Member Spotlight: Reaching a New Threshold in Recovery
For 60 years, Thresholds – a National Council member – has been transforming the lives of Chicago residents struggling with mental illness and addiction by breaking cycles of poverty and unemployment. In this interview, Dr. Steve Weinstein, a medical director at Thresholds and member of the National Council’s Medical Director Institute, discusses the impact of their recovery-oriented services.
What’s the secret to Threshold’s success?
Our success began with our founder and first CEO, Jerry Dincin. He mentored a bright and energetic group, some of whom now serve in senior clinical administration. They carry Jerry’s passion to serve clients – we call them “members” – who have been disenfranchised due to their illness. They are continuing a forward-looking vision by bringing in evidence-based approaches to services and finding creative ways to fund integrated psychiatric, medical and substance use care. Finally, we benefit from the consistently strong guidance our current CEO, Mark Ishaug, and board of directors provide. Their actions embody our mission.
What recovery-oriented services do you provide to set members up for success?
Our approach to recovery has many components. For example, we use “people-first” language, and we teach staff to do strength-based assessments and motivational interviewing (MI). We also use evidence-based practices that are recovery-centered, like wellness management recovery, integrated dual diagnosis treatment, supported employment and smoking cessation. And we employ persons with lived experience in both administrative and clinical positions. We were one of the first to do so.
Staff trained in strength-based assessments and MI emphasize the potential of each person to recover in their own way. Addressed in the context of a collaborative treatment plan with the member, this approach opens the conversation for them to explore their dreams and aspirations, as well as social determinants like housing or employment. For members with co-occurring substance use disorders, our staff help them examine how their substance use impacts their ability to reach their goals.
What are some common misconceptions about addiction and recovery?
The biggest mistake is thinking there is only one way toward recovery. There is often a myopia about substance use: Nothing good can happen for the individual while they are still using. That point of view can be stigmatizing. Another mistake is separating substance use from mental health care. Behavioral health providers are doing more to integrate the treatment of mental health and substance use, but there remains a lot of room for improvement.
To meet individuals with addiction where they are, our counselors introduce the concept of harm reduction to members who have co-occurring substance use disorders. This includes education about medication-assisted treatment (MAT), like Suboxone, and assisting the member with meeting one of our providers to determine readiness for MAT. Some members choose to abstain from an opioid with MAT, but also choose to continue using other substances. The counselor continually helps the member assess their progress through group and individual therapies.
How important is receiving integrated care in attaining recovery?
An integrated approach is essential for assisting an individual in learning about their physical and mental health, and how one impacts the other. Integrated care at Thresholds means many of our members get psychiatric and medical care at the same health care center, from providers who maintain communication with our outreach staff. It means ensuring our staff has access to medical records from the health centers and that they’re working with providers to have recovery-based approaches.
When you think of Threshold’s enduring impact, what success stories come to mind?
Thanks for asking this question. We have numerous stories of success. One member reunited with family and met his grandchildren for the first time after residing for two decades, isolated and lonely, in an institute for mental disease. Another member, after spending years in a forensic psychiatric hospital, has since held steady jobs and goes to the gym with a group of friends. It’s gratifying to see!