Amber Nelms 0:00

Well, hello. Today's guest is Brent S. Clinton, the executive director of Oasis Event, a residential treatment program focused on helping adolescents and families navigating mental health challenges. With a background in family health and behavioral health leadership, Brent is dedicated to creating a high-impact clinical environment that supports real change during critical moments in a young person's life. Well, how did you get started in that industry? Tell me the story, Brent.

Brent Esplin 0:32

Yeah, so my license is marriage and family therapist, and many years ago, about I guess a quarter of a century ago, sadly for me, in my brain I'm young, but I'm old. I'm an old guy now. I was just completing graduate school and needed to get find a supervisor that would that would be able to help me complete my hours towards licensure. And I found myself employed in an adolescent residential treatment program and fell in love with working with teenagers and have been doing it ever since.

Amber Nelms 1:03

Wow, that's fantastic. So you work in the short-term high-intensity care for adolescents in crisis. What have you learned about what actually creates lasting change in such a critical window?

Brent Esplin 1:14

So I've worked in a variety of different settings over the last 25 years. I've worked in long-term residential programs. I helped start a psychiatric hospital about 10 years ago, and then most recently been in this space of short-term residential and assessment. And what I found is that as we're able to teach teens as well as their families skills that they can not only use while they're in the residential program in the structured setting, but also skills that they could be able to utilize when they're back at home, that's what tends to bring lasting results, along with the engagement of parents in the treatment process. Certainly as a family therapist, the family piece is really, really critical. And if you have a teen that goes to a treatment program and learns amazing skills and does amazing work over, let's say a 60 to 90 day frame of time, and then they go back to the same family system at that where there's a level of dysfunction, a lack of ability to communicate, then the chances of them going back to the same behaviors are very, very high. That's what we found to be very successful. And so we on the front end will talk to the parents that are engaging with us and let them know the importance of their involvement in the treatment process, and that if they're not willing to really do their part and do their work alongside their teen, then we're probably not the best program for them.

Amber Nelms 2:44

Oh, I love that. So you have really narrowed down on your ideal client. Is that a part of your or your intake process now? You're like, no, if they have these characteristics, we're just not even going to take them.

Brent Esplin 2:57

Yeah, I just think it's important to be up front with parents about what they're getting. And because we want it to be a successful experience for the teen or for the parents, along with us as a program. And we're not always the best fit for every family out there, and we want to hopefully determine that up front prior to getting into the treatment process. Yeah, thank you for asking me about that, Amber. That's one of the things that we're really excited about, is that over the last, like I said, 25 years, as I've worked in numerous adolescent residential programs, treatment is very, very expensive. And I mean, to the tune of about $15,000 a month. And most average folks, like myself, would never be able to afford that. You're talking about the top 1% of America that's able to afford that. And so what we've done, and what I've seen over time is especially as I was working in the acute psychiatric hospital setting, is I saw teens that would come to our psychiatric hospital, they'd get stabilized on some medications, discharge plan back home. And the sad part is many of them would be a revolving door and would return to us. And they needed more than what a psychiatric hospital could provide. However, the parents couldn't afford it. And here in Utah, many of the families have numerous children and they just couldn't afford to be able to do that. So that's part of the mission behind Oasis is being able to create access to more families out there. And the model that we've developed is short-term in nature because we found that insurance companies will be open to and willing to provide treatment for maybe 60 to 90 day period of time. They're not going to pay for a whole year, but they'll at least pay for that frame of time. And so we actually pre-authorize with insurance companies, which only requires the parents to pay deductible and co-insurance up front. So let's say their deductible is $10,000 and then they're able to get $70,000 worth of treatment. It's really a valuable resource and being able to allow more and more like blue-collar families that have insurance to be able to access the care that they truly need for the teen and for the family themselves.

Amber Nelms 5:09

Oh, that's fantastic. So was OASIS always formed with that in mind to be able to have an insurance component to it, or is this more a recent development?

Brent Esplin 5:19

From the very beginning. So prior to Oasis, I had helped start another program that was insurance-based. And that's where I started the idea and the thought process of, hey, you know what? I want to create something that if my team needed a treatment program that I'd be able to afford to access. And so the group, our parent company, as they reached out to me about the idea, what we did is we we took kind of some of the things that I'd learned from a treat a previous program that we'd developed and brought it together. So the idea behind OASIS, OASIS is actually an acronym that stands for observation, assessment, stabilization, and intensive support. And so with OASIS, we have developed a model where like the assessment piece is a key component. We've seen so many teens that have come into our facility that are either misdiagnosed or have never had any kind of formal diagnosis, which is really important in the process of identifying, hey, what treatment modalities are going to be most effective for this teen. And so we have this assessment piece. So in the first, usually in the first two to four weeks, we're doing comprehensive assessing, which includes psychological testing with each of the teams that we serve, and includes genomic testing so that we're able to take a look at how they metabolize medication to be able to identify what's going to be the best medication regime for them. Nutritional assessments, full health and physical, because we want to look, take a holistic approach with the teens that we're serving and identify, hey, are there some medical things that are going on that are directly affecting their mental health? It's been pretty pretty incredible to see there's in situations where through doing that health and physical assessment, we've been able to identify that we've seen situations where there's, like for instance, uh we had a young woman that came to our program that was lactating. And oftentimes lactation is a direct result of a medication. And so our prescriber immediately took him off of the medication, and yet she continued to lactate. And so then the doctor just said, Hey, I think she needs to have an MRI. And honestly, I, as the executive director, I was like, that seems a little extreme, doesn't it? Like, why are we jumping right to the MRI? And yet, you know, you trust the medical provider, the MRI is completed, and it comes back and identifies that there is a tumor on her pituitary gland. And so, with that, that was that that was what was directly impacting very severe depression, very severe anxiety. And it was so relieving, honestly, for the parents, as our prescriber and our medical doctor talked to the parents about this, they literally cried because then they realized, oh, okay, here's the reason behind our daughter changing so significantly in such a short period of time. And so she was able to complete her treatment with us and then go back home and take care of the tumor that had been developed. And so I describe that because there's this, once again, there's this holistic approach to the assessing that we're doing because we want to make sure that the teens we're serving that we're that we are, you know, going the right direction from a treatment standpoint. Interesting because we see a lot of teens that come to us, like I said before, misdiagnosed. And what we're seeing, Amber, is we're seeing, first of all, teenage girls that are coming to us misdiagnosed borderline personality traits.

Amber Nelms 8:38

Isn't that the fun one? Everyone's right.

Brent Esplin 8:41

Well, and the reality is, you know, they're since they're teenagers, they can't receive the full diagnosis, right? Because they're not 18. But so they come up with these traits, and then when reality, what we're finding is we're doing the psychological testing, is so many of these teenage girls are actually on the autism spectrum. And autism spectrum and borderline personality traits presents very, very similar. And yet we're seeing these kids, and once again, these girls are on the autism spectrum, and there's a much different approach that you take with these teens on the spectrum than you do, you know, borderline personality traits. So we're seeing that element with the girls that we serve, and with the boys, it's even a little bit more challenging because we're seeing a lot of boys that come in that are misdiagnosed, either oppositional defiant disorder or even worse, conic disorder. And with that, like here's the thing like we had a situation where a teen was referred to us from back east, and the referral partner called me and said, Brent, I got this young man, and he has been diagnosed by a nurse practitioner, which, you know, a nurse practitioner, they are asking questions and and they're and then they're just kind of like, you know, trying to see like what does it feel like? And when in reality, the reason why we're doing the psychological testing piece is because that's a much better weight and to determine the diagnosis, right, through the instruments that are being utilized. And so this referral partner said to me, Hey, you know what? This young man has been has been diagnosed with conic disorder by a nurse practitioner, and I don't think he's conic disorder. The unfortunate part is he's like six foot two, he's about 220 pounds, solid muscle, and no program will take him because he's been diagnosed with conic disorder. And I don't think he's conic disorder. In fact, I think he's on the spectrum, on autism spectrum, but nobody will touch him. And he's so he's like, Brent, will you give this kid a chance? And honestly, we're kind of rolling the dice a little bit because we're like thinking if this kid acts out and be and he gets into a therapeutic hold, it's gonna be not pretty, right? Yeah, and so so anyway, so we took a chance, he comes to our program, we do the psychological testing and our full comprehensive assessment, and sure enough, we identify he's he's on the autism spectrum, and he was actually did really well. He was very high-end on the spectrum, really sharp kid, but had this level of rigidity to him that also presented sometimes like you would if you're opposition befiner conic disorder. And then we were able to get him from us to an appropriate next treatment program, not for kids with conic disorder, but for kids that are on the autistic spectrum. And he was able to thrive and is now back home thriving. Now, here's the I guess the important part of this, and that is if he wouldn't have received an appropriate diagnosis, if they would have left him diagnosed with conic disorder and sent him to a program for chic disorder boys, guess what's gonna happen? He is going to become his diagnosis, and he's gonna go down a very different path, which is so scary and so sad. And that's why with our services, we are really passionate about making sure that we're getting appropriate diagnoses, and it's actually a cost that we're absorbing the psychological testing piece, and it's and that's really expensive.

Amber Nelms 11:47

Get that covered by insurance?

Brent Esplin 11:48

Unfortunately, it is it is not typically. They don't since they don't require it for residential treatment, that they don't, they they they oftentimes don't pay for us. So we absorb the cost, which I mean, it's you know, it's about five to eight thousand dollars, you know, for for psychological testing. And so, but we are pack so passionate about it because, well, partially, my passion comes from my own family. I mean, a big part of my why is I've got two two boys who are who were diagnosed early on with ADHD. Like in the fourth grade, my oldest son was really struggling in school. We went to parent-teacher conference. The teacher, Mr. Green, sat my my wife and I, Julie, down and said, Hey, you know what, Brent Julie, I'm really concerned about Canyon. He's struggling to learn how to read. He's not staying up on his subjects. I'm concerned that he has ADHD. And so, and he was our first kid. We're like, we don't know what we're doing, right? So, all right, what do we do? Okay, we're gonna try to change diet, exercise, sleep. And nothing seemed to really work for him. And so we were fortunate, Mr. Green advocated for us with in the local school district to get this the school district psychologist to come and do some modified testing with my son Canyon, as well as my son Eli, who was two years younger, who was also having similar challenges. And through the testing, they were able to identify that that yes, that there's components of ADHD, not hyperactive type, which is kind of in your face or problems, go to the principal's office. They are both ADHD inattentive type. They're physically there, but their mind is like somewhere else, right? And so they identified that this is one of their struggles, also identified that both struggle with dyslexia, which is part of the challenge with reading, right? And then also identified that they were actually very, very smart kids. Really smart, you know, and so part of my passion comes from the fact that we were able to get that support early on for my own kids, and I couldn't afford psychological testing for both of my kids, let alone one of them. And so, because of that, like my kids went from really struggling in school to getting the support that they needed, getting on an appropriate medication. Now, medications, trial and error as well. The first medication we tried didn't work for one of them and actually made him depressed. Anyway, we realized very quickly it was making him depressed. So we changed both of them to the a different medication. And they took medication throughout their elementary school years, and then they learned skills. They learned skills to be able to help them to focus and concentrate, and then as into their junior high and high school years, they didn't require the medication. And one of the skills that they learned that really helped them to focus and concentrate was sports, was exercise, movement, working out, helped them dial in their brains, right? And so these kids went from basically, you know, really struggling, struggling in elementary school to doing better in junior high and then getting to high school, both ended up with 4.0s in high school.

Amber Nelms 14:56

Right?

Brent Esplin 14:57

And I am, and then even into college, my oldest just finished college with a 4.0 and finished with a master's degree in accounting. And I say I say all this because the kids that I see at OASIS are just like my own kids. They are very, very smart. They've had challenges oftentimes with ADHD, with dyslexia, other, you know, it's challenges, mental with mental health issues, and yet they're really smart. They just learn differently. And that's part of what we're doing is trying to help them understand, hey, you know what? You can do this, you can achieve things, right? You just have to be able to believe in yourself and learn skills.

Amber Nelms 15:32

Yeah, it's amazing. You know, it's inspiring to see how passionate you are about your actual patients. And I get really like chills thinking, like, it's so great that you're running an organization with that kind of passion. I love to know that there are healthcare people out there that can run a good company, think through the things, but really, really care about how it's done and how it's done well, and do what it takes to do a good job. It's clear that you're highly passionate. It's awesome to meet you. And you know, it also really stuck out in my brain about how much our industries are crossing over to each other and the fact that a lot of the the peop the teenagers are actually on the spectrum, right? So it makes me reminded again of why it's so important that we help teenagers, young kids, like you can always send kids over, or even we do take teenagers and adults too sometimes because they weren't diagnosed until they'll they're way older. So it's fantastic to see what you're doing. But actually, I'm interested to also know what do you think in your industry right now, what technology you think do you think is underutilized and could be improved to help run an organization, a healthcare organization properly? What is the area that we're still missing?

Brent Esplin 16:55

Yeah, I think we are so new into the AI world right now that I think we're just trying to figure out how to best lean into that to create efficiencies. So as a therapist, I can remember as a new young therapist working all week and on Friday and Saturday spending four to six hours handwriting notes for the sessions, right? And part of it was like, I love spending time with the kids, and and yet the documentation part was not something that was fun for me. So I'd kind of put it off. Right? Yeah, I hate it. Yeah, I think most clinicians do. And so part of what we've started to lean into is working with organizations that can create efficiencies for therapists through utilizing artificial intelligence to help with the documentation, to help with creating efficiencies so that we're able to do what we do best as clinicians and spend quality time with the teens and the families and not have to spend so much time on the documentation piece and still be able to have technology help us to formulate a quality note that meets medical necessity. Because as we've talked about, we're working directly with insurance companies and we have to have quality notes. And you know what? Not all therapists also are awesome at documenting to medical necessity.

Amber Nelms 18:18

Do you what are you using right now for your CRM or scheduling platform? What are the tools you use for those?

Brent Esplin 18:25

Yeah, so we use what's called Blue Step. Have you heard of Blue Step before? Okay. It's a CRM that that is, I think they're based actually in here in Utah. They work with a lot of adolescent residential treatment programs.

Amber Nelms 18:40

Is it more specialized in that? Is that their expertise and their niche?

Brent Esplin 18:44

Um, they I think they actually also it's also used in assisted living facilities, I'm pretty sure.

Amber Nelms 18:51

As well.

Brent Esplin 18:52

Um so kind of along those lines. And they've also partnered and they slash we have also partnered with an organization called Videra Health, which is the AI component, and they're working in medical surgical hospitals as well as in you know residential treatment programs to help incorporate the AI piece into the CRM and have an API between the two and have them so that that we can be able to you know tap into that within our CRM.

Amber Nelms 19:22

Awesome. Very good. And what about from a scheduling perspective? Do you have a separate platform for that? Or do you have a hard time with scheduling? You probably don't in because it's more um a clear line, very more complicated.

Brent Esplin 19:36

We have a captive audience in residential treatment, right? And so we're really from a scheduling standpoint, we're really only utilizing Google Calendar, right? Because we got the kids there, we're just scheduling the parents for for their weekly family sessions.

Amber Nelms 19:51

Well, you know, we are almost running out of time. I can keep asking you questions, but I am excited that I got to meet you, and I'm really glad that a lot of people will hopefully hear about your company because it's designed from the right aspects, it's very clear. And you are helping a lot of people get set up in the right way. So I'm so thankful that you came on the podcast today that I got to meet you. Thank you for taking your time. I know you are busy, and yeah, I was inspired by you today. So thank you.

Brent Esplin 20:22

Thank you, Ebert. It's great to connect with you. When you're in Utah, do you come to Utah much?

Amber Nelms 20:28

I have. Okay. I thought about doing a high rocks race out in Utah.

Brent Esplin 20:33

Okay, okay. Well, come out when you come out here, please come and see us. We'd love to show you around our our our program, have you meet some of our kids and and uh that would be a privilege. Yeah, we would love that.

Amber Nelms 20:46

Thank you so much.