Research reveals more every day about the complexities of addiction recovery, including the importance of sober support and relapse prevention strategies. Fortunately, new technologies put many of these game-changing recovery tools within reach for millions. Listen in as addiction clinician Janelle Wesloh talks with host William C. Moyers about the most promising innovations in recovery support—coaching, apps, tools and activities—and why daily encouragement is such a powerful motivator.
0:00:15 William Moyers
Hello and welcome to Let's Talk, a series of podcasts produced by the Hazelden Betty Ford Foundation on the issues that matter to us, the issues that we know matter to you too. Substance use prevention, research, treatment of addiction, recovery management, advocacy, and education. I'm your host, William Moyers, and today I'm joined by my long-time colleague, Janelle Wesloh. Welcome, Janelle.
0:00:41 Janelle Wesloh
0:00:42 William Moyers
You're the Vice President of Clinical Excellence, Innovation, and Recovery Management. That's a long title.
0:00:48 Janelle Wesloh
0:00:48 William Moyers
What does that mean?
0:00:50 Janelle Wesloh
Well it means so many different things. We'll start with the Clinical Innovation part of it. This is our efforts to make sure we're providing the very best possible care for the patients that come to us counting on us to not only pull them out of the disease of addiction and clinically manage their illness, but also to move them into self-management where they have the right tools and the right support so they can have a successful, happy life in recovery long after they leave us and leave treatment.
0:01:16 William Moyers
And the reason for that is because we for a long time particularly say when I went to treatment 30 years ago at Hazelden, it was all about the acuity. We recognized the acuity of the illness but we've moved away from that. Explain more about the fact that it's not just the acuity anymore.
0:01:31 Janelle Wesloh
Well, how we look at it now is about how long we can stay engaged with somebody.
0:01:36 William Moyers
0:01:37 Janelle Wesloh
So, it's important that we address the acuity when someone comes to us. They may need detox. They may need very intensive residential care. But as they start to get better medically and spiritually and with their mental health and all the holistic pieces that build together to form their clinical picture, they start to need less of our clinical management. They don't need us every day to be checking their blood pressure or to be in group three times a day. They start to get to the point where they need a little less of that. So we start moving them into the next level of care where they have less—less clinical management and start to learn how to do things on their own. So they start to learn how to find support in the community. Find medical providers in the community that understand their illness and can support them in the right way. So as we start engaging people longer and moving them down that chain of acuity, to where they're managing that on their own, we still wanna provide some lifelines or safety nets for them along the way. Because what we've found through research and just through working with thousands of people is that as you move into recovery, there's certain pitfalls that pop up at certain times—
0:02:40 William Moyers
0:02:40 Janelle Wesloh
Throughout that—throughout that life cycle. And having the right support and the right tools in place at those times can prevent them having to come back into that very intensive level of care like residential or detox. But to help them get back on track quickly and at a lower level of care so they can get back into their lives and self-management right away.
0:02:59 William Moyers
Because we know addiction—substance use disorder—is a chronic illness which means it can't be cured, but it can be treated and people who have it can manage it. Right? And we've gotta give them those tools.
0:03:11 Janelle Wesloh
Correct. Just like any other chronic illness. The substance use disorder field is really starting to realize how important it is to provide ongoing case management, ongoing support, ongoing tools. Recovery check-ups. Just like you'd have for any other chronic illness. Looking at what are the vital signs that we would utilize during care and after—after treatment ends. To help people stay on track or to get them back on track quicker so their lives are not as interrupted, the loved ones around them aren't as interrupted, and we can keep everyone on track moving down that road to recovery, and having a very happy, successful life as they—as they go year after year.
0:03:48 William Moyers
And technology plays a huge role in that. We recognize that at Hazelden Betty Ford. You've been on the cutting edge for many, many years in that area of how do we harness or how do we develop technology. Talk to our listeners and our viewers today about the role that technology plays in all of this.
0:04:06 Janelle Wesloh
Certainly. That comes to the innovation part of my title which has been something I've been passionate about for many many years—
0:04:14 William Moyers
Yes. [nodding, smiling]
0:04:14 Janelle Wesloh
—But just recently has become formally part of my role, which is very exciting. Starting way back in 2006, we started to realize that we had people from all over the country coming to us for help and doing really well in treatment. But then they would go back home. And how do you stay connected with people who are all over the country in all different parts and varying levels of motivation and varying levels of engagement. How do we stay connected with them? And we started very long ago with a program called MORE. My Ongoing Recovery Experience. It was a technology platform built specifically for people in recovery. With content, videos, fact sheets, and also the ability to work with a recovery coach. At the time they were all licensed recovery coaches. A lifeline for them. Anytime they needed. And we'd proactively reach out to them at certain times. And ask them how are you doing, is there anything we can do to help you. Is your transition from treatment to home going smoothly? If not, what can we do to make it smoother for you?
0:05:11 Janelle Wesloh
It might be that they were recommended to see a psychiatrist in their home area to continue the medications that were started for depression or anxiety. And maybe that fell through where they're not taking new patients. We could case manage that, help them get a new referral, to make sure that didn't become a bump in the road to their recovery.
0:05:27 William Moyers
Is MORE a recovery app, per se? Or is it something different?
0:05:32 Janelle Wesloh
Yes. And yes. It is both. [Moyers laughs] So, it is a platform that we utilize in our patient portal. So much like most people have a patient portal with their own physician or clinic—
0:05:40 William Moyers
Yes. Sure. [nodding]
0:05:41 Janelle Wesloh
—We have a patient portal that our patients use as well. So we have this wonderful platform where our patients as they're in treatment and afterwards can get at all these resources that are specifically built for them. Knowing how successful that was, we also at Hazelden Betty Ford built an app. That was similar to that platform called Mobile MORE Field Guide to Life. And has quite a bit of content in there as well as daily affirmations, weekly sober challenges, just really an engaging, interactive app that people can utilize to stay engaged and to help them feel motivated and excited about their recovery.
0:06:17 William Moyers
Do you have to be a Hazelden alum to be able to access some of these technological advances that we offer?
0:06:25 Janelle Wesloh
Some, yes. But most no. We wanna make sure that we offer these support tools and technology to anyone in recovery. So our mobile apps we have so many of them that Hazelden Betty Ford has produced, but the one I was speaking about, Mobile MORE Field Guide to Life, is available to anybody both with Androids or Apple or whatever platform you may have to just go out and get it like any other app and utilize it. And it has all kinds of great content including some videos that you produced for us, William. [smiles]
0:06:53 William Moyers
Oh, I did?!
0:06:54 Janelle Wesloh
0:06:54 William Moyers
Oh, wow. I guess I'm famous now or something. [chuckles] Janelle, we have had a podcast with Dr. Steven Delisi who of course is intimately involved now in our professional education solutions. We have enormous content in our organization. People tend to think of us as a 24-hour-a-day book or some of the other meditation books, how has technology—how are you harnessing technology in capturing that content and delivering it?
0:07:22 Janelle Wesloh
Well I think technology gives us this fantastic opportunity to overcome you know typical problems that would happen because of resource constraints. You can't have a person you know in every single state to try to help everybody or every single town. So when you start to use technology, you really broaden your reach. You can take this fantastic content, package it up in different ways that will fit for what the patient wants, what the person in recovery wants. And they can take those pieces that are meaningful to them—
0:07:48 William Moyers
0:07:49 Janelle Wesloh
And because we have these technological solutions like apps and social networks and different platforms, people can come to. They can take what works for them, it's very patient-centered, very recovery-centered, and take what works and then move on and get what they need and continue in their life of recovery. So it keeps our content from being on a shelf in a book—
0:08:09 William Moyers
0:08:08 Janelle Wesloh
—If you think about way old school. And makes it accessible to so many more people in so many different ways.
0:08:14 William Moyers
Is technology as we apply it at Hazelden Betty Ford just for the younger generations?
0:08:20 Janelle Wesloh
There's sometimes a misconception that that's the case. Of course our young adults and our younger folks that come to treatment have grown up with this technology and to them it's second nature. It's like writing cursive is to us which they don't do anymore. [Moyers chuckles]
For them, it's easy. For people of my generation, we came to it a little later but, you know, grabbed onto it pretty quickly. The misconception comes from some of our older patients which you know of course we have patients of all ages. And what we found is given the right coaching and a little bit of patience, and for some not even that because they are—they're Facetiming their grandkids. I mean our older generation has grabbed onto technology as a way to stay close to their family. So a lot of them have already started to bridge that gap and with just a little bit of handholding if needed, some patience and some tips, most of them do just fine on the technology and really seem to embrace it as a way for them not to feel so alone or isolated depending on where they live and how close their family is.
0:09:19 William Moyers
I'm excited by all the things that Hazelden Betty Ford is doing under your leadership. It spooks me a little bit because I am from the old school and even today when you walk the halls or you go onto the units, there they are that very essence of what got us here all these 70 years ago, this is our 70th year now, 1949 to 2019, and that's the Twelve Steps and the Twelve Traditions that hang on the wall of every one of those units. Have you ever felt any tension between what was birthed in the late 1930s and where we're going today?
0:09:52 Janelle Wesloh
You know, most of the time that's due to misconception.
0:09:57 William Moyers
Huh. [smiles, nods]
0:09:56 Janelle Wesloh
And so we're glad when people bring that to us and say well what about fellowship?
0:10:00 William Moyers
Yeah. Yeah. Yeah. [nodding]
0:10:00 Janelle Wesloh
How can people have fellowship behind a computer screen? And the fact is if you design the solutions correctly, it can enhance that and encourage it. For example, our MORE program has recovery coaches. What we found is that most people though recommended to attend Twelve Step self-help groups after they leave treatment, don't necessarily just run out and do that. It's a little scary to go to your first meeting on your own.
0:10:22 William Moyers
0:10:23 Janelle Wesloh
So a coach's main role in those first few calls is to really encourage and support that person and maybe even connect them with another alumni in their community to help them go to those meetings. And start to get really connected in that recovery community. So it's easier to disconnect from their using community.
0:10:38 William Moyers
0:10:38 Janelle Wesloh
Which is really one of the very first critical tasks of someone going home to their home community.
0:10:43 William Moyers
So what I hear you saying then is that technology will be vitally important to the future of our mission and our ability to expand our mission but we're not going to use technology to replace the fellowship that is at—well the first word of the first step of the Twelve Steps is 'We'.
0:11:00 Janelle Wesloh
0:11:00 William Moyers
And there's nothing like a meeting, there's nothing like a group experience, and technology can perhaps bring people together, but at the end of the day it's that interaction that counts, right?
0:11:08 Janelle Wesloh
Exactly. Exactly. We had a great story of somebody who came to us for treatment that lived in a very rural area. It took him about two and a half hours to get into the nearest town. So as we're building a plan for this person so he could be successful in his early recovery, he committed to going to one meeting a week. In town. And that's great. That's a five-hour round trip, plus the meeting, hopefully some fellowship before or after—
0:11:28 William Moyers
0:11:30 Janelle Wesloh
That's a big commitment. But he committed to it and he did it. In between, he supplemented that with online meetings. So he was still interacting with people in recovery. But that worked for him. You have to really take his situation and make the plan fit. If we had told him 90 meetings in 90 days, we would be setting him up to fail.
0:11:47 William Moyers
0:11:47 Janelle Wesloh
And that's not what we're about. You know, that's what our clinical standards are all about. Meeting people where they're at, giving them a plan they can be successful at, and that they buy into so they'll actually go do it. And that's how we see success and better outcomes.
0:11:58 William Moyers
So Janelle, you talk about innovation and technology and bringing Hazelden Betty Ford to people who can't get to Hazelden Betty Ford. Talk to us about what's happening in Telehealth. What is Telehealth and how is it being applied?
0:12:14 Janelle Wesloh
Telehealth is such an exciting area for us. And we're really poised to expand how we are utilizing it for our patients to reach people we could never reach before. It's been around for a long time. But—and we've dabbled in it in different ways. Currently, we're working in Telehealth in three very distinct ways. One we have two of our Addiction Psychiatrists who are seeing people via telehealth that normally would not be able to continue seeing them after they left care. And one of the key things for this—it's so difficult to find really good Addiction Psychiatrists that the more we can have these great resources and great staff members available to our patients, it's such a critical need, the better off. So telehealth really expands that reach. We're also using telehealth in one of our recovery support programs. Or a program that we use when people leave treatment to keep them connected. And that's our connection program—
0:13:03 William Moyers
0:13:03 Janelle Wesloh
Which is support and monitoring after treatment happens. We are now offering either that by phone, which is our traditional way, and also offering it via video visit. So if somebody would like to see us on a video screen, phone, tablet, desktop computer, they can also choose that as well. Which has been very interesting. And probably what I think one of the most exciting ways we are experimenting in Telehealth is we've started to pilot a virtual intensive outpatient program. To really reach people we would never be able to reach to continue on in their trajectory from less intense treatment over time so they can be in their home areas and still be getting the excellent care and resources and treatment from our skilled providers in a group. Getting fellowship. And as they reconnect into those recovery communities. So very exciting. Meeting people where they're at. Expanding access to people who normally wouldn't have it. Which is really a part of our mission.
0:13:57 William Moyers
Once upon a time, you had to come to a Hazelden Betty Ford site to experience that mission. Or maybe get it through a book. And now we're taking that mission through your good work, through technology, and all the other innovation that's occurring, we're taking it to people as you said where they are in that moment that they need to experience our mission. Janelle Wesloh, thank you very much for taking the time to be with us today.
0:14:19 Janelle Wesloh
Thank you, William.
0:14:21 William Moyers
And thank you all for joining us for another edition of Let's Talk, a series of podcasts on the issues that matter to us and matter to you. On behalf of our Executive Producer Lisa Stangl, I'm your host William Moyers and we'll see you another time.