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Peer Support Specialists Roles. Linda Kaplan, M.A. October 17, 2011. Recovery – The Facts. Is a reality for millions of individuals and families There are many pathways and styles of recovery Recovery is a voluntary process Recovery flourishes in supportive communities
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Peer Support Specialists Roles Linda Kaplan, M.A. October 17, 2011
Recovery – The Facts • Is a reality for millions of individuals and families • There are many pathways and styles of recovery • Recovery is a voluntary process • Recovery flourishes in supportive communities • Recovery gives back (to individuals, families and communities) what addiction has taken away • Substance use treatment (individual behavioral care) must move beyond emergency and palliative care to care oriented to promoting long-term recovery White, W. & Davidson, L.: “Recovery: The Bridge to Integration?” Behavioral Healthcare, November, 2006
Recovery Oriented Systems • Movement away from acute episode of care to treatment and recovery from a chronic condition which focuses on continuity of care and offers supports over time and across agencies • The service system goes where the potential client is rather than insisting that the client come to the service and services are individualized rather than a one-size fits all approach
Recovery Oriented Systems • Services and supports move away from a deficit and problem approach to a strengths-based approach • The involvement of people in recovery is an essential characteristic of ROSC: • primary partner in their own treatment/recovery plan • involvement as representatives of agency boards, trainers, members of the workforce, consultants, and active members of program quality improvement.
SAMHSA Working Definition of Recovery Recovery from Mental and Substance Use Disorders: A process of change through which individuals work to improve their own health and wellbeing, live a self-directed life, and strive to achieve their full potential.
Guiding Principles of Recovery • Recovery is person-driven • Recovery occurs via many pathways • Recovery is holistic • Recovery is supported by peers and allies • Recovery is supported through relationships and social networks
Guiding Principles of Recovery • Recovery is culturally-based and influenced • Recovery is supported by addressing trauma • Recovery involves individual, family, and community strengths and responsibility • Recovery is based on respect • Recovery emerges from hope
SAMHSA Recovery Support Strategic Initiative • Four Dimensions: • Health: overcoming or managing one’s disease(s) as well as living in a physically and emotionally healthy way; • Home: a stable and safe place to live that supports recovery; • Purpose: meaningful daily activities, such as a job, school, volunteerism, family caretaking, or creative endeavors, and the independence, income and resources to participate in society; and • Community: relationships and social networks that provide support, friendship, love, and hope.
Recovery Support • Greater focus on what happens BEFORE and AFTER primary treatment • Transition from professional-directed treatment plans to client-developed recovery plans • Greater emphasis on the physical, social and cultural environment in which recovery succeeds or fails
Recovery Support • Integration of professional treatment and indigenous recovery support groups • Increased use of peer-based recovery coaches (guides, mentors, assistants, support specialists), and • Integration of paid recovery coaches and recovery support volunteers within interdisciplinary treatment teams.
Recovery Capital • “Recovery capital is the quantity and quality of internal and external resources that one can bring to bear on the initiation and maintenance of recovery.” (Granfield & Cloud, 1999)
Types of Recovery Capital • Social –social network including family, friends • Physical – employment, housing, transportation, health, recreation • Human – internal capacities or skills, e.g. communication skills, problem-solving skills,
Principles of Recovery Coaching • Small caseloads to do intensive services • Clearly defined roles • Community-based service model • Strength-based services • Use of Motivational Interviewing • Develop or enhance resources (Recovery Capital) • Behavioral skills training • Ongoing Relationship • From Loveland and Boyle 2006
Strength- Based Services • Two basic principles: • People have strengths and capacities that can be nurtured and enhanced • People can grow and prosper if given access and control over resources necessary for them to thrive in the community Rapp, (1998).
Roles of Peer Coaches • Help individuals with SUDs access needed services, supports and resources, such as • Employment • Restoration of civic rights • Education • Stable housing • Skills training • Coordination and linkage to allied services • Full range of human services • From Loveland & Boyle 2006
Why Use Peer Recovery Coaches • Using peers who have been successful in their own recovery provides a message of HOPE to those who are seeking services. • It also offers opportunities for people in recovery to give back.
Principles of Strength-based Approach • Focus is on the individual not the pathology • Community is viewed as having ample resources • Interventions based on person’s self-direction • Use of aggressive community outreach • People can continue to grow, learn and change
Where Peer Recovery Coaches Operate • Recovery community organizations • As part of addiction treatment or other organization • Faith-based or other community-based organization • Paid staff • Volunteer
When Recovery Coaches are Used • To engage people before treatment • During treatment to provide needed services • After treatment to sustain recovery & continue to provide support & services • In lieu of treatment
Qualifications for Recovery Coaches • Lived experience or family member or ally • Ability to establish empathy with the individual • Ability to work with diverse populations and cultural backgrounds • Comfort in working independently in community settings • Ability to focus on and reinforce positive strengths and behaviors • A high level of energy and commitment • Acceptance of extremely flexible working hours • From Loveland and Boyle 2006
General Competencies • Aspects of addiction treatment and how to access it • Stages of Change Theory • Motivational interviewing or motivational enhancement techniques • Behavioral problem solving techniques for addiction treatment • Principles of recovery from either an SUD or mental illness, and • Case management activities and applications particular to recovery management. • From Loveland & Boyle 2006
Community Competencies • Community resources for social support and how to access each • Resources for food, clothing, shelter and other distal needs and how to access • Resources for medical care and how to access • Resources for mental health care and how to access, • Mutual aid recovery groups, their functions, values and beliefs and how to access • Faith based organizations and how to access • From Loveland and Boyle 2006
Recovery Coaches Can… • Do outreach • Motivate • Serve as a role-model and mentor • Problem solve • Advocate • Educate
What Peer Recovery Coaches Do • Help with: • Recovery goals • Action plans • Solve problems related to recovery –sober housing, recreational activities, job skills, connecting to other services • Supportive and collaborative relationship not directive
What Peer Recovery Coaches Are Not • Counselors or therapists • 12 - Step Sponsors • Clergy • Physician/Nurse
Recovery Groups • Recovery coaches can also lead groups that provide support or information and education • Topics can include life skills, parenting, anger management, employment skills
Supervision • Ongoing Supervision is essential • Group • Individual • Training on boundaries and ethics – • Need to remember principles of recovery • How might action harm others • What laws, policies or standards would apply in this situation.
Discussion How are you using Recovery Coaches? What are the benefits? What are some of the challenges? Areas for expansion?
Resources • Manual for Recovery Coaching and Personal Recovery Plan Development by Loveland and Boyle, Fayette Companies, 2006 (contact dloveland@fayettecompanies.org) • “What Are Peer Recovery Support Services?” http://store.samhsa.gov/shin/content//SMA09-4454/SMA09-4454.pdf • “Pillars of Peer Support: Transforming Mental Health Systems of Care through Peer Support Services” http://www.gmhcn.org/files/Articles/PillarsofPeerSupportService_Report.pdf
Contact Informatin Linda Kaplan Senior Public Health Advisor SAMHSA 1 Choke Cherry Road, Room 5-1083 Rockville, MD 20857 240-276-2917 (p) linda.kaplan@samhsa.hhs.gov