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5/27/14 1 INCLUDING FAMILY AND COMMUNITY IN THE RECOVERY PROCESS Presented by William “Bill” White and Joe Powell May 29, 2014 Download the PowerPoint slides & access CE quiz here: www.naadac.org/includingfamilyandcommunityintherecoveryprocess A presenta*on by the NAADAC, the Associa*on for Addic*on Professionals Misti Storie, MS, NCC WEBINAR ORGANIZER Director of Training & Professional Development NAADAC, the Associa/on for Addic/on Professionals USING GOTOWEBINAR Control Panel Asking Ques:ons PowerPoint Slides Polling Ques:ons Audio (phone preferred) www.naadac.org/ includingfamilyandcommunityinther ecoveryprocess A presenta*on by NAADAC, the Associa*on for Addic*on Professionals A COMPONENT OF THE RECOVERY TO PRACTICE (RTP) INITIATIVE www.naadac.org/recovery OBTAINING CE CREDIT o The educa/on delivered in this webinar is FREE to all professionals. o 2 CEs are FREE to NAADAC members who aEend this webinar. Nonmembers of NAADAC receive 2 CEs for $25. o If you wish to receive CE credit, you MUST complete and pass the “CE Quiz” that is located at: (look for TITLE of webinar) www.naadac.org/includingfamilyandcommunityintherecoveryprocess www.naadac.org/webinars A CE cer/ficate will be emailed to you within 21 days of submiXng the quiz and payment (if applicable) – usually sooner. o Successfully passing the “CE Quiz” is the ONLY way to receive a CE cer*ficate. Free to NAADAC Members!

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Page 1: Including Families Webinar Slides...2014/05/29  · 5/27/14 1 INCLUDING FAMILY AND COMMUNITY IN THE RECOVERY PROCESS Presented by William “Bill” White and Joe Powell May 29, 2014

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1

INCLUDING FAMILY AND COMMUNITY IN THE RECOVERY

PROCESS

Presented by William “Bill” White and Joe Powell May 29, 2014

Download the PowerPoint slides & access CE quiz here:

www.naadac.org/includingfamilyandcommunityintherecoveryprocess

A  presenta*on  by  the  NAADAC,  the  Associa*on  for  Addic*on  Professionals  

Misti Storie, MS, NCC

WEBINAR ORGANIZER

Director  of  Training  &  Professional  Development  

NAADAC,  the  Associa/on  for  Addic/on  Professionals    

USING GOTOWEBINAR

•  Control  Panel  

•  Asking  Ques:ons  

•  PowerPoint  Slides  

•  Polling  Ques:ons  

•  Audio  (phone  preferred)  

www.naadac.org/includingfamilyandcommunityintherecoveryprocess  

A  presenta*on  by  NAADAC,  the  Associa*on  for  Addic*on  Professionals  

A COMPONENT OF THE RECOVERY TO PRACTICE (RTP) INITIATIVE

www.naadac.org/recovery

OBTAINING CE CREDIT

o  The  educa/on  delivered  in  this  webinar  is  FREE  to  all  professionals.    

o  2  CEs  are  FREE  to  NAADAC  members  who  aEend  this  webinar.    Non-­‐members  of  NAADAC  receive  2  CEs  for  $25.      

o  If  you  wish  to  receive  CE  credit,  you  MUST  complete  and  pass  the  “CE  Quiz”  that  is  located  at:  (look  for  TITLE  of  webinar)  

www.naadac.org/includingfamilyandcommunityintherecoveryprocess  

www.naadac.org/webinars  

A  CE  cer/ficate  will  be  emailed  to  you  within  21  days  of  submiXng  the  quiz  and  payment  (if  applicable)  –  usually  sooner.  

o  Successfully  passing  the  “CE  Quiz”  is  the  ONLY  way  to  receive  a  CE  cer*ficate.    

Free  to  NAADAC  Members!  

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WEBINAR LEARNING OBJECTIVES

o  Describe  how  the  family  and  community  have  been  affected  by  addic/on  

o  List  3  strategies  for  including  individuals,  family  members  and  the  community  in  the  recovery  programs  

o  Define  community  recovery  capital  

o  Iden/fy  how  to  assess  community  recovery  capital  

Joe Powell, LCDC, PRS

WEBINAR PRESENTER #1

Execu:ve  Director  

Associa/on  of  Persons  Affected  by  Addic/on  (APAA)  

[email protected]  

JOE POWELL – PERSON IN LONG-TERM RECOVERY

The  family  follows  a  predictable  and  

progressive  course  in  response  to  living  in  an  environment  where  the  disease  of  addic:on  is  

ac:ve.  

Similar  signs  and  symptoms  of  the  alcoholic/addict.  

ü  Tolerance  of  the  addict  

ü  Denial  of  the  Elephant  

ü  Plays  detec/ve    

ü  Preoccupied  with  addict  

ü  Tries  to  hide  the  problem  from  family  and  friends  

ü  Con/nue  to  make  excuses  and  cover  for  addict  

ü  Lose  friends  and  family  

ü  Develop  ulcers,  headaches,  nervous  breakdowns,  depression  

WHO IN THE FAMILY IS AFFECTED BY THE DISEASE OF ADDICTION

o  We  develop  our  first  sense  of  who  we  are,  how  the  world  works  and  how  we  fit  into  the  world  in  our  family  of  origin.  

o  The  addicted  family  member  maEers  more  than  the  family  as  an  en/ty.    (Family  denial)  

o  The  primary  enablers  in  a  chemically  dependent  family  is  usually  someone  who  is  emo/onally  connected  to  the  addict.  (The  whole  family)  

o  Parents,  spouses  and  children  of  the  addict/alcoholic  have  hidden  their  most  life-­‐shaping  experiences  behind  a  veil  of  silence  and  secrecy.  

WHO IN THE FAMILY IS AFFECTED BY THE DISEASE OF ADDICTION

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The  "don't  trust"  rule  means:  

o  don't  trust  anybody  outside  the  family  

o  don't  trust  the  police  

o  don't  trust  the  addict  or  your  own  percep/ons  

SUBSTANCE USE DISORDER FAMILY SHAME

Shame:  Family  problems  should  stay  within  the  family  -­‐  Influencing  how  they  reach  out  to  others  for  help,  their  ini=al  reac=ons  in  counseling  process  

The  "don't  talk"  rule  means:  

o  don't  tell  other  people  about  family  problems  

o  don't  talk  about  problems  with  other  family  members  

o  don't  speak  un/l  spoken  to  

SUBSTANCE USE DISORDER FAMILY SHAME

Shame:  Family  problems  should  stay  within  the  family  -­‐  Influencing  how  they  reach  out  to  others  for  help,  their  ini=al  reac=ons  in  counseling  process  

The  "don't  feel"  rule  means:  

o  Don’t  get  angry  (Mad)    

o  Don’t  get  depressed  (Sad)  

o  Don’t  be  afraid  (Scared)  

SUBSTANCE USE DISORDER FAMILY SHAME

Shame:  Family  problems  should  stay  within  the  family  -­‐  Influencing  how  they  reach  out  to  others  for  help,  their  ini=al  reac=ons  in  counseling  process  

The  Learning  Phase  

o  Family  members  gradually  become  aware  of  stress  in  the  family.  

o  Family  rela/onships  become  strained:    arguments,  tension,  domes/c  violence,  less  communica/on,  etc.  

o  Family  members  begin  to  experiment  with  defensive  behaviors.  

o  Learning  may  not  be  conscious,  but  is  strong  and  habit-­‐forming.  

OUTSIDE FAME BUT INSIDE SHAME

The  Harmful  Phase    

•  Family  members'  defensive  behaviors  become  automa/c  and  compulsive.  

•  The  family  blames  the  chemically-­‐dependent  person.  

•  Family  members  feel  helpless  to  control  the  chemical  use  and  begin  to  believe  that  they  and  their  behavior  were  the  cause  of  the  problem,  leading  to  feelings  of  guilt,  shame  and  self-­‐blame.  

•  Family  members  deny  their  own  pain.  

FOREVER, MY FAULT

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The  Escape  Phase  o  Repeated  major  crises  become  rou/ne  occurrences.  

o  Family  members  suffer  overpowering  feelings  of  rage,  guilt,  and  disloyalty  regarding  the  chemically-­‐dependent  person,  and  seriously  begin  to  look  for  ways  to  escape.  

o  Separa/on,  deser/on,  and  some/mes  suicide  are  seen  as  the  only  way  out.  

o  At  this  stage,  separa/on  from  the  dependency  situa/on  is  not  enough.    All  members  of  the  family  need  help.  

ACTING OUT FAMILY SHAME

Enabling  =  any  ac=ons  that  prevent  the  person  with  a  substance  use  disorder  from  experiencing  the  consequences  of  their  drinking  behavior  

o  Acknowledging  the  problem  and  adop/ng  a  paEern  of  tough  love  could  speed  up  the  day  when  the  person  with  a  SUD  “hits  boEom”  and  ini/ates  recovery.  

o  Reverend  Vern  Johnson  felt  there  had  to  be  a  beEer  way  to  intervene  in  alcoholism  than  to  sit  and  wait  for  the  person  to  hit  boEom.    

o  He  developed  a  technology  of  family  interven/on  through  which  the  boEom  could  be  raised  to  meet  the  person.    

o  He  pioneered  the  use  of  a  loving  confronta/on  between  the  person  with  a  substance  use  disorder  and  those  who  cared  for  him/her  to  precipitate  a  crisis  that  most  ohen  resulted  in  the  person’s  entry  into  treatment.  

FAMILY DENIAL

o  The  family  does  what  they  do  out  of  a  sincere  desire  to  help  the  person  with  a  SUD  and  to  maintain  the  family.    

o  With  the  crisis  of  addic/on/alcoholism,  the  tradi/onal  tools  of  family  problem-­‐solving  and  crisis  reac/on  do  not  work.  

AFFECT ON THE FAMILY

o  Families  are  made  dysfunc/onal  by  the  aEempt  to  cope  with  alcoholism/addic/on  in  the  only  way  they  know.  

o  Aher  all  they  have  done,  they  think  they  fail  in  the  role  of  wife,  husband,  parent  or  children.    They  try  harder.    They  take  on  the  responsibili/es  of  the  person  with  a  SUD,  not  realizing  that  this  causes  the  him/her  to  become  irresponsible.  

AFFECT ON THE FAMILY

o  They  have  tried  what  religion,  society  and  our  culture  has  taught  them.    It  doesn’t  work,  and  the  resul/ng  despair  and  guilt  bring  about  confusion  and  chaos.  

o  As  the  person  with  a  SUD  must  be  viewed  as  a  vic/m  of  a  disease,  so  must  the  characteris/cs  of  the  concerned  persons  be  viewed  as  a  reac/on  to  the  progressive  stress  of  the  disease.      

o  Their  behavior  has  a  very  immediate  mo/va/on:  stabiliza=on  of  the  family.      

o  In  the  context  of  what  is  best  for  the  person  with  a  SUD,  behavior  of  a  concerned  person  may  be  dysfunc/onal;  but,  in  the  context  of  the  rest  of  the  family,  the  behavior  might  appear  quite  func/onal.  

AFFECT ON THE FAMILY

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o  The  common  denominator  among  these  roles  is  that  each  in  its  own  way  is  an  aEempt  to  survive,  a  coping  strategy.      

o  These  roles  are  seen  as  providing  children  and  adolescents  with  support  and  approval  from  persons  outside  the  home,  from  adults  or  peers.      

o  For  example,  the  responsible  one  probably  is  a  good  student,  mommy’s  liEle  helper,  and  gets  praise  for  both.    The  danger  to  a  youth  is  becoming  frozen  in  an  adopted  role.    The  role  can  become  a  life/me  paEern.    

SURVIVAL ROLES IN THE FAMILY & COMMUNITY

o  The  Vic/m/Dependent  person  

o  Primary  Enabler  

o  The  Frustrated  Parent  

o  The  Hero    

o  The  Scapegoat  

o  The  Lost  Child    

o  The  Mascot  

o  I  survived  the  disease  of  my  parents  only  to  acquire  it  myself.  

SURVIVAL ROLES: CODEPENDENT

o  The  impact  and  affect  of  addic/on/alcoholism  is    visible  throughout  the  community  with  alcoholism,  drug  addic/on,  liquor  stores,  drug  dealing,  in  schools,  entertainment,    poverty,  housing,  domes/c  violence,  social  impact,  unemployment,  rites  of  passage  and  mental  illness  

o  The  community  have  stuffed  its  feelings  from  their  trauma/c  wounds  and  have  lost  the  ability  to  feel  or  express  their  truths  because  it  hurts  too  much.  

AFFFECT ON THE COMMUNITY

o  The  recommenda/on  to  seek  help  is  par/cularly  vital,  considering  the  majority  of  people  with  diagnosable  disorders,  regardless  of  race  or  ethnicity,  do  not  receive  treatment  in  the  community.    

o  The  s/gma  surrounding  addic/on  is  a  powerful  barrier  to  reaching  treatment.  People  with  addic/on/mental  illness  feel  shame  and  fear  of  discrimina/on  about  a  condi/on  that  is  as  real  and  disabling  as  any  other  serious  health  condi/on.  

AFFFECT ON THE COMMUNITY

o  Repeated  Modeling  Childhood    

o  Always  Confused  o  Cannot  Please  Family  

o  Repeat  Mistakes  

o  Unreal  Expecta/ons  of  Life  o  Mixed  Messages  

•  “I  love  you/Go  away”  

•  “Cannot  do  right/I  need  you”  

•  “Always  tell  the  truth/I  don’t  want  to  know”  

•  “I’ll  be  there  for  you/Then  forget”  

FAMILY DENIAL

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o  Healthy  Rela/onships  o  Lack  Self  Esteem    

o  Receive  double  messages  

o  Learned  behaviors    and  “Submerged  Issues”  

•  Treat  family  members  as  objects  

•  Explain  away  everything    -­‐    Tap  Dance  

•  Crisis  Children  Panic  

•  Children  set  self  up  

COMMUNITY CONSPIRACY OF DENIAL

The  Addict/Alcoholic  hides  behind  the  wall  of  denial  

o  The  Marriage  –  money,  beauty,  words,  save  you  

o  The  children,  Parents  and  in-­‐laws  o  The  Employer  

o  Doctor    o  Minister  

o  AA  Community  players  behind  the  wall  

COMMUNITY CONSPIRACY OF DENIAL

o  Family  members  have  most  ohen  found  healing  and  purpose  when  they  join  together  for  their  own  mutual  support,  love  and  advocacy.  

o  Families  u/lize  the  community  for  resources  for  basic  needs,  safety  security,  belonging  and  needs.    

HEALING THE COMMUNITY

!Faith

Work orschool

Socialsupport

BelongingFamily

Housing

Peersupport

Treatment &rehab

PrimaryFocus

CommunityLife

In the model. clinical care is viewed as oneof many resources needed for successfulintegration into the community

Service System ProgressionModel 3: Recovery-oriented

System of Care

o  The  recommenda/on  to  seek  help  is  par/cularly  vital,  considering  the  majority  of  people  with  diagnosable  disorders,  regardless  of  race  or  ethnicity,  do  not  receive  treatment  in  the  community.    

o  The  s/gma  surrounding  addic/on  is  a  powerful  barrier  to  reaching  treatment.  People  with  addic/on/mental  illness  feel  shame  and  fear  of  discrimina/on  about  a  condi/on  that  is  as  real  and  disabling  as  any  other  serious  health  condi/on.  

HEALING THE COMMUNITY

1)  Educate  yourself  on  the  recovery  process  for  individuals  and  families.    

2)  If  your  recovering  family  member  is  living  with  you,  provide  a  sober  environment  to  support  that  recovery.  

3)  Seek  professional  and  community  peer  support  (from  a  group  like  Al-­‐Anon)  for  your  own  physical  and  emo/onal  health.    

4)  Support  your  family  member's  involvement  in  treatment  ahercare  mee/ngs  and  recovery  support  groups.  

5)  Assist  the  recovering  family  member  with  assistance  in  loca/ng  sober  housing,  employment,  child  care,  transporta/on  or  other  recovery  support  needs.    

6)  Asser/vely  re-­‐intervene  in  the  face  of  any  relapse  episode.        

FAMILY HEALING & RECOVERY PROCESS

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MASLOW’S HEIRARCHY OF NEEDS

Self Actualization

ESTEEM (Respect)

Self, Family and community LOVE

(Belonging, being a part of the

community) Emotional, fellowship

SAFETY & Security, Companionship, information,

instrumental (housing/employment) and emotional (trauma) community

supports

Physiological Food - Shelter - Job – Health crisis Clothing

Emotional - Instrumental information Support

MAINTENANCE

ACTION non traditional recovery

PREPARATION for a Cultural

Congruent Recovery

CONTEMPLATION

PRE-CONTEMPLATION

Historical  Trauma,  Libera*on,  and  Cultural  Healing:      

Addic/on  within  communi/es  of  color  is  best  viewed  within  the  larger  historical  context  of  slavery,  oppression,  trauma  and  disaster.      

o  Such  historical  traumas  destroy  personal  iden/ty  and  hope,  erode  cultural  sources  of  resilience,  and  fuel  the  appe/te  for  anesthesia.      

o  Recovery  is  best  framed  within  the  larger  framework  of  libera/on  and  personal/cultural  survival.      

o  To  be  personally  and  culturally  meaningful,  the  recovery  stories  of  African  Americans  may  have  to  be  nested  within  their  larger  history  and  contemporary  experience  as  a  people.  

CULTURES OF RECOVERY

o  People  recovering  from  addic/on  have  evolved  a  language  (e.g.,  “recovering”/”recovered”)  and  rituals  (e.g.,  sobriety  birthdays)  to  describe  and  celebrate  their  experience.    

o  Language  and  rituals  for  family  members  is  much  less  defined.  Some  refer  to  themselves  as  “families  in  recovery”  or  a  “family  member  in  recovery,”  even  though  some  family  members  felt  such  terms  were  ambiguous  and  confusing.  

o  Some  family  do  not  play  a  role  in  the  family  member’s  recovery  but  is  happy  for  her/him/family.  

RECOVERY CULTURE

Cataly*c  Metaphors:      

•  To  achieve  recovery,  each  addicted  individual  must  find  sense-­‐making,  life-­‐transforming  ideas  that  abort  the  rituals  of  drug  use.    

•  Such  metaphors  spark  profound  breakthroughs  in  percep/on  of  self  and  the  world  that  in  turn  lead  to  drama/c  reconstruc/ons  of  personal  iden/ty  and  interpersonal  rela/onships.    

•  Linking  AOD  use  to  historical  oppression,  portraying  alcohol  and  other  drugs  as  weapons  of  con/nued  oppression,  and  portraying  sobriety  as  an  act  of  resistance  and  libera/on  can  serve  such  a  transforma/ve  func/on  for  some  African  American  clients.    

AFRICAN AMERICAN CULTURAL RECOCERY

 Family  (as  system,  subsystems  and  individuals)  Adapta*ons  to  

Progression  of  Addic*on  Family  (as  system,  subsystems  and  individuals)    

o  The  family  in  response  to  addic/on  and  the  addic/on-­‐related  deteriora/on  in  role  performance  of  a  family  member.  

o  Suggest  that  the  marital  or  family  environment  is  actually  an  agent  in  ini/a/ng  and  sustaining  addic/on  

o  The  former  studies  depict  family  members  as  innocent  vic/ms;  the  laEer  depict  family  members  and  par/cularly  the  wife  of  the  male  alcoholic  as  an  “e/ological  agent”  or  a  factor  “complica/ng  the  illness.”  

FAMILY ADAPTATIONS TO PROGRESSION OF ADDICTION

Throughout  Stages  of  Long-­‐term  Recovery  o  A  major  implica/on  of  this  research  is  the  no/on  that  children  and  

families  go  through  a  “trauma  of  recovery”—a  readjustment  of  expecta/ons  required  by  their  con/nued  psychological  isola/on  from  the  addicted  parent  going  through  early  recovery  (Brown,  1994).    

o  The  diversity  of  family  life  is  as  wonderful  in  its  capacity  for  resilience  as  it  is  some/mes  horrifying  in  its  capacity  for  cruelty.    

o  Each  family  must  be  its  own  model.    

o  Interven/on  into  families  must  be  characterized  by  gentleness  and  humility  rather  than  by  clinical  arrogance  born  of  knowing  THE  truth  about  the  impact  of  addic/on  and  recovery  on  the  family.  

“TRAUMA OF RECOVERY”

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MY STORY – THE POWER OF STORY

THANK YOU!

William “Bill” White

WEBINAR PRESENTER #2

Emeritus  Senior  Research  Consultant  

Chestnut  Health  Systems  

[email protected]  

www.williamwhitepapers.com  

ADDICTION RECOVERY: MULTIPLE LEVELS OF HEALING

o  Personal  Recovery:    3  core  dimensions    

o  Family  Recovery:  5  family  subsystems    

o  Community  Recovery  (“Healing  Forest”)  

•  community  subsystems  (e.g.,  government,  business,  educa/on,  religious  ins/tu/ons,  healthcare,  social  service,  arts,  sports,  media,  cultural  subgroups,  mutual  aid)    

RECOVERY CAPITAL (RC)

Recovery  Capital  =  internal  and  external  resources  (at  personal,  family  and  community  levels)  that  can  be  mobilized  to  ini:ate  and  sustain  long-­‐term  recovery  from  severe  AOD  

problems  (Granfield  &  Cloud,  1999;  White  &  Cloud,  2008)  

PERSONAL RECOVERY CAPITAL

o  physical  recovery  capital:    physical  health,  financial  assets,  health  insurance,  safe  and  recovery-­‐conducive  shelter,  clothing,  food,  and  access  to  transporta/on.      

o  human  recovery  capital:    values,  knowledge,    educa/onal/voca/onal  skills  and  creden/als,  problem  solving  capaci/es,  self-­‐awareness,  self-­‐esteem,  hopefulness,  meaning  and  purpose  in  life,  interpersonal  skills.    

RECOVERY CAPITAL (RC)

Recovery  Capital  =  internal  and  external  resources  (at  personal,  family  and  community  levels)  that  can  be  mobilized  to  ini:ate  and  sustain  long-­‐term  recovery  from  severe  AOD  

problems  (Granfield  &  Cloud,  1999;  White  &  Cloud,  2008)  

FAMILY/SOCIAL RECOVERY CAPITAL

o  encompasses  recovery-­‐suppor/ve  in/mate  rela/onships,  family  and  kinship  rela/onships  (defined  as  family  of  choice),  and  social  rela/onships    

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RECOVERY CAPITAL (RC)

Recovery  Capital  =  internal  and  external  resources  (at  personal,  family  and  community  levels)  that  can  be  mobilized  to  ini:ate  and  sustain  long-­‐term  recovery  from  severe  AOD  

problems  (Granfield  &  Cloud,  1999;  White  &  Cloud,  2008)  

COMMUNITY RECOVERY CAPITAL

o  Encompasses  community  aXtudes/policies/resources  that  promote  the  preven/on  and  resolu/on  of  AOD  problems.      

o  Cultural  capital  is  a  form  of  community  capital,  e.g.,  local  availability  of  culturally-­‐prescribed  pathways  of  recovery  that  resonate  with  par/cular  individuals  and  families  

ROLE OF RECOVERY CAPITAL IN PREDICTING LONG-TERM RECOVERY OUTCOMES

o  Science  is  confirming  what  front-­‐line  addic/on  professionals  have  long  known:      “environmental  factors  can  augment  or  nullify  the  short-­‐term  influence  of  an  interven/on”  (Moos,  2003,  p.  3;  Humphreys,  Moos  &  Cohen,  1997).      

o  Therapeu/c  processes  in  addic/on  treatment  must  encompass  more  than  a  strictly  clinical  interven/on  (Simpson,  2004).      

o  Strategies  that  target  family  and  community  recovery  capital  can  elevate  long-­‐term  recovery  outcomes  and  elevate  the  quality  of  life  of  individuals  and  families  in  long-­‐term  recovery  (White,  2009).  

AUDIENCE POLLING QUESTION

Does your organization have one or more staff/volunteer positions dedicated to

increasing recovery support resources in the communities you serve?

RECOVERY CAPITAL PRESCRIPTIONS

1)  Support  screening  and  brief  interven/on  (SBI)  programs  that  reach  people  before  their  recovery  capital  is  depleted  

o  Precovery:  Engaging  and  mo:va:ng  people  at  pre-­‐ac:on  stages  of  change    

2)  Engage  people  with  low  recovery  capital  through  aggressive  community  outreach.      

3)  Focus  on  hope  as  a  recovery  catalyst,  e.g.,  myth  of  “hiXng  boEom”;  pull  (hope)  forces  versus  push  (pain)  forces      

4)  Assess  recovery  capital  on  an  ongoing  basis,  moving  beyond  pathology-­‐based  assessment  technologies  and  monitoring  RC  over  /me  

5)  Use  RC    levels  to  help  determine  level  of  care  placement  decisions  (See  Matrix  next).  

6)  Embrace  program/professional  roles  in  community  recovery  capital  development  

7)  Use  RC  measures  to  evalua/on  program/professional  performance  

RECOVERY CAPITAL & LEVEL OF CARE PLACEMENT DECISIONS

High  Recovery  Capital   High  Problem  Severity/Complexity  

Low  Problem  Severity/Complexity   Low  Recovery  Capital  

Recovery  Capital/Problem  Severity  Matrix  

MEASURING PERSONAL/FAMILY RECOVERY CAPITAL

o  Assessment  of  Recovery  Capital  Scale    

o  50-­‐item  scale  and  scoring  instruc/ons  posted  at  www.williamwhitepapers.com  

o  Psychometrics  published  in  Drug  and  Alcohol  Review  (Groshkova,  Best  &  White,  2012)  

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STEPS FOR MEASURING COMMUNITY RECOVERY CAPITAL

o  Extensive  problem  data  with  liEle  solu/on  data;  Need  for  recovery  resource  mapping  

o  Plot  problem  indicator  data  by  zip  code/census  tract/ci/es/coun/es/states,  etc.  

o  Plot  recovery  resource  data  by  same  catchment  area,  e.g.,  Tx  resources,  mutual  aid  mee/ngs,  recovery  support  ins/tu/ons,  etc.  &  by  special  popula/ons,  e.g.,  women,  young  people,  etc.        

o  Iden/fy  areas  of  high  problem  severity  and  low  RC  (and  missing  types  of  RC)  for  targeted  development  ini/a/ves    

o  See  (Johnson,  et  al.,  2009)  for  detailed  descrip/on  

RECOVERY CARRIERS AS COMMUNITY RECOVERY CAPITAL

o  Recovery  is  contagious  (White,  2010).    

o  Recovery  is  spread  via  recovery  carriers  (White,  2012).  

o  Prevalence  of  recovery  carriers  can  be  strategically  increased.      

o  Mechanisms:    Alumni,  volunteer,  recovery  coach,  advocacy,  educa/onal,  community  service  opportuni/es  

CULTURES OF ADDICTION / CULTURES OF RECOVERY

o  Cultural  elements:    people  (iconic  figures),  places  (landmarks)  &  things  (language,  values,  rituals,  symbols,  literature,  art,  music,  etc.)  

o  Styles  of  cultural  affilia/on  (acultural,  bicultural,  enmeshed)  

o  Recovery  as  a  transcultural  journey  

o  Building  cultures  of  recovery  

(White,  1996)

KINETIC IDEAS FOR RECOVERY COMMUNITY DEVELOPMENT

1)  Long-­‐term  addic/on  recovery  is  a  reality.  

o  In  terms  of  s/gma  reduc/on,  stories  trump  science.    

2)  There  are  mul/ple  pathways  of  recovery—all  are  cause  for  celebra/on.  

3)  Recovery  flourishes  in  suppor/ve  communi/es.  

4)  Recovering  people,  once  part  of  the  problem,  can  become  part  of  the  solu/on.  

5)  Local  vanguards  of  recovering  people  can  put  faces  and  voices  on  recovery  as  living  proof  of  these  proposi/ons.  

ADDICTION TREATMENT AND COMMUNITY RECOVERY CAPITAL

Inreach  

Outreach  

Recovery  Community  Development  (RCD)  Ac*vi*es  •  RCD  specialists  roles  in  future/

incorpora/on  into  recovery  coach  ac/vi/es  

Integra*on  of  clinical  and  community  development/cultural  revitaliza*on  models  

(White,  2002,  2003,  2009)  

AUDIENCE POLLING QUESTION

Does your organization offer services/support to individuals and families in later stages of

recovery?

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PERSONAL/FAMILY RECOVERY SUPPORT THROUGH STAGES OF RECOVERY

o  From  AC  to  RM  models  of  recovery  support  

o  Greatest  need  for  “therapy”  may  be  aher  period  of  recovery  ini/a/on  and  stabiliza/on  (Dennis,  Foss,  &  ScoE,  2007)  

o  Ameliora/ng  the  “trauma  of  recovery”  (Brown  &  Lewis,  1999)  

o  Providing  “scaffolding”  for  sustained  family  recovery  across  the  family  life  cycle  (White  &  Brown,  2011)  

STEPS FOR INCREASING FAMILY ORIENTATION OF ADDICTION TREATMENT

o  Shihing  Unit  of  Service  from  Individual  to  family—with  “family”  defined  non-­‐tradi/onally  as  family  of  choice  

o  Outreach  to  families  regardless  of  readiness  for  change  of  the  “iden/fied  pa/ent”    

o  Screening  &  Assessment  Elements,  e.g.,  boundary  permeability,  family  subsystems  &  individual  health  status  

STEPS FOR INCREASING FAMILY ORIENTATION OF ADDICTION TREATMENT

o  Family-­‐focused  treatment,  including  paren/ng  &  preven/on  training  

o  Asser/ve  linkage  to  family  support  resources  

o  Family-­‐focused  recovery  checkups  

o  Invita/on  for  service  and  advocacy  via  local  peer  support  and  local/state/na/onal  advocacy  organiza/ons  

BREAKING INTERGENERATIONAL CYCLES

o  Addressing  historical  trauma  (Brave  Heart,  et  al,  2011,  1998)  and  cultural  revitaliza/on  (Coyhis,  2000,  Coyhis  &  White,  2006)  

BREAKING INTERGENERATIONAL CYCLES

o  Family/children’s  programs  integrated  into  addic/on  treatment  and  recovery  support  services  

o  Enhancing  effec/veness  of  parents  in  recovery,  e.g.,  integra/ng  paren/ng  educa/on  into  treatment  and  post-­‐treatment  recovery  support  services  

BREAKING INTERGENERATIONAL CYCLES

o  Targeted  preven/on  ac/vi/es  for  children  with  family  histories  of  addic/on  

o  Early  interven/on  strategies  aimed  at  preven/ng/shortening  addic/on  careers  

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PROMOTING FAMILY WELLNESS IN LONG-TERM RECOVERY

o  Need  for  research  on  long-­‐term  recovery  

o  Need  for  research  on  long-­‐term  family  recovery  

o  Focusing  tri-­‐direc/onal  service  integra/on  ini/a/ves  on  family  as  the  unit  of  service  

o  Integra/ng  wellness  ac/vi/es  into  con/nuing  care,  alumni  ac/vi/es  and  local  RCO  ac/vi/es    

o  Specialized  services  for  affected  children  

THANK YOU!

ASKING QUESTIONS

Ask questions through the Questions Pane

OTHER RTP WEBINARS

www.naadac.org/webinars    

Defining  Addic*on  Recovery  •  Thursday,  January  9,  2014  @  3-­‐4:30pm  ET  

What  Does  Science  Say?  Reviewing  Recovery  Research  •  Wednesday,  February  5,  2014  @  3-­‐5pm  ET  

The  History  of  Recovery  in  the  United  States  and  the  Addic*on  Profession  •  Thursday,  March  6,  2013  @  3-­‐4:30pm  ET  

Defining  Recovery-­‐Oriented  Systems  of  Care  (ROSC)  •  Thursday,  April  3,  2014  @  3-­‐4:30pm  ET  

Understanding  the  Role  of  Peer  Recovery  Coaches  in  the  Addic*on  Profession  •  Thursday,  May  1,  2014  @  3-­‐4:30pm  ET  

Including  Family  and  Community  in  the  Recovery  Process  •  Thursday,  May  29,  2014  @  3-­‐5pm  ET  

Collabora*ng  with  Other  Professions,  Professionals,  and  Communi*es  •  Thursday,  June  26,  2014  @  3-­‐4:30pm  ET  

Using  Recovery-­‐Oriented  Principles  in  Addic*on  Counseling  Prac*ce  •  Thursday,  July  24,  2014  @  3-­‐5pm  ET  

Exploring  Techniques  to  Support  Long-­‐Term  Addic*on  Recovery  for  Clients  and  Families  •  Thursday,  August  21,  2014  @  3-­‐5pm  ET  

WEBINARS ON DEMAND

•  Medica:on  Assisted  Treatment  •  Building  Your  Business  with  SAP/DOT  •  SBIRT  •  Billing  and  Claim  Submission  •  Ethics  •  Co-­‐occurring  Disorders  •  Test-­‐Taking  Strategies  •  Conflict  Resolu:on  •  Clinical  Supervision  •  ASAM  Placement  Criteria  •  DSM-­‐5  Proposed  Changes  

www.naadac.org/webinars  

CE  credit  s:ll  available!  

Free  to  NAADAC  Members!    

WWW.NAADAC.ORG

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OBTAINING CE CREDIT

o  The  educa/on  delivered  in  this  webinar  is  FREE  to  all  professionals.    

o  2  CEs  are  FREE  to  NAADAC  members  who  aEend  this  webinar.    Non-­‐members  of  NAADAC  receive  2  CEs  for  $25.      

o  If  you  wish  to  receive  CE  credit,  you  MUST  complete  and  pass  the  “CE  Quiz”  that  is  located  at:  (look  for  TITLE  of  webinar)  

www.naadac.org/includingfamilyandcommunityintherecoveryprocess  

www.naadac.org/webinars  

A  CE  cer/ficate  will  be  emailed  to  you  within  21  days  of  submiXng  the  quiz  and  payment  (if  applicable)  –  usually  sooner.  

o  Successfully  passing  the  “CE  Quiz”  is  the  ONLY  way  to  receive  a  CE  cer*ficate.    

Free  to  NAADAC  Members!  

Thank  You  for  Par*cipa*ng!  

www.naadac.org/recovery    

NAADAC,  The  Associa*on  for  Addic*on  Professionals  1001  N.  Fairfax  St.  Suite  201  Alexandria,  VA  22314  p  800.548.0497  f  800.377.1136  

NAADACorg    

Naadac    

mis/@naadac.org    

NAADAC  

 

Bill  White  –  [email protected]    

Joe  Powell  –  [email protected]