Making the shift to a recovery-oriented model of treatment

September 9, 2013
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A shift is beginning to occur in the addiction treatment community, toward a “recovery-oriented system of care” or a “recovery paradigm.” This means taking a broader look at a life of recovery for the individual rather than “fixing” a substance use issue in a treatment setting and sending the client out into the world. Lorie Obernauer, PhD, recovery consultant and coach and former Alumni Coordinator at CeDAR in Colorado, says that at CeDAR (Center for Dependency, Addiction and Rehabilitation), “We are actually putting something into play that is really directed to helping our clients live in recovery and use some new tools to understand the new world that they are now entering.”

She says this model of treatment is a solution-oriented model rather than one of relapse prevention, as it has been in the past. Obernauer will be presenting on this topic at this month’s National Conference on Addiction Disorders with Steve Millette, MS, LAC, Executive Director of CeDAR.

During the presentation, the duo will discuss how CeDAR has implemented a recovery-oriented curriculum as part of its treatment program. They will also dive into details about how the program was developed based on supporting evidence for this curriculum.

Obernauer says the curriculum CeDAR developed was “really based upon the notion that there’s a new culture that our clients will become part of as they move along their recovery journeys and we believe that we can prepare them to live in that culture.”

She says treatment professionals can be “tour guides,” helping clients move from what William White calls a “culture of addiction” to a “culture of recovery.”

“When they’re ready to move into a culture of recovery, there’s a whole new set of elements and norms that need to be learned and followed. I think that addiction professionals can be the ones to help clients make that transition by very intentionally teaching clients what this new culture will require of them, what it looks like, and how it works,” Obernauer explains.

Obernauer says the same elements apply in both cultures, but the “rules” about those elements are different. For example:

  • Language: Obernauer says swearing and slang may be used frequently in the addiction culture. “There are ‘buzz words’ for certain drugs or for ‘getting high’ that you'd probably only know if you were an addict,” she explains.
  • Dress: In the culture of addiction, it may be “normal” to wear a t-shirt with "drug slang" written on it. She says that she has worked with many young women who wore short skirts, tight sweaters, or other kinds of provocative clothing and changed their style completely when they got into recovery.
  • Food: In the culture of addiction, fast food and unhealthy snacks seem to be popular. Additionally, those in this culture often don't want to eat at all so as not to "ruin their high." One of the important parts of the culture of recovery includes eating healthy foods.
  • Values: In the culture of addiction, individuals often say whatever they need to say to get what they want. “Secrecy is paramount,” Obernauer says. However, in the culture of recovery, openness, honesty and willingness are strongly valued.

Also at the NCAD session, Obernauer and Millette will be providing tips for the audience about organizational culture and how that needs to change to support the implementation of a recovery curriculum in a treatment setting and some very specific details about what the curriculum looks like, what it includes.

Of course, there may be challenges or barriers for organizations to adopt a model such as this. Some of the barriers may include:

  • The personnel that they have working for them; the skill-set of the people that are working there.
  • The mission and the vision of the organization and what it hopes to do.
  • A matter of space and the actual physical layout of the organization that will possibly impede being able to bring community groups into the organization to facilitate that kind of integration.

Millette will be discussing these barriers at the NCAD presentation and will talk about how an organization can figure out what its barriers are and how to overcome them.

He will be presenting a 16-step assessment tool that can help organizations create a new environment that has more of a recovery orientation. The assessment tool takes a look at how they currently engage clients, what kind of screening and assessment tools they’re using, what their service goals and emphases are, what the roles of the personnel who are working there are, and how the organization is relating what it’s doing to the community.

Obernauer says there are some basic principles for putting a recovery orientation into practice, including:

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