In this interview, we spoke with Melissa Monroe, Clinical Director at Rushford Center, a Hartford Healthcare company. Melissa shares her thoughts on the evolution of TetherAll at Rushford and the impact on client engagement and their outcomes.

By: Michelle Voegtle, M.Ed., LPC, and Director of Clinical Programs at TryCycle Data Systems Inc.

Can you tell me a little bit about your role as Clinical Director at Rushford?
I manage multiple outpatient treatment programs throughout the state of Connecticut for Substance Use and Mental Health. We also offer Medicated Assisted Treatment at different levels of care such as Partial Hospitalization, Intensive Outpatient, and Outpatient, both short-term and long-term.

What are some of the biggest challenges you face as a treatment provider working with individuals in early recovery?
Preventing relapse and really working to engage clients. Engagement and consistency are the hardest challenges, from the first day a client starts treatment, and then through all the different levels of care.

How did TetherAll play a role in supporting your goal to increase client engagement and consistency in treatment?
The main purpose for using TetherAll was to enhance the client experience (in treatment) and increase client engagement. In the spaces between treatment appointments, a lot can happen, and we couldn’t capture that between sessions before TetherAll. Especially for clients who go a week in between sessions, a lot can change, and it’s hard to process that in a one-hour session.

TetherAll gives clients a chance to share more and gives clinicians more insight into what’s happening in their clients’ lives. It enhances the actual treatment hour because clinicians already have so much information ahead of time!

It also gives people an outlet to be honest; TetherAll provides a safe space for clients to share information, and to disclose it in a way that’s private.

I understand you were one of the first agencies to build and utilize TetherAll, what was that like? Can you tell me how the concept came about?
Our Medical Director approached me one day and shared an opportunity regarding an app that connected to clients outside of treatment. I’ll admit, initially, I thought it was just one more project on my plate. But it quickly turned into my passion project; I prioritized the project knowing it was innovative, something that was going to help people.

The TryCycle team was great, always inviting and it was exciting. No idea was ever off the table, there was a lot of exploration and thoughtful conversations. There was a lot of testing to see what would make sense, being open to making changes, and adapting to the clinical needs. TetherAll was an opportunity to be better, to help our clients in new ways.

Tell me about engaging clinicians.
Clinicians realize that TetherAll is value-added to a client’s treatment, and they see the benefit. They see the value added in a lot of different ways; for example, when clients use TetherAll over the weekend or on holidays. It serves as a deeper connection for a therapist to their clients.

What about Recovery Support Specialists (RSS)? Are they using TetherAll?
Yes. Our Recovery Support Specialists (RSS) use TetherAll to provide feedback and intervene when a client may not be doing very well, they are very responsive. But RSS don’t just use TetherAll for high-risk clients; they help clients focus on their recovery overall. They let clients know, “I see that you are staying sober, I see you, I hear you.” Clients want to talk with someone that really understands; their Recovery Support Specialist is seen as accepting and engaging. There’s tremendous value in having the RSS engage with clients through TetherAll.

What have you learned about implementing TetherAll as a clinical tool?
This tool really helped our staff with client engagement. Because of TetherAll, we have had a lot of interventions with clients to keep them safe. The fact we haven’t had deaths by suicide or overdose with clients using TetherAll is amazing. Especially with something we couldn’t predict or prepare for like the pandemic.

“If we didn’t have TetherAll, the pandemic for us would have been very different. I learned through that crisis how valuable the tool is; to see it in action, was a big deal.”

As scared as I was for the safety of our clients, I knew we had a life-saving tool.

Anything I didn’t ask you that you’d like to add?
I would love to see TetherAll continue to grow and expand. Every program is so different in how it functions. I would like people to understand that it can work no matter what they apply it to: medical, clinical, or mental health. It can be helpful in so many ways.

“The most important thing I’d want clinicians and clients to know about TetherAll is that it’s easy.”