It's interesting, so we have lots of different fields here kind of coming at addiction treatment. And also working in different settings, whether it's predominantly a mental health setting or a primary care setting, or a public health setting. And so I think that's just a very interesting observation that lots and lots of different ways to access care or to be seen, and to meet treatment. One of the probably obvious to some of the students watching is that not all fields are represented here at this table. And so I wondered if somebody could speak to what are some of the other clinical services or disciplines that you work with in providing addiction treatment to your patients. >> Psychologists and social workers first come to mind as very key persons in treatment of substance use disorders. Both of them can do therapy. Social workers also focused I think often on a lot of the life issues that people may come with that need networking as far as getting services, being part of a programs that are out. And I feel like they really specialized very well in that area of care. That's really vital. Psychologists are very important with testing, and also with therapy. So they're quite expert at those and I often refer people to psychologist for those needs. >> So psychologists often provide our evidence-based psychotherapies and treatment. >> Yes, we do, yeah, specialized care. >> And specialized care. And then social workers often, it sounds like can really address the structural issues that we will touch on in this course, as well. But some of those barriers to accessing treatment, the patient's homeless or- >> Yeah, getting services. >> Getting services, etc, right? And also social workers often provide therapies. There's so many licensed clinical social worker who are pretty expert in psychotherapy. >> And I had worked at previous primary care on a mobile medical van, and a lot of times we used outreach workers. They can't treat but they can definitely screen and identify. And we also had substance use counselors on site which are a little bit different than psychologist, and licensed clinical social work. They're trained specifically in helping people with addiction issues. >> To assess and help them come to treatment. >> Yeah, and that's an excellent point because what we've talked about in the beginning of this conversation was waiting for people to come in the door. >> Right. >> And of course, there's great reluctance often times for people to come in that door. And so the question is, how do we not just open the door more widely, but how do we remove the room and bring the room out to them? Things like mobile caravans, outreach workers, harm reduction programs are all designed to meet people where they're at, rather than waiting for them to come to us. >> Yeah, that reminds me of some work being done here where we're actually taking addiction treatment into black churches around New Haven. Just trying to get out there where people are. Does anybody here work with pharmacist? >> Yeah, was going to say there's one key one we're leaving out. In the VA, in the primary care setting that I was working in, that was an inter-professional model. There was a pharmacist and pharmacy students that were there. And that was hugely helpful in talking about certainly different medications that they're on polypharmacy. But thinking about smoking cessation, especially for teaching purposes. They were just their presence and people could bring them in even to speak with the patients, and provide patient education. And so they played a really integral role with the team. And another provider that was present in this interdisciplinary team in particular, which I don't think normally comes up and thinking of substance use treatment was a physical therapist. And someone who might be seeing someone for a chronic pain or might be seeing someone for claudication that they get from their smoking. That they by sort of working with other people on the team and thinking about their substance use could come back, and bring something. Like I think this is what needs to be addressed or they could educate the patient. And sort of help the patient think about how they're smoking might be contributing to something they're having, or their chronic pain. How are they using their medications? And so it's not a specialty that we normally bring into this discussion, but I think they absolutely can- >> There's a lot of relevance. >> Be quite relevant, yeah. >> Another VA, we've also expanded into chaplaincy. Often times people who are struggling with issues around addiction are dealing with purpose and values, and what brings meaning. And so chaplains have also become interested in this topic of addiction. And so there's many disciplines it seems like that can benefit from further training, but also have a lot to bring to our field.