Second chances are important to Libby McCaskey – WSTC’s SUDP telehealth counselor. “I was born with congenital heart disease,” she explains. “I knew from a very young age that life is short, and I may not live a long time. God gave me a second chance at life, and I want to honor that by helping people. I want to make the most of my time here.”
Libby made that decision at a young age, and at 16 years old, she chose the chemical dependency program at Olympic College as the pathway to her goal: a program that would train her to help others to obtain a second chance at life. She began her career with an internship at a local substance use disorder treatment facility at 18 years old. “It was really, really hard,” she says. “Being 18, and with no background in addiction, a lot of people didn’t respect me. And I had so much to learn, it was embarrassing. I almost gave up.”
Seeing the Issue From a Different Angle
After two-and-a-half years, Libby decided to take a break, and she and her husband began fostering children through a behavioral health foster care program. The time spent helping foster children gave Libby time to think about her certification, and whether she wanted to go back to it. The children they welcomed into their home were victims of addiction, and they had behavioral health issues, trauma, and other serious problems. Seeing where they came from and how it affected them gave Libby a deeper perspective. “The parents are struggling. They’re using substances, and these kids are the ones paying the price for it. That motivated me.”
Completing an SUDP Certification
With the deadline approaching for obtaining all the supervision hours she needed for Substance Use Disorder Professional certification, Libby came to work at WSTC in Poulsbo. “I felt a lot more mature and ready for the job,” she says. She was able to get the last 500 hours, take the test, and drop the “trainee” status, becoming a full-fledged SUDP.
Following Dreams
Then she and her husband got the opportunity to move to Eastern Washington. “It’s always been a dream of mine because I ride horses,” she explains. “I wanted a lot of open space and better weather for that.” However, fulfilling that dream seemed to close the door on her role as SUDP. The closest treatment center to her new home is located over an hour away.
Libby worked as a dental assistant for a while, but she knew it wasn’t something she wanted to do long-term. On a whim, she decided to email Ken Wilson, CEO of WSTC, to see if he would be able to re-hire her to work for WSTC remotely. “I was so pleasantly surprised that he liked the idea,” she says. “I’m extremely fortunate to work from home because I live 45 minutes from the closest town.”
Setting Expectations
As a telehealth counselor, Libby has found that some things tend to be more difficult on Zoom than they are in a traditional session. “I have to work harder at engaging people,” she says. “Once they’re engaged, they stay engaged. But I think they have the idea they’ll come through Zoom, and it’ll be an easy way to get through treatment.”
In fact, invariably there are participants in the beginning who seem to think that group attendance is a task that can be completed while they run errands with their kids, driving around town or pushing a shopping cart through Safeway. Libby counters these attitudes and behaviors by setting concrete guidelines and maintaining those expectations.
Groups begin with check-ins, where each person talks about their week. When she opens the discussion, some people seem more reticent to speak up, and she has to work to encourage participation from everyone. “Some people have no problem just jumping in, but most people feel like they need to wait until it’s their turn or be called on. I try to call on every person to make sure they have their chance to say what they want to say.”
Seeing the Effects
At first, Libby worried that people would feel like they were getting less help than they would in a traditional setting. Then she saw studies showing that people tend to have a better attendance rate over telehealth, and that the results are just as good.
“People really do show up. I don’t have many no-shows to my groups,” she says. “And I’ve had clients tell me that they still feel like they’re getting the help they need even though they don’t have the face-to-face connection.”
Reaching People Who Need Her
Since the pandemic, many industries have moved their services online. For the most part, though, the SUD treatment field has not been as forward thinking. “I’ve done research on other treatment agencies,” Libby says. “While some have telehealth for individual sessions, I haven’t seen any doing groups, which means people at those agencies aren’t able to complete the whole program through telehealth services.”
Having telehealth available is critical for many, as it’s the only way they have to access treatment. “Some people are more willing and comfortable with talking over Zoom,” Libby explains. “I’ve seen a lot of clients who have extreme anxiety, either around other people or driving, to the point that it interrupts their daily life. It’s hard for them to function.” Other people who may need telehealth include people who have lost their driver’s license and aren’t able to get to a treatment facility, people who have child care issues, and people with medical and mental health difficulties.
“All those people have been sent to me,” Libby says. Telehealth has created a space for them to get the second chance they need, and she’s pleased to have the opportunity to offer it to them. “I think it’s really awesome that WSTC has developed that option for the people who need it.”
