Sanford House at John Street for Men is quiet on a Saturday. After a long week, the men in residential treatment embrace the weekend and Saturday programming with a more casual vibe. This is not to say we set aside the evidence-based practices we employ during the week, but the work is more relaxed and organic.
The subject of our Limelight Interview, Lance Howe, works during the week, but also facilitates Saturday programming at John Street. He says the lighter atmosphere helps to establish community within the house. It also provides a respite from the more structured programming during the week.
Saturday programming is fun. As the facilitator, I have the ability to be a bit more casual. We use music therapy, and movies – where we discuss relational concepts ‘before and after’ recovery. It is just a less structured way to get there.
Lance Howe, MS, CADC
Saturday Programming, Establishing Community – Limelight Interview Lance Howe, MS, CADC
1. Let’s start with the fact you began working for Sanford during a pandemic. How has COVID-19 impacted residential treatment?
Well, I started working at Sanford this summer, first with Saturday programming and then full-time. So, I do not know Sanford other than with COVID-19 protocols. I don’t have a lot to compare it to, other than previous work I’ve done. COVID has certainly effected treatment, but the core has not changed. There is not as much connection to the community in-person. But there is human connection on an individual basis, and of course telehealth for 12-step meetings. I am a strong proponent of connection in recovery and the work of Johann Hari, so I appreciate the detriment to isolation and the positives in community.
2. What is your primary focus?
I believe that substance use disorders are tertiary to the problem. First is trauma, then mental health related issues, and then comes the dependence on substances. My primary focus is establishing the core experiences that cause addiction. The rest will fall into place like dominoes. We might not solve everything in residential treatment, but we can start unpacking the suitcase.
3. What is your treatment philosophy? Those things you know to be true about addiction?
I’ll go back to my radical attention to the concept espoused by Johann Hari. We turn to substances because we can’t connect to other things – there are deficiencies in our connection. And we must feel connected to another human being or beings. We are more “connected” than ever before online, but it has culminated in loneliness. And then COVID-19 stepped in …
4. Why did you become a therapist?
Why? I have always had a drive to be involved with helping people. But I just didn’t know how I would do it. I stumbled into therapy … The interest that drove me to this field was subconscious. I was raised by a single mother, functioning without a GED … extensive substance issues … The universe does that to people – gets us to where we want to be.
5. Tell me about your experience in the tribal community.
I worked with tribal communities, first in Arizona and later in the Upper Peninsula with The Bay Mills Indian Community. They are one of the Sault Ste. Marie bands of the Chippewa. My ex-wife is tribal, and we moved there for her job, but I also facilitated outpatient therapy groups while there. And I spearheaded needs/programs such as harm reduction and Narcan distribution. The tribal communities have cutting edge healthcare systems.
6. What is the key to recovery success? Connection?
Two things. First, appropriate step-down care after residential treatment. The longer the duration of treatment (a year, year 1/2), the better the chances of long-term recovery. And secondly, establishing a community. It can be AA or NA, Buddhist based, church, alumni groups, a new set of sober friends, hiking, biking, disk-golf! Everyone’s recovery is different, but everyone needs connection.
7. What about the biggest pitfalls/triggers to relapse?
Over confidence. Exposure to triggers before a comfort level in recovery is established. Not being vigilant. Forgetting you are in recovery and stopping doing the things that got you to that point.
8. What’s the “fun” part of your job?
I love Saturday Programming. It allows me to be more casual with things like relevant movies and music therapy. Saturday Programming is less structured, more organic and builds community.
Why gender specific, and is there anything particular with men’s addiction treatment?
Gender specific is the gold standard for residential treatment. With the short amount of time we have them in-house, men heal best with other men. And the particular thing about men’s treatment is redefining what “manliness” is. We are dealing with emotional ineptness, and trauma. Those are the biggest things to overcome.
9. What about the most challenging part of the job?
Balancing personalities in the house. And knowing when to let the group explore an idea, and when to hold back. It seems like that would be easy, but it took me a while to get good at it. You have to find the balance, and I have a knack for the “gentle push” if appropriate. However, if a client is not ready to share, I am not an advocate of forcing a person to share – you can read the body language.
10. Do you read for pleasure? What kind of books?
I am an avid reader! Whenever I move, the first thing I do is find a bookshelf for my books. Books are like people to me – a person’s library is a snapshot of who they are. I read all kinds of things.
11. What makes Sanford unique?
The beautiful, comfortable setting. Phenomenal!
12. What is your favorite journey?
The past couple of years I have devoted to self-exploration. I found I was telling others to “live their truth” and “find their passion” and I was doing none of that myself. Unfortunately, it led to a divorce, but it has been a heartbreaking and cool journey.
13. What is your most marked characteristic?
I think my most marked characteristic is that I am not a native Michigander. I’m an Okie, born and bred and it has shaped my outlook. I’m not from here.
14. Words or phrases you use a lot (or overuse)?
That’s really powerful. I like to redefine what “powerful” means to the men at John Street. And let them know that when they are at their most vulnerable, it can be a powerful moment in their recovery …
15. Finally, do you have a motto?
I have two heroes of fiction – Oscar Wilde and Mark Twain. These quotes are probably my mottoes:
Life is far too important a thing ever to talk seriously about. Oscar Wild
The pause – that impressive silence, that eloquent silence, that geometrically progressive silence which often achieves a desired effect where no combination of words, however felicitous, could accomplish it. Mark Twain
Thanks Lance. SH