Strategizing for the Treatment Industry’s Future

Recovery Unscripted banner image for episode 99

Episode #99 | July 11, 2019

Featured Guest: Nick Jaworski

What can the addiction treatment industry do to better understand how its marketing reaches the public without getting overwhelmed in an ocean of data?

We’ll answer this with Nick Jaworski, owner of the Circle Social marketing agency, on this episode of Recovery Unscripted.

Podcast Transcript

Interviewer: I’m here with Nick Jaworski.

Nick Jaworski: That’s right.

Interviewer: How are you doing today?

Nick: Doing very well. Appreciate you having me on.

Interviewer: Awesome. Thanks for being with us. Let’s start with you telling us some about your background, your story, your journey to doing what you’re doing in this world.

Nick: A lot of people know me in this space. I have my own podcast, The Recovery Executive Podcast and Circle Social Inc. marketing company. I got involved like a lot of people do, went through my own recovery story quite a while ago about 20 years ago or something like that. I didn’t have a great experience going through recovery in terms of the program, the quality, stuff like that.

Anyway, like 20 years I started the marketing company and things like that. When I started the company, we started working with addiction treatment centers and behavioral health clinics right off the bat just organically. That slowly got me into the space again, remembering my own experiences and then getting a little bit deeper into our clients and working with them were closely. We found out that we were really good at what we were doing for them in terms of driving admissions.

As I was growing the company, then I decide that we needed to focus. We were all over the place. We were doing education, we were doing home improvement, we were doing recovery. It just didn’t make sense because we were running what too many different industries at the same time. I said, “I want to focus. What do I want to focus on?” I said, “Well, I really like helping people. I think there needs to be a lot of changes within the recovery space and we can help do that.”

Then as I started to really research the space, I started to get into the whole shady world of online, internet marketing. There was really two problems. This was back 2015 or something like that. When you went online and you looked for a treatment center, all you found was lead aggregator sites. It looked like a non-profit or it looked like some help line, but it was really a for-profit third party, not a treatment center most of the time. They would take your name, your number and your insurance information and sell it to the highest bidder.

Interviewer: It looks like a directory. It’s as if you’re going to some list of top treatment centers or the phone book or whatever. Some of it was third parties, some of it was actually owned by treatment centers as well which is a whole other problem, but keep going.

Nick: That’s a whole other thing. Anyway, I started to figure that out and said, “Well, this is shady.” I actually got cued onto it by one of our clients. We were running social media campaigns and things like that so we’ll take the messages on our end. We get a message from a guy saying, “Hey, we can help with admissions for your center.” I’m like, “That’s nice. That’s nice of him.”

Interviewer: You don’t have a center.

Nick: Well, yes, we’re operating on behalf of our clients.

Interviewer: Then what would happen?

Nick: We go to the executive director and we say, “Hey, we’ve got this person that’s willing to help you and connect you with patient that need services.” He’s like, “Let me tell you about this.” That’s when I started to learn about patient brokering and all that kind of stuff. Anyway, that fit into the online marketing thing.

Then the other end of it was when we did find treatment centers online that were legit, no one ever answered the phone. They wouldn’t get back to you, their websites were really crappy, you couldn’t navigate them. From those two parts, I’m like, one, recovery is important to me. I want to help people in this space. Two, there’s this shady stuff happening in the online marketing space where people are being treated as really dollar signs rather than as patients.

Then you had some of the treatment centers themselves that weren’t set up to compete with the lead aggregation, these guys that have a lot of money and know how to market. The stuff that looked good that was being effective in a marketing sense was the worst quality stuff. Then the good treatment that was still going on, people couldn’t even find it or couldn’t get a hold of them.

Interviewer: That’s right.

Nick: You had two problems, you had problems on the provider end, not good quality stuff out there. They you had problems with the patient end with them not being able to find good quality. I said, “Well, we can solve this.” I said, “We’ve already been solving it. ” We started pushing really hard in the space, built up a really strong brand, got connected with people, picked up clients, all that kind of stuff. That’s how we ended up where we are today.

Nowadays I walk into a treatment center and everyone knows who I am which is weird because I don’t know them half the time. They’re like, “It’s Nick Jaworski.” I’m like, “How did you know me?” They’re like, “My CEO makes me listen to your podcast or makes me read your stuff.” I’m like, “Okay, well, nice to meet you.” That’s been the journey. I’m sure we’ll get into it, but the marketing world’s still murky within addiction treatment, especially online. You got to be careful. It’s hard to know what’s quality and what’s not. That’s something that we’re trying to change and trying to improve. We want to bring patient-centered care. Not just through the treatment space, but to the way it’s marketed and to the way people learn about it, so they know what good treatment is. This is important to us.

Interviewer: I’m going to move in this a little bit. Sorry. It’s battling the room noise here. That’s interesting that you were not only in recovery yourself, but you had a not so great experience with treatment. I imagine that’s one of the motivators too. It’s like, okay, I know that there’s this great need and there’s people out there who want to help, how can I help connect this and in the end elevate the whole thing?

Nick: Exactly. My real goal is to revolutionize the way that we’re doing addiction treatment in the US. It’s not effective right now overall as a system. It’s very fractured. Again, going from my business background, a little bit of past histories. I used to be an international turnaround guy for schools. That’s what I did before I got into the marketing company. I did the marketing sales for the schools I ran.

Interviewer: What kind of schools?

Nick: International schools, so Turkey, China, Vietnam, the US.

Interviewer: Like for diplomat kids?

Nick: Well, could be. For actual kids that were trying to learn whatever. Schools won’t be doing so well, so they’d call me in. I’d flip them and get them operating appropriately and profitable and things like that. When we started working with treatment centers, we saw a lot of the same problems. There’s not great business models in place, not good operations.

From a profitability standpoint, there was a lot of money in the space for a long time. You were able to operate a pretty poor business model and still survive. It’s no longer the case. It’s not as profitable as it used to be, like significantly less.

Interviewer: It’s hard to convince someone like, “Hey, you’re doing things wrong.” They’re like, “Hey, look at all the money we’re making.”

Nick: That changed as we built into the space. Then we said, “Okay, look, we can do the marketing piece here. We’re going to help you connect with patients, get the phone calls, but then we can also help you make sure that those patients choose you as a center by making sure your proper operations and follow-up in clinical care.” We started at combining those components together, which has been unique. We’re very hands-on. I’m in and out treatments. I’ve been in and out of probably 10 treatment centers in the past month and half across the country. It can be exhausting the travel.

Interviewer: I imagine that’s cool though if you’re seeing them firsthand like back to back to back. You’re really able to see like, this is out of the ordinary in a good way or a bad way because you have that perspective.

Nick: Right. We get all the data on the back end. We know what works and what doesn’t work. We’ve seen it across the country in different environments. It’s interesting because people usually initially engage us for marketing, they need help finding patients who need support. Often we come in and they’re like, “Oh my God, you helped us with so many areas, because you helped us with the clinical and the way that we do calls and the way that our CRM functions with our website, that functions with our call team.” That’s been probably one of the most rewarding experiences, is to realize that we’re having a holistic effect on the overall center rather than just making the phone ring.

Interviewer: Here at Innovations in Recovery, you gave a presentation called Positioning Your Center for Long-term Growth and Success. You touched on this a little bit, but could you dive in a little bit more about the landscape and how it’s changed? You said that a few years ago, it didn’t matter as much how you were doing things because there was a lot of money to be made, but also shady things were going on and that was going unchecked in a lot of ways. Now, as that’s tightened up, that’s changed the landscape for everyone. Give us that overview.

Nick: This is really going to be for like what treatment center owners and workers out there; the high-level overview of what’s happened. To give everyone background, there was a lot of loose regulation in the space, patient brokering was legal. It was legal to pay for flights. It wasn’t really considered an inducement necessarily. This loose regulation allowed people to take the money they got from the insurance and pay for your flight in and pay for cigarettes and pay for video games and pay for massages and whatever else they were paying for patients as they came in, pay for housing. That was part of it. Now your regulation is lot tighter. That’s changed.

Before, you had very high reimbursements. There weren’t the insurance billing codes in place originally when treatment centers popped up, in conjunction with Obamacare then mandating high levels of coverage for mental health and addiction treatment. Before, there wasn’t really a mandate or the mandate didn’t have teeth before Obamacare came in. Obamacare said you have to pay for addiction mental health like you pay for physical health services.

I now how to take like knee surgery and equate that with a 28-day stay in addiction treatment center, meaning that I’m paying $50,000-$60,000 for that. Whereas before, that wasn’t the case. Really high reimbursements, people sending bills to insurance companies and getting reimbursed ridiculous amounts of money at first. Insurance companies caught on to it, started reducing levels of reimbursement and that continued for quite a while.

Nowadays, you have 50% or more or less revenue coming in for a patient than you used to. That’s been a huge change in the field. It goes back to the what we’re talking about. The amount of money you could spend on marketing was ridiculous before. The way you ran your business could be pretty a lot of leaky buckets, money running out at the bottom. People often weren’t even noticing.

A big piece of this has actually been the opioid crisis. It’s starting to change a little bit, from the opioid crisis and before, let’s just work with 18 to 26-year-old millennials. I’m a mom. 85% of people calling in are moms, or women at least, not necessarily moms. They’re, “My son is doing pot or he’s drinking too much,” or, “My daughter is doing a bunch of coke.” I’m not super freaked out about it. I’m upset. I may be not happy where we’re having fights at home, things like that. Maybe, I’m worried about it but I’m probably not going to push my child into treatment necessarily because, whatever, I did stuff when I was young. I don’t like it but we’ll get past it. With the opioid crisis, now I’m worried about overdose. I see it on the news. It’s everywhere. Now, I’m calling in a panic. I’m calling it a crisis. My daughter disappeared. She’s on the street. I haven’t seen her in two weeks. She just came home. I Google a treatment center and try and get her in within 24 hours. That drove a lot of this. Then connecting that back to Obamacare.

When people get pretty deep in addiction, especially if it’s heroin or something that’s more of a high-end street drug, they tend to lose jobs. They tend to lose their insurance but Obamacare allowed that insurance coverage be up to the age of 26 under the parents. All these other people are struggling because they don’t have insurance, but the millennials did even if they didn’t have employment because they were covered under the parents.

This pushed a lot of people into treatment from a crisis standpoint. Most treatment centers grew up with this experience of, you answer the phone and you see if they’re going to come in tomorrow or not, which is weird. Who else in healthcare does that? If I’m going in for even a knee surgery, I’m going to interview a couple of hospitals, talk to a couple of doctors, might wait a week on it. When I’m worried that my child’s going to die tomorrow and there’s not another chance, I’m going to call and make that happen.

A lot of people started going to treatment. Before it was new, people weren’t aware of it. They didn’t know what to expect. Nowadays, they’ve had loved ones go through five, six, seven, ten times. They’re very familiar with the system, the program. There’s been a lot of bad press on it. All these trends have really squeezed the industry in terms of the reimbursements, in terms of the people coming in.

Deductibles are much higher now than they used to be. Rather than paying $500 out of pocket or nothing because I used my deductible already, now I’m paying five grand out of pocket. I’ve got to pay for the flight. I’m nervous about the center because there’s bad publicity. This is my sixth round through treatment. I don’t even know if I trust them anyway. All these trends have really squeezed things.

Interviewer: It’s made it harder on the patients and on the treatment centers?

Nick: Yes.

Interviewer: How has this all trickled down, this perfect storm that you’re describing, how does this trickle down to affect the way that treatment organizations are able to do business? Maybe, they’re going out of business. How has this affected them?

Nick: A lot are going out of business. That’s definitely happening especially in Arizona, California, Florida; these saturated hotspots, partly, because this destination rehab model is dying. That’s a big trend that’s happening, it’s localization. It’s better from a clinical perspective to send people locally most of the time according to the research. They’re closer to family. They’re closer to the jobs and the environment that they’re used to. People are trying to send locally, but they’re more trusting of local centers.

I don’t know who the center in Port is. I’m in New Jersey. I don’t know these guys. I’ve heard the bad press. I want to keep them closer to home. That localization is important. Also from a Google perspective, a lot of people are using AdWords. A lot of people are running SEO, Search Engine Optimization. Google is pushing more locally. If I’m searching for something, most of the time I want something local. Google just assumes that and it’s more likely to show local results, whereas before, a lot of treatment centers used to run SEO to rank. I could be at Florida center-

Interviewer: From wherever.

Nick: Yes, ranking in New Jersey. Even Adwords, you’ll get lower quality scores if you’re not local as much. Google verifies everything in terms of where your address is and stuff like that. This localization trend has been a really big one for our treatment centers. Again, lower reimbursement environment. A lot of treatment center from a marketing standpoint, were willing to pay $5,000-$10,000 in marketing spend per admission.

Interviewer: That means they were getting it back?

Nick: Yes. They’re getting $30,000 back, maybe costing them another $5,000 to run the program, so very large profit margins on that. There’s some other stuff maybe we can get into later on that. They had a lot of money coming in that they could afford to do this stuff, but now you can’t.

Even from a national marketing perspective, there’s 20 million people in the US struggling with an SUD, while paying on marketing and to reach 20 million people is really expensive. Whereas, if I’m trying to reach the metropolitan area around San Diego where we are, or maybe I’m trying to reach three million people, it’s the heck of lot cheaper. All these forces have changed the way that centers need to market and what’s important to them.

They used to chase policies. Now, they have to build community, build reputations because reputation means a lot these days. People are aware of what’s going on. A good behavioral health program is always involved in the community. That hasn’t been the case before. Centers didn’t focus on it before.

Interviewer: Ultimately, this is a good thing for everyone. It’s just in the transition there can be some challenges.

Nick: It’s painful. Business owners have to adapt. A lot of the people that got involved within recovery from a business standpoint didn’t have a business background before. A lot of people have come up through recovery. This is their first business. They got into a business that was very profitable with very little investment and very little business savvy. They’ve been shocked by this.

Whereas, I’ve built a couple of businesses, I’ve helped turn around a number of schools. We help a lot of our clients turnaround things or grow. I get it. I understand the ups and downs and the cycles, whereas a lot of people are caught off guard. I’m like, “This is just part of it. This is the way you got to do. This is how you fix it.” They’re like, “What? That’s different than what we did before.” I’m like, “Well, yes because we’re in a different place now.”

Interviewer: They’re just growing pains for the whole industry. Another area this is diversifying your marketing. Before, a lot of people maybe relied solely on SEO or solely on PPC or solely on something that they would just keep pumping money into and that was enough at the time. As all this has changed, how has that diversification of the marketing become a bigger part of it?

Nick: Super important. That’s something we push with all our clients all the time. You have to diversify your marketing span. It’s just like you’re investing in the stock market. I’m not going to put all of my money into Microsoft because if it collapses, then I lose my entire network. I have to have diversification to make it through ups and downs in different market cycles and whatnot.

Marketing is the same. I should be running TV spends if I have that budget. I should be running Facebook, AdWords, business development, the alumni outreach, local sponsorship, CE events, things like that because not everything is going to work all the time and work in the same way. Let’s say, in quarter one, my Facebook campaigns are giving me admissions of $2,000 in admission. My AdWords are coming in at $6,000 in admission. Maybe, I’m going to shift that budget and put more money into Facebook because it’s bringing in the cheaper admission overall than AdWords, but that might flip-flop by the summer.

Now suddenly, my Facebook campaigns are bringing in $6,000 Adwords are $2,000, I will reallocate those budgets. If you’re just reliant on one and let’s say the $6,000 is unsustainable for all of your admissions, well, now, you’re screwed from a business perspective. You have to have different throttles that you can move up and down. Then the other really important piece that a lot of centers haven’t understood is that they are cumulative in their effect.

I always say they could be on Adwords and Facebook together and you’ll see a 10% lift in overall inquiries and admissions because they work together and support each other. If I see a billboard or something, let’s say it’s a treatment center, and I go online to research treatment centers and the first three that pop up, one of those is the billboard that I saw two days ago, which one am I going to click on? The one from the Billboard. I’m not going to call because I saw the Billboard, but two weeks later when I’m freaking out and I want to get my loved one into treatment and I see that name, I recognize that, I’m going to go straight to it.

That’s how marketing works together to support each other, especially on the business development front. A lot of business development support comes through these larger, broader campaigns because professional referral sources trust people that have a brand out there and that they’re familiar with because they’re legit.

Interviewer: Exactly. I’ve heard this story said of Ford Motor Company spends so much on TV advertising. Nobody sees an ad and calls and buys a car or runs out the door and goes and buys cars. It’s all part of a cumulative effect that it’s reminding them like, “Hey, Ford is a big car company that’s putting out all this stuff.” It’s
a legit player in that arena.

Nick: Absolutely. It’s understanding that decision-making process that it’s long term, especially for the high cost of addiction treatment. People have not been traditionally used to that in the addiction treatment space. It was immediate gratification. They called in crisis, they came in, but that’s a limited number of people. There’s only so many people in a given month that are in crisis that are going to call.

When every treatment center in the US, all 14,000 of them, are betting on the same AdWords, keywords, it drives the cost sky high. Now, you’re going to pay $200-$300 a call. We’ve seen as high as $3,000 a call on certain campaigns. Those campaign weren’t necessarily run well, but we’ve seen that.
Interviewer: Yes, and most of those calls are not good.

Nick: Exactly. They’re not a good fit for the program. When you run other campaigns, whether it’s Facebook or your BD teams out there, or TV or whatever, again, if I need treatment now, instead of going to AdWords or going to Google and searching, and then all these other people that have really good SEO pop-up. I’m going to go, “Oh, I know Foundations Recovery Network. I want to go to treatment there because I know those guys.” You actually bypass that system of you having you to compete. You’re not competing with anyone else because you got into their head six months ago.

Interviewer: Yes, That’s where the community outreach part of it comes in as well. If you’re part of the community, that’s like you’re already in the circle of trust.

Nick: Right. t’s all about trust. That’s what people understand. Marketing is the process of building trust at scale in a way that drives the desired action. So many people think marketing is awareness or engagement or sales or something like that, it’s not. Marketing is about building trust because I will buy from someone I trust. Same thing like, you mentioned Ford.

I’m going to drop $20,000 in a car, am I going to go to some no-name lot and buy a brand of car that I never heard of or buy a car with a Chinese model on it? No way in hell. I’m not going to spend that money to buy a car I don’t know if it’s going to breakdown or not in a year, but Ford I trust, they’ve been around for a long time.

Brand and marketing is about trust and that drives decision-making behavior. There is a very strong correlation between the amount of money you’re asking for something and the amount of trust that has to be built. If I’m sending you a $1 fidget spinner, you don’t really care. You’re like, “I don’t really know Nick, I don’t really know fidget spinner company, but sure it’s a buck.” If I say, “Hey, this is a $20,000 car, you’re going to buy.” Now you’re going to research, you’re going to figure out if Nick is a good guy, if he’s trying to screw me over on this sale. There’s a lot more that goes into that process.

Interviewer: Yes. Another element of this is the transition of using technology, using data analytics within this industry. Talk about why has healthcare, and specifically behavioral health care, been so slow to adapt to using those tools?

Nick: Interesting. Maybe if you can be a little bit more specific on the question in terms of data? When I think of data in the behavioral health space, and I think of AdWords, a lot of people were using that data. What data do you think specifically hasn’t been used?

Interviewer: I’m trying to think an example. Maybe as they’re diversifying, finding out what actually works, and maybe being surprised by the actual results.

Nick: Sure. I see where you’re going. Actually, there’s a lot of issues with that. This is across the board, it’s not just behavioral health. I talk to CEOs running $400 million companies, that have no idea where their sales are coming from or what their channels are; part of that customer journey process.

Within addiction treatment, what’s happened is what’s called, final attribution in the marketing space. What generated that call and did it convert to an admission? It’s what they’re doing. They’ll say, “Okay, look, we have special numbers that track where people are calling from. This call came from an AdWords campaign and that converted to admission, so we’ll assign that to AdWords, or we’ll assign it to a Google search.”

Then going back to our other examples, let’s say I saw a billboard. I saw that and of course I didn’t call because I was driving, but I got home and I searched it and then I called. Unsophisticated business owners could say, “Well, that’s a Google call.” That’s our SEO has been effective. No, it was the billboard that generated the interest that drove a Google search.

Usually, most customer journeys are a lot more complicated than that. We don’t just call and do something. I’ve seen it multiple times, maybe I talked to friends, I looked at some online reviews. Then I saw a Facebook campaign come across at the right moment. The again Google searched it. I didn’t call in from Facebook, I Google searched it, read a little bit more and then called. That’s the traditional customer journey.

You’re trying to track all the data and understand where people are entering and finding out all about you, what’s engaging them, and then where they’re actually calling from. That data is really important, but then understanding location data. A lot of programs don’t realize that most of their admissions are probably coming from– If you’re doing IOP or an inpatient program that is not having overnight stays, they’re coming from a 30-mile radius a lot of the time. If you’re having overnight stays, it might be 130 miles maybe 200 if you went farther out. Most people come from those radiuses [sic].

Understanding that kind of data and then looking at your call center conversions across the process. If I’m pushing a campaign out there, Facebook is really easy because you get ridiculous amounts of data on it. I can see, did people click on that ad? If they clicked on the ad, did they click on the link to whatever I want them to do? Or did they watch the video? What percentage of the video did they watch? How long were they on the page? How far did they scroll down the page? I think gets really scary, but we have a lot of tech in the back end that tracks all that stuff.

Then what call center reps are doing the best? Like this person had 100 calls and 10 of them turned into admissions, this person had 100 calls and only 4. I better check and see if there’s training needed. A lot of programs just haven’t taken that data and used it to really understand the entire process. They don’t use it to optimize a part of the problem.

We get this in the market all the time; they want more calls. We don’t have enough admissions, we need more calls. Well, we’re looking at your calls and the call quality we’re driving here is the same we drive for other clients, but you’re converting three times less. That’s not a call volume problem. That’s a call rep-training problem. You’re not able to connect with the patients in an empathetic way on the phone that is making them want to admit to your center.

You’d have to use your data to say, “Where is my problem?” From the internet side, it’s like, okay, they’re clicking on it, but then they’re not actually calling from the page. That tells me my ad campaign is fine, but the landing page is a problem. The data tells you where you’ve got to optimize or fix things.

Interviewer: How do you unravel that customer journey to find all the things they’ve seen or how that has all added up?

Nick: This tech sits on the back end. Different tools out there allow you to monitor those different pieces. Everyone is familiar with cookies these days. You got these online cookies that follow you around in an anonymous way and track what you’re doing and stuff like that. The other thing that I caution people on is people get really obsessed with the data then and they want to track everything. They want to know everything. You can’t. You will never know exactly what’s going on with people. You never even will track them 100% through. At the very least, I don’t know if they asked around friends and family. I will never know that.

You just have to be comfortable with the fact that you’re not going to know everything exactly where everyone is coming from. It’s just, are we seeing an overall lift in inquiry volume? Are we seeing an overall lift in admissions? Again, you go that Facebook and AdWords example. If I am pushing Facebook campaigns on top of AdWords and I get a 10% lift, it’s not necessarily coming from AdWords, it’s not necessarily come from Facebook. It’s those two things combined. It’s the synergistic effect.

As marketers, and as we tell our clients, they don’t obsess over where your final inquiry is coming from. Just make sure you’re testing out campaigns to see that they’re having positive results, push those budgets up, see if the positive results continue. Go on a step by step incremental fashion, but don’t obsess over every little detail in the data.

Interviewer: Even with all the data that is possible to have today, that can in itself be overwhelming if you don’t know what to do with it, or you don’t you know what how to analyze it.

Nick: That’s right. It’s very interesting when we go and we look at all the marketing campaigns. They will post a file, and we’re like, “This is too expensive or this isn’t converting right or this is under performing.” We see so many campaigns and we have so much data on the back end that we know that, but a lot of programs, they don’t. The only data they’ve ever seen is their data. When they’re getting a $3,000 call on AdWords, they’re like, “Well, I don’t know, maybe this is normal. I know it’s expensive, so this is what we do.” Whereas do we go and you’re like, “Oh my God, you’re paying ten times more than you should be paying. You got to shut that campaign off.”

Interviewer: Another part of this is the internal element, making sure everyone within that organization is on the same page and getting everyone to buy in on that. Talk about why is that important to eventually achieve everyone’s goals?

Nick: Great question. Integrity is everything. Trust is everything and not just marketing, but in your business. Again, your brand, what you think about is trust, but that trust has been built. I trust that a Ford car is not going to break down on me tomorrow because they’ve been around for a long time. Everyone I know drives one. We’ve seen it over and over again.

I know that if I buy a pair of Nike shoes, it’s not going to fall apart on me on my first run. That brand, I didn’t know that the first time Nike came out. It’s really important for people to really get connected and understand, “How are we building trust in the business? For a treatment center, that’s clinical. Your clinical program is everything and that has to come through.

So many clinical programs will work with heads of marketing team completely disconnected from their clinical. You’ll see things like the market– alternative to 12-steps has actually become popular in the general populace demographic. A lot of people are gravitating away from just straight up 12-step programs. Then suddenly, the marketers will pick up on that because they’ll run a test campaign. They’ll see okay, alternative to 12-steps is doing better than 12-steps, let’s run the alternative 12-step campaign, except that no one talks to the clinician. The clinician is still running a 12-step program. It happens all the time.

It’s really frustrating, but then what happens your business loses integrity. It loses trust because people come in, they feel jilted. You have someone that leaves treatment early against medical advice. Or they won’t refer to you. Or other clinicians learn about it and stop referring to your business development team. If you don’t have–
Interviewer: Then it’s 10 times harder to earn that trust back.

Nick: That’s right. Many people think, again, they think marketing is sales. They’re like, “If we can just get more calls and convert those calls, we’ll have a good business.” No, I can’t save a business that doesn’t have a good product or service. In the treatment space, again, that’s your clinical program. Clinical quality has to come first, and then I can build up good campaigns around that and we attract the right people.

Again, it’s an iterative process. A really easy example. Let’s say that I’m doing a program for firefighters. I have a firefighter track in my program, and so I market that. Well, you’re going to get a bunch of firefighters. Then your clinical team gets really good at those firefighters. They know what’s specific to them, that there’s problems on the job side, what are the mental issues they’re dealing with, and they get better clinically.

Again, then you promote that and then they refer more to you because you’re getting better clinically. You’re better than everyone else because you have specialized in being able to treat firefighters. This is virtuous cycle, better product service lead into better marketing because, again, I’ve seen the data what people respond to, what’s effective for them. That’s really important to have that integrity throughout your entire business communication messaging.

Interviewer: On the flip side of that, if you don’t have a firefighter specific program or a bunch of specialized training in that, you don’t want to run a bunch of language in your marketing that says, “Hey, send your first responders to us.”

Nick: Right, and you see that a lot unfortunately. Integrity throughout the process. Make sure that your clinical aligns with your messaging so the right people are finding you.

Interviewer: To bring this full circle here, what are maybe one or two things that you wish more people in the treatment industry understood about marketing strategy, building trust, all that?

Nick: A lot of different pieces. One, you can’t build trust in a day. I can’t walk into a room and say, “Hey, my name is Nick Jaworski. I run an amazing marketing company, you guys should work with us.” It doesn’t work. The same thing for treatment. You can’t walk into a room– I always say that marketing is just like real life. If you won’t do it in real life, don’t do it in a marketing campaign.

I’m not going to walk into a networking event and take my business card and like, “Hey, I’m from Circle Social. Come over here.” Why are you just shouting about yourself online? Why are you just shouting about yourself at a conference or whatever? It’s not going to be effective. That’s jack. It’s like, “Would I do this in real life?” Yes or no. I make this comparison a lot too with social media. It’s like social media is free, you should just do stuff on social media. Okay, great. It’s free, but it doesn’t really convert very well for a lot of different reasons. I can go stand on the side of the highway with a sign about my business. That’s free too, but it’s not going to be super effective. You have to understand what’s effective for you.

Understand that marketing is a catalyst, it builds trust. Then you have to deliver on the back end and your sales team has to convert that. That’s really important. Trust takes time. Really good campaigns take three months to six months to really build out and become effective because I have to build that trust over time. Yes, you’ll get your crisis calls. You’ll get the people that need it right now, but to get the people that are more discerning, or people earlier on in the decision-making process, or the people that need that trust, that’s really important. That’s going to be important to make sure that there is time for that to be built.

The final attribution piece is making sure that you’re not just obsessed with where that exact call came from, but understanding your entire system and process and how your customers initially find you to making the conversion. Then, finally, patient first. Everything starts with the patient. Start with your patients, focus on your patients. Don’t focus on your numbers. Most centers call us and they say, “How many people can get me how fast?” That to me is already like, you don’t really have a mind about [crosstalk]

Interviewer: You’re thinking about it the wrong way.

Nick: Right. You don’t really have your head in the right space to be helping people. Your head is to focused on the business. I get it when the center is in crisis. The center has been at 10%, they’ve been losing money for six months, we’re about to close. Yes, you got to think about that stuff, but you should have been investing back when you had money. That’s a hard thing for people is when you have money, you invest and you diversify. Yes, you don’t make as much money, but you build a sustainable business for the long term. That’s going to help everybody because if you’re here, you can help more people.

Interviewer: We’ve talked a lot about the barriers, the challenges that are part of the environment right now. Do you have one or two examples of success stories where you’ve helped someone and seeing what you want to see from them?

Nick: Yes, sure. From the business standpoint, we’ve gone into centers that literally had 20% census and no admissions coming in. Integrated their clinical programs with their marketing and built out multi-part strategic campaigns, and helped those programs grow to 60% census in three months. Seeing that turnaround is really something that’s rewarding to us, taking a program that’s really struggling and making it better.

It comes with so many pieces. Again, it’s not the marketing that’s saving them. That’s part of it. It’s us helping train their call team to make sure that their call team is doing a really good job on the phone. It’s making sure that there’s good follow up with that call team. It’s making sure that the clinical team really respects what the call team is doing and there’s communication there. All these different pieces.

Another example that I’ve been really proud of is recently working with a big organization. We came in and saw everything that was going on. AdWords, in particular, was out of control in the spend that was happening. Just with some simple tweaks, we were able to bring down the cost of AdWords by a couple hundred thousand dollars within the first month and still maintain the same level of census, just because it hadn’t been structured and optimized appropriately. That’s someone’s salary every month that we were saving. Those are definitely success stories that are very rewarding when you have them.

Interviewer: Yes. We’ll wrap up with this final question. Everyone who works in this industry fights this cause of recovery every day, has their own reasons for wanting to do that. I know, obviously, I didn’t realize you were in recovery yourself. I’m sure that’s a big part of it for you. Could you end by summing up why this mission matters so much to you?

Nick: That’s a great question. I feel like I could talk a long time about it, but I won’t. It matters so much to me because I think it’s so broken. I think there is so much opportunity for improvement. So many people are struggling in their lives because we’re not effectively dealing with the crisis. We’re not communicating about the crisis. There has been so much of a myopic perspective in the field of like a one size fits all, there’s only one way to do treatment. It’s just absolutely not correct. That’s my passion, is making sure that people get the help that they need in multiple pathways and actually having effective support for people. This whole idea of mental health is really similar to physical health.

I always make this comparison, you can’t decide you’re going to get fit and then be fit. It doesn’t work that way. I’ve got to go to the gym, I’ve got to start exercising, I’ve got to start dieting and eating right. Again, I’m not going to be fit tomorrow, it’s going to take me several months to do that. Mental health is exactly the same. It takes 28 days minimum to build a new habit. That’s because you’re rewiring the circuits in your brain.

I can’t just say, “I’m going to be happy today,” or “I’m going to stop drinking today,” because I’ve built up 10 years of neurological wiring that I have to rebuild in a different direction just like I built up my muscles to get fit or to lose weight or whatever. I think that’s probably the most important thing that I’m trying to change, is that mentality of understanding in this process, understanding that people are smart and intelligent and they can do it. It’s not as simple as you get this choice or biology dichotomy. That’s false.

Choice is involved, biology is involved with a very long and difficult process. Most people I know can’t stay on a diet. Imagine how hard it is to kick a heroin habit; a lot harder.

Interviewer: All right. Well, Nick-

Unlearning Toxic Masculinity

Episode #105 | January 8, 2020

In a culture that often encourages a toxic version of masculinity, how can treatment providers help men unlearn harmful stereotypes and uncover their own trauma?

We’ll answer this with SCRC clinical director Hedieh Azadmehr on this episode of Recovery Unscripted.

Cultivating an Environment of Innate Listening

Episode #104 | October 2, 2019

As the healthcare industry evolves, how can treatment professionals turn off the noise and really listen – to emerging trends, to their patients and to themselves?

We’ll dive into this with speaker, coach and founder of human connection company BluNovus James Hadlock on this episode of Recovery Unscripted.

The Realities of Self-Harm and Suicide

Episode #103 | August 15, 2019

What can behavioral health providers do to better understand the realities of self-harm and to know how to respond when they spot the signs in their patients?

We’ll discuss this with non-suicide self-injury specialist, author and counselor Lori Vann on this episode of Recovery Unscripted.

For more about Lori’s work, visit

Integrating Buddhism and the 12 Steps

Episode #102 | August 8, 2019

How can ancient principles from Zen and Tibetan Buddhism integrate with modern treatment programs to help more people build lasting recovery?

We’ll discuss this with author Darren Littlejohn on this episode of Recovery Unscripted.

For more about Darren’s book, The 12 Step Buddhist, visit

Can LGBT-Affirmative Therapy Help Re-Write Internalized Messages?

Episode #101 | July 17, 2019

In a heteronormative culture, how can providers use affirmative therapy to help LGBT individuals re-write the false messages they’ve internalized?

We’ll answer this with psychologist, author and activist Dr. Lauren Costine on this episode of Recovery Unscripted.

For more about Dr. Lauren’s work, visit