My summer 2019 internship was at Journey Mental Health Center in Madison, WI, my hometown. It began as the Child Guidance Center back in 1848 with 6 staff and grew to become JMHC in 2012 with over 500 staff, the majority of whom are in community services and outpatient services. I worked in the Outpatient Services building on the West campus, which mostly serves individuals who require services ranging from supportive case management to medication maintenance. Outpatient Services includes a variety of treatment and assessment programs such as working with drug/OWI treatment court, some culturally specific programs (African-American, Latinx populations), and family and youth based services. JMHC also works with a variety of other levels of care, ranging from institutionalization to Assertive Community Treatment.

I was also lucky to be able to participate in two training sessions that Journey provided. The first was a training on Dialectical Behavioral Therapy (DBT). DBT, developed by Marsha Linehan in the 1980s, focuses on the concept of dialectics, or "dialogue" between contradictory elements. DBT as a whole includes skills training, individual therapy, and ability to call one's therapist to ask for coaching in using the skills. This training specifically focused on Distress Tolerance (DT) skills, including ways to reduce parasympathetic nervous system arousal, stopping oneself from acting impulsively on their emotions, accepting reality, naming and understanding emotions, and effective interpersonal communication. The second was Suicide Risk Assessment Training. We looked at both static and dynamic risk factors, the four main components of suicidality, and then how to formulate and respond to risk (be it an action plan, consultation, or a filed report). I took notes and kept the handouts, so I was given the opportunity to learn valuable skills I can apply to my life, or the lives of others.

My main job at Journey was the intern for a therapy group specifically focused on women and the foundations of substance use recovery. I went in with my supervisor, took notes, and filled out the notes in the women's charts at the end of the session. Every session would start with a check-in go-around, where each attendee would say their name, their substance(s) of choice, how they would rate their week on a scale of 1-10, and one success from the past week. The topics we covered included the use/abuse/dependence continuum, strength-based recovery, stages of change, urges/triggers/cravings, the science of addiction, social support, skills for different stages, protracted withdrawal, healthy eating/sleeping, and common issues women face in early recovery. I really learned a lot about substance use through these women and their stories.

One group attendee had gone to prison twice, overdosed twice on heroin, and said crystal meth saved her life because it got her off of heroin, and helps her focus because she has ADHD. However, she has to be sober to get ADHD medication, so she was working towards that. Sometimes she’d have a bad week and use, but she would say her success was coming to group, and that’s no small feat.

One woman was 130 days clean from alcohol, marijuana, and crack. She said she felt bad that she still smoked cigarettes, but if that’s what it took to keep her off of the other things? She went from shaking a cup on the street (to spend on drugs) to having a good place to stay, a faith community she values, and journaling and working on a book, to tell her story to other people.