The Recovery Center Experience: Principles and Practice. A Brief Overview

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1 The Recovery Center Experience: Principles and Practice A Brief Overview New Jersey Prevention Network 11 th Annual Addiction Conference March 4, 2011 Atlantic City Convention Center Atlantic City, NJ Michael Santillo, LCADC org 03/07/11 1

2 How did we get here? Key research findings: Underscore weaknesses of addiction treatment Emphasize importance of early and sustained recovery support services Most people with alcohol and other drug (AOD) problems don't seek help Less than 50% of those admitted into treatment successfully complete More than 50% of individuals discharged from addiction treatment relapse within twelve months/most within days 03/07/11 2

3 How did we get here? Addiction recovery starts before a person stops using AODs People recovering from severe AOD problems are not fully stabilized until between four to five years of sustained remission People with severe AOD problems require sustained social support: To disengage from a culture of addiction and enter into an alternative culture of recovery To transition from recovery initiation to lifelong recovery maintenance Assertive approaches to post-treatment treatment continuing care can increase long-term recovery outcomes in adolescents and adults 03/07/11 3

4 How did we get here? There are four factors that are commonly present In the relapse prevention of most addictions: Community/External Compulsory Supervision Provides an external conscience and external source of vigilance against relapse Dependence on Competing Behaviors Provides a substitute for AODs New Relationships Fellowship, support and love are important to recovery Inspirational Group Membership Spirituality and religion are important to relapse prevention (Vaillant, G. What Can long-term Follow-up Teach us About Relapse and Prevention of Relapse in Addiction?. British Journal of Addiction, 2006; 83: ) 03/07/11 4

5 How did we get here? Health Care Reform (Affordable Care Act) Attempts to: Make health care more affordable Make health insurers and providers more accountable Expand health coverage to all Americans Make the health system sustainable Obama administration is planning to make recovery-orientedoriented services accessible through the SAP&T block grant awarded to the states by SAMHSA. Medicaid reimbursement for peer-to-peer support services Health Homes are a strategy for helping individuals with chronic conditions manage those conditions better. 03/07/11 5

6 How did we get here? Research findings and future changes in our heath care system are: Prompting calls to shift addiction treatment from a model of acute intervention to a model of sustained recovery management Triggering g new experiments in the delivery of pre-treatment, in-treatment and post-treatment recovery support services (White, W. & McLellan, A. Addiction as a Chronic Disorder: Key Messages for Clients, Families and Referral Sources. Counselor, 2008; 9(3), 24-33) (Haberle, B. & White, W. Gender-specific Recovery Support Services: Evolution of the Women s Community Recovery Center to the Women s Recovery Community Center. 2007) 03/07/11 6

7 What is a Recovery-Oriented System of Care? A Recovery-oriented system of care shifts the design of the Addiction treatment from: An acute care model, focused on: The pathology of addiction Serial episodes of biophysical stabilization To a model of sustained recovery management, focused on: The internal and external assets required to initiate and sustain long-term recovery from AOD problems (i.e., recovery capital). (White, W. & Davidson, L. Recovery: The bridge to integration? Part one. Behavioral Healthcare, November 2006) (White, W. & Cloud, W. Recovery capital: A primer for addictions professionals. Counselor, 2008; 9(5), ) 03/07/11 7

8 What is a Recovery-Oriented System of Care? The next logical step On-demand d recovery-oriented system of care: Providing integrated recovery support and treatment services Pre-treatment, in-treatment and post-treatment recovery support services Full continuum of treatment services Initiating services and engaging persons with AOD problems at the exact moment they reach out for help Most willing and motivated t Leads to best outcomes 03/07/11 8

9 What is a Recovery-Oriented System of Care? Moving into the Recovery Zone The Recovery Zone is a term used to describe a state of sustained recovery characterized by long periods of abstinence,,gainful employment, stable housing and supportive and rewarding social and spiritual connectedness. A client s entry and stabilization in the Recovery Zone is accomplished by reducing service fragmentation, promoting service continuity, and increasing clients capacity to manage their chronic disease more effectively. 03/07/11 9

10 What is a Recovery-Oriented System of Care? 03/07/11 10

11 What are Recovery Support Services? Recovery support services complement the focus of treatment, outreach, engagement, and other strategies and interventions to assist people in establishing an environment supportive of recovery and in gaining the skills and resources needed to initiate and maintain recovery. Recovery Support Services aim to: Remove personal and environmental obstacles to recovery Enhance identification of and participation in the recovery community Enhance the person s recovery capital 03/07/11 11

12 What is Recovery Capital? Recovery capital is the internal and external resources that can be drawn upon to initiate and sustain recovery Three types of recovery capital: Personal Recovery Capital Physical Recovery Capital Physical health, financial assets, health insurance, safe and recovery-conducive shelter, clothing, food, access to transportation Human Recovery Capital Values, knowledge, educational/vocational skills and credentials, problem solving capacities, self-awareness, self-esteem, self- efficacy (self-confidence in managing high risk situations), hopefulness/optimism, perception of one s past/present/future, sense of meaning and purpose in life, interpersonal skills (White, W. & Cloud, W. Recovery capital: A primer for addictions professionals. Counselor, 2008; 9(5), 22-27) 03/07/11 12

13 What is Recovery Capital? Family/Social Recovery Capital Intimate relationships Family and kinship relationships Social relationships that are supportive of recovery efforts Family/social recovery capital is indicated by: The willingness of intimate partners and family members to participate in treatment The presence of others in recovery within the family and social network Access to sober outlets for sobriety-based fellowship/leisure Relational connections to conventional institutions (school, workplace, church, and other mainstream community organizations) (White, W. & Cloud, W. Recovery capital: A primer for addictions professionals. Counselor, 2008; 9(5), 22-27) 03/07/11 13

14 What is Recovery Capital? Community Recovery Capital Community efforts to reduce addiction/recovery-related stigma Visible ibl and diverse local l recovery role models A full continuum of addiction treatment resources Recovery mutual aid resources that are accessible and diverse Local recovery community support institutions (recovery centers / clubhouses, treatment alumni associations, recovery homes, recovery schools, recovery industries, recovery ministries/churches) Sources of sustained recovery support and early re-intervention (e.g., recovery checkups through treatment programs, employee assistance programs, professional assistance programs, drug courts, or recovery community organizations (White, W. & Cloud, W. Recovery capital: A primer for addictions professionals. Counselor, 2008; 9(5), 22-27) 27) 03/07/11 14

15 What is Addiction? Addiction is a chronic, relapsing brain disease characterized by compulsive drug craving, seeking and use that persist even in the face of extremely negative consequences. Individuals with addiction often require multiple courses of treatment t t to stabilize their condition. Like with other chronic illnesses addiction requires a continuum of care for effective prevention, intervention, treatment and recovery support. Sustained recovery relies on an ongoing system of recovery support services, including housing, job training and mentoring. 03/07/11 15

16 What is Recovery? Recovery refers to the ways in which persons with or affected by addiction tap resources within and beyond the self to move beyond experiencing these disorders to managing them and their residual effects to build full, meaningful lives in the community. It is regaining wholeness, connection to the community, and a purpose-filled life. (White, W. and Davidson, L. Recovery: The bridge to integration? Part one. Behavioral Healthcare, November 2006) 03/07/11 16

17 What is a Recovery Center? Recovery Centers Connecticut Community for Addiction Recovery (CCAR) has developed four Recovery Community Centers Pennsylvania Recovery Organization - Achieving Community Together (PRO-ACT) has developed three Recovery Community Centers Vermont Recovery Network (VRN) has developed nine Recovery Centers Massachusetts Recovery Project has developed four Recovery Centers Eva s Village in collaboration with the NJ Division of Addiction Services has one Recovery Center New Jersey Recovery Center at Eva s Village 03/07/11 17

18 What is a Recovery Center? The mission of a Recovery Center is to: Mobilize resources within and outside of the recovery community Enhance the quantity and quality of support available to people seeking and experiencing long-term recovery Mobilize the members of the recovery community to reduce the stigma of addiction Educate the public about addiction recovery Help shape pro-recovery public policies 03/07/11 18

19 What is a Recovery Center? A Recovery Center (RC) is a recovery oriented sanctuary anchored in the heart of the community It exists to: Build recovery capital Organize the local recovery community's ability to care Serve as a physical place for recovery development (linkage to recovery-conducive employment, recovery homes, recovery workshops, planned leisure activities, community service work) Serve as a medium for connecting people with recovery needs to people with recovery assets Provide a venue for sober socializing Create an organizational/human bridge between the professional treatment community and the recovery community (From Core Elements of A Recovery Community Center, CCAR, 2006) 03/07/11 19

20 What is a Recovery Center? A RC is not: A treatment agency, a 12 Step club house or a drop-in center although aspects of all of these are apparent Seeking to duplicate existing resources A place for people to simply hang out, watch TV, play cards or pool and attend a daily meeting (Yet, a RC will host specific social events and recreational activities) A drop-in center whose primary purpose is to refer and help people get into treatment (Obviously, people in need of help will enter a RC and we will do everything in our power to assist them) (From Core Elements of A Recovery Community Center, CCAR, 2006) 03/07/11 20

21 What is a Recovery Center? ARC RC: Must be Volunteer-driven, member-inspired and premised on peer support Delivers peer-to-peer recovery support services using its volunteer force Maintains a structured schedule of recovery-related workshops, trainings, meetings, services and social events Targets people in recovery, family members and friends to serve as volunteers Is a place where a person with long-term recovery can give back Is also a place to find workshops, training and educational sessions to enhance one's own recovery Exists as a recovery resource for the local community (From Core Elements of A Recovery Community Center, CCAR, 2006) 03/07/11 21

22 What is a Recovery Center? A Recovery Center should be at a minimum 2,500 square feet and have these standard areas: Group/training room that seats a minimum of 50 Computer room that can comfortably hold at least 3 computers (high speed internet capable) Two offices: one for the Senior Peer Coordinator and the other for additional staff Reception area Telephone room, for making Telephone Recovery Support calls with at least three phones Lounge area for reading and socializing Kitchen area Childcare room (From Core Elements of A Recovery Community Center, CCAR, 2006) 03/07/11 22

23 What is a Recovery Center? At a minimum, an effective Recovery Center needs the following staff: One full time Senior Peer Coordinator, in effect, the "director" of the RC Ideally, this person will be intimately familiar with the local recovery community and knowledgeable of all local social services, businesses, faith organizations and neighborhoods. One Assistant Peer Coordinator One Administrative Assistant At least one Childcare Worker (From Core Elements of A Recovery Community Center, CCAR, 2006) 03/07/11 23

24 What is a Recovery Center? All program services at a RC are overseen by the RC s paid staff and are influenced by the RC s Advisory Board/Council, RC membership and the local recovery community. Recovery Coaching/Mentoring Peer one-on-one recovery support (an integral part of every RC) Delivered by volunteers (usually another person in recovery) Trained using the guidelines of the RC training curriculum Receives ongoing training and supervision Information and referrals Recovery Support Outreach Phone Calls ( checkup calls) Helps peer participants develop Recovery Plans 10 Life Domains (Recovery, Health and Medical, Work/career, Learning, Financial, i Living i Situation, ti Social Relationships, Leisure, Family, Spiritual/Creative) Goal(s), Plan, Timeframe (From Core Elements of A Recovery Community Center, CCAR, 2006) 03/07/11 24

25 What is a Recovery Center? The Recovery Coach/Mentor is a: Motivator and Cheerleader Exhibits bold faith in individual/family capacity for change; encourages and celebrates achievement Ally and Confidant Genuinely cares, listens, and can be trusted with confidences Truth-teller t Provides a consistent source of honest feedback regarding selfdestructive patterns of thinking, feeling and acting Role Model and Mentor Offers his/her life as living proof of the transformative power of recovery; provides stage-appropriate recovery education and advice Problem Solver Identifies and helps resolve personal and environmental obstacles to recovery (White, W. Sponsor, Recovery Coach, Addiction Counselor: The Importance of Role Clarity and Role Integrity. Philadelphia, PA: Philadelphia Department of Behavioral Health and Mental Retardation Services, 2006) 03/07/11 25

26 What is a Recovery Center? The Recovery Coach/Mentor is a (continued): Resource Broker Links individuals/families to formal and indigenous sources of sober housing, recovery-conducive employment, health h and social services, and recovery support Advocate Helps individuals id and families navigate the service system assuring service access, service responsiveness and protection of rights Community Organizer Helps develop and expand available recovery support resources Lifestyle Consultant Assists individuals/families to develop sobriety-based rituals of daily living Friend Provides companionship (White, W. Sponsor, Recovery Coach, Addiction Counselor: The Importance of Role Clarity and Role Integrity. Philadelphia, PA: Philadelphia Department of Behavioral Health and Mental Retardation Services, 2006) 03/07/11 26

27 What is a Recovery Center? Equally important, the Recovery Coach/Mentor is NOT a: Sponsor Does not perform AA/NA service work Therapist Does not diagnose, probe undisclosed issues ; does not refer to their support activities as counseling or therapy Nurse/Physician Does not make medical diagnoses or offer medical advice Priest/Clergy Does not respond to questions of religious doctrine nor proselytize a particular religion/church (White, W. Sponsor, Recovery Coach, Addiction Counselor: The Importance of Role Clarity and Role Integrity. Philadelphia, PA: Philadelphia Department of Behavioral Health and Mental Retardation Services, 2006) 03/07/11 27

28 What is a Recovery Center? A RC will provide: Support for recovery housing through knowledge of available sober housing within the community Child care services for parents involved in RC activities Employment support and vocational (Job Readiness) training to help build personal recovery capital Referrals to "recovery-friendly" employers found in the community Social/recreational events and activities that are member and community driven and supported by peer volunteers Monthly/weekly membership meetings (an integral part of an RC) Provides constant and consistent feedback from the community (From Core Elements of A Recovery Community Center, CCAR, 2006) 03/07/11 28

29 What is a Recovery Center? A monthly schedule of activities Posted prominently in the RC itself and available on the internet Family/community education and support groups A recovery center website A wide array of 12 step meetings, recovery support groups, faithbased groups, recovery oriented workshops, wellness classes, life skills training classes and recovery retreats Recovery resource dissemination Recovery literature, books, DVD s, pamphlets, flyers, etc. Transportation services To transport people and help with access to external recovery support services (From Core Elements of A Recovery Community Center, CCAR, 2006) 03/07/11 29

30 What is a Recovery Center? Volunteers are the RC's number one resource and must be treated as such. Staff is paid to support the volunteers and will make an outstanding effort to recruit, train, engage, supervise and recognize RC volunteers. All programs and services in a RC are best implemented by volunteers who are trained by RC staff. (From Core Elements of A Recovery Community Center, CCAR, 2006) 03/07/11 30

31 Protective Wall of Human Community The experience of community is comprised of four natural relationships: relationships to family and friends spiritual relationships relationship to Self relationship to the culture and society around us Our members experience the Recovery Center as a home, a place where friends and family come together. th They reconnect with their Higher Power and learn to love themselves once again. They become aware of their innate potentials and ultimately come to view themselves as productive members of society. 03/07/11 31

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