Not long ago, an addiction professional would walk into a meeting room or training class and see no one besides clinicians of similar backgrounds staring back. Today, these rooms also are likely to be populated with peers and faith workers, and sometimes it can appear as if vastly different languages are being spoken about the same issues.
At an Aug. 23 breakout session at the National Conference on Addiction Disorders (NCAD) in St. Louis, two officials with the Missouri Department of Mental Health will discuss the challenges of establishing a multidisciplinary team in today's treatment and recovery support systems. The morning session is aptly named “Lions (Faith Workers), Tigers (Recovery Workers), and Bears (Professional Workers), Oh My!”
“This is an ethics session. … We will be talking about how you reconcile these various perspectives,” says Scott Breedlove, the state mental health department's fiscal manager. He adds, “There is not a right or wrong perspective.”
Breedlove and co-presenter Mark Shields, who directs Missouri's federally funded Access to Recovery (ATR) efforts, have been at the forefront of the development of recovery support services. The ATR grant has brought more faith-based programs to the table in the state, and other treatment organizations are at various stages of integrating peers into their operations (while some independent peer-based initiatives are starting to take shape as well). Each group has a somewhat different take on its role and participation.
“The professional world puts a high value on behavioral health education and having letters at the end of your name,” says Breedlove. “On the other hand, peers value their experience; they say, 'I'm at this table because I've lived it.' Faith workers say, 'I'm here because God sent me here.'”
Breedlove and Shields in their NCAD session will use a visual aid of three hats to demonstrate that sometimes the conflicts that can arise over differing roles can occur even within one individual. Missouri programs now can be certified as both treatment agencies and recovery support entities, meaning that some clinicians may now be counseling some patients at the same time that they're offering post-treatment support services to others. The same rules don't apply to each scenario.
“At first we were quick to take a counselor code, change a few words, and say, 'Here's the peer code.' That doesn't work,” says Breedlove. “They are two vastly different functions.”
For example, an outpatient program counselor would almost never give out his/her cellphone number to a client, while a peer would definitely want individuals to have his/her number. From the peer's perspective, “I might want him to contact me on a Friday night if he's feeling like he's going to take a drink,” Breedlove says.
Breedlove says that the working relationships that are developing among degreed professionals, faith workers and peers in his state have been largely productive. There of course remain some challenges. For example, there have been some ethical complaints against faith workers who have been accused of using life skills classes to preach religion, or of attempting to exclude certain clients from a federally supported program.
Breedlove and Shields hope to encourage dialogue with their session audience to determine how these relationships are evolving in other states. The NCAD meeting is presented by the publishers of Addiction Professional and Behavioral Healthcare.
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