5 Questions for Domenica Personti, Program Manager

5 Questions is our staff spotlight feature where we introduce you to the people who make BCCS run.

Name: Domenica Personti 

Job: Program Manager, Lancaster Center

Time with BCCS: 4 years

1. Tell us what you do at Brandywine.

I was recently promoted to Program Manager at the Lancaster site. I do a lot of trainings for the staff, supervise the Perinatal program, the NSAFE program, the Core department, as well as all the support services, Anger Management, Partial, and IOP.

This position still allows me to do front line work. I still have the opportunity to meet and talk with clients on a daily basis. I want to make sure that I am available to them. Recently, I set up a “sound-off” for clients, twice a day every Tuesday for the whole month of October. Anyone who wants to can come and sit with me, and just have a conversation about things that they like, and things that they want to change, and things that they think we are doing well. Hearing what the clients have to say is really important to me.

My biggest challenge is probably slowing myself down. I would like to just do everything, like, tomorrow! And I’m constantly working on me, to slow down and look at things realistically. It’s challenging for me to not be spontaneous, especially when you see this great vision that we have. I see Brandywine with this great vision, so it’s exciting, and sometimes it’s hard to slow yourself down and work through it.

2. Anger Management and Partial Hospitalization are some of the new programs you’ve introduced at Brandywine. Tell us about these programs and why they were introduced.

We offer Anger Management in a one day, eight hour course on Fridays and/or Saturdays. It made sense to do it here, to make it an affordable and allow the clients to “one stop shop,” like we do everything else at Brandywine. It provides easier access. They’re right here. They can take it here. It’s also open to the public. Anyone can come and take it, but originally, it made sense for our clients.

Partial Hospitalization is for our clients who are having a little bit of difficulty at our other levels of care. So when we see that they’re struggling and need a little bit more intensive treatment, we can refer them to our Partial program. That runs 7 AM to 1:30, Monday through Friday. It includes education and group therapy sessions. They get a half an hour to 45 minute lunch. So it’s kind of like school, so to speak.

3. You’ve also been very involved in addressing the educational needs of Brandywine staff. How important is ongoing training to the services our staff provides?

This is so important. Our field shifts and changes so often, that we have to be up to speed as to what new treatment modalities are out there, and what new tools we can use to treat our clients. I feel like it’s such an important tool that the staff need, as well, if we can constantly keep them fresh, even if it’s retraining in certain areas.

I want the staff to be cross trained, so that everyone can work in any aspect of treatment here at Brandywine. My vision is for all staff to be able to work in multiple areas, fill in when needed and be true team players. For example, anyone can do intake, and everyone understands and knows what NSAFE does. So if an NSAFE client doesn’t have access to a case manager right away, one of the Core counselors should be able to meet with that client, and at least occupy them and help them a little bit until their primary is available. This will improve the quality of our care, and we will treat the clients better. I think that’s all part of training.

Education is so, so, so important now. When I came into the field, you just had to have an Associates degree. That was in ’99. Now, there’s such a focus on education, as well there should be. The day I stop learning, I’m really not any good to anyone else, and I believe that. That’s why I’m still in school. I just try and push education, absolutely. You can’t really do a whole lot without that anymore.

4. Tell us your favorite client success story.

I had a client that I worked with as support for the counselor, when I was a supervisor. When I met him, [he] had just went through a pretty bad relapse, had been using for about 10 months. I met with him pretty often for a good 3 or 4 months, got him linked up with a lot of support services that he needed. He ended up going to school for ten weeks, got a skill certification, and then got a union job, and he’s now a 13 day client [with 3 years clean and twice a month pickups.] So that’s a pretty awesome success story. And I still see him pretty often and I still look and see how he’s doing, so that’s a good feeling.

5. If you had $30,000 to donate to BCCS, what would you do with it?

I would do criminal re-entry, absolutely, without a doubt. I went into this field when I was 19 years old, gaining my first experiences working at Gander Hill Prison and with AmeriCorps. We went into the prison and did a project based around vocational rehab, and how it benefits people who are at risk for substance abuse and incarceration, due to any kind of history of crime. While I was there, I was exposed to so many intelligent people who had just fallen into the wrong crowd, or used drugs at a young age, and I was amazed at the level of intelligence a lot of them had, and their current situation kind of held them back.

I would take $30,000 and I would do a criminal re-entry program, and I would help the offenders coming out of prison before they even got out. Case management services for the couple weeks before they get out, and then assist them with housing, employment, and record expungement. That’s a really big deal. I think that’s one of the biggest hindrances that our clients who have criminal history have, in getting employment. So that would be, without a doubt, what I would do with it.

The Magic Group

“Do Not Disturb. Magic Group in Session.”

There’s no such sign outside the door at the end of the second floor hallway, but if there were, that’s what it might say. It’s an exclusive club, invitation only. They meet here three days a week, from 9 AM to noon. And there’s a positive energy in the air; so much so, that walking in on a session feels like you’re interrupting something very important. Some have taken to calling it the Magic Group.

Whatever they call it, the group of 17 people at the Brandywine Counseling Lancaster Center is hard at work on their recovery. Sean, 28, who’s been attending for four weeks, describes what goes on. “It is at times really good, because we get a lot of people in here that are eager. We’ve got a good mix of people, different cultures, different people at different stages. [Some are just] starting to learn about their addiction; other people have been through programs like this before, and those people are willing to help other people.”

Sean is part of the IOP, or Intensive Outpatient Program. Run by counselor Janine Rinderle, the IOP consists of 3 hours of group counseling, 3 days a week, as well as individual counseling. It’s a higher level of care designed to help participants set and work toward their goals for recovery.

Brandywine introduced the service in 2009 at Lancaster and two other locations, realizing that traditional monthly counseling wasn’t enough for some patients. Unable to remain abstinent, they were at risk of discharge from the methadone program, which often leads to relapse. This was despite having consistent attendance and making a good effort in treatment. Patients who fit this profile and meet other medical criteria and agency requirements, are now recruited by staff for the IOP.

Sean was one of those on the verge of discharge. Traditional treatment had worked for him at first, but only for so long. “I just hit a crossroads after awhile, a couple months in. Once I got clean, I guess I needed something a little more than once a month. My counselor approached me to say they might recommend me for the IOP. I didn’t get too much information before I got in, because it was a new program.”

It was a similar situation for “Charles,” 38, who has been in the IOP for two months. “Recovery is hard for me. I was clean for five years straight. One day I relapsed, and since that time, I’ve been trying to pick myself up again. I thought I could do it by myself, but you can’t. When you’re an addict, you need help. You need the support.”

Joining the IOP is a big commitment. Participants not only have to be willing to do the work, they have to make time for the three hour sessions. “When I heard about the IOP, I was a little skeptical,” says Sean. “Coming here, it’s gonna cut into my time.” But his commitment brought unexpected benefits. “I’m a little more active. I wake up [and] get my day started a little earlier. And you meet more people here.” He’d never socialized much with other people on the clinic, but that has started to change.

Charles also came in with doubts. “In the beginning, I was a little nervous talking [in group], like everybody. But it’s coming along. I’m glad I’m in here. In group, we all get along. In the beginning, everybody was quiet, but we all give feedback now. I’ve got people to help me, and that’s what I like. Now I’ve got my support.”

Janine uses a wide variety of activities to help keep group members engaged, including psychoeducational components, art therapy, and goal setting. At times, she lets group members dictate where the topic goes. She has them practice relaxation techniques, and teaches skills to reduce anxiety. This is particularly useful in slowing down a craving when it occurs.

“Far too often, a craving occurs and is immediately acted upon,” she explains. “But if clients give themselves the chance to work through some of the thoughts associated with the craving, they may avoid following through with the urge to use.”

The most important technique she tries to use in group is a client-centered approach. “I want to create an environment where group members feel ownership of the group, where they feel safe and not judged. Giving members unconditional positive regard allows them to try new behaviors and ways of thinking within the context of the group. The group is a time where they can really work on things with the help and support of myself, but also the other group members who have been through similar trials and struggles.”

Charles has been able to take what he’s learned and make changes in his life. “The therapy she’s giving us, it’s good, believe me! I’m using the tools right now with this person in my life, a drug dealer. I’ve changed my ways with my behavior. All the feedback I’ve taken, it’s working for me.”

Sean has also gained insight from the group. “Being in a group helped a lot, seeing everyone else struggling, it wasn’t just me. I think it’s the more time in here, the more time we spend with the people, and the counselor. Three days a week and three hours long, that’s what’s really helping us.”

“The biggest progress I see in clients is a change in their motivation,” says Janine. “Many of them enter the IOP angry, frustrated, and hesitant; however, after a few weeks, I begin to see big changes in how they relate to one another, how much they open up in group, and the newfound motivation to become engaged and to take more of a proactive role in their recovery.

“I think the magic is that group members have become very close with one another. They meet three days a week and while some were hesitant at first to open up, it wasn't long before they were all sharing personal experiences. The closeness that has formed between them is, I think, what helps them feel supported and understood.”

The first seven members of IOP are about to successfully complete the program, many of them long-time drug users who have provided their first ever negative drug screen. There is a waiting list to get in. Many clients hear about the program by word of mouth, or when they see fellow clients like Sean sticking with treatment and doing better. “I think people are starting to hear more about it,” he says. “It’s starting to get a little buzz out there, as more people learn about it.”

Or they hear it from Charles, who would be back on the street right now if not for the program. They hear how the IOP turned his frustration into motivation. “I brought myself in here. If I’m doing it without missing days, that means I care. I want change. I take it one day at a time.

“The thing is good! I like it!”

Now that is magic.


Brandywine Counseling services are funded by and is part of the system of public services offered by Delaware Health and Social Services, Division of Substance Abuse and Mental Health. For more information, please call 302-656-2348.

Out Of the Dark, A New Dawn

On a bus stop bench on a frigid February morning, a young couple sat together shivering, and counting down the minutes until 9:00.

“How much longer?” Dawn asked her boyfriend.

“Four more minutes.”

Dawn broke into a smile in spite of the stinging cold. “Oh, I can’t wait! Soon they’ll open up… it’ll be so warm inside!”

He smiled back. “In four minutes, I’m gonna be layin’ on that comfy couch and gettin’ some sleep!”

A miserable, exhausting night neared its end. They had spent it at the bus stop on Lancaster Avenue, with all their belongings in their backpacks, and only their coats to keep them warm. But at 9:00, right behind them, they had a place they were welcome in the Brandywine Counseling Outreach Center. Dawn watched the buses come and go, full of people with places to go and things to do. Her plans today were simple: Get warm. Find some food. Hide from probation. Then, find some more heroin. Tomorrow, she’d do it all again. It wasn’t always this way. Six years ago, she had a normal life, a job, and a place to live. But one seemingly innocent car ride led her off course.

“I was working in a restaurant, and one of the other employees was asking me for rides. When he was getting out of the car, he was picking up drugs. I got curious about what he was picking up, and he let me try the heroin just by sniffing it one time. Eventually, he ran out of money to pay me for the rides, so he would start giving me drugs instead of gas money. I started to get sick if I wouldn’t use it, so I started to use it every day.”

“For a little while, I was okay. I could afford it. I started to be late for work. I started spending all my money on only drugs. I had to move back in with my parents, then I started to steal from them. I lost my job. I started stealing from cars and people’s houses, and ended up on probation.”

Dawn’s choices had led her down a destructive path of addiction, homelessness, and being on the run at age 27. She met her boyfriend and they stuck together, but there seemed to be no way out. They weren’t looking for help; only to survive. It was rare to find a friendly face that understood where they were. BCI case manager Sharon Brown was one who did.

“Hey, guys. Need a light?”

“Nah, we smoked our last cigarette hours ago.”

“Here. We’re not supposed to do this, but go on, take it.”

“Oh, thank you so much!”

“It’s too cold for y’all to be out here. Why don’t you come inside? There’s coffee and donuts. I can get you warm clothes, a place to wash up. You can crash on the couch, watch TV, read some books…”

Since that day, the pair became regulars at the drop-in center. “It became like a little home to us,” Dawn recalls. “We would go inside during the day, and sleep in there, and at nighttime we would just stay outside all night.” She began to trust the outreach staff. She began using their services, taking HIV tests, and visiting the needle exchange van. She learned about other services she wasn’t yet ready for.

“They would let us know that the methadone clinic was there, but they never seemed like they were judging us, or trying to push us into anything we didn’t want to do. They knew that we knew the services were there, and that we would use them when we were ready to.”

One day, a probation officer came to the bus stop. He took Dawn into custody, and she served six months in jail. In July 2008, she was released and reunited with her boyfriend. They were both free of drugs for a while, and even found themselves an apartment. But by September, they had relapsed and were using heroin again. They returned to the needle exchange.

“When we started coming back, they knew we were using again. They were a little more adamant this time. ‘You guys really need to try methadone this time, before you end up back in the situation that you were in.’” The couple faced a difficult decision.

“No way I’m gettin’ on methadone. It’s just another way to get high. It’s just as bad!”

“Well, I’ve heard those stories too, but what about the people we know who got on it? Seemed like it was working for them.”

“That’s true. They do look better. They’ve got jobs, they look stable.”

“Why don’t we try it? It’s the only thing we haven’t tried.”

With that, a window of trust had opened. The next morning, Dawn and her boyfriend went in to BCI, and they both started on methadone. She knew it would be a challenge to make her daily dosing, individuals, and groups, but she committed to getting clean as strongly as she had committed to getting drugs. Sharon Brown continued supporting her as her Safety Net Services case manager. Safety Net specifically targets two high-risk groups, women and recently released ex-offenders, often living on the streets. Knowing that willingness to accept help comes and goes, case managers meet clients where they are, ready to connect them to services they need when that window opens.

“Sharon was a big help,” says Dawn. “She’s always checked on us, made sure we have everything that we needed. I’m glad the outreach really latched on to [us].” But there was a big surprise for Dawn on her intake day. Nurse Barbara Garrity gave her the news at orientation.

“Now just to let you ladies know, when you get on methadone, it seems like it’s a lot easier to get pregnant. But Dawn, you’re already pregnant!”

“Oh! Really? Wow, that’s quite a surprise!”

“Yes! But we have a program just for pregnant women."

Dawn was 4 weeks along. Her surprise quickly turned to motivation to stick with treatment. She was determined to deliver a healthy baby. She was transferred to the pregnant and parenting women's program, which assists over 20 clients every year to deliver drug free babies. Her counselor, Aja Redmond, linked her with prenatal care, helped her identify her triggers for drug use, and taught her about FAS and nutrition. Four months into treatment, Dawn was staying abstinent. Things were going well. It was then that the couple received another surprise.

“We’re having twins! Oh, wow… two babies? How are we going to do this?”

“Don’t worry, Dawn, we can deal with it. Just one more obstacle in our way.”

“This is so difficult… I’m staying clean and doing what I need to do, but every day something else comes up.”

“Yeah, it would probably be easier to go back to the streets and start gettin’ high. But look at all the good things we’ve accomplished. We’ve come too far to throw it all away.”

And so, preparing for twins became the latest challenge in their shared journey to recovery. “We were already together when we were looking to get clean. We weren’t willing to separate for any reason, so we had to do it together.” Dawn recalls. “[It helped,] having somebody to walk through it with you, share all the ups and downs, and remind you how far you’ve come and where you still want to go.”

Dawn had support not only from her boyfriend, but from Aja and the women's program. She redoubled her efforts to set and achieve goals, worked on her parenting skills, and cut back on smoking. As her due date approached, a case manager made a home visit, making sure they had food, clothes, and baby furniture. On May 15, Dawn gave birth to healthy, identical twin boys.

“Being in a relationship and having the babies helped me get clean, because it gave me a reason to want to move forward in life,” she says. “Having the children and having a partner that loves you and is there for you, gave me my life back.”

Today, Dawn’s children are 4 months old, and she is nearing one year clean. She is a picture of composure as she tells her story and tends to her sons at the same time. She shifts one baby from her arms into a stroller to pick up the other, then reverses again. As they fuss, she remains calm and soothing, wiping mouths, giving them their bottles, even laughing cheerfully to herself as her son’s expression changes from restless to content. She shows no trace of her former life on the streets, sleeping at bus stops. She looks like a mom.

“I think for the two of us to go from where we were, to where we are now, it’s all pretty much thanks to Brandywine. This is the longest period of clean time either one of us has had. Being able to come up here every day and be accountable for your actions, and have people checking in on you, along with the medication that you get, has made us successful.”

Dawn sees a bright future ahead for her family. Life is not simply about surviving anymore; it’s about building a future for herself and for them. They’ve moved into a relative’s house, and they have a car. She hopes to one day own a home, put the children in a good school, and go back to school herself. For now, she wants to stay clean and sober, enjoy family life, and continue to build her support system. She’s on the right course again, and it all started with a friendly face offering food and shelter, no strings attached.

“It feels like a blessing. It feels that God was with me all along, and He’s looked out for me, and that He made a way for me to get better, and as long as I continue to follow it, things will continue to get better. It hasn’t been easy for us at all, but we’ve been able to get through it. I’m very happy with the way things are now.”

Brandywine Counseling services are funded by the U.S. Dept. of Health and Human Services, SAMHSA/CSAT; and Delaware Health and Social Services, Division of Substance Abuse and Mental Health. For more information, please call 302-656-2348.

5 Questions for Sally Allshouse, Executive Director

5 questions is our ongoing feature where we introduce you to the people who make Brandywine Counseling run, spotlighting a different staff member every two weeks.

Name: Sally Allshouse
Job: Executive Director
Time with BCI: 21 years

1. You’re retiring at the end of June after a long and distinguished career in addiction treatment. How did you get started in the field?
It was sort of like a coincidence. I student taught in 1969 at Forwood Elementary School. And I ran into the woman who I taught under, at a department store where I was working, and she asked, “Why are you working here?” And [she] had a friend, Rev. Richard Hamilton, who had just been appointed by the Governor to start drug abuse services in the state of Delaware – because before then, there wasn’t any, it was only alcohol services – and she hooked me up with an interview with him. And I was one of the first outreach workers in the State of Delaware back then. So that was 1970.

2. What would people be surprised to know about your job?
One, I love it. That I do know about the clients, still. I do, through incident reports and through talking to the site supervisors, still get very involved with client issues. Every day’s different. There is no typical day. The biggest challenge over the years has been to keep my stress level down, not to prejudge things, try to be fair about situations, and keep a fresh look at what we do and how we do it. I dislike hearing, “That’s the way we do it.” And to me, that’s important, to be able to keep looking at things in a fresh way.

3. What advice do you have for someone who would like to do the job you do?
A student intern, maybe 5 or 6 years ago, asked me that question, and my response to her was that she should learn how to juggle. And I think that’s true. You need to be able to have more than one ball in the air. You need to be able to realize that everything you do is connected, so if you drop one, they could affect the whole organization. So someone needs to be able to think on their toes, and remain calm, and try and get a perspective about what’s going on.

4. If you had $30,000 to donate to BCI, what would you do with it?
You know, there’s so many areas. And I’ve read what people have said to you about what they would do. I would really like a fund established for the kids. There are so many children that are affected by this disease. They stand in line with their parents, or we see them in our outreach, and we see them in all the programs. We have people who are generational here, whose parents were here, and now they’re here. And if we could do something in the prevention area for those kids, I think that would be wonderful.

5. What are you most proud of in your time at Brandywine?
So many things. Services for women, and their children. That’s always been a priority to me. And outreach, I think. Doing our outreach has been very valuable. There’s been a couple of clients that I’ve been really proud of, that have gone from being clients [to being employees.] Someone who served on our board for awhile and then became an employee, I think he’s a great success. Clients who have gone from entry into our medication-assisted programs, all the way to Newark and just coming in monthly. I think there have been great successes for that.

She Found Recovery, and It Is Beautiful

Wanese put her key in the lock, opened the door, and stepped into her new apartment. She was home. Not in a shelter, not in a transition house, but her own place, for the first time in quite awhile. She smiled as only someone finally successful at addiction recovery after many failures, can.

Home, health, and family were things Wanese once took for granted. That was before she began using drugs at the age of 13, starting with heroin, and soon afterward, cocaine and marijuana. She started just to fit in with her peers, but her addiction continued for 27 years. Over that time, a life that was once stable disintegrated.

“I come from a beautiful home. My mother was a registered nurse, and she understood addiction, so she was my support. My brothers and my dad, they gave up on me. They didn’t believe in me, because they didn’t understand addiction.” Wanese struggled to hold a job, and acquired a criminal record. She battled depression and attempted suicide three times. She had a son but was unable to be a good parent.

Wanese had tried entering treatment, but each time, she couldn’t stop using drugs. “I wasn’t ready to stop getting high. I thought I was, but I wasn’t. I was trying to stop for all the wrong reasons. It wasn’t for myself. It was for my mom, my son, or for the court.” Each time, she missed her appointments and eventually walked off the program. It seemed there was no way out.

But one year ago, she decided to try again. Sitting in a jail cell for a drug dealing charge, she made up her mind to succeed this time. She thought of her son, now 18, about to graduate high school. She knew he needed her in his life. “I decided to turn my life around. I surrendered in jail. I prayed to God and told Him that if I could get through this 24 hours, I would never use again.” So once again, Wanese walked in to Brandywine Counseling, having vowed to stay clean right from the door. Could she do it? It wouldn’t be easy.

Her willpower was tested right after admission, when she landed a job with a pharmaceutical company. She really liked the job, but stressed about it. Could she get to work on time after her daily methadone dose? Would her hair sample reveal her past drug use? Would they fire her for it? Wanese almost gave up and walked away from treatment again. But with her counselor’s encouragement, she stuck it out. Her company learned of her past drug use, and her involvement in treatment. They were supportive, they didn’t fire her, and she was very happy.

At the same time she was learning to cope with stress, Wanese was also finding outside peer support and structure. When she entered BCI, she had also put herself in a transitional housing program, Mary Mother of Hope. There, she attended support groups and got help with life skills like starting a savings account and budgeting plan. She also began going to 12 Step meetings in the community, 3-4 times a week. She was gaining focus, and finding stepping stones to a new life.

Her BCI counselor, Zona Holloman, was also a big help because she could share her own recovery experience with Wanese. “She has helped me tremendously. Dealing with a counselor that has been down the same road and path that I have been through, that can relate to what an addict’s coming from, made a lot of difference. She has helped me to understand a variety of things I didn’t know coming into this process. Narcotics Anonymous, Alcoholics Anonymous, or getting a sponsor, or making sure that I was in a safe haven. Letting me know that anything is possible as far as me advancing in life, and I could go on and on.”

Wanese’s own determination, plus the support of others, was working in her favor. She was keeping her promise to stay clean. Right from the door, she had not even a single positive drug screen. It wasn’t long before she reached the 90 day milestone. She was awarded weekend takehome medication, joining over 400 BCI clients at this stage. Soon, three months became six, and then nine, and she continued to earn more bottles. Excitedly, she burst into Zona’s office one day with the words, “I received my third bottle, and it is beautiful! Especially the weekend ones, because I don’t have to get up or rush to come to the clinic.” Each new bottle was a reminder of what was really beautiful, her new life.

Wanese recently celebrated one year clean. She has a good job. She’s been off probation for 9 months. She bought a car that has helped her attend more 12 Step meetings. She even chairs the meetings at her home group and finds other members to share their life story. She has a good sponsor and works on placing the 12 Steps into her life every day. And, she has her brand new apartment.

“I moved into my own place last week. I’m still on the same format and program, just like if I was at Mary Mother of Hope. I’m in the house by 10:00, even through curfew is at 11. I still make my meetings, I still do my Step work, I still affiliate myself with people who are clean and sober, and I’m still adjusting.”

She has new goals and plans, like going back to college. “I have a degree in computer science [but] because of my drug use, I’m not in that field today. Times have changed, as far as computer technology. [Now,] I would like to be a drug and alcohol counselor.”

Most important of all, she has her son back in her life. She achieved custody and he will move in with her after graduation, to the new apartment. Wanese is free of drugs and has gotten back what she’d lost. Home, health, and family. “It’s a beautiful feeling. There’s just not a word that really can describe it. It’s only through the grace of God. It’s a beautiful feeling.”

The Problems We Can't Help, and The Ones We Can

A few weeks ago I got an email from Chris, our Nurse Practitioner, that he thought would make a good post for the blog:

"As a consultant and part-time employee for BCI's-MM2 Program (Newark site), I have noticed firsthand the effects of our economy in crisis. I have witnessed recently at least three clients who have been laid off or who are living with the daily fear of losing their employment... These consumers have earned their position in the MM2 program. Most have been drug-free for several years plus. They are so proud of their accomplishments including buying their own home with their own money. Now the economy has taken a terrible turn for the worse with no certain timeframe for recovery. This enormous stress and burden for our consumers may be too much. This financial burden may be an unforeseen trigger for RELAPSE. I can only try to be optimistic, empathize and offer support for our consumers during this dismal transition.”

Well, I didn’t post this right away. I thought it was missing something. Honestly, it was kind of a downer. Yeah, the economy’s bad – tell us something we don’t know. I wanted to at least leave the reader with some hopeful moral, or some call to action, but nothing came to mind.

Yesterday, Chris asked me about the post, and I still hadn’t found my ending. He wasn’t sure what to add either. So the conversation moved on, and he started telling me about a recent evening at our Newark site. It was one of those long, cold, winter days and they were waiting for the last client of the day before they could close and go home. The client came in, and picked up her medication, and when she went to leave, she had a flat tire. So Chris helped her change the tire. Then, there was something else wrong with the car and she needed someone to give her a ride. So Chris waited until she got a ride home, even though it was late, and cold, and the end of a long day. “Well, I couldn’t just leave her there!” he said.

So after he told me all this, I asked, why didn’t you send me that story for the blog? Not only does it have a nice ending, but it gives me the ending I wanted for the first story. Because even in these tough economic times, for every seemingly hopeless story, there is another hopeful story somewhere.

5 Questions for Ilian Bustos, Hispanic Program Counselor

5 Questions is our ongoing feature where we introduce you to the people who make Brandywine Counseling run, spotlighting a different staff member every two weeks.

Name: Ilian Bustos
Job: Counselor, Hispanic Program, Lancaster Center
Time with BCI: 2 years

1. Why did you decide to work in addiction treatment?
The most important thing for me is to help people, to make a difference, to give them a chance to change their lives. It’s not our job just to listen to the client, but also to analyze and help them find solutions. You can’t change the life that another person has, but at least you can make a little change for them, with groups, or through talking, even from the time that they meet you.

2. Aside from language, what special needs do your Hispanic clients have when they come to us for treatment?
Most of the people that come here feel that they are fighting with the world, and sometimes they don’t feel accepted in the world. The challenge for me is to let them understand what they need to ask of themselves, in order to be able to find another way to help them. This way, we can help them to find another way to see their lives, and especially to feel needed in this world. [My biggest challenge is] to find a way to send a message to a client, and it doesn’t matter if it’s in Spanish or English, it’s really a challenge to find that gate that’s open, just to get the message out and try to do something different.

3. Tell us about the group you run.
This group is every Tuesday at 6:00, and it’s just for Spanish-speaking [clients]. I have people who are on the Drug Diversion program, Core division, and also Intake. I think the most valuable thing during my group is that I allow the people to talk. I use that to help them realize difficult aspects of their lives, especially their needs. I think the most important part is that they feel that they bond with the same culture and the same ideas, and I think that helps them to understand their treatment in another way.

4. Kiesha told us why she prefers to do intakes over being a permanent counselor. Why do you like being a permanent counselor?
It’s wonderful the way you can see how the client is making improvements in their own recovery. There are some clients, of course, who can’t make any improvement during their treatment, but it’s good when you see them coming back and trying to do something different. For example, people who are changing the thoughts they used to have at the beginning, who were not engaged in the program and recovery. When they are administratively discharged and they come back, they have another attitude. They are thinking about how to improve the kind of life they have, and especially to be a better person.

5. Tell us your favorite client success story.
I had a client who refused to have treatment at the beginning, and he tried his best, [but] eventually he was discharged. A couple of months later, I received a phone call from him, giving thanks. He mentioned that, thanks to all the advice I gave him, he was able to start doing something better. He continued at another treatment facility -- he’s no longer at BCI -- but at this point, he’s doing something different. He’s doing something for good.

5 Questions for Kiesha Wright, Intake Counselor

5 Questions is our ongoing feature where we introduce you to the people who make Brandywine Counseling run, spotlighting a different staff member every two weeks.

Name: Kiesha Wright
Job: Intake Counselor, Lancaster Center
Time with BCI: 1 year

1. How is the economic downturn affecting your clientele and how you do your job?
I’m an intake counselor, which means that I see people when they come straight from the streets. A lot of our clients that are coming in right now are very, very needy. When I say needy, I mean housing, food, clothes. Because the economy is so bad, a lot of [counseling] time is being taken up with things that people need immediately. So that definitely puts a strain on what I do. Because we’re therapeutic. A lot of that therapeutic aspect is being taken out. If we can help them with food, and things like that, we’re supposed to. But it’s not supposed to be our primary job. My whole session shouldn’t be on helping the client get food, housing, and clothes.

And that’s why we have case managers now. What we do now is try to coordinate with their case manager, who does handle Medicaid, food, housing, clothes, and other necessary resources, so that we can do the therapeutic aspect of counseling.

2. As an intake counselor, you see clients on a temporary basis until they’re stabilized, but you don’t follow them through treatment. What’s the appeal and the challenge of working in intake?
It depends on how much you want to be involved with the client, and how far you want to follow them. Intake works for me, because I don’t only get to see the end result. When they move up [to a permanent counselor] they’re supposed to be stabilized, [and if I’m the new counselor] I don’t see anything that they went through to get there. I’m the type of person that wants to see the client through all of those steps. Once they are stabilized, I want to pass them on to somebody who’s maybe a little bit more experienced, somebody who will follow them the rest of the way. Not everybody gets stable before they go upstairs, but in an ideal situation, I would take them through all the beginning stages, get them 30 days clean, and then they would go upstairs to Core.

My biggest challenge in doing my job is not to take it personal, not to take it home with me. If I’m working with someone and they get 30 days clean, and they relapse, I can’t take that as if they relapsed because of me. I have to also be understanding. They’re going through different stressors than I am. And, not to take it home with me.

3. Many of our staff express their personality in how they decorate their office – tell us what you have in your office.
I have a big poster of a waterfall, and the water’s green and the sky’s blue, and this is what I use to escape when I’m having a very, very stressful day. I also have a lot of sayings. “Life is about making mistakes and learning from them.” “Make an effort, not an excuse.” And, “You can’t change your past. You can change your future.” I have other little thoughts for the day. I have a little plant that one of the girls gave me that left, that I’m trying to keep alive.

When I got here, I got the office painted. I wanted it to be really bright, because I wanted people to walk in my office and just, like, cheer up! Even if they were sad! Unfortunately, I was told that I couldn’t make it as bright as I wanted to. (Laughs) So I settled for orange. So, when people walk in my office, I want them to be, first of all, surprised by the color – like, “Oh, that’s a bright color,” and open up their eyes. And I just want them to feel comfortable. I try not to have anything that’s intimidating to people, or anything that’s going to offend anyone. I also have the regular things, too, some NA schedules, some diagnosis charts. I have some of Habib’s decorations, so he has a little touch in my office too.

4. What’s been your most rewarding moment at BCI?
When somebody reaches 90 days clean time [and earns take home medication], and the reaction that they give you. And you’ve seen that person struggle, you’ve seen that person from intake - which is why I like intake - you’ve seen that person come in and say, “I’m not gonna make it, but, this is what I have to do, to maybe stay off the streets.” And they actually get to 90 days, and you see the reaction that they give you. That’s a big reward. I actually have two clients that just reached their 90 days.

I have a client who transferred to us from Kirkwood Detox. She came in and she was like, “You know what, Kiesha, I’m gonna stay with my mom. She’s gonna kick me out, I’m still using, the hardest part for me is to get to 90 days. I can’t get to 90 days, I won’t make it to 90 days, but I’m gonna try.” Her son’s father took custody of the child, so she was upset about that. She wasn’t employed, she had psych issues, and she was just all over the place. Well, I just recently saw her for our third or fourth session, and she now has four months clean. She’s going to court for a custody hearing. She’s very hopeful that she’s going to get custody back of her son. I’ve even met her son. She got a job, so therefore, she’s paying for her own medication. Things are going better between her and her mom, because her mom’s not financially supporting her.

So that actually made me feel happy. She came in recently, and she was like, “I just want to thank you for sticking it out with me, ‘cause you could’ve just gave up on me. And that’s what I thought you counselors did, you just pushed people through.” So, that made me feel good. It made my heart smile a little bit.

5. If you had $30,000 to donate to BCI what would you do with it?
I would update the computers, because we’re going paperless now, and I had a couple clients where I couldn’t do their intake, or couldn’t complete it. I keep getting the error message, “No Token.” So I would update the computers, definitely, because that’s a big, big, big part of it. And… oh yeah! I would put it into having our own food closet for people that are not in NSAFE or Safety Net, so it’s not like we’ve got to send clients out to get food. We’d have the food here. Of course, I guess, we’d have to build another room for it. So I’d build the room! (Laughs) And have the food in there, and also a clothes closet. So the computers, a food closet, and a clothes closet within BCI! That way it makes it easier for everybody. That’s what I would do.

5 Questions for Darlene Pezzullo, Nurse

5 Questions is our ongoing feature where we introduce you to the people who make Brandywine Counseling run, spotlighting a different staff member every two weeks.

Name: Darlene Pezzullo
Job: Nurse, Newark Center
Time with BCI: 4 years

1. How did you get started in the field of addiction treatment?
I have been a nurse for 37 years. The first few years I worked in the Medical Surgical Department of a Hospital and then a Geriatric Rehabilitation Center as a Treatment nurse. Then the next 20 years were spent as a Case Manager for USHC, AETNA and Cigna Medical Insurance Companies. I had spent so many years behind a desk working in an office, I felt that I had lost the one on one contact with clients. I missed that. Don't get me wrong, I loved nursing no matter how I could care for my patients, but I truly missed the hands-on aspect of nursing.

In 1998 my husband and I relocated to Delaware from Northern New Jersey. I landed a job at Upper Bay Services and Counseling, I worked in the Sunrise program, which was responsible for the direct care of clients being discharged from long term psychiatric facilities and reintroduced to society. This program allowed me to get directly involved with patient care again. After 3 years, the program closed down and I took a job with Northeast Treatment Center’s Kirkwood Detox. This facility offers a short term, inpatient detox program for alcohol and drugs. This was my first taste of the addiction field.

One of the part-time nurses I worked with at Detox was Ena Dryden, a full-time nurse at BCI Lancaster site. She informed me that a new facility of BCI would be opening down at the Riverfront for opiate addiction. We discussed the methadone program and what Brandywine had to offer in services to opiate dependent clients, and I was extremely interested, so I was eager to interview for the position. And, here I am 4.5 years later, happy, content, loving my job, my co-workers and the wonderful relaxed atmosphere of the Newark site.

The typical day at the clinic starts around 4:30 in the morning, getting the dispensing pumps ready with methadone, preparing the clinic for new intakes, preparing the exam room for yearly physicals. The nurses observe urines for drug screens scheduled for the clinic as well as the Drug Diversion Program. We offer Suboxone, and alternative choices for clients for opioid treatment. Our department is responsible for keeping accurate medical records on our clients. I assist Dr. Glick with his appointments of clients who see him for continued prescriptions of psychotropic medications.

I think I have a very good open relationship with my clients. I greet them in the morning with a smile, ask them how they’re feeling, and what’s going on with them in their daily lives. I remind the clients of the positive choice they have made by facing their addiction, and taking the right action to better themselves and their families. And that there is "Always Light at the End of their Tunnel."

2. What would people be surprised to know about your job?
That methadone really does work! Through education, counseling and taking methadone, we have seen clients be able to regain their life back, employment, and a happy home.

We are a staff of dedicated, compassionate nurses and counselors who come to work every single day and face our clients with a smile. We watch some succeed in the program, move on to the 30-day program, or no longer need our services. We have done our jobs! But, for the ones who fail, we are here to pick them back up with a smile, and without judgment. They’re no different than we are. Everyone has a story of how their addiction was started and OUR job is to listen and offer the best services and help we can give. I would encourage any nurse with an interest in the Drug and Alcohol field to come and look at the methadone program. These are people just like us. They have their own problems. We’re not here to solve them, we’re here to help them as much as we can, through education.

3. The Newark site had a 25% increase this year in number of clients who had stayed in opioid treatment for one year or more. What do you think is the reason for this?
Dedication of the Newark Staff! We have wonderful, caring, compassionate nurses, concerned and well-educated counselors and a clinic which offers treatment with a smile. Why wouldn't a client want to come our clinic? We care. We offer methadone, counseling, psychiatric treatment and medical care, all wrapped up in one. We are a well-rounded treatment facility. We have made our clients feel comfortable and safe. This type of caring from our staff has allowed us to be the BEST in the industry.

4. Many of our staff express their personality in how they decorate their office – tell us what you have at your work station.
I’m a big New York Giants fan. I’m from northern New Jersey, I grew up right outside the Meadowlands. I have a NYG coffee mug and I hang up newspaper clippings of NYG game highlights, if I can get away with it! With almost every man that walks up to my dispensing window during the football season, we can talk about the teams, players and standings! And I think, they think that’s kind of neat.

I am also known to have holiday decorations in my window, beanie babies, Easter bunnies, St. Patty's pot of gold, Xmas tree, but the best of all is my four stuffed Dwarves named Grumpy, Doc, Dopey, and Sleepy. My office space isn't that big (it's a dispensing window area), but what I have definitely entertains the children while their parents are getting medicated. I like to think I put a smile on everyone's face and it makes their day brighter! "

5. If you had $30,000 to donate to BCI what would you do with it?
I would use the money for a salary for a Prenatal Counselor and/or Case Manager at the Newark site. We have had many young women deliver babies this past year, and they struggled during and after delivery with being on their own, abandoned by their husband, boyfriend, loss of housing, insecurities, mental issues, and facing their own addiction, and difficulty understanding the withdrawal process of their newborn. Our facility could use the education and expertise to help educate and direct these young women. There are many new fathers as well, who could use help with understanding the complete role of parenting. With the addition of a prenatal counselor, it would allow our team at Newark to be versatile and well rounded in all phases of care with our clients.

5 Questions for Jeremy Zane, Therapeutic Supervisor

5 Questions is our ongoing feature where we introduce you to the people who make Brandywine Counseling run, spotlighting a different staff member every two weeks.

Name: Jeremy Zane
Job: Therapeutic Supervisor, Lancaster Center
Time with BCI: 4 years

1. Safety Net Services is one of the BCI programs you’re involved in. How are you addressing an unmet need for substance abuse treatment and HIV/AIDS services in Wilmington?
Our main focus is getting people into treatment. The [Christiana Care] infectious disease clinic, who is the largest HIV treatment provider in the city, was referring a lot of people to Brandywine, and a lot of people weren’t making it. The first thing that we’re doing is the seamless transition. A lot of times we get referrals from the infectious disease clinic the day people find out they’re HIV positive. In fact, in the first five months, there’s already been 4 or 5 where we were at the infectious disease clinic the moment they found out that they were positive. So from day one, we’re linking up these two services. We want people to understand that HIV is treatable, that it’s not a death sentence anymore, as long as a person takes care of their body, and takes their medication. Also, substance abuse treatment can coincide with HIV.

We’re talking about a population that is probably taking the bus everywhere, or needing to get rides. Transportation can be a very significant barrier in itself. We’re talking about a person who could be going, in one day, from substance abuse counseling, get on the bus, go downtown, go out to the infectious disease clinic, sit all day out there, get the things that they need to get done, and then go back into the middle of town to Connections or Community Mental Health for their mental health services. That’s a lot of running around. And if the person is in a lot of need, and needs services every week, the chances they will get those services consistently, decreases greatly, having to run around town that much.

Having Christiana Care’s remote site here, a person can come in, get their substance abuse treatment, see the nurse practitioner, get their HIV meds, and they’re able to do it all under one roof. The mental health component also can be contained here. A person with mental health issues can have their evaluation done here, can have their medication management done here, can get their prescription through here. Everything that person needs is contained under one roof.

2. You also helped start Recovery Counts for people who weren’t succeeding in the usual track of treatment. What is this program and how did it come about?
I remember the day, there was a particular client who came over and said, “They’re discharging me off the clinic, but right now, I’m clean. I can give a clean urine right now, but I’m being discharged.” And from that moment, Basha [Silverman] and I kind of looked at each other and thought, “I wonder how many other people there are like that, who are being told they’re discharged, and now, this is when they’re going to decide to make that change?” And after looking at it, we found it to be quite common. So what we wanted to do was to come up with a program that, we say in a very concrete way: This is your last chance at treatment. If you do not demonstrate changes now, you’re going to be referred to a higher level of care, and you’re going to be discharged from the opioid treatment program.

We started a pilot program of about a dozen people. And what we were able to do was, really offer them more intensive services. We’re going to have a couple of groups a week, we’re going to be meeting for an individual session every single week, until we get through this and over this hump. And from that point, it started to grow. And then what we started to realize was that, maybe we should start working with people at the beginning. Anybody who’s on contract at all is then going to go into this program.

The reason they’re not succeeding in treatment is because, maybe we’re not offering intensive enough services. This person needs to be seen more than once a month, and they need a case manager, they need to be coming to group. And the same person running the group needs to be running their individual counseling sessions, so they can incorporate what’s going on in group back in the individual session, in a seamless way.

We also look at an outcome questionnaire. By decreasing incarceration risk, housing need, [and increasing] interpersonal relationship skills, education and employment, it has a correlation with their urine screens. As negative urine screens go up, these factors improve.

3. Recovery Counts and Safety Net Services could both be described as harm reduction approaches to addiction treatment. Do you have an opinion of whether harm reduction or traditional treatment is more effective for clients?
I personally believe that a harm reduction model is more effective. Now, you have to really define what harm reduction means, because it means different things to different people. Some people who are on the liberal side of the harm reduction model say that no one should ever be penalized for urine screens, ever. That a person should never have negative consequences, should never have hard holds. I’m certainly much more on the conservative side than that. I believe that a person needs time to change. They’re going to be positive while they’re in treatment, and the day they walk in the door, you can’t possibly expect them to just, all of a sudden, start submitting negative urine screens. So where is that point? Is it two months into treatment, eight months into treatment? And from my point of view, that’s going to be different for everybody. That toleration, that acceptance that a person’s going to be positive while they’re beginning treatment here, in my opinion, is still part of the harm reduction model.

I also believe, however, that there’s also some point where, if we’re not demonstrating changes at this level of care, and allowing the person to continue their behaviors at this level of care, it’s more detrimental than it is helpful. And we need to make efforts to get a person into a higher level of care, which can be perceived as punishment. If we’re discharging a person because we believe they can’t succeed at this level of care, and they don’t want to go inpatient, then that person’s probably going to perceive what we’re doing as punishment, and I think some of the purest harm reduction model thinkers would also think that that’s punishment as well.

4. How did you get into the field of addiction treatment?
I got introduced to Brandywine when I was at Wilmington College with my undergrad degree. Basha had come in and was doing a presentation about the outreach services that Brandywine had to offer. And at that point, I really didn’t know what I was going to do with an undergraduate degree in psychology. And that was the first time that I became interested in outreach in general, and in getting into the substance abuse field. So I came in for an interview, and there was a project they had just gotten some funding for, and I just kind of fell into it that way.

And once I’d gotten involved and started working with the population… you grow into it. It became something that was very interesting to me. The substance abusing population has mental health issues, they have medical issues, and counseling people with substance use disorders, you get a little piece of everything. So, as opposed to just working with people with depression, or just working with people with post-traumatic stress, you get all that here, but the common thread is, everybody’s also abusing substances. So you get a more complete package, and a more dynamic caseload, in my opinion.

5. What is rewarding about your work at BCI?
I think everybody says that they’ve got a couple of clients who’ve really made changes, and with some of the clients that I’ve had now for 2-3 years, you see them struggle and struggle and struggle, and then finally get to this ultimate goal. The first time a particular client gets travel bottles. When somebody is detoxed successfully who was about to be kicked off the clinic a year ago. Everybody’s got those two or three clients that they’re always going to keep with them. That type of satisfaction, that type of reward and internal satisfaction that you get, I don’t see how you could possibly get that at any other job.

5 Questions for Kim Ortiz, Nurse

5 Questions is our ongoing feature where we introduce you to the people who make Brandywine Counseling run, spotlighting a different staff member every two weeks.

Name: Kim Ortiz
Job: Nurse, Lancaster Center
Time with BCI: 2 years

1. What led you to work in addiction treatment rather than a doctor’s office or hospital?
Three experiences have prompted me to go into an addiction treatment center:

In addition to being a nurse, I am a musician also. I became acquainted with a fellow musician who started playing for one of my choirs years ago. I found out that he was an addict and learned about his cruel childhood and what triggered his drug use. We still managed to become the best of friends. On one occasion, I didn't hear from him for two days, which confirmed my suspicions that he must be using. By Monday, he came to my door, asking to take a shower. I refused to let him in my home. In fact, I packed his clothes, gave him $5 for gas, kissed him farewell, closed my door, and then slid to the floor in tears. He was as close to me as any brother could ever have been. It hurt to have to practice "tough love." But I did. The story goes on, [and] through his recovery process, we stayed in touch. It was this friend that taught me to have an open mind about people and not to be so judgmental.

Before I came to Brandywine, I worked at the Veterans’ Hospital. Many of the patients were current drug users. They were introduced to drugs while in the military, serving in various wars. While assessing some of my patients, I got to know many of them. I loved working there. To see the things they were having to struggle and deal with, it’s become a desire of mine to help people.

[Also,] I love psychiatry, getting to know people and what makes them tick. One of my dreams is to further my study so that I will better equip myself to counsel those that are in need. I play a major role in scheduling Dr. Tavani's appointments (the Psychiatrist here at Brandywine.) It's interesting to hear the experiences and challenges that our clientele have endured. The past-to-present stories of some of our clients would make the top best book seller's list and it wouldn't even be fiction! What better place to work than Brandywine, to touch these areas of interest for me?

2. The nursing staff sees our clients every day, when they come to your dispensing window. What’s your relationship like with your clients?
They feel like family to us. We get to know what's happening in their lives on a regular basis. They bring their children in, bring us pictures of their families. When a client comes to my window, if they’re having a problem with anything, I can talk to them. I think they feel comfortable at confiding in us about their lives, things that they might not tell other people here. I love talking with people and I love helping people, so I really count that as a privilege.

The thing that I value most in working here as a nurse is, that I am working with people that are the same as you and I. I believe most people have some type of addiction, whether it be food, sex, drugs, or working too much. It's what we do to try to make up for the off-balance that is reflected in our lives. I hate the stigma that's placed on [addiction]. We sometimes put people in this little box, and think that they all should be labeled as such, as an "addict." But the fact is, that these are real people, with real issues, real problems, and real concerns. If we treat them as such, I think we get back the same respect that we would expect. I wish our society would get out of the mindset that, "They are just addicts." Yuck!! No!!! A lot of them didn't ask to be in this position. If we could just be understanding about that, the world would be a much nicer place, as far as I'm concerned.

3. The BCI medical staff has been very involved in our P2R efforts to improve access to treatment. We’ve become less like a doctors’ office and more like an emergency room, with all walk-in intakes, no appointments. Do you think those changes have helped the clients?
I do. I think that it makes it easy. I can get a call on the phone today from someone asking, “How do I get into this program?" And I can say, "We're open every day of the week. Be here by 5:00 in the morning, Monday through Friday, first come, first served." If they want treatment right away, they know that we're available, we're flexible, and all they have to do is get here. Once they get in here, we take their names, and, 1-2-3-4-5-6! We take six people, Monday through Wednesdays, and two clients on Thursdays and Fridays. As long as they're willing to get here by 5:00 A.M., their chances of being seen are really good.

4. What advice do you have for someone who would like to do the job you do?
My advice would be to go in with an open mind, and to not have that judgmental stigma of people that are addicted to a substance. If they can block that out of their mind and realize with every client, there is a story. There's background history. And God knows, that if we read all of the background history that Dr. Tavani compiles on each client that she sees, some of our stigmas would definitely change. In many instances, it may not have been that client's fault that propelled them into substance abuse. What caused that client to use? Were they born addicted with an addicted parent to govern them?

If we could just get that stigma out, I mean, throw it out the window, and realize, these are people, just like those coming out of the hospital with physical ailments. Our clients have major physical impairments going on, maybe stemming from the experiences that have happened in their lives. Whether it was just choosing the wrong friends and someone starting them on the drug-use trail, as innocent as that may sound, now they're stuck with a habit that they wish they had never started. In all of this, remember that, many of our clients are here because they want help desperately. Do everything that you can to give them that help without enabling them.

5. What is the most rewarding part of your job?
There are several rewarding aspects of my job.

[First,] being able to run to emergencies. Just recently, we had somebody who had a seizure, and he fell out in the waiting room, and hit his head, and we had to call 911. I like trauma type settings, so when that kind of thing happens, it’s an adrenaline rusher for me. Being able to get that person revived, and get them back conscious. That’s firsthand nursing experience right there.

When a client comes to my window and tells me that they're going to a job interview, and they're afraid to reveal to the employer that they are on methadone, I feel their fear. I enjoy encouraging them, “Think positive! Hold your head up, and smile, smile, smile!” Reminding them that they are doing this for themselves, and they are doing all within their power to heal themselves, so they can do better in their lives. This is all that any of us want in our lives ... to do better. “So, go get that job! You're gonna do this for you!" Then, it really makes my day when they come back to report that they did indeed get the job, and thank me for being so supportive. Hallelujah!!!

Lastly, when a client finally gets to zero milligrams of methadone. It's a day of rejoicing!!! They've done their part in their treatment, and are finally able to walk away from here without any withdrawal symptoms. To God be the Glory!!!!

5 Questions for Cindy Pence, Counselor

5 Questions is our ongoing feature where we introduce you to the people who make Brandywine Counseling run, spotlighting a different staff member every two weeks.

Name: Cindy Pence
Job: Counselor, Newark Center
Time with BCI: 4 years

1. Why did you decide to become an addiction treatment counselor?
I have my Bachelor’s in business, and I developed a love and desire to be in this field from my own experience and my own recovery, even though there weren’t drugs and alcohol in my recovery. I came from an abuse and codependency background, and in the midst of my therapy, from day one, I knew that’s what I wanted to do. And I knew that I could not be successful in this field until I had reached the healthy mindset that I needed to be in, in order to counsel other people. I went into my own therapy in ’97, and approximately 7 years after that, in ’04, I got the job with Brandywine, and I was very blessed when they offered it to me. And I’ve loved it. My job has had a positive impact on my own well-being in my own life outside of here, because I can practice here with clients what I already know from my own recovery knowledge.

2. Many of our staff decorate their office with personal items. Tell us what you have in your office.
It’s like my home! I wanted to have an office that was full of serenity, where people would feel comfortable. Instead of an office setting, a homelike, warm setting. When I had my interview with Pam [Stearn], I’ll never forget - when I saw my office, I cried, because I couldn’t believe, it was the first time I had a closed office with a door on it! And I remember looking in one of my corners, picturing a Christmas tree there. So ever since I’ve worked here, I’ve had a Christmas tree in my corner, and clients have always complimented my tree.

3. What is your biggest challenge in doing your job?
Having difficult clients. I have some that are very personable. They warm up to me, connect with me from day one. And then I have a select few who challenge my weaknesses with patience and endurance. But I also am blessed when I have these kind of clients, because it tells me where I need to work, and how I need to be professional in helping them, and focus on their needs.

4. What advice do you have for someone who would like to do the job you do?
Make sure they have a passion for it, and that they’re really attuned to other people and their needs. And they don’t put themselves ahead of the clients. They really have to have compassion for other people, and have good boundaries.

5. Tell us your favorite client success story.
I have a client that came to me on a contract, and is now going to be in [Methadone] Medical Maintenance II, where he gets the 14 days of wafers, by next month. So that right there has just been an accomplishment, where I worked well with him. He did the harder part, but I could see that his individual [sessions were] an asset in his life and [led to] good outcomes. [He learned to avoid] being around negative people, being influenced and triggered to go use illicit drugs. [He] developed a better support system, which I helped him do, and I also spoke of the consequences if he didn’t do it, which could help him make better changes and choices for himself. And as he was accomplishing through treatment, he would express self-assurance. He gives himself all the credit and not me, which was good.

Video: The Joy of Being Normal

AATOD has produced a video on the benefits of methadone treatment called "The Joy of Being Normal." They hope to get the message out to a large audience that methadone helps people lead normal lives, and dispel the myths that persist. 3 patients and family members tell how their lives were saved. Nice work, AATOD, and hopefully this video will help change minds.

Video: BCI and the "Whole Patient" Approach

BCI is featured in a new video on SAMHSA's Recovery Month website called "Medication Assisted Therapies: Providing a 'Whole Patient' Approach to Treatment." Several patients talk about how methadone saved their life, plus comments from James Harrison and Dr. Glick. Also, a panel of experts discusses the many benefits of medication-assisted therapy. The BCI portion begins about 13 minutes in.

Dispensing Mural: Climb to the Top and Soar in Your Recovery

The Lancaster dispensing area has been livened up with a brightly colored mural, thanks to a group of volunteers from Chase. The team of a dozen people from the nearby Wilmington office took time out of their workday yesterday to give back to the community. In doing so, they’ve made the daily routine of coming in for medication more welcoming for nearly 700 methadone patients.

One wall depicts how we can turn stumbling blocks into stepping stones to climb toward recovery, using faith, help, health, and hope. The opposite wall is all about reaching the top of that climb and being ready to fly, because the sky is the limit when you’ve overcome your addiction. We think this is just the right mix of inspiration and fun to greet our patients every morning. And this is only phase 1 of the project, because now, our patients will get to add personal messages in the blocks to those who have helped them in their climb toward recovery.

We thank Rachel Aponte and her group of artists from Chase for this gift they’ve given us. For an afternoon’s work, they became part of the recovery process for today's patients and many more to come.

5 Questions for Chris Zebley, Nurse Practitioner

5 Questions is our ongoing feature where we introduce you to the people who make Brandywine Counseling run, spotlighting a different staff member every two weeks.

Name: Chris Zebley
Job: Nurse Practitioner
Time with BCI: 4 years

1. What is your job at BCI?
I’m a board certified adult nurse practitioner and HIV specialist. I actually work for Christiana Care Health System. My department is the Community HIV Program. I collaborate with Dr. Szabo, who’s an infectious disease physician, and we run an HIV clinic here at the Lancaster site every Tuesday morning. The whole idea was to allow a one stop shop to get your mental health, your substance abuse treatment, and if you’re HIV positive, to get your HIV medical care under one roof. We call it “nested services.”

2. What services do you provide to BCI clients?
A nurse practitioner can treat acute and chronic illnesses throughout the lifespan, along with having prescribing privileges. I can practice independently, whereas a physician assistant must have supervision.

The services I provide include case management and treating acute illnesses. The clients who come in to see me generally present with maybe a tooth abscess, bronchitis, a skin infection, sprains or strains. The client may be unable to see their primary care physician, or worse yet, because of their addiction, might not see it to be a priority to take care of their health. I make referrals to dentists, PCP’s, foot and eye appointments. On occasion I’ll refer them to the ER, and I can call people that I know in the emergency room. There’s many, many things that I’ve done for people as part of referrals and such.

In my HIV clinic I have around 35 clients. I get referrals from my department, from NSAFE upstairs, Outreach, or by word of mouth. The medical management of these clients is very intense, because the majority have “advanced disease,” so it’s my duty to assist them in maintaining optimal health. We treat patients with very, very heavy co-morbid conditions - Hepatitis C, heart failure, vascular problems. I may do pill planners to aid in the adherence of their medicines, treat any acute illnesses that may arise, and also provide health maintenance by making sure they have their necessary screenings, such as a colonoscopy, Pap smear, or mammogram.

On Fridays I usually do annual physicals for Dr. Glick, as well as intake physicals for methadone, Suboxone or Revia. I do part time work with the Medical Maintenance Level 2 program at Newark where the people come in once a month for their methadone.

I’ll be working hand in hand with Outreach on Safety Net Services. I’ll be providing case management, HIV medical care, and psychotropic medication management.

3. What drew you into a career in the addiction treatment field?
This is something that I grew into. In the hospital we’d always have people that were disadvantaged, and stigmatized in society - IV drug users, the homeless, HIV infected individuals. These were real people with real illnesses who never asked for anything, and were very appreciative of the care they received. And I always thought, I’d like to work with these individuals, because they had a lot of needs, simple needs, that could be fulfilled.

This was a job posting with Christiana Care. I was working in employee health as a nurse practitioner at the time. I happened to see this posting, and it was for the Riverfront. An HIV clinic, but you would be working in a methadone clinic. I didn’t even know what a methadone clinic was, really. I didn’t realize how many people actually go to these places.

There were many people telling me, “You’re not gonna like it. You’re gonna regret taking that job.” You can’t go on hearsay. If I’d really listened to people, I might not be here today. I would not even have taken the position. I had to experience that for myself. And from day one, it was fine, it was nothing like what people told me it was going to be. I enjoyed it from day one. Because we’re able to meet the people’s needs, that’s a big thing.

4. If you had $30,000 to donate to BCI, what would you do with it?
Certainly the Outreach. They’re the ones that get people in here. They do so much good, whether it’s the food closet, or the clothes closet, and to help for that needle exchange to grow. As we see the research and the data come down, I’m sure the federal government and the state will allow us to expand. But that’s been a plus here for Brandywine Counseling. I’ve done intakes and I asked them, “Well, how did you know to come here?” And they said, “Well, it was the needle exchange.” That’s an indicator that it’s working.

I’d also open more transitional housing, because recently the CDC announced that homelessness is now the single largest contributor to HIV infectivity.

5. What is it like to work with these clients?
You’ve really got to like people in their worst condition, and in their good condition. And that’s what nursing is about, the human response to illness.

These people are survivors. They’re very, very smart. They could be executives if they could put their mind to more positive things. Some of these people could have been very, very wealthy and rich, the way they’ve been able to hustle, to get money for drugs. People have written about, if we could only find out how these people, the disenfranchised, tick, and how they’ve been able to survive these harsh illnesses, without a lot of medicine, then we could treat a lot of other illnesses cost effectively without using medications.

My first patient that I ever saw [now] comes here for take-homes twice a week, so they’ve been drug free for almost two years. I have them come in for support, and they’re part of my HIV clinic too. To me that’s a success story, because they know that they can come in at any time, whether they can see their counselor or not. To really see this person get out of the deepest, darkest abyss, where they were constantly using, and she’s not now, so she’ll continue in her recovery. That was pretty cool, to actually see that.

5 Questions for Jenn Kutney, Counselor

5 Questions is our ongoing feature where we introduce you to the people who make Brandywine Counseling run, spotlighting a different staff member every two weeks.

Name: Jenn Kutney
Job: Counselor, Bridge Perinatal Program
Time with BCI: 2 years

1. Tell us about your job and the clients you work with.
I’m a counselor for pregnant women, [and] women with young kids, that have a lot of case management issues, a lot of people with dual diagnosis. I wanted to work with families, and women in particular, women with children. That’s really why I came here.

A lot of our clients are coming in with problems with Health and Social Services. They’re coming in pregnant. [They] don’t really understand methadone and how it reacts with pregnancy, that whole interplay. A lot of women need housing help.

These are people that are coming from very chaotic backgrounds. They bring a lot of that chaos here to get it out, and it makes it chaotic here sometimes, and if you take it personally, it’s gonna burn you out.

2. What is your biggest challenge in doing your job?
There aren’t a lot of services for women with young children. There’s not a lot of housing programs available for women with young children. There’s not a lot of treatment programs available for women with young children.

You can get a single woman into treatment a lot easier than you can get a woman with children into treatment. You have to deal with finding a place for the children to go while she’s in treatment. I’m so grateful for The Lighthouse Program, because it’s desperately needed! It’s a great concept for a treatment program and I think it could do wonderful things if it continues.

And also, one of the biggest challenges is providing addiction services to women with open Division of Family Services cases, because sometimes they don’t quite understand what addiction is, the disease of addiction, and things like relapse.

3. What has been the most rewarding moment for you at BCI?
I started as a case manager, and I had a client on my caseload from day one when I walked in the door. DFS had taken her kids, and terminated her rights to one of her children, and taken the baby right from the hospital. She was discharged almost a year ago now. And I actually hear from her now, and she’s doing wonderfully. She’s clean, she’s moving out of state to get away from everything, and she’s doing very, very well.

4. Many of our staff decorate their office with personal items – tell us what you have in your office.
I like to hold things for clients, apparently! Right now I have strollers, and clothes, and all sorts of stuff. I wasn’t originally in this office, so a lot of the things I have are inherited. I inherited a picture from Kathy Kelley. I have kids draw me pictures, I have pictures of the babies, and of my nieces and nephews, hand drawn pictures.

5. What is something people would be surprised to know about your job?
How dedicated a lot of these women are to their families. The biggest stereotype I’ve heard since I started working here is that these women really don’t care about their kids. And they really, truly do care about their kids, and how their kids are doing, and making their life better, so that their kids don’t have to go through a lot of the things that they went through.

5 Questions for Karen Barker, Account Manager

5 Questions is our ongoing feature where we introduce you to the people who make Brandywine Counseling run, spotlighting a different staff member every two weeks.

Name: Karen Barker
Job: Account Manager, Lancaster Center
Time with BCI: 13 years

1. What is your job at BCI and what do you enjoy about it?
The job that I do is like information central. I take the money from the clients, but also, I try to keep everybody informed of what’s going on, including clients, staff, anybody that needs anything. [When a client comes to the window,] first they have to pay. Then they may need to see their counselor, so I page the counselors. They may have a doctor’s appointment, or they have lab work, or they need to go up front for some other reason. I try to just be in a million different directions, while standing in one spot.

As nasty and argumentative as it is, it’s still one of the most enjoyable things in my life.

2. What advice do you have for someone who would like to do the job you do?
Be patient, and understand that every person that steps up to your window is not the same person who was there thirty seconds before, and everybody deserves to be treated on their own basis, not in the space of someone else.

3. You give out a “thought of the day” to the clients on slips of paper. How did you get that idea and where do the thoughts come from?
I’ve done that for the past 15 years. I got the idea because one of my very favorite clients, when he first came on, said, “Miss Karen, I need to be told what to do every day.” And I just laughed at him, and so that actually became the first daily reading the next day. The very first reading said, “Sometimes I need direction, though I don’t like being told what to do.”

From that point on, I tried to do one every day, and they get very upset if there’s not one every day! “Yo, Miss Karen! Where’s my reading?” And the readings come from either my mind -- I think of something in the middle of the day, write it on a slip of paper, tape it on the wall – or someone says something to me that I know they need to hear again, come back at them, and I’ll just make that one of the readings.

4. What has been the most rewarding moment for you at BCI?
One specific client, and him finding the sobriety that he looked for, is always something that I carry around. When it gets tough and you think no one can do it, I just think back to that first person whose urine was clean.

He came directly from the hospital, and he was in the kind of state that, both mentally and physically, he was a beaten man. But he knew that it was up to him to pull himself up on his feet -- we’d stand behind him if he fell backwards -- but he had to pull himself up. And when I saw the kind of strength from how far down he was, I knew that, just being there for when they get straight, but also when they fall -- because he fell many times -- but every time he came up, he was ready to do it again, wholeheartedly. And it’s very emotional to watch, you get very attached.

5. If you had $30,000 to donate to BCI, what would you do with it?
I would start out with $10,000 straight off to the Bridge Perinatal division. I would take another $20,000 to start an outreach that is equal to the methadone piece, because I find that when people first come on the clinic, that’s the hardest time. They’ve already hit bottom. They are so done that their own mother is done with them. They have no one to borrow 4 dollars from, they have nowhere to find 4 dollars. But the clients willingly help the clients. And so I would start that to be available for clients during their first 30 days of treatment, and make it easier for them to stay in treatment.

5 Questions for Dana Foster, Counselor

5 Questions is our ongoing feature where we introduce you to the people who make Brandywine Counseling run, spotlighting a different staff member every two weeks.

Name: Dana Foster
Job: Counselor, Newark Center
Time with BCI: 5 years

1. What is your job at BCI and what do you enjoy about it?
I basically educate clients on the disease concept of addiction, and then I help them identify their goals, what they want to work on. I help them identify their triggers for relapse, help them develop a relapse prevention plan, and address any issues that might be hindering them from progressing in their recovery.

Every day you learn something new about a person. You learn another person’s perspective about life and their experiences. I enjoy just seeing anyone who really feels happy with themselves - that, to me, just puts a smile on my face and makes me feel like I was a part of something.

2. What led you to a career in addiction treatment and to your present job?
I always knew that I wanted to be counselor. I come from a family of addiction, and I’ve seen how recovery changes a person. I’ve seen people in addiction, and then I’ve seen them progress in their recovery. I know that it changes them completely, and I wanted to be a part of that transformation.

I started at BCI as an intern through DelTech on the Bridge-Perinatal unit. Then I was hired on as the VIP counselor - they’re known as the Medical Maintenance 1 clients now - but I had all the clients with four and five bottles [of take-home medication, which they earned after 1-2 years clean.] That’s where I started, at Riverfront. Then when Riverfront closed, I went to Lancaster Avenue, and then I came here to Newark. Now I’m a Core counselor, plus I still have some of my old Methadone Maintenance 1 clients.

3. What would people be surprised to know about your work?
That the clients aren’t just methadone addicts. They didn’t switch their addiction from heroin to methadone. That’s the stereotype that I hear a lot, and that the clients experience on a regular basis. They’re constantly being judged about, “Oh, you’re not clean, you’re on methadone.” But that’s really not true. For the clients that are clean, they’ve really worked on some things. There’s plenty of clients that are on methadone but switch [from heroin] to alcohol, or switch to cocaine. So the ones that are actually abstinent of all drugs or alcohol really have worked hard to get where they are. And it does take work, it’s not just about switching the physical addiction.

4. Tell us about your favorite client success story.
There was a client that had been here for probably 15 years. She had the type of reputation that no one wanted to deal with her, she was a very difficult client. When she was transferred to me, she had already been clean for about a year and had come a long way. She was on a low dose of of methadone, but was very dependent on the support she received from BCI. It was no longer a physical withdrawal, but she was scared to death to detox.

I worked with her for about three years on a lot of personal issues, and she finally detoxed off of methadone, and she’s doing beautifully. She still calls once in awhile and says how well she’s doing. She has a mortgage on a house, she got married, she found an inner peace and developed positive coping skills. She’s just doing really well. It’s just a total turnaround from what she was.

5. What advice do you have for someone who would like to do the job you do?
Education is important, knowledge about addiction is important, but really, the most important thing is the ability to have empathy for others. Clients don’t care where you went to school. They don’t care how far you got, they really don’t. What they care about is that you’re understanding, you’re not judging them, and that you’re able to connect with them.