In this episode, Kathleen is joined by David Leap, Outpatient Clinical Supervisor at Fairbanks as they discuss the first licensed Online Intensive Outpatient (IOP) program in Indiana and the program’s benefits. Read the full transcript from the podcast below or listen to it here or on iTunes or Google.
Kathleen Gill: Welcome to Recovery Talks, a Fairbanks Podcast where experts from Fairbanks Treatment and Recovery Center, located in Indianapolis, Indiana, take time to discuss unique aspects of addition, substance use disorder and recovery, as well as other relevant issues, with our guests.
Kathleen Gill: I’m your host Kathleen Gill. I’ve worked at Fairbanks since 2007, and I am a woman living in long-term recovery.
Kathleen Gill: Today on Recovery Talks, we are joined by David Leap, the Outpatient Clinical Supervisor at Fairbanks.
Kathleen Gill: Thank you so much for being here, David.
David Leap: No problem, thank you Kathleen.
Kathleen Gill: Tell me a little bit about how you got started at Fairbanks, and what you’re doing.
David Leap: I got started with Fairbanks actually as an intern back in 2011. Did a yearlong internship placement there, and got hired in immediately after graduation, which was really awesome, and I’ve been working there ever since. Started off as our Inpatient Float Counselor for about six months, then did PHP for almost four years, and have been in the Clinical Supervisor role for pushing three years as well.
Kathleen Gill: Fantastic. So describe to us what Intensive Outpatient Services are.
David Leap: In terms of Intensive Outpatient Services, or IOPs we like to call it for short, is a program that’s really designed for individuals with mental health addiction types of behaviors going on to get back into the real world. It’s really designed for people going back to school, going back to work, whatever, just to have a little bit of that extra support, some structure, and work on the recovery from that type of a standpoint.
Kathleen Gill: So this is after they have been inpatient and through the Detox program?
David Leap: Correct. Or they could also be directed into that, so maybe they haven’t quite hit that full need to do an inpatient type of a stay. Maybe they’ve gotten a couple DUIs and their lawyer encourage them to get ahead of some things, and look at having some treatments, some resources to help them out with their legal situation, get some education, things like that.
David Leap: So we get some people kind of then you work from there, all the way up to after they’ve needed, again, that inpatient type of a feel.
Kathleen Gill: Okay, great. So we are living in an ever-changing world, and I understand that Fairbanks has launched an online IOP approach.
David Leap: That is correct.
Kathleen Gill: So tell us about that.
David Leap: Online IOP is a new opportunity. Again, we’re looking at how can we best reach those people who need some extra help. And one of the things we’ve realized over time is that some of our clients, even though IOP tends to be about nine hours a week, sometimes their work schedule just doesn’t work out well with that. Maybe they work second shift and try to do a morning IOP or evening IOP, just isn’t conducive with their schedule. Maybe it’s a client that they want to stay connected with Fairbanks and they’ve not been able to traditionally do so, because they live too far away. Different things like that. College students. If they’re in college and they have some issues going on and they need some extra help, sometimes them leaving school and all that type of stuff may not be as conducive as well, and lose some structure. So it’s really designed to help look at some different ways to get clients involved, get some help in ways that have not been an opportunity before.
David Leap: So that’s really kind of the basis of that. We also like to use it as an opportunity for individuals who maybe are a little bit worried about some confidentiality aspects. So maybe it’s a big business owner, or maybe it’s somebody that works in the legal system, or they’ve got clients who may be in our actual programs as well. So it’s a way to kind of avoid some of that conflict of interest as well, and keep them still in some anonymity as well.
Kathleen Gill: So you mentioned that the Intensive Outpatient Programing is nine hours a week. What does that nine hours typically look like?
David Leap: So in a traditional IOP that nine hours consists generally of about seven and a half hours of actual group therapy, and about an hour and a half of education throughout the week. Looking at our adult programing, Monday and Tuesday they have group therapy from six to nine at night, or from nine to twelve in the morning, and then on Thursdays for the evening program, and we have our family program that has some educational components. So family’s able to come and get some education as well with our client. Unfortunately just because our work schedules we can’t offer or typically go, we do not have any kind of family programing for our daytime one. We also allow our families to come to that evening program, for that lecture and things as well, if needed. So that’s kind of how the typical one works.
David Leap: So they get a lot of time too in that seven and a half hours to process, go over some education within the group itself, to share homework assignments. Just to kind of check in and really feel what’s going on, are they getting used to that peer support that’s going on in the program as they’re again returning back to work or school, or whatever else is going on in real life.
Kathleen Gill: So with the online, is it a group setting or is it purely individual counseling?
David Leap: Yeah, this is what makes it really different. So this is actually our program where it is really going to be more individualized. It is set up where clients are watching online modules, from trusted professionals in the field, that go over various topics. So they spend a good portion of their time actually watching these video modules online. And then they have, approximately once a week, an hour, either session for therapy or case management. And there’s a little bit of opportunity to kind of do a little hybrid between the two. But typically an hour for them to interact with a counselor one-on-one over the internet, and use a video kind of chat opportunity with them.
David Leap: So then that really means that they’re able to maybe share some things that they typically wouldn’t in so much in a group. They can go a little bit deeper, a little bit further, and then the counselor just has them as that individual captive audience to really address some of those types of things.
Kathleen Gill: And then from a family aspect, is there any way to bring in the family into an online IOP?
David Leap: Yeah, actually family or some type of an accountability partner is a major requirement for the program. We like to have them have somebody that can kind of keep their eyes on them and help provide some extra support and structure for them as well. So this person maybe will go to some open meetings with them, may help them watch some of the video modules, or talk about some of the process questions that come up with those video modules, and just kind of have that extra support for them. The counselor is also supposed to be able to check in with the family as well and see if the family has any kind of concerns. So the families who are involved in this have the opportunity to watch, like I said, all those modules as well, so the family can go on and get a lot of education and knowledge from this program, too, which is pretty cool.
Kathleen Gill: So you mentioned that the typical IOP, or Intensive Outpatient Programming, is a six week course. How does the online program work?
David Leap: So the online program is similar in some ways. It does have a little bit more flexibility, but that’s also because there’s actually more sessions across with it as well. Our typical IOP, just standard by itself, is about 18 sessions, and the online session, or online IOP, is about 25 sessions. And that’s just to make sure everybody’s getting really the source material that they need to out of that. So it extends a little bit longer. That being said, a client can still finish the online IOP in approximately six weeks on the fast end, and on the long end they need to finish within about nine weeks.
Kathleen Gill: How do you determine whether online IOP, or the traditional Outpatient Programming, is the best fit for a client?
David Leap: I think there’s a lot of case-by-case situations that make that determination. Again, just a long process to figure out what it needs to be. One thing is we really want to look at though for someone doing the online IOP again is really is there a need or a barrier that online would be able to overcome, that live services would not. Research in insurance really likes the idea of that group therapy model for early addiction treatments, so that’s why still live IOP is one those programs that we push very hard as well. We would like to see those clients being able to build relationships with other people. That being said, if we run with that confidentiality type of issue or somebody worrying about their anonymity, this again opens up another opportunity, and again we’re going to push them going to 12-Step Meetings, or other self-support groups, to help with that.
David Leap: So that’s one thing we have to look at is, again, where does that confidentiality part play into. Another one’s going to be again if they’ve got good family support, or again some type of an accountability person. Somebody who is living alone in a hotel, not really a great idea for online IOP. Somebody who is in college on the other hand, where they may not have family there, but they’ve got a roommate in the dorm that’s willing to kind of help out and just make sure, yeah, they’re watching these modules, is fine. Or if they’ve got an RA that’s able to assist with some of that type of thing.
David Leap: So those types of situations again become another big factor into it. Transportation can be one. So again, maybe the client can’t get to us routinely. So if transportation is now the issue, then that makes a great candidate for online IOP, again particularly, again, if they’re not living alone or have some additional support and structure that they can have some type of accountability with.
Kathleen Gill: But you say that insurance does cover the online?
David Leap: Yeah. Most of the typical insurance companies that we’re able to use for our IOP services will cover this as well. The one that is going to be an option that with online IOP is not going to be a possibility, will be any of the Medicare type of placements. So that would also include [Anthem HIP 00:09:35]. So unfortunately clients who have that are not at this time eligible for online IOP. So they would have to do a live IOP with us, or going to be referred to another program.
Kathleen Gill: And of course self-pay is always an option.
David Leap: Yes, self-pay is also an option.
Kathleen Gill: So what are you seeing the effectiveness of online IOPs?
David Leap: With it still being as new as it is, we have not had a lot of clients come through the program to the point where they’ve completed it yet. We are finding though again that it’s got a largest convenient pieces of it. For clients unable to sleep one night, it’s an opportunity for them to go on and just watch some of those modules and have something to do. We’ve had some clients where, again, life situations happen and they’re able to just do a lot of focus on this, within a few days, rather than three times a week, making that designated time.
David Leap: So from those perspectives, we’ve definitely had a lot of positive feedback from the clients, really enjoying that. On the other hand, some of the other concerns we’ve had with it is if there’s been connectivity issues with the cameras and things like that. That did happen early on and we’ve been able to work through that, so we’ve not had any of those issues lately which is really good. That’s something we hope for continuing clients moving forward. But some of those things were early learning curve things that we just didn’t know were going to happen.
David Leap: That being said, with the clients we’ve had some completion with, or clients who are nearing completion at this point, it has been positive feedback and they’ve enjoyed their experience, and learning a lot. I think that they, again, feel a little bit more free to talk about whatever’s really going on, because they know they’re not having to worry about other people hearing certain things.
Kathleen Gill: I can imagine that that would be beneficial.
Kathleen Gill: So how does one get enrolled?
David Leap: So if someone getting enrolled in online IOP, would kind of do the same thing that most of our other clients do. They would need to contact our access department, have an assessment, and follow up with whatever recommendation happens first. So maybe they’re not appropriate for IOP at that point, they do need to detox, so then they could do that. Or if they need PHP, partial hospitalization, they could do that. But once they are appropriate for an IOP level of care, whether, again, as a step down or direct admit they’d be able to be placed into that program.
David Leap: At that point, if they are currently within our program, they would get together with me and I would give them a kind of orientation folder, give them some drug screens and mouth swabs to be able to take home for the drug aspect of accountability there. And that’s again where family comes in really as a big help, is they can help with those drug screens and those mouth swabs, as well as they can do those on the camera with the counselor as well, for the mouth swab part of that. And then once they have those materials and all that, we kind of get them set up with the online system that they need, and they get information on how to register and everything. Once they get their account information emailed to them, they’re able to go and start watching the videos.
David Leap: If they are direct admit they will get the same information, the mouth swabs, the drug screens, from the access staff, and they will follow kind of the same suit at that point. But if they are somebody who’s already getting involved in our program, I will meet with them and give them that information as well.
Kathleen Gill: Very good. And then once they are enrolled… I know you said there was 18 to 25 hours and they’re going to be watching videos… kind of walk me through again if you would, once they are enrolled, what can one expect?
David Leap: Once one gets enrolled, it’s pretty open for them to get started pretty quickly. Once they have their account, they can get into the system, log in, and start watching the modules. We do have it set where they can’t go through that program before the six weeks, like I mentioned it has to be at least six weeks, but they can start watching as many video modules as they have access to from day one. And then again, like I said, about every week or so, up to a couple times a week depending on their particular schedule of where they’re at in the program, they would have a case management session or counseling session with the counselor. And so yeah, they watch so many modules up to that point, then the counselor would have the session with them and then they’re free to watch kind of that next set of modules moving forward, so on and so forth.
David Leap: And again we would also be encouraging them to again attend 12-Step Meetings or other self-help support groups in the meantime as well. So kind have all of that going on, and then again, some contact with family and having them involved as much as possible too.
Kathleen Gill: For the traditional IOP, there is a recovery management program that people are eligible to participate in once a week. Is there anything like that offer for the online participants?
David Leap: Yeah, so what we like to refer to with that is if they are local and, again, it was a issue related to timeframe or whatever, if they have a timeframe that will work out for them to attend our live recovery management, then we offer that. If they’re out of the area we try to help them find a place in their local community, that they can still get connected to a recovery management type program. So at that point it’s really kind of up to the client how much they want to commit to doing that, but we do offer and encourage that, because, again, we find that the more they’re involved in their early recovery, the better their chances are for long-term success.
Kathleen Gill: Indeed. So why do flexible recovery programs matter?
David Leap: I think they matter because, again, it allows us to target a new base of clientele that maybe haven’t been able to have some of that success before, or possibly maybe during a timeframe that would have been beneficial for them or not, they maybe wouldn’t have had in the past.
David Leap: So again, looking at a college student. We’ve had college students enroll in a lot of our live programming and they are having to dismiss themselves from school, or miss class time for engagement in actual programming. So now we’re taking where they already have some structure, maybe it’s not the best structure they could have, but some structure, we’re moving that structure, to replace it with another structure. But it’s also causing problems with both structures because a lot of times they’re not fully engaged in the live IOP or higher level of care while they’re still in school. So a lot of times they’re trying to compete with which one’s more important.
David Leap: And so again with this, again focusing on the college students, there’s an opportunity where they’re not having to withdraw from classes, they don’t have to miss their class, they can do this late at night after they’re done with their classes and homework and get ready for bed, or they can do it first thing in the morning. It’s really flexible for them in that aspect. So that makes it a very interesting perspective.
David Leap: And one of the online clients we’ve had has been a business owner, and so for him the opportunity to manage his business and do a live IOP was not super convenient. And so this allowed the opportunity for him to be involved in this program, do what he needs to do, and also maintain his business and not have to miss important meetings and things like that.
Kathleen Gill: Just out of curiosity, have you discussed taking this into the prison system, or…?
David Leap: We are looking at a few different opportunities. I don’t know if we have fully considered that yet. I don’t know officially if there’s any kind of concept on how well we can get this into a prison system, again, because there has to be a secure environment for them to be able to work out of a little bit, for that one-on-one counseling and case management session, as well as online opportunities. So I don’t know honestly without having discussions with the legal departments and things like that, how easily this would be.
David Leap: I know one of the things we are looking at is going out and outreaching to some of the local colleges and things in the area and letting them know we have this service, and also pairing it with our Prime For Life service, which is an educational program that’s not quite treatment heavy focused yet.
Kathleen Gill: I would imagine that that would be a tremendous opportunity on the college campuses.
Kathleen Gill: Who do you find your ideal candidate to be for online IOP?
David Leap: I think our ideal candidate is someone who is going to be driven and self-motivated. Our counselors for this program do follow up with the clients, but again if they’re waiting, kind of putting everything on to the weekend, I don’t know that that’s the best learning route for them. So somebody who’s driven, motivated, and willing to kind of maintain. It’s really highly encouraged that somebody does this for approximately about an hour a day, and I think that’s where they get the best learning in from. So I think that’s going to be a big part of it. And again other aspects are going to be just some of those other things we already talked about. Do they have reliable transportation or not, and if they don’t have it, then that makes a good candidate. Do they have that accountability source at the home? If so, then yes, that makes a good candidate.
Kathleen Gill: When you talk about the accountability partner or the family involvement, the disease of addiction certainly affects the entire family.
David Leap: Absolutely.
Kathleen Gill: What do you think loved ones should know about someone fighting addiction or living in recovery?
David Leap: I think family, just in general, the more educated they get with this, the better they are. I think they need to realize that again it is a family disease, so it is not just their loved one who is seeking our services that is being impacted by this. I think the more that they can stay appropriately involved with the counselors and the support system that this person’s working with, the better. And just learning better ways on communicating, better ways of giving their loved one a chance to build some trust and success, while at the same time not just blindly trusting. For example, if a client says, “Hey, can I have some gas money?” Make sure they bring the gas receipt back, and make sure that all the money there is accounted for. But at the same time if you never give them that chance to go purchase gas, how are they ever going to have that chance in the first place. So just things like that.
David Leap: And I think just too that the more the family learns that this is a lifelong aspect that the individual in recovery is having to deal with, will be important as well. If they don’t have that understanding, if they think that their loved one’s just going to come to treatment and get cured, the family is setting themselves up for failure as well. So just knowing that it’s a lifelong battle, it does get easier over time, same time the family needs to know that things can always happen.
Kathleen Gill: And also that recovery is possible. While there are a lot of people out there that relapse is very much part of their story, when the individual suffering with substance abuse disorder, if they have the support and a good relationship within that family unit, that is instrumental to success as well.
David Leap: Absolutely.
Kathleen Gill: Is there anything else that you’d like to tell us about the online IOP or IOP in general?
David Leap: I think they are again both great programs. Again it’s looking at different natures and what it’s there for. But again, both of them are strong. They’ve got good curriculum for each individual. It’s got a lot of chance that whether it’s, again, a live IOP where they’re in group where they do get a lot of individual attention within that, and also, again, whether they’re in the online IOP they’re going to get just a different type of individual attention with that. So yeah, I think they’re, I guess, they’re both good programs. It’s going to give people a very good chance of success in working in an recovery program, as well as giving them the ability to develop lifelong bonds with people kind of going through the same thing, again, in that live program. And if, again, they’re in the online one going to meetings, it still gives them that same chance to have those lifelong bonds. So either way, as long as they’re connecting those different ways, it’s a really awesome opportunity for them to make good choices moving forward.
Kathleen Gill: Indeed. And of course there’s always volunteering and Alumni Association membership that Fairbanks offers. Fairbanks is on the verge of celebrating 75 years of being in business here in the Indianapolis area, and there’s a lot of people that have found help in their initial steps into recovery in Indianapolis.
David Leap: Absolutely. It’s awesome.
Kathleen Gill: David, thank you so much for joining me. At Fairbanks we like to say Together We Can, and that’s an open-ended statement that means we can do more, and overcome more, when we do it together. To end our Podcast today, we’d like to know how you would finish that statement. So, Together We Can…
David Leap: Create and restore hope.
Kathleen Gill: I like that very much.
Kathleen Gill: This has been Recovery Talks, a Fairbanks Podcast. If you or a loved one needs support in the journey of recovery, the experts at Fairbanks Treatment and Recovery Center can help. Visit our website at FairbanksRecovery.org for recovery resources. Or call 800-225-HOPE for immediate help.
Kathleen Gill: Thanks for listening today.