Tag Archives: Peer-based recovery support services

WHO IS BEST QUALIFIED TO PROVIDE RECOVERY SUPPORT SERVICES?

Written by William White

The explosive growth of nonclinical recovery support services (RSS) as an adjunct or alternative to professionally-directed addiction treatment and participation in recovery mutual aid societies raises three related questions:

1) What is the ideal organizational placement for the delivery RSS?

2) What persons are best qualified to provide RSS?

3) Are RSS best provided on a paid or volunteer basis?

At present, non-clinical RSS are being provided through and within a wide variety of organizational settings by people with diverse backgrounds in both paid and volunteer roles. While research to date suggests that such services can enhance recovery initiation and long-term recovery maintenance, no studies have addressed the three questions above or the broader issue of the kinds of evidence that should be considered in answering these questions.

I have repeatedly suggested that these questions should be answered by methodologically-rigorous research evaluating whether recovery outcomes differ by variations in delivery setting, attributes of those providing the services, and the medium (paid vs. volunteer) through which such services are provided. There are, however, considerations beyond such outcomes that ought to be considered and factored into decisions on the design and delivery of RSS.

As for organizational setting, I have heard such arguments as follows:

  • RSS should be provided by addiction treatment organizations to assure a high level of integration between treatment and post-treatment continuing care.
  • RSS should be provided by criminal justice and child welfare agencies to assure the balance between the goals of recovery support, public/child safety, and family reunification.
  • RSS should be provided by hospitals and other primary care facilities to assure effective integration of recovery support and primary health care.
  • RSS should be provided through public health authorities to assure the integration of prevention, harm reduction, treatment, recovery support, community-level infection control (e.g., HIV, Hep C), and wellness promotion.
  • RSS should be provided by behavioral managed care organizations (or insurance companies) to assure coordination and integration of support across levels of care (and potentially multiple service providers) and the effective stewardship of limited financial resources.
  • RSS should be provided by private professional recovery coaches who can coordinate support across multiple systems and across the long-term stages of recovery.

RSS are now being piloted through all of the above arrangements, but I think a strong argument can be made for providing RSS through and beyond all of the above settings under the auspices of authentic recovery community organizations (RCOs). Allocating financial resources to deliver RSS through these organizations and to the community at large has the added advantages of: 1) maintaining long-term personal and family recovery as the primary service mission, 2) drawing upon the experiential knowledge within communities of recovery to inform the provision of RSS, 3) contributing to the growth of local recovery space/landscapes (i.e. community recovery capital), 4) financially strengthening the infrastructure of local RCOs, and 5) proving greater peer support to the workers providing RSS.

Similarly, RSS are now being provided by people from diverse experiential and professional backgrounds. I think there are many RSS functions that can be effectively delivered across this diversity of backgrounds, but I think the delivery of these services by people in recovery who have been specifically training for this role offers a number of distinct advantages. Through the delivery of peer-based recovery support services, people in recovery can uniquely offer: 1) recovery hope and modeling (living proof of the reality of long-term recovery), 2) normative information drawn from personal/collective experience on the stages and styles of addiction recovery, and 3) knowledge of and navigation within local indigenous recovery support resources. Such hope, encouragement, and guidance is grounded in more than 200 years of history in which people in recovery (i.e., wounded healers, recovery carriers) have served as guides for other people seeking recovery from severe AOD problems (See Slaying the Dragon, 2014). It offers the further advantage of expanding helping opportunities for people in recovery—creating benefits for both helpee and helper through the helping process. (See discussion of Riesman’s Helper Principle). Some of these advantages are limited, however, when the knowledge of the RSS specialist is drawn from personal experience within only one recovery pathway—thus the importance of combing experiential knowledge with rigorous training and supervision.

If we accept the delivery of RSS through recovery community organizations and by people with lived experience of personal/family recovery from addiction, there still remains the question of whether those directly providing RSS should be in paid or volunteer roles. The most prevalent model of delivering RSS is presently through paid roles, with progressively increasing expectations of education, training, and certification—similar to the modern history of addiction counseling. Paying people in recovery to provide RSS has the advantages of expanding employment opportunities for persons in recovery, acknowledging the value and legitimacy of experiential knowledge and expertise, and potentially creating a more stable RSS workforce. That said, the professionalization and commercialization of the RSS role risks undermining the voluntary service ethic within the recovery community, potentially creating an unfortunate future in which people in recovery would expect financial compensation for all service work.

One option is to provide funding to RCOs for the recruitment, orientation, training, and ongoing supervision of RSS, while relying primarily upon trained volunteers to deliver such services. Only time will tell if this option is a viable and sustainable model for the delivery of high quality RSS. If not, great care will need to be taken to avoid the over-professionalization and over-commercialization of recovery support. Questions related to the design and delivery of RSS should be answered primarily through research on RSS-related recovery outcomes, but such research should also examine broader benefits and the potential for inadvertent harm rising from particular models of RSS.

 

 Written by William White and posted on June 22, 2018 at WilliamWhitePapers.com

http://www.williamwhitepapers.com/blog/2018/06/who-is-best-qualified-to-provide-recovery-support-services.html

William L. White is an Emeritus Senior Research Consultant at Chestnut Health Systems / Lighthouse Institute and past-chair of the board of Recovery Communities United. Bill has a Master’s Degree in Addiction Studies and has worked full time in the addictions field since 1969 as a streetworker, counselor, clinical director, researcher and well-traveled trainer and consultant. He has authored or co-authored more than 400 articles, monographs, research reports and book chapters and 20 books. His book, Slaying the Dragon – The History of Addiction Treatment and Recovery in America, received the McGovern Family Foundation Award for the best book on addiction recovery. Bill was featured in the Bill Moyers’ PBS special “Close To Home: Addiction in America” and Showtime’s documentary “Smoking, Drinking and Drugging in the 20th Century.” Bill’s sustained contributions to the field have been acknowledged by awards from the National Association of Addiction Treatment Providers, the National Council on Alcoholism and Drug Dependence, NAADAC: The Association of Addiction Professionals, the American Society of Addiction Medicine, and the Native American Wellbriety Movement. Bill’s widely read papers on recovery advocacy have been published by the Johnson Institute in a book entitled Let’s Go Make Some History: Chronicles of the New Addiction Recovery Advocacy Movement.

 

 

Share
Posted in Addiction, Addiction Recovery Posts, alcohol, Alcoholism, Coach Credentialing, Drug Abuse, Opioid addiction, Parents, Recovery Coaching, Research, Sponsor | Tagged , , , , , | Comments Off on WHO IS BEST QUALIFIED TO PROVIDE RECOVERY SUPPORT SERVICES?

New Training Resource for Supervisors of Peers and Recovery Coaches

Recently, a new resource on the Supervision of Peer Based Recovery Support Services has been published under a grant from the Regional Facilitation Center and the Oregon Health Authority, specifically from the Health Services Division of the OHA. This is a resource is designed for the training of supervisors of Peer Recovery Support Specialists and Recovery Coaches.

Peer-based recovery support services (P-BRSS) have grown exponentially in recent years as an adjunct, and in some cases, an alternative to professionally-directed addiction treatment. P-BRSS are also being integrated within allied human services, primary health care, the child welfare system, the criminal justice system, and managed behavioral healthcare organizations. Reviews of the research to date on P-BRSS (See White, 2009; Reif, et al, 2014; Boisvert, et al, 2008) suggest salutatory effects of such services on long-term recovery outcomes. A growing body of literature explores such areas as the history and theoretical foundation of P-BRSS, the role of such services within drug policy, the integration of P-BRSS into recovery community organizations, avoiding role ambiguity and role conflicts in the delivery of P-BRSS, and ethical issues that arise in the delivery of P-BRSS.

But surprisingly little has been written on the supervision of peer recovery support services. Through support of a grant from the Oregon Health Authority (Health Services Division), Substance Use Disorder Peer Supervision Competencies has just been completed. The report is authored by Eric Martin, Anthony Jordan, Michael Razavi, Van Burnham, IV, Ally Linfoot, Monta Knudson, Erin Devet, Linda Hudson, and Lakeesha Dumas. J. Thomas Shrewsbury. Dr. Jeff Marotta, Dr. Ruch Bichsel, and Kitty Martz served as editors. The supervisory competencies are organized within four sections of the report: Recovery-Oriented Philosophy, Providing Education & Training, Facilitating Quality Supervision, and Performing Administrative Duties. This document is an invaluable resource for organizations involved in the recruitment, selection, orientation, training, and on-going supervision and evaluation of recovery coaches and other support specialists. It stands as an excellent complement to SAMHSA’s 2015 Core Competencies for Peer Workers in Behavioral Health Services.

I think the greatest mistake that could be made in guiding the delivery of P-BRSS would be to assume that traditional models of clinical supervision within addiction treatment can be indiscriminately applied to the supervision of P-BRSS delivery. If that occurs, peers providing recovery support service will be turned into little more than junior counselors and the potential vitality of that role and the broader role of community in long-term recovery will be lost.

P-BRSS require a distinct role definition, different standards of practice, and different models of supervision. Substance Use Disorder Peer Supervision Competencies will help assure such distinctiveness. I commend this report to all organizations providing peer-based recovery support services.

This blog post has been written by William White. The link to this article at the William White Papers web site is:

http://www.williamwhitepapers.com/blog/2017/05/new-resource-on-supervision-of-peer-recovery-support-services.html

William (Bill) White is an Emeritus Senior Research Consultant at Chestnut Health Systems / Lighthouse Institute and past-chair of the board of Recovery Communities United. Bill has a Master’s degree in Addiction Studies and has worked full time in the addictions field since 1969 as a street worker, counselor, clinical director, researcher and well-traveled trainer and consultant.   He has authored or co-authored more than 400 articles, monographs, research reports and book chapters and 18 books. His book, Slaying the Dragon – The History of Addiction Treatment and Recovery in America, received the McGovern Family Foundation Award for the best book on addiction recovery. Bill was featured in the Bill Moyers’ PBS special “Close to Home: Addiction in America” and Showtime’s documentary “Smoking, Drinking and Drugging in the 20th Century.” Bill’s sustained contributions to the field have been acknowledged by awards from the National Association of Addiction Treatment Providers, the National Council on Alcoholism and Drug Dependence, NAADAC: The Association of Addiction Professionals, the American Society of Addiction Medicine, and the Native American Wellbriety Movement. Bill’s widely read papers on recovery advocacy have been published by the Johnson Institute in a book entitled Let’s Go Make Some History: Chronicles of the New Addiction Recovery Advocacy Movement.

You can contact Bill White at: http://www.williamwhitepapers.com/ or bwhite@chestnut.org

Share
Posted in Coach Credentialing, Recovery Coaching, Uncategorized | Tagged , , , , , , , , , , , , , , , , , , , | Comments Off on New Training Resource for Supervisors of Peers and Recovery Coaches