Bridging the Gaps: Reimagining Opioid Recovery
A podcast where we confront disparities, challenge outdated approaches, and reimagine a future where opioid addiction treatment is equitable, accessible, and effective for all communities."
Bridging the Gaps: Reimagining Opioid Recovery
The Cultural Divide: How Racism Shapes Recovery Journeys in Communities of Color
When cultural barriers meet systemic racism in addiction treatment, the results can be devastating for communities already facing disproportionate substance use impacts. This powerful conversation with Yusuf Shafi, CEO of Alliance Wellness, and Dr. Cedric Weatherspoon of Empower Therapeutic Support Services reveals the complex realities faced by Black and East African communities seeking help for substance use disorders in Minnesota.
Both leaders bring deeply personal connections to their work. Yusuf shares how witnessing a neighbor's struggle with alcohol as a 12-year-old Somali immigrant sparked his passion for addiction treatment, while Dr. Weatherspoon describes growing up during the crack epidemic and now watching fentanyl devastate the same communities. Their frontline experiences illuminate how cultural disconnects, language barriers, and provider biases create significant obstacles to effective care.
The discussion doesn't shy away from uncomfortable truths: Minnesota ranks fourth worst for Black Americans in socioeconomic outcomes, standard treatment models often fail communities of color, and the mental health workforce remains overwhelmingly white. When Somali clients lack words in their language to describe mental health concepts, or when Black clients encounter providers who don't understand intergenerational trauma, treatment outcomes suffer.
Yet this conversation offers more than criticism – it presents a roadmap for transformation. From building culturally specific treatment centers to developing research led by people of color, from training providers in cultural humility to implementing accountability measures, the speakers outline practical steps toward more equitable care. Most powerfully, they demonstrate how providers who understand cultural context can bridge the gaps between evidence-based practice and lived experience.
Whether you're a healthcare provider, community advocate, or someone supporting a loved one through recovery, this episode will transform how you think about the intersection of race, culture, and addiction treatment. Subscribe now to continue this vital conversation in part two.
Welcome to Bridging the Gaps Reimagining Opioid Recovery the podcast where we confront disparities, challenge outdated approaches and reimagine a future where opioid addiction treatment is equitable, accessible and effective for all communities. I'm Joanna Rosa, and today we're diving into an issue that profoundly impacts treatment outcome, yet often goes unaddressed racism and substance use treatment. From bias clinical practices to systemic barriers. We'll examine how racial inequities shape access, care and recovery. More importantly, we'll discuss how providers, advocates and communities can work together to eliminate bias and build a more just and effective system. Join us for part one of this important discussion. Thanks for joining us. Today. We have in-house Yusuf Shafi, the CEO and Director of Alliance Wellness, and Dr Cedric Witherspoon, president of Empower Therapeutic Support Services here in North Minneapolis. Welcome to the conversation. Today's topic is racism and substance use. Thank you for having me.
Speaker 2:I'm looking forward to talking about mental health and substance use.
Speaker 3:Yeah, thank you for having me as well. I'm happy to be here. I'm looking forward to this conversation, so thank you for having me.
Speaker 1:Thank you. Well, let's take a minute to talk about your direction, yusuf. Could you tell us a bit about your background and work?
Speaker 3:Sure, so my name is Youssef Shafi. I came from Somalia to the United States when I was about 12 years old, moved into Burnsville, minnesota, and always wanted to help people. I've always wanted to study social work and been passionate about addiction. I've been a man of health since I was 12 years old. We had this gentleman who lived in a neighborhood that I grew up and he was struggling with substance use disorder and he would oftentimes use alcohol and everybody in the neighborhood would come out and talk about him but never talk to him. They would talk behind his back and there was a big elephant in the living room.
Speaker 3:I come from a community where there's a lot of shame and guilt when it comes to addiction and mental health. One day I went up to him. The cops would get called, the paramedics would come and everybody would talk to him, but then they would go back to their house. I was like what's going on with you? Why are the cops always here? He I was like what's going on with you? Why are the cops always here? He shared that he was struggling with loss and grief and that's why he was drinking to cope.
Speaker 3:I thought that's what I want to do when I grow up help people and that's how the idea of social work and things like that came, thank you. I went to school, got my associate's degree in human services, did a lot of volunteer stuff, got my bachelor's in social work and then my master's in social work as well. I went to the University of Minnesota. When I was in grad school, I worked at Cook Clinic in South Minneapolis and I've seen a lot of people that were struggling with addiction that were from my community, and this is back in 2012, 2013. And you know, we didn't have any programs that were culturally specific, so I thought I could do something for my community. That's how the idea of Alliance Wellness came about.
Speaker 2:I'm Cedric Weatherspoon. I am the CEO of Empowered Therapeutic Support Services, located in North Minneapolis. My connection to this work is both personal and professional. My personal story is I grew up in Pensacola, Florida, seeing a lot of addiction, family members who have struggled with addiction, friends, other community members and I grew up during the crack epidemic, so seeing that the fentanyl and opioid addiction continue to impact communities of color is just surreal. It's really dialing to why I'm committed to partnering with people who understand chemical health and how it impacts community and while using my experience my over 30 years experience with working in mental health and seeing how those two pieces come together.
Speaker 2:Empower has been in business for about 17 years and we've seen work with people of color who experience generational trauma, and a part of that generational trauma is dealing with addiction issues and family members who have addiction issues. Professionally, I'm growing a community to have a conversation around our relationship with addiction. I am a licensed marriage and family therapist and a doctor of marriage and family therapy. My main approach is looking at it in the context of family how can families support their family members struggling with addiction and mental health issues?
Speaker 1:This topic came about because one of the main themes we kept hearing over and over again in the groups that we were collaborating with was that racism is a pervasive problem in substance use treatment. Our focus on Black, East African and Indigenous communities when it comes to substance use treatment was very specific. We know that the mental health workforce does not reflect cultural diversity and cultural responsiveness. 87% of licensed alcohol and drug counselors are white. 90% of LMFTs are white, 89% of LPCCs, so licensed professional clinical counselors, are white. And then around 88% of licensed psychologists and psychiatrists are white. So that does make seeking help more difficult because we just don't see ourselves in the room. Can either of you speak to that, yeah?
Speaker 3:I think lately, the last two or three years, I've seen a lot of people of color going into the field, which is great. I've been mentoring a lot of young people that are becoming a therapist or LADCs, which I think is very vital. When I got my LADC or my LICSW I think we had a handful Maybe I was the fifth LICSW or something like that it was less than 10 people in the whole state of Minnesota who were Somali, who were licensed therapists and same as LADC. I was probably the fourth or fifth person who was LADC in the state of Minnesota and that was like four years ago, five years ago. So I mean we need to do better in that department. But I will say there's a lot more people that are going to the field and you're right, the system is complicated and oftentimes in my community there's a lot of language barrier.
Speaker 3:It's hard for clinicians to understand what East African people are going through or the norms and the culture. That's why I do a lot of these trainings to educate the providers to better serve our community, Because sometimes you can do more harm than good if you don't know what you're doing, if you don't understand. We've been through a lot with the civil war and there's a lot of intergenerational trauma and a lot of gap between the youth and the Somali parents. Like I live in America now but my parents are Somali, they want me to speak the language, but all my friends are white or Black or Native. It's confusing for someone who's 12 years old or 14 years old. So my goal is just to educate providers to better serve our community, because sometimes I feel like a lot of the providers might understand what's going on in our community.
Speaker 2:First of all, those numbers are jaw-dropping given that evidence shows cultural matching is an effective way of addressing mental health in communities of color, and so it's those numbers. It's kind of like you know we need to do more as organizations and advocacy on the value of having a more diverse profession. So it's a lot of work being done. I know the AAMFT are really embedded, really trying to put together strategies to recruit more folks of color, but the reality is the process of becoming a therapist is very long, tedious and it's very expensive. So if we have economic disparities and we're wanting to recruit other people in the field, then it's not that people don't want to be therapists, but if you have those economic disparities, it prevents them from becoming a therapist. Economic disparities it prevents them from becoming a therapist. And even going through being able to get licensed to take the tests is cost associated with that. The supervision is cost associated with supervision.
Speaker 2:I know it's a lot of initiatives out right now in Minnesota to eliminate those barriers, but it's still a difficult climb because, yes, you're offering me supervision and to pay for my tests, but also being able to maintain a family on a salary that may not be able to provide for you and your family. That's another barrier, and so people have to deal with so many different barriers financial barriers to even become a therapist. But on the other side, we have had people who are very committed to going through the process. As a provider, I try to be as supportive as I can to eliminate those disparities myself by being able to support them professionally or provide a space for them to learn and grow quickly so they can get through the process quickly. I think we have a lot of people who have or are currently license-seeking. They developed their skills and they had experience to be able to serve our community. But I think it's very important that we are coming together as a collective and being able to advocate for more diverse people in our field.
Speaker 1:What are you both seeing in terms of individuals wanting to come into the counseling field as part of their careers? What do these typical students look like?
Speaker 3:Students that have either dealt with mental health or had a family member who was struggling with addiction or mental health. That's what I see and also, you know, we've the last four or five years our community have been really struggling with the opioid epidemic and a lot of young people have seen that either their friends have passed away or they had a family member who was struggling with addiction. So a lot of them are going to school now to be an addiction counselor or to be a therapist and so forth. So that's what I've been seeing lately. Anywhere between 20 to 30-year-olds are going to school. Some are changing their majors from biology.
Speaker 3:When I told my parents that I was going to be a social worker, they're like are you crazy? You should be an engineer or a doctor, as any immigrant family will tell you. They're like oh, you don't make a lot of money being a social worker. You should be a doctor or a nurse or an engineer. That's where the money's at. And I'm like well, I don't really like being a doctor or engineer. I like helping people. So it took a while to convince my parents about going to school and I always wanted to help people. So that was my passion and I think a lot of young people now are educating their parents about hey, this is what I want to do, this is something I'm passionate about.
Speaker 1:Yeah, and so you're seeing people having that direct personal experience entering into the field, correct? What about you, cedric?
Speaker 2:Well, I see a mix. I think predominantly folks entering into I feel are women, are Black women. Those are the folks who work at our clinic is, you know, predominantly Black women who have experience with being in the field. And then we have a couple of young people. The challenge with the younger generation is some of the problems in our community are very complex and generational. So for a new therapist to come in and try to navigate those problems, whether they're Black or white, it's very complex. You have to have a creative mind and be a creative thinker. I think a lot of young people are creative thinkers, but it's some hard frameworks that you really need to learn to be effective with families who have multiple stresses in their lives.
Speaker 2:We have a story behind the story. Behind the story, A lot of folks are seeking longer-term therapy and it takes a lot of work. It's back and forth when you're dealing with trauma, especially historical trauma, because trauma work is very difficult for the therapist and the family. So, learning under those conditions, having the right people in place, it's expensive to have someone to do the supervision piece, Because when you're working with folks with complex issues for young therapists, it's important for them to have some supervision and extra support, and even having a strong, experienced therapeutic team to show the new folks the ropes.
Speaker 1:Yeah, so, with this complex and intergenerational trauma from a substance use issue, what are some of the things that you're seeing in terms of intergenerational trauma and substance use I think there's.
Speaker 3:What I've seen a lot recently is lack of identity for a lot of the young men and women. I'll share a little story about when I came to the United States. I moved into Brunswick, minnesota. This is back in 2000. Not knowing the language, not knowing the culture, moving from a different country that everybody looks like you and then moving to a different country that everybody's different. And then you think about my mom's trauma, my parents through the Civil War. Their trauma was definitely leaving the Civil War and me coming here not knowing the language, going through the system, not understanding that. And then you got kids born here that know English and everything but their friends overdosed next to them or seen their friends die because of drug addiction. So those are three different generations with three different trauma and it all looks different, if that makes sense.
Speaker 3:So with the young people it's like am I Somali? Am I Muslim? Am I white? Am I black? All my friends are white. I live in the suburbs in Apple Valley, in Lakeville, in Burnsville. My parents want me to keep the religion and the language and so there's a lot of confusion for young people and even with me when I came here that was kind of hard for me. I wouldn't say I got lucky because a lot of people that were my peers didn't know. You know they didn't get lucky because of peer pressure. And so for me I got lucky because I was able to take the good thing about both cultures and leave the bad stuff out. I think that's part of my success. There's a lot of great things about Somali culture and there's a lot of bad things. Same thing in America. There's a lot of great things in American culture and there's things I don't care for. So I was able to take the good parts and combine them into one.
Speaker 1:I think that's where I got today because of that. So then, kids experiencing this confusion today are really, really vulnerable to substance use.
Speaker 3:Absolutely, absolutely. And that's how it starts. You know, in our community there's a lot of depression, a lot of anxiety. We don't talk to our kids. In our community the parents are, basically, they know everything. So if they tell you to do X, y and Z, you do it. There's no, like you know, you should be an engineer? Well, I suck at math. No, you should be an engineer? Well, I suck at math. No, I don't care. Figure it out. And then there's no question.
Speaker 3:Okay, so a kid struggling. I hated math, but I knew that I was going to be a social worker. I didn't have to do all these math classes. So for a young kid that can't talk back to their family or their mom or dad, that could be really challenging. Now I'm failing all my classes. I'm smoking weed, hanging out with the wrong kids, I have depression, anxiety and the parents are pressuring me or forcing me. I leave the house and hang out with the wrong crowd next to you know, I'm introduced to fentanyl and I'm unhoused. And now I have a record because I have to support my habit. That's 200 hours a day, which I can't support. So now I have a criminal record. Now I can't get a job, I can't get housing support.
Speaker 1:So now I have a criminal record. Now I can't get a job, I can't get housing. Tell me about, in the Somali community, the overall idea about substance use treatment. Are there misunderstandings or is this more accepted now?
Speaker 3:I think we lost a lot of young people and may God rest their soul and I think it's one of those things that we try to hush-hush, but now it's becoming very difficult because we have so many young people that are dying. I think some of us are getting it. We finally have people in recovery that are speaking about the experience, which is awesome. Like four or five years ago we didn't do that, but now there are a lot of people doing great work in the community. People are speaking of their experiences in addiction and recovery now, but we have this lot of black and white thinking in our community. Either you have an addiction problem or you don't. Either you have a mental health diagnosis like you're crazy, or you're not. Quote unquote. That has to change, because people can be in recovery and thrive. People could have a mental health diagnosis and thrive, and there's a lot of misconceptions about a lot of things, like methadone, for example.
Speaker 3:People criticize me for having a methadone clinic and saying well, you're going from one drug to another. So having that mindset and that mentality has to change, because even the concept of harm reduction is not something that is like why are you doing drugs? First of all, you're not supposed to do drugs. Well, I am doing drugs. What are we going to do about it? You know, is methadone going to help me Absolutely I know what's in the methadone versus buying something from someone that I don't know what's in there.
Speaker 3:We spent a lot of time in the last four or five years doing a lot of education around Narcan or Naloxone and harm reduction, like people having access to Naloxone, having access to Suboxone or Methadone, because oftentimes people use because of their withdrawal or craving and things like that and people don't understand fentanyl. Fentanyl is a very, very powerful drug. You know, and we've been doing a lot of work around just basic education of what are opioids, what are some symptoms of someone experiencing overdose, how to use naloxone, calling 911, things like that. People are even afraid of calling 911 because they think their kids will be taken away. There's a lot of misinformation around overdoses and they think you're a bad parent and the cops will take your kids away.
Speaker 2:They think you're a bad parent and the cops will take your kids away. Well, I would say some of the similar struggles you're struggling with in the Somali community is similar to the Black community. But you know, I think a lot of our pains and struggles are symptoms of undealt-with trauma stemming back to slavery. I think what I've been seeing in our field is old behaviors repackaging themselves as new ways of dealing and coping today. If you look back historically, all of the behaviors that we're kind of struggling with now, it stems back to like trauma. We have not healed from trauma. Old people are like, oh, why don't you move on? Look, you're thriving so well. But you pointed to a lot of statistics that says, yeah, we're not really thriving, we're kind of maintaining Some people are doing well and there's a handful of folks who are not doing very well. I think the biggest thing so far is I want to go back to just talking about how the opioid and fentanyl addiction epidemic is impacting our young people.
Speaker 2:I love my music. I love hip hop. I grew up on it. I've seen it transformed to very positive hip hop where we had public enemy uplifting type hip hop, and to like dance, like hey, let's get together and let's dance and have a good time. And then, in the 90s, shifting to the drug addiction and telling the story of what's going on in our community and empowering people through telling the story. And then now going through being caught being like commercialized to the point is the most offensive stuff you can say is the stuff that sells. And then one of the biggest thing is glorifying the high end of drug use. First it was drug selling, now it's drug selling and now it's drug using, I think, to young teenage minds who are looking for identity and belonging. That sets a big stage that impacts our community in a negative way.
Speaker 2:When I talk about the work we have to start putting forward, we have to start looking within our community and looking at the things that we can control. If you're out there and you're singing, you know, take more drugs, do some fentanyl, that piece we can control that piece as a culture. Get together and have a conversation about how does that impact other people? I know it's all entertainment and that's what it frames into. Yes, it's entertainment, it's storytelling. I can appreciate all of that other stuff, but we also have to look at impact. We can't turn our head away from the impact it has on our youth, even the gang culture.
Speaker 2:When you start talking about how gang culture is impacting our youth, they're not going to look deep. It's like, let me figure this out and all the beautiful pieces that why gangs came to be or why do people use, they're just going to take the surface approach. They're going to look at, oh, this person is doing, they're famous and they're okay. So that's how young people look at it. As an adult, I understand they're telling a story, they're being creative, they're telling a story about what's going on, but the youth don't necessarily process things that way and I think as a community, as a Black community, we have to look at that and start to have real dialogue.
Speaker 2:Not put a dialogue to say, hey, what you're doing is awful, stop doing it. Let's say, hey, how can we tell the complete story of what you're saying? Because some of those stories are three to five minute songs. You know it's not like Sugar Hill Gang. They had a 20 minute rap. Now it's just three to five minute songs. You know it's not like Sugar Hill Gang. They had a 20 minute rap. Now it's just three to five minutes of telling a story with no ending, no connection.
Speaker 2:We're not connected to the pain. We talk about some of this gun violence we're dealing with. You hear about hey, yeah, we hunted this person down, we had a conflict with him and he got shot but they don't talk about how it impacts the family, the community and all the people experiencing pain and loss by the person who perpetrated that violence, and then the other person, the family who we lose, another community member, which more than likely is a young person. So all of that is connected to the work that we do. It's not just oh, we're just going to deal with the addiction piece. We have to deal with the trauma, the violence and all those multiple, complex layers to it, and so, as a collective, we have to look within and say what are the things that we need to fix? What do we need to learn as a system at large?
Speaker 2:I always tell other providers just because you're offering something doesn't mean someone knows how to use it. Like I use the example, you can toss me a keys to the most expensive Ferrari with gear shifting systems and all that stuff. I probably wouldn't be able to get it out of park because I haven't received the education around how to use this to benefit me. Why does this benefit me to have this super fast car? It goes back to our mental health services. We create these models and all these frameworks. Let's implement it.
Speaker 2:And then folks are like what are you doing? We're just learning to be comfortable with therapy. Now, after all of these years coming in and talking about our problem, we don't even know where the problem lies. When we're talking about addiction, we tend to hide in that. You know it's those folks over there. It doesn't impact us. You know this person has been struggling a long time, but now it's impacting our kids in the same way the crack epidemic impacted my generation. I think it boils down to having a real conversation, being real with our kids, being real with our community and then trying to figure out what we need and how to ask for and get what we need to be able to address these issues.
Speaker 1:You know it's interesting that first of all, I couldn't help bring to mind the ripple effect right of an incident of gun violence or substance use with one member of family and how everybody is affected around that person. And then I want to throw in the layer of race, because that further complicates the ability to receive help when do you even go? And I want to layer in the fact that Minnesota's the fourth worst city for Black Americans based on disparities and socioeconomic outcomes Fourth on the list. We got a whole 50 states to choose from and we're fourth right. In my work as a dual licensed therapist, it was really hard to be in treatment spaces as a therapist and as a licensed alcohol and drug counselor and use these models on bodies of color that just didn't fit. It didn't fit, it didn't compute and the system is not necessarily designed for them to succeed in this care. Do you have any experience? Can you speak into some of that?
Speaker 3:Yeah, I mean we don't even have words when it comes to mental health. There's a lot of language barriers. I feel like there's not even words that can describe. You know, like I know, people get misdiagnosed or underdiagnosed or overdiagnosed because of maybe interpreting or understanding some words. There's certain words that we don't have in Somali. I just don't know how to describe it, but there's not a specific word for something that you're trying to interpret or translate. So that's challenging at first. I mean, we also had, you know, the treatment space and we have had clients transfer from other programs and we have had counselors who were biased straight up bias and talking to clients about the immigration status or saying, thank god, so-and-so is back in the president office because of you. How could that be therapeutic? People have a lot of mixed emotions.
Speaker 1:Counselors have a lot of power very real power dynamic in that space.
Speaker 3:If you don't do X, y and Z, I'm going to call your PO. If you don't do this and that, I'm going to let the judge know or I'm going to let your public defender know. So definitely a challenge, and that's why I'm excited about the future, because there's a lot of young people that are from the community going to school. Everyone that I see I'm like hey, do you want to go to school and be a therapist? Do you want to go to school and be an addiction counselor?
Speaker 1:I love that you're encouraging that yeah absolutely, mentorship is important.
Speaker 3:I do see the challenge when it comes to a lot of biases, a lot of discrimination, a lot of racism straight up racism because of the clients that I serve from my community and the encounters they had in the system. You're right, some of this framework and some of these concepts are not something that are friendly to our community, culture and religion. We have to create our own frameworks, but it takes time right. So this is something that took Americans a long time. The concept of therapy is a white Western culture thing for us. When we talk about therapy, it takes a while for us to educate people about it's just talking to someone about your problems and people takes a while for them to trust you. In our communities we're just introducing that new experience of hey therapy. It can help you can help you, you know. So people are getting there, but it takes time. It doesn't come overnight. What?
Speaker 2:I'm hearing a lot of is we don't have enough people doing research around the things that we care about. So we always look at what do you do to increase capacity in the field? But we need to also increase capacity in research in the field, but we need to also increase capacity in research. So more people who look like us are doing the research, able to develop relationships to get real data. When I look at some of these models although they're tested in our community, from my experience, if a person of color is doing that research, they get a different outcome versus a non-person of color working with the same community, because it's this level of trust, the level of realness. I mean, that's what we talk about all the time. It's like let's keep it real and being able to trust each other and really engage in writing things that work for us. And it's two ways of doing that.
Speaker 2:You have evidence-based practice versus practice-based evidence. Evidence-based practice is what you do in your clinic, informing practice and research, so that's more of an applied approach. Evidence-based practice that means we're doing things in the field, collecting data, and then we roll out a quantitative. So I think for our community and this is what I'm hearing from a lot of folks in research. Qualitative is a storytelling, so we come from a nature of storytelling. We should be using that method to get to effective treatment. When we're talking about working with people of color versus like. Here's the numbers. They all correlate. We can use this model and using the numbers first, and you can use a blend of both research method, but I think more so we need more people engaging in being researchers and more people in the field. I'm wondering what those statistics look like for people who are actually doing the research around issues that we are having opioid treatment in our communities and mental health treatment in our community. I would be curious to see how many people of color are in research.
Speaker 1:Even thinking back to the models that I learned as a therapist, those are evidence-based practices, yet the sample sizes for communities of color have typically been very small. Yet they're presented as if this is generalizable. We, as clinicians, have to take this out into the world and use these tools. What I know as a Black woman and a therapist is that these tools are not fully effective for Black and brown folks. There are times where I have to adapt and use several tools across several modalities in order to start addressing trauma, in order to start addressing how racism impacts identity. Right, understanding how functioning addicts are moving throughout the world just trying to survive, just trying to feed their family. Right, it's interesting how what we learn and what we take out into the world feels like a bait and switch. Right, can't fully use this tool because it doesn't necessarily fit right.
Speaker 2:That's why internships are even more important now, because the people who have the most experience can mentor other people to be able to use these tools in an effective way and then also run interference because, like you said, misdiagnosing is huge. You know you misdiagnose. The thing that I tell my intern is like that is a DSM and that's the most powerful tool that you will ever encounter. So, being responsible with your diagnosis, take this stuff serious and be able to capture the narrative you know. So, yes, this person may have this depression or this person may have addiction. In what context? So that's the second question.
Speaker 2:Yes, all the things line up, but in what context? So that's the second question. Yes, all the things line up, but in what context? And so, once you get the whole story, you begin to diagnose from that standpoint, because you have enough evidence to support your diagnosis. Like a clinician of mine told me. He said diagnosis, you can always be a little bit off, and so you could definitely look at it from a standpoint like are we going to put a lot of weight on that because it's off, or are we going to put more weight on context, Because, at the end of the day, if I give you a diagnosis, you still got to go face it. Deal with that in the real world.
Speaker 1:Diagnoses are weaponized right, not only in the mental health space but in substance use as well, and that's often the first entryway that Black and brown folk have to this world of treatment is that break the system, design them to say, hey, you have a problem, now get an assessment and then follow whatever the recommendations of the assessment are. Now you're in the system and now right, we have the mental health piece where these diagnoses follow you forever, they don't go away, and so we have a responsibility as therapists to be really cautious. And I like Z codes, because Z codes give the context of what an individual is experiencing rather than jumping straight to a diagnosis.
Speaker 3:Yeah, absolutely A lot of it leads to insurance and claims and justifying. It's all about those claims. Business side of it too, I get it. A lot of clients don't read this. You know small print. It's like you do an assessment and file recommendations that could be doing treatment for whatever a month or two or three or whatever. Then there's aftercare. So if the probation is going to follow after they're even done with treatment, you still have to do aftercare. So that client's like, well, I did treatment, I finished, yeah, but now you have to go to AA or NA, you know sober house or whatever that might be. People might not understand that and clients oftentimes don't read the small print.
Speaker 1:How do you explain that?
Speaker 3:to them. It's challenging, definitely challenging. We just try to be honest with them and explain to them like this is a continuum of care. It's not just like especially in our community there's a sense of like getting things done as quickly as possible, you know, and it's a process of recovery. It's not, you know, it's not like step one to step 10. You know, it looks different for everybody. For some people they might start slow and things might change, or vice versa.
Speaker 3:Recovery is a lifetime achievement. It's not a 90 days, not a six months, not a one year, not a five years. It's a lifetime achievement, you know. So just try to explain to them that it's a process and to take it slow and one day at a time, and it might sound like cliche, but really that's how it is One day, 24 hours a day. I'm not going to use waking up every morning If you believe in AA or NA, following your steps, things like that.
Speaker 3:I think education is so vital for a lot of people, just explaining to them and also having peer support specialists that's one of the things that have been a game changer for us is we have people that they used to use drug with, you know, three, four years ago and now they're sober and they're like, if that guy can get sober, I could do it, because that guy was a lot in the streets, you know, and it's kind of cool to hear that Some of them are in management now that went through a program and are sober four or five years, got married, going to schools, ladc, staying sober, got jobs, having kids, you know. I mean it's beautiful and they get to work with clients that they know from the community or from the streets. So that has been really effective for us.
Speaker 2:Now. I appreciate the work that you do. This is a great conversation. What goes in my mind? The biggest thing that comes in my mind right now is like OK, how do we build infrastructure as a community so we can have more choices in where we refer people from a mental health standpoint, because becoming sober is not an easy journey? So you go back and forth.
Speaker 2:In some facilities you have to follow the regimen or you're out. Some facilities don't deal with comorbidity. Where you're dealing with mental health and substance use, where do we find those facilities that understand the context of our culture and support the back and forth? Because some folks go back and forth and then they just lose If they were getting into the cycle of breaking relationships. Your chemical dependency stuff is sabotaging your relationships within your family, your interpersonal circles, and you go into another relationship, which is the treatment piece, and then you sabotage that relationship and folks reject you even more. So, like you said, education component of how treatment actually works, how to use a peer mentor. What does that mean? How do we use 12 steps in an environment that's not a culturally responsive environment and how do you use that to be able to remain sober or reduce your harm, reduce your use? So those are some huge questions that I think you know.
Speaker 2:I'm always encouraging growing professionals to keep going until you build a clinic or do something bigger, because once we do get to a point where we can refer folks within our community to cultural responsive people who are doing treatment, then we could I mean, I think it changes the game because we can dictate how treatment is delivered. And right now, in our small community of providers, we aren't able to go to that next tier because, after providing the mental health services, you know how many providers of colors are actually in treatment, who own the treatment center. And so I know Turning Point is one that's been in the community for a long time, but I'm pretty sure they're at capacity. Your clinic, I don't know where you're at so far as capacity, but I think we have to continue to build these clinics. It's always like where do you get funding to do that work and be able to talk about the need for this demographic of people without experiencing, oh, you're doing this for this group of people, this model may not work for everybody, and so it's kind of like yeah, you have colon cancer, so everybody who has cancer in general get to go to the colon cancer guy because he knows cancer.
Speaker 2:That doesn't make any sense at all. Everybody has their own individual needs, no matter what race or culture, but we have limited our capacity to be able to address those needs there, and so I know it's a big taking to build a clinic, a chemical treatment facility. So that might warrant some more conversation about where's the starting point for us to build these clinics, to be able to serve this population who have like multiple stresses going on.
Speaker 1:The providers in our current state to better understand cultural needs and values, because that's also building capacity. How do we have these conversations, not only amongst ourselves but with other providers, to say, have you thought of this? There are some different considerations for the populations that you serve.
Speaker 3:I mean, I've been doing a lot of trainings like how to better serve the East African community and the clients. I've been doing a lot of work around the do's and don'ts in therapy. Don'ts in therapy I have this whole presentation about cultural, religion, family aspects, addiction, aspects like what is our view in our community? What are the common themes and things that we're seeing from our community? And to their defense, a lot of people are reaching out. You're seeing people being willing to have these conversations.
Speaker 1:Absolutely, that's beautiful.
Speaker 3:And that has been really helpful. A lot of them are like oh, I never knew this, you know, I learned like during Ramadan. What do you do with patients or clients that are in your clinic? Or if you have an inpatient, how do you support them through Ramadan and Eid, big holiday and so forth? So I think a lot of I've done this for Fairview and some of the bigger agencies that are reaching out and seeking help, which is great. That's the only way, I think, because I can't do this work alone. There's a lot more providers now, which is great, but even providers that are not culture specific, what can I do to support them so they can do the work?
Speaker 1:Yeah, absolutely.
Speaker 2:I think the training people reach out and ask, hey, could you do some training for me around working with Black men or the Black community. It's great conversation. I love the conversations. Conversations are like oh aha moments. We can do this, we can implement all of these different things, but when it comes to after the training, are you able to implement these practices?
Speaker 2:My number one struggle is, yes, you pay for the training, but how can you follow through with implementation and evaluating if you're doing it right, with implementation and evaluating if you're doing it right? And so that goes back to us doing the writings and having these models, developing models that are very specific to a point where we can implement these practices. If we don't have our own agencies, how can we train other folks to implement these practices? It's like the books that we read in school very specific to a specific population. This is how you implement it. This is how you evaluate it. We need that same type of energy when it comes to addressing communities of color stepping away for a while and saying I got to do some writing and get all of this stuff captured so we can start implementing these practices real time and sharing this with other agencies who are serving our folks. But are they open to getting the training and the support with implementing the practices. It could look like we create a manual or approach and work together a collective of folks interested in chemical health creating a manual. Then we implement the manuals, coach people how to implement these processes.
Speaker 2:The most difficult part is stop. Some of these agencies don't need to think the way that they normally think. If you're coming from a Eurocentric lens and trying to implement a Eurocentric understanding of chemical health and trauma, it might be challenging for you. The whole picture here are some folks of color. This is their experiences, and being able to immerse yourself in understanding the journey of a person of color, then I think that's the biggest piece, because undoing those biases can be very difficult. It takes a lot of time and a lot of resources. So I mean, it's not a direct. How do you eliminate racism? It's like we have to work together to create a model. And is there funding for that? Probably not. But do folks need to be committed to doing it for the greater cause? Yeah, we're probably going to have to say you know what this is for the cause and then start to get together and create our model, teach folks how to implement it.
Speaker 1:Right, it's interesting you bring that up, because the implementation part and having clinicians check their own bias is not a check the box. It's an ongoing exploration in order to be able to think in a different way rather than relying on those biases and not take it personal.
Speaker 2:And that's the biggest piece is people internalize and take it personal. Physicians get trained this way. Like we provide care because we are on a social contract and we need to implement the best practices, we're morally accountable. The same thing can happen in our field. You learn because you want to honor that contract to serve everybody, everybody. And that's challenging. It's like, okay, we have to serve a diverse population. We're asking you to look at yourself and check your own biases, because we all have biases, whether we like to believe it or not.
Speaker 1:How would you encourage providers to challenge their awareness and understanding of their clients of color?
Speaker 3:I always tell providers it's okay not to know. You don't have to be an expert Like if you ask, hey, why do you guys do X, y and Z? Clients will tell you we do this because of X, y and Z. Be willing to be vulnerable and ask questions and make mistakes, and that's okay. Oftentimes people feel like they have all these degrees. I had a gal who came in and she's like I'm X, y and Z and I'm LMFT and LADC and LPCC and one of the clients is like I don't know what that is, I don't care for it. So it's important for you to meet people where they at and people use that word a lot just meet people where they're at. Meeting people where they're at means not knowing what the hell you're doing at times about their culture, and that's okay. And so I challenge people to just be willing to make mistakes. Tell the client hey, I don't know much about X, y and Z. Can you please help me understand? And that's how you learn.
Speaker 1:Yeah, the other piece I picked up from what you said is that what may be important to the clinician may not be important.
Speaker 3:Yeah, we don't care about your credentials, even like for me. I don't go around saying I'm an LSSW, I don't give a damn. It is a big thing in being a clinician and I'm proud of it. But for some of my clients that's not a big deal to them. They want to know the real me and what I can do for them, not so much the other way around.
Speaker 2:I think in our profession we always talk academic settings to talk to folks on. How do you build a relationship based on validation, listening and all the skills that we try to impose on our clients. As a therapist, you have to do the same thing, also engaging in personal growth. As a clinician, you always have to do self-evaluation, self-inventory. There are things that happen in therapy that you're like wow, it felt a little funny and I really didn't understand that. Digging deep into yourself and understanding this is my worldview and then getting the right kind of consultation and supervision to help you process it. I think a lot of times when folks get their degrees, it's like, yeah, I'm out here, I'm well-trained and I specialize in this. But when we're talking about doing that self as a therapist work, it's being aware of your blind spots, like you were saying. You said a lot of folks get into this field because they had pain too. They want to help others heal from their pain and if you have come from a traumatic background, it pops up. How do you process, how do you have awareness around that? How do you process that with your peers? You have your blind spot. You may not have worked on that and you might need to take a step back. Bring in a co-therapist to really support your learning and development. Just because you've been in the field for 30 years, you still can have blind spots and you still can learn.
Speaker 2:So far as agencies, I think it's about policy. You really got to take a look at your policies of how you train people to deal with diverse populations or how you staff in your clinic. If you're in a predominantly black neighborhood and all your clinicians are don't look like the neighborhood, then you have to have policies in place to diversify that workforce. Now, not to say that white folks can't work with the black community yes, you can, but it takes work and lived experiences and it's just not a straight line. I think folks like okay, I learned X, y and Z, I went to my sociocultural class and go to these training around racism, so I'm ready to go. I mean, that's the setup.
Speaker 2:You have to immerse yourself in the culture, understand the culture historically and all of these different associated with working with diverse populations. If you could do that and continue to get called out on your stuff when your biases show up. Because we live an American culture. We were all raised to understand things from an American cultural situation from our lived experience, and we all have diverse experiences. I don't understand what it's like to be a Somali man in Minnesota dealing with the health care system, because that's not my lived experience. But what I do understand is what it feels like to be isolated. I understand what it feels like to be unheard, and how do we use that general knowledge that everybody has experienced where they have felt unheard or not acknowledged in some way? How can we use that to build on, how to expand our understanding of how other people experience it?
Speaker 1:So final takeaways for our audience today.
Speaker 3:Just find ways to keep learning and keep growing, having goals for yourself as a therapist, as a clinician, and be willing to learn and grow as a clinician, as a person. This addiction and mental health stuff is always changing and there's a lot of politics, policies and things that are changing funding insurance companies. There's always something happening. The advice is for you to be willing to accept change and willing to change. I think is also important.
Speaker 1:Thank you.
Speaker 2:I think my biggest takeaway is we need more researchers. So if you're a person who may be a master's level person, or at least seeking more education, having more folks that will research in practice so we can really capture the story of what we're trying to address in mental health and opioid addiction, I think that's a big piece, just having more information from folks who look like us writing our narrative. The second thing is growing as a professional. We need folks who are seeing the clients and committed to doing it in the field committed to doing it in the field. But we also need those folks who are capable of building infrastructure or starting an agency that could serve this community. That would be definitely beneficial because then we can refer other folks to people we know that understands you, know how it works real time and then understand how to utilize this research and make it more culturally responsive.
Speaker 2:And then the third thing is we want to make sure that folks have a plan to implement what we're training them on, because I don't want to feel like I'm using my time to check a box to say you went through this training that you're not prepared to implement. So tier one is receiving the information, understanding it and then start having discussion how we're going to implement this method to what we are, our existing structure. And then the last thing is just being aware that everybody has different needs and so utilizing the right tools to be able to address needs and not do a blanket. Oh, this is the majority of the people, so we're going to implement these strategies in our clinic. So folks can't. You know, like you still, it's still like a watered down piece that for folks who are people of color, Thank you.
Speaker 1:Okay, so it's not a one size fits all approach. Tell the good people where you can be found. Tell them how to plug into the Alliance Wellness Center.
Speaker 3:Sure, you can go through our website, which is AllianceWellnessCentercom, or you can call our office at 952-562-3740. You can follow us on Facebook, instagram and TikTok under Alliance Wellness Center.
Speaker 2:Thank, you and you can find us at wwwempowerfamshortforfamilycom. You go to the website. You can sign up to get virtual therapy. We offer virtual therapy. I love in-person therapy. We offer virtual options in couples therapy, and so you can find us there. We have a Facebook page. You can look up Empower Therapeutic Support Services and you can find us on Facebook.
Speaker 1:All right. Thank you both for your time today.
Speaker 3:Thanks for having us. Thank you.
Speaker 1:That's a wrap for today's episode of Bridging the Gaps Reimagining Opioid Recovery. Thank you for joining us in this vital conversation about racism and substance use treatment. Next episode, we will continue with part two of our discussion. If what you heard resonated with you, please share it with your network and help us spread awareness. Don't forget to subscribe to stay updated on future episode releases. Until next time, let's keep working towards a more equitable and compassionate system of care.
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