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