2014 Outstanding Clinicians Awards

Now in its sixth year, Addiction Professional's Outstanding Clinicians Awards honors clinical professionals who demonstrate a commitment to informed practice and who never waver from a focus on the individual patient. Professional colleagues and readers of the print magazine and website nominate individuals in the categories of counselor, clinical manager, nurse and physician. This year we received around 100 total nominations, and we are grateful for the enthusiastic response.

The following profiles of Lisa Finlay, Tom Callahan, Jackie Leitz-Sanfelippo and Ken Roy, MD, reflect the dedication seen every day in these honorees' own organizations as well as in programs across the nation. We will formally honor this year's winners on Aug. 23 at our National Conference on Addiction Disorders (NCAD) in St. Louis.

Lisa Finlay

Position: Lead clinician

Organization: Triangle Residential Options for Substance Abusers (TROSA), Durham, N.C.

Quote: “On a general level I don't have an agenda for every resident. What they want to work on is what we work on.”

Comment from a colleague: “She is patient with her clients and meets them where they are; sometimes she is the first person in their lives who accepts them as is.”

Lisa Finlay does not adhere to one clinical approach alone in her work at Triangle Residential Options for Substance Abusers (TROSA), a therapeutic community (TC) for men and women in North Carolina. Dialectical Behavior Therapy (DBT), cognitive-behavioral therapy (CBT) and mindfulness approaches are just some of the research-supported practices commonly used in the groups Finlay runs. For her, it is about getting a complete read on a resident.

“Coming from an outpatient program before this, I really have enjoyed working in an inpatient setting. I'm working with people on all aspects of their lives,” says Finlay, 53.

She currently is prioritizing an effort to become more skilled at treating the process addictions that often surface in the recovering substance addict. Her ever-present drive to learn more inspired the former supervisee who nominated Finlay for the award to write about her, “Lisa is committed to learning about addiction and recovery; she never acts like she knows it all.”

Finlay still can be considered relatively young in the counseling profession, having started around age 40 and discovering a second career. She had acquired counseling skills originally in her work with a battered women's coalition. She now gets energized by seeing successes and playing a role in bringing about change in someone's life.

And TROSA is about equipping residents with the tools for change. Most of its operating costs are covered by revenue from a number of on-site businesses staffed by residents who build vocational skills and learn the importance of teamwork. A record number of residents, close to 500, are in the two-year residential program now; on a quarterly basis around 25 to 30 graduate in what becomes a highly emotional ceremony; many often mention Finlay by name as the person who taught them important coping skills.

The work is challenging for both residents and their clinicians—given that this is a TC, structure and rules predominate (Finlay says male and female residents cannot speak to each other for the first six months unless the topic is work-related; only after a year can there be any active socializing). Yet Finlay clearly has brought a perspective that has contributed to making the program more well-rounded.

“I really hounded the president of the organization to get hired,” she says. “Traditional TCs did not include counseling or psychiatry.”

Finlay sees around 25 residents per week in counseling, does supervisory work with interns in the organization, and assists in credentialing training for individuals who have graduated from the program. She tailors her approach to the personal stories she hears from individuals or in group. “I kind of like to ad lib and go where the group goes, and in a sensible way,” she says.

Tom Callahan

Position: Executive director

Organization: Cove Forge, Williamsburg, Pa.

Quote: “A lot of people who go through school don't get a lot of information about addiction and how it works. I want our clinicians to believe that anybody they meet is capable of recovery.”

Comment from a colleague: “He views himself as a subservient leader to his staff, and is committed to one mission, and that is to help those afflicted with the disease of addiction.”

Tom Callahan has served in multiple roles at Cove Forge, a 225-bed west central Pennsylvania facility offering multiple levels of care (it has been owned by CRC Health Group for most of Callahan's 14 years there). While now in the director's role, he still engages in clinical supervision and maintains close ties with the counseling staff, while also maintaining a private-practice caseload.

“I think it's really important for me to keep my skills sharp and to stay in touch with what got me into the field to begin with,” Callahan says.

He describes himself as “a grassroots kind of guy” who enjoys addressing issues from the ground up, This aptly describes the work he has done to establish an initiative that likely will prove to have a lasting impact across the CRC family of centers, and perhaps beyond.

Back in 2012, Cove Forge analyzed its departure rate from treatment against medical advice (AMA), and found that by far the largest number of individuals leaving early were young men in the 18-to-24 group with opioid dependence and a co-occurring mental health diagnosis. The critical period when these young patients were leaving treatment generally spanned days 7 to 9. “Something is going on neurochemically when these individuals lose focus,” says Callahan, 59.

He decided to immerse himself in research on the interventions that can stimulate endorphin production—everything from exercise to music to humor. These would become the foundation of the Hope Program at Cove Forge, first targeting these young patients in the early days of treatment but now being applied at the center more broadly to cover an entire treatment stay as well as non-residential levels of care.

“From day one we engage patients in diet and supplements,” says Callahan (there is even a “Hope mix” of nuts, cranberries and other healthy snacking fare). “We have groups that focus on laughing. There is exercise and humor even in detox.”

Cove Forge found that a 25% AMA rate in the targeted group plummeted to around 5% after the initiative's implementation. “I would like to see this thing fully operationalized,” Callahan says.

He fully embraces a whole-person, bio-psycho-social-spiritual approach to understanding the disease and its treatment. In addiction, “I think the brain is hijacked,” he says. “With abstinence, support and tools, people have an opportunity to get their brain back.”

Jacalyn Leitz-Sanfelippo

Position: Nurse

Organization: Wisconsin Department of Corrections, Oshkosh Correctional Institution, MICA program

Quote: “One of the most difficult things for the men who come in is to gain trust. They have been on the streets or in prison, and they generally don't trust people who are not inmates.”

Comment from a colleague: “She brings humor when we get stressed, words of comfort when we struggle, and challenges complacency. When Nurse Jackie is mentioned in this institution of 2,000, the immediate response is one of respect and a smile.”

The Wisconsin Department of Corrections' own “Nurse Jackie” admits that her job at an Oshkosh Correctional Institution medium-security unit for dually diagnosed felony offenders often becomes a juggling act. Jacalyn Leitz-Sanfelippo is teaching health and addiction classes and helping to develop treatment plans along with her medication monitoring duties, for a population that generally is suspicious of most anyone in a position of authority.

But as much as Leitz-Sanfelippo is credited with being a stabilizing influence for a difficult-to-reach group, she in turn wants to highlight the contributions of the multidisciplinary staff around her. Among these are an addiction counselor, an outreach specialist who follows inmates' progress for a year, and a staff sergeant whose main role involves security but who also teaches inmate classes. “They are invested in treatment and recovery and they enjoy what they do,” she says of her colleagues.

Leitz-Sanfelippo's first exposure to behavioral health occurred early in her nursing career when she worked on an acute psychiatric unit of a general hospital. Insurance pressures eventually convinced administrators to combine the unit with an alcohol and drug unit, and Leitz-Sanfelippo says she began to understand the connections—this helps her immeasurably in her current role. Each participant in her program has a substance use disorder and serious mental illness diagnosis.

Some of the inmates on her unit participate in the 11-month program as an alternative to revocation of probation status, while others are from the general prison population. Most arrive with a lack of insight into the health issues that plague their lives.

“My topic in a recent class was hepatitis. There were eight guys in the room, and they had no idea what organ hepatitis affected,” Leitz-Sanfelippo says. They also need to be educated that a diagnosis of a physical illness such as hepatitis C or HIV doesn't amount to a death sentence, and can be managed just as an addiction can, she says.

She often tries to introduce a lighter approach as she seeks to assist inmates in working through emotions. She says a breakthrough often occurs when an offender openly acknowledges a traumatic experience for the first time. Mainly, she communicates hope, even if her enthusiasm sometimes is met with a rolling of the eyes from skeptical offenders.

And Leitz-Sanfelippo never fails to share credit for successes with others, making a special mention of her clinical supervisor Michael Kemp (calling him “one of the best advocates for treatment and recovery I have had the opportunity to work with”), as well as MICA psychologist Danielle Shallcross, PhD.

So does the Nurse Jackie from America's heartland have anything in common with the Hollywood-version Nurse Jackie, as portrayed in the Showtime series of the same name? It would appear not. “I watched the show once, and that was enough,” she says matter-of-factly.

A. Kenison Roy, MD

Position: Medical director and founder

Organization: Addiction Recovery Resources, Inc., Metairie, La.

Quote: “Physicians have been very inept at treating addiction, and that includes psychiatry as a field. Medicine has to humble itself and learn from counselors.”

Comment from a colleague: “He remains a firm, but fair and caring, teacher who is committed to helping people reshape their lives and see past the shackles of addiction.”

Don't expect Ken Roy, MD, to assume the stereotyped persona of a physician feared by other professionals in the addiction treatment community, as a presence that for instance would push medication solutions and downplay all else in treatment.

“I absolutely abhor the prescription of medication as the sole treatment of addiction,” says Roy, medical director of Addiction Recovery Resources in Louisiana. “It is inefficient, illogical, and in many cases criminal. However, the use of medication is not evil.”

Roy brings a broad perspective to his numerous roles with the residential and outpatient treatment center, a longtime behavioral health private practice, and the River Oaks Hospital dual-diagnosis unit. He started his medical career in family practice, then after hitting bottom in his own addiction would retrain in psychiatry and eventually identify opportunities to fill a need for treatment and recovery services in the greater New Orleans area. At 71, he says he is healthier than he's ever been and sees no reason to slow down.

The services at Addiction Recovery Resources reflect a comprehensive vision. “The program embraces the 12-Step philosophy and in fact teaches the neurobiology of 12-Step recovery,” Roy says. The facility's statement of core values reads that “spiritual practice is necessary to recovery because spiritual practices harness pleasure drives in the service of higher purpose, still emotional pain, and calm anxiety.”

At the same time, Roy says no one would pursue a job with Addiction Recovery Resources if they questioned the pivotal role of the physician in treatment. But there remains an open discussion at all times about medications' benefits and risks, and the organization consistently solicits staff feedback about any adverse effects of medications that patients are taking, he says.

Roy and his colleagues also emphasize family engagement in treatment and recovery, as they aggressively attempt to prepare family members for the return of a somewhat different person after treatment. He says of the facility in general, “We're very community-based. We're a respectable and respectful place, not a pretty place by a lake.”

He reinforces a collegial atmosphere in the workplace, saying that the work setting needs to be fun as well as efficient and productive. The colleague who nominated him for the award wrote that Roy has prioritized maintaining an environment for professional growth.

Roy is not one to believe that physicians could ever dominate the addiction treatment landscape. “I could no more treat addiction by myself than fly to the moon,” he says.

He adds, “I think there will remain a spectrum of services, not all supervised by physicians. Everything that I have learned about addictions started with what I learned from counselors.”