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W
ith recovery now the dominant model
for alcohol and drug treatment,
commissioning and research in both
England and Scotland, there is a
clear need to have an accessible,
simple-to-use method for mapping recovery
achievements in and out of formal treatment. This
article introduces the REC-CAP (short for recovery
capital), a new instrument that provides frontline staff
with an easy-to-complete assessment of a client’s
recovery functioning, and can become a useful
component of recovery-oriented care planning. In
addition to locating the client within a recovery
framework, it will also provide an organisation with
objective measures of changes and gains made by
recoverees during and after formal treatment.
In both Scotland (Scottish Government, 2007) and
England (Home Office, 2008), public policy has seen a
radical shift in focus and emphasis away from drug and
alcohol interventions targeting crime and blood-borne
disease to a more optimistic model based on individual
wellbeing, quality of life and active engagement in the
community. This transition to a recovery approach
echoes the evidence from the mental health field
where recovery has been shown to be characterised by
a clutch of linked characteristics – connectedness,
hope, identity, meaning and empowerment (collectively,
CHIME; Leamy et al, 2011).
While the transition to a recovery model has
provided much-needed hope and belief to addiction
professionals, policymakers, family members and
those with addiction problems, it also provokes a
significant challenge for the science of addiction,
around the measurement of success. Although there
are a number of tried and tested outcome measures –
the Addiction Severity Index (ASI) and the Maudsley
Addiction Profile (MAP) to name but two – they have
both emerged out of a pathology model where the aim
of treatment has been the reduction of acute
symptoms and adverse life consequences. They are
not suited to the measurement of a growth of
wellbeing and positive achievements as would be
needed to track a recovery journey. What the REC-CAP
does is to address this omission and so create a
measure of growth that can continue long after acute
treatment needs have been addressed, and which
measures wellbeing and engagement in society.
RECOVERY CAPITAL
The key to this dilemma is addressed in an article by
White and Cloud (2008) who concluded that long-
term recovery is much better predicted on the basis
of strengths than on the management and reduction
of pathology symptoms. This builds on work
previously done by Granfield and Cloud (2001) who
used the term ‘recovery capital’ for the first time to
refer to the resources available to an individual to
support their recovery journey. Elaborating on this,
Best and Laudet (2010) categorised recovery capital
as containing three dimensions:
• Personal recovery capital
represents the skills,
capabilities and resources a person has that
includes such things as self-esteem, resilience
and communication skills.
•
Social recovery capital
is the central component
of recovery capital and includes the level of social
support the person has, a network of support for
their recovery and their commitment to and
engagement with the support network.
•
Community recovery capital
is the resources
available in the community, consisting of the
quality of treatment services, but crucially the
availability and attractiveness of recovery
communities and champions.
The three levels of recovery capital are assumed to
exist in a complex and interactive dynamic, where
improvements in one area have positive knock-on
effects in the others.
However, much of the work on recovery capital in
the addictions field has been largely theoretical and
it was really with the production of a measure that
this changed. One of the authors of this article,
along with William White, a research consultant for
Chestnut Health Systems and a leading recovery
figure in the US, and Teodora Groshkova from the
Institute of Psychiatry, worked together to produce
the Assessment of Recovery Capital (ARC:
Groshkova, Best and White, 2012). This is a
validated and accepted research tool currently used
in a number of countries that measures personal and
social recovery capital, and which has been shown to
14 |
drinkanddrugsnews
| February 2014
Recovery |
Outcome analysis
www.drinkanddrugsnews.com
David Best
,
Tracy Beswick
,
and
Merce Morell
explain
how their new online
outcome measurement
tool assesses progress
on the recovery journey
‘Long-term
recovery is much
better predicted on
the basis of
strengths than on
the management
and reduction of
pathology
symptoms.’