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Today we speak to our friend and co-worker, April Knasinski. April discusses her role at our facility, the importance of therapy, aftercare plans, and pitfalls to avoid. April is a Licensed Clinical Social Worker and Licensed Clinical Addictions Counselor in the state of Indiana.
Aaron Reason:
Hey guys, this is Aaron Reason, your host of A Reason to Live. First and foremost, I just want to say thanks again for all the feedback that we’re getting. You guys have been amazing. We really appreciate all of our listeners. I’m excited to bring episode four to you. We’ve got our good friend that we work with here, April, so we’re going to get a view of what the clinical side of recovery looks like here. So stay tuned. Hope you enjoy the episode.
Speaker 2:
Located in Anderson, Indiana, Bridges of Hope is a detox and residential treatment facility assisting those experiencing alcohol and substance abuse addiction. Our treatment philosophy is based on a comprehensive and integrated approach to addressing all issues related to substance abuse disorders and co-occurring mental health issues. Addiction treatment at Bridges of Hope can guide you safely through withdrawal from drugs and alcohol, and teach you important skills that help you achieve long-term recovery. Client care is our highest priority, and we offer our clients all-inclusive treatment services. Our ultimate goal is to identify the challenges, concerns, and problems related to substance use and mental health disorders to provide professional clinical treatment to all of our patients. For more information on our services, visit us at behoperehab.com or call 844-449-6392.
Aaron Reason:
Hey guys, welcome back to A Reason to Live. This is your host, Aaron Reason here with my producer, Michael Whitlock.
Michael Whitlock:
Hey everybody.
Aaron Reason:
And we have a special guest today, April Knasinski. She works with us. She is awesome and amazing, and we’re so excited to have you on the show April.
April Knasinski:
Thank you.
Michael Whitlock:
I’m extra excited just because I’ve known April for easily over a decade.
April Knasinski:
Yes.
Michael Whitlock:
We worked together at another facility, not for addiction, but for developmental disabilities. So I know from history that she’s well-educated, intelligent, a lot of fun, younger than me by five weeks and one day, because for a full year we get to be old people together, and for five weeks and one day, she gets to brag about how she’s the young friend in our,
Aaron Reason:
Absolutely.
Michael Whitlock:
Yeah.
Aaron Reason:
And I mean, she’s got to be a very strong woman having put up with you for a decade.
Michael Whitlock:
Absolutely.
April Knasinski:
Thank you.
Michael Whitlock:
Way strong.
Aaron Reason:
Yeah.
Michael Whitlock:
Way strong.
Aaron Reason:
My Lord.
Michael Whitlock:
So why don’t you start off by telling us a little bit about your background, credentials, addiction services, that kind of thing.
April Knasinski:
Okay. So I have a master’s degree in social work that I got in 2011. I have a bachelor’s degree in psychology that I got clear back in 2000.
Michael Whitlock:
Ooh.
April Knasinski:
So if you’re counting, April makes 23 years of working in the field of mental health and addictions.
Michael Whitlock:
Great. Great.
Aaron Reason:
That’s awesome.
April Knasinski:
I’ve come so far that I’m a licensed clinical social worker, and I’m also a licensed clinical addictions counselor, and I’ve been doing that for almost 11 years now. So that’s been fantastic. I’ve worked in inpatient facilities for addictions and I’ve worked in community mental health and on the side for fun, I am a core appointed special advocate for the county I live in, and I also teach at a local university to help rear up addictions counselors so that we have plenty instead of always wishing we had more.
Michael Whitlock:
So you need more to do because you’re just,
April Knasinski:
Absolutely.
Michael Whitlock:
Pulling your weight in the world.
Aaron Reason:
Yeah.
April Knasinski:
Absolutely.
Aaron Reason:
April, you really need to step it up. I thought I was going to be impressed, but man, I’m just like,
Michael Whitlock:
Well, let’s not forget your two most important jobs. You’re also a wife and a mother.
April Knasinski:
A wife and a mother, yes.
Michael Whitlock:
And those are full-time jobs in itself.
April Knasinski:
Absolutely, yes.
Michael Whitlock:
So that’s great. We appreciate all that you do, and I was excited when our clinical director said that you were looking for some relocation, and it was just a perfect fit for us. We both had worked with you before and we knew what you brought to the table, so it was a natural fit for you to join our team. One of the things I love about you is that you can deliver news that is hard hitting, but yet in a loving fashion so that someone receives a message and yet they don’t want to just run away, quit the program,
Aaron Reason:
Yeah.
Michael Whitlock:
And not everyone can carry that skillset. So that’s definitely something I’ve always appreciated about you.
April Knasinski:
Thank you.
Michael Whitlock:
So.
Aaron Reason:
Awesome. Well, let’s jump into the questioning. So tell us about your role at our facility here.
April Knasinski:
Okay. So my title is clinical manager. I do a little bit of everything here too.
Aaron Reason:
You do.
April Knasinski:
I’ve got anywhere from two to three clients that are mine that I get to walk them through their therapy for their 28 days while they’re here. But also it is my responsibility to do individual supervision and group supervision with the therapists here. So that’s kind of one of my passions is growing people.
Aaron Reason:
Yeah.
April Knasinski:
And so one day when I retire, there’s this whole set of people that are very skilled and ready to take on the world. So I love to watch clients grow just as much as I love to watch the therapists grow.
Aaron Reason:
Yeah. That’s awesome. I mean, I think that we all have that passion, right?
April Knasinski:
Yes.
Aaron Reason:
I mean, there’s something about when you see the light come back on in a client’s eyes and they start to get it and they start to feel better about themselves and see and know their worth. I mean, to me, that’s just the most beautiful thing ever.
April Knasinski:
It is.
Aaron Reason:
It really is.
April Knasinski:
Yeah.
Aaron Reason:
So we talked a little bit about your background in the addiction field. Can you just kind of elaborate on that? So what made you want to get into this field specifically?
April Knasinski:
Okay. I myself am not an addict, but I come from a family that I tell the clients all the time, if you shake my family tree, more addiction falls out than not. And so kind of way back in my very beginning of my career, I was given the opportunity to learn about addictions. And at that point it was just sheerly personal. I wanted to know why does my family do what it does and why do I not? Like it just didn’t make sense to me. So that’s kind of where it started. And then from there, my career kind of started with children both in the DCS realm and the juvenile probation realm.
Aaron Reason:
Okay.
April Knasinski:
And I was getting an awful lot of children whose parents were addicts.
Aaron Reason:
Right.
April Knasinski:
And at some point I just said, I feel like I can’t really help them unless I also help their parents. So that’s kind of how the career has kind of changed and morphed over time. But it really was a personal reason I got into it. I’ve lost family members. I have family members in long-term recovery, and then I still have a family member that’s an active addiction. So it’s half personal, but also half as a therapist, I love to see people change and grow, and this seems to be the field that I can watch that the most I think, so.
Aaron Reason:
Yeah. I like that. And Michael, you talked about that in our first episode about just how addiction touches everybody.
Michael Whitlock:
Really does.
Aaron Reason:
In some way, some form everybody’s affected by it. And so that’s awesome that that became your passion and,
April Knasinski:
Yes.
Aaron Reason:
That you’re helping others in that way now, so. So what is the clinical side of recovery look like? What is involved at a residential facility like ours?
Michael Whitlock:
Yeah. Walk us through patients walking in the door for the first time, what kind of they can expect?
April Knasinski:
Okay. So we like to do warm handoffs, which means within a matter of a day or so of them being here, even though they’re sick and not feeling well, they’re probably going to meet their case manager and they’re going to meet their therapist, and it’s just a, hello, here’s who I am and here’s what I’m going to do with you when you’re feeling better. So that they feel connected to some of the professionals in the building and get to see that they are going to get some services that are clinically oriented.
Michael Whitlock:
So there’s truly a team that’s focused on these patients.
April Knasinski:
Absolutely.
Michael Whitlock:
Okay.
April Knasinski:
Yeah. And then from there, as they start feeling better and start engaging in services, they’re going to meet with their therapists for the first time and usually within the first five days or so, and they’re going to complete a pretty in-depth assessment, and they’re going to create some treatment plans for themselves. What is it I hope to accomplish while I’m here? So I think those are the building blocks to get them started.
Aaron Reason:
Yeah.
April Knasinski:
They’re going to do individual counseling at least once a week. What I love about our facility is that our caseloads are so small in comparison to other facilities that we can see them a couple times a week if we want to or need to. So I think that’s phenomenal. They’re going to get group therapy all day long, all day long. And to me, that’s kind of one of the most important components because they need to be with like-minded people who,
Michael Whitlock:
Sure.
April Knasinski:
They were sick last week too. They get it. They understand completely. And their staff members that they see all day long have walked in their shoes. And I think that’s really important for them to hear and see.
Michael Whitlock:
How long is a typical residential program?
April Knasinski:
Typically 28 days.
Michael Whitlock:
Okay. And so that’s uniform around other facilities. And that’s probably funding based or a modality, if you will?
April Knasinski:
Yes. It’s typical across all facilities and it’s really insurance driven. They’ve decided that 28 days is a great round number for a residential stay.
Aaron Reason:
Yeah.
April Knasinski:
I wish they changed their minds, but.
Aaron Reason:
Yeah.
Michael Whitlock:
So 28 days, you come in, you get your treatment, and then you’re cured, right?
April Knasinski:
Absolutely. Absolutely.
Michael Whitlock:
The battle is over.
April Knasinski:
Yes. No, I wish it were.
Michael Whitlock:
Yeah.
April Knasinski:
But it is not. We do a lot of preaching of 28 days is just the tip of the iceberg. And our hope is that they go on and do other services once they’ve completed here, and we do our very best all around the building to talk them into that. So because the more structured time you can have, the better off you’ll be.
Aaron Reason:
Yeah.
Michael Whitlock:
Why don’t we go ahead and hit our first sponsor, and we’re going to come back after that.
Speaker 5:
At the Indiana Community Addiction Network, we offer the new standard and medication assisted treatment. So if you’re ready to put substance abuse behind you, we’re here to help. We are a local family owned center who will create an individualized physician led care plan to help you reach sobriety. At ICAN, we treat your addiction based on your unique needs and have full addiction treatment programs. Get started on recovery today, call ICAN now to speak to an advisor at 888-635-1470, or visit us at addictionsnetwork.com.
Aaron Reason:
Okay guys, welcome back. So April, we talked about the family sessions, the group counseling, and we touched on aftercare. Tell us about aftercare and why you think it is so important for our clients.
April Knasinski:
Okay. So it literally is just like it sounds. After they leave here, what are they going to do to maintain that sobriety?
Aaron Reason:
Yeah.
April Knasinski:
And there’s lots of options open to people. If we were going to do a true continuum of care and step down as we need to, after residential would be an intensive outpatient program that’s usually nine hours a week and includes some component of individual therapy as well, hold you accountable with some random drug screens and things like that. So it truly is the next step-down. And then from there, you might go to an outpatient setting where maybe you’re going to continue to get your medications, you’re maybe going to continue to do some individual therapy, but it just sort of lessens over time. The reason that that’s so important is kind of what I had said earlier, is the longer you can stay in structured programming, the better you’ll be. And I think that that allows people to maintain relationships, maintain some accountability, but also some support, because sometimes it’s just a bad day and you need as many people to call as you possibly can.
Aaron Reason:
Yeah.
April Knasinski:
So aftercare is really, really important. PHP is another option that if you’re looking to stay in a housed program, if you will, where they’re going to offer you a place to stay, PHP maybe where you go after residential.
Michael Whitlock:
What does PHP stand for?
April Knasinski:
Partial Hospitalization.
Michael Whitlock:
Okay.
April Knasinski:
Okay. So they step down in hours as far as how many hours they’re in group per day.
Aaron Reason:
Okay.
April Knasinski:
So they’re in group five hours a day compared to our six that we are in residential. And it oftentimes has housing for you. So for those that are homeless or have burnt bridges with just about everybody, and they’re not in a safe environment, that’s the best option for them. And then from there, they can continue to IOP and outpatient. And then there’s sober living, which sober living is generally another program that provides housing and that it comes in all kinds of different forms, all kinds of different rules, all kinds of expectations, and it really depends on what your needs are at the time. The biggest component for people going on to sober living is that’s about the part in the continuum of care that allows you to maybe start working again. So for a lot of people, that’s very important to begin having an income again and paying off some bills or contributing again.
Michael Whitlock:
I would say that from my point of view, the biggest concern I’ve seen with patients in our program is they have these great aftercare plans towards the beginning, because I know this is created throughout their whole 28-day stay.
April Knasinski:
Yes.
Michael Whitlock:
They’ll create these great aftercare plans, and as they start feeling better, and then they start feeling the pressures of bills and family obligations, they’ll start chipping away at those plans.
April Knasinski:
Yes.
Michael Whitlock:
And then they leave. And unfortunately, they chipped away, I think too much. And then we see some relapses, which is just horrible. And they put in all this work, they detoxed, and then they get back into some of these bad environments. And so that’s where the aftercare plan is important, not only developing a strong aftercare plan, but sticking to it.
April Knasinski:
Absolutely.
Michael Whitlock:
And so I know that that’s part of your clinical therapy sessions, that you’re not only talking about the root causes of addiction, but you’re trying to eliminate some of those hazards and obstacles that occur and talking people out of trying to eliminate those chippings off, if you will, so.
April Knasinski:
Yes.
Aaron Reason:
Well, I think from an addict’s perspective, you begin to convince yourself that you’re okay at a certain point, like,
Michael Whitlock:
Oh, sure.
Aaron Reason:
You start feeling better about yourself, you get healthy again, and things are falling into place. And then when that begins to happen, your mindset’s like, okay, well, I’m okay now. I’ve got it figured out.
Michael Whitlock:
Absolutely.
Aaron Reason:
And there’s a common saying, and a lot of people that don’t understand addictions say this a lot. They’ll say like, you got this, you got this. The truth is, we don’t ever got this. What we do have is it’s said in the program, a daily reprieve, a daily pass, which is really contingent upon our spiritual maintenance. So to sum that up, what that means to me personally is I have a daily pass from using as long as I keep doing the things that I’ve done to get to the place where I’m at. And I think that’s what, like you talked about sober living. That’s what I did when I left rehab was I went to a sober living environment. It was very strict, and there were days that I did not like it, but I needed that structure.
April Knasinski:
Sure.
Aaron Reason:
And I, like you talked about, I needed to be around like-minded people,
April Knasinski:
Sure.
Aaron Reason:
That were going towards the same goal for sure so.
April Knasinski:
It helps create a habit.
Aaron Reason:
Yeah.
April Knasinski:
28 days isn’t a habit yet.
Aaron Reason:
Yeah.
April Knasinski:
So.
Michael Whitlock:
Early on when I first started working at this facility, I sat in a class that our CEO was teaching about neuroscience, and that was very enlightening for me because I wasn’t completely familiar with how much addiction affects the brain and sets people up for continued failure.
April Knasinski:
Absolutely.
Michael Whitlock:
Can you touch on just, and I just say a brief amount because it’s a really big topic, obviously,
April Knasinski:
Sure. Sure.
Michael Whitlock:
But what is it about the brain that’s going on during addiction that causes people to keep failing?
April Knasinski:
So the chemicals that we’re putting in our body, no matter what form it is, is changing literally our neurotransmitters in our brain and changing the way information is now delivered. We are a dual diagnosis center here. And I think that’s the only way to do that because when it comes to the neuroscience behind it, every single patient that walks in this door is dealing with depression on some level. And not because it was something that was there beforehand or it happened because of some trauma, just simply put their brains stopped making dopamine the whole time they were using. And that’s our happy chemical. That’s the thing that says, Hey, there’s joy to life somewhere. And when they decide to stop using their brains don’t just automatically go, huh, I probably should start doing that again.
Aaron Reason:
Yeah.
April Knasinski:
Right. So they go through a period and everyone is different. I mean, it could be three months, it could be up to two years where their brain is trying to figure out that okay, we stopped taking these chemicals, and it’s my job then to pick up and start working again. So they go through a period of, I’m trying to figure out sobriety, I’m trying to figure out life. There’s some damage that’s been caused that they’re trying to fix. And then their brain sort of slowly catching on to what it should have been doing in the first place. So it plays a huge part in it. A huge part.
Michael Whitlock:
So the brain is actively your forced enemy in a way.
April Knasinski:
Yes.
Michael Whitlock:
Because it’s making you weak for what you are hungry for. And that’s either,
April Knasinski:
Yes.
Michael Whitlock:
To be high or to have that dopamine of be happy.
April Knasinski:
Yes.
Michael Whitlock:
No one wants to be depressed.
Aaron Reason:
Right.
Michael Whitlock:
And the thought of having to wait months or even years, that’s a long time for somebody to,
April Knasinski:
Yeah.
Michael Whitlock:
Have to keep working on something. And willpower’s just not enough. That’s why all this education is important, the aftercare plan, keeping yourself in a safe environment. We’ve talked about sponsors.
Aaron Reason:
Yeah.
Michael Whitlock:
We’ve talked about 12 step programs, just it’s about having basically a barrier of defense.
April Knasinski:
Yes.
Michael Whitlock:
And not just one thing, but lots of things for someone to have a chance at success so.
Aaron Reason:
Yeah. And I mean, I really, actually this reminds me of a conversation I had with a client last night about acceptance. Right. And we talk about in the program when the fog lifts, because when you first come in the program. I remember being in meetings, and in my mind, I’m thinking of all these really cool things to say, and I’m listening to everybody else and all these guys that have been sober for years. And I’m like, man, they sound so smart. I got to say something really smart too. And then when it would come from my thought to my mouth, it just would, I’d be like, yeah, that’s really cool. I love being sober. And I’m like, what was that all about? You know what I mean? I could not get a clear thought out. And you’re right, the brain needs to heal.
April Knasinski:
Yes.
Aaron Reason:
And you get to this point finally, it’s like the longer that I go on, the more my thoughts are processed more clearly. And it’s like you can feel yourself healing, not just physically, but mentally for sure, so.
Michael Whitlock:
Well, I think it’s one of the important parts of our program too, that there are events that occur that are surrounding, or they’re about fun while sober. Right. So that people can realize that they can do it without these chemicals, but yet still have fun.
Aaron Reason:
Oh, absolutely.
Michael Whitlock:
So I know that our groups have gone out and done some bowling and done some events related to the town. I think Halloween, there’s been some things, and it’s great opportunity for people. We even have people that want to go out and do yard work because they feel good about getting outside, getting some of that vitamin D from the sun and contributing to something. So there’s just different ways to find that inner joy again, without addiction being a part of it, so.
Aaron Reason:
Yeah, absolutely.
April Knasinski:
That’s one of the best parts of this program, because I’ve seen other programs, I’ve been in other programs, and this is not a part of other programs.
Michael Whitlock:
Oh, good.
April Knasinski:
Yeah. So I love that part.
Michael Whitlock:
Something we’re doing right. That’s great.
April Knasinski:
Yes.
Aaron Reason:
Absolutely.
Michael Whitlock:
One of our last questions is what have you seen that leads to people’s failures? And I know we touched on it a little bit, but what are you seeing where people are relapsing? What kind of mistakes are they making so that we can spread the word to others to avoid these pitfalls?
April Knasinski:
There’s a couple. The first one is the, I’ve got this, and it’s exactly what we just talked about. It’s that comfort level. It’s the I finally feel good after a decade of time and realizing, maybe not realizing that it takes so much more than just feeling good.
Aaron Reason:
So much more.
April Knasinski:
And so that’s kind of the biggest one. The second one is kind of just getting in their own way. Right. And what I mean by that is you had talked about a little bit of chipping away of their services over time, because they do feel better. I can go back to work. I can keep myself busy. I have a family. I’m going to work on rebuilding that relationship. And they sort of feel like they’re invincible,
Michael Whitlock:
Sure.
April Knasinski:
That they don’t need those extra services, or they don’t understand the importance of what those extra services will give them as far as those barriers that you were talking about, like that wall of defense. I think also is, this is not a lifelong disease, is a mindset that some people get into. And so I’m cured, I’m done. That’s not always the case. It’s very rarely the case so.
Michael Whitlock:
I mean, several of us in the world have had COVID, right? It’s the unspeakable disease or condition that we’ve experienced over the last few years. We’re so glad to get over COVID, but this isn’t something people get over.
April Knasinski:
No.
Michael Whitlock:
It’s something that stays with you forever. You have to keep fighting. And one thing that I think has been difficult is people surround themselves with like-minded friends, typically. And when you go back to friends that are still living in the addiction lifestyle,
April Knasinski:
Yep.
Michael Whitlock:
You’re likely to fall into some old patterns.
April Knasinski:
Sure.
Michael Whitlock:
And sometimes you have to say goodbye, and it doesn’t have to feel warm and fuzzy,
April Knasinski:
Right.
Michael Whitlock:
But it’s just a truth that if these are going to be bad influences, you have to stick up for yourself and you have to say goodbye. And so I know that’s something as, and we can see that for people that are talking about reconnecting with old friends, and we know what’s coming around the corner for them.
April Knasinski:
Sure. Even outside of old friends, most of the clients I run into are going to have to say goodbye to a loved one, like a mom or a dad, or a brother or a sister, because they haven’t made the choice to get well yet. And so saying goodbye to a family, but it’s my mom, April.
Michael Whitlock:
Yeah.
April Knasinski:
It’s my dad.
Michael Whitlock:
Yeah.
April Knasinski:
I can’t abandon them. I’m not asking you to abandon them. I’m asking you to put yourself as the number one priority for a minute.
Aaron Reason:
When I got sober, I was about 60 days clean, and I’d been with my wife for 11 years, and at the time I was hoping that she would get help and she would do the same thing. But when she didn’t do that, I had to make that tough decision and walk away from an 11-year marriage because she just wasn’t ready. But I was and I knew that, and that was one of the hardest things that I had to do in the beginning. But it really is about putting yourself first. And that may sound selfish in a way, but this is life or death for me. And if I’m fighting for my life, then I can’t let anybody or anything hold me back. I take it that seriously. So,
April Knasinski:
Absolutely.
Aaron Reason:
If I’m fighting for my life, I’m going to fight with everything that I’ve got. And that means making those tough decisions and walking away from people that you love. And like you said, it’s in a respectful way. I want nothing but the best for her. But I’ve learned I can love people from a distance,
April Knasinski:
Yes.
Aaron Reason:
And I can even pray harder for them from a distance as well, and still take care of myself and my needs.
Michael Whitlock:
It might be the kick in the pants they need also.
Aaron Reason:
Yeah.
April Knasinski:
Sure.
Michael Whitlock:
Not only, or it’s only when you lose everything that you realize you’ve hit rock bottom and you need help.
Aaron Reason:
Yeah.
Michael Whitlock:
And if you stay with them, you could be bringing them down too, if you keep pushing off of each other’s addiction or feeding off each other’s addiction rather. So yeah, absolutely. It’s definitely the way to go. So I just want to thank April for coming in today.
Aaron Reason:
Yeah.
Michael Whitlock:
It was great talking to you. I love being your friend and your coworker. I love the knowledge that you bring, the love that you bring, you genuinely care. If I had a family member that was fighting addiction, I would want someone like you in their life to take care of them.
Aaron Reason:
Absolutely.
Michael Whitlock:
That would make me feel better. So thank you for your time.
April Knasinski:
Thank you.
Aaron Reason:
Thanks April. We appreciate you coming on.
Michael Whitlock:
That’s a wrap for episode four of A Reason to Live. Let’s give a shout-out to our guest, April K. So fun to talk to her. So knowledgeable. Give a shout-out to our host, Aaron Reason. Thanks for bringing your love, style and compassion to this podcast and the world of recovery. Just like to remind everybody that following us is the best way to show your love and appreciation on social media. Making sure to spread the word of each of these episodes so that people can learn about what the world of recovery and addiction looks like. Make sure to follow us and give us a rating if you so wish on each of our podcast forums. That includes Apple, Google, iHeartRadio, Anchor, Spotify, and Amazon Music. Have a great day.
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