Peer-based Models of Recovery
Rockwell Fund, Inc. (RFI) invests in mental health, with a focus on mental health and substance use issues, otherwise known as co-occurring disorders. In the past three years, RFI has funded the creation of programs that reach communities of color where resources are not as prevalent. The substance-recovery continuum of care in our region has several gaps, but those gaps are magnified for low-income communities. Not only are there substantial barriers to finding available treatment, but there are few options for post-treatment recovery supports. In light of these circumstances, peer support has become a critical element in helping all individuals have the chance for long-term recovery.
A common problem related to recovery is that once an individual completes treatment, recovery is difficult to maintain, particularly when one returns to the community the addiction began in. The most critical period of vulnerability is the first 90 days after treatment. Furthermore, it takes 4 to 5 years for the risk of relapse to drop below 15%. According to nationally recognized behavioral health expert, Ijeoma Achara-Abrahams, the main question is now “How do we nest the process of recovery within the person’s natural environment?”. We have a long way to go in resolving this challenge, but leveraging the power of peers allows for individuals to have continuous support.
Many of our grantees use peer-based recovery support (PBRS) as their strategy, where people with lived experience, with both substance use disorder and recovery, help others achieve long-term recovery from substance use. Because peers have gone through similar experiences, it is easier to establish a sense of mutual identification, trust, confidence, and safety which allows for a more honest and open relationship. Peer support recognizes that recovery is not just about sobriety, it’s also about re-entering the community as a new person. People in recovery must make new goals, find new ways of participating in the community, and navigate life without their old coping mechanisms. Peer support is paramount in assisting those in recovery tackle these challenges.
There are a couple of reasons why peer support is invaluable to the recovery process. First, recovery coaches are there to aide individuals in recovery through a supportive, rather than directive, role. Recovery has many pathways and it is recognized that there is no one right way. Whether individuals seek faith-based recovery or choose to complement it with other recovery activities, one of the underlying values of PBRS is respect for the individual and his/her decisions.
Second, the use of recovery coaches allows for PBRS to be implemented across various service settings and thus interwoven into the community. PBRS allows for flexibility and adaptability, making peer services available in churches, courts, jail/prison, recovery centers, medical centers, or social service centers. As mentioned previously, even though we need change at the institutional level in order to achieve recovery-supportive environments, having the human element in recovery coaches has a meaningful impact for those in recovery.
Although PBRS has its advantages in being accessible, there have been issues with the treatment realm and the very nature of using peers. One of the advantages of PBRS is that it can meet the needs of people at different stages of the recovery process, including before, during and after treatment. However, difficulties can arise when treatment and recovery efforts, especially if housed within the same agency, are not aligned.
Another issue is varying rules and standards on becoming a recovery coach. Given that this is a sensitive area to work in, it’s crucial to have set quality standards and job scopes for recovery coaches. In addition, there are larger implications to the field – unregulated recovery coaching can endanger the model fidelity and dilute this promising practice. In the last legislative session, House Bill 1486 was passed that 1) allowed for peer services to be covered under Medicaid and 2) established uniform standards of quality for peer recovery coaches. Together, these changes will continue to make high-quality recovery more accessible.
RFI funds several organizations in the substance use recovery field, serving both youth and adults:
- Unlimited Visions Aftercare (UVA) is a person-centered, community integrated model of recovery, providing free recovery support services to youth, adults, and families in outpatient and residential treatment, as well as walk-ins, at its Recovery and Wellness Center. Peer-recovery coaching is a critical aspect of person-centered recovery, and UVA has demonstrated its ability to incorporate recovery coaches into treatment teams and work with clients on their goals. In this way, there is a continuum of care from treatment to sustained recovery.
- NAMI Greater Houston (NAMIGH) seeks to improve the lives of all persons affected by mental illness through support, education, and advocacy-based programs and services. NAMIGH leverages the power of peers with over 500 volunteers, all with lived experiences with mental illness, running support groups, teaching classes, and helping with outreach. They have also been intentional about developing more community-based services for Spanish-speaking communities. Through this network, more people have learned about mental illness and received the support they need to access treatment and/or recovery supports.
RFI is proud to support these organizations and ensure that everyone has access to the recovery resources they need to maintain a healthy life.
The most critical period of vulnerability is the first
days after treatment
It takes 4 to 5 years for the risk of relapse to drop below
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