building recovery-oriented systems of care for drug court participants laura griffith director of...
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Building Recovery-oriented Systems of Care for Drug Court Participants
Laura GriffithDirector of Programs
April 15, 2014
What Is Recovery?
There are over 23 million American adults in long-term recovery – no longer have a problem with alcohol or other drugs.
Definitions of Recovery
J. F. Kelly & Hoeppner, 2012
Snapshot of Life in Recovery
4
LIFE IN ADDICTION LIFE IN RECOVERYMeasured average length of time in addiction – 18 years. Measured average age of recovery – 36 years old.
Measured in 3 stages. Stage 1: < 3 yearsStage 2: 3 to 10 years Stage 3: 10+ years
FINANCES70% experienced financial problems
FINANCESHealthy financial circumstance improved as recovery progressed. Paying bills on time and paying back personal debt doubled. Fifty percent more people in recovery pay their taxes.
MENTAL HEALTH PROBLEMSTwo-thirds had untreated mental health problems
MENTAL HEALTH PROBLEMSUntreated mental health problems decreased fourfold
CRIMINAL JUSTICE INVOLVEMENT Over half (53%) reported one arrest;
1/3 experienced more than 1 incarceration
35% had had their driver’s license revoked
CRIMINAL JUSTICE INVOLVEMENT Involvement with the criminal justice system
decreased tenfold Restoration of driving privileges
EMPLOYMENT AND EDUCATION Half had been fired or suspended
from work; 61% frequently missed work or school
33% had dropped out of school
EMPLOYMENT AND EDUCATION 10% reported employment problems; 83% are
steadily employed, and 28% have started their own business
78% have furthered their education or trainingCIVIC/FAMILY ENGAGEMENT Two-thirds participated in family
activities Volunteerism was at 31% and 61%
voted
CIVIC/FAMILY ENGAGEMENT Participation in family activities increased by
almost half (46%) to 95% Volunteerism was 84% (more than doubled) and
voting increased to 86% (an increase of 41%)
Why is it important? What does it mean?
Recovery is associated with dramatic improvements in all areas of life
Life keeps getting better as recovery progresses.
Policies, systems, services, and supports are needed to help more people initiate and sustain recovery
Additional research is necessary to identify effective and cost-effective recovery-promoting policies and services – to build recovery-oriented systems of care
Established 2011 Over 95 member organizations (35 states) with local, state, national, and international focusBuilding infrastructure and capacity to provide:
• Public education • Advocacy • Peer recovery support services
ARCO
Focus: Recovery and Wellness
Shifting from a crisis-oriented, professionally-directed, acute-care
approach with its emphasis on discrete treatment episodes….
…to a person-directed, recovery management approach that provides
long-term supports and recognizes the many pathways to health and wellness.
Recovery-oriented Systems of Care
Mobilizing resources to: Build the capacity of communities,
organizations and institutions to support recovery
Build on the strengths and resilience of individuals, families and communities to promote recovery, health, and wellness.
Expand the menu of services and supports across the entire recovery continuum
Ensure people in or seeking recovery receive dignity and respect
Lift discriminatory policies and barriers to recovery
Recovery-oriented Systems of Care
Mobilizing all of the resources in our communities to:
Accord people in or seeking recovery dignity and respect
“Recovery capital” of Drug Court participants
Build the capacity of institutions that Drug Court teams have relationships with to support recovery
Building Connections to Family and Community
JOBS/EDUCATION/CIVIC ENGAGEMENT
Recovery GED programs, high schools and colleges
Employment discrimination against people in recovery with criminal justice history
Restrictions on voting rights for people with criminal justice history
Opportunities to volunteer and build work histories
Recovery-oriented Systems of Care
RCOsRecovery
Community Centers
Recovery Homes
Recovery Schools
Recovery Industries
Recovery Ministries
Recovery Cafes
What is Needed: Recovery Capital
Physical: includes health (access to care), financial assets, food/clothing/shelter, transportation
Human: includes culture, values, knowledge, education, inner- and interpersonal skills, judgment, and other capacities
Social: includes connectedness to social supports and resources, intimate/family/kinship relationships, and bonds to community and social institutions
Recovery Capital is the breadth and depth of internal and external resources that can be drawn upon to initiate and sustain recovery from addiction. (Granfield and Cloud, 1999, 2004; White, 2006)
Consequences of Addiction Can Deplete Recovery Capital
Limited education Minimal or spotty work history Low or no income Criminal background Poor rental history Bad credit Accrued debt and/or back taxes Unstable family history Inadequate access to health care
Creating and Reinforcing Recovery Capital
Safe and affordable place to live Steady employment and job readiness Education and vocational skills Life and recovery skills Health and wellness Sober social support networks Sense of belonging and purpose Connection to family and community
Services to help individuals and families initiate, stabilize, and sustain recovery
Provided by individuals with “lived experience” of addiction and recovery
Non-professional and non-clinical Distinct from mutual aid support, such
as 12-step groups Provide links to professional treatment,
health and social services, and support resources in communities
Peer Recovery Support Services
What Makes Peer Work Effective?
Focuses on establishing trust and building relationship
Builds on a person’s strengths to improve Recovery Capital
Promotes recovery choices and goals through a self-directed Recovery Plan
Utilizes recovery community resources and assets
Provides entry and navigation to health and social service systems
Models the benefits of a life in recovery and elevates recovery as an expectation
Effective outreach, engagement, and portability
Manage recovery as a chronic condition Stage-appropriate Cost-effective Reduce relapse and promote rapid
recovery reengagement Facilitate reentry and reduces
recidivism Reduce emergency room visits Create stronger and accountable
communities
Benefits of Peer Recovery Support Services
When Are PRSS Delivered?
Across the full continuum of the recovery process:
Prior to treatment During treatment Post treatment In lieu of treatment
Peer services are designed and delivered to be responsive and appropriate to all stages of recovery.
Where Are PRSS Delivered?
Recovery community centers Faith and community-based organizations Emergency departments and primary care
settings Addiction and mental health treatment Criminal justice systems HIV/AIDs and other health and social service
agencies Children, youth, and family service agencies Recovery high schools and colleges Recovery residences and Oxford Houses
Peer Recovery Coach
Personal guide and mentor for individuals seeking to achieve or sustain long-term recovery from addiction, regardless of pathway to recovery
Connector to instrumental recovery-supportive resources, including housing, employment, and other services
Liaison to formal and informal community supports, resources, and recovery-supporting activities
NOT Just Recovery Coaches…
Peer telephone continuing support Peer-facilitated educational and
support groups Peer-connected and –navigated
health and community supports Peer-operated recovery residences Peer-operated recovery community
centers
Recovery Community Centers
Vision: creating a community institution like a Senior Center
Provides public and visible space for recovery to flourish in community: Recovery on Main Street
Serves as a “community organizing engine” for civic engagement and advocacy
Operates as a “hub” for PRSS and recovery activities
Includes participation of family members Provides volunteer, service, and leadership
opportunities Positions the recovery community as a key
stakeholder with the greater community
Drug Court participants can complete their community service hours at USARA’s recovery community center.
A USARA Family Resource Facilitator works with families who are involved in the Family Drug Court program in the Juvenile Courts.
Example
PRO-ACT (Pennsylvania Recovery Organization – Achieving Community Together) works with its Drug Courts by providing a Certified Recovery Specialist (CRS) to each Drug Court participant. They assess Recovery Capital and develop Recovery Plans in order to help participants enhance and strengthen their recovery.
CRS’s provide ongoing support thru each level of the Drug Court process either face-to-face or thru the use of telephonic recovery support.
Example
Example
In Vermont, the Chittenden County Drug Court refers many people to the Turning Point Center of Chittenden County, a peer-run recovery community center.
All new drug court participants take part in a six-session “Making Recovery Easier” group, funded by the Court Administrator’s Office.
Faces & Voices of Recovery