Adding Recovery Professionals to the Continuum of Care

What is the purpose of our work, of all the prevention, intervention and therapy, all that merciful medical model and multi-volume DSM? The treatment plans? Aftercare? All this helping apparatus – what’s it for?

Now, the agreed response is that “recovery” is our mutual goal irrespective of our specialization or wherever we engage professionally with substance use disorder. Recovery is the stated goal of interventionists, counselors, addiction doctors and nurse-practitioners, community mutual-aid. Where, then, do we add recovery professionals?

Way back when I completed a reputable program for alcoholism, I remember being issued with a treatment plan, a 12 Step meeting list, and a plethora of good wishes from gifted counselors, many of whom remain personal friends. Clinical staff had done a great job with me, but I still hadn’t the first idea where to find the bus back into the city or the money to pay my rent. To this day – forgive me! – I haven’t read that treatment plan; it’s somewhere in my archive, safely stowed by UHaul. Could I have used a recovery coach? Could I ever!

A recovery coach is defined by training pioneers CCAR (the Connecticut Community for Addiction Recovery) as “Anyone interested in promoting recovery by removing barriers and obstacles to recovery and serving as a personal guide and mentor for people seeking or already in recovery.” Barriers? Obstacles? In this model, we’re talking about quotidian life-challenges: couch-surfing might be considered a barrier to recovery, unemployment an obstacle to rebuilding a credit score. Recovery coaches usually have direct personal experience of meeting these challenges in their own lives.

Indeed, Professor Thomasina Borkman at George Mason University wrote about the value of deploying such “peers,” locating non-clinical authority (her word) in a potent mix of “experience” and “expertise” (1976, quoted in William White). In the recovery field, this formulation has come to mean: “Experience coming from a personal history of, or exposure to: (i) substance use disorder, (ii) the process of change, and (iii) a sustainable life in recovery; Expertise requiring application of that knowledge to the skill of helping others establish, and live in, their own definition and pathway of recovery across a lifetime.” (Riddick, 2017).

According to the International Coach Federation, leaders in advancing the coaching profession, coaches “partner with clients in a thought-provoking and creative process that inspires them to maximize their personal and professional potential.” Avowedly non-clinical, ICF sees coaching as an integral part of a thriving society.

Thus, to be effective, coaches require strong communications expertise and a mature understanding of the recovery experience on which they rely. As professionals, we’ll also have completed practice-specific training, we’ll attest to a profession-specific ethical code, and we’ll hold a role-specific certification from our local state board.

Just what is it that recovery coaches do to support the continuum of care? The simplest definition is that we help people build a sustainable life in recovery. And we do it by using our own strengths to support self-efficacy in others. “Our strengths help us be happier, fulfilled, engaged, and energized, achieve our goals, have better relationships, and bounce back faster from setbacks,” writes career coach, Sonya Tinsley.

That is, coaches focus on the recovery goals of the individual (“client” or “participant”) through purposeful conversations; in effect, mini-strategic planning sessions. These conversations are propelled by the agenda-setting question, “How can I help you with your recovery today?” We leverage our own experience to present options and resources, we encourage practical initiatives in support of both micro goals and the individual’s recovery mission, and, if it’s helpful, we can be something of an accountability buddy. Most important, we serve as role models for recovery (“this is what recovery means to me”), encouraging individual visions for that sustainable life. What you might refer to as “talk WITHOUT therapy.”

In the field, we call this process “building recovery capital.” CCAR has listed no less than 32 individual lifestyle items under this heading, including housing, employment, education, finances, community. The engagement with a recovery coach will last as long as the individual/client finds value in this capital-building collaboration – or until insurance cuts off the funding, but that’s a different issue!

The National Council for Behavioral Health (2018) has quantified several benefits of introducing recovery professionals into the continuum of care. These benefits include reduced treatment re-admission rates, rapid turnaround following re-admission, decreased hospitalizations, and reduced length of hospital stay, all of which results have positive implications for the bottom line. Even more personal outcomes such as increased recovery capital, community & civic engagement, and realizing personal potential, have also been identified. As NCBH’s Tom Hill, formerly of SAMSHA, concludes, “Recovery is an expectation.” What’s not to love?

Traditionally, recovery coaches have been seen as bridging the gap between treatment and a life in the recovery community, the very gap I experienced when my treatment program concluded. Increasingly, however, coaches are also being deployed in emergency rooms as part of triage teams.

“Recovery coaches support patients admitted as a result of an opioid overdose or other drug or alcohol related crisis,” says Phil Valentine, CCAR Executive Director. Speaking to results, Valentine adds, “Coaches have demonstrated effectiveness in linking Emergency Department patients with treatment and community-based recovery resources.”

In truth, recovery coaches can embody the potential of recovery for anyone at any point in the continuum of care from prevention through to a sustainable life in recovery.

Let’s agree to share that strengths-based definition of “recovery”: A process of change through which individuals improve their health and wellness, live a self-directed life, and strive to reach their full potential.” (SAMSHA, 2011). Anything less is not enough.

Ruth Riddick is a Certified Addiction Recovery Coach and a CCAR-designated Recovery Coach Professional. She serves as Community Outreach at Alcoholism & Substance Abuse Providers of NYS, as a Coach/Trainer/Mentor at Sobriety Together ™ and as a peer recovery subject matter expert in a variety of settings. She has been honored for her work by Caron Treatment Centers, Crossroads of Maine, and Irish America magazine.

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