David Minot, Executive Director of Mental Health News Education, the non-profit organization that publishes Behavioral Health News, interviews Johana Lizarraga, a Program Coordinator of Outpatient Substance Use Services at Outreach in NYC and Long Island. Johana details her work with the Spanish speaking Latin community as a Credentialed Alcoholism and Substance Abuse Counselor (CASAC) where she is changing the world through healing, recovery, and advocacy for those who truly need it.
David Minot: Hi and welcome to the Behavioral Health News Spotlight on Excellence series, where we feature exceptional leaders and innovative healthcare solutions that are raising the standards of care in the behavioral health community. My name is David Minot and I am the Executive Director of Mental Health News Education, the non-profit organization that publishes Behavioral Health News and Autism Spectrum News. Our mission is devoted to improving lives and the delivery of care for people living with mental illness, substance use disorder, and autism while also supporting their families and the professional communities that serve them by providing a trusted source of science-based education, information, advocacy, and quality resources in the community.
Today, we are speaking with Johana Lizarraga, Program Coordinator of Outpatient Substance Use Services at Suffolk Avenue for Outreach. Outreach is a non-profit organization that provides life-changing drug and alcohol abuse treatment and training services in New York City and Long Island.
Johana, thanks so much for being here with us today!
Johana Lizarraga: Thank you for having me!
David: How about we start by having you tell us a little bit about your role as Program Coordinator at Outreach and maybe provide an overview of the services provided there.
Johana: Sure. I would like to start by mentioning that it’s perfect that we’re having this conversation now because September is National Recovery Month. I think it would be helpful to start by providing a background of Outreach. Outreach first started in 1979. The organization’s mission has always been to build healthier lives and meet the needs of the community we serve. We’ve evolved through the years and have been able to open multiple locations. We have some in Queens, Brooklyn, and in Long Island. The Outreach headquarters is located in Richmond Hill, where we provide outpatient services and have the Outreach Training Institute. We have another location in Ridgewood, which offers services for adolescents and it’s residential treatment. We have another one in Greenpoint that provides outpatient services. We have a few locations in Brentwood on Crooked Hill Road that provides adolescent residential services, outpatient services, and where we have another Training Institute – which I actually attended and was able to get my CASAC there. At the same location, there is a recovery residence for women. And we also have an Outreach Recovery Center at Pilgrim State where they provide outpatient and community residential services for men and veterans and an MAT hub. We have another location in Bellport which provides outpatient and day rehab. There is another location one in Roosevelt, which is our newest one, called the Outreach REACT Center where they provide outpatient services. And of course, we have left Suffolk Avenue which is the location where I currently work where we offer outpatient services. We also offer services in Spanish and English for men and women over the age of 18. At Suffolk Avenue we have a parole track, a DWI track, a MICA program, we offer peer services, parenting, anger management, and evening and morning groups. We are also a component to the women’s CR. And we are connected to Sun River Health, which is a van that provides medical services to our clients here. So, we do a lot!
It’s a lot. But, if we look into what I do as a Program Coordinator at Outreach, you never really know what’s happening day-to-day. Working in this field keeps you on your toes. It’s always exciting because you’re not going to be bored, I can tell you that much. We manage crises here. Sometimes when I come in, I have to deal with medication issues. Or I’m answering emails and handling what to do if there’s somebody’s calling out. I also run groups. I also do individual sessions because, as a Program Coordinator, I carry a small caseload with about 10 to 15 clients. I run reports, attend trainings, host events representing Outreach, and things like that. So, I have the best of both worlds. I have the management position as well as keeping the connection with the clients and still being a clinician.
David: You mentioned you attended the training institute where you got your CASAC. Can you tell us a little bit more about your personal journey that led you to choose this career and how you got here?
Johana: Of course. I migrated from Peru in 1998 when I was seven years old, having to learn a different language. I graduated from Brentwood High School, went to Suffolk Community College, and then attended the Outreach Training Institute. I spent a year at the training institute and was able to get my CASAC-T. I did my internship at Outreach – I’ve always been here! I’ve been here for about nine years now. After my internship, I started out Outreach as a secretary in 2012. While I was a secretary, I attended the community college and at the same time did the Outreach Training Institute. So, I was doing double schooling and working at Outreach part time while I was a single mom as well. I completed that, did my internship here, and went to Stony Brook University. I was hired as a part time than a full timer counselor here, where I helped grow the Spanish track for the Latin community.
At some point, we had about five clinicians that offered Spanish services, which was amazing. But then, COVID hit, and things became a little bit more challenging for us. During COVID, I think everyone went through a little bit of a crisis where you were questioning what you’re doing. I ended up losing my father due to COVID. After having a discussion with the director, I took some time off because I really needed it. I’m an only child and I’m very close to my mom, dad, and my daughter. When I was going through a very hard and difficult time, I was able to get support I needed from my team members at Outreach. They asked me, “What is it that you really want to do?” So, after taking some time off, I came back – not that I left the job, but I just took a little bit of like a vacation time to just recuperate and get my thoughts together. And I realized this is truly what I want to do. And you know, they have a great program. They offer tuition reimbursement here. They said, “You should go back to school! We support you.” I attended online classes at New Hampshire University, where I completed my bachelor’s in psychology in 2021. I’m now attending Adelphi for my master’s in social work.
I started off as something as simple as a Secretary to now a Program Coordinator here at Outreach. And I realized that after going through like multiple challenges, my passion is working in this field because I realized that, despite the rough days, making an impact in someone’s life that leads to change is truly my passion. We all have a voice. And I think that it’s our duty as a community to learn to utilize it for those who fear to utilize their voice, and I think together, we can create change and definitely save lives.
David: You are certainly changing lives with your important work! Is the work that you do primarily with the Spanish speaking Latin community?
Johana: Yes. When I first entered, I started working with women and then, because I spoke Spanish, we figured why not offer those services in Spanish, right? I’ve pretty much always served the Latin community. And it’s been challenging for this community. Treatment hasn’t always been accepted by this community – it has been rejected because there’s so much taboo around it. Because of that, it has definitely been challenging to work with them, I would say, but it’s also been very rewarding to be able to see the outcome of the change – of planting that seed.
David: What are some specific challenges that you and others in the field serving the Latin community have had to face? You mentioned the stigma and the taboo and getting past that I’m sure is part of it.
Johana: It is. But also, I think there aren’t enough opportunities for people to obtain their education in this field – there isn’t a lot of promotion of it. And, you know, I’ve noticed that the younger generation who are coming into this field are not always fluent in the language, which is an issue. The people who migrate to this to this country, it’s almost like they’re leaving everything behind, including the language or they’re forced to learn another language, and they’re not teaching their children their native language. It’s challenging sometimes when we get people who apply for a position and I’m speaking to them in Spanish and they’re not fluent – so they’re not going to be able to serve that community. And I can’t stress enough that there aren’t enough clinicians who speak the language and can serve our communities. There are so many people that have decided to leave the field. I had mentioned earlier that we had five clinicians and now we are down to just two. And the stressful part about it, I believe, is the large caseload. I want to serve everyone. I was actually saying that to a group the other day, that I wish we could have so many more clinicians. But because of COVID, we had to reduce the quantity of people we serve in a room. We used to have group rooms of 15 people where now we had to reduce that to six.
David: So, you are meeting in person – it’s not just all virtual?
Johana: Yes, we do everything in person. We do offer telehealth if it’s needed, but because we deal with people who are mandated, it’s better to have them in person.
David: So how receptive do you think the Latin community is now versus in the past to receiving help for substance use disorders and mental health issues?
Johana: I think that there’s definitely been a change. I’ve noticed that, when I first started, the substance was only alcohol – there was no such thing as marijuana, cocaine, crack, heroin, or anything of that nature, at least in Long Island where I was located. And it’s now so much more broad. They’re more open to talking about the trauma and the issues that led them to the U.S. and what they’ve tried and the feelings and emotions around all of this. I think that after COVID, there’s so much more promotion of mental health, that they’re more open to it. And you know, there’s implementation of the trauma screen and all of these things that really trigger further conversations, not just the substance use disorder that they’re coming for. It’s now so much more and it’s combination of everything. It started out as just alcohol, and now it’s everything.
David: Is there something in particular today, September of 2022, that is really pervasive in the Latin community as really a big issue?
Johana: I think for the Latin community, it’s heavier on the alcohol and the cocaine, whereas for English speaking tracks, it’s heavier on marijuana and opiate use. That’s the difference that I’ve seen.
David: This is clearly a stressful job. How do you and your colleagues handle the stress and avoid burnout as substance use disorder counselors?
Johana: We’re very fortunate to be able to offer supervision – we have individual supervision on a weekly basis. We also have case conferences, which is where we all get together once a week for about an hour and a half (sometimes we go over a little bit) on a weekly basis. We also have a great team. I’m very fortunate to work with such a great team. We have three supervisors here. Our doors are always open and we talk to each other. I think that is the best thing to do if you’ve had a really heavy session, you can go in and talk to someone about your feelings. You can talk about what you’re feeling if there’s some countertransference going on. We also encourage self-care. Outreach gives us personal days and days off sometimes. If you feel like you’re overwhelmed, we encourage you to take a day off and do something for yourself. Personally, I take therapy. I have a therapist I see every week and have been doing so for years. That’s been very helpful for my own growth and my personal self-care – she encourages me to go out and do things I love.
David: It sounds like you have a supportive family at Outreach.
Johana: Exactly! We eat together. That’s another thing, we eat together when we’re stressed. It’s maybe not the best coping skill, but we’ll say, “Are we ready to order tacos today?”
David: We’ve talked about some of the challenges and the stress that you grapple with. Can you share some of the highlights that come with your work?
Johana: For the people that get into this field, it’s really because you’re passionate about helping others. But for me, it’s also about being able to see the progress, no matter how small it may seem. You’re planting the seed for someone, you’re doing this change, you are helping others get to where they need to be. People who come here are mandated and I can’t sugarcoat that. And sometimes that can be a little bit of a challenge because we struggle to get them to want to see the help that they need. There’s a difference between seeing somebody who wants help versus somebody who doesn’t know how to ask for it. It’s not that they don’t want it, they just don’t know how to ask for it or they don’t really know that it is an issue in their life. Engagement is something huge for us and we get pushed back.
The other day, I was talking to someone about the difficulty of realizing that you really can’t do this on your own. As much as you want to think you can, you really can’t and getting there is a little difficult but it’s also rewarding. It’s rewarding to see that, wow, it took us this long to get to the conversation of, “You know what, maybe I need this.” I always say, “I’m not here to tell you the answer. I’m here to help you find the answer. Whatever that means for you.”
David: It must be really gratifying to see the progress for people from when they’re really struggling to eventually feeling empowered to take steps to improve and make changes. Of course, the road to recovery will continue to be an ongoing process, but you are helping them to reach certain milestones and directing them down the right path so that they may continue to make progress in their lives.
Johana: Right. And just because something means something to me doesn’t mean it’s going to be effective for them. It’s really about providing person-centered care and working with them to achieve their goal, whatever their goal is.
David: I’m sure every situation is different.
David: With the workforce shortage, you mentioned the difficulty of filling positions for Spanish speaking clinicians and counselors. Can you provide a message of inspiration and hope for people who are considering a career as a counselor working with people living with substance use disorders?
Johana: I can say that this field is a growing field – there’s so much need for the services. You will have multiple opportunities – there are so many agencies who provide different tracks or different things that you may be interested in. I think it’s really important to remember that it’s really about changing one person at a time. My biggest message would be that the substance use field is challenging. It takes a special individual to want to go on a journey with a powerful meaning to change the world through healing, recovery, and learning to advocate for those who truly need it.
David: That’s really a nice message. You’re really making a difference in people’s lives and making a positive impact on the overall community. I think that’s a good place to stop. I really value our time together and I want to thank you for taking the time to talk with me. It’s been such a pleasure to speak with you.
Johana: Same! Thank you for having me here.
For more information about Outreach, please visit opiny.org and stay tuned for our next installment of the Behavioral Health News Spotlight on Excellence Series.