty clinics.

Methadone is a medication for people dependent on opiates, who have often battled addiction for a long time and are taking high doses every day to avoid withdrawal. Methadone can be very dangerous medication if used outside of medical monitoring and federal regulations are very strict to ensure safety when using methadone. More people die each year from illegal use of methadone than any other medication. Methadone is dispensed daily at a clinic and those pursuing this course of treatment must visit the Chittenden Clinic daily to receive their dose.

Buprenorphine is an alternative course of treatment for opiate addiction, appropriate for those who have enough maturity, discipline and stability to participate in an office based program. Buprenorphine is a partial agonist which makes it a safer medication with less chance of overdose.

What is the Hub and Spoke method of substance abuse treatment?

Prescription drug abuse is the nation’s fastest-growing drug problem. Vermont is ranked the 34th worst of all the states in the non-medical use of pain relievers and for the first time ever, treatment admissions for opiate addiction surpassed that of alcohol addiction. In addition, drug diversion continues to be a problem for many reasons. In response to this problem, The Agency of Human Services (AHS) in collaboration with community providers proposed a coordinated, systemic response to the complex issues of opiate and other addictions in Vermont, now referred to the Hub and Spoke model, or “Care Alliance for Opioid Addiction.”

Although this initiative initially focused on creating capacity in the system for adequate medication assisted treatment for the increasing numbers of individuals with opiate addictions, it also created a framework for integrating treatment services for other substance use disorders and co-occurring mental health disorders into a medical home model. In addition, this treatment approach is proposed to help reduce recidivism in people who have been incarcerated and enhance outcomes for families where addiction is an identified problem for child welfare.

Very large waiting lists for methadone indicated insufficient treatment capacity and fewer providers have been willing to prescribe buprenorphine for new patients. With more Vermonters seeking treatment for opiate addiction every year, this difficulty of access to MAT is a problem. The Hub and Spoke system reaches more people and provides more MAT options for patients. It also offers increased supports directly to physicians in medical office settings, assisting them in effectively managing and treating patients.

This helpful diagram from the Vermont Department of Health illustrates the Hub and Spoke system

This helpful diagram from the Vermont Department of Health illustrates the Hub and Spoke system

What is a Hub?

A Hub is defined by AHS as “a specialty treatment center responsible for coordinating the care of individuals with complex addictions and co-occurring substance abuse and mental health conditions across the health and substance abuse treatment systems of care.” www.healthvermont.gov/adap/treatment

A Hub is designed to do the following:

♦ Provide comprehensive assessments and treatment protocols.

♦ Provide methadone treatment and supports.

♦ For clinically complex clients, initiate buprenorphine treatment and provide care for initial stabilization period.

♦ Coordinate referral to ongoing care.

♦ Provide specialty addictions consultation and support to ongoing care.

♦ Provide ongoing coordination of care for clinically complex clients.

What is a Spoke?

A Spoke is defined by AHS as “the ongoing care system comprised of a prescribing physician and collaborating health and addictions professionals who monitor adherence to treatment, coordinate access to recovery supports, and provide counseling,

contingency management, and case management services” www.healthvermont.gov/adap/treatment

Spokes can be:

♦ Blueprint advanced practice medical homes

♦ Outpatient substance abuse treatment providers

♦ Primary care providers

♦ Federally qualified health centers

♦ Independent psychiatrists

What does this look like here in Chittenden County?

The HowardCenter’s Chittenden Center Clinic is the Hub for Northwestern Vermont including Chittenden, Franklin, Addison and Grand Isle Counties.  The Chittenden Clinic has two locations – one at the University Medical Center and the other on San Remo Drive in South Burlington. The Spokes consist of 200 prescribing physicians in a variety of medical and behavioral health outpatient settings. Lund recently became a Spoke.

How did Lund become a Spoke?

In order to become a Spoke, Lund needed to add a Medical Director to our existing substance abuse treatment program. Dr. William Grass is the current Medical Director. His responsibilities include tending to the general and mental health needs of clients, acting as a consultant to the nursing team and to the clinicians and monitoring and evaluating urine test results. A crucial part of his work is evaluating and managing medication assisted treatment for our residential and community clients Dr. Grass is at Lund one day a week and also runs his own private psychiatry practice where he has practiced as a spoke physician for several years. Dr. Grass sees the benefits of MAT in Lund’s treatment program but as one part of a wider approach , “Life skills and parenting education are also an important part of treatment. MAT expands access to this sort of treatment in a population of people where opioid use disorder may be more prevalent than in the general population. Through the Hub and Spoke system, we’re able to expand access in a specific population of people. Healthy families mean a healthy future and that is important.

Lund’s residential and community treatment leadership team began conversations with Vermont’s Blueprint staff, who oversee Spoke implementation for Chittenden County, early in 2014. As a formal Spoke provider, Lund now receives funding from Vermont Health Access to deliver the comprehensive health services to clients receiving Spoke services, which optimizes treatment and health outcomes.

Having Dr. Grass on staff expands the medical team. Lund’s nurse, Jessilyn Dolan, is glad to have him on board, “Our clients’ medical needs have increased and become more complex over the last few years and it is very useful to have him to consult with. It is also really helpful to have a prescribing physician on staff so that if there is a time crunch with a new resident coming in who needs medication or a medical emergency, we have him to call on.”

Is MAT for everyone?

Not all people who have struggled with opiate addiction use medication assisted treatment. Having Dr. Grass on staff allows for him to consult with treatment teams and assess each client’s treatment plan and help decide whether MAT might be beneficial. As of the writing of this article 42% of clients at our residential treatment center are participating in MAT.

Medication is just one part of Lund’s treatment approach and is not appropriate for everyone.  Lund offers a comprehensive approach that includes clinical and psychiatric services, health care, education and case management to pregnant and parenting young women, their children, and other key family members. Our therapists, teachers and caseworkers not only assist women in their recovery from substance abuse or mental health issues, they help them identify their strengths and maximize their potential by offering parenting education, as well as life skills and job training.

August 8, 2014

“Creating an Intentional Community of Health”- United Way brings people together to talk about substance abuse

Posted in Events, Residential, Substance Abuse and Mental Health Services, United Way tagged , , , , at 11:15 am by Lund

We know that opiate addiction is a problem in Vermont that now affects every single part of the community.  The state has seen a nearly 800% increase in opiate use in the last 14 years and a concurrent increase in crime and rates of incarceration.  Governor Shumlin dedicated his entire State of the State address this spring to the omnipresence of this issue, “It doesn’t affect just one class of people, it affects rich and poor,” Shumlin says. “It knows no party lines, it knows no economic lines.”   Bringing this issue to light in such a prominent way has forced people in the state to confront the problem and begin to talk about solutions.

This week the United Way of Chittenden County held a community forum to discuss the problem of opiate addiction and to allow for concerned community members to offer their ideas for solutions.  The event attracted over 120 people from all different backgrounds – medical professionals, law enforcement, social workers, academics, school administrators, parents, community activists, politicians.  It was an interactive meeting with plenty of time allowed for discussion and questions.  There were people in the room for whose lives had never been touched by drug use and people in the room in recovery.  There were people whose political and social backgrounds were so widely different that no other situation would have brought them together.  The common thread was concern for people in Vermont battling this illness.  There was an air of understanding and willingness in the room.  One lady advised the crowd to look around.  “We’ve got the right people in this room,” she said, “open your hearts and see the potential.”

United Way on Opiates

When the crowd broke out into groups for smaller discussions many people could be heard sharing how addiction had touched their lives, “It’s a sad, sad diseases,” said one medical professional, “and we mustn’t forget that it’s a disease.  This is not a choice people are making.  They get stuck in a hole and they can’t get out.”  In a later session of break out groups, the room was posed with questions to discuss – What is the state of treatment facilities in Vermont, what does prevention really look like, how can we provide the tools people need when they are in recovery so that they don’t slip back into the same lifestyle, how can we create an intentional culture of health instead of an unintentional culture of addiction?

Courtney Farrell, Associate Director of Residential and Community Treatment Services at Lund, who attended the meeting found the open discussion time to be most useful as it allowed people to connect the problem of addiction in the state with other issues.  “We had good conversations about how as a community we can be more proactive in working effectively together to support child protection as it relates to addiction in families, rather than just see it as one agency’s problem to fix.”  Collaboration and the interconnectedness of social issues were two themes that underlined the entire forum.  Brian Southworth from Lund, also an Associate Director of Residential and COmmunity Treatment Services, noted, “Participants were energized by the prospect of finding more effective ways to improve communication and more collaboratively address opiate addiction. There were a number of commitments made to facilitate forums in Burlington, and adjoining towns, for the purpose of expanding the conversation and planning.”

Attendees were encouraged to leave the discussion with an idea for one thing that they themselves could do to help address the problem.  One way that you can help is to support Lund which is the only treatment facility for substance abuse and mental health issues in Vermont where women can receive treatment while staying with their child.   Our residential treatment center serves 26 pregnant or parenting women and their children as they work towards an independent, successful life in recovery.  We also provide integrated, wraparound family support and education services to support the whole family in breaking cycles of poverty, abuse and addiction.  Lund works closely with other community organizations to ensure that we have a collaborative approach and a comprehensive understanding of the complex nature of addiction.   To learn more about Lund, click here.   To make a donation, click here

“Lund has shown me a life I didn’t even know existed. Lund has shown me how much more of a person I can be, and what it really means to live, not just to stay alive. Lund has given my daughter, Sienna,  the chance to break the multi- generational cycle of addiction, by helping her to have a mom who doesn’t use drugs.  My mom, my grandmother and my great grandmother are all addicts.  Who knows how far back it goes”  Tina, 26.

 

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