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.