THE LANGUAGE OF RECOVERY

RECOVERY HEALTH SUMMITWINNSBORO, SOUTH CAROLINASEPTEMBER 30, 2014

Ed Johnson, M.Ed., MAC, LPCThe Carolinas and Kentucky Program ManagerSoutheast Addiction Technology Transfer Center, HHS Region 4 www.attcnetwork.org/southeastEMail: edjohnson@msm.edu

SOUTHEAST ADDICTION TECHNOLOGY TRANSFER CENTER (SOUTHEAST ATTC, REGION 4)

Southeast ATTC is one of 10 Regional and 4 National Focus resource centers for addiction-related information funded through by the Substance Abuse and Mental Health Services Administration (SAMHSA). Southeast ATTC, located at the National Center for Primary Care at the Morehouse School of Medicine in Atlanta, serves the states of Alabama, Florida, Georgia, Kentucky, Mississippi, North Carolina, South Carolina and Tennessee.

WORDS & LANGUAGE

WORDS

Words are important. If you want to care for something, you call it a flower; if you want to kill something, you call it a weed.

Don Coyhis

LANGUAGE MATTERS • Language is the key to changing the way

people with substance use disorders see themselves and the way they are seen by others.

• Changing language is a way to personally and culturally close one chapter in our history and open another.

• Our goal today is to open a discussion about the layers of meaning that fill our personal and professional language while being respectful to all points of view.

• Be willing to question your beliefs and assumptions about the language we use

Watch your thoughts, they become words

Watch your words, they become actions,

Watch your actions, they become habits

Watch your habits, they become

characterWatch your character, it becomes your destiny

Anon.

“We know from the research that has been conducted by some of the worlds leading neuroscientists that drug addiction is not a moral failing on the part of the individual, it’s a chronic disease of the brain and it can be treated. This isn’t my opinion and is not a political statement and it really isn’t open for debate because the evidence is clear and it’s unequivocal. It’s a fact born out by decades of study and research and it’s a fact that neither the government nor the public can ignore.”

Gil Kerlikowske, Director of National Drug Control Policy Betty Ford Center June 12, 2012

TYPES OF CHRONIC DISEASES

Hypertension Diabetes Asthma

THE LANGUAGE OF RECOVERY

RECOVERY “Recovery is a process of change whereby individuals improve their health and wellness, to live a self-

directed life, and strive to reach their full potential.”

SAMHSA/CSAT 2011

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 Recovery is culturally based and influenced Recovery is supported by addressing trauma Recovery involves individual, family and

community strengths and responsibilities Recovery is based on respect Recovery emerges from hope

LANGUAGE OF RECOVERY

THE MOST RESPECTFUL WAY OF REFERRING TO PEOPLE IS AS PEOPLECurrent Alternative ReasoningClients / Patients / Consumers The people in our program

The folks we work withThe people we serve

More inclusive, less stigmatizing

Alex is an addict Alex is addicted to alcohol Alex is a person with a substance use disorderAlex is in recovery from drug addiction

Put the person first Avoid defining the person by their disease

The terms listed below, along with others, are often people’s ineffective attempts to reclaim some shred of power while being treated in a system that often tries to control them. The person is trying to get their needs met, or has a perception different from the staff, or has an opinion of self not shared by others. And these efforts are not effectively bringing them to the result they want.

Mathew is manipulative Mathew is trying really hard to get his needs met Mathew may need to work on more effective ways of getting his needs met

Take the blame out of the statement Recognize that the person is trying to get a need met the best way they know how

Kyle is non-compliant Kyle is choosing not to… Kyle would rather… Kyle is looking for other options

Describe what it looks like uniquely to that individual—that information is more useful than a generalization

Mary is resistant to treatment Mary chooses not to… Mary prefers not to… Mary is unsure about…

Avoid defining the person by the behavior. Remove the blame from the statement

Jennifer is in denial Jennifer is ambivalent about……Jennifer hasn’t internalized the seriousness of….Jennifer doesn’t understand…………

Remove the blame and the stigma from the statement

Current Term / Phrase Alternative

Self Help Groups Mutual Aid Groups

Substance Abuse / Addiction

Substance Use Disorder

Drug of Choice / Abuse Drug of Use

Denial Denial / Ambivalence

Relapse Recurrence/Setback

Relapse is Part of Recovery

Recurrence may occur as part of the Disease

Clean & Sober Drug Free; Free of illicit or non-prescribed medications

DESCRIBING A RECOVERY ORIENTED SYSTEM OF CARE

Recovery-oriented systems of care shift the question from “How do we get the client into treatment?” to “How do we support the process of recovery within the person’s environment?”

H.Westley Clark, MD, JD, CAS, FASM

Recovery Management (RM) is a philosophical framework for organizing addiction treatment and recovery support services across the stages of:

pre-recovery identification and engagement

recovery initiation and stabilization (treatment), and

long-term recovery maintenance

With the ultimate goal of quality of life enhancement for individuals

and families

THE LANGUAGE THAT WE USE

They’re not ready They don’t want it bad enough They haven’t hurt/lost enough They’re too resistant They are in denial

“THOSE PEOPLE” Alcoholic Addict Drunk Old Wino Crack Head Junkie Needle Freak Benzo Queen Garbage Head

Burn Out Pot Head Loser Waste Case

And then there is “Chronic Relapser”

or“Chronic Recidivist”

My clients don’t hit bottom; they live on the bottom. If we wait for them to hit bottom, they will die. The obstacle to their engagement in treatment is not an absence of pain; it is an absence of hope. —Outreach Worker (Quoted in White, Woll, and Webber 2003)

PATHOLOGY VS. STRENGTH BASED

“When I stopped living in the problem and began living in the answer, the problem went away” Alcoholics Anonymous p.449 (3rd Edition)

TO SUM IT ALL UP By us changing our language we can start the

process of the general public changing their language and perception

We need to bring unequivocal messages of hope that the problems of substance use disorders can be resolved

The focus needs to be on the solutions that recovery brings The reality of recovery The diversity of patterns of recovery The variety of methods used to achieve recovery

If you have some respect for people as they are, you can be more effective in helping them to become better than they are

John W. Gardner