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Recovery coaching signals paradigm shift

March 11, 2016
by Richard D. Davila, PhD, and William B. Secor, PhD
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One of the innovative techniques used in the substance use disorder treatment field is recovery coaching. A recovery coach helps support the many pathways to recovery. This constitutes just one component of a growing armamentarium of new, innovative, multimodal and holistic techniques available to those in the recovery process and to those who provide services. This form of assistance fills a vital role in the recovery process, as it deals directly with those in recovery and is not constrained by other forms of help such as psychology, psychiatry, counseling and sponsorship in Alcoholics Anonymous (AA) and other 12-Step programs.

Recovery coaches operate in the here and now, the present. Although the past can influence the present, it cannot be changed. It is better that the recovering person understand his/her past, but not become a prisoner to it. Recovery coach training differs from training in traditional counseling and therapy in this respect.

Trained recovery coaches are sometimes paid and sometimes function as volunteers, and are available to those in recovery on a basis varying from daily to as-needed. They serve in a sense as mentors for those in recovery, performing in a role of advising, suggesting, guiding and encouraging those on the recovery path. They do not impose their views on the recovering individual, but place him/her in charge of the recovery—the recovering individual is responsible for his/her choices. It is a technique that has been used with individuals from many different backgrounds. Notably, it has been used successfully with many in the entertainment field, as well as with physicians and professional athletes.

A recovery coach works with a person in recovery using a wellness plan (reachable goals and objectives related to self-care). The wellness plan is the recovering individual's plan, not the coach's plan. The recovering person writes and maintains the plan, and the recovery coach supports this process. Also, the recovering person and the coach work with a “recovery capital plan,” identifying deficits in areas such as housing, recovery support, etc., that are present as a result of the active addiction. The recovery capital plan also offers the ability to see what was not lost, and what supports remain in the recovering person's life.

Recovery coaches apply an adult learning theory approach that shows respect. They acknowledge that adults are internally motivated and self-directed. They know that the recovering person comes to the coaching relationship with life's learning experiences, and is acknowledged for that. The recovering person is treated with dignity and respect. This is basically an assets model. The recovery coach looks at what is right with the person, not what is wrong.

The unconditional support for recovery is vital to the recovering person in moving beyond the acute phase of treatment, as is getting family and community buy-in for the person's recovery.

Family engagement

It is almost a truism that the person in recovery, especially long-term recovery, has made positive life changes. He/she no longer uses alcohol or drugs, has sometimes changed jobs for the better, views the world differently, has changed behavior, has changed beliefs, and has more supportive and understanding friends.

However, this does not mean that the recovering person’s family members or significant others have changed. In several situations they still see and relate to the person in recovery as they once perceived that person to be in active addiction, not as the person is now. This can be very destructive and can impede recovery or prevent new ways of relating to family members.

The paradigm shift to a recovery-oriented system of care (ROSC) model tries to address this aspect. Just as the recovering person needs support and direction, so does the family of the recoveree. In 2013, co-author Dávila and Michael Mendel Galer, MEd, created and implemented a two-day seminar entitled Recovery Family Mentor.1 The idea is for families dealing with a substance use disorder to gain an understanding of the family dynamics that occur in an affected family system, including codependency, differentiation, triangulation, stigma, labels, emotional buttons, and living in the story instead of the present.

Continuum of services

So as we look at the many aspects of a ROSC, we see the importance of moving from an acute-care intervention model to a disease management approach.2 A ROSC implies a continuum of services rather than crisis-oriented care. It emphasizes, where possible, care in the person’s community and home, using natural supports. And it focuses on services provided to people’s families during the initiation, ongoing and post-acute stages of recovery.

Studies support the benefits of recovery coach services, mutual aid societies and social supports in bringing about long-term recovery.3 Some of these efforts receive a boost from use of technology, such as apps that allow the recovering person to remain in constant touch with sources of support.

The importance of ongoing individual, family and community support in navigating a successful road to long-term recovery is well-documented. Treatment programs need to move beyond focusing on the acute stages of recovery, and plan for long-term recovery. They can start by supporting development of a ROSC approach in the community in which they do business.

 

Richard D. Dávila, PhD, is the former Campus Director for Springfield College's School of Professional and Continuing Studies on the Tampa Bay, Florida campus. He is currently a full professor and coordinator of the addictions track at the school. William B. Secor, PhD, is a Florida-based researcher and provider of education services, with past research focusing on areas such as stress, child abuse and learning disabilities.

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This is a great article. The facility where I work employs recovery coaches to great effect. There is a definite benefit to this form of support and recovery coaches are a great asset to our clinical team. Our recovery coaches begin working with clients in residential treatment to establish rapport, and continue to follow up with clients for up to a year following treatment. We have seen an improvement in long term success rates when recovery coaches are involved.

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