Author Archives: Melissa Killeen

Recovery Contagion within the Family

By Bill White

Addiction runs in families, but far less known is the fact that recovery also runs in families. Recovery Contagion is a phenomenon have captured my attention in recent decades and been the focus of numerous articles. Recovery contagion is defined as the recovery from a disease spread by close contact.

Scientific studies are unravelling the factors that combine to elevate risk of intergenerational transmission of addiction and related problems. These mechanisms of transmission include genetic and neurobiological influences, fetal alcohol spectrum disorders, assortative mating (attraction of those exposed to parental addition to individuals who share this family history), co-occurring conditions, temperament, developmental and historical trauma, family dynamics (e.g., parental/sibling modeling and collusion), early age of alcohol and other drug (AOD) exposure, and disruption of family rituals. (See Here for review of studies). Rigorous studies have yet to be conducted on the prevalence, patterns, and mechanisms through which addiction recovery of one family member increased the probability of other addicted family members also initiating a recovery process. The purpose of this article is to offer some observations on these issues drawn from decades of observation of families impacted by and recovering from severe and persistent Alcohol or Drug misuse problems. The following suggestions should be viewed as hypotheses to be tested via scientific studies and more expansive clinical observations.

  • Innumerable patterns of recovery transmission exist within families. Recovery transmission may occur intergenerationally (e.g., parent to child) and Intragenerationally (between siblings) and reach the extended family and social network. The recovery influence may also be bi-directional, e.g., mother in recovery to addicted child, child in recovery to addicted mother). Recovery transmission, like addiction, can also skip generations.
  • The probability of recovery initiation of an addicted family member increases as the density of recovery within an addiction-affected family network increase. The contagiousness of recovery and the push and pull forces towards recovery increase exponentially as other family members initiate recovery and as overall health of the family system improves.
  • The mechanisms of recovery transmission within affected families include:

1) infusion into the family of increased knowledge about addiction and recovery by the family member(s) in recovery,

2) withdrawal of family support for active addiction,

3) truth-telling about the addicted family member’s behavior and its effects on the family, 4) elicitation of hope,

5) recovery role modeling,

6) active engagement and recovery guidance by family member(s) in recovery,

7) assertive linkage and co-participation in recovery mutual aid and other recovery support institutions,

8) assistance when needed in accessing professional treatment,

9) post-treatment monitoring and support, and

10) adjustments in family life to accommodate recovery support activities for recovering members and family as a whole.

These individual mechanisms achieve heightened power when sequenced and combined over time.

  • Recovery of a family member can spark personal reevaluations of AOD consumption of other family members, resulting in a potential decrease in AOD use and related risk behaviors, even among family members without a substance use disorder. This may constitute a hidden benefit of recovery in lowering addiction-related costs to community and society.
  • The recovery contagion effect on other family members exists even when the recovering family member isolated themselves from the family to protect his or her own recovery stability. The family’s knowledge of the reality of his or her continued recovery and its effects on their health and functioning exerts pressure towards recovery even in absence of direct contact.
  • One of the most complicated forms of recovery contagion is between intimate partners who both experience AOD problems. The recovery of one partner destabilizes the relationship and increases the probability of recovery initiation of the other; addiction recurrence in one partner increases the recurrence risk in the other partner. Recovery stability is greatest when each partner established their own recovery program in tandem with activities to support “couple recovery.”
  • Where conflict exists between a family member in recovery and a family member in active addiction (e.g., a father in recovery and an actively addicted son), the conflict can serve as an obstacle to recovery initiation of the addicted family member. Though recovery initiation may be slowed, recovery prognosis is still increased, and the conflicted relationship is often reconciled when both parties are in recovery. When not reconciled, conflict can continue to be played out via different pathways of recovery.

It is rare to escape injury to family within the addiction experience. Such injuries increase progressively within families in which multiple people are experiencing AOD-related problems. For those of us who find ourselves in such circumstances, the greatest gift we can offer our family is our own recovery.

Related Papers of Potential Interest

Evans, A. C., Lamb, R., & White, W. L. (2014). Promoting intergenerational resilience and recovery: Policy, clinical, and recovery support strategies to alter the intergenerational transmission of alcohol, drug, and related problems. Philadelphia: Department of Behavioral Health and Intellectual disAbility Services. Posted at http://www.williamwhitepapers.com/pr/2014%20Breaking%20Intergenerational%20Cycles%20of%20Addiction.pdf

Navarra, R. & White, W. (2014) Couple recovery. Posted at http://www.williamwhitepapers.com/blog/2018/03/couple-recovery-robert-navarra-psyd-lmft-mac-and-bill-white.html

White, W. & Savage, B. (2003) All in the Family: Addiction, recovery, advocacy.   Posted at http://www.williamwhitepapers.com/pr/2005AllintheFamily.pdf

White, W. (2014) Addiction recovery and intergenerational resilience Posted at http://www.williamwhitepapers.com/blog/2014/07/addiction-recovery-and-intergenerational-resilience.html

White, W. (2017). Family recovery 101. Posted at http://www.williamwhitepapers.com/blog/2017/12/family-recovery-101.html

White, W. Addiction/Recovery as a family tradition. Posted at http://www.williamwhitepapers.com/blog/2017/12/family-recovery-101.html

White, W. (2015) All in the family: Recovery resource review. http://www.williamwhitepapers.com/blog/2015/11/all-in-the-family-recovery-resource-review.html

White, W. L. & Chaney, R. A. (2008). Intergenerational patterns of resistance and recovery within families with histories of alcohol and other drug problems: What we need to know. Posted at http://www.williamwhitepapers.com/pr/2012%20Intergenerational%20Resilience%20%26%20Recovery.pdf

 White, W. L. & White. A. M. (2011).  Tips for recovering parents wishing to break intergenerational cycles of addiction. Posted at: http://www.williamwhitepapers.com/pr/Tips%20for%20Recovering%20Parents.pdf

About the author:

Bill White published this article on his web site on September 05, 2019.. Bill White is a preeminent researcher on addiction and recovery. He received a Lifetime Achievement Award from the Faces and Voices of Recovery in 2015. 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.

His web site is: http://www.williamwhitepapers.com/

*Definition of Recovery Contagion:

The recovery from a disease spread by close contact.

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What do I need to be a recovery coach?

Recovery Coaching within a Recovery Oriented System of Care - SHE RECOVERS®  Foundation

Posted by Melissa Killeen, MSOD, MPhil, NCPRSS

I published the second edition my book Recovery Coaching – A Guide to Coaching People in Recovery from Addictions in 2019. Since the first edition was released (in 2013) there have been several changes in certification requirements for recovery coaches, or peer recovery specialists. The training of coaches has become one of the fastest growing aspects of the coaching field. So what kind of training do I need to be a recovery coach?

Many of the organizations that offer addiction recovery coach training or peer recovery-support specialist training are listed on my web site . For many people interested in being a recovery coach, the training costs are an important factor. Deciding on the best training organization and the training necessary to fulfill the state certification requirements can be confusing. So I would like to attempt to clear up this confusion and will attempt to answer these questions in this post:

What are the guidelines I must meet to apply for recovery coaching training?

Applicants must meet the following guidelines to apply for a training course in order to be a recovery coach or a peer recovery support-specialist. These guidelines are shared by many training organizations and certification boards across the nation as a standard for what a potential recovery coach must have before applying for recovery coaching training:

High school diploma, GED or higher

Minimum of one year of direct knowledge of sponsorship and 12-step programs

Minimum one year of sobriety from substance use or one year sobriety in co-occurring mental health and substance use disorders (self-attestation)

Have a minimum of one year experience working with a family member, loved one or significant other that is addicted, is attempting to recover or who has loss their life due to an addiction(self-attestation)

What kind of training do I need to be a recovery coach?

Certification boards require the coach to receive peer recovery specialist or recovery coach training from an organization that is authorized by the state to give this training. This ensures the training will fulfill the requirements mandated by your state’s certification board. In order to find out what authorized training organizations are, go to your state’s certification board.

After your research, you will need to complete the following:

  • Each state and organization has different requirements. So first check with your state to ensure the courses you take will be accepted by the state credentialing board.
  • A certain amount of hours in coaching training (46-120 hours depending on the state) in topics such as addiction recovery theory, motivational interviewing, relapse prevention, cultural awareness, suicide prevention and HIV-AIDS education
  • 8-16 hours of coaching ethics.

The places in which you receive this training are quite diverse. In the links section of this web site,  ( https://www.mkrecoverycoaching.com/recovery-coach-training-organizations/ ) I list over 250 organizations offering recovery coach training. The courses can be virtual, or in a classroom. The costs for this training is diverse as well, from free (in Ohio) up to $4,000 per course. The length of the course could be three days or four months.

At no time does taking a recovery coaching course give you an immediate state certification board recovery-coaching credential. It gives you a document (called a certificate) that says you completed the training hours. There are many coaches who do not seek state board certification and use this document or certificate from a training organization as adequate proof they are knowledgeable in performing the duties of a recovery coach.

There is a central international credentialing organization, the International Certification and Reciprocity Consortium, commonly known as the IC & RC, which runs many state credentialing boards and has developed an exam for a Peer Recovery (PR) Certification. The IC & RC suggests applicants check with their state credentialing board for specific test-taking guidelines.

What differentiates a Peer Recovery Coach from a Professional Coach?

Why the “Professional Coach” title? The word “professional” will differentiate Peer Recovery Coaches with more coaching experience and more training from other peer coaches with credentials or certifications. Employers ( e.g., hospitals, providers, prisons) employ coaches, and for these employers  the term “Professional” signifies a higher level of competence and expertise.

There are trainings offered that can give a coach more information that may not be on the state certification board list but are very helpful. The kinds of training I found helpful as a new recovery coach are conflict resolution and management, anger management, intervention training, co-occurring disorders, behavioral addictions, the pharmacology of addiction, as well as knowledge about coaching families in relationships with addicted persons. There are also trainings on how to be a recovery coach in a hospital Emergency Department, working with Narcan revived patients, or working with people in prisons or the homeless. There are also organizations that offer Professional Coach certification (CCAR- Conneticut Community of Addiction Recovery, (https://addictionrecoverytraining.org/ ) and the International Coaching Federation that offers three different levels of life coach training: associate, professional- and master-level coaching certificates https://coachingfederation.org/

After you receive this initial Peer Recovery Coach training, additional trainings can open up to you. The more time you engage in being a recovery coach and the more educational credentials you receive; you move closer to the “Professional Coach” status.

Are there any additional credentialing organizations for recovery coaching certification?

NAADAC, the Association for Addiction Professionals, and the National Certification Commission for Addiction Professionals (NCC-AP) offer the Nationally Certified Peer Recovery Support-Specialist Certification. Similar to the state certification- however- the NAADAC certification is good to use in every state in the union. So a coach does not have to worry about reciprocity from one state to another. The requirements the  NAADAC recommends, in order to receive certification, mandates a coach read and sign a statement on the application affirming adherence to the Peer Recovery Support-Specialist Code of Ethics. The new coach will confirm they have taken the NAADAC six-hour ethics training course and have completed six hours of HIV/other pathogens education and training course (also available through NAADAC).Credentialing boards require supervisors of the coaches-in-training to sign a document verifying they have supervised the coach during the 200-hour period of the coach’s  practice training. Letters of recommendation are also items required by some credentialing boards. Other state boards require a recent photograph.

 NAPS, or National Association for Peer Support is an organization for peers focusing on mental health recovery peer support as well as addiction recovery support. They have education and credentialing standards that are listed at : https://www.peersupportworks.org/.

As always, check with your state credentialing board for specific requirements for credentialing training. Many states only accept training from an organization that have had their trainings screened by the state and authorized to be used as a credentialing training source.

What is the next step in the  process of being qualified, getting training, and then credentialed as a recovery coach or peer-recovery support specialist?

After you have completed the research as to what type of credentialling you want (e.g. state certification board, IC & RC or NAADAC), then seek out the training you can afford. Go to https://www.mkrecoverycoaching.com/recovery-coach-training-organizations/ for a list of addiction recovery coach training organizations

  1. Verify that you meet the qualifications to apply for the course (e.g. be 18-years-old, have a GED or high school diploma, one year sobriety from any addiction)
  2. Take and pass the course, retain the coaching certificate for future purposes
  3. Research places like Recovery Community Organizations or treatment centers to work or volunteer as a recovery-coach-in-training to receive your practice hours.
  4. Complete the recovery-coach-in-training supervised practice hours that are required by the state board or the NAADAC
  5. Apply to your state certification board or the NAADAC for the time to take the recovery coach exam(a fee will apply)
  6. Send in your application with paperwork verifying the completion of practice hours to the state credentialing board with a certification fee (the additional fee varies for every state, from $100-$250)
  7. If you pass the exam and meet all the requirements listed on the application, you will receive your recovery coaching or peer-recovery support specialist certificate
  8. In the next 2 – 4 years take the required courses for renewing this certificate. Refer to your state board or the NAADAC for more information on courses and renewal time frames. A renewal fee will be required.

So, whether you are working as a coach, looking to become one, if you are a family member, or an ally ready to learn about the recovery process, we can promise you the process to become a coach is a transformational experience.

Good luck on your journey.

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Every Narcissist needs a Codependent Love Addict

“The most common toxic relationship is between the codependent love addict and the narcissist love addict. Opposites attract and love addicts are vulnerable to charming people.” -Author, therapist and founder of Love Addicts Anonymous, Susan Peabody.

Narcissism is a personality disorder. It stems from childhood abuse. When these abused children are young, they decide that the world, and the people in it, are bad and they are the only ones that are good. These thoughts result in a distorted view of themselves. They are the ones that are perfect, and they should be catered to. They lack compassion for others because everyone else is ‘less than or wrong. In general, narcissists are incapable of maintaining a healthy relationship because they have to be in control at all times.

But really, a narcissist has to be in control because they experienced the trauma of not being in control, being abused, abandoned, or made to feel ‘less than’ at a young age. In order to feel they are not being abandoned, abused, thwarted, or hurt they have chosen to put on false bravado, to dominate, and/or exhibit righteousness to protect their damaged “inner child” from being seen.

These narcissistic behaviors hide the fact there is a hurt child and in its place is this thoroughly in control adult-child, which is what the young child assumes their parent wants and will love. This becomes a belief of “You will love me because I am in control.” This behavior finds a home in any gender; male or female, non-binary, trans, or any sexual preference; heterosexual, gay, bisexual, and in any type of relationship; collegial, familiar, or intimate.

If you keep your eyes open, you can detect a narcissist’s need for control and self-centeredness. If you make an error, they will be critical and unsympathetic. A narcissist will never forget a past mistake. They hold you to a high standard and exhibit disdain for what they consider weakness or vulnerability.

Narcissists are very charming in order to seduce people into liking them. Their ability to impress people is amazing. They appear confident, exciting and are a “match made in heaven”. Love addicts fall for narcissists and bond with them. Narcissists are so good at their craft, that when their true colors emerge, they manipulate their codependent love addict partner to ensure they will not abandon them.

A codependent love addict fears abandonment as much as the narcissist

It is as if the narcissist and codependent love addict are fighting for the same thing. The codependent love addict fears abandonment as much as the narcissist. Early abandonment of a child places that kid into a very harsh environment, forcing them to figure out a way to survive. They hate the fact they were abandoned but believe that they can endure, and if they work hard enough, to prove their worth, their parent (or love interest) will not abandon them, thus ensuring abandonment will never happen to them again. This becomes a belief of” You will love me because I will do for you before I do for myself.”A codependent love addict adult emerges from this traumatic early childhood experience.

Narcissists and codependent love addicts are trauma survivors

Both narcissists and codependent love addicts are survivors. A narcissist will overwork in order to get what they need to survive. A codependent will scrape and do without in order for their offspring and family to survive. Both of these behavioral types excel in sales, in service positions, or dealing with the public. If they need more money than a 9-5 career can provide, they overwork. We will find them at a grocery store stocking shelves at midnight or selling craft goods on Etsy. The narcissist will make demands to the codependent to do ‘more for me’ or ‘love me more.’

The codependent love addicts are constantly fulfilling their role as the primary enabler for their narcissists. A consummate “make doer”, the codependent is unable to speak up for themselves, selling themselves short in order to avoid the pain of conflict with their loved one. Both are strong and resilient, yet mute to the need for resolution of the inner turmoil surrounding their early, adverse childhood traumas.

You might want to consider attending a 12 step mutual support group such as:

http://www.loveaddicts.org/

http://www.slaafws.org

http://coda.org/

http://www.adultchildren.org/

To find a professional with counseling experience in love addiction go to the Society for the Advancement of Sexual Health (SASH), which is a nonprofit organization dedicated to scholarship and training of professionals certified in sex and love addiction treatment.

For training and to find a professional with counseling experience in trauma, and love addiction consider the International Institute for Trauma and Addiction Professionals (IITAP) which is a resource for therapists specializing in the areas of sex addiction recovery and trauma.

Other good books and resources are:

We Codependent Men – We Mute Coyotes: Hope, Inspiration, and Healing for Men Living with Addicted People by Ken P, Bob T

Codependents No More- Codependents’ Guide: Heal Yourself After a Toxic Relationship, Overcome Jealousy, Possessiveness, Anxiety, and Boost your Self-Esteem

Codependent Mother: Codependency Cycle Recovery for a Daughter. No more Toxic Emotional Abuse in Family Relationships. A Guide to Cure Afflictions and Healing your Self-Esteem by Dana Jackson

The New Codependency: Help and Guidance for Today’s Generation by Melody Beattie

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