In Milwaukee Magazine’s August issue, Dr. Chantelle Thomas was one of two experts discussing the affects of the COVID-19 pandemic on mental health, including alcohol and drug abuse. Please take a moment to read the article below.

How to Get Local Help If the Pandemic Has Affected Your Mental Health

Staying home and limiting social contact has helped keep us safe and healthy, but it can also increase feelings of isolation and anxiety, and can trigger alcohol and drug abuse. Two local doctors discuss how to identify symptoms and where to find help.

BY EVERETT SULLIVAN, Milwaukee Magazine, August 28, 2020

MILWAUKEE MAGAZINE: How has the coronavirus crisis affected demand for mental health and addiction services?

DR. JUSTIN KUEHL: The COVID crisis has definitely led to increased stress, increased risk of depression and anxiety, among all individuals. A lot of the issues that are common with depression such as insomnia, isolation, lack of interest in normal pleasurable activities – those are things that have really ramped up because of being isolated, because of having to socially distance from others. There’s definitely an ongoing risk here in the community, and I don’t think we’ve seen the biggest wave of effects yet. It’s something that we’re definitely, as mental health professionals, aware of and really concerned about as we continue to move forward through this crisis.

DR. CHANTELLE THOMAS: I’m working in a residential environment for substance abuse treatment and co-occurring mental health issues. I think we’ve definitely seen an upsurge in different types of issues emerging as a result of shelter-at-home. Folks who may have been struggling before, now with this current situation, are more visible to family members, because everybody is in the same space. I think not having other outlets for relieving stress or anxiety or the pressure that’s building up around the uncertainty that we’re all facing is leading people to more desperately go to the thing that they know can provide them with some temporary relief.

MM: What symptoms do you think friends and family should look for in loved ones who might be struggling with addiction or depression?

JK: One of the things to look for is changes in patterns of behavior. Sleep can be affected as part of either depression or anxiety, so if family members notice a change in sleep patterns, that’s definitely a warning sign. Lack of interest in activities that previously they were really interested in. Mood changes, looking more depressed, expressions of hopelessness. Those are all things that family members really need to be attuned to and listening for in conversations. The next step is realizing that there is help available. Just because we’re in the midst of this crisis doesn’t mean that our community providers, our institutional providers, our county providers aren’t still there and willing to help. For example, here at Milwaukee County Behavioral Health Division, our crisis service continues to operate in some modified ways, but still in the same way we were before COVID. Our crisis line number is available; that’s a line people can call just to get advice, to get referrals, to even talk through if they’re having a really tough time to the extent of even having suicidal thoughts. Our crisis clinicians, who go out and do assessments, are still able to do that. So, if it really comes to the need for a face-to-face intervention, that’s something Milwaukee County can choose to offer.

CT: It’s a really good time to be curious about what’s happening for people and to inquire and ask questions. In those moments when people are not able to talk about it or want to shut the conversation down very quickly, that can be a sign of concern. Access to help has actually increased for a lot of people who are very vulnerable. Part of that has come with the support of insurance providers and the state sanctioning telehealth and mental health therapy over the phone or over video conferencing. In terms of contacting our clinic, the main number there is not an automated person, it’s an individual who answers the phone every time. We also provide a service when people are looking for substance abuse treatment that helps direct them to a better fit if our program isn’t right for you. I will say for family members or friends that are concerned and are looking to reach out, be mindful of what sort of messaging you’re putting out about yourself and how you’re managing this situation. I think family happy hours can be a really fun thing when appropriate, but if most family gatherings are virtually happening in the context of alcohol or substance use, it really becomes alienating for someone who wants to connect, if that’s the platform in which it’s happening.

MM: In a major crisis event like this, what changes in alcohol consumption do you see?

CT: I’ve been struck by how much alcohol is talked about in the context of this pandemic. People are struggling to find reasons to connect virtually unless they involve alcohol a lot of the time. It’s like, “Hey, let’s have a drink on Zoom,” or, “Let’s FaceTime and have a drink,” as opposed to, “Hey, let’s just connect.” I imagine for people who are in recovery or trying to reduce their use, how much more alienated those individuals might feel if they don’t feel like that’s a resource for relieving stress.

MM: The coronavirus has severely affected communities of color in America. Justin, how would you say that this has translated to the mental health of members of those communities in Milwaukee County?

JK: It’s the anniversary today [May 20] of the county executive declaring racism a public health crisis here in Milwaukee. I think it’s striking because it’s something that Milwaukee County as a whole has been really in tune to, really trying to help address some of the effects of racism and the disparity that our community experiences. So, you had that backdrop, and then you add in COVID. What this has really shined more light on is the fact that when you have pre-existing disparities, such as health disparities that make people more susceptible to COVID, that actually increases mental health concerns in terms of anxiety and the worry about getting sick. So you just start compounding some of those pre-existing conditions with the current situation which leads to more stress, potentially more depression, and it’s definitely harder to cope overall.

MM: How do you think isolation within lockdown has affected mental health and addiction?

JK: As human beings, we’re social individuals. We want to connect. We want to reach out. The lack of physical touch alone is such a huge variable. As we hear about discouraging handshakes, discouraging hugs, not being able to have those kind of connections with others, that has a huge impact on mental health.

CT: Some people say addiction is a disease of isolation, because one of the major aspects of what happens for people who end up in a use cycle is that some make a choice to physically distance themselves from people and use in isolation, and also, when you’re using in a room with other people, it immediately creates a barrier. A lot of the time, in the world of treatment, what we’re trying to assess are the barriers to connection. That’s one of the primary ways to promote healing in the recovery process. And so, if you actually have an entire environment that’s promoting, for completely understandable reasons, isolation, it just makes it much easier for people to be in hiding and to feel alienated. One of the biggest things that we work on with folks is developing the muscle of asking for help.

MM: The most vulnerable groups affected by COVID-19 are older adults and those with underlying conditions. How has their mental health has been affected as this crisis has unfolded?

JK: For groups of older adults and individuals with disabilities, even before COVID, there were some limitations and barriers to social connectedness for those who live in, say, a congregate setting like supported housing. There sometimes isn’t the same community involvement, community connectedness that other individuals enjoy. So now you layer on COVID. It’s really amplified some of those pre-existing conditions. That feeling of stress and anxiety feeds into the overall environment and layers on additional problems and stressors for those individuals.

MM: There’s been a constant stream of news related to COVID-19. How do you think someone who wants to stay informed can do that without getting overwhelmed?

JK: I think that there’s really two important takeaway points. One is that you really need to find the good sources of information. It’s important to turn to good sites: the CDC, our state government and Milwaukee County provide good ongoing guidance. The second major take-home point is to know when to quit. We have the tendency to just want to continue to search and get more information. But we need to be able to say ‘this is enough,’ because it does become overwhelming, and it actually becomes anxiety-provoking, when you just get so much information – and sometimes contradictory information – which then leads to further anxiety and further worry, so know when to say ‘when.’

MM: What do you think everyone can learn about their own relationship with alcohol through being in lockdown?

CT: This is a really interesting opportunity to learn about what it means for you to take care of yourself in the face of stress, in the face of a crisis. So many people are defining self-care as drinking, giving themselves a way to check out a little bit, to reduce anxiety, to alleviate stress. A really good way to test your relationship with alcohol or a substance, when you’re concerned about it, is to attempt pulling back on it or stopping: starting to set goals, maybe not drinking on a certain day. Now, I will put that caveat that for people who have a strong drinking relationship on a daily basis, we never encourage people to stop without medical support because that can be dangerous.

MM: For anyone who wants to seek help, what kind of guidance would you offer them?

JK: From a Milwaukee County standpoint, we have the crisis line, we have our mobile teams, we have our network of contracted mental health providers that’s available and willing to help in these situations.

CT: When you start to let people know that you might be struggling, you will be very shocked to learn the number of people who have also been struggling and might be able to share something with you about talking to a therapist or talking to a mental health professional. Those are things that aren’t likely to come up in conversation until someone takes the risk of saying it. And then of course, reaching out to our facility, The Manor. There’s a contact number  that can help guide you to a person who can help you navigate what kind of resources might be available to you if you’re struggling. 

MKE Lifestyle Magazine’s Lori Acken interviewed our very own Dr. Thomas for her expert insights on alternatives to opioids for pain relief. Please take a moment to read the article below.

Rethinking Relief: New ideas for pain mitigation amid the substance abuse crisis

BY LORI ACKEN, MKE Lifestyle Magazine, Jun 26, 2020

In early 2010, I underwent a pair of surgeries to remove a giant cell bone tumor from my leg and repair the significant damage it left behind. After several days in the hospital, I came home with an opioid medication to ease my pain. 

It worked very well. So well that I stopped taking it three days in.

It wasn’t that I didn’t appreciate the relief. I did. But at the time, I was also the stressed-out working mom of four busy teenage kids, including one with severe special needs. In one swallow, that medication took away the heft of those stressors too. I was suddenly the most serene person on the planet. And I knew instantly how hard it would be to let that go.

Fast-forward a decade. My octogenarian dad is now the patient who is immobilized by pain, in his case from severe arthritis in his back. Despite his age and incapacitation, opioids are off the table, courtesy of a nationwide epidemic of substance abuse that has left medical professionals battling for effective ways to ease pain while curtailing that epidemic. Factor in the COVID crisis that has even the sturdiest among us self-medicating, and pain patients and the doctors and therapists who treat them are even further challenged to keep minds and bodies protected and pain-free.

How Did We Get Here?

According to medical toxicology specialist Dr. Jillian Theobald, an assistant professor at the Medical College of Wisconsin and associate medical director at Wisconsin Poison Center, the path toward epidemic began in the early ’90s when Dr. Mitchell Max, a National Institutes of Health pain specialist and prominent member of the now defunct American Pain Society, lamented the medical community’s ongoing struggle to quantify patients’ pain levels and provide effective relief. In nationwide speeches, Max also challenged the idea that long-term opioids for pain unrelated to cancer could result in dependence or serious side effects, augmented by a pair of small, retrospective studies to that effect. Others within the pain community jumped on the bandwagon, based on what Theobald calls “this small little snippet that was published in a journal that essentially said, ‘We looked at all the patients that we gave long-term opioids [to] for non-cancer pain and they did not get any addiction issues.’”

Pharmaceutical companies wasted little time in further convincing an already anxious medical community that these powerful medications in generous doses were a true panacea for suffering. Meantime, the American Pain Society’s designation of pain as a “fifth vital sign” — one not measurable with medical equipment, but no less significant — took hold with the Joint Commission on Accreditation of Healthcare Organizations, the Veterans Health Administration and beyond. Theobald says that while the campaign was well intentioned, it also left health care workers hyper-focused on pain. Patients scored their pain level on a 1-10 scale or pointed to a cartoonish chart and doctors reached for their prescription pads.

“What happened then is that our prescribing escalated,” Theobald says. “If you look back to the ’80s, we now prescribe four times the amount of pain medication. We don’t have four times the pain as we did 20 years ago or [more] than in the rest of the world. The prescriptions just dramatically escalated. What happened then is that there are now these patients on long-term opioids — whopping doses of them — and we started to realize that people were getting addicted.” And no one knew quite what to do next. 

Some drugmakers produced abuse-deterrent formulations. Many doctors shied away from opioids altogether. New prescriptions plummeted.

“2015 was the first time that we saw the total number of prescriptions written in the U.S. decrease,” Theobald says. “And now that we in the medical community knew this is a problem, the Center for Disease Control came out with opioid prescribing guidelines for people with chronic pain a few years ago. So you have all these people on crazy doses of opioid pain medications and they can’t get their prescription.”

They started looking elsewhere for powerful relief, ushering in a burgeoning heroin [an opioid made from morphine] epidemic as patients across all socioeconomic strata realized that the drug was cheap and relatively easy to come by.

“I see this as a problem that the medical community created, and we’re not doing very much to fix it,” Theobald says, noting an emerging methamphetamine epidemic as well. “We’re not doing much in terms of education on how [do] you wean these patients off of these whopping doses of opioids that are so dangerous for them to something else? How do you condition them to other pain modalities? … We have this aftermath from what had happened, and I don’t know that we’re doing the same well-intentioned approach this time.”

The Head and The Hurt

Doctors also remain challenged to fully address the emotional and psychological issues that result from — or preclude — the pain event.

“Pain is such an interesting condition, because I think, even more than many medical conditions, it really is defined by a physical and an emotional experience,” says Dr. Chantelle Thomas, executive clinical director at The Manor, a residential addiction treatment center in the hills of Wisconsin’s Kettle Moraine Forest. “So it’s a really unique area of treatment, because oftentimes it gets relegated to being addressed in an entirely medical setting — when we know that a significant component of it has pretty serious emotional implications. Expectancy and beliefs about pain and fear about pain have a direct impact on how someone experiences pain in their life, whether it be acute or chronic.”

Thomas grew up in a family of physicians and understood early the interplay between psychology and medicine. She arrived in Madison from California at roughly the same time the CDC opioid guidelines were put into place, earning a Ph.D. in clinical psychology and a post-doctoral fellowship in health and rehabilitation psychology from the University of Wisconsin. Thomas witnessed firsthand the sort of relief doctors felt at having the protocol to work from, coupled with the distress of patients who were on excessive doses of medication having the proverbial rug pulled out from under them. And how each struggled to find common ground.

Thomas worked with addiction specialist Dr. Randall Brown toward establishing addiction treatment programs inside primary care clinics, so patients diagnosed with a substance use disorder in a primary care visit could be seamlessly connected to an addiction medicine specialist and behavioral health provider. 

She stresses that most primary care physicians are deeply compassionate people by nature, highly invested in forming a long-term, trusting bond with their patients. Confronted with a patient in severe pain, Thomas says, “if they say no to an opiate, what are they going to offer them instead when their entire job is to alleviate suffering and to help someone literally with their pain? 

“So a very big part of my job working in primary care was really supporting physicians in having difficult conversations, and providing them with a different level of support in ascertaining what might be some of the behavioral and emotional aspects of self management that are contributing to this person’s difficulty in feeling better,” Thomas continues. “What other vulnerabilities they might have in their life and their relationships and their reflexes for self-care, or lack thereof, contribute to them being in a cycle of feeling really stuck and very much suffering. And also fixated that this medicine is going to be the thing that cures it.”

Both Theobald and Thomas reinforce the importance of doctors managing the latter expectation in addition to managing the actual pain, helping patients realize that some discomfort is necessary to recognize that their situation is improving and that healing is taking place since pain medications only stop the patient from feeling discomfort.

“It’s really tricky,” Thomas says. “You can give someone a bottle of pain pills and say, ‘Here, take these.’ But [it is tougher] having a more nuanced conversation about, ‘Here’s a scale of one-to-10, so should I take it when I feel a two? Or do I take it when I feel an eight?’ Really getting specific with people about, ‘Look, if you take it when you feel a two every time, you’re probably going to take more than you need. You’re not going to be as connected to the actual healing process that’s happening in your body, so you won’t get helpful cues from your body about what you should and shouldn’t be doing.’”

Better Together

Theobald and Thomas agree that true relief is a multimodal effort — which comes with its own set of challenges. Theobald cites the mixed blessing of medicine’s warp-speed progress, creating a wide range of hyper-focused specialists that often force patients to see multiple doctors for total relief, requiring time and additional medical bills that can compound patient stress. “They end up getting bounced around in the system, and a lot of the time it’s a physician reading the clinic note which doesn’t always detail the long conversations you have with patients about a plan of care,” Theobald says.

Adds Thomas, “With just a little bit of discussion, you can find that, with a lot of patients who have a pain condition, whether it be acute or chronic, what they tell you they believe the problem is and how the pain meds are working for them, and what the physician will tell you the problem is and how they believe that the pain meds are working for the patient, the chances of those two stories matching up is very low. Which is really unfortunate.”

Both doctors support the move toward integrated-service settings — “primary care clinics or even chronic pain management clinics having therapists embedded in the clinic so that when you go see your doctor you’re also seeing a therapist or behavioral health provider at the same visit together or in tandem,” Thomas explains. “It’s the gold standard for what we should be doing … and I think there’s something really powerful about integrating services so that the full onus of responsibility is not on the physician to act potentially outside of their scope.”

Embracing Options

Theobald says that, in America’s quick-fix culture, pain-mitigating lifestyle changes such as weight loss and exercise, or progressive treatments such as hypnotherapy and physical therapy aren’t always well received when a patient expects immediate relief from a pill. Still, she says, there are a host of effective options that doctors can offer patients, singularly or in combination, to ease that transition, including lidocaine patches, topical ointments, injections of steroids or numbing medications, splinting or bracing of the joints, and oral NSAIDs.

Thomas, a certified biofeedback practitioner, says the therapy is another tool for regulating an unsettled nervous system. She is also a great proponent of physical and occupational therapy, though she recognizes that many patients have trouble accepting the initial added physical discomfort that is often part and parcel before real relief is achieved.

“Therapeutic massage is also very powerful,” says Thomas, “because, in a lot of chronic pain conditions, people are living in this constant state of vigilance or hyper-vigilance because they’re always anticipating when they’re going to feel a jolt of pain, or the chronic pain has just been too much and there are muscles that are constantly in tension — and the person doesn’t even realize it’s happening. Therapeutic massage can be a really great way to build that awareness.”

In short, she says, any form of treatment that helps patients form and grow comfortable with the mind-body connection is helpful in managing pain both now and in the future.

“We know that stress and anxiety and even depression can amplify the experience of pain as felt in the body,” Thomas says. “And so if you don’t tune in to those signals and learn how to modify them, you’re essentially handing a megaphone to your body’s pain system.” MKE

As The Manor approaches its sixth year of providing truly personalized addiction treatment, we are excited to announce that our family is growing as we embark on our next chapter.

Introducing Windrose Recovery — a new name for the same expert team that has shaped The Manor into the premier addiction treatment center that it is today.

Our new programs, Midwest Detox and Windrose Counseling are located in Brookfield, Wisconsin and allow us to provide a full continuum of care.

• Midwest Detox — Safe, comfortable detoxification and assessment services in a serene and private setting.
• Windrose Counseling — Outpatient programs individually tailored to each client.

Visit windroserecovery.com to learn more about all our treatment programs.

The process of deciding to seek residential treatment for a substance use disorder can be terrifying, daunting and confusing. Despite the slowly growing cultural tolerance towards those in recovery from drugs or alcohol, the idea that you may personally need rehab can evoke feelings of desperation and failure.   

This could be especially true if you have previously gone through treatment and it did not “work” for you. If you are a loved one trying to assist someone struggling, you may feel equally confused and bewildered. How do you sift through the countless websites for various treatment centers in order to make an informed decision? 

What are the right questions to be asking during this trying time, when it is a matter of life and death? How do you make a decision this important? What if it does not work? And why did treatment not work before?  

What questions should you ask a treatment center?

When considering which facility to entrust with the care of your loved one and their path towards sobriety, it is important to gather information related to: 

1. A treatment center’s philosophical approach to treatment
2. The therapeutic strategies employed and the training level of clinicians administering the treatment
3. The percentage of individual versus group therapies, and what are the therapeutic elements of the program
4. Treatment center’s approach towards medication management
5. Specific details on how the family system is incorporated in the treatment experience (how much time is spent on family therapy, how do they assess the family’s readiness, how is family work individualized)
6.  Treatment philosophy and services offered for dual-diagnosis (or co-occurring mental health/trauma)
7. How “success” is measured in the program
8. How is length of the stay in the program is determined

These are just a few considerations that should be taken into account when determining if a treatment center offers the “best fit” for you or your loved one.

What is their approach to treatment?

Many programs are 12-step based, meaning they derive their treatment curriculum from the fundamental principles of the 12-step program, for example, those found in Alcoholics Anonymous. As a result, in some treatment programs, clients are often required to participate in 12 step programming as a critical component of the treatment experience. However, some individuals experience an aversion to the language and philosophy associated with this model, thus it is very important to inquire how a treatment center might approach these concerns.  

What is the staff training level?

Many facilities will provide a list of the type of therapies their clinicians are trained to implement; for example, cognitive behavioral-based treatment, mindfulness-based practices, somatic-based therapies, EMDR, and/or dialectical behavioral therapy. Assessing the number of clinicians at the facility that are dually-licensed (for both substance abuse and mental health) may be an important indicator of the clinicians’ ability to conceptualize and treat the complex interplay between mental health and substance use issues.  

It may also be beneficial to discover what the ratio is for clinical staff to clients, as well as understand the breakdown of the multi-disciplinary team. Does the primary therapist providing care to the clients have at least a master’s level degree and are they fully licensed (as opposed to accruing hours as a supervisee)? How frequently will the client meet with a physician? Are there other holistic providers that are considered a part of the staff? What is their level of training and expertise in their respective areas? Does the treatment team operate collectively, or does it appear that each is serving their individual agendas?

What does their weekly programming consist of?

Asking for the specific number of hours a week that a client will be working one on one with an individual therapist can be an important indicator of the opportunities for individualized programming. Many programs may place a heavier emphasis on group therapy over individual therapy and/or supplemental activities. Depending on the length of your stay at a residential level, it’s important to consider whether programs that favor group modalities will sufficiently target the root of the often unconscious and self-protective defenses many clients have acquired over the years. In particular it is important to consider whether you consider the depth of connection with a therapist as an important factor in facilitating change.  

Another area for consideration involves the structure and content of the groups. Are groups primarily didactic (psycho-educational) versus process-focused, are there skill-based groups, are groups interactive or lecture-based? What are the basic qualifications and level of training of the individuals facilitating the groups as opposed to peer-led groups? If group programming composes the majority of the treatment experience, it feels highly important that you’re intentional about selecting a treatment center whose groups are structured in a way that will most likely engage your interests or style of learning. It’s an unfortunate reality that many people do not really find themselves learning new content if groups are structured in a way that does not account for the unique challenges and participants of the clients who are attending.  

What are the policies related to medication management?

Will all clients be evaluated by a psychiatrist? How does the facility handle medication management? How is the role of medications contrasted with what can be facilitated with intensive therapy? What is the approach to medications that are considered “controlled substances?’ What is the stance towards medications intended for relapse prevention? What type of medications are maintained and which are considered problematic for long term use?  

Medication management is a very important part of the treatment process; however, facilities vary greatly in their approach and their emphasis on medications. Many clients can go through treatment to address a substance use disorder but remain on medications that can have problematic concurrent risk potential. Sadly, in some instances, medications can be used to replace the efforts of staff and clinicians to put in place alternative coping strategies that actually teach clients how to feel what is a necessary part of the healing and self-discovery process.

What does family involvement look like?

Oftentimes when treating substance use disorders, there is, understandably, one person that takes primary focus, the individual seeking treatment. We have come to appreciate, however, that without addressing one’s family and social support system the likelihood of a successful outcome dramatically declines. It is important to recognize family involvement as essential, but family work can take many forms.  Good questions for consideration involve: How will my family/support system be evaluated for participation, how is the family’s role in the healing process conceptualized and explained, and how will they be prepared to be supportive to their loved one with respect to their own concerns? What does the “family program” look like, or what does the “family weekend” involve? Will the family be directly involved in therapy or primarily be receiving one-directional education? 

Do they offer treatment for dual diagnosis?

Fortunately, many treatment centers have evolved to recognize the critical importance of widening the treatment lens to include co-occurring mental health concerns. However, there is still a persisting inclination for some facilities to have certain clinicians that are licensed to only treat “substance use issues” while a different set of clinicians focus on “mental health.” More concerning are treatment environments that require a referral outside of the facility to treat “mental health issues.” As a treatment consumer, this is a critical element to differentiate, as the interplay between substance abuse and mental health symptoms can be a key factor in understanding why some clients become perpetually stuck in a cycle of relapse.  

Another element to consider involves the treatment center’s level of expertise in addressing co-occurring psychiatric disorders and even how they conceptualize the intersection between addiction and mental health. In particular, there is growing awareness of the critical necessity for effective treatment of co-occurring or underlying trauma that so often runs parallel to persistent substance use cycles. There are very specific interventions for treating co-occurring trauma that critically inform a clinician’s ability to understand the incredibly complex and often self-limiting emotional processes that accompany trauma related struggles. For example, inquiring of a facility the ways in which they therapeutically identify, address, and treat shame can be a revealing indicator of their sophistication in addressing a very nuanced and powerful paralytic for many people who continue to suffer.  

How do they measure their success?  

It is understandable that concerned family members often weight a treatment programs’ abstinence rates as heavy marker of treatment success or efficacy. Some websites will advertise extraordinarily high “success” rates; however, it is important to consider several questions that allow you to more critically evaluate this data and these claims. How does a facility ensure accuracy of the data obtained and what percentage of the residents are completing this data post treatment? Are there other metrics of success that serve as important indicators of change? Is success determined based on the evaluation of the client? On the family? On whether they use substances again? Is abstinence the only goal of treatment? Complicating things further, some programs may promote their treatment formula as the “cure” for substance use disorder which can cause even more frustration and hopelessness when treatment “does not work.” 

Why We’re Different – Treatment at The Manor

We at The Manor subscribe to an understanding of addiction that is not limited solely to the brain disease model. We conceptualize substance use disorders as a complex and heartbreaking attempt for many individuals to tolerate the world, seek relief, and escape their pain. In this regard, substances can temporarily allow you to feel more comfortable in your own skin and with other people. Simply providing education about the harms of use and a prescription for modifying one’s behavior, does not sufficiently reach or inspire change for many of our clients. Becoming sober is incredibly hard work.  We deeply respect the ways in which our clients have learned to protect themselves from the change that is so desperately needed. If the solutions to this maddening cycle were simple there would be no need for residential treatment.  

Rather we make it our mission to understand the unique barriers and stuck points that each client encounters. This is only facilitated through earning deep and meaningful therapeutic connections. For this reason, we place a strong emphasis on individual therapeutic work with at least six individual session hours occurring weekly. We also believe in the power of group therapy when facilitated with a lens that creates intimacy, trust, and cohesion. Group therapy can sometimes create opportunities for understanding yourself in relationships in ways that can be profoundly impactful. The point is that we use the connections that you build with your peers and your therapists to more deeply understand the relationship patterns that have been contributing to your feeling stuck and unhappy.  

Again, it is in these conversations that clients begin to reconnect with who they feel they are most authentically. By pulling back certain expectations about self– without substances, without unnecessary medications, without distractions– individuals can begin to learn to both discover and like who they are. They may develop the capacity to enjoy themselves and others for the first time without being altered. They can begin to replace and repair the story they’ve told themselves for so long, and rest instead in a new narrative, that they are worthy of love and belonging.

 On a daily basis, we are inspired by the resilience and courage of our clients. This is how we at The Manor measure success: after years of hiding, clients can begin to explore what most scares them, recognize the power of their own vulnerability, and live with a level of transparency that is rarely found in most of the general population, sober or not. This is why we have so much respect for our clients and the bravery they demonstrate in the treatment process.

We aim to be as helpful as possible in the process of assisting you in finding the best possible care for yourself or your loved one. If you have any questions about any of the above-mentioned topics, please feel free to reach out to us today at 414.930.1930!

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We hope this message finds you and your families well. As a society we are in uncharted territory, a time of understandable fear and caution. We can all feel the internal impact of this moment on our hearts and in our nervous system. 

At The Manor, we have carefully and intentionally considered how to best honor our primary mission: safely caring for our clients. At moments of heightened intensity, we are reminded of the critical importance of maintaining our connections, identifying what is most relevant, and growing through the vulnerability of our shared human experience. The Manor is devoted to compassionately providing holistic treatment that takes into consideration the changing world around us. Our commitment is unwavering to maintaining the safety of our secluded campus in Wisconsin’s Kettle Moraine Forest. We remain fortunate and grateful to continue providing this essential care to our clients while serving as a resource for those seeking help in the Midwest and beyond.   

In accordance with the CDC and the Wisconsin Department of Health Services, we are taking the following steps:

• All visitors, staff and clients are screened to reduce the possibility of introducing the virus into our secluded treatment environment. 
• All staff members were asked to avoid travel and any other exposure to high-risk venues to ensure we can continue to care for our clients.
• Only those who are symptom-free will be allowed on campus.
• Staff and clients are taking steps to stop the spread of all germs, including an increased emphasis on frequent and proper hand-washing techniques.
• Social distancing measures have been put in place, including the avoidance of handshakes and other physical contact.
• We have increased strict standards of cleaning, including more frequent disinfection of all hard surfaces.

Additionally, The Manor has implemented the following changes to its program schedule to minimize the risk of exposure for our clients and staff:

• Therapeutic outings that involve public exposure have been eliminated and our focus has shifted to enjoying the range of outdoor/open-air activities. 
• Community meetings are being provided via live streaming or are being held on campus by staff members in recovery. 
• Spiritual programming will currently be held onsite or facilitated through live streaming in our theater.

We are determined to continue providing our clients the quality care they deserve. Our approach will continue to evolve as further guidance is provided by the CDC and the Wisconsin Department of Health Services.

If you have any questions or concerns, please call us at 414.930.1930.

Yours Truly,

Dr. Chantelle Thomas

Executive Clinical Director

The Manor

The Manor’s executive clinical director, Dr. Chantelle Thomas, spoke at the Families Against Narcotics (FAN) Family Forum in Washtenaw County about “Reducing Adolescent Substance Use Through Family Education, Communication and Connection.”

Dr. Thomas also presented at “Breaking Down Barriers to Treatment,” an education series co-hosted by Feinberg Consulting, The Manor and Urban Recovery. Dr. Thomas gave an engaging talk defining the common clinical barriers to treatment and ways for clinicians to build strength, depth, and authenticity with their clients (also pictured below).

Thank you to everyone who made it out to these events! We hope to be back to Michigan soon!

September is National Recovery Month—and The Manor is honored to celebrate the courage and strength of all those on their personal path to recovery.

Our own Executive Clinical Director, Dr. Chantelle Thomas, along with Dr. Marcus R. Earle, Ph.D. and Oren Matteson, led a timely and engaging panel discussion in Chicago on the identity of men and the concept of masculinity in the wake of the #MeToo movement.

Each panelist shared their experience working with men and women during this critical time of change — and generated an engaging conversation striving to broaden perspectives and understanding. They addressed such questions as “How have our views of men and masculinity changed or remained the same?” and “What is changing for women?”

Dr. Chantelle Thomas is The Manor’s Executive Clinical Director and a Clinical Psychologist specializing in addiction treatment, trauma and health psychology. With her experience in trauma work, Dr. Thomas guides our clinical team in the comprehensive assessment and treatment of each guest. Dr. Thomas is also a certified biofeedback practitioner, providing clients at The Manor with an added dimension of insight and discovery helping them better regulate and understand the psychological impact of stress and chronic trauma.

Thank you to everyone who attended and joined the discussion! And a special thanks to Millennium Counseling Center and Psychological Counseling Services for co-hosting the event with The Manor!

Addiction to prescription pain relievers affects millions of Americans — across all communities — suffering from both chronic and acute pain. In a captivating seminar in Deerfield, Illinois sponsored by The Manor, respected addictions specialist Peggy Hough, LCPC, CADC revealed the risks and signs of prescription drug addiction, how to prevent this addiction and alternatives to pain management. Beginning with eye-opening statistics of the growing prevalence of addiction to prescription pain medications in the United States, audience members learned the biological, psychological and cultural components of pain; how opioids affect both the body and the brain; current treatment protocols; and proven alternatives as well as emerging techniques to relieve pain.

KETTLE MORAINE, Wis., June 28, 2017 — The Manor (discoverthemanor.com), a luxury residential addiction treatment center in Wisconsin’s Kettle Moraine Forest, announced it is now offering an additional body-oriented approach in the healing of individuals who have experienced trauma and substance abuse.

This approach, called Somatic Experiencing, is used to release trauma stored in the body. Somatic Experiencing can be especially effective for those whose bodies are stuck in a trauma response and are consequently suffering from emotional and physical symptoms such as depression, anxiety, chronic pain or constant feelings of disconnection. Specially trained clinicians at The Manor work individually with clients to help them regain self-worth and increase their sense of safety by facilitating a deeper level of comfort and connection within their own bodies.

“The experience of trauma itself can be largely nonverbal “stated Dr. Chantelle Thomas, Executive Clinical Director of The Manor. “So doing a deeper exploration of trauma as stored within the body can be particularly enlightening in gaining access to unresolved emotional and psychological issues.”

“Some individuals who deeply struggle with their own internal barriers can be much more receptive to somatic-based therapies because this approach can be subtle, gentle, and sometimes less threatening,” continued Dr. Chantelle Thomas. “You’re not approaching someone through the front door. You’re finding another access point. It can be a really interesting tool for engaging people who are struggling with more traditional therapeutic modalities.”

Somatic Experiencing is just one component of The Manor’s holistic approach, along with trauma-sensitive yoga, personal training and massage therapy. By combining these somatically focused modalities, The Manor helps clients effectively discover that their bodies can be a powerful tool that can help predict unsafe situations and recognize signs of danger that are often precursors to relapse.

About Somatic Experiencing
Developed by Dr. Peter Levine, Somatic Experiencing is a therapeutic approach that focuses on the body’s response to trauma. Somatic Experiencing helps clients regulate the nervous system and achieve a heightened sense of self-awareness. During a Somatic Experiencing session, the practitioner gradually introduces small amounts of traumatic material, observes the client’s physical responses and guides clients to develop self-regulation strategies to restore the body’s regular stress responses. This approach helps reduce symptoms of traumatic stress such as chronic pain, constricted breathing and addictive behaviors.

About The Manor
The Manor, an exclusive addiction treatment center nestled in Wisconsin’s Kettle Moraine Forest, offers a genuinely residential program where guests live and receive treatment within a comfortable and confidential setting. As an independently owned treatment center, The Manor has the freedom to ensure that guests’ clinical needs always come first. From the holistic and personalized treatment plans to the private suites, each detail is designed to nurture, respect and guide guests on their unique journey to lasting recovery. Conveniently located in the Midwest near Chicago and Milwaukee, The Manor is easily accessible from two international airports.

For more information, please visit discoverthemanor.com.