Building an Ethical Culture

Recovery Unscripted banner image for episode 43

Episode #43 | November 7, 2017

Featured Guest: Tom Garofola

Today, I’m joined by Tom Garofola, Chief Marketing Officer of Retreat Premier Addiction Treatment Centers. He sat down with me at the Moments of Change conference in Florida to share his own remarkable journey – from playing in the rock ’n’ roll scene of 1970s New York to training as an addiction counselor in a penitentiary to now leading a team of marketing reps for Retreat. He also examines how the culture within the treatment industry has allowed unethical practices to take root and how the ethical people in this field can rise up and bring treatment back to its core purpose: helping people in need.

Podcast Transcript

David Condos: Hey guys, welcome to another episode of Recovery Unscripted. I’m David Condos, and this podcast is powered by Foundations Recovery Network. Today, I’m joined by Tom Garofola, Chief Marketing Officer of Retreat Premier Addiction Treatment Centers. He sat down with me at the Moments of Change conference in Florida to share his own remarkable journey from playing in the rock and roll scene of 1970s New York to training as an addiction counselor in a penitentiary to now leading a team of marketing reps for Retreat.

He also examines how the culture within the treatment industry has allowed unethical practices to take route and how the ethical people in this field can rise up and bring treatment back to its core purpose, helping people in need. Now, here is Tom.

I’m here with Tom Garofola. Thank you for being with us today, Tom.

Tom Garofola: Thank you. I appreciate the opportunity.

David Condos: Good to have you here. To start things off, could you tell us a bit about your personal story and why you got started serving in the world of addiction recovery.

Tom Garofola: I started in this business in 1993. Obviously, I had some of my own personal experience with addiction as well as I lost a brother to drinking and driving. He had suffered some addiction. I was intent on changing my life. I wanted my kids to be proud of me.

I remember when I was finishing treatment, I was like, “What am I going to do?” My mother used to call me a jack of all trades a master of none. I figured the one thing that I did know enough about I think at least at that time was drug and alcohol. An opportunity came to go back to school and to begin a career and try and help people.

This career that I have had now for almost 25 years, it’s really been good to me. I have the ability to try help people. Each and every day I do that, I remember where I came from. In today’s world, I have kids that played baseball and I coached them literally that have already died. I have more work to do. I have more work to do.

David Condos: So you mentioned that you have your own personal history with recovery, and when we were talking earlier you said you even came up in New York playing with Joan Jett and The Ramones, and that’s a crazy story, man.

Tom Garofola: Well, yes. [laughs] People tell me someday I should write a book and I don`t want to make this all about me. But I do think I have some kind of a story. I have been with people in the Battery of New York. If people remember what the Battery was back in the 70’s and 80’s. I’ve been involved in politics over the past. I’m not now, but for about eight years.

David Condos: What were you doing in that capacity?

Tom Garofola: I was involved locally in New Jersey and I ran a couple of campaigns for some local people. Back in the 70s before and actually basically is where I started my own personal story. I lived just outside of New York across the Hudson River. I spent a lot of time in New York. I had a band and I played with people. I hang out with people who had made it, at least professionally. Some of the them are gone and were gone before me.

I had my moments. I’m reduced to this point to an occasional karaoke or an open mic, but I still try to carry it on. Am not sure how well I do.

David Condos: Coming out of addiction into your new life and recovery, you were deciding on what could you do with yourself now. How did you get connected in this industry and then eventually with your retreat?

Tom Garofola: When I went to treatment, I went to what’s called state-sponsored vacations. Towards the end of my time there, I heard about a program that the federal government was offering and New Jersey was of one of the places. If you were approved, you would go back to school for two college courses which would give you six college credits, as well as your entry level certifications for counselor in New Jersey.

I worked where I finished at Integrity House in New Jersey. I started off there. A good friend of mine who worked there took a position, a high level position with the company called Spectrum Health in St. Louis. They had the contract in New Jersey for the department of correction. I went back as a counselor there. That was kind of fun because when there were gates closed behind me every day to go to work, I worried about who might make a mistake and think I was supposed to stay.


David Condos: That’s an interesting environment, I’m sure.

Tom Garofola: Yes, it was definitely, definitely interesting. My master’s and thesis was done on the high recidivism rates for adult male substance abuse in the current justice system. I worked in that environment for several years. I worked for a company that does detox in hospitals around the country. The current owner, the person who founded Retreat, Peter Schorr, was in the middle of another project in southeast Pennsylvania. I joined him. We’ve been together since. I have been with Retreat since its inception.

I think that it’s no perfect program but I do think that we do as well as anybody. It really fits how I feel ethically about this business and what people do. I’m proud to be part of Retreat. I’m Chief Marketing Officer and I’ve had a lot of wonderful opportunities to meet a lot of good people. As far as am concerned, I have as good a team as there is in the business.

David Condos: You touched on you have some clinical background as well.

Tom Garofola: Yes.

David Condos: Could you tell us more about how that kind of has helped inform you now that you are Chief Marketing Officer doing the marketing side? How has that helped your vision, your perspective with the marketing?

Tom Garofola: Half of my team also has clinical background. In today’s environment where there are so many shady and unethical things that go on at different so called treatment program, the clinical knowledge that I have and that some of our staff has, has allowed us to be able to really vet who we’re going to work with us. In this industry, people are looking for referrals. Marketing, that’s what it is. Look around here. Everybody wants the next referral, so do we. But I’m not taking referrals from people that think am sending back and they’re not doing what they’re supposed to do.

Unfortunately in today`s environment, we don’t get enough time with people who need help. When I started this business, there was no such thing as a continuum of kit. At least that catch phrase wasn’t there. That only began when managed kids started to get involved and people’s private insurances started to go from nine months a treatment to six months to three to what we have now.

The people at ASAM at that time decided they needed to figure out how to deal with that, and so they came up with a continuum of kit. It allows me, as a clinician with a clinical background, I don’t want to say I’m a clinician but I stay up on it enough. I have staff that that’s what they do. It allows me to know who am working with.

David Condos: You mentioned earlier the idea of ethics, and that’s a big thing that a lot of people are talking about right now, is unethical practices that are going on in this industry. Let’s start this part of the conversation by asking, why do you think it is that there is field addiction treatment that seems so prone to this unethical behavior?

Tom Garofola: Money. It’s simple. It’s money. The last number I saw, there was a 45% to 48% return on investments. That’s why you have companies that have nothing to do with addiction that are opening places, especially Florida model program. The Florida model was first created with all good intentions. It would lengthen people stays. It would be a cheaper cost. But when things like Obamacare when kids were allowed to be carried till they were 26, when that kicked in, a lot of people that know how to make money looked at it and started doing the things that we’re seeing.

There is nothing wrong in making money, but you can make money in this business and do it right. We have everything in this business now. There is a steakhouse, not that good chain steakhouse, that owns a place on the western coast of Florida. That’s the simple answers to why. There are people out there who will head hunt as predators, call them whatever you want, but all they are about is money. That’s the reason why it’s like that. There are people who are trying to make money, and they will do in any way they have to some people. I think it’s a shame. But literally, we have a generation, your age, that’s dying. It’s sad to me. It’s really sad.

David Condos: What are some other examples like some unethical practices you’ve seen or just kind of examples that show the general culture of these things, like being accepted? Because it’s kind of like they’re accepted until somebody comes out and says this isn’t how we do it.

Tom Garofola: Listen, I know enough of what goes on in the industry and the back rooms, smoke filled rooms, if you will. You have people that drop off envelopes to certain places for their referrals.

You have people that call themselves Marketers that are literally getting paid per head. I’m not sure if it’s still this way, but a year ago, they were getting paid $3,000 to $5,000 per head. That’s crazy. That doesn’t lend itself to quality care or being concerned about the type of care that somebody’s going to get. There are some people that know who they are, know those people and those places that work like that. We stay away from it. There’s no reason to do that.

You can help people, you do what you have to do, you can make some money, if that’s the biggest issue for people. We all want to make money. We want to survive, we want to take care of our families better, there’s nothing wrong with that, but you can do it right.

David Condos: Yes, and it just seems like it’s that culture of treating these people in need as kind of a throw away population, is the term. So it’s just kind of like you’re trading in a commodity more than you’re helping this person get to where they want to be.

Tom Garofola: And sadly, that’s what this population is viewed as, a throw away population. They did it to themselves. That’s what the stigma’s all about. That stigma I think is continuously perpetrated almost indirectly from some people in our field who have been doing this a long time and feel like there’s only one way to do it. Medication assisted treatment right now is this hot topic. Why is it okay for somebody who’s got 30 years clean time, it should be their way that this person gets it? It’s a different world today. These kids are dying at a rate that’s staggering. The drugs out there, they’re a lot stronger.

David Condos: Powerful, yes.

Tom Garofola: They’re much more powerful. It’s the perfect storm.

The drugs are more powerful, you have less time to treat them. People that have been clean a long time and got it through AA or NA need to open their eyes a little bit and need to broaden their mind. What worked for you doesn’t necessarily work for somebody else. Whatever gets somebody on the road to recovery, even if it’s medication for some period of time or if it’s what they need forever as long as if they’re not shooting dope, they’re not doing pills or doing something that’s going to kill them, why is that bad? For me, my preference is that you get clean and sober and you don’t use anything, but I’m not living your life. Narrow minded thinking is part of what keeps the stigma going, I think.

David Condos: Yes. For people who are in this industry and want to do things the right way, they want to take up this course and want to help change things, what are some things you recommend to them for how they can do that, even just in their own business or in their own community?

Tom Garofola: Look for people that care about what they’re doing, that care about helping people. You don’t have to be in recovery to provide treatment, you don’t have to be in recovery to be a good therapist or to be a good marketing rep to help people get treatment. You just need to have a moral conscience, you need to want to do it right. Up in the New York area, there used to be a store called Syms. The owner, Sy Syms, his motto on TV, in commercials would say, “At Syms, an educated customer is our best consumer.”

I think it’s the same thing whether it’s parents looking for treatment for their kids or people opening businesses and looking for the right people to look for them in this industry. An educated consumer is the best.

David Condos: Another part of this ethics discussion deals with insurance. What are some of the ways that you’re seeing people taking advantage of loopholes or insurance in some way and how do you see that becoming better?

Tom Garofola: You have places that literally will buy somebody their insurance. Now that would be nice if it were from an altruistic bone in that company’s body, but that’s really not what it’s about. They’ll lay out $1,500 for the insurance and it’s obviously unethical. Whether it’s criminal or illegal, I’m not 100% sure, but it should be. That’s one way. On the flip side, the insurances are helping to kill kids. What we’ve tried to do is work with the insurances. If you can’t beat them, join them.

You now have insurances that are looking for best practices. So that you want to get in their network, on their preferred providers list, you have to show that you have best practices. So that’s what we’re trying to do. But you have insurances that you have somebody that’s been through treatment six times, if they give them detox if they’re lucky. Sometimes they won’t even approve the detox. If you suffered from diabetes or you suffered from cancer. If you relapse four times, is the insurance company going to tell you you can’t get any more help? It’s –

David Condos: It’s a double standard.

Tom Garofola: – double standard, it’s just really sad. Again, it goes into all of these different factors that are helping the addiction problem get worse, not better.

David Condos: Yes. Now, looking at a bigger picture view, what are some things we can do as an industry to fight that culture, and also fight the general lack of trust that people are starting to feel about addiction treatment?

Tom Garofola: In my humble opinion, there are few things that you can do. The reason why the insurance companies are so powerful is because they spend a lot of money on lobbyists. It’s very hard to get those people in Congress that are benefiting from the lobbyists work to go against the insurances. The insurances are capitalizing on that. We have a few organizations and businesses that offer advocacy, there needs to be more. There literally needs to be more of that.

I think that that’s one way. I think if you know places are unethical or doing things like that, I think that you should out them. I come from the streets of New York City. I’m not much on snitching, if you will. I’ll snitch all day long. Let me know, let me know who you are.

David Condos: Just outing them to your peers or–?

Tom Garofola: No. You can out them to your peers. Obviously, everybody’s litigious, everybody’s going to sue you. But now, especially in Florida, you have people that you can out them too. But you can get the authorities to look at what’s being done by one place or another. I think that needs to happen also. I think the places that are doing treatment the way it’s supposed to be done, meaning the client or the patient is top priority, I think they all need to bond together. I don’t look at everybody here as competitors.

There’s so much business, unfortunately, for everybody. We should work together to make it a clean industry, to make it something that everybody can be proud of, to make it so that when a family send their 20-year-old to treatment, they can have the confidence that their kid is going to get care. He’s going to be given the tools so that they can begin a life of recovery if they choose to use the tools.

David Condos: And like you said, so much of this business is done on referrals. If you are a company who really wants to take a stand for this, you have a lot of power when you decide who you work with, right?

Tom Garofola: Exactly. You see commercials, companies that generate referrals. Most of those places that are doing this are lead generators. They don’t really care what’s being done in the business. Same way some places that do just detox or short term residential. When they send to the next level of care, they’ll send to anybody, they’re getting business back. That’s really not the measuring stick, it shouldn’t be. The way we look at it is, we don’t get enough time with people. 26 days, 30 days, 17 days, it’s not a lot of time. You want to refer to somebody you know is going to pick up the ball from there, at that next level of care. I think those are the things that we need to do.

There’s a lot of work to be done and there are a lot of talented people and ethically sound people, people with big hearts, people who’ve been through the addiction process themselves or just want to help those people. Those people need to bond together, they need to come closer.

In my role now, I don’t do direct marketing anymore. I have a big staff, a very talented staff. But I do spend a lot of time interacting, developing relationships that I think can help people. And sure, do I want them in our beds if they fit and are appropriate? Yes, but I don’t care if we can put them in treatment. There are a lot more people that don’t have insurance that need help than there are those that have insurance. I see a lot of them in New Jersey. Having been around a long time, I get a lot of calls for that. We try to do the best we can and in either helping them ourselves or finding the appropriate place, it’s important.

David Condos: Yes, not to leave anyone hanging is just like, “Okay, well, that’s not just going to benefit me so much, so can’t do it.”

Tom Garofola: No matter what.

David Condos: Yes. All right. Well, let’s wrap up with this final question. You’ve devoted a lot of your life to this mission over the past 25 years plus, right?

Tom Garofola: Yes.

David Condos: To close up, could you sum up why helping people find recovery is so important to you?

Tom Garofola: I think God has kept me around for a reason. I had many opportunities where He could have said, “You know what? It’s time to come home or go somewhere.” It’s all I know. Lives matter, people matter, their lives matter. People deserve a chance to get better, if they want it. For me, again, I look at things almost personal. I watch kids that I coach, taught them how to throw a ball. For whatever time I have left in this business, it’s important to me and I’m going to give it everything I’ve have, it’s just who I am. I think people who know me know that.

David Condos: Thank you for your time today and for the great work you’re doing. Its been a pleasure. I can tell that this is a passion of yours and it really comes through. I appreciate it.

Tom Garofola: Thanks.

David Condos: All right. Thank you Tom.

Thanks again to Tom for joining us. Now we get to welcome Will Hart from the Life Challenge team. He joins us each month to give us an update from their community, which is the aftercare support network for those who have gone through Foundations treatment programs, and anyone else up for accepting the challenge of living life in recovery.

Last month’s challenge was to get into the spirit of fall by curving a pumpkin, and now Will is back to share the new challenge for this month. Welcome, Will.

Will Hart: Hey. How are you doing?

David Condos: Doing all right man. Good to see you again.

Will Hart: Good to see you too.

David Condos: All right. What have we got for this month?

Will : With the holiday season here and Thanksgiving right on the way, we figured to make a list of things you think would fall would be a great challenge for this month.

David Condos: Excellent. Again, getting into the spirit of this month’s season.

Will Hart: Yes.

David Condos: I like it. What do they do with that?

Will Hart: We kind of thought is make a list. For me, it would be my friends, my job, my dog. Just take some time, say thank you to those people that might make your list. Just take some time to think about it, reflect on it. If you’d like, we’d love to see some of your stuff you think. Share it with us. Share with others you’re around. Try to get the whole idea going out there.

David Condos: Yes, and again, a good reminder, once you make the list, reminder for yourself to kind of I really am thankful for my family or my friends or my dog or whatever. Just a reminder for you to put yourself in to that.

Will Hart: I think some people would be surprised with they come with.

David Condos: Yes. As always, they can share it on your website

Will Hart: Yes. The bargain rights page is probably the best spot. If you want to send us a picture of your list and just the picture of you and write a little description of what you think will work. We’re always happy to hear from you.

David Condos: All right. Sounds great. Thanks again.

Will Hart: Thank you.


David Condos: This has been the Recovery Unscripted podcast. Today we’ve heard from Tom Garofola of Retreat Premier Addiction Treatment Centers. To learn more about his work, visit Thank you for listening today. If you like what you hear, please leave us a rating on your podcast app. We’d love to hear what you think. See you next time.

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