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Weekly UpdatesIn our first year of presenting awards to honor excellence in clinical care, Addiction Professional has selected a counselor, a clinical manager and a physician who have much different backgrounds but share a passion for learning and a commitment to their clients.
The stories of Glynis Matthews, Ruthann Adam and Frederick Montgomery reflect an ability to overcome obstacles in a field with a workforce that is often described as being in crisis. We hope you find that these individuals represent the kinds of approaches you take in your own work, as well as the innovations the field seeks as it nurtures the next generation of clinical leaders.
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Glynis
Matthews
Position: Counselor
Organization: Consulting with military families for U.S. Department of Defense (served as adolescent counselor at Ernest Kennedy Center in Goose Creek, South Carolina at time of nomination)
Age: 32
Quote: "We underestimate our clientele's intelligence. They can see through us; they know whether someone is being genuine. If they have a certain level of respect for you, they will do what it takes to get your approval."
Comment from nominator: "He is a powerhouse of energy and strives to reach every client 'where they are,'" writes Barbara Melton, Matthews' clinical supervisor. "He connects with these troubled adolescents (and their families) and has the highest retention rate for groupwork that I have ever seen in 15 years as a supervisor."
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Glynis Matthews traces his success with clients to his own difficult upbringing in an alcoholic home in Mississippi's housing projects. He says there is an almost unspoken understanding between himself and many of his clients--an appreciation of shared circumstances.
After serving in the Marines and then graduating from college in South Carolina, Matthews started working in a group home for youths, where feedback from staff began to tell him that he might have found a career path. "My client talks about you a lot," he recalls clinicians telling him. "His parents are saying they're glad you're involved."
Matthews later would introduce the Matrix Model of treatment to the Ernest Kennedy Center, which serves a largely rural population in South Carolina. The treatment model emphasizes the therapist serving as a teacher/coach and building a positive, encouraging relationship with the client in order to facilitate behavior change. The approach was designed for use with individuals dependent on stimulants.
Matthews believes he represents a new wave of counselor who works to meet clients where they are situated. He tells them that the only behaviors he won't tolerate are absenteeism and disrespect, but he can handle just about anything else.
"A lot of the 'old schoolers' want to control the client," he says. "But we're not in control of our clientele and we need to understand that."
Matthews also does not hesitate to acknowledge his limitations, saying his empathy for people who have faced difficult circumstances is critical to his work and means that he probably would not be effective treating celebrities or other people of privilege. He is excited about the opportunity to reach out to returning veterans and their families through his new role with the Defense Department.
Matthews says he tends to ask simple questions of his clients: What do you want? What are you doing to get it? Is it working? The rest is about building an empathic relationship and doing what it takes to get the job done. Colleagues at the Ernest Kennedy Center remarked on how willing he was to take personal time to make sure every detail was addressed.
"You're dealing with people; what if that person was your child?" Matthews says. "Would you want someone to give your child something that is lukewarm? Nothing about me is lukewarm."
PHOTOGRAPHER: KEITH DENNIS
Ruthann Adam LCDC
Position: Clinical program director
Organization: Memorial Hermann Prevention and Recovery Center, Houston
Age: 51
Quote: "We're always working with counseling interns; my concern is that I don't want to just let them loose on the patients. They are attached at the hip with other counselors, for at least 500 to 1,000 hours. We have to find out if they're serious about doing this, and if they have the temperament."
Comment from nominator: "She had led the diversification of the clinical programs to include a focused young adult program curriculum (18-24 year olds) and an executives and professionals program that works closely with state organizations that monitor nurses, physicians, pharmacists and other licensed professional groups," writes Matthew Feehery, Memorial Hermann's CEO for behavioral health services. "Ruthann also helped assemble a top-notch bilingual treatment team to serve the cultural and language needs of Hispanic individuals, thereby creating one of the few Spanish speaking residential programs in the U.S."
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Ruthann Adam was 13 years into her sobriety when she began to pursue work in the addiction treatment field for a second career. She worked in admissions at Memorial Hermann before becoming clinical director for the prevention and recovery operation about two years ago. "It was more in my manager's mind for me to advance," she says. "He said I would make a good director."
Adam is linked to a number of addiction treatment innovations in the large and nationally known health system, including establishment of a treatment team fluent in Spanish and a continuing care program that routinely attracts more than 250 participants on Saturday mornings. Her observations about the multifaceted needs of the patients Memorial Hermann serves have usually led her to pursue a new certification for herself and a new treatment track for the center.
"The patients continue to need longer lengths of stay, but the resources are not always available," Adam says. "We make sure that somehow the patients get what they need; we don't turn patients away."
Adam is a strong believer in meeting the needs of patients through the cooperative activity of a multidisciplinary treatment team. "We need to look at the whole person, so we can put this puzzle together," she says. "I want to hear from everyone. I listen to my counselors and I listen to the other doctors. I learn from the other clinicians."
Adam, who in 2005 was named member of the year by the Texas Association of Addiction Professionals, oversees a clinical staff of about 35 for an operation of 90 inpatient beds and 100 outpatient slots. But in some ways she believes it is the patients who run the operation, in the sense that their needs dictate both the individualized treatment approaches and the general programming that is made available to all.
She looks for counselors who respect patients and are teachable and ethical. "I see enthusiastic people wanting to come into the field," she says.
Adam adds that she has learned from past supervisors that it is possible to be firm and compassionate with clients at the same time. This approach was embodied in a T-shirt that one of her first groups of patients admiringly created for her. The shirt pictured a dog with a chain in its mouth and a fitting takeoff on her first name: "Ruthless."
PHOTOGRAPHER: JOHN LYNCH
Frederick Montgomery MD
Position: Medical director
Organization: Sundown M Ranch, Yakima, Washington
Age: 69
Quote: "We approach things here in a very basic way that is wonderful. We don't deal with the thinking that says, 'I drink because my wife hates me, or because I have an eating disorder.' We're cognizant of all the other issues, but our approach is, 'You drink because you're an alcoholic. You have a genetic difference, and you've got to stop drinking.'"
Comment from nominator: "Early on Dr. Montgomery realized the value in medical students gaining an understanding of alcoholism and the treatment offered at programs like Sundown M Ranch," writes facility executive director Scott Munson. "Beginning in the mid- '70s he invited medical students from the University of Washington to Sundown for a practicum. This program continues today with each of the residents in the local family practice program doing a rotation at Sundown during their second year."
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Frederick Montgomery's perspective on addiction as a young physician did not differ much from the stereotype. In medical school he had done biopsies on alcoholics' livers, and he saw these individuals as representing a subculture completely foreign to him.
One of the young patients during Montgomery's residency was a parole officer who had been experiencing serious personal problems. It was not until the patient contacted him a couple of years later that Montgomery learned the man was an alcoholic. But the two had connected, and now that the former patient had gone into recovery and was working at Sundown M Ranch, he was calling to offer Montgomery a job.
Montgomery knew little about chemical dependency when he was hired as a psychiatric consultant in 1973, but by 1975 his inquisitiveness and his effectiveness with patients had landed him the medical director's post. Even with today's bureaucratic demands on treatment administrators, Montgomery says nearly all of his time is still spent on patient issues.
"I try to determine their psychiatric status," he says. "I see how they relate to me, and I explore their personality style and how it should be dealt with."
The work is a cooperative venture with treatment staff, who he believes have much to teach him about work with alcoholics. In the meantime, he is primarily responsible for managing client medical issues ranging from chemical withdrawal to demential to co-occurring mental illness.
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