Outpatient Drug Rehab and Mental Health

outpatient drug rehab

Outpatient Drug Rehab and Mental Health

Spotlight on Nick Reifner – New Life House Alumni

Nick Riefner, New Life House alumni, told me all about what he’s been up to since completing his stay in our recovery community, obtaining his CAADAC certificate and celebrating five years of sobriety on May 15th.

What are you doing for work?

I am a Chemical Dependency Counselor at Visions Adolescent Treatment Center in Los Angeles. I have a set list of clients whom I see, I have some 1st Step clients and I have some primary Intensive Outpatient clients who are there 5 days a week, attending 3 groups, family and individual sessions with therapists and counselors. Essentially, my primary role there is to help them with their recovery. I don’t really deal much with the family, that’s the job of the therapist. There are times when I am asked by the therapist to be part of a session with my client and their family so sometimes we will work on the same case load. Feeling comfortable as far as being a young adult in early recovery is crucial and also helping young adults with productive life skills that will benefit them in the recovery and moving forward in their life is my goal.

The kids I work with in outpatient are all in transition, whether it’s from from high school to college or in high school and learning how to transition to living a recovered life. I can help them learn about situations like going away to college, being separate from their community and getting involved in healthy activities so that when there’s a huge party scene, they’ll know how to handle it. In some situations I am a recovery mentor I guess you could say, but also a life coach.

I also am an outreach coordinator for the alumni at Visions and so I keep in touch with all the alumni. We have a huge snowboarding trip every year, a softball game, I’ll call either from 6 to 15 alumni a week and invite them to events that we set up. Every Friday we have Recovery Fun with the outpatient clients, we’ll take them out and go bowling, to the arcade, the movies, skydiving indoors. We like to get everyone involved so that it’s not just the daily grind of school, outpatient sessions with therapists and counselors.

How old are your clients?

We have anywhere from 14 to 18-year-olds sometimes we’ll have a 19-year-old or 13-year-old but the average age group is 14 to 18. 80% of our clientele are 17 to 18 and I mostly work with older age group.

Nick Riefner

Nick Riefner, CAADAC I

How are the underage addict and the over 18 addict treated differently?

Well, everyone I work with has issues specific to him or her. I’ve found that the kids who are under 18 will have a little less experience with drugs and alcohol and more mental health issues generally. When I have a client with a significant amount of experience primarily with drugs and alcohol and I have another client who has less experience with drugs and alcohol but has had more issues regarding the family or trauma, I will treat them a little bit differently as far as the recovery goes. For instance, the client who has more history with trauma and significant relationship issues with family I would definitely work with him/her on the addiction aspect but also on how to simply become somebody who is able to have relationships, or understand what it means to communicate correctly. The client who has had a very significant amount of experience with drugs and alcohol are more on a recovery tract.

Every outpatient client I work with has had some experience with drugs and alcohol at some point, so I’ll always work with them on recovery. If they are in IOP, they are required to go to meetings, work with a sponsor, etc. If they are in 1st Step there, it’s a little more suggestion based: “I suggest you try out the meetings and I suggest you get a sponsor, I suggest you do the steps,” etc., but it’s not required.

What would you do if the child you are working with confided something in you that was detrimental to their recovery, stopping them from growing, impeding the unification of their family system or was engaging in secret keeping?

Well, I would definitely confront them. The conversations I have with all my clients are confidential. The only time I’ll break their anonymity is obviously if they threaten their life or threaten someone else’s life. We all talk as a clinical team as far as every client is concerned and as to the best interest of the client. It tends to be the norm for majority of kids; where you cultivate this relationship with them over time, one peer to another, they get comfortable with you and things start to come out. What I’ve found very successful has been confronting the behavior but also allowing them to own and create their own consequences. I empower them and validate what they say but also hold the boundary that their behavior’s not okay and they need to figure out a solution. I had a kid with more significant challenges in this respect and he kept running into walls, so I had to break it down step-by-step.   He needed more direct confrontation and direction: “hey this is not okay, here’s how do we do it, this is what needs to happen now, you need to put this down, go tell this person you were wrong,” etc. He responded a lot differently, especially when I allowed him to feel empowered enough to create his own consequences and figure out the solution on his own.   Diving into the solution through this process is ultimately the goal and then they learn to trust that they can come to me as a sounding board, asking me what I think about this, is this wrong or is this right and then coming up with their own suggestions.

Regarding the shooting deaths by Elliot Rodger in Santa Barbara recently: here’s a young man who has been diagnosed with Asperger’s Syndrome, from a nice family, had experienced bullying in childhood, isolated and had an addiction to Xanax. Without getting into the gun debate, what do you think could’ve been handled differently? How can something like this be prevented in the future?

Well, I don’t know how significant his diagnosis was or what therapy he had but I do know that people tend to want to be heard, by their peers especially. When people can be more attentive and listen to each other it allows them to feel more comfortable. Then you can create a relaxed state where you’re able to chip away at the things that aren’t working. They drop the wall so someone can get into the obsessions that drive their thinking, patterns that drive their attitudes. People were getting so worked up about how crazy he was sounding, which is the normal human instinct I know, but considering his diagnosis and what he was writing, how he was acting, if a mentor could’ve maybe sat down with him and let him voice the way he felt without judgment, and then helped him come up with solutions to his thinking, it might’ve helped. But people tend to distance themselves from dual-diagnosed clients; that’s been my experience and that’s what I’ve heard from a lot of clients. There’s not a lot of compassion between peers. Then the diagnosed young adult has the perception that friends are distancing them selves because they think “he’s crazy.” That in itself perpetuates the unhealthy thinking that: “the way I think, the way I feel and act, even the way I look is insane.” So how does someone like him get a good outlook on himself and his life? He bought into the thoughts that women hated him. Maybe if someone would have sat down and helped him interpret it, would’ve allowed him to feel validated, if he were a part of a recovery community he wouldn’t have felt so alone….it might’ve helped, but again, I don’t have enough information.

I think bullying also has a part to play. I think bullying itself is its own issue, its own problem. A lot of kids on the spectrum, kids with Asperger’s with mental disorders, processing disorders, have a lot of history of being bullied because people think they’re different, crazy, stupid or retarded whatever and they don’t know how to process it. Again, a lack of compassion from peers. They’re having a hard time processing life in general, so they can’t process what relationships are like and they go out and shoot guns, cut them selves, develop eating disorders and substance addictions.

I’ve learned a great therapeutic tool at Visions called DBT, Dialectical Behavior Therapy. It’s used mostly for Borderline and suicidal clients and proven over the last five or six years to be very beneficial with every sort of mental health issue and even some chemical dependency. It is a sort of validation system that’s been very successful in helping people feel heard.

Do you think the 12 steps can cure everything? (I am smiling!)

Do I think the 12 steps can cure everything? (he laughs) I suggest the 12 steps to every client I have. Even when it comes to a client that has only smoked weed once or drank once but has really significant trauma and family issues or is maybe super depressed…I still suggest the 12 steps. I will suggest that they not look at the drug addict or alcoholic part of it, have them focus on how the steps can benefit a particular problem they have. I had a client who was severely depressed and I suggested that he get a sponsor and work the steps on his depression and not on his alcoholism. It worked wonders for him, he has a girlfriend now, he’s happy.

And like I said, I suggest the 12 step experience with everyone, but I know that some people say it’s not for them and they want nothing to do with “recovery,” so for them I’m more of a life coach.   The 12 steps changed my life, so I continue to work them and they continue to help me feel inspired.

What are your plans for the future?

Well, I have my CAADAC certificate and I’m in school right now majoring in Psychology. I want to get my Masters and become an MFT (Marriage and Family Therapist) or MSW (Master of Social Work). I’m not exactly sure but eventually the long-term goal is to become a therapist.

New Life House recovery community is so proud of all that Nick has accomplished in his work in outpatient treatment and with every road he continues down. The recovery world has gained a great life coach!

3 Comments
  • Elly Rowland
    Posted at 08:10h, 17 June Reply

    Nick, thank you for being an amazing sponsor to Mason. You have made a positive difference in all of our lives as a result of your work with him. No words can express my true gratitude for all you have accomplished with Mason. Mason is now a reflection of you. I felt a connection with our first handshake and was so happy you agreed to be Mason’s sponsor. Thank you for taking the time and effort to help guide Mason on his path to recovery.

  • Michelle Raymond
    Posted at 10:52h, 17 June Reply

    Hi Nick,
    Wonderful to hear of your 5 years and that you are doing so well. I think of you and the amazing transformation I witnessed while at New Life House. Wishing you all the best.

  • Debbie O-A
    Posted at 11:14h, 17 June Reply

    I second your emotion Elly! Nick has been an inspirational Sponsor to my son as well. Blessings to you Nick, on whatever path your Higher Power has in store for you.

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