Future Direction of Recovery Support Services in the U'S'

1
Future Direction of Recovery Support Services
in the U.S.

• Daphne Walker-Thoth, Missouri Institute of Mental
  Health
• Sular Gordon, Committed Caring Faith Communities

2
Although addiction is considered a chronic
disease, most treatment uses acute care
interventions rather than a disease management
approach. The Substance Abuse and Mental Health
Services Administration (SAMHSA) is leading a
national effort to shift from an acute care model
of treatment to a chronic care approach known as
a recovery-oriented systems of care. Recovery
support services as a complement to treatment are
an important component of this approach.
3
Working Definition of RecoveryRecovery from
alcohol and drug problems is a process of change
through which an individual achieves abstinence
and improved health, wellness and quality of
life.SAMHSA National Summit on Recovery
September 28-29, 2005
4
Recovery Support Services (RSS)Non-clinical
services that assist individuals and families to
recover from alcohol or drug problems.RSS
include social support and a full range of human
services that facilitate recovery and wellness.
They may be provided in conjunction with
treatment, or as separate and distinct services.
They may be delivered by peers, professionals,
faith and community-based organizations, and
others. RSS are a key component of
recovery-oriented systems of care.
5
Recovery-oriented system of care requires a
transformation of the entire service system

• The system is more responsive to needs of
  individuals and families.
• The language, culture, and spirit of recovery is
  infused throughout system.
• The system makes services accessible that engage
  and retain people seeking recovery.

6
Recovery-oriented system of care requires a
transformation of the entire service system

• The system provides a continuum of services
  rather than crisis-oriented care.
• Where possible, the system provides care in the
  persons community and home using natural
  supports.
• The system offers care that is age- and gender-
  appropriate and culturally competent.
• The system recognizes that there are many
  pathways to recovery.

7
Guiding Principles of Recovery- Oriented System
of Care

• There are many pathways to recovery.
• Recovery is self-directed and empowering.
• Recovery involves a personal recognition of the
  need for change and transformation.
• Recovery is holistic.
• Recovery has cultural dimensions.
• Recovery exists on a continuum of improved health
  and wellness.

8
Guiding Principles of Recovery- Oriented System
of Care

• Recovery emerges from hope and gratitude.
• Recovery involves a process of healing and
  self-redefinition.
• Recovery involves addressing discrimination and
  transcending shame and stigma.
• Recovery is supported by peers and allies.
• Recovery involves rejoining and rebuilding a life
  in the community.
• Recovery is a reality. It does and can happen.

9
How is SAMHSA Facilitating Recovery-Oriented
Systems?

• Convened a National Summit on Recovery in 2005.
• Hosted series of regional meetings on
  recovery-oriented systems of care.
• Convened Recovery Support Services National
  Conference in 2007.
• Committed to ensuring a person-centered approach
  to recovery that offers clear choices to
  individuals.
• Increasing involvement of grassroots, faith and
  community-based organizations that afford people
  multiple pathways to recovery.
• Committed to the vision of a life in the
  community for everyone.

10
History of Recovery Support Services in Missouri

• Began April 1, 2005 as part of the Access to
  Recovery (ATR) program.
• Involved building a network of over 100 faith and
  community based providers.
• Offered as a complement to substance abuse
  treatment services.
• Involved establishment of 10 faith and
  community-based Recovery Support Access Centers
  sites that issue vouchers.
• Built on what faith-based organizations were
  already doing to help people recover.

11
Description of Missouris Recovery Support
Services

• Family Engagement
• Pastoral Counseling
• Recovery Mentoring
• Spiritual Life Skills
• Transportation
• Work Preparation

• Care Coordination
• Re-entry Coordination
• Child Care
• Drop-in Centers
• Emergency/Temporary Housing
• Extended Residential Support

12
Missouri Recovery Support Service Outcomes
Rate of Change from Intake to Discharge -
April 2005 to January 2007
Consumers who utilized recovery support services
plus clinical treatment showed greater decrease
in days of alcohol and drugs use from intake to
discharge than consumers who utilized clinical
treatment only.
13
Missouri Recovery Support Service Outcomes
Consumers who utilized recovery support services
plus clinical treatment showed greater decrease
in legal system involvement from intake to
discharge than consumers who utilized clinical
treatment only.
14
Missouri Recovery Support Service Outcomes
Consumers who utilized recovery support services
plus clinical treatment showed greater increase
in days of education or employment from intake
to discharge than consumers who utilized clinical
treatment only.
15
Missouri Recovery Support Service Outcomes
Consumers who utilized recovery support services
plus clinical treatment showed greater increase
in positive social connections from intake to
discharge than consumers who utilized clinical
treatment only.
16
Future of Recovery Support Services in U.S.

• Financing Sources
• Quality Assurance
• Best Practices
• Infrastructure Support
• National Accreditation
• Certification for Recovery Support
  Workers

17
Future of Recovery Support Services in U.S.

• Methodology for matching clients recovery
  support service needs to services.
• Expansion and strengthen of collaboration between
  systems.
• Research on elements of recovery supports that
  are critical to long-term recovery.

18
References

• White, W. (2004). The history and future of
  peer-based addiction recovery support services.
  Prepared for SAMHSA Consumer and Family Direction
  Initiative 2004 Summit, March 22-23, Washington,
  D.C.
• White, W. Kurtz, E. (2006). Recovery Linking
  addiction treatment and communities of recovery
  A primer for addiction counselors and recovery
  coaches. IRETA, Pittsburgh, PA.
• U.S. Department of Health and Human Services,
  Substance Abuse and Mental Health Services
  Administration. The role of recovery support
  services in recovery-oriented systems of care.
  (unpublished).
• U.S. Department of Health and Human Services,
  Substance Abuse and Mental Health Services
  Administration, Center for Substance Abuse
  Treatment. National Summit on Recovery Conference
  Report. September 28-29, 2005, Washington, D.C.