Welcome back to the Embrace Family Recovery Podcast! I am delighted to introduce you to Geoffrey Golia, the former Clinical Director of New York Center for Living. Geoffrey has recently joined the New York City Criminal Justice Agency as Director of Clinical Services for the Queens Supervised Release Program.
Geoffrey’s work centered around Substance Use Disorder Treatment for
adolescents, young adults, and their families. Geoffrey has a fabulous way of teaching about the challenges of parenting young adults facing Substance Use Disorders and parenting in general.
Please meet Geoffrey Golia.
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See full transcript below.
00:01
You’re listening to the Embrace Family Recovery Podcast, a place for real conversations with people who love someone with the disease of addiction. Now here is your host, Margaret Swift Thompson.
Margaret 00:28
Welcome back, today, I would like to introduce you to Geoffrey Golia, the former clinical director at New York Center for Living an outpatient clinic for young people and teens ages 13 through 30, dealing with substance use disorder and mental health issues. Geoffrey’s work not only addresses the need of the young person, but also sees the impact on the wider family and significant people around them.
In this first episode with Geoffrey, we will discuss not only the impact of the disease of addiction on young people and loved ones, but the various treatment options and methods that can be used to support those involved and prepare families to navigate the road ahead, once their loved one is engaging in treatment and recovery. Welcome Geoffrey Golia.
01:19
the Embrace Family Recovery Podcast.
Margaret 01:35
I’m really honored that you have agreed to do this, and I thank you for being here. And really expect that my audience no matter whether their loved ones are adult children or younger. I have the privilege of having Geoffrey Golia. With me today, who I got the privilege of seeing on a webinar, Geoffrey, we were together, and you were the presenter. And I was really impressed by the way you describe the challenges the people who love someone with this disease experience. And so, what I would really appreciate before we get into some of the things that I heard you say that I’d love my audience to hear is, where you work, who your population is, who you serve. And we’ll make sure all of this is on the information of the podcast so people can look you up and look up your wonderful services.
Geoffrey Golia 02:27
Well, Margaret, thanks for having me. I’m really excited to be here. As you mentioned, I’m Geoffrey Golia. I’m a licensed clinical social worker. I’m the clinical director at the New York Center for Living. We are an outpatient clinic that provides substance use treatment for teens, young adults aged 13 to 30. We operate at an IOP or intensive outpatient level of care as well as an outpatient level of care in confront a lot of different services, individual services, psychotherapy, group therapy, psychiatry, to recovery coaching, parent coaching, and family therapy.
We understand that substance use disorder doesn’t just impact the identified client, in our case young people, but also their families. And so, our program is really developed to address not only that young person in treatment, but their parents, siblings, any other significant others that we can support.
And one thing I would say is that when young people make a change, when they start to embrace recovery, both in good ways and in challenging ways it interrupts the patterns of the family. And so not only do we want to coach parents on expectations, on positive reinforcement, on setting boundaries, but we also want to help them to navigate the road when their kid starts to get better. And so that’s an exciting part of the work that we do.
Margaret 03:42
And you’re in Manhattan.
Geoffrey Golia 03:44
We are, we are in Manhattan in New York City. We serve folks from all five boroughs from Westchester County, some folks come to us from Long Island, occasionally Connecticut and New Jersey. But there we are in East 52nd Street Monday through Friday, nine o’clock to 8pm. There to serve the young people of this area.
Margaret 04:01
And one of the things that I think appeal to having you on for me was, I’ll be transparent, most of my clients who I work with on the family coaching side are older adults, not the adolescent population. But I thought about, it as like the audience that experience struggle with parenting an adult with substance use disorder and other addictions, in a similar way that they struggle when they’re younger. That infantizing thing that happens because of behavior. So I think some of the ways you approach it and talk about it could be useful for anyone of any age navigating change within the family system with recovery.
Geoffrey Golia 04:40
Well, I appreciate you saying that. One thing that I would say is that, um, the talk you heard was about How to Talk to Your Kids About Substance Use and what you I think realized early that in fact, that talk is about parenting. And we’re going to discuss here certainly has a relevance to adolescents, emergent adults, adult children and how parents can parent them, and support them and hold boundaries, and send messages of support to encourage and motivate them to engage in substance use recovery.
And at the same time, I’d like to say that, you know, some of the advice I give or the guidance I give, is really true to the lifespan, you know, my daughter is three years old. And I find that the parenting I do with her, though has relevance, I think, to ways in which other folks parent and so, you know, I talk about authoritative parenting, and I know we’re gonna go over this more, but ways that we can find that sweet spot to demonstrate love, compassion, support for our children, but also at the same time, strong expectations, strong boundaries, and help to scaffold and guide them towards success in the future, whether they’re struggling with substance use, mental health issues or other issues or not.
Margaret 05:48
You’ve had also a career where you’ve worked with diverse populations. When you look at the work you do with people who are dual diagnosis, mental health issues, substance use disorders. What do you think the number one challenge for the surrounding family is? What do they tend to come to you and say, gosh, I just can’t get this, or I’m not sure what to do with this?
Geoffrey Golia 06:10
Very good question. Let me think there’s a couple that come to mind.
I mean, one is managing this stigma, right? We look around and we want our kids to be the best and the brightest, and we want them to have as few issues as possible, not just for them, because it makes their lives easier and less complicated. But also for us, how does it reflect on us as parents? How does it mean that we have to continue to engage in a lot of parenting, right? I think the fantasy is that at a certain point, they emerge into adulthood, that relationship shifts, and there’s not a lot of parenting that needs to happen anymore, Those relationships become more mutual.
So, I think the stigma and like the challenge of acknowledging like my kid has a problem. And ergo, my family has a problem that we need to address. And I think, from their understanding the magnitude of it, right. How deep is the problem? And that’s where in our program, we engage in an initial assessment, which includes both a psychiatric evaluation and what’s called a bio psychosocial assessment, so that we can really understand the story of not just the client, but the family intergenerationally, in terms of what’s coming up recently, and how development has happened.
And so, from there, it’s about saying, this is a salient and significant issue that needs to be addressed at this level of care, or at a higher level of care. And from there, being able to then wheeled those recommendations in a way that’s compassionate that recognizes the challenge of hearing that sometimes parents have a hard time human right, that situation is significant enough to require intensive intervention.
The other thing, I think, is denial. I was trained in psychoanalytic and psychodynamic therapy, and while I’ve trained in other modalities, they sometimes go back to those old ego defenses, and denial is the most ancient one. We want to think it’s not there. And as families get into patterns, where they enable, ignore, minimize, deny, the identified patient, the young person with the substance use issue, they utilize denial a lot, right? It’s not happening, I’m just gonna keep on doing what I’m doing, right? I’m not gonna deal with that. And that’s when the issues will proliferate.
And so, what we really want to focus on is we want to shine a light on the issues, we’re only as sick as our secrets. And that includes families. And so yeah, our initial engagement with parents is one, I think that this goes across the board with any good program like ours, or any coaching practice is compassion, curiosity, de-stigmatizing normalizing to the extent that normalizing is going to help folks get in the door wall. So then recognizing sometimes the severity of the problem. And so that I think to answer your question, right, is these are some of the things that we we face and we deal with, and I would say to like, learning how to reparent
Margaret: Yeah,
Geoffrey Golia: it’s been a lot of the work.
Margaret 08:56
And with the denial, you know, I see in my families, a level of denial, because you want to believe the best in your person, a level of denial, because of the fear around is this really that bad? The recognition of their own journey, and I grew out of it, and it’s not that bad. Do you see that a lot in your families as well?
Geoffrey Golia 09:20
Yeah, certainly the thing that I think I speak about when I do that parenting talk, because I think it’s important for parents to look at their own behaviors, their own history, and that’s relevant and important. But recognize that while the apple doesn’t fall far from the tree, sometimes it’s far enough that yes, there issues with substances might be more severe than maybe yours was right? Maybe you utilized alcohol and cannabis as a younger person, and somehow that came out in the wash, right?
Or otherwise, maybe you are in fact using that
Margaret: Right.
Geoffrey Golia: but that young people can present with more serious substance use issues and for us to try to look at that not out of the context of the family system, but look at that to say, what’s going on here that feels unique and different. The other piece of that is I think for parents who don’t necessarily have issues with substance use disorder, but do drink alcohol, right? Or maybe use cannabis recreationally in a way that is unproblematic for them is
Margaret: Right.
Geoffrey Golia: You know, the kids will say, well, you do it, you know, and I think for a parent to be able to confidently say, for a number of different reasons, it’s different because of your age, right? Developmentally, it is not good for you right? Now, I am setting the boundary to say that that is not something that you should do, you know, we should seek to delay all use until the mid 20s. Right. All the evidence suggests that if you delay use until the age of 26, which is a tall order, but the evidence suggests that if you do that, then any use after that shows a decreased risk of developing a substance use disorder. And then of course, there’s the neuroscience, right around use of cannabis for young people use alcohol for young people, and the negative impact that it has on their brain, not withstanding their behavior, right.
But for parents, I think it’s about being able to kind of be confident, as it were to say, these are my boundaries. These are the expectations as the parent and listen, there’s beautiful things going on in like the revolution around parenting in this country, around being thoughtful with our children, respecting their personhood. What we don’t want to lose I think in that is that parents have a responsibility to set clear boundaries and expectations with their kids. To utilize as best they can positive reinforcement, we seek to use the same positive reinforcement and treatment. So anyway, just to kind of button this up, I think that parents doing that work to be sort of courageous and open in how they communicate, and maintain those strong boundaries and strong expectations. And again, with love,
Margaret: Right.
Geoffrey Golia: Tell our kids that we love them all the time. But what follows from that isn’t always I’m gonna let you do everything. But I love you. And therefore no.
Margaret 11:42
And I think that that’s one of the things I hear in the change and evolution of resources approaches, is the struggle with boundaries being cutting people off, which I totally disagree with. And I don’t think that is accurate. But that’s some of the stigma around setting healthy boundaries. And being a loving parent, while having boundaries. My language is love the person, have boundaries against the behavior and the disease. And I’m guessing that would be similar to you. Do you find that families along that line come to you with so much fear that it almost paralyzes them to do this differently? Because they’re just so afraid for the future of their child?
Geoffrey Golia 12:22
Yeah, absolutely. You can feel it sometimes, right? How afraid they are.
And the fear is, in some ways doing the wrong thing. If I’m maybe overstating, am I overstating it? Is this normal? Is it not because I don’t want to overcorrect. And I don’t want to do something that’s going to drive my child away. Right. So that’s certainly the fear .
Or the fear that I’m afraid for my child is truly unmanageable right now, and I don’t know what to do, right. And then they’re seeking help. I’m reminded of a quote from the book Game of Thrones, when Ned Stark says, you know, “the only time we can have courage is when we’re afraid.” You know, I noticed that it was revealed that quote, not everybody reads those book is as nerdy as me. But I do think that that is a moment where we can step up, and we can start to build capacity to say, okay, I’m afraid now. And my fear, though, needs to drive me to act with love and compassion towards my child in a way that’s going to support, hopefully build some motivation towards critically examining their issues.
I think the parents of young people have the capacity too, to persuade in strong ways towards treatment, it’s more difficult with adults, and that’s where you get rhetoric and language around cutting people off or setting that boundary.
For younger people, the incentive structure is different.
Margaret: Sure.
Geoffrey Golia: And I think that you can utilize that initial fear and concern and say, Okay, I’m gonna seek support and get help. What are the things that our program does is we provide parent only support, the young person is not willing to get treatment, we will support that person. That could be psychotherapy, that can even be psychiatry. But one piece that I really encourage my staff, especially my family therapist, is around parent coaching, right? Like what you do, right, which is just how do we help that parent to eventually go back to their child and say, I am now equipped with the toolbox to manage my fear. And as it were sublimated into a process by which I can support you in treatment. And I can, as it were, do what I need to do to get you there. Because that’s a big conversation that we have.
Margaret 14:19
I love that. And I have absolutely experienced people who started their own recovery before their child partners, anybody has found their way in the rooms and you see the impact that has on the trajectory for the person who is on the family side, getting the help, whatever that is for them, but then the impact that can have for their loved one. I always say, you know, telling an addict to do something, when they have the disease within them, they will find the opposite and convince you that’s accurate. Whereas if you role model out loud your recovery and ways you take care of yourself. They’re seeing that there’s a part of them that knows that and you’re not getting in the muck with the disease as easy when you do those behaviors. But it’s a learning, that’s a huge change.
Do you find families reticent to get help for themselves or your population tends to be that the young person is identified as the patient in this case, but the families are eager to also get help and education.
Geoffrey Golia 15:17
I mean, fix my kid, right? You hear that all the time? Fix my kid. I mean, you don’t necessarily always literally hear that. But that’s the message you’re getting right? Is they need to be fixed. And so what are you doing about it? Right, what are you doing for your own recovery? What do we use that rhetoric is so important, right around recovery, we’re on recovery for something. And, and from something, I would say that, you know, utilizing early and often the language of parents and family recovery, is I think, key in kind of laying that groundwork for what that is going to look like.
And so, listen, we early and often set the expectation that our program involves parent only groups, multifamily groups, family therapy, family coaching as necessary. That is an essential part of the work that we do. And my sense is, you know, in everywhere I’ve worked, that sort of worked on this issue, has recognized and sought to provide interventions to the family, and to the parents, because it is absolutely necessary.
One of my family therapists, you know, he’s a trained MFT. And he does a lot with family systems, right, and that sort of approach. And the idea is that families seek homeostasis all the time, right. And so, when you say to them, there’s a significant issue with your child, whether they are in treatment, or you’re seeking to get them in treatment, you also need to do the work, because any interruption with them is going to be an interruption in the whole system. And so, you need to find a way to roll with that. And for the people who can’t see me, I’m doing a silly move with my arms, like a wave, because that’s what we have to do, we have to ride that wave and give people the capacity to balance in that context.
16:54
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Margaret 16:58
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18:01
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Margaret 18:11
So, this may be two minute of an issue, but I hear it a lot. So, I’m gonna throw it out because I’m guessing there’s listeners who feel it and are experiencing it. You get to that point when your child turns 18. They’re still struggling, they may not have engaged in recovery yet. And as you said, when they’re in the home, and they’re minors, there’s more leverage/ability to help them find services make them happen. How do you support people in that transition phase? Because you treat adolescents, young adults. So that’s a really complicated stage on many levels for the family surrounding them, because I suddenly have no authority or limited ability, using old school language to influence them in a way that I might have prior to them being an adult, according to law.
Geoffrey Golia 19:03
To some extent, that’s true, right? It’s a different form of leverage when they’re younger, for instance, right? If and, you know, it’s strange to kind of jump to this extreme example, right. But when you say you can’t live here, if you are doing that, right, you can’t do that with folks under 18. I’m sure every jurisdiction has sort of different laws about that. But when you’re 18, that is sort of a nuclear option, right that one could utilize. And listen, that decision is extremely difficult and involves a lot of I think, work to get there. And to think about how to utilize that in a therapeutic way, then people differ about what they think about that. But I would say this 18-year-olds and up, 18 to mid 20s, even to 30s Right, and I’ll be honest, like so my experience is mostly with folks under 30. So I’m gonna kind of stay in my lane with respect to that is that those young people, those emerging adults are still exceptionally dependent on their parents. And there are thoughtful ways that parents can utilize leverage in order to work treatment at that time. And so, I think it just opens up different options with respect to doing that. But I would say that like, so if we recognize that maybe the parenting hasn’t been consistent and authoritative, Irvin Yalom says, you know, you can’t strike while the iron is hot strike while the iron is cold, you got to do what you can do.”
Right? Right.
We can focus on developing a plan by which parents can thoughtfully utilize leverage and set clear expectations and boundaries, to help to enhance motivation towards sobriety, right, because the other piece around this is that you can send the transport team to send a young person to treatment, and they go to treatment. And sometimes it works. And sometimes it doesn’t, in large part, because they have kind of looked around and said, you know, what, my life is unmanageable, even as at a young age, and I want to make a change, right. So, they’ve already moved to a different stage of change, from pre contemplation to contemplation, maybe the planning, maybe to action, maybe there’s a little bit of a few of them. But motivation enhancement, right is going to be the key here, right is going to be about really being able to the best of your ability, if there’s not acute safety concerns, to say to a young person, I’m setting a clear expectation about what I want, my message of support is that you seek treatment and that you seek recovery. These are the ways in which I will support you in that, and these are the ways that I can’t support you, if you don’t do that. And then being consistent with those and coaching programs like ours, we can help to not only treat that young person, and treat the family, and provide the coaching. But also, sometimes it’s as simple as like writing it out like a contract. And it’s funny because, you know, working with young people of different stripes in different areas, right? They’re always surprised at how much work adulthood is. And I’m like, you need to plan everything, you need everything your calendar, you need to write things down. Like you can’t just go willy nilly on these things. And so sometimes as parents, it’s about like, this is the script, this is what we’re gonna say, this is what we’re going to repeat, because the consistency and repetition is so important when it comes to being able to set those expectations, set those boundaries and then see it through.
Margaret 22:01
And so, I hear your point that the leverage changes, and it’s inciting and influencing or attempting to their level of motivation, because ultimately love and compassion leads this, right. But that can get so messy, because the love and then the fear get tangled up. And it’s like, oh, what if it goes horribly wrong? What if it gets worse? What if right, the what ifs.
So the piece that I hear is vital to the work you do and I agree in mine, is helping the families, the loved ones get some stability and a plan for themselves, some language, some understanding, and understand the nature of the illness with which they’re dealing with because a lot of people have an expectation of, based on that stigma of what it looks like that may look very different than what’s going on in one’s home. So, helping them understand those things as part of the journey that I hear you offer.
22:59
Geoffrey Golia: Psychoeducation is kind of like the technical word for it. And it sounds like oh, look, I’m learning about like psychological issues and mental illness. But psycho education is about understanding a wide swath of important information, the impact that substances have on the brain, the impact of substances have on the family system, you know, what different recovery oriented systems of support exist out there, what kinds of treatments exist out there that can be helpful for this. What medications for addiction treatment can be utilized in the service of this knowledge is power in these situations. And I think that what we see with parents coming in is they don’t know. Right? I look at like the search, you know, get the back end like that what people search that leads us to our website, right? And like the things they might have heard IOP somewhere, right? So, they’re searching substance use IOP.
Right?
You know, they’re searching for teen program, right? Like all these things like, this speaks to people kind of Googling and saying, I don’t know where to start here, right? And so, when they call us, the first thing is how are you doing? Right? You’re calling is because things aren’t going? Great. So, let’s just start there, how are youdoing? And then from there, we can start to provide information education about our program of other levels of care. And then in the program, we can provide psychoeducation on substances interacting with the brain addiction, overdoses, all of that important information for families that they can be equipped and know about this issue. Because again, the fear that you mentioned before is tied so much to our lack of knowledge.
For sure
It’s tied so much to the unknown, and also of the stigma of substance use, right, where are they getting it? What are they using? And by the way, I mean that there’s some real concerns about that. Right. The proliferation of fentanyl isn’t deadly and dangerous issue. Right. It’s great that we have things like vivitrol, and buprenorphine, and it’s great that we have Narcan. But you know, we do want to provide you know, we don’t want to scare but we do want to provide fact based information that helps people to just feel like a little bit more knowledgeable and then also give them the support so they can build that urge to move forward.
Margaret 24:25
Sure. Yeah, you cover a lot that right there. I mean, you know, I think about the average person searching, I think that’s a fascinating thing. Because I know, when I worked in a treatment center for a long time, I would often find families would come in and say, what language are you speaking, you will have these terms and these acronyms and these things, and I don’t know why you’re. So a part of the psychoeducation is huge from the get go. And also, the inability for some people. And I would say myself included in my journey, when I love someone with this disease, to speak it out loud to maybe find someone who knows how to steer me in the right direction. That silent search, that keeping it down low while trying to figure it all out, can really be challenging, like you say, when they’re searching IOP, because I’ve heard that term, but they don’t really know what it means. So, it’s an interesting challenge for families. We really have to work don’t we have Geoffrey on destigmatizing mental illness, substance use disorder, and all aspects of our life that seem to have this dirty feel to them, which it isn’t? It’s just like if we had another ailment.
Geoffrey Golia 26:07
My medical director, Dr. Collins, who is a great mentor for me, he talks a lot about the language we use, right? We’ve tried to stay away from words like clean, and we can say that person tested negative, right? Or I’m clean and sober. Well, you’re sober. And that’s awesome. Right? But clean, right? Has this kind of judgment to it. Right?
So, a lot of it is one yes. Getting rid of the jargon, when we’re speaking with parents, right. Obviously, we use jargon, I think internally because it’s expedient. But I think for parents, we want to use commonplace common-sense language. I shy away from substance abuse, focus on substance use, right or maybe misuse, right? Being thoughtful about those sorts of things. I have something to where I’d prefer not to use the term marijuana, but cannabis, right, because there is a bit of a racist origin to the use of that term. Although, you know, I don’t hold it against other folks necessarily. But I do like to provide that education.
So, beyond that, when we’re talking about increasing awareness and information for parents, folks like you, and maybe the science and folks like me, but the parent coaches that people were kind of on the front lines, who are meeting people in the moment of crisis, and the moment where they pick up the phone. You are the translators and navigators for them of this world of treatment. Which has programs that are great, and programs aren’t great. And that levels of care that makes sense for this person and levels of care that don’t make sense for this person. And I do think that like, that is so key, our capacity to build rapport and relationship, and from then to guide in a way that’s thoughtful, sometimes directed, but oftentimes not. If I encounter a family and I say, listen, we’re not the right level of care you the high level of care, what do I do? And I say, well, here are the options.
Right.
I can’t tell you how to get your kid from point A to point B, I can offer the options and to some extent, if there’s a program you’re looking at, I would take their advice with respect to that. But what I can do is I can help you to some extent pros and cons this out right? What’s gonna be the benefit of this approach versus this approach.
And a lot of that’s contingent on the individual factors of that family, the dangerousness of the substances being used the potential lethality issues around personal safety issues around safety of the family. There’s so many different you know, issues and all we can do is try to partialize, which is to say create a nice look understandable list of what’s happening there. And then do the pros and cons to determine what’s the best way that we’re going to get this young person the help that they need.
Margaret 28:27
And then add on the help for the family which you do, and many facilities do which I am very glad for.
Outro: Comes back next week where Geoffrey and I continue the conversation. And we discuss parenting styles, cohesive, consistent decision making, and how these play a role in the family dealing with a loved one battling the disease of addiction.
I want to thank my guest for their courage and vulnerability and sharing parts of their story. Please find resources on my website
This is Margaret Swift Thompson.
Until next time, please take care of you!
