“I came to this work honestly, as a patient first.” Robert Hilliker joins us from Ethos Behavioral Healthcare. He shares his journey from his first experience with therapy as a thirteen-year-old through getting a PHD in Clinical Social Work to starting multiple organizations with the intent to put mission in front of margin. They are hyper-focused on patient experience, team values and recovery success. He says, “Anybody that is not in long term recovery in my family system has died from addiction.” Enjoy.
The Illuminate Recovery Podcast is about Mental Health, Mental Illness, and Addiction Recovery. Shining light on ways to cope, manage, and inspire. Beyond the self care we discuss, you may need the help of a licensed professional. Curt Neider and Shelley Mangum are a part of Illuminate Billing Advocates (illuminatebilling.com). They are committed to helping better the industry and adding value to the lives of listeners by sharing tools, insights, and success stories of those who are working on their mental health. #illuminaterecoverypodcast
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i came to this work honestly as a patient first robert hilliker joins us from ethos behavioral health care he shares his journey from his first experience with therapy as a 13 year old through getting a phd in clinical social work to starting multiple organizations with the intent to put mission in front of margin they are hyper focused on patient experience team values and recovery success he says anybody that is not in long-term recovery in my family system has died from addiction enjoy welcome to the illuminate recovery podcast we shed light on mental health issues mental illness and addiction recovery ways to cope manage and inspire beyond self-care we will discuss you may need the help of a licensed professional my name is kurt neider i'm a husband father entrepreneur a handyman and a student of life i avoid conflict i deflect with humor and i'm fascinated by the human experience and i'm shelley mangum i am a clinical mental health counselor and my favorite role of all times is grandma i am a seeker of truth and i feel like life should be approached with tremendous curiosity i ask the dumb questions i fill in the gaps the illuminate recovery podcast is brought to you by illuminate billing advocates make billing and collection simple with leader in substance abuse and mental health billing services verification and analysis of benefits pre-authorizations utilization management accurate claim submission and management denial and appeal management and industry leading reporting improve your practice's cash flow and your ability to help your clients with eliminate billing advocates uh curt and i have the privilege of talking with robert hillicker today robert is the chief executive officer at prairie recovery center and chief clinical officer at ethos behavioral health group robert is driven by a deep commitment to serve others and is passionate about the subject of hope and despair in clinical treatment his 20 years in the field of addiction and mental health encompasses private practice clinical supervision the creation and management of clinical programming and co-founding of the lovett center in 2014 and co-founding of ethos in 2018. um robert i have no doubt that you've had a profound influence on the industry and we're you know kurt and i are super happy to be able to talk with you and have a conversation today on on this episode so thanks for being here yeah thank you thanks for having me and uh glad to be with you guys absolutely so it's always kind of nice to start out um introducing yourself maybe giving a little bit of background how you ended up in the industry i've yet to find anybody that you know grew up going yeah this is where i want to work i want to work in substance abuse and mental health recovery i might i might be that person for you then shelly because this is so i'll tell you i come from a long line of alcoholics i'm actually the third generation of my family in recovery so grandparents parents me anybody that's not in long-term recovery in my family system has died from addiction so it's it's it's it's a bit of an either or a proposition um in a lot of ways um and uh and so um you know i got into this workout many people get into this work in terms of behavioral health which is i was a patient first i come by the work honestly i came in as a patient and i stayed because this is what i wanted to do i knew at a really young age this was absolutely what i wanted to do i was actually 15 years old when i went to my grandmother who's a therapist and i said um hey i want to i want to train to be a clinical social worker and um she asked me a really important question she said you know if you saw thousands of people in your career and only definitively helped one of them would it be worth it and i i sat with it she asked me to kind of sit and think about that and i came back to her later and i said yeah i think it would and she said then i think you should do it and and so you know i feel like at least one person's been helped uh so the rest is is kind of gravy and uh and that's you know been the last um in the last 20 years of my life i started out in the field as a paraprofessional kind of working while going through school but working in the industry and in the field in a variety of different roles and settings and then um you know got you know my when i earned my master's really began working in my kind of area of practice now which is which is largely related to you know professionals with substance use and cochrane mental health so i have a lot of psychiatric training in my background but because my recovery you know personally and professionally that's been a continued interest and i tend to work with attorneys about 80 of the people i see are actually attorneys [Music] i always kind of joke if you know people feel like their patient is difficult they're probably my patient and i like that i think they're wonderful and really enjoy immensely working with with those folks so yeah that's um it's interesting because i've always said that um you know people who who go through or deal with the struggle of addiction and mental health um are typically some of the highest functioning people that i know right they just are incredible people and and they have these obstacles in their way and and being able to go through that recovery process and and do the work and really do the deep work um it's evident in the outcome right and when i look at the different kinds of things that you've been involved in robert and the influence that you've had in the industry i would say that you're you know we might call you an overachiever because yeah because you've got a lot a lot of stuff going on and you've made a lot of difference um and it and it might be valuable to talk maybe a minute for you know you talk about so many people in your family that were you know dealt that dealt with addiction and that suffered with addiction maybe talk about that struggle in growing up in that and how you kind of how you got past it because that's that's not always easy yeah you know um i i i think i was exceptionally lucky and i think people that know a lot about my background would find that kind of an interesting statement because we grew up you know relatively you know poor uh abuse of all kinds and um all sorts of really dysfunctional stuff within that system but i had some wonderful wonderful things as well like you know if you look at are you familiar with aces i'm sure adverse childhood experiences so if you look across that and you take like an aces test i have like i'm like a affirmative yes for like all of the adverse childhood experiences but then if you look on the other side of that there's a resiliency test and i have all the resiliencies as well right i was really clear that i had people that loved me um i had that there was exceptional care taken to get me into treatment early um really early in my life and it changed the whole trajectory of my life and i had tons of people um i had a a pretty meaningful community of support even in the midst of struggle and lots of other things and um and that that idea of strong social ties and meaningful relationships is what um is what sustains me today so you know i was just really lucky in that regard to have that i i i i never questioned whether my parents loved me or wanted the best for me or anything like that there's just a lot of profound struggle and all that and and so i had kind of both the the hardships and some of the challenges and um all those factors that facilitate resiliency so really in a lot of ways and just quite lucky yeah very lucky and and but i think i think it's an interesting piece because a lot of a lot of people that i've come across and that others come across they have that resiliency piece they just haven't learned to apply it you know into something other than addiction right yeah right so being able to to bring that up and say hey look you do have all these resiliency pieces and you're incredibly talented let's just you know i mean in order to survive in a in an addictive in a really heavy addictive um pattern you got to be able to do some really cool survival things right and be very resourceful and and those are resiliency pieces and so i like that you bring that up because i think it's vital yeah yeah i i think um you know you talked about this idea about achievement i think there was a time in my life where achievement mattered a lot more than it does now um i think at the end of the day what i've really settled into is that you know if you're looking at the enneagram i i'm not so much i i don't have as much of that three kind of achiever energy um as much as i am very squarely in the in the camp of of being a seven an enthusiast um i i'm i love uh kind of everything i have kind of a passion and a lust for a lot of things right um and so i i pursue stuff in a kind of doggedly and that that is really more where that that comes from these days it's less uh feels less about achievement and taking some just how i am in the world that that would have fueled addiction and use it for the benefit of recovery and trying to be in service to people and trying to like for example grow ethos grow our behavioral health company grow right now you know my my principal role within our company is is really trying to grow the prairie recovery center and let people know kind of uh the incredible work that i think we're doing here um in terms of treatment and um and so yeah i i get um i get really passionate about it i get really excited about um you know lots of things i'm definitely an enthusiast and then i have enough of that kind of eight-wing boss leader energy if you're familiar with the enneagram stuff that um that it kind of holds it all together and i'm not just like floating off in the clouds but i like that justification right you're grounded it's all it's all good maybe talk while you've brought it up talked about you know ethos and prairie and and maybe even love it too because you've you know you had a hand in that as well talk about the relationship between those organizations and your role in that sure yeah and and i can back up and say you know so i trained a builder psychiatry clinic uh what feels like a long time ago now under glenn gabbard which was an amazing experience then um went on to train as a postgraduate phillip meninger and that really shaped a lot of my developmental experience and in terms of my philosophy of care my approach to care being psychodynamically oriented i went on to do two years of postgraduate fellowship training at the center for psychopsychoanalytic studies in houston and um and then went on to do doctoral education at icsw which is the institute for clinical social work in chicago and that's all psychodynamically oriented so i was trained in this pretty neofreudian tradition and then i later came out of the closet as a jungian which is something i like to talk about now in terms of my approach and and the centrality of spirituality and dreams and um and imagination and all of that um so my that training background is important because it informed a lot of how i approach building and developing systems of care so the lens through which i see the world is this psychoanalytic psychodynamic lens a very relational psychoanalytic lens and so um i found it very interesting and that's how love it really started i had started a company in 2011 with brene brown um you may have heard of her um it's called the daring way and i was the chief clinical officer and um and and we um we did some incredible stuff she had great foresight which is not surprising and she was like what's next for you and i was like this i love this and she was like no you've got your own unique ideas to contribute to the world like what will that be and so i left there i actually started love it concurrent to my role there and then realized that love it in order to really take off needed you know my full-time kind of attention so i really um concentrated my energy and my efforts in that direction and along with my partner at the time and still my partner but at that point it was just he and i which is myself and will davis and then we later brought on a third managing partner stacy torn who's been incredible she has a doctorate from usc in clinical social work um and very importantly she has a background in finance um was it in ron what's that other places so it has this wonderful financial mind because my basic strategy up to that point was uh yeah sure i think we just if we if we make more money than we spend you know we'll just keep growing and um and she's like yeah it's a little bit more complicated than that at this point so um so it's above my pay grade so um stacy's been a wonderful addition to our our partnership so those are our three kind of managing partners but what we did was in 2014 we started love it as a community for health professionals and all this is to say i started to apply psychodynamic thinking not just to how i thought about patients but how i wanted to think about our the way we do things as practitioners in the field so i tell this story about how i was sitting across from people talking about how important it was to be meaningfully connected sitting with patients and then in between patients i found myself completely alone and disconnected that's the world that most clinicians in this field live in particularly in private practice they espouse the meaning of connection and they practice in movies that are totally isolated low you know clinicians basically have this experience of of you know understanding connection but not living in a way that actually reflects it and so that's what love it was about as a community of health professionals was the idea of bringing people together where they could co-locate their practices have a whole lot of specializations under one roof and collaborate in meaningful ways what i didn't anticipate was understanding that i i just didn't i probably didn't know enough about most therapists because i like most people projected the way i am which is pretty entrepreneurial and willing to kind of assume risks and jump out there and do things and what i actually found was that most clinicians didn't want any of that they didn't they actually kind of came to us and said can we just work for you in kind of a different way can we work for you but have this culture that you're talking about and so that really was um so so love it was this proving ground it was our kind of great experiment and it's still operating today as ethos wellness love it it's part of our one of our ethos locations and kind of our flagship outpatient center it's beautiful it's a sixteen and a half thousand square foot building in the heart of um uh montrose in houston um and they're doing you know i mean it probably even today see you know we see 2 500 to 3 000 patients a week out of that location i mean it's it's amazing they're they're you know the work that's happening there is incredible but what we've grown into is ethos behavioral health group is really something altogether different where we have a whole system of care um with that represents about 150 people in total and spans across medical detox residential care php iop supportive outpatient after care and regular outpatient and we're in texas five locations in and around the houston area because we're i don't know how much you know about houston but it's a great example of urban sprawl we just kind of like go further and further out and so we you can have five locations in a space and still not be um too too um densely populated there uh in you know can't you don't start cannibalizing your own locations because it's just such a huge city and people are so spread out um and then we have our chicago campus which we've operated for several years it's got a wonderful program manager there named taylor johnson and um and then we have dr modiano who's a an incredible addition psychiatrist based out of that location he's wonderful so great team in chicago and then recently we've added california and specifically an office in sacramento that savannah malcatian has gone to open which is really exciting as well so that's kind of you know where where we started and where it's come to in a nutshell each layer of that growth and development has really been about growing in ways that reflect that idea of a dynamic workplace environment a psychodynamically oriented system of care not just for patients but also for us to think about ourselves and to work collaboratively in meaningful ways together and so the community i'm really proud of our team at the prairie i brag on them a lot uh but we [Music] you know gosh like half the people out here i've known for close to 20 years and so even though we opened the program uh bought the facility in 2018 renovated it to open as a residential facility in 2019 it feels like we've been operating forever because the team we have are it's all 20 20-year relationships 15-year relationships and so we have this incredible culture here of really love and belonging and connection and that permeates how we show up with patients really clearly and so i'm super proud of that i feel like well i'd say my crowning achievement in life is that um i've maintained a successful marriage to my lovely wife and we have four children but outside of our children and um and our marriage i'd say uh you know this has been kind of the crowning jewel of my kind of work workplace achievements well it's and it's incredible what you're able to accomplish i know we were talking you know kind of pre-show about the idea of of private equity you know companies coming in and buying up um organizations substance abuse and mental health organizations and and kind of what happens in that field so let me ask you this question as you build um you know ethos and it grows and and it sounds like it's growing you know pretty pretty well um pretty in a healthy way how do you how do you keep how do you keep it pure and and with that same image and and same um culture that you're talking about yeah so um well i'll tell you uh it's a it's a great question and i and i i kind of wish we had started recording our pre-show interview because we got into some fun stuff so maybe we can we can rap about that now but um you know it's a great question i think one one thing is um we're always a kind of mission first organization so we put mission in front of margin and what that looks like is not sacrificing the quality of political service delivery um really putting that first as as our highest priority the patient experience is really critical and my belief is that if you do really good work with people that you'll make money like you'll like business will grow organically as a function of of doing the right thing first right and um and a lot of people don't see it that way and private equity can't see it that way because the way that it's structured is is in a three to five year turn right and a lot of times it's that in our field it's that kind of five year turn and so they ride the reputation of something that's been built but deteriorate the quality so they're undercutting the quality at every step of the way so that there's something profitable to kind of flip and sell you know sell along uh you know and and not really have to worry about what happens after you know i always think like what happens after these behavioral health groups make three or four of those turns so it can't be anything left you know it's got to be like what else can you cut you know like no water no you know you can't have anything you know like you know we're not feeding you anymore um so there's nothing left to cut um but you know to your point about how do we how do we grow i'll tell you how i started my day 7 30 a.m every monday we have a team call and we hop on and i um introduce one of our staff values so our first staff value is have fun the second is love and serve others the third is is about fostering hope which is really central to our treatment the one i covered today last week it was no mistakes only key learning where key learning culture that's something i learned from renee in my time working with her is that if you want to have a cultural environment that's interested in learning about one another you've got you can't focus on mistakes you've got to organize it as a key learning and so we have that kind of no mistakes only key learning but one i covered today was about embracing change and i kind of introduced some ideas about that how we think about that in relation to our patients but also how we think about that personally and then our entire staff you know whoever wants to chime in starts to chime in on the call and and a lot of times you know they're relating to it in a professional manner but they're also relating it to it in a deeply personal way uh and uh and so people are talking about the ways that they struggle with change in their own lives personally in their own recovery journey or whatever that process looks like and we've obviously gone through a ton of change uh in the course of the global health pandemic we've gone through immense changes you know the fact that we're doing this virtually and not in person or something you know all of that is informed by um the change that we've been through and uh and so you know we're you know that's part of how we um part of how we would stay true to mission and stay true to form is is basically um you know maintaining those kind of meaningful relationships and connections within our company regardless of the size um and part of that's broken up you know it starts to break up by location right so you have more individual location leadership um that manages that because we're a lot like primates people are you know uh outside of you know where and it's funny you know that like a primate group with a troop of chimpanzees or something probably in a group that averages maybe like 150 right and we're at that mark we're at like 150 and outside of that 150 right um there would be a new troop that forms or something and so for us i think what growth beyond this point looks like is is is cultivating more middle management and individual location leadership to really um empower them to to lead teams and to to feel like they have a hand in day-to-day management in a meaningful way and uh and and just working with those leaders to stay really committed to mission um you know our our our our kpis are like you know do people feel loved when they leave our treatment you know i mean that that's literally one like that's one of our exit evaluation questions like i i don't know another treatment center that asks like do you feel that the staff here genuinely loved you um and that's super important to us um and i my hope is that that comes through at every level of what we do that's um it's quite incredible robert what because what i hear you saying is what we all talk about in you know in the therapeutic world and in the clinical world we all talk about how connection is the opposite of addiction and connections vital but this this point that you bring up is is very interesting and maybe one of the reasons why i moved away from private practice is i had in my mind that there should be this association of clinicians that are helping and supporting each other and it never felt like that's what was happening but here you've created a space in and how long when you when you get on the phone at 7 30 how long are you talking with your team um that that's a 30 minute call that we start our day with um so we do that every monday um and then we'll convene again like here uh we'll convene for 90 minutes at 1 o'clock today with the patients so we bring like at the prairie we do a community meeting we bring all patients and staff together and we have a kind of psychodynamically oriented um in a way group time together where we're reflecting um and the staff are encouraged to really contribute in meaningful ways um with the patients obviously you know there's a use of self we we're really diligent about that we're not putting our problems on patients or sharing in ways that are inappropriate but um but we're real people and um and you know um i think that really comes through in what what it is that we do and our passion for working with people um so yeah they call this morning is it's our 30-minute kind of start to the week and it gets everything rolling and everybody hops into their 8 a.mwith a different sense of connection it doesn't that's the thing it doesn't take doesn't take much it's it's more about intentionality it's about creating and holding space and some intention for that than it is about you know taking seven hours a week to do team building or something um you know uh i think that 30-minute call will will be more meaningful to people than um than any like icebreaker you know uh team building thing you know trust falls or whatever else that people do so we do kind of go for that change that you've been talking about right changes it's the challenge is that it's just not always the same it's always different you've got to kind of navigate that so part of the positivity of that is looking at okay over the last 18 months and the change that we've all had to go through and with covet is to say okay there are definitely some negatives but what are the positives right we do a podcast and two years ago if we would have said hey we're going to do a podcast and we're just going to do it over the phone it probably would have sounded pretty inauthentic right or or forced whereas like now that's just what people do we're familiar with it right we're ready to do it our you know our company we work remotely everybody's remote so all of this stuff we're super familiar with friday night we all got together and went to a baseball game and it's i mean in eight months probably the first time that most of those people even seen each other right so to me that's kind of a negative right like we've gotten used to this good change this remote working thing but it's different so how do you like kind of maintain that authenticity and that kind of thing because you bring up the monkeys thing and the leadership thing where my immediate thought was like well yeah but monkeys don't have technology right they don't have the ability to connect with more people you can probably you know lead effectively and have a close connected organization of much more than 150 people because you have this ability to be seen and to communicate effectively but how do you collect that communication back right that's one of those challenges for you to get back you know how to get higher than 150 is those people can get to know you through that monday morning meeting and some of those other ways to connect but how do you really stay in touch with that group of 150 people and that's part of that growth right it's not it's not impossible or easy or or anywhere in between it's just how do you do it you know it's different for everybody right right and i think that's what i you know was speaking to in terms of empowering middle management and leadership to kind of you know really step in and fill that gap i can't you know if we have nine locations i can't be i can't even visit all of them uh for one day a week seven days you know if i work seven days a week um but uh that's where the partners come in right myself will and stacy we kind of divide and conquer in a lot of ways um really taking on um different facets and elements of our business and different sectors of our business in a really meaningful relational way um and then you know i meet with i meet with people one off and and have lunches and coffee and we really do a lot of i would say more often than not um we spend a lot we spend a lot of our time doing a lot of internal outreach you know and you're right about technology and the role of technology and we have done a lot to improve systems and processes and to leverage technology to drive change in meaningful ways in our in our organization over the last few years particularly the last two years has been this kind of like hockey stick curve uh kind of just you know growth for us in terms of what's happened in the midst of all this i mean we overnight we had to reinvent ourselves talk about embracing change we had to reinvent ourselves as a telehealth company you know um 90 of our business went online and it was just it was wild you know but we've adjusted accordingly and all that now with delta variant where we're you know we have returned largely to in-person uh interactions now we're being you know we're having to do more masking we're having it you know just be really vigilant and and mindful about the the the health health and safety aspects and qualities of that so we've been really attentive to that and i'm proud to say that we've you know knock on wood we've we've managed that effectively for you know the last year and a half or whatever but to your point about technology i believe that technology has outpaced our capacities in terms of our our relational world right so um so while we can maintain connections to thousands and thousands of people and i can post updates on instagram and facebook and linkedin and whatever other platform you want to utilize um that that sense of relationship that sense of knowing someone the capacity to be vulnerably and meaningfully connected to them probably caps out at a much lower uh a much much lower number and so you know what what we're trying to do is um how do you grow reach more people serve more people help more folks but do it in a way that still feels meaningful relationally of course first and foremost the patient but also to the staff and technology you know has its its drawbacks in terms of you know it if we're not careful it becomes the tail that wags the dog it can absolutely dehumanize us um and so we try to be really vigilant about how do we leverage technology to drive change while also being really attentive to the fact that we're in it we're in an industry that's about people and and that that means facilitating real and meaningful connection to people um so we still do a lot uh a lot in the way of trying to do that it's interesting that you talk about the ability versus the ability to kind of know versus actually connect because there are like some social changes there that are kind of slowly occurring right like i i'm not on much social media beyond linkedin but i kind of you know for family members see it there's this ability to know so much about people that you don't actually know right or or that you're not you know they might even be friends but you're not necessarily staying in touch but you know what's changing and you know what's occurring and then when you see them in real life do you pretend like you don't know any of those things like is it assumed that you know those things you know or like there's people that you're friends with online that you wouldn't even say hello to at the grocery store or if you did it would be awkward like we don't know each other we've never talked but like we we've liked each other's pictures a thousand times you know like there's this kind of this right lack of connection in that relationship and then also like kind of this cultural dynamic that has to change about that over time so it'll be interesting to see what we do with that as humans but yeah no no doubt i mean i think um and we're seeing more and more of the kind of detrimental impact that that has on people um the capacity that we have these days uh for anonymity is really um it creates some challenges you know what people will say and do under the guise of being anonymous versus what happens when you when you actually have to like show up and and kind of own that so it's it's interesting i think a lot i i think technology is vastly um technological development has vastly outpaced um human development um human beings we're we're not engineered to change as rapidly as the world has changed around us and uh and so that that that's a fascinating thing and it creates all sorts of challenges i mean um i mean we see it a lot in in treatment you know one of the co-occurring issues that we now see and treat in treatment is people's kind of addictive uh connection to technology right the way that they can't put it down the way that they can't disconnect from it or be with themselves or look inward and so there's there's you know part of treatment is largely creating a kind of separation from some of that and a reflective space to be able to actually look inward at yourself um for a minute you know so true story and i'm wondering you know as you talked about that idea that you know just doing telehealth you know we you can help people and you can make some connection um but i've heard it from just many many many clients is i can't do much more of this virtual treatment or you know this virtual stuff what's what's that looking like with your with your community you know um it's a really mixed bag i was talking about it with a guy this morning who's saying you know i'm really you know tired of this and and this and that and no doubt i mean there's a part of me that um i i will tell you that i think zoom or any of this stuff is is a distant distant second place from in person interaction and and and the felt experience of being with someone um hands down the flip side is it has created an accessibility to care for people um i'm seeing a lot of people that i i i probably still see more people clinically than i should um but it's what i'm passionate about so i love it and i continue to see people clinically so um i'm seeing people in kind of more remote and rural areas of texas that i've picked up in the last year and a half that have said hey all of a sudden treatments treatment's doable for me and so for them it is a lifeline that was non-existent and you know two years ago it wasn't even on the radar um not in this way i mean telehealth was of course but but but not not like this not where people like me who would have never really elected to do a lot in the way of telehealth suddenly is doing uh most of my stuff virtually the other thing is because i see professional folks let's see that let's say they drive down to my office for you know you know essentially one hour session well houston traffic etc time of day whatever tack on 30 minutes each way it now there's two hours of their time so let's say they're an attorney that bills i don't know 500 an hour a thousand an hour i mean whatever they whatever they're doing the opportunity cost for for attending care is tremendous to them so they're like so not only do i have to pay you your fee but i can't see the people that i build by the hour and and when you chunk out your weak and billable service units or hate billable units of time as as attorneys and a lot of other professions do the idea of virtual is like man i can take an hour i take an hour for lunch i can sit at my desk and see you and it's again created an accessibility that wasn't there before so people who who might have said hey this is a barrier to accessing care like i can't give up a chunk of my day 25 of my work day or something like that to go see you well now it's like no you're taking your lunch hour you know um and that that's actually uh you know kurt was talking about what what are those kind of almost you know the silver linings in this that's kind of a silver lining in some of this is we've seen some changes to accessibility that are ultimately positive um i think some of this stuff is here to stay obviously i think there's going to be a number of people a growing number of people wishing to return in person and that's okay most of our stuff these days now is hybrid we're doing a mixture of in-person and online and just trying to manage all that safely and effectively and i totally agree with what you're saying there's there there's opportunities that have opened up that we've been talking about opening up for years and covet has kind of forced that hand it'll be interesting to see how that levels out as as as covid does whatever kova does and and we can get back into you know face to face if we want to because it's i think telehealth is here to stay it's not going away even if covet you know when and if covet does yeah yeah i i quite agree i think and and we've seen that even with with access to recovery communities and 12-step communities and things like that i think it was unheard of to imagine you know really going to meetings online you know it was like no if you if you're in a densely populated urban area there's tons of meetings lots of opportunities to go but people have been able to start attending meetings in london and sydney australia and like cool like it's created it's it's the world uh has become way more accessible in terms of recovery communities all over and i think people are really intrigued by that and want i mean from what i'm seeing i i think it's going to be a mixture of people that say you know like it used to be like how many meetings a week do you hit you know if you're in 12 community or whatever like you know gotta three meetings a week or go to five meetings a week or whatever it is i think um the the the [Music] way we're gonna be talking about that from here on out is like i go to two in person meetings and and two zoom meetings or you know i catch this in person home group and then you know the rest of my stuff i do on zoom or whatever um so that that that i think is gonna be really interesting it's it is and and it'll and it's interesting to watch and go you know really how's that gonna land where's that gonna land but it's not going away and it's super valuable i um i am a bernay brand you know brene brown a fan and and you know love her work and love what she's done and i can see that you know that experience and that time working with the daring way and and building that has definitely influenced the work that you do here um i mean you know i know she's not the only one that does that kind of work but she's she's really it's it's out there and she's done a great job of organizing it and implementing it and it's it's incredible so i love to hear you talk about that and implement those in your culture as well yeah yeah um you know yeah i mean renee's one of a kind um she's she's contributed a lot and she's a thought leadership in our field and um and it's been one of those things that uh you know i'm really glad that you know in a lot of ways um i kind of you know i had done some startup type things before that but that was i would say you know as an entrepreneur that's really where i cut my teeth this is in that work um with her and i'm so glad that she had the foresight to say hey you have these like unique contributions to make the to the field what will that look like and really challenged me to actually think beyond um what i saw as kind of an endgame um uh she had the foresight to kind of think is is a is a launching pad um and and i'm super grateful for that always will be and and it's been true uh i i've been able to contribute a lot of my own unique intellectual property to the to the world as a function of that and not feeling like i had to um play small in her shadow or stay stay put there but um could go and do other things and uh so that's been that's been really remarkable but then take the best of those parts you know best parts of that experience and re-articulate them in the things that i've continued to do so i'm really really glad for that it's incredible um robert it's been so fun having you on today i know we could talk for hours and hours about the industry and we were talking earlier about the work that's done in the background to advocate for these people for clients and and people in treatment i have a hundred questions about what does it look like to work with with attorneys and you know the minds those working minds but we'll have to save that for another time but uh this has been pretty incredible i i appreciate you being on and and for the work that you do because i can tell that it really is it's it's it's got a culture which i'm always about culture right you build that culture and the rest will you know evolve off of it and grow from it so i love to hear that yeah yeah well thank you guys for taking the time to visit and you know i i enjoyed the conversation and like you said there's there's probably 10 other things to talk about so i hope we'll we'll continue that yeah definitely we need to for sure thanks robert
i came to this work honestly as a patient first robert hilliker joins us from ethos behavioral health care he shares his journey from his first experience with therapy as a 13 year old through getting a phd in clinical social work to starting multiple organizations with the intent to put mission in front of margin they are hyper focused on patient experience team values and recovery success he says anybody that is not in long-term recovery in my family system has died from addiction enjoy welcome to the illuminate recovery podcast we shed light on mental health issues mental illness and addiction recovery ways to cope manage and inspire beyond self-care we will discuss you may need the help of a licensed professional my name is kurt neider i'm a husband father entrepreneur a handyman and a student of life i avoid conflict i deflect with humor and i'm fascinated by the human experience and i'm shelley mangum i am a clinical mental health counselor and my favorite role of all times is grandma i am a seeker of truth and i feel like life should be approached with tremendous curiosity i ask the dumb questions i fill in the gaps the illuminate recovery podcast is brought to you by illuminate billing advocates make billing and collection simple with leader in substance abuse and mental health billing services verification and analysis of benefits pre-authorizations utilization management accurate claim submission and management denial and appeal management and industry leading reporting improve your practice's cash flow and your ability to help your clients with eliminate billing advocates uh curt and i have the privilege of talking with robert hillicker today robert is the chief executive officer at prairie recovery center and chief clinical officer at ethos behavioral health group robert is driven by a deep commitment to serve others and is passionate about the subject of hope and despair in clinical treatment his 20 years in the field of addiction and mental health encompasses private practice clinical supervision the creation and management of clinical programming and co-founding of the lovett center in 2014 and co-founding of ethos in 2018. um robert i have no doubt that you've had a profound influence on the industry and we're you know kurt and i are super happy to be able to talk with you and have a conversation today on on this episode so thanks for being here yeah thank you thanks for having me and uh glad to be with you guys absolutely so it's always kind of nice to start out um introducing yourself maybe giving a little bit of background how you ended up in the industry i've yet to find anybody that you know grew up going yeah this is where i want to work i want to work in substance abuse and mental health recovery i might i might be that person for you then shelly because this is so i'll tell you i come from a long line of alcoholics i'm actually the third generation of my family in recovery so grandparents parents me anybody that's not in long-term recovery in my family system has died from addiction so it's it's it's it's a bit of an either or a proposition um in a lot of ways um and uh and so um you know i got into this workout many people get into this work in terms of behavioral health which is i was a patient first i come by the work honestly i came in as a patient and i stayed because this is what i wanted to do i knew at a really young age this was absolutely what i wanted to do i was actually 15 years old when i went to my grandmother who's a therapist and i said um hey i want to i want to train to be a clinical social worker and um she asked me a really important question she said you know if you saw thousands of people in your career and only definitively helped one of them would it be worth it and i i sat with it she asked me to kind of sit and think about that and i came back to her later and i said yeah i think it would and she said then i think you should do it and and so you know i feel like at least one person's been helped uh so the rest is is kind of gravy and uh and that's you know been the last um in the last 20 years of my life i started out in the field as a paraprofessional kind of working while going through school but working in the industry and in the field in a variety of different roles and settings and then um you know got you know my when i earned my master's really began working in my kind of area of practice now which is which is largely related to you know professionals with substance use and cochrane mental health so i have a lot of psychiatric training in my background but because my recovery you know personally and professionally that's been a continued interest and i tend to work with attorneys about 80 of the people i see are actually attorneys [Music] i always kind of joke if you know people feel like their patient is difficult they're probably my patient and i like that i think they're wonderful and really enjoy immensely working with with those folks so yeah that's um it's interesting because i've always said that um you know people who who go through or deal with the struggle of addiction and mental health um are typically some of the highest functioning people that i know right they just are incredible people and and they have these obstacles in their way and and being able to go through that recovery process and and do the work and really do the deep work um it's evident in the outcome right and when i look at the different kinds of things that you've been involved in robert and the influence that you've had in the industry i would say that you're you know we might call you an overachiever because yeah because you've got a lot a lot of stuff going on and you've made a lot of difference um and it and it might be valuable to talk maybe a minute for you know you talk about so many people in your family that were you know dealt that dealt with addiction and that suffered with addiction maybe talk about that struggle in growing up in that and how you kind of how you got past it because that's that's not always easy yeah you know um i i i think i was exceptionally lucky and i think people that know a lot about my background would find that kind of an interesting statement because we grew up you know relatively you know poor uh abuse of all kinds and um all sorts of really dysfunctional stuff within that system but i had some wonderful wonderful things as well like you know if you look at are you familiar with aces i'm sure adverse childhood experiences so if you look across that and you take like an aces test i have like i'm like a affirmative yes for like all of the adverse childhood experiences but then if you look on the other side of that there's a resiliency test and i have all the resiliencies as well right i was really clear that i had people that loved me um i had that there was exceptional care taken to get me into treatment early um really early in my life and it changed the whole trajectory of my life and i had tons of people um i had a a pretty meaningful community of support even in the midst of struggle and lots of other things and um and that that idea of strong social ties and meaningful relationships is what um is what sustains me today so you know i was just really lucky in that regard to have that i i i i never questioned whether my parents loved me or wanted the best for me or anything like that there's just a lot of profound struggle and all that and and so i had kind of both the the hardships and some of the challenges and um all those factors that facilitate resiliency so really in a lot of ways and just quite lucky yeah very lucky and and but i think i think it's an interesting piece because a lot of a lot of people that i've come across and that others come across they have that resiliency piece they just haven't learned to apply it you know into something other than addiction right yeah right so being able to to bring that up and say hey look you do have all these resiliency pieces and you're incredibly talented let's just you know i mean in order to survive in a in an addictive in a really heavy addictive um pattern you got to be able to do some really cool survival things right and be very resourceful and and those are resiliency pieces and so i like that you bring that up because i think it's vital yeah yeah i i think um you know you talked about this idea about achievement i think there was a time in my life where achievement mattered a lot more than it does now um i think at the end of the day what i've really settled into is that you know if you're looking at the enneagram i i'm not so much i i don't have as much of that three kind of achiever energy um as much as i am very squarely in the in the camp of of being a seven an enthusiast um i i'm i love uh kind of everything i have kind of a passion and a lust for a lot of things right um and so i i pursue stuff in a kind of doggedly and that that is really more where that that comes from these days it's less uh feels less about achievement and taking some just how i am in the world that that would have fueled addiction and use it for the benefit of recovery and trying to be in service to people and trying to like for example grow ethos grow our behavioral health company grow right now you know my my principal role within our company is is really trying to grow the prairie recovery center and let people know kind of uh the incredible work that i think we're doing here um in terms of treatment and um and so yeah i i get um i get really passionate about it i get really excited about um you know lots of things i'm definitely an enthusiast and then i have enough of that kind of eight-wing boss leader energy if you're familiar with the enneagram stuff that um that it kind of holds it all together and i'm not just like floating off in the clouds but i like that justification right you're grounded it's all it's all good maybe talk while you've brought it up talked about you know ethos and prairie and and maybe even love it too because you've you know you had a hand in that as well talk about the relationship between those organizations and your role in that sure yeah and and i can back up and say you know so i trained a builder psychiatry clinic uh what feels like a long time ago now under glenn gabbard which was an amazing experience then um went on to train as a postgraduate phillip meninger and that really shaped a lot of my developmental experience and in terms of my philosophy of care my approach to care being psychodynamically oriented i went on to do two years of postgraduate fellowship training at the center for psychopsychoanalytic studies in houston and um and then went on to do doctoral education at icsw which is the institute for clinical social work in chicago and that's all psychodynamically oriented so i was trained in this pretty neofreudian tradition and then i later came out of the closet as a jungian which is something i like to talk about now in terms of my approach and and the centrality of spirituality and dreams and um and imagination and all of that um so my that training background is important because it informed a lot of how i approach building and developing systems of care so the lens through which i see the world is this psychoanalytic psychodynamic lens a very relational psychoanalytic lens and so um i found it very interesting and that's how love it really started i had started a company in 2011 with brene brown um you may have heard of her um it's called the daring way and i was the chief clinical officer and um and and we um we did some incredible stuff she had great foresight which is not surprising and she was like what's next for you and i was like this i love this and she was like no you've got your own unique ideas to contribute to the world like what will that be and so i left there i actually started love it concurrent to my role there and then realized that love it in order to really take off needed you know my full-time kind of attention so i really um concentrated my energy and my efforts in that direction and along with my partner at the time and still my partner but at that point it was just he and i which is myself and will davis and then we later brought on a third managing partner stacy torn who's been incredible she has a doctorate from usc in clinical social work um and very importantly she has a background in finance um was it in ron what's that other places so it has this wonderful financial mind because my basic strategy up to that point was uh yeah sure i think we just if we if we make more money than we spend you know we'll just keep growing and um and she's like yeah it's a little bit more complicated than that at this point so um so it's above my pay grade so um stacy's been a wonderful addition to our our partnership so those are our three kind of managing partners but what we did was in 2014 we started love it as a community for health professionals and all this is to say i started to apply psychodynamic thinking not just to how i thought about patients but how i wanted to think about our the way we do things as practitioners in the field so i tell this story about how i was sitting across from people talking about how important it was to be meaningfully connected sitting with patients and then in between patients i found myself completely alone and disconnected that's the world that most clinicians in this field live in particularly in private practice they espouse the meaning of connection and they practice in movies that are totally isolated low you know clinicians basically have this experience of of you know understanding connection but not living in a way that actually reflects it and so that's what love it was about as a community of health professionals was the idea of bringing people together where they could co-locate their practices have a whole lot of specializations under one roof and collaborate in meaningful ways what i didn't anticipate was understanding that i i just didn't i probably didn't know enough about most therapists because i like most people projected the way i am which is pretty entrepreneurial and willing to kind of assume risks and jump out there and do things and what i actually found was that most clinicians didn't want any of that they didn't they actually kind of came to us and said can we just work for you in kind of a different way can we work for you but have this culture that you're talking about and so that really was um so so love it was this proving ground it was our kind of great experiment and it's still operating today as ethos wellness love it it's part of our one of our ethos locations and kind of our flagship outpatient center it's beautiful it's a sixteen and a half thousand square foot building in the heart of um uh montrose in houston um and they're doing you know i mean it probably even today see you know we see 2 500 to 3 000 patients a week out of that location i mean it's it's amazing they're they're you know the work that's happening there is incredible but what we've grown into is ethos behavioral health group is really something altogether different where we have a whole system of care um with that represents about 150 people in total and spans across medical detox residential care php iop supportive outpatient after care and regular outpatient and we're in texas five locations in and around the houston area because we're i don't know how much you know about houston but it's a great example of urban sprawl we just kind of like go further and further out and so we you can have five locations in a space and still not be um too too um densely populated there uh in you know can't you don't start cannibalizing your own locations because it's just such a huge city and people are so spread out um and then we have our chicago campus which we've operated for several years it's got a wonderful program manager there named taylor johnson and um and then we have dr modiano who's a an incredible addition psychiatrist based out of that location he's wonderful so great team in chicago and then recently we've added california and specifically an office in sacramento that savannah malcatian has gone to open which is really exciting as well so that's kind of you know where where we started and where it's come to in a nutshell each layer of that growth and development has really been about growing in ways that reflect that idea of a dynamic workplace environment a psychodynamically oriented system of care not just for patients but also for us to think about ourselves and to work collaboratively in meaningful ways together and so the community i'm really proud of our team at the prairie i brag on them a lot uh but we [Music] you know gosh like half the people out here i've known for close to 20 years and so even though we opened the program uh bought the facility in 2018 renovated it to open as a residential facility in 2019 it feels like we've been operating forever because the team we have are it's all 20 20-year relationships 15-year relationships and so we have this incredible culture here of really love and belonging and connection and that permeates how we show up with patients really clearly and so i'm super proud of that i feel like well i'd say my crowning achievement in life is that um i've maintained a successful marriage to my lovely wife and we have four children but outside of our children and um and our marriage i'd say uh you know this has been kind of the crowning jewel of my kind of work workplace achievements well it's and it's incredible what you're able to accomplish i know we were talking you know kind of pre-show about the idea of of private equity you know companies coming in and buying up um organizations substance abuse and mental health organizations and and kind of what happens in that field so let me ask you this question as you build um you know ethos and it grows and and it sounds like it's growing you know pretty pretty well um pretty in a healthy way how do you how do you keep how do you keep it pure and and with that same image and and same um culture that you're talking about yeah so um well i'll tell you uh it's a it's a great question and i and i i kind of wish we had started recording our pre-show interview because we got into some fun stuff so maybe we can we can rap about that now but um you know it's a great question i think one one thing is um we're always a kind of mission first organization so we put mission in front of margin and what that looks like is not sacrificing the quality of political service delivery um really putting that first as as our highest priority the patient experience is really critical and my belief is that if you do really good work with people that you'll make money like you'll like business will grow organically as a function of of doing the right thing first right and um and a lot of people don't see it that way and private equity can't see it that way because the way that it's structured is is in a three to five year turn right and a lot of times it's that in our field it's that kind of five year turn and so they ride the reputation of something that's been built but deteriorate the quality so they're undercutting the quality at every step of the way so that there's something profitable to kind of flip and sell you know sell along uh you know and and not really have to worry about what happens after you know i always think like what happens after these behavioral health groups make three or four of those turns so it can't be anything left you know it's got to be like what else can you cut you know like no water no you know you can't have anything you know like you know we're not feeding you anymore um so there's nothing left to cut um but you know to your point about how do we how do we grow i'll tell you how i started my day 7 30 a.m every monday we have a team call and we hop on and i um introduce one of our staff values so our first staff value is have fun the second is love and serve others the third is is about fostering hope which is really central to our treatment the one i covered today last week it was no mistakes only key learning where key learning culture that's something i learned from renee in my time working with her is that if you want to have a cultural environment that's interested in learning about one another you've got you can't focus on mistakes you've got to organize it as a key learning and so we have that kind of no mistakes only key learning but one i covered today was about embracing change and i kind of introduced some ideas about that how we think about that in relation to our patients but also how we think about that personally and then our entire staff you know whoever wants to chime in starts to chime in on the call and and a lot of times you know they're relating to it in a professional manner but they're also relating it to it in a deeply personal way uh and uh and so people are talking about the ways that they struggle with change in their own lives personally in their own recovery journey or whatever that process looks like and we've obviously gone through a ton of change uh in the course of the global health pandemic we've gone through immense changes you know the fact that we're doing this virtually and not in person or something you know all of that is informed by um the change that we've been through and uh and so you know we're you know that's part of how we um part of how we would stay true to mission and stay true to form is is basically um you know maintaining those kind of meaningful relationships and connections within our company regardless of the size um and part of that's broken up you know it starts to break up by location right so you have more individual location leadership um that manages that because we're a lot like primates people are you know uh outside of you know where and it's funny you know that like a primate group with a troop of chimpanzees or something probably in a group that averages maybe like 150 right and we're at that mark we're at like 150 and outside of that 150 right um there would be a new troop that forms or something and so for us i think what growth beyond this point looks like is is is cultivating more middle management and individual location leadership to really um empower them to to lead teams and to to feel like they have a hand in day-to-day management in a meaningful way and uh and and just working with those leaders to stay really committed to mission um you know our our our our kpis are like you know do people feel loved when they leave our treatment you know i mean that that's literally one like that's one of our exit evaluation questions like i i don't know another treatment center that asks like do you feel that the staff here genuinely loved you um and that's super important to us um and i my hope is that that comes through at every level of what we do that's um it's quite incredible robert what because what i hear you saying is what we all talk about in you know in the therapeutic world and in the clinical world we all talk about how connection is the opposite of addiction and connections vital but this this point that you bring up is is very interesting and maybe one of the reasons why i moved away from private practice is i had in my mind that there should be this association of clinicians that are helping and supporting each other and it never felt like that's what was happening but here you've created a space in and how long when you when you get on the phone at 7 30 how long are you talking with your team um that that's a 30 minute call that we start our day with um so we do that every monday um and then we'll convene again like here uh we'll convene for 90 minutes at 1 o'clock today with the patients so we bring like at the prairie we do a community meeting we bring all patients and staff together and we have a kind of psychodynamically oriented um in a way group time together where we're reflecting um and the staff are encouraged to really contribute in meaningful ways um with the patients obviously you know there's a use of self we we're really diligent about that we're not putting our problems on patients or sharing in ways that are inappropriate but um but we're real people and um and you know um i think that really comes through in what what it is that we do and our passion for working with people um so yeah they call this morning is it's our 30-minute kind of start to the week and it gets everything rolling and everybody hops into their 8 a.mwith a different sense of connection it doesn't that's the thing it doesn't take doesn't take much it's it's more about intentionality it's about creating and holding space and some intention for that than it is about you know taking seven hours a week to do team building or something um you know uh i think that 30-minute call will will be more meaningful to people than um than any like icebreaker you know uh team building thing you know trust falls or whatever else that people do so we do kind of go for that change that you've been talking about right changes it's the challenge is that it's just not always the same it's always different you've got to kind of navigate that so part of the positivity of that is looking at okay over the last 18 months and the change that we've all had to go through and with covet is to say okay there are definitely some negatives but what are the positives right we do a podcast and two years ago if we would have said hey we're going to do a podcast and we're just going to do it over the phone it probably would have sounded pretty inauthentic right or or forced whereas like now that's just what people do we're familiar with it right we're ready to do it our you know our company we work remotely everybody's remote so all of this stuff we're super familiar with friday night we all got together and went to a baseball game and it's i mean in eight months probably the first time that most of those people even seen each other right so to me that's kind of a negative right like we've gotten used to this good change this remote working thing but it's different so how do you like kind of maintain that authenticity and that kind of thing because you bring up the monkeys thing and the leadership thing where my immediate thought was like well yeah but monkeys don't have technology right they don't have the ability to connect with more people you can probably you know lead effectively and have a close connected organization of much more than 150 people because you have this ability to be seen and to communicate effectively but how do you collect that communication back right that's one of those challenges for you to get back you know how to get higher than 150 is those people can get to know you through that monday morning meeting and some of those other ways to connect but how do you really stay in touch with that group of 150 people and that's part of that growth right it's not it's not impossible or easy or or anywhere in between it's just how do you do it you know it's different for everybody right right and i think that's what i you know was speaking to in terms of empowering middle management and leadership to kind of you know really step in and fill that gap i can't you know if we have nine locations i can't be i can't even visit all of them uh for one day a week seven days you know if i work seven days a week um but uh that's where the partners come in right myself will and stacy we kind of divide and conquer in a lot of ways um really taking on um different facets and elements of our business and different sectors of our business in a really meaningful relational way um and then you know i meet with i meet with people one off and and have lunches and coffee and we really do a lot of i would say more often than not um we spend a lot we spend a lot of our time doing a lot of internal outreach you know and you're right about technology and the role of technology and we have done a lot to improve systems and processes and to leverage technology to drive change in meaningful ways in our in our organization over the last few years particularly the last two years has been this kind of like hockey stick curve uh kind of just you know growth for us in terms of what's happened in the midst of all this i mean we overnight we had to reinvent ourselves talk about embracing change we had to reinvent ourselves as a telehealth company you know um 90 of our business went online and it was just it was wild you know but we've adjusted accordingly and all that now with delta variant where we're you know we have returned largely to in-person uh interactions now we're being you know we're having to do more masking we're having it you know just be really vigilant and and mindful about the the the health health and safety aspects and qualities of that so we've been really attentive to that and i'm proud to say that we've you know knock on wood we've we've managed that effectively for you know the last year and a half or whatever but to your point about technology i believe that technology has outpaced our capacities in terms of our our relational world right so um so while we can maintain connections to thousands and thousands of people and i can post updates on instagram and facebook and linkedin and whatever other platform you want to utilize um that that sense of relationship that sense of knowing someone the capacity to be vulnerably and meaningfully connected to them probably caps out at a much lower uh a much much lower number and so you know what what we're trying to do is um how do you grow reach more people serve more people help more folks but do it in a way that still feels meaningful relationally of course first and foremost the patient but also to the staff and technology you know has its its drawbacks in terms of you know it if we're not careful it becomes the tail that wags the dog it can absolutely dehumanize us um and so we try to be really vigilant about how do we leverage technology to drive change while also being really attentive to the fact that we're in it we're in an industry that's about people and and that that means facilitating real and meaningful connection to people um so we still do a lot uh a lot in the way of trying to do that it's interesting that you talk about the ability versus the ability to kind of know versus actually connect because there are like some social changes there that are kind of slowly occurring right like i i'm not on much social media beyond linkedin but i kind of you know for family members see it there's this ability to know so much about people that you don't actually know right or or that you're not you know they might even be friends but you're not necessarily staying in touch but you know what's changing and you know what's occurring and then when you see them in real life do you pretend like you don't know any of those things like is it assumed that you know those things you know or like there's people that you're friends with online that you wouldn't even say hello to at the grocery store or if you did it would be awkward like we don't know each other we've never talked but like we we've liked each other's pictures a thousand times you know like there's this kind of this right lack of connection in that relationship and then also like kind of this cultural dynamic that has to change about that over time so it'll be interesting to see what we do with that as humans but yeah no no doubt i mean i think um and we're seeing more and more of the kind of detrimental impact that that has on people um the capacity that we have these days uh for anonymity is really um it creates some challenges you know what people will say and do under the guise of being anonymous versus what happens when you when you actually have to like show up and and kind of own that so it's it's interesting i think a lot i i think technology is vastly um technological development has vastly outpaced um human development um human beings we're we're not engineered to change as rapidly as the world has changed around us and uh and so that that that's a fascinating thing and it creates all sorts of challenges i mean um i mean we see it a lot in in treatment you know one of the co-occurring issues that we now see and treat in treatment is people's kind of addictive uh connection to technology right the way that they can't put it down the way that they can't disconnect from it or be with themselves or look inward and so there's there's you know part of treatment is largely creating a kind of separation from some of that and a reflective space to be able to actually look inward at yourself um for a minute you know so true story and i'm wondering you know as you talked about that idea that you know just doing telehealth you know we you can help people and you can make some connection um but i've heard it from just many many many clients is i can't do much more of this virtual treatment or you know this virtual stuff what's what's that looking like with your with your community you know um it's a really mixed bag i was talking about it with a guy this morning who's saying you know i'm really you know tired of this and and this and that and no doubt i mean there's a part of me that um i i will tell you that i think zoom or any of this stuff is is a distant distant second place from in person interaction and and and the felt experience of being with someone um hands down the flip side is it has created an accessibility to care for people um i'm seeing a lot of people that i i i probably still see more people clinically than i should um but it's what i'm passionate about so i love it and i continue to see people clinically so um i'm seeing people in kind of more remote and rural areas of texas that i've picked up in the last year and a half that have said hey all of a sudden treatments treatment's doable for me and so for them it is a lifeline that was non-existent and you know two years ago it wasn't even on the radar um not in this way i mean telehealth was of course but but but not not like this not where people like me who would have never really elected to do a lot in the way of telehealth suddenly is doing uh most of my stuff virtually the other thing is because i see professional folks let's see that let's say they drive down to my office for you know you know essentially one hour session well houston traffic etc time of day whatever tack on 30 minutes each way it now there's two hours of their time so let's say they're an attorney that bills i don't know 500 an hour a thousand an hour i mean whatever they whatever they're doing the opportunity cost for for attending care is tremendous to them so they're like so not only do i have to pay you your fee but i can't see the people that i build by the hour and and when you chunk out your weak and billable service units or hate billable units of time as as attorneys and a lot of other professions do the idea of virtual is like man i can take an hour i take an hour for lunch i can sit at my desk and see you and it's again created an accessibility that wasn't there before so people who who might have said hey this is a barrier to accessing care like i can't give up a chunk of my day 25 of my work day or something like that to go see you well now it's like no you're taking your lunch hour you know um and that that's actually uh you know kurt was talking about what what are those kind of almost you know the silver linings in this that's kind of a silver lining in some of this is we've seen some changes to accessibility that are ultimately positive um i think some of this stuff is here to stay obviously i think there's going to be a number of people a growing number of people wishing to return in person and that's okay most of our stuff these days now is hybrid we're doing a mixture of in-person and online and just trying to manage all that safely and effectively and i totally agree with what you're saying there's there there's opportunities that have opened up that we've been talking about opening up for years and covet has kind of forced that hand it'll be interesting to see how that levels out as as as covid does whatever kova does and and we can get back into you know face to face if we want to because it's i think telehealth is here to stay it's not going away even if covet you know when and if covet does yeah yeah i i quite agree i think and and we've seen that even with with access to recovery communities and 12-step communities and things like that i think it was unheard of to imagine you know really going to meetings online you know it was like no if you if you're in a densely populated urban area there's tons of meetings lots of opportunities to go but people have been able to start attending meetings in london and sydney australia and like cool like it's created it's it's the world uh has become way more accessible in terms of recovery communities all over and i think people are really intrigued by that and want i mean from what i'm seeing i i think it's going to be a mixture of people that say you know like it used to be like how many meetings a week do you hit you know if you're in 12 community or whatever like you know gotta three meetings a week or go to five meetings a week or whatever it is i think um the the the [Music] way we're gonna be talking about that from here on out is like i go to two in person meetings and and two zoom meetings or you know i catch this in person home group and then you know the rest of my stuff i do on zoom or whatever um so that that that i think is gonna be really interesting it's it is and and it'll and it's interesting to watch and go you know really how's that gonna land where's that gonna land but it's not going away and it's super valuable i um i am a bernay brand you know brene brown a fan and and you know love her work and love what she's done and i can see that you know that experience and that time working with the daring way and and building that has definitely influenced the work that you do here um i mean you know i know she's not the only one that does that kind of work but she's she's really it's it's out there and she's done a great job of organizing it and implementing it and it's it's incredible so i love to hear you talk about that and implement those in your culture as well yeah yeah um you know yeah i mean renee's one of a kind um she's she's contributed a lot and she's a thought leadership in our field and um and it's been one of those things that uh you know i'm really glad that you know in a lot of ways um i kind of you know i had done some startup type things before that but that was i would say you know as an entrepreneur that's really where i cut my teeth this is in that work um with her and i'm so glad that she had the foresight to say hey you have these like unique contributions to make the to the field what will that look like and really challenged me to actually think beyond um what i saw as kind of an endgame um uh she had the foresight to kind of think is is a is a launching pad um and and i'm super grateful for that always will be and and it's been true uh i i've been able to contribute a lot of my own unique intellectual property to the to the world as a function of that and not feeling like i had to um play small in her shadow or stay stay put there but um could go and do other things and uh so that's been that's been really remarkable but then take the best of those parts you know best parts of that experience and re-articulate them in the things that i've continued to do so i'm really really glad for that it's incredible um robert it's been so fun having you on today i know we could talk for hours and hours about the industry and we were talking earlier about the work that's done in the background to advocate for these people for clients and and people in treatment i have a hundred questions about what does it look like to work with with attorneys and you know the minds those working minds but we'll have to save that for another time but uh this has been pretty incredible i i appreciate you being on and and for the work that you do because i can tell that it really is it's it's it's got a culture which i'm always about culture right you build that culture and the rest will you know evolve off of it and grow from it so i love to hear that yeah yeah well thank you guys for taking the time to visit and you know i i enjoyed the conversation and like you said there's there's probably 10 other things to talk about so i hope we'll we'll continue that yeah definitely we need to for sure thanks robert