The Sanctuary Byron Bay
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Newsletter #8 - Spring 2010

In this issue:

Director's Introduction - Michael Goldberg

Welcome to the Spring edition of our Sanctuary Byron Bay newsletter. We’ve had a busy year with increasing demand for our unique services. This spring, for the first time since the financial crisis began, we’ve had to utilise a waiting list, though thankfully, the wait is merely measured in weeks, not months.

Our continuing success can be directly attributed to the consistency we strive for and the standards of excellence to which we constantly aspire. The Sanctuary Byron Bay remains one of the few places in the world where a wide range of conditions can be treated on a one-to-one basis – with the treatment environment and treatment team being completely devoted to each resident. This one-to-one focus is very resource intensive and for it to work, an outstanding treatment team is required. For the past seven years, I’ve been fortunate to have nurtured as the core of the Sanctuary Byron Bay, a tightly knit team of highly experienced treatment professionals who have over the years, have learnt to work together in a highly integrated and seamless manner.

I’ve had a number of offers to expand the Sanctuary Byron Bay and to increase the number of treatment teams on board, but in reality, I’ve no doubt that our existing staff are actually our greatest assets and for this reason, I’ve resisted any expansion plans to really focus on maintaining and building my remarkable team. My original vision for the Sanctuary Byron Bay was to develop the best therapeutic services possible, and having done so, my commitment remains to maintain and constantly improve on our achievements.

In this edition of our newsletter, we highlight the integrated nature of our clinical services, explaining the lengths to which we go to achieve integration of a range of clinical modalities such that our customised programmes are always experienced as a seamless service. We also take a look at the administrative side of our programmes, introducing one of our Client Service case managers, Karen Stuart who describes her role and her contributions to the team.

I invite you to call me at any time if you have any queries about our services or if you or someone you know might benefit from our assistance.

I hope you enjoy this 8th edition of our Sanctuary Byron Bay newsletter and I wish you all the very best.

The Sanctuary Approach to Integrative Medicine

The Sanctuary has a unique approach to integrative medicine where we truly integrate every modality to deliver a holistic, well considered treatment. This aligns us with the broader definition of medicine being the art or science of restoring or preserving health, not merely providing a dose of a curative – as most of us have experienced in many mainstream clinical settings limited to 15 minute consultations and pharmaceutical drugs as the main solution.

It is true that some clinics have made shifts towards multi-modal practice but where claims are made about the practice of integrative medicine, these often amount to the mere fact that eastern and western treatment modalities are combined and offered in parallel, rather than in true synchrony. Different practitioners may be available in the same location or may be ‘brought in’ together, but treatment is still conducted separately, with little communication occurring between the different practitioners regarding diagnosis, approach, rationale, and types of treatments proposed; with even less consideration given to how the different approaches might be adapted to complement each other. Instead, ‘corridor consultations’, where snippets of client details are exchanged between practitioners on the run, usually constitute the so-called integrated approach to treatment.

Regardless of whether there is a range of practitioners and modalities available, communication between practitioners and substantial integration of these modalities must happen to a degree necessary for a truly coordinated treatment plan to be developed.

The Sanctuary’s approach to integrated treatment goes beyond the common model of integrative medicine at multi-modal clinics. It begins with a detailed initial assessment conducted by our Clinical Director, a highly experienced psychologist and psychotherapist. Following this assessment, and after gaining an appreciation of the client’s goals for treatment, a team of practitioners is convened according to the client’s needs. These teams are flexible and can include a number of modalities but always including a general practitioner, a senior psychotherapist, naturopath, physiotherapist, acupuncturist, body-worker, yoga and meditation teacher and a specialist chef. Other modalities can be incorporated as required or as new needs become apparent.

Each practitioner is briefed prior to meeting the client but each will subsequently conduct specific assessments relevant to their treatment modality. Formal case conferences are then held twice weekly with the first case conference held within three days of a client’s arrival. At case conferences, each practitioner has the opportunity to discuss their diagnosis, observations, clinical opinions and treatment recommendations and to clarify any aspect of their treatment rationale that might not be understood as well by other practitioners. Where contradictions become apparent, these are resolved through discussion, negotiation and consultation with other practitioners. No aspect of the client’s stay with us is left unexamined, with carers and chefs also contributing their experiences of the client so that the treatment team functions in coordination and in unity. Our aim is to have all our practitioners and staff ‘on the same page’.

Importantly, every aspect of a client’s treatment is reviewed on a daily basis. Even though team case conferences are held twice a week, relevant practitioners liaise as required through the week, and practice notes and daily notes are collated and reviewed daily to enable us to remain responsive to any changes affecting our client.

In order for information to flow smoothly and efficiently between practitioners, The Sanctuary Byron Bay relies upon therapeutically oriented administrative staff who are trained to pick up any issues relating to the day –to-day management of each client’s program, and to inform any practitioner should any specific follow-up be required.

Obviously this is a very resource intensive approach but our results consistently show that truly integrated treatment can only occur where sufficient time is invested in coordinating a diversity of clinical perspectives. At The Sanctuary Byron Bay, we are committed to maintaining our well deserved reputation for effective, efficient and above all else, compassionate integrative care.

Karen Stuart Client Services Manager

One of our key aims at the Sanctuary Byron Bay is to have each client in residence enjoy a responsive and nurturing experience. From the point of view of each client, the efforts of many practitioners seemingly coalesce in a seamless, integrated service. But behind the scenes, a lot more discreet work is carried out than is easily evident. In this newsletter, the Sanctuary Byron Bay offers a glimpse into the less public world of our Client Services case managers, who work tirelessly in the background to ensure all programmes run smoothly and effectively.

We are pleased to introduce Karen Stuart, one of our Client Services case managers, who offers some insight into her role:

I work under the direction of the Clinical Director, the Administration & Client Services Director and the general Clinical team to devise and coordinate a client’s programme before they arrive. Even before a client arrives, a lot of liaison is necessary between the Client Services case managers, the Clinical Director and all practitioners to make sure everyone has the same information and that all the preparatory work in setting up the programme is completed satisfactorily. Once a client is in residence, I am responsible as the primary liaison for the client on a day-to-day basis, ensuring any requests are reviewed by the relevant practitioners and generally ensuring all clinical information is disseminated between practitioners accordingly.

I really consider one of the most important aspects of my role as developing a close rapport with each client: checking in with them by fax and daily phone calls, responding to their requests, and making sure I can create an atmosphere of mutual trust so each client feels they have an open forum and environment to express their authentic needs.

It’s important also that I support the personal care staff and practitioners working with the clients. Often they need regular updates and clarification of any aspect of the client’s day so that everyone is ‘on the same page’ and can respond consistently. It’s amazing just how much coordination is required to ensure at the experiential end of the program, that everything flows seamlessly and seemingly without effort. There are a lot of complex tiny steps that need to happen behind the scenes for an integrated program to work.

Sometimes I describe the work of Client Services as resembling a duck gliding smoothly through the water. We try to keep everything on the surface looking tranquil, smooth and effortless, but underneath the water, out of sight, there’s a lot of frantic paddling going on! We really try to take the stress out of a client’s stay by attending to all the little things like family visits, extra administration work, requested outings, departure arrangements – even dealing with pets. Our aim is to remain practical while maintaining a sense of nurturing responsiveness, for which the Sanctuary is now well known.

In a sense, Client Services case managers have to walk a fine line being responsive to a client’s requests and helping the clients maintain the restraint required to fulfil their overall therapeutic goals. For example, it is not necessarily in a client’s best interest to see a movie with explicit scenes showing drug taking and drinking if they are in the early stages of addressing substance abuse. Likewise, a client’s request for particular types of food may be contraindicated by the recommendations of the Sanctuary naturopath. Every request needs to be reviewed by the treatment team and this constant liaison between practitioners, the client and their case managers is what makes our program unique and absolutely responsive to a client’s therapeutic needs.

My own personal background is in social welfare and education, so as you can imagine, it was a challenge for me to commence work in a private health care organisation where the programmes seemed so expensive and elitist. But since working here, I’ve been amazed at how the one-on-one focus with a dedicated team of highly skilled practitioners can work wonders in such a short time. I’ve seen the most complex and intractable cases respond to our team effort, resulting in impressive growth and recovery. I’m pleased to be part of this effort.

I also appreciate the steps we take here at the Sanctuary to treat every enquiry with compassion and dignity, even if the enquirer is not able to afford our services. We always make sure we explore all referral options for each enquiry and in fact, one of the projects I’m involved in now is the development of an online treatment directory for Australian enquirers.

I have my own personal history as a substance user and while I was always able to function well despite my addictions, I did eventually seek successful treatment at a rehab and I’m now consequently deeply empathic to those facing a similar journey. I understand how cranky and miserable one can be while in the middle of a detox, and I think my own personal perspective helps me deal with clients in a way that reminds them they aren’t alone.

When I see people suffering in the early stages of recovery, I’m reminded of how self-destructive addictive behaviours can be. To be free of addictions requires work, but work that is so well worth doing. For the short term pain, a whole lifetime of gain can unfold – I’m glad to be able to be part of a client’s transition from self-harm to self-care.