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Scott Webb: Trauma informed care is not unique to Sierra Tucson, but the mind body spirit approach, known as the Sierra model is. And joining me today to discuss trauma informed care and how Sierra Tucson can help people who are suffering is David Cato. He's an Interim Clinical Director at Sierra Tucson. This is Let's Talk Mind, Body, Spirit by Sierra Tucson. Sierra Tucson ranked number one best addiction treatment centers, 2020 in Arizona by Newsweek. I'm Scott Webb and David, thanks so much for joining me. We've got a few things to cover here. Primarily want to talk about trauma informed care. So let's start here. What exactly is trauma informed care?

David Cato: Trauma informed care is basically the way that we meet people where they're at. For example, people might have certain triggers that come up. They might be triggered by a certain event or scenario, or maybe a person. And our goal is to meet them wherever they need to be. For example, if somebody is triggered by some kind of person or something that someone says, we definitely want to make sure that we're staying away from those things that might be triggering, we don't intentionally want to set up the stage for activation or upset if we can avoid it.

Host: Oh, that's great. I love that approach that really sort of patient centered and trauma informed care that you meet the patients where they are to try to best treat them. And when we talk about treatment modalities which one specifically can help individuals who are dealing with a traumatic event?

David Cato: There are a lot of different modalities that can help. And two of the modalities we use at Sierra Tucson that are actual clinical based modalities are somatic experiencing and EMDR. And EMDR stands for eye movement, desensitization and reprocessing. Somatic experiencing works with the nervous system and helping the nervous system heal from trauma that someone has experienced. And what we see, we have these responses that come up in our nervous system, they're called fight, flight, or freeze responses based on threat to that we've received before. And so I might, for example, be afraid of animals if I was attacked by a dog at one time. And so my response might be to run away if I see a dog. And so we work through those responses and we work through how our nervous system holds on to those traumas. That's how somatic experiencing works. I'm a somatic experiencing practitioner, but not an EMDR therapist. So I'll say what I do know about EMDR, which is that it helps basically target memories that are traumatic and it actually helps through bilateral stimulation. It helps the memory be less impactful and less triggering to that person.

Host: It's really interesting that you bring up the dog reference because I was bitten by a dog when I was a kid that was a ball that went into the fence into somebody's yard. And I reached over the fence to get it. And the dog came out of nowhere and clamped onto my arm. And I still have that feeling. I love dogs and I love petting dogs, but right before I reach for a dog or pet a dog, I do sort of relive that moment. Almost every time of that feeling of that, the trauma of that dog coming out of nowhere and clamping onto my arm. You know, I know that Sierra Tucson started the Sierra Model, which is treating mind, body and spirit. Why is that approach important to you?

David Cato: It's really mostly because of what happens in our bodies when we experience certain traumas, kind of like what you were just saying is there's this recognition of something in the body that says, Hey, this is not safe for me. And so because of our bodies and our connection to our nervous systems, we also have our brain that's involved in the memories that we have associated with things and also our spirit or spirituality, which is how we feel and connect to things. And so as we work on all of that together, it really helps bring everything into healing, especially because if my nervous system is starting to heal, my brain is going to be more calm. I'm going to have more peaceful moments than if I had a lot of activation and trauma still in my nervous system.

Host: And that's great. And really is one of the things that separates Sierra Tucson from other treatment facilities or other modalities is really treating the entire person, both the mind, the body, the spirit, you know, not just one part of that, but how all of those things for all of us really work together and need to be treated as kind of a whole, you know, it's really a great approach. Can you share an example of a client or resident, you know, who had an issue and the treatments they went through and a real success story?

David Cato: Even though I'm an administrator here, I do some clinical work sometimes. And recently there was a professional that I had worked with years ago that had referred someone here. And they had asked me to meet with that person and do some work with them. And so I met with them a couple times a week and did some somatic experiencing trauma healing type, nervous system work with them. And when they came into treatment and when they were working with me in the beginning, they couldn't make eye contact. They held their head down in shame and were really struggling with being able to connect to other people. And the work that we did together, I did some attachment based work as a by all, it's kind of related to somatic experiencing, but basically helping engage in eye contact more and being able to feel safe with a provider mostly because of what might have happened as a child through maybe the parents were abusive or maybe the parents were depressed or struggled with substance use disorder. And so we get into the nervous system and help them feel safe. And by the time that person left treatment, they were able to make eye contact, were able to keep their head up and actually connected resourceful. And that person had actually reached out to me after they left treatment and thanked me for the work that we had done together, as things were still going well for them. And so it's things like that, that I see the real success stories that really still tell me that we do great work here.

Host: Definitely. And I'm sure that's really gratifying for you, as you say, you become an administrator, but to still do some clinical work and to know that you really reaching and helping people that's really great. Right?

David Cato: Absolutely.

Host: That's awesome. So why or when would someone consider residential versus outpatient services for treatment?

David Cato: I'm glad you asked that question just because when people are looking into what they want to do for treatment, and there's all the different levels of care from inpatient to residential to outpatient. And so if somebody is looking into residential treatment, that's really more along the lines of needing 24 hour around the clock care, like nursing care, medical care, making sure that they're able to feel safe and protected for people who are looking into outpatient, going into an outpatient program, whether it be a intensive outpatient program or a partial hospitalization outpatient program, that's where you don't need the 24 hour around the clock care. You can care for yourself. You can get through your day without a lot of maladaptive coping from like substance use or eating disorder behaviors or that kind of thing for people who are in residential treatment. They're the ones who are struggling with cravings for substances, or maybe they're struggling with eating disorder behaviors like bingeing and purging, and they really need that support. Also what's big in residential treatment, at least here for us is we get people here who have suicidal ideation and might have self harm. And so people who are actively suicidal or having a lot of suicidal ideation or are self-harming, they are not usually very appropriate for an outpatient level of care. And they'll often get referred to inpatient or residential level of care.

Host: Yeah. And good to know that there are options for everybody wherever they're at, whatever their needs are, whether they need that supervision and that, you know, sort of constant round the clock care or whether they can do some more of these things themselves. Good to know that there are options for sure. I want to ask you about COVID-19 and the pandemic and how maybe that is informing your work right now in the care right now, the types of trauma that people are suffering from, how they're dealing with COVID-19 and how that integrates, or, you know, relates to you and your work and the facilities, and kind of bring that together for us?

David Cato: With COVID-19, we're definitely in, everyone keeps saying this phrase, but unprecedented times, and it's definitely accurate that that is unprecedented and no one can really know what to expect. At least even now we don't even know what things are going to look like within the next few months. And a lot of people who come in here, their lives have been very negatively impacted by COVID-19 due to maybe they're having to isolate, you know, they say, you know, social distance and quarantine, and that can lead to isolation. And so these people are not really out and getting social engagement like they were before. Some people are losing their employment as a result of COVID-19 some people, because they're home more often, they're using more alcohol and there's a lot of different things where people's symptoms get exacerbated when not only there's something like a pandemic going on, but also that the whole social setting has changed for them. And so a lot of people that do come in are struggling actively with how COVID-19 has been.

Host: Yeah. And I think you're so right. I think the isolation has been so difficult for so many, you know, that they call it social distancing, but the reality is it's physical distancing and that's something that we all need. We need that physical contact, that physical interaction and COVID-19 has been so difficult for so many on so many levels. For sure. David, as we wrap up here today, what would you like to say to people who are struggling with trauma, whether it's COVID-19 related or not, what would be your best advice for them right now, as you say, during these unprecedented times?

David Cato: The first thing I want to say is you are not alone. This is something that you don't have to go through by yourself. Whether you decide that you want to go to treatment, or even if you're just on the cusp of asking for a therapist or reaching out to a friend or a family member for some support, you're not alone. You can get better, you can heal. And your ability to be able to ask for support is going to be the biggest part of that.

Host: Definitely. We want to empower people. We want them to advocate for themselves. And I think that's such a great way to end there that there is help. You can heal. You just need to reach out. And we certainly hope that people do David so great having you on today. I can hear the real compassion in your voice and know that if people walk through the doors there, that they're going to get great care in that great, you know, mind, body, spirit approach that Sierra Tucson, the Sierra Model has. So thank you so much for your time and you stay well. For more information. Call (800) 842-4487 or go to Sierratucson.com. Sierra Tucson, where change begins. And if you found this podcast helpful, please share it on your social channels. Check out the full podcast library for topics of interest to you. This is Let's Talk Mind, Body, Spirit by Sierra Tucson. I'm Scott Webb. Thanks for listening.