[Joanna]
Welcome everyone to Delivering Recovery on How to Harness Family Ties to Drive Recovery. I am very happy to have Ward Blanchard here with me today. Ward is the founder and original owner of the Blanchard Institute.
And Ward, I think you started the Blanchard Institute about the same time I started Vista Research Group, was it? You started in 2017?
[Ward]
Yes, it was 2016 is when we kind of started to create it, started taking clients in 2017.
[Joanna]
All right, super. Can you describe a little bit about the Blanchard Institute and just overall what you offer to the patients? And then I want to dive into some of the discussion about the very unique family program you have.
[Ward]
Sure, no, absolutely. As you'll find out, I love talking about families. And the Blanchard Institute is a community-based IOP and PHP continuum, and outpatient continuum of primary substance use disorders, really dual-diagnosis outpatient care.
And it's based in Charlotte, North Carolina. Right now we have two locations in, one in Charlotte and one in Lake Norman. I actually just announced that we're opening another in Winston-Salem and soon hope that the goal is to build a continuum across the state.
So we're excited about that.
[Joanna]
Yes, it's going to be another PHP IOP?
[Ward]
Yes, ma'am. Just like it's what I'm talking about, that we are really a community-based continuum, the IOP and PHP and, you know, OP and beyond is really a continuum of care that delivers those services to individuals and families, you know, within their community. You know, our residentials are wonderful.
And what we know is that the majority of individuals that struggle with dual diagnosis issues and substance use disorder, have a fully functional job and need to exist in the stream of life. And so that's what we do at the Institute with a certain special added component of really providing some comprehensive family care and family support throughout that continuum. And so right now we, like I said, have been doing that since 2017 and are excited about continuing to do that beyond North Carolina.
[Joanna]
Well, the reason I wanted to bring you on Delivering Recovery was I think what you've done with the family program is so unique with multiple different parts to it. And having gotten involved in the addiction treatment world as a result of my daughter, I know just how important the family programs are. So could you describe what the Blanchard Institute offers to families of patients who go there?
[Ward]
Sure. Yes, ma'am. And, you know, discussing recovery and treating this disease from a family disease perspective is certainly not a novel concept. We've known, and it's been out there for a long time, at least since First Lady Betty Ford made her announcement in the 1980s.
So the fact that we treat and support the treatment process from a family disease perspective isn't novel or new, but how we do it is quite different and quite new. And what I mean by that is, you know, I never really understood when I was a young professional why residential centers were the only treatment resource that had family programs when residential centers have the shortest time period with clients and actually are destinations, like you travel to the residential center and so you have the least access to families. And what we do and what we realized at the Institute is when you're a community-based organization and you're right there in the stream of life with your clients and families, you have the longest exposure to clients and families.
And so as a client enters treatment with you and in PHP or IOP and that's normally a few weeks or can be as long as a couple months long those families live and work and exist in their stream of life right there, just a couple miles from you. And so as a clinician, that allows us just a longer runway to really provide support for families. And we do that through a combination of what I call the group support, education, immersion workshops, like specifically we have a once a week professionally-facilitated support group just for families that happens every week.
And we couple that with, we also have another longer three-hour session that has a combination of groups and a lecture period. So you have education and you have a professionally facilitated process group. And that's the regular consistent support that runs routinely.
But all of these resources really sort of birth from what really makes us special is the family workshop, immersion workshop that we provide to families, which is very similar to your two and a half day traditional family program that people often experience at residential centers. You know, we do that on the outpatient level and provide that sort of family immersion workshop on a half day, Friday, all day, Saturday, and which is a combination of lectures, small groups, experiential exercises to give the family and the client just a wide variety of experiences, opportunities to not only invest and learn themselves, but most importantly, connect with other families and other clients that gives them that sense that they're, they're not alone.
[Joanna]
So you have, I think it was Thursday nights, you have a family session just for families. So that kind of sounds like Al-Anon, but because there's a clinician there, you're able to do more, right?
[Ward]
Yes, it's very true, because we're very outspoken about how much we advocate for family and loved ones, support groups and community support groups. And our Thursday night group doesn't replace those. We call it the resilience group.
And the resilience group that we have every Thursday night has a professional present. And so there's a little bit of difference there. And we make sure that we make clear that our Thursday night resource doesn't replace Al-Anon, but it is different, meaning that that professional clinician is there for a reason.
They're there to provide education. They're there to get to provide direction. They're there to provide guidance.
They're also there, like where Al-Anon, where you often hear that they don't allow cross talk and sort of unguided unhealthy conversation that can often happen in any group, that the professional is there to provide the safe space, redirection, and a sort of that element of support that's needed from a professional clinician. But make no mistake, the magic and the special sauce really happens between the connection between the family and loved ones.
[Joanna]
Yeah, just I know meeting other families who were going through the same thing was just so useful when I was going through it with my daughter, because you feel like you're the only one who's dealing with this, because of course, people don't talk about their loved ones that have, that are in treatment for addiction. And so I remember myself, what a difference. I still kept in touch with one of the moms that I met back in 2008, when our daughters were roommates at one of the residential centers. And we just talked a couple weeks ago, actually.
[Ward]
That sums it up, Joanna, like the two most powerful words you can say to somebody when they're suffering and struggling is “me too”. And that really intimate connection that happens with this unique suffering that that parent that you met in 2008, probably within the first few hours that you met her, that in some ways, she understood you in ways that certainly some people during your whole life didn't understand. And so you can't reproduce that out of a textbook.
That's just an experience that you must have with one another.
[Joanna]
So there's a Thursday night group just for families, and that's virtual, right? And you allow anyone to attend, right?
[Ward]
That is virtual, and it is open to the community. Anybody, any family member, any loved one, anybody who is impacted by a relationship with an individual struggling with substance use disorders can absolutely attend that. You do not have to have a client formally admitted into Blanchard by any stretch.
[Joanna]
So then you also have, I think it's Saturday mornings, that you have every Saturday morning, every week, there's a family session, family and patients. Is that right?
[Ward]
Yes, this is a unique resource. This resource is for those clients that are formally admitted into the Institute. This is a three-hour resource on Saturday that is broken up into a combination of activities. For the first hour, hour and a half or so is an educational hour, often an opportunity to discuss an ongoing topic, whether it's boundaries, relapse prevention, communication, codependency, those topics that we have professional clinicians that present on.
And then we take a break and give everybody a chance to stretch their legs from the scene. And then when we come back, the last hour, hour and a half is that intimate opportunity to have a professionally-guided process group. And what makes this real special is it's multifamily and clients and family members and loved ones attend.
And so what that allows is family members and loved ones and clients to be in a group and hear from other clients, other families in a way that they may not always be able to hear from their own family member or their own child or their own spouse who's struggling. Sometimes that emotional history may provide some added element of not hearing somebody so much, but that's one of the most powerful feedbacks we have is those families and clients who get to hear from other clients and other family members that aren't connected to them, they can hear their story and experience far more clear.
[Joanna]
Fascinating, fascinating. So one of the things that I thought I remembered you telling me a while back was that these family programs are required. Is that right?
[Ward]
Yes, ma'am. That's what we, when we talk about family treatment, one thing we discuss very openly at the Institute that we, when we say that we provide family treatment, it is, we are known for it. Our tagline is, you know, world-class family focused, “Family is our DNA”.
It is, it is on our website. It is on every admissions form that you sign. And so we're very, you know, upfront about it.
But for the most part that as we, we talk about that families go through a parallel process and go through often the same amount of struggling and trauma that clients do. And they need, and most importantly, they deserve to have appropriate levels of support and treatment that, you know, aren't always accessible.
[Joanna]
So you have every Thursday night, you have a family meeting. Every Saturday morning, you have a family and patient meeting, and then you offer the family workshop five times a year also.
[Ward]
That's right. So every week, what the structure is, they get about combined over four hours consistently, you know, every week, whether they do the process group and do the Saturday opportunity, you know, regularly, families and loved ones have about four hours consistently. And then once every 10 weeks, so once every IOP session that usually lasts about, you know, 10 weeks, once every couple months, we provide this family system workshop.
And that is a day and a half resource that also has virtual and hybrid opportunities that we certainly invite and encourage all clients and families to attend in person. However, we have opened it up and the ability to provide it completely virtual for those family members that may live in a different state or not able to attend in person. We, we have hybrid opportunities.
And so, you know, this resource goes Friday night for three hours from 5.30 to 8.30, and then all day on Saturday from 9am to 5pm. So it's a, it's a combination of about 12 plus hours of resources. And, you know, lastly, we also encourage and invite community professionals that attend that because we give away about 10 to 12 free continuing education credits for any licensure professional that attends. This most recent weekend, we had about 60 out of the over 200 attendees, you know, were community professionals. And so, and it's all free. And that's another important is this family workshop, you know, along with the resilience group is free and open to the community to attend.
[Joanna]
It's amazing. And insurance isn't paying you for any of this. Is that right?
[Ward]
That is correct. That the resilience group and the family workshop is free and open to the community. It's, these are the resources, like I mentioned, that you don't have to have a client formally in Blanchard to attend.
And we invite and welcome, you know, attendants. As you may remember, it's tough walking in those Al-Anon doors for the first time or the treatment doors for the first time, or it's tough, as they say, picking up that thousand pound phone. That's tough enough in itself.
Having a financial barrier just adds another layer that you have to navigate through. So we really want to try to remove those barriers and make this uncomfortable process as comfortable as possible.
[Joanna]
So you're offering all these extra things that insurance isn't covering for your patients or their families. How do you see the patients change as a result? And how do you see the families change?
You know, I guess I'm asking a bigger question, like, you know, why is this so important? Tell us how you know it's working.
[Ward]
Absolutely. And, you know, even in a microcosm, you can see and experience families and clients change just within the weekend. In fact, that's actually something that we, you know, communicate on Friday night at 5.30 when we're welcoming everybody and starting off. I'll actually say once I've thanked everybody for being super excited to attend a family workshop on their Friday night and weekend, we know everybody is just, you know, very excited to be there, that we understand that when people come in there, they're often, you know, uncomfortable and don't know some or most of the faces. And so it's kind of an awkward or disconnected, you know, experience when you walk into a bunch of, you know, people, individuals that you may not know. And so I'll actually say, you know, put a pin in this moment about how you feel right now, because tomorrow about, it happens about 11, 11.30, almost by the end of the morning, there'll be a dynamic difference in the energy, the connection in the room. We'll actually struggle to get, to herd the cats on break time when we give them a five-minute break, you know, because they're talking and connecting with one another. We'll actually struggle to get everybody back in the room, you know, start on time because of, they're actually connecting too much, but we've got stuff to do. And you can see and, you know, feel that intangible but invaluable connection that happens when two people that, like you said, when they're out there in the stream of life, suffering in silence, when they finally get to experience, you know, another individual, another human that can sit there with them and empathize with something that they have this unbearable pain that unites them.
But now they finally feel like they're not alone. So when you get to experience that firsthand, it truly is like magic and it's like contagious, you know, it is very much a blessing. It's empowering and it very much is contagious.
It's that connection that you can see and experience.
[Joanna]
One of the things that you mentioned to me that I also found really interesting was that you require the families to come to the intake assessment. Can you describe how you handle the intake? Because I thought that was very interesting and some other centers might want to hear about it.
[Ward]
Sure, yes. It's the assessment period. And, you know, that's the one of the things that we subscribe to.
And I know those out there listening, whether professionals or families or is, you know, when individuals are in the midst of their disease and or in their active substance use disorders, they may be in a mental space that isn't quite the clearest or isn't quite, you know, themselves when the active disease is going on. And so that's what sort of the disease does. It kind of steals our self-awareness when we're in the middle of it.
And so if you think about it and, you know, our goal in the assessment appointments is undoubtedly to get information just like you would in an initial evaluation. There's no question that's, you know, important to get through that, you know, red tape. It's required and I think everybody understands how important it is to to get that basic information.
But when it comes to really trying to understand the disease and understand how the disease has impacted not only the individual, but has impacted the family disease, we want to try to get as much information and collateral information and perspective as possible just allows us to see not only the disease better, but see and experience the client better or the family better. And I think we can all agree that that information coming from only one source, coming from only the client, like we said, who may be in the middle of active disease may not be the best judge of what's going on at that current time, just themselves. And so having the family there where they also get to provide their experience there, what they witnessed. Not only that, but you get to experience the beginning part of that interconnection process, where they've been out in the stream of life, maybe looking through resources.
And this treatment experience is very new to them. They don't know what to expect. They know this disease is killing their loved one, and their loved one may have an appointment.
But what's going on in there, this disease that's not only hurting my child or my family member or my spouse, but is also hurting me, it provides them an outlet to begin to heal and begin to receive. And equally as important is to begin to receive information, education, and support that is just the first step in the treatment process. But overall, the more that we can connect, and the more that we can involve in a very healthy way, then the better off, you know, the client is.
And that's, we call that the sphere of influence, Joanna, those family members, those loved ones, and even those key stakeholders within the client's inner circle. They're all, you know, invited to come, but certainly the families and loved ones that are closest to the individual, we certainly really try to encourage it, you know, expect, support them to come.
[Joanna]
So your regular clinician, one of your clinicians takes the patient off and does the assessment, and then you separately interview the family? So you're doing basically like two separate assessments at the beginning?
[Ward]
It's two separate assessments, right, we put it, you know, the family system is our client, you know, the family system is our client. And so the professional sits there and has the primary person of concern, the individual struggling, providing their sort of experience and their answers to the formal biopsychosocial. And then secondary is the family members and loved ones who have also attended are there to provide their perspective of what's going on, what they experience, and to receive information that may be new to them when it comes to understanding the disease concept. It really is an advocacy for the client, it's one of the truths that we provide that education on that, you know, disease model that hopefully will begin the empathy process between families that stops the finger pointing and the shaming that may happen to the suffering individual where the family member points at them and says if you go get help, if you go, you know, fix your issues, then all of our problems go away. You know, that can be very, very shaming and unfair and just toxic to the overall family's health and well being.
And so this process, when we invite the families and encourage them, really is an act of client advocacy for them, for us to invite the family in and say, “hey, you're a part of this too”, in a very “we” theme or “we” feeling instead of a finger pointing “you” experience. When this becomes a collective “we” process, you know, we find not only is that the most effective evidence-based way to treat the family, most importantly, it begins the healing and connection process in the family with a good first step.
[Joanna]
You also mentioned to me before that it can be really useful because you offer both PHP and IOP if a patient comes in and says, you know, oh, I think I'll be fine with IOP that, that you can get the family support for more intensive treatment up front.
[Ward]
It's, you know, and sometimes it may be intensive treatment, sometimes it may not. It just is a treatment that is guided by the professional. You know, if you think about when you have any disease or any, you know, medical illness, when you walk into the doctor's office, by all means, it's a collaborative relationship.
But I don't know, I don't know your doctor, Joanna, but I don't get to go into mine and demand what type of treatment or prescriptions that he or she is to get me. No, I certainly have choices and we play a collaborative role, but I don't get to dictate treatment as the client. And so in a similar fashion, one of the reasons that I think you can attribute our, you know, success to is that we treat it just like any other disease that the licensed professional, the licensed trusted professional guides the treatment process.
Nobody, nobody dictates it. You know, the client doesn't dictate it and the professional certainly doesn't dictate it. I tell people I'm not one of those professionals that is, believes in that steel on steel, you know, shut up, take the cotton out of your ears and put it in your mouth or whatever. Is that tough love? I don't know.
I believe in the appropriate expression of love. But this treatment is a collaborative, very motivational interviewing type of treatment, just guided by the professional. And that's what we begin to communicate at the, um, you know, at the assessment too, because if there's family members out there, you can imagine that if you're not participating in treatment, that your loved one goes off to this appointment and comes home and tries to communicate what they saw, what they experienced, what they said, how many families have been through that.
And how do you know? I mean, like, how do you know? I mean, is that really what the professional said or it just doesn't really enlist a lot of opportunities for trust and support.
But, however, if you have families that show up there in a healthy way, it provides that element of support and transparency and begins the road of reestablishing that trust, which, you know, thanks to Vista, that is one of the foremost items that and goals that clients have when they enter treatment. I think it's something like 75 to 85 percent of clients check into treatment to repair relationships with their family or gain trust back with their family. So this is just the beginning step of that.
[Joanna]
Can you think, I'm going to put you on the spot, can you think of any recent examples of how you, of something that happened that made you so confident that the family involvement had made a real difference in a patient's recovery?
[Ward]
Oh, absolutely. In fact, you know, some months ago that there was a young adult female who came in, you know, herself, and she was in her early 20s, and she scheduled the appointment and came in herself. And we couldn't exactly get a hold of the family.
So there was a disconnect with them being there right then. But it certainly was a family that wanted to participate. They just couldn't be there right at that moment.
So the client went through the biopsychosocial and went through the assessment and heard the recommendation. And she herself said “I'm not in a place where I should be the one to make these type of decisions”, acknowledging that she was unhealthy. But she said, “I hear the recommendations, please, but I'll just come back in three to four weeks when I'm in a better frame of mind”.
And, you know, it's never in this day and age, that's a serious thing. So we made sure that we got, you know, appropriate releases and asked if we could communicate with the family of which she obliged. And so we were able to contact the family and spent about 30 minutes with them on the phone, kind of educating them with this process and family involvement and actually what, you know, the client with her permission allowed us to share.
And so once that family got educated and involved and committed to the process, within two days, the client had checked into not only the appropriate recommended treatment, but also had checked into the gender-specific female recovery residence and was excited about it. And actually, I think, saw me in the hallway a few days later and said, I'm so grateful to be in Betty's house. And this was the same girl that four days before was in our office, which families should be excited that your child who's struggling made the appointment herself, came in herself, willingly gave the assessment.
But when it came time for that recommendation and follow through, she wasn't there. She couldn't even recognise that she wasn't in the mental space to make the decision. And so that's why we're like, hey, and that's why you should follow the recommendation of professionals and check into treatment.
She wasn't willing to do it. She wasn't willing to follow through. And so she left and it was that added family component, that added element that we provide at that assessment, that with the combination of supporting each other, that not only did the client check in, she checked into that sober living and like I said, was grateful about it the next time I ran into her.
[Joanna]
Fantastic. Wonderful. One last question and then we're going to have to wrap up.
You've been using Vista's outcomes research since I think about 2019. Have you found Vista's research useful either during treatment or afterwards in attracting patients or getting reimbursements or anything like that?
[Ward]
Absolutely, Joanna. I think I found that we found that Vista is an invaluable resource for multi-faceted reasons. All that you describe, real-time, Vista with their interactive client self-report that happens with consistency, I can tell you that that information, there are times where we've gotten alerts, real-time alerts that when a client is filling out their information and they put that their mood or their just mental space isn't in the healthiest place, we'll get a real-time alert that allows us immediate action. That's something that happens when it comes to also just the collective data that we can accumulate. Absolutely, we're able to see and experience objective evidence-based information that shows significant progress in a client that when they check into treatment and their depressive symptoms or their trauma symptoms or their anxiety symptoms, once they go through Vista's standardised tools, we're at a significant level of heightened.
Then by the time they're in their last episode of treatment, have this significant decline. Just that visual can really empower a client. Sometimes when you're in the middle of going through this treatment or early recovery process, you can feel like, man, I just haven't felt like I've made much progress.
I haven't felt like, and we forget what it was and how we were when we came in. It's kind of like why we often in some treatment centres take a picture of a client at some residential centres for their ID badge. We'll take a picture of a client in day one.
Then by the time they graduate or complete treatment day 30, you can take another picture and see that they basically had a metamorphosis into another human being. We don't always see or experience that ourselves because we're fighting that internal battle where our own worst enemies that if I didn't do it perfect enough, then I didn't do it. This allows us to show evidence and visuals of significant progress, which validates the hard work.
Then as we all know, this disease is a progressive disease. The continuation that allows us to follow and get information back on who and how these individuals were able to stay three months sober, six months sober, a year into the recovery process, getting this information back not only to advocate and support our clients, but how do we grow and learn as professionals? How do we continue to really press ourselves to be the best professional that we need to be for our clients?
I tell all the professionals that work in this disease, they really treat this disease with the reverence of how deadly it can be. That means that we're constantly trying to measure and understand are the evidence-based tools and resources, are they being effective? Are there tweaks and things that we need to work on?
It provides an excellent tool for that. Lastly, and a very real advocacy for clients and their families, it does allow us to advocate and fight the insurance companies, which is on behalf of the clients that I consider that just essential client advocacies, because the more that we're able to do that and get authorisations from the insurance company, the less financial burden this is. Because our clinical treatment isn't dictated by insurance companies.
We provide the clinical treatment and the clinical recommendation, and the arguing and battling the insurance companies is on behalf of the client. It really provides us that evidence-based information and data to say, hey, what we're doing is working here, and we're going to add this element of therapy or this element of EMDR or of additional treatment. It's the recommendation either way, don't make the family pay for it.
This is something that the insurance really needs to pay for, and Vista has been very effective in helping with that.
[Joanna]
Fantastic. Fantastic. Well, Ward, we're going to have to wrap up now.
I just wanted to say thank you so much for coming and sharing your experience. I've just been fascinated by everything you've been doing at the Blanchard Institute, and congratulations again on making such a wonderfully effective center. Your outcomes have been excellent.
I just want to thank you so much for coming.
[Ward]
Thank you, Joanna, and thank you guys for all that you guys do, because you guys have come a long way since 2015.
[Joanna]
Yes, we have.
