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Episode 17: Jeffrey Quamme
103 Plays5 months ago
Jeffrey Quamme is the Chief Executive Officer of the Connecticut Certification Board, a workforce development agency focused on the SUD prevention, treatment, recovery and harm reduction industry.
He is an internationally certified Master's level addiction counselor and clinical supervisor, and holds credentials as a Certified Nonprofit Executive and Certified Nonprofit Consultant. He is an expert trainer as well as a podcaster and author.
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Transcript
Introduction to Destination Change and Guest
00:00:10
Speaker
Welcome to Destination Change, a podcast where we talk recovery, treatment, and more. I'm your host, Angie Fiedler-Sutton, with the National Behavioral Health Association of Providers. Our guest today is Jeffrey Kwomit. He is the Chief Executive Officer of the Connecticut Certification Board, a workforce development agency focused on the SUD prevention, treatment, recovery, and harm reduction industry. He is an internationally certified master's level addiction counselor and clinic supervisor. Knowles Credentials is a certified nonprofit executive and certified nonprofit consultant. is an expert trainer, as well as a podcaster and author. Welcome to you to Destination Change,
Journey into the Recovery Industry
00:00:45
Speaker
Jeff. Thanks, Sam. Glad to be here. Awesome. Now, my first question is pretty much the same for everybody. How did you get into the recovery space? Why that versus all the other job options that are out there?
00:00:58
Speaker
You know, like many of us, it I kind of fell into it. You know, I started out as an undergrad with a psychology degree and and worked in juvenile detention. It kind of worked my way up the ladder until I went to graduate school. and really started working with individuals with really acute needs, folks with chronic psychiatric disorders who are in crisis. And that also led to working in crisis, ah individuals with really acute problems related to substance use disorders.
00:01:30
Speaker
And I kind of felt I had a knack for it in terms of through my own experiences with my family and things, not personalizing the things that were said to me and being able to kind of look at things objectively to help people get where they want it to be. Now, certainly some of the things I learned initially now would be considered unethical as we've changed, but it really was just that. It was something that I found I had an act for, people that I really liked. Awesome. How did you get involved with the Connecticut Certification Board?
00:02:02
Speaker
I had been working in the field for quite some time clinically and at a training I was introduced to the former director who at some point reached out to me and said what I consider being a deputy director under him. Thought about it, talked to some people, made that move. He ended ended up leaving the organization about three years later and that was 2013 and I was promoted to CEO and here I am. Been there about 15, almost 16 years total. Well, you talked briefly in your your how you got into the industry, things have changed a little bit. Let's talk a little bit about
Evolving Treatment Approaches
00:02:38
Speaker
that. what Since you've been in the industry since for at least 15 years, what has changed for you? What are some of the things that you've seen that today that are now that are different from from when you started? The things that I was trained to do
00:02:51
Speaker
those many years ago were very directive. You told people what to do and what they had to do. You didn't necessarily take into consideration their individual characteristics and their backgrounds and things like that. It was really a one size fits all. And there was a lot of kind of that they need to be quiet and listen to me instead of the other way around. Where we are now, thankfully, we're at the exact opposite end of the spectrum, where we're listening more to what the people in front of us have to say and what they want to get out of their recovery, as opposed to kind of a scripted outcome that we're looking for. I think there are some struggles along the way for people who in this field are resistant to change, and there are many of us that really struggle with change,
00:03:40
Speaker
But we're working towards really a client focused base that they're determining what they want to get out of treatment and out of their own recovery instead of us telling them. And I think that's a great spot to be in. You know, I said we have a little more work to do, but we're at that point, at least with research and with what we're saying, we need to really implement that as a better job of implementing that. Well, in terms of treatment and changes, one of the things we talk about here on destination change is that recovery is a journey. And like any journey, it's not a straightforward thing. There are barriers. What are some of the barriers you've come across that people have come across for moving forward in their recovery?
Barriers in Recovery
00:04:23
Speaker
Through my career, I've really worked more with folks who don't have significant amount of recovery capital. That's not a term we used at the time, or have poor social determinants of health. Certainly, again, not terms that we use. We call it the poor, or indigen, or chronic, or whatever it may be. But people with less resources, and from listening to them and from watching them, I've learned a lot about Barriers that that are in the way and that we've really worked to change one of the things that I saw a lot of were female clients being called non-compliant
00:05:00
Speaker
because they had childcare issues or they had issues with transportation, taking three buses to get somewhere. And the field just kind of accepted that. And now we're at a point where we can say, hey, these childcare issues are legitimate. We finally recognize that and are working to get through that barrier. Now it's not perfect. Financial barriers still exist ah for some folks. ah The word that people use is stigma, but I say discrimination, which is much more of a strong term that people are discriminated against when seeking treatment. We see discrimination in employment, older laws to protect it, that kind of stuff still goes on. There are many, many, many barriers. The list goes on.
00:05:50
Speaker
Back to your work with the Connecticut Certification
Role of the Certification Board
00:05:53
Speaker
Board. For those who may not be familiar with what a Certification Board does, kind of tell me, walk me through what you do on a daily basis, what your job entails. Well, being a small agency, I do everything, ah including empty the garbage. But what we do is we are a workforce development organization that was selected by our single state agency. In our case, it's the Connecticut Department of Mental Health and Addiction Services as a contractor to provide evidence-based training and credentialing to individuals in the field to verify their competency
00:06:32
Speaker
in order to protect the clients that they serve. I have a colleague in Pennsylvania who says, my job is to protect your clients from you. That's a little stronger than I would normally go. But the idea is, is the same. We want to make sure that people are qualified, um have the best information and are practicing ethically in order to protect clients and their families and the community as a whole. Um, in my role, I'll do anything from, ah preparing trainings, doing trainings, working on with other groups in the state or nationally on trying to change some things that are out there, trying to improve some processes. you Writing for Counselor Magazine is something that I do on occasion. ah So I am fairly busy with almost anything and everything you can imagine about running a nonprofit.
00:07:23
Speaker
But the primary focus of my job is to review the applications that come in from individuals wishing to be certified to make sure that they meet the internationally identified standards so that we can say, hey, there's a level of competence here. And they're they're showing us that they're competent, not just by training, but by supervision and by work experience saying, I know how to do these things. And that certification is verification of competency. Now we have people on every level listening to this podcast, people from CEOs to people who are just starting. So I always like to ask too, if someone's just getting started out, what kind of resources do you like to use? What kind of things would you recommend for people to go to? I always like to tell people to not necessarily accept ah except the status quo that they hear.
00:08:15
Speaker
from others and to look into educating themselves. There are resources online, there are videos, there are things that we want people to understand. Many people come into the field because of their own lived experience. And as valuable as that is, we want them to understand that their lived experience is not to be all and end all of everybody else. We get people with tremendous amounts of enthusiasm for the field, but only have seen one perspective and that's what worked for them or what didn't work for them. And we want them to accept that there's a ah different pathways. So really to kind of check their beliefs,
00:08:56
Speaker
first, against what the evidence says in the and against what others' experiences are, that to realize that it is a much bigger picture than they may understand. Great. Now, when I was doing my research for Mia, I found your LinkedIn and your bio there says you're like you're just a guy who likes to challenge the status quo and ask questions. Talk a little bit about about that and then kind of what kind of challenges that you like to to face.
Challenging Established Norms
00:09:21
Speaker
I put that in because I see a lot of people giving themselves titles of change agent, innovation person, thought leader. And I don't think that that's for me to determine that for me. I'm just the guy who has seen a lot of things and questions because I want to know the right answer, not because I do know the right answer. and More times than not, I'll have an opinion. And somebody will check that and and will give me evidence to show that it's a wrong opinion. And I appreciate that because I just want to be able to tell people what's right. Things that have come up is I've talked to a group of people that we talked really
00:09:57
Speaker
often on LinkedIn and out about credibility issues that the field faces. So we have a 70 year plus history of being para professionals and working um you know as spar as paid sponsors or things. That's what the field was. It's not necessarily what ah you know what we're doing today and saying, let's look at the things the field says versus what the field does to see what's really going on. Like we say that we're client first, but we never ask them what they want until after we've gotten all this information about their who's paying and their background. And I really think that that's a struggle and to say, Hey, why don't we just ask, what are you looking for from us? What would you like to see happen by coming here? And then everything else will take its place. We have people in a clinical roles who
00:10:52
Speaker
say they form relationships ah with clients, but make the point that, hey, I'm in recovery too, I'm just like you, but we know they're not just like and everybody is different. And we want them to spread their wings a little bit and learn how to develop that relationship and help clients understand that the recovery bubble that is protects people in early recovery is not for everybody and not going to continue moving on. You have to deal with individuals who may or may not be like you to have a life in the community. Your boss may not be recovery friendly. Your spouse may struggle with the idea. Your medical providers may struggle with that idea. So yeah you kind of have to learn to form relationships. And I think that's the battle and there's that that's something that's not paid enough attention to.
00:11:45
Speaker
We already talked about like what has changed. What kind of trends do you see coming forward that you're seeing that you might that you would want to make sure people are paying attention to?
Emerging Trends in Treatment
00:11:57
Speaker
That's a great question because one of the things that we see in this field are trends every few years. And what although some of these trends are really positive, what tends to happen is it becomes kind of the Wild West and people will take these trends far from what they should be. One of the things that we saw was probably around 2005, 2006, there was such a focus on co-occurring. Every discussion revolved around co-occurring disorders.
00:12:25
Speaker
Then that kind of went away and that discussion went away and we started dealing with the issues with opioids and the opioid crisis. And I struggle with that term because being on the East Coast, people have been dying from heroin on the East Coast and on the West Coast you know for 70, 80 years or or more and we've been treating them effectively. ah Many of them and so there was a push on medication assisted treatment We've seen a big push in a trend towards using the lock zone and that saves lives and I I But the lock zone itself is just the start for somebody who wishes care, right? We just want they're alive and then we had a push towards trauma-informed care
00:13:08
Speaker
And as important as that is, as realistic it is, you know as kind of a framework of how we do things, that's been bastardized somewhat where we've got people unqualified trying to do trauma work when they're not trained in doing trauma. They're digging up trauma rather than accepting the fact that this individual may have experienced trauma in their life and creating a safe framework. So it goes too far and that in that. And we may see the same with harm reduction, which is one of the current things. going too far on either side. But I think the biggest trend right now that we're seeing is the infusion of psychedelic assisted treatment and into our world. And when I talk to experts and people who have been doing that, they're very excited that there's a focus on that. But there's not really a set of guidelines or a set of best practices. So they have concerns about somebody taking on that role of being a psychedelic provider.
00:14:05
Speaker
without all the appropriate preparation and follow-up. So the trends are positive, but I always have the concerns about when somebody goes too far in one direction, so it's not meeting what the idea was that we're trying to get across. And now co-occurring is coming back around. People are starting to talk about co-occurring again. And my concern is not that people providing Care in the field aren't able to do that aren't able to do the things that they're supposed to I just think that there's there's a fringe that becomes a loud voice sometimes and that's not always is healthy or accurate and when you ask questions it makes people uncomfortable because you're questioning something that they believe in strongly and And they take it as an affront as opposed to, hey, I really want to know, why do you have this perspective? just It can be ah been difficult. You don't make a lot of friends. I think it's an important aspect. And there are many people that I've kind of joined in with that that do that.
00:15:07
Speaker
Well, you've talked now a couple of times about you know changing you know changing your mind and all that. Walk me through one of the times when you yourself have changed your mind about something and and how that came about. Absolutely. When I first really was exposed to the idea of harm reduction, I had a hard time getting it, getting the idea because my mind was people are supposed to go to treatment if they need it and then have follow up the community and go into recovery as I saw it or as a definition worked. But from listening to people being told I was wrong, being shown I was wrong and talking to people who have expertise in the field or who have experience with it, I started to see things a little bit differently
00:15:52
Speaker
over time and then kind of realize, whoa, I was way out of base on this because I didn't know enough. I was kind of against it because I didn't know about it and I didn't make an informed decision. right There are people who still disagree with the notion of harm reduction and they have their own perspectives, but if they know why they're against it, instead of just saying, upfront, I don't like it, it's a bad idea. I think that we tend to have different opinions about it. If you don't like something, know why you don't like it, learn about it so you can understand, that's at least an informed opinion. And your opinions shouldn't go to clients. I can have an opinion about something, but if it's gonna benefit a client and it's something that they wanna try and it's safe,
00:16:44
Speaker
Absolutely, our job is to support that. So I think that's what that was just a big one with harm reduction and learning from people who told me the truth and showed me the truth. It's humbling when you, the other the first few times you say, well, I was wrong. But then you kind of appreciate it because you're at a point where you say, oh, okay, now my knowledge on this is a little better and I'm much more comfortable with this opinion. Awesome. Well, let's talk a little bit about your podcast.
Podcasting and Writing Contributions
00:17:14
Speaker
Give me the elevator pitches to what it's about and that. Absolutely. It's called Scope of Practice. And it really is called that because it focuses on anything and everything under the scope of practice ah of individuals who work with clients who are seeking recovery, seeking treatment in the substance use and mental health but disorder field. It's aimed at professionals. And we really want to have conversations
00:17:40
Speaker
with people who were change makers or who have a different opinion or who have possibly controversial opinions to get it out there for people to hear and really have discussions about. We don't want people to jump on an opinion because it's something that one of my guests may say and I may happen to agree with or disagree with. I want someone to make their own opinion. And we've talked to people who have been ah controversial. We talked to ah the gentleman who was the founder of the first safe injection sites in New York City. And the day that podcast was released to talk about that, I had scheduled the podcast with the ah vice president of medical at Hazilden and they canceled their appointment to speak with me. Interestingly, on the same day that that podcast came out, I can't say that they're related, but I can't say that they're not related.
00:18:36
Speaker
We talked to a gentleman, a doc in Los Angeles, who talks about the idea of co-dependence being way too negative and hunt that punishes family members for caring about what happens to their family member, instead of talking about pro-dependence and saying, we love the fact that you care so much for this person. Let's find good and healthy ways for both of you to work on that. So we want to ah applaud you for still being concerned about this person, but let's find better ways for everybody that you can express that and and put something in behaviorally. We talk to people who think the treatment system is horrible and should be knocked down. That's a lot of discussion. I have some lined up. I'm talking about, I'm going to talk to somebody who's an expert in racial biases and diagnosing. And I'm excited about that because I want to hear these things. We talk about some criminal justice stuff. The one thing that we really don't do
00:19:32
Speaker
Too too much is talk to individuals who have their own recovery and and have them tell their story there's a lot of that and there are people who do that a lot better than i do and. Have been in the field for so long my interest doesn't lie in that my interest lies in things that are challenging. And I, you know, I appreciate others who can do that well, but it's just not my thing. We've done it a couple of times with a couple of famous athletes, but it's not something we do regular regularly. Excuse me. Now, is it a weekly, monthly, just.
00:20:09
Speaker
How often does it come out? We try to do it twice a month. Sometimes that doesn't work out based on on guests and availability of people. But we we shoot for two times a month. It's free to listen to. We're actually working on developing a possibility that someone can get a CE for listening if they answer some posts. Podcast questions we just we're not there just yet. We haven't given it too much talk till recently But it's yeah, we want people just to listen. ah It's scope of practice is the name of it. It's on our host site, which is Podbean and But it's also available on iTunes and Amazon I check it but after I recorded and get it in I check it by listening on Amazon, but I hate listening to my own voice and Oh yeah, no, no. I don't think anybody does like listening to their own voice. I'm the same way. Talk a little bit more about your work as a writer and a trainer. Um, what kind of things do you write? And you said you were wrote for counselor magazine. What kind of topics do you typically stay with? I try to stay within the field with an interesting topic. Sorry for counselor i've done some items for some other magazines. Uh, the latest issue that's out of counselor has an article i wrote a while ago talking about,
00:21:27
Speaker
The need to protect ourselves ah ah from like active shooter Situations because they can't arise when I talked to an interviewed an expert in Los Angeles who that's his job is training people ah how to deal with that I've written about how do we as professionals handle the nimby situations that not you know, they're not in my backyard when there's treatment or recovery options in the neighborhood and it's like, do we want to fight against that? Well, then now we're just looking for a fight. How do we find common ground and make these things happen?
00:22:02
Speaker
I've got one that's coming out. I had a conversation with Johann Hari about Billie Holiday, and we talked about some of how Billie Holiday's experiences were the mirror image of what the drug war in this country is trying, you know, has tried to do. ah So I try to write about things, again, that are a little bit different, but are of interest to the reader, and counselors very, very agreeable to that. They may say, hey, we'd like you to stay in with this, but they they let me choose to do what I find interesting and important and they've been great about that. Now you're also a trainer um and you're an internationally certified master's level addiction counselor and clinical supervisor. Let's talk a little bit about what you train people.
Ethics and Supervision Challenges
00:22:45
Speaker
What I really like to train people on it are issues around ethics. I think it's really important that we have discussions about ethics
00:22:53
Speaker
before something happens so that we can avoid them. And i I really work hard to make those interesting because ethics conversations can be boring. And when I ask people about ethics conversation, they'll say just what I had referenced. Oh yeah, somebody did something, so we have to have a conversation about it. I want people to come and and realize that ethics is something that we aspire to, to be ethical practitioners and think about things in an interesting way. So I do a lot of ethics on clinical supervision, the ethics of the therapeutic relationship. I think the therapeutic relationship is something that yeah we talk about
00:23:31
Speaker
And I like to train a lot on clinical supervision and that seems to have a lot of traction because it's an ongoing issue in the field. You know, sometimes people just don't know how to be supervised or people get promoted to supervisor because they handle a very difficult caseload or they handle the biggest caseload or they're very organized or they just got a license, whatever it may be. People often get promoted to supervisory. And without training and a focus on what it takes to be a supervisor of what you really need to do and expect, they're setting that individual up for burnout and failure. So we try to avoid some of that by talking a lot about supervision. I spent years going around talking about best practices for medication. It's just the treatment, you know, in working with clients, not the medical piece, meeting clients where they're at. And and that's kind of how I got my start in training.
00:24:26
Speaker
but I'm very lucky I get to go around the country and and get asked to do certain things, mostly around ethics and around clinical supervision and the relationships right now. Well, let's talk a little bit more about supervision. I mean, especially since the certification board is a workforce development agency, what are your some of your, I guess, tips would be the best word to ah to be a good supervisor? I think the biggest tip, and it's it's almost repetitive, is building that relationship between supervisors and supervisees and each understanding what the role is of the other.
00:25:04
Speaker
So supervisees. take a big role in the the direction of the supervision by their preparation. They have rights and responsibilities, which have been researched saying, you know, this is what a supervisee should do. These are the rights and responsibilities of the supervisor. And it really is a team effort. Although the research is kind of mixed on correlation between good supervision and client outcomes, we know it makes a team better. So relation it gets right back to relationships and having that supervisor relationship.
00:25:37
Speaker
And for somebody, especially who moves from being a coworker into a supervisor, that relationship has changed significantly. And is there a conversation between people to say, let's talk about this. Let's talk about what the differences are. And I thought that really solves a lot of problems. Being a leader, being middle management is very, very difficult. Being a clinical supervisor is tough, not only because of what your role is, but also because you're the goal between your clients, I mean, you're you're the staff that you supervise, and administration. So you can get it from both sides. So having a good sense of emotional intelligence and practicing that you know is something that we talk about a lot.
00:26:24
Speaker
you know, all of the different roles. Supervisors are not only responsible for the safety of every client that their folks work with, but they're also responsible for the professional development or encouraging and promoting the professional development of the staff that they supervise, looking at who's best to do certain things, helping to identify strengths and deficits so that clients get the best care. It's a very, very difficult position ah to be in. And I think Well-meaning people who are great clinicians often get put in these positions without training. And it's not something that just comes naturally because it's a different type of relationship.
00:27:04
Speaker
So I want people to be successful in that role because if staff are happy and they stay with an employer, that continuity also helps the clients that comes in. We know that. And people don't leave jobs because of money necessarily. They leave it because of things like supervision. Hey, I'm not being supervised. I'm being ah left in the wind on some of these decisions. Yeah, no, I've had supervisors in the past before that, i that's the reason why I love the job, so. Yeah, it's it's hard to have, you know, we train people on having that difficult discussion that you're not meeting what we expect from you in this. We talk about how to do that in the training. I've done three hours of training live on How do we do that? Have that difficult conversation because you may be telling these things to people that were your colleagues and friends. And once you learn that and how do you do that, you know, it's almost like coaching.
00:28:04
Speaker
A player will run through the wall for a coach that cares about them as a person. And I don't say that just because my Huskies are in the national championship game tonight and the women were in the final four with a rotation of only seven players that they used. But I have to brag a little bit about the Huskies. Now, we're getting close to the end of the podcast. Was there something that you wanted to talk about that we haven't or that you thought I was going to ask, but we didn't?
Importance of Relationships
00:28:33
Speaker
I really didn't have any expectations, so but I do want to talk a little bit more about the key to good work is the relationships. We know the research shows that 30% of intentional client change comes from the relationship
00:28:46
Speaker
And that's the most of the highest pretends that we actually have a role in because 40% changes outside of the treatment environment because the person decides to, because of other factors. We know the placebo effect accounts for 50% of change and the technique accounts for 50%, but our relationship accounts for 30%. And as a supervision, obviously it makes sense. We want to see change that our clients want, but as a supervisor, We want to see intentional change in the staff as well to get better at this, to focus more on this. So we have to have that kind of relationship.
00:29:23
Speaker
to make that happen. The relationships are everything in this field. Every relationship is managed a little bit differently. But you know to me, that's the gold standard. Somebody who can form relationships and act as, I think that's how we act as a role model for clients. Not by saying this is what I did to get here today. It's being true and in the moment and saying, what am I doing today to work on the relationship with you today? Because if you're not willing to do that work, you can't ask the client to do that work. I can't to ask you to trust me if I don't show trust in you. Oh, that leads into question. I like to ask everybody just kind of, why do you do it
Personal Fulfillment in Work
00:30:02
Speaker
again? Why this versus, you know, accounting or I'm not good at anything else. I don't have any real job skills. No, it's, I find it corny sometimes to say it's a calling, but it's, it may be it's really all that I've ever done.
00:30:21
Speaker
working with clients with with needs. And I don't think it came from anything. I want to change the world. I want to i just happen to enjoy the work. And I like the outcomes. It's great when somebody and can tell you the changes they made you know and you can see them. But to being a part of that difficult process in the early acute piece is something I loved when I worked clinically. I loved working with individuals that had personality disorders. because of training and practice as an intern, but i there's something for me about working with the clients that other people have written off or find difficult because learning of the relationship makes them much less difficult if and or not difficult at all. We realize that maybe we're putting them in that position. I just love what I do. Like most of us, we love being broke, but i didn' I love what I do. I wouldn't change it.
00:31:18
Speaker
Now, if you could travel back in time to when you were first starting out, what kind of advice would you give yourself in terms of your career?
Advice to Younger Self
00:31:25
Speaker
I would give myself the same advice I was taught to give the clients back then. I would tell myself to shut up and listen. Instead of thinking that I knew everything, which is kind of a young person's view when they start out. But that's about it. I wouldn't want to miss some of the bumps I've had because I've learned from them. I had a boss that used to say, you either succeed or you learn. But that's a mindset as well. And it works. Oh, I've learned the hard way. yeah I don't learn things the easy way. I need a bump on the head to to get it. But I'll take that bump on the head gladly when I see what the change has been.
00:32:02
Speaker
Now, if someone wanted to get ahold of you or learn more about you, where would they go? They can email me at my work email. It's a little tricky. It's jqammeatctcertboard.org. Or you can find me on LinkedIn, Jeffrey Kwame. I'm glad to talk to anybody that reaches out with questions or with concerns. Awesome. Well, thank you very much. You've been listening to Destination Change. Our guest today was Jeffrey Kwame. Thanks for being here. Our theme song was Sun Nation by Kitza and used via Creative Commons license by the Free Music Archive. Please consider rating and reviewing the podcast on Apple Podcast so we can get more listeners. In the meantime, you can always see more about the podcast, including show notes and where else to listen on our website, www.nbhap.org. If you have questions for the podcast, please email us at info at nbh. Thanks for listening!