support and techniques to nurture the early shoots of recovery. And for this
to happen, the champions have to be visible and accessible.
Critical to the model outlined in Addiction Recovery is the idea that social
capital is a contagion from one person to another, and while champions do
not have to be in recovery, they will almost always provide links and supports
to individuals and groups who are. But for this to work, there have to be
groups or champions to access, and some knowledge or awareness of them.
While this will often involve mutual aid groups, there can be two problems
– one is the lack of visibility to people starting their recovery journeys (in and
out of treatment) and another is the off-putting myths and rumours that are
often perpetuated by professionals who have little contact with, or experience
of, recovery groups, or indeed with wider community assets and champions.
Thus, the success of SHARP and Parkview in Liverpool, of the Basement
in Halifax and of LEAP in Edinburgh, is partly about the charisma and strength
of their champions, but also because they create strong and supportive
bridges from ‘treatment’ to role models and support structures for recovery.
Where recovery is invisible (or exclusively anonymous) there is a structural
barrier to recovery contagion.
What this also means is that recovery is easier to achieve in some areas
than in others – where there are accessible, visible and attractive champions
who are well known in the community and recognised as such in specialist
services, the bridge to recovery is both easier to find and easier to cross. And
what this means for addiction specialist services is that they have three
crucial roles to play in a recovery journey.
First, the therapeutic alliance builds hope and trust and generates a shared
belief that recovery is possible. Second, that the specialist service and its links
to partner agencies such as housing and primary care enable the person to
grow well and safe enough to make recovery choices, and third, that the bridges
are in place from treatment to champions and groups of recovery. The research
cited in the book on areas that have created successful bridges – Liverpool, the
Wirral, Edinburgh to name only a few – suggests that the building of bridges and
networks of champions creates the conditions to allow recovery contagion to
take place at a community level.
But the contagion is not merely among service users and people later in their
recovery journeys. It also crucially takes place in families and communities and,
to date, our ability to harness the strengths and resources of the families has
been limited. And then there is another critical group – the professionals and their
commissioners – whose belief about recovery and their tacit models of change
I
n my new book on the recovery movement, Addiction Recovery, I set out a
theory for recovery that is based on around 1,000 recovery interviews and
completed questionnaires collated in the last five years. Basically, the model
is that people achieve stable and lasting recovery as a developmental
process of growth, where their personal and social resources (recovery
capital) are sufficient that they are in a position to take advantage of a ‘window of
opportunity for change’. This may be involve formal treatment, but will almost
certainly involve engagement with at least one person or group who is the catalyst,
the inspiration and the role model for the initial steps to recovery.
One of the big challenges for researchers interested in recovery is the question
not only of who is likely to recover and under what circumstances, but who the
‘recovery champions’ are who will inspire and sustain the recovery journey. While
the 1,000 stories suggest that everyone recovers in incredibly diverse and personal
ways, the one ‘rule’ would appear to be that nobody does it alone.
So who are these people who champion recovery? The majority of people who
are the catalysts and carers for the recovery journey are themselves in recovery, but
this is not a rule and there are numerous occasions on which family members,
specialist addiction workers and other professionals are cited as the ‘turning point’.
What these individuals tend to have in common is the ability to transmit hope
and the positive expectation that recovery is possible, proving their commitment
by ‘going the extra mile’ and being there to support and encourage. With peers
this is what Moos (2011) has referred to as ‘social control’ and ‘social learning’,
where individuals early in their recovery journey can observe and learn how
people do their own recovery. We still have no satisfactory research into what
the characteristics of the champion are, or whether more is better, although we
do have a good idea that more time spent with people in recovery is a good
predictor of quality of life (Best et al, 2011).
Another key finding from the body of research I’ve been involved in, discussed
in the book, is that there are broadly two phases of recovery journeys. In the first
are the basic enablers that allow for the personal growth that evolves into recovery
capital. In this first phase, the key tasks are to help individuals resolve acute
crises around health, housing, and the practical barriers to change. This is
something that is consistent with mental health recovery journeys (Rethink, 2008).
But these are enablers in the sense that they create the conditions from which
quality of life and enduring change emerge.
For people to make the leap from the first area (the domain of specialist
treatment services and their acute linkage equivalents) to the second, it
appears that champions act as the bridge that plants the seeds of hope and the
Recovery |
Evidence
20 |
drinkanddrugsnews
| February 2012
www.drinkanddrugsnews.com
Newlan
David Best considers what a genuinely
recovery-oriented system of care should look like