Recovery Practice Development Toolkit (RPDT)

Transcription

1 Recovery Practice Development Toolkit (RPDT) PRODUCED BY ON BEHALF OF THE WEST MIDLANDS DRUG & ALCOHOL TREATMENT SYSTEM AUGUST 2012

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3 Recovery Central is an informal network of people, based in the Midlands, who are recovering from addiction or are keen to support the recovery movement. The network aims to bring together a whole range of activities including mutual aid groups, self-help services, volunteering opportunities, training and employment support, social and leisure events all aiming to create a recovery community for like-minded individuals to meet and support one another. The aim of this particular project tool (RPDT) is to help providers of drug treatment services to become more recovery focused, in their work with people in active addiction. This is one example from the network that is delivered by people in recovery, or active addiction, for people in recovery, or active addiction. You alone can do it, but you can t do it alone! For further details please check out the website This memory stick contains all the documentation associated with the Recovery Practice Development Tool (RPDT). Examples, of which, are in this booklet

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5 CONTENTS Page No. Executive Summary 2 Understanding Recovery 4 Key Elements of the Recovery Practice Development Tool (RPDT) 6 Guidance on Delivering the Recovery Practice Development Tool (RPDT) 9 Resources 12 Evidence Sheets 14 Service User Questionnaire 22 Practitioner Questionnaire 26 References 30 Presentation 32 0 P a g e

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7 EXECUTIVE SUMMARY This toolkit is not a quality assured training course or clinical audit tool. It does not intend to provide a prescriptive definition of recovery or how it should be implemented. Its aim is to stimulate open and transparent dialogue about developing a recovery-oriented culture among users, providers and treatment systems. This toolkit has been informed by people who have experience of, both, active addiction and recovery from addiction to drugs and alcohol. It aims to provide a framework that places service users right at the centre of discussions; using their experiences and perceptions to elicit the necessary changes. The Coalition s Drug Strategy places a significant focus on building a recovery-oriented substance misuse treatment system; reflecting the increasing emergence of the UK recovery movement. A key tenet is the need to develop and underpin an inspirational recoveryorientated workforce; promoting a culture of ambition, and a belief in recovery (Drug Strategy 2010). This will require a cultural shift and a change in attitudes and values towards greater client authority, a philosophy of choice and an emphasis on empowering service users to self-manage their own recovery. The treatment system has an opportunity to initiate long term recovery, through identifying and signposting to appropriate resources to underpin the principle of individualised care. Practitioners as facilitators or coaches can provide the necessary encouragement and support that will enable service users to identify their own goals and develop solution focused strategies to meet these. This Recovery Practice Development Tool (RPDT) has been designed to provide a structured framework, within which, providers and treatment systems can explore and assess the recovery readiness of their internal practices and policies. To ensure a holistic view, it is suggested that evidence is sourced from, as a minimum, service user assessments, treatment/recovery plans, staff interviews/observations, views of service users / families, service documentation. The resulting Development Plan will identify areas that need a targeted focus and a baseline against which to monitor progress. This toolkit can be used in isolation as a self-assessment; however this is not in keeping with the spirit of the toolkit that aims to maintain service users at the centre. The workforce project members should be utilised to facilitate the groups and assess the evidence. These are trained individuals who have experience of the treatment system, and good practice, in being recovery oriented. The scheme provides an opportunity for people in recovery to learn new skills and gain useful work experience. 2 P a g e

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9 UNDERSTANDING RECOVERY In the context of substance misuse, it is important to note that recovery does not mean just abstinence, but includes opioid substitute treatment (OST), for whom, this is a more viable option. Furthermore, recovery does not simply mean the end of addiction:- The process of recovery from problematic substance use is characterised by voluntarily-sustained control over substance use which maximises health and wellbeing and participation in the rights, roles and responsibilities of society. (UKDPC Consensus Group, 2008) Recovery is a lived experience and a unique process of change for each individual, who needs to make informed and healthy choices to improve their quality of life; and find a definition of what recovery means to them an individual, person-centred journey, as opposed to an end state, and will mean different things to different people (Home Office, 2010). DrugScope cites a comprehensive list of what they believe to be the Underlying principles of recovery :- 1. Hope and aspiration Treatment should provide help, support and opportunity; whilst recognising the assets, strengths and potential of people who are affected by drug and alcohol problems. People in recovery stress the importance of having someone to believe in them. Hope, can be enhanced by having more control over own life, by having things to do, be interested in and by seeing how others have found recovery (Clarke, 2009). 2. A journey, different people take different roads - a process shaped by the individual s needs, options, assets, resources, priorities and motivations. Services should work closely with users to develop and deliver individualised recovery plans that encourage people to choose and adapt their own path. 3. The value of drug-free outcomes as the ultimate goal of recovery but recognises that abstinence can take time and that there is a key value in medically-assisted recovery. Treatment systems should be balanced, integrated and responsive to service users whilst remembering that practitioners already know a lot about what works. 4. Engaging with the range of an individual s needs - The Drug Strategy 2010 explains that recovery can only be delivered through working with education, training, employment, housing, family support services, wider health services and, where relevant, prison, probation and youth justice services to address the needs of the whole person. 5. Social inclusion - Recovery is about working to remove the barriers back into society and communities. This includes addressing the stigma experienced by people who are trying to tackle their drug or alcohol problems. Those with severe addiction problems are often the most marginalised and dislocated members of society, many of whom who have experienced severe trauma in early life (Bamber, 2010). 4 P a g e

10 6. Service user networks and mutual support - Recovery is about empowering people with direct experience of drug and alcohol problems to support each other; recovery is contagious. It is about integrating peer support and mutual aid options into recovery planning; it is about recovery champions and other people who are able to tell their stories and share their experiences (including those benefiting from medically-assisted approaches). 7. Families - often play a critical role in supporting members with drug problems e.g. providing emotional support, housing, access to leisure and other forms of meaningful activity and initiating and supporting engagement with treatment services. Families often need to recover from the impact of another s substance misuse - Family members and carers can be positive advocates but can also reinforce negative attitudes based on their own experiences and lack of hope in the future. (Maddock & Hallam, 2010) 8. Communities The process of recovery takes place in a wider community. Service users themselves, and members of their communities, can foster recovery through collective social effort and innovation such as social enterprises. Communities can have a need for recovery too e.g. from their experience of open drug markets, acquisitive crime or alcohol related crime and disorder. 9. Taking responsibility - Many people with drug or alcohol problems have had difficult lives including abuse, neglect and trauma in childhood - but that does not detract from the fact that their behaviour has often caused harm to others. A relatively small number of problem drug users are responsible for large volumes of acquisitive crime. Some drug using parents fail to provide a safe and appropriate environment for their children. Recovery is about taking control and about participation in the rights, roles and responsibilities of society. 10. Inclusion of other health and public health interventions Treatment has a responsibility to prevent death and disease, which is critical for good public health as well as the wellbeing of the individual. The Drug Strategy 2010 includes prevention of drug-related deaths and blood borne viruses among eight best practice outcomes for a recovery oriented system ; but other issues, such as, the effectiveness of child safeguarding arrangements and specialist drug and alcohol services for young people should not be forgotten. The Recovery Orientated Drug Treatment report, produced by Professor John Strang s expert group, acknowledges the valuable role of prescribing as a component of a phased, integrated package of treatment that minimises risk while being ambitious for each individual patient s recovery. 5 P a g e

11 KEY ELEMENTS OF THE RPDT The eight key elements of recovery-oriented practice for the RPDT were developed to capture the values, principles and methods which support recovery from addiction. They incorporate descriptions of recovery-oriented practice from both the field of mental health and from the emerging practice advice and guidance from the substance misuse field. There will be some overlap between the different elements, which are intended to be used concurrently. The order of the elements does not reflect their importance. 1. Clearly demonstrates a belief in, and commitment to, recovery - This element is a values based concept and those values should be a central feature. Practitioners have to believe that people can change; celebrate the successes and view set-backs and relapse as an accepted part of the process of recovery (Slade, 2009). They should demonstrate a belief in the strengths and assets that all service users bring with them; and create the environment, conditions and practices that support people s recovery. The most important task is for a service provider to identify and maintain the attitudes and beliefs required to inspire sustained change in clients. Once someone holds a belief that the client can sustain change, the skills and knowledge will come (as stipulated by DANOS, Models of Care, NICE guidance, etc.). Without the appropriate attitudes and beliefs, the competence and knowledge is not enough. (NTA, 2012) 2. Supports achievement of clients self-defined goals - Recovery is a personcentred journey, based on self-determination and self-management. Practice should promote service user-led decision-making in accordance with the individual s own aspirations, values, needs, resources and circumstances (Shepherd et al, 2008). Stephen Bamber (2010) describes five principles of recovery planning: Recovery plans are self-directed Recovery planning should be facilitated by the key worker (or recovery coach/mentor), but should be the responsibility of the service user or client Recovery plans should be subject to regular review led by the client Recovery plans should guide the therapeutic journey towards specific (and evolving) outcomes and goals Recovery plans are owned by the service user or client and should accompany them on their journey through and beyond services 3. Has an asset based approach - Identification of personal and social capital that builds on people s strengths, resources, resilience and ability for an individual to manage their own life. This is in stark contrast to a deficit-based approach that highlights problems and needs. Those entering treatment services tend to have lower levels of personal and social capital and are more vulnerable (Best, 2009). The role of a recovery-oriented practitioner is to help and support the service user, and their significant others, to build their recovery capital and become less reliant on treatment services. 6 P a g e

12 4. Acknowledges and involves significant others in the client s treatment journey This could include family members, carers, friends, employers, recovery champions and mentors. Non-using family members and friends can have a crucial role to play in helping people in recovery; if service users will welcome the involvement. Family members and significant others should be given support in their own right by treatment services, including person-centred strengths-based needs assessments. They should be encouraged and supported to meet others in a similar position to themselves through mutual aid groups. Practitioners should offer, and provide or support, access to a range of therapeutic interventions including behavioural couple s therapy, family therapy and community reinforcement approaches as recommended in the NICE guidance. 5. Delivers effective, outcome focused and recovery-oriented interventions as evidenced in the NICE guidelines - Recovery-oriented practitioners should be working to increase the number of clients to become drug-free by reviewing caseloads and offering appropriate and timely options; including planned support for those who choose detoxification. The provision of a prescription alone should not be considered to constitute the totality of treatment. The prescribing of any medication (and perhaps especially of OST) must not be allowed to become detached and delivered in isolation from other crucial components of effective treatment. (Strang 2011) Treatment is more effective if is delivered in an environment that encourages effective links and bridges to the recovery community. Other elements of treatment should also be offered including psychosocial interventions, encouragement and assertive linkage to attend mutual aid and peer support groups. 6. Encourages and supports meaningful service user involvement - in all levels of decision making from the individual recovery plan to the collective organisation and national policy influencing. The participation of service users has to be embedded in the culture of treatment services. Employment and volunteering opportunities are a key mechanism alongside feedback and evaluation opportunities. Recovery-oriented services will encourage and support the introduction of recovery champions as mentors and role models. Successful service delivery by service users/people in recovery is a powerful tool to challenge the negative misperceptions that can exist in society. 7. Promotes and supports social inclusion/community integration - People rarely recover in isolation and recovery is contagious. Support in the community is essential for the on-going recovery journey and is often underpinned by mutual aid and other peer support, which should be championed by practitioners. Best and Gilman (2010) observed that the growth of the visible recovery movement has a ripple effect that produces a collective recovery capital. Practitioners should be creating active links with local peer support and mutual aid groups; as recommended in the Orange book: 7 P a g e

13 The benefits of these groups can be further enhanced if key workers and other staff in services facilitate contact with them, for example by making an initial appointment, arranging transport or possibly accompanying patients to the first meeting and dealing with any subsequent concerns. These interventions can be of benefit to a wide range of people at different levels of the care and treatment system. (Department of Health, 2007) 8. The organisation has a clear governance structure, with robust quality and clinical standards Recovery principles should be integrated into all management processes and key publications, such as, recruitment, job descriptions, supervision, appraisal, audit, planning and operational policies. Practitioners should also think about the values, ideas and attitudes that inform their practice and whether these are compatible with principles of recovery. Supervision should be reflective on the practice of front line workers; and support their learning and development in relation to person centred, recovery-oriented practice. This approach requires a more creative and positive approach to risk management that should actively and meaningfully involve service users (Slade, 2009) Managers of treatment agencies should ensure that their service implements the recommendations of the Recovery-Orientated Drug Treatment Expert Group (Strang 2012) and the 12 immediate steps that can be taken to improve the recovery-orientation of treatments that include prescribing. 8 P a g e

14 GUIDANCE ON DELIVERING THE RPDT It is recommended that an RDPT Project Group is established to include practitioners and ex/current service users with an expertise / interest in recovery; plus other staff or stakeholders as appropriate. The Workforce Development Consortium can be brought in to facilitate this part of the process; and encourage the development of practitioner and user recovery champions. The role of the project group is to facilitate the process of the RDPT:- Be responsible for collecting and collating the evidence for recovery-oriented practice from service user assessments, recovery/treatment plans and service documentation Recruit to, organise and help facilitate the discussion groups users and practitioners Analyse and interpret the findings Contribute to the development plan The project co-ordinator will need some consideration - a manager from within the service, an external consultant, commissioner or a local recovery champion. They should be given the appropriate authority, time and support to engage with the project, which includes being able to examine service documentation and have access to practitioners for the discussion group. The role of the project co-ordinator is to oversee the process, facilitate the project meetings, support other group members and ensure the development plan is produced and implemented. The other key constituents, of the project structure, are the service user and practitioner discussion groups. It is important to get a representative sample of service users; trying to avoid the usual suspects or cherry picking clients with certain views. Volunteers and recovery champions should be included if they work closely with individual service users, as should group workers. The questionnaires can be used with individuals or to facilitate the group discussions. It is recommended, as a minimum, that the evidence for recovery-oriented practice is collected from five different sources: Assessments Recovery/treatment plans Staff Interviews / Observations Service users Service documentation/information Although there will be a fair amount of overlap, which helps confirm findings, each source should provide some unique evidence. 9 P a g e

15 Source Assessments Recovery / Treatment Plans Staff Interviews / Observations Service Users Service documents & information Evidence Opportunity to explore whether a recovery approach is part of a service user s induction from the outset. It will provide valuable evidence on whether the service has an asset based approach, promotes a partnership between client and key workers and is prepared to consider an exit date. Written records of a recovery-oriented approach and responsiveness to changes in the circumstances of service users. Plans are particularly useful for assessing the range and quality of treatment and other recovery-focused support that are provided. They are also a record of who leads the treatment the worker or service user. Practitioners are an important source of information about the organisational values and beliefs. They can provide a useful perspective of the gaps and strengths in leadership, management and governance; to ensure that a recovery focus is embedded throughout the organisation. Can provide another interesting perspective for comparison with other pieces of evidence. They may be able to present solutions for improving practice and service delivery and the identification of gaps in opportunities available. This cohort may have valuable insight into the mutual aid and post treatment support services available. They reflect the level of commitment and support for recovery and offer a sense of the organisational culture. It may be interesting to explore how organisations are perceived by external stakeholders, through their literature. Documentation should be considered alongside actual delivery to ensure there is congruence. When completing the evidence sheets all examples of good practice, in terms of a recovery focus, should be recorded; to ensure a thorough exploration. The scoring is a subjective process reliant on the judgement of project group members and according to the quality and quantity of evidence produced. No Evidence Substantial Evidence To ensure confidentiality is protected any information should be recorded anonymously. 10 P a g e

16 A score matrix is provided electronically, on the memory stick, as part of the toolkit. The scores from each of the evidence sheets (up to 40 individuals) should be entered into the matrix. This will then be calculated to produce one overall average (mean) score for each of the eight key elements. This will provide a brief overview of where, and to what extent, key elements of recovery-oriented practice are being met within the service. The evidence sheets can then be referred back to, for the detail. Key Element of Recovery-orientated Practice Assessments Recovery/ Treatment Plans Service Users Practitioners Service Documentation & Information Average Score 1. Shows a belief in and commitment to recovery 2. Supports achievement of self-defined goals 3. Has an asset based approach 4. Acknowledges and involves significant others 5. Effective treatment interventions 6. Service user involvement 7. Promotes social inclusion 8. Governance Structure N/A N/A Average Score All the evidence gathered can then be used to inform the content of the final component a Development Plan. This should be shared with all the relevant stakeholders and any adjustments should be made after the consultation process has completed. A template for the development plan is provided as part of the tool-kit. Key Element of Recovery-oriented Practice Areas for Improvement Actions Responsible Date Outcomes 11 P a g e

17 RESOURCES The Recovery Practice Development Tool provides a framework for assessing recoveryoriented practice and a process to enable those who deliver and receive services to begin thinking about the changes that can be made to deliver improvements. Services will need to access other resources to support implementation of any necessary changes required. The list below is not exhaustive and guidance continues to emerge. Practice Implementing Recoveryoriented Practice Resources Shepherd et al (2008), Making Recovery a Reality ity_policy_paper.pdf RODT interim report Resources for reviewing, planning and optimising treatment: Treatment reviews and drug screening in the 2007 Clinical Guidelines: Recoveryoriented treatment interventions Resources on opioid substitute treatment: Resources on detox:- Community - In-patient - Re-engagement in the NTA s treatment completion good practice guide: NICE-recommended psychosocial interventions, using the audit tool in the NTA/BPS Toolkit Assessment Assessment/reassessment of recovery capital: Recovery capital: 12 P a g e

18 Recovery Planning Bamber. S (2010) Five Principles of Recovery Planning Resources on recovery planning: Resources on recovery communities: Mutual Aid and Recovery Communities Resources on building social networks: Resources on Social Behaviour Network Therapy: Skills Hub resources on family support: Partnership Agencies Management and Leadership Resources on appropriate supported/facilitated referrals: Clinical supervision - a practical guide for the alcohol and other drugs field - [NCETA - Australia] 13 P a g e

19 Evidence Sheets Demonstrates a belief in and commitment to recovery Points To consider:- Organisation actively promotes hope and optimism that is central to recovery A clear organisational culture and attitude of positivity and recovery from addiction Externally viewed literature clearly reflects a recovery focused culture The treatment journey should be recovery-focused from the start with a clear expectation of an exit point A strong emphasis on responsibility, resilience and personal growth Community / leisure / social activities and mutual aid groups are clearly marketed in waiting areas Recovery coaches / people in recovery have a strong presence throughout the organisation Success is acknowledged and overtly celebrated Evidence: 14 P a g e

20 Supports achievement of clients self-defined goals Points To consider:- Personal goals are routinely reviewed, progress is recorded and celebrated; and users are supported and encouraged to own and lead their recovery planning Recovery planning should be facilitated by the key worker but should be the responsibility of the client Reviews should evidence the necessary flexibility to respond to clients changing priorities, goals and life issues Plans should guide the journey towards specific (and evolving) outcomes and goals Use of person-centred planning tools such as ITEP/BTEI or other mapping techniques Access to a menu of treatment and social opportunities from which a client can build their recovery plan Access to people in recovery / peer mentors in order to support the clients ownership Evidence: 15 P a g e

21 Has an asset based approach Points To consider:- The focus is on strengths not diagnosis, symptoms, problems, or perceived deficits. This may include personal goals, coping strategies, family & social network, life experience, valued social roles, hobbies and interests, personal attributes Strengths & assets are utilised to find solutions, identify and develop personal and social capital to aid the recovery journey This approach is clearly articulated in internal and external documentation to all stakeholders including users and significant others Organisation has proficient knowledge of a choice of local community assets / resources that can be readily and easily accessed by clients Recovery plans clearly indicate a strengths / asset based approach to care planning Evidence: 16 P a g e

22 Acknowledges and involves significant others in the clients journey Points To consider:- The needs and impact of families, carers and significant others are routinely explored within the care / recovery planning process Assuming the client consents, personal and intimate relationships with significant others should be regularly explored as an asset or barrier to recovery Recognition that service users' families and significant others may need support in their own right to address the impact of others drug use A range of therapeutic interventions should be available e.g. behavioural couple s therapy, family therapy, community reinforcement approaches as recommended in the NICE guidance. Assertive linkage is offered to family support services (including mutual aid) Service information clearly articulates the value of involvement and participation; and that the necessary mechanisms are in place to support this Evidence: 17 P a g e

23 Delivers effective, outcome focused and recovery-oriented interventions, as evidenced in the NICE Guidelines Points To consider:- Organisations clearly offer a varied menu of recovery-oriented interventions including maintenance, abstinence, de-tox and rehab Evidence that the Strang recommendations have been adopted Clear adherence to NICE and Orange Book guidance Service users & significant others are confident in their expectations and understanding of their recovery journey A clear pathway to eventually exit treatment from the outset to include post treatment support options A visible presence and access to people in recovery Assertive linkage to mutual aid and community support Access to other health promotion services including overdose prevention Evidence: 18 P a g e

24 Encourages and supports meaningful service user involvement Points To consider:- A comprehensive induction process and clear evidence that users are in partnership with key workers / practitioners in goal setting and recovery planning Access to role models or mentors; and people in recovery recruited as champions, peer supporters, volunteers and/or paid staff. Meaningful service user involvement is an integrated and ongoing component of service activity at all levels e.g. recruitment, training, developing policy, governing bodies A member of staff is responsible for service user involvement Support and facilities provided for service user led groups Key mechanisms could include feedback opportunities, involvement policy or charter, rights/responsibilities and complaints procedures Offered information about other involvement schemes such as Patient Opinion Access to leisure and social activities Evidence: 19 P a g e

25 Promotes and supports social inclusion / community integration Points To consider:- Availability of leisure and social opportunities including community resources, access to transport, housing, education, employment schemes, arts, sport, leisure, and recreation. Evidence of interventions that promote growth and self-reliance, such as encouraging individuals to self-direct their recovery by linking to community events/volunteering Also includes connections to faith groups, interest groups and non-drug treatment community resources such as libraries, community centres and shops. Information and assertive linkage to mutual aid groups/recovery networks - 12-step meetings, SMART recovery programmes, recovery cafés, web-based recovery forums and communities (Wired-in) Evidence: 20 P a g e

26 The organisation has a clear governance structure, with robust quality and clinical standards Points To consider:- The organisation has a visible definition / mission / set of principles or statement promoting recovery Recovery principles should be integrated into all management processes and key publications, such as, recruitment, job descriptions, supervision, appraisal, audit, planning and operational policies Reflective supervision and workforce development strategies that promote person centred, recovery-oriented practice Strict adherence of clinical governance guidelines and adoption of Strang recommendations and NICE guidance in delivering interventions Evidence: 21 P a g e

27 SERVICE USER QUESTIONNAIRE Staff believe in my recovery from addiction and encourage my goal towards better life choices and access to opportunities Evidence Evidence My goals, hopes and ambitions are considered in my treatment Evidence My strengths, skills and abilities are encouraged by staff 22 P a g e

28 Staff help me to include people who are important to me in my treatment and help to support them Evidence The treatment and support that I receive is the best I could get for my recovery Evidence The treatment and support that I receive is the best I could get for my recovery I am encouraged and supported to be involved in my treatment and how the service works Evidence 23 P a g e

29 I am encouraged & supported to be part of my community & to meet others in recovery Evidence Do you have any other comments you would like to say about the treatment you receive or anything about recovery? Evidence 24 P a g e

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31 PRACTITIONER QUESTIONNAIRE I believe that recovery is possible for all service users and I actively work with them to enable their recovery journey Evidence I help identify and address service users self-defined goals and aspirations Evidence I acknowledge, value and help build service user s strengths, skills and abilities Evidence 26 P a g e

32 Evidence I fully involve service user s family and significant others where I can I facilitate recovery-oriented treatment interventions that are the best for the service user s recovery Evidence Evidence Service users have a significant influence on how the service is run 27 P a g e

33 Evidence I support access to a range of options to develop or strengthen social networks and community integration Evidence I am supported and valued in my work and opportunities exist to reflect on and develop recovery-oriented practice Do you have any other comments you would like to say about recovery oriented practices in the organisation? Evidence 28 P a g e

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35 REFERENCES Adfam and DrugScope (2009) Recovery and Drug dependency: a new deal for families Anthony, W.A. Recovery from mental illness: the guiding vision of the mental health system in the 1990s. Innovations and Research 1993; 2: Bamber, S. (2010) Five Principles of Recovery Planning Best, D. et al (2009) Addiction Research & Theory 17(6) Best, D. et al, (2010): Recovery and Straw Men: An Analysis of the Objections Raised to the Transition to a Recovery Model in UK Addiction Services, Journal of Groups in Addiction & Recovery, 5:3-4, Best, D. and Gilman, M. (2010) Recovering Happiness, Drink and Drugs News, 15 February Borkman, T. (1998). Is recovery planning any different from treatment planning? Journal of Substance Abuse Treatment, 15(1), Campbell-Orde, T. et al (2005) Measuring the Promise: A Compendium of Recovery Measures, Volume II. Cambridge, MA: Human Services Research Institute. Centre for Substance Abuse Treatment, Substance Abuse and Mental Health Services Administration, Davidson, L. et al (2009) A Practical Guide to Recovery-Oriented Practice Tools for Transforming Mental Health Care. Oxford: Oxford University Press Department of Health (England) and the devolved administrations (2007). Drug Misuse and Dependence: UK Guidelines on Clinical Management. London: Department of Health (England) the Scottish Government, Welsh Assembly Government and Northern Ireland Executive DrugScope (2009) Drug Treatment at the Crossroads DrugScope (2012) Building for Recovery Granfield, R. and Cloud, W. (1999) Coming clean: Overcoming addiction without treatment. New York: New York University Press Granfield, R. and Cloud, W. (2001) Social Context and Natural Recovery : The Role of Social Capital in the Resolution of Drug-Associated Problems, Substance Use and Misuse, Vol. 36, pp Higgins, A. (2008) A Recovery Approach within the Irish Mental Health Services: A Framework for Development. Mental Health Commission Home Office (2010), Drug Strategy 2010 Reducing demand, restricting supply, building recovery: supporting people to live a drug free life Maddock, S. and Hallam, S. (2010) Recovery Begins with Hope, Centre for Mental Health Mental Health, Drugs and Regions Division (2011) Framework for recovery-oriented practice, Victorian Government, Department of Health, Australia. NTA (2012) Building recovery in communities: a summary of the responses to the consultation 30 P a g e

36 O Connell, M. et al (2005) From rhetoric to routine: Assessing perceptions of recovery-oriented practices in a state mental health and addiction system, Psychiatric Rehabilitation Journal, 28, Psychosocial Interventions For Drug Misuse: A framework and toolkit for implementing NICE-recommended treatment interventions, NTA Repper, J. & Perkins, R. (2003) Social Inclusion and Recovery. Balliere Tindall: London. Ridgway, P. (2004) Assessing the recovery-commitment of your mental health service: A Users Guide for the Developing Recovery Enhancing Environments Measure (DREEM) UK Version Sheedy, C. K. and Whitter, M. Guiding Principles and Elements of Recovery-Oriented Systems of Care: What Do We Know From the Research? HHS Publication No. (SMA) Rockville, MD Shepherd, G. et al (2008) Making Recovery a Reality. London: Sainsbury Centre for Mental Health. Shepherd, G. et al (2008) Making a reality of recovery, Sainsbury Centre for Mental Health Slade, M. (2009) 100 ways to support recovery: A guide for mental health professionals. Rethink Slade, M. (2010) Measuring Recovery in Mental Health Services, Psychiatry Related Science - Vol 47 (3) Strang, J. (2011), Recovery-orientated drug treatment an interim report, NTA, UK Drug Policy Commission (2008). A vision of recovery UK Recovery Federation. Consultation paper (2009) White, W. (2008a) Recovery Management and Recovery-Oriented Systems of Care: Scientific Rationale and Promising Practices, Pittsburgh, PA: Northeast Addiction Technology Transfer Centre, Great Lakes Addiction Technology Transfer Centre, Philadelphia Department of Behavioural Health and Mental Retardation Services White, W (2007) Addiction Recovery: Its Definition and Conceptual Boundaries, Journal of Substance Abuse Treatment, Vol. 33, No. 3, pp P a g e

37 PRESENTATION INTRODUCING THE RECOVERY PRACTICE DEVELOPMENT TOOL This presentation, available on the memory stick, offers an introduction and context for the tool when describing to partners or stakeholders. It has been produced, deliberately, without any branding, in order, for users to edit or make additions at will; and to meet own branding requirements. 32 P a g e

38 33 P a g e For further details please check out the website