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RECOVERY COACHING. SUPPORTING A SUCCESSFUL TRANSITION INTO RECOVERY . A BRIEF HISTORY . Imported the problem 1792 – 2,579 distilleries w/annual per-capita consumption 2 ½ gallons 1810 – 14,191 w/annual consumption 4 ½ gallons 1830 – consumption rose to 7.1 gallons . A BRIEF HISTORY .

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recovery coaching

RECOVERY COACHING

SUPPORTING A SUCCESSFUL TRANSITION INTO RECOVERY

a brief history
A BRIEF HISTORY
  • Imported the problem
    • 1792 – 2,579 distilleries w/annual per-capita consumption 2 ½ gallons
    • 1810 – 14,191 w/annual consumption 4 ½ gallons
    • 1830 – consumption rose to 7.1 gallons
a brief history1
A BRIEF HISTORY

Dr. Benjamin Rush – possible father of the disease concept

Attitude changed towards social value of alcohol

Late 1700s – start of the Temperance Movement

a brief history2
A BRIEF HISTORY
  • Groups formed to assist chronic alcohol abusers
    • Signed a pledge for abstinence
    • Fraternal Temperance Societies and Reform Clubs later provided financial support
    • Failed because of inconsistencies in membership requirements & mission purpose
a brief history3
A BRIEF HISTORY
  • Late1800s – special institutions & professional roles
    • Inebriate “homes”, “dry hotels”
    • Inebriate asylum - large medical directed facilities
    • AA physicians & nurses & “AA Wards”
a brief history4
A BRIEF HISTORY
  • Emmanuel Church of Boston (1906)
    • Used religion, psychology & medicine
    • Clinics pioneered use of lay alcoholism psychotherapists
    • Jacoby Club – support meetings & social events
    • Used “friendly visitors”
a brief history5
A BRIEF HISTORY

1935 – founding of Alcoholics Anonymous

Industrial alcoholism specialists

Entrepreneurs opened “AA farms” & “AA retreats”

a brief history6
A BRIEF HISTORY
  • 1940s & 50s – Yale Center of Alcohol Studies
    • Pioneered new outpatient model
    • Continued lay therapist mode
  • Codification of “Counselor on Alcoholism”, “Minnesota Model” pioneered by Hazelden
a brief history7
A BRIEF HISTORY

1970s – roles rapidly professionalized

Education & training requirements escalated

Today’s focus on (acute) bio-psycho-social stabilization

Many service models focus on reduction of client’s deficits and pathology

stabilization vs recovery
STABILIZATION VS RECOVERY

Treatment is viewed at the “magic” solution

Short, well defined period with special protocol

Goal – to develop skills & resources to maintain abstinence & find quality of life

get to treatment with varying levels of motivation, awareness, knowledge, & capacity of dealing with their disorder

sustained recovery management
SUSTAINED RECOVERY MANAGEMENT

Recovery – (process) of implementing these skills into strategy that accomplishes those goals

Disengagement – relapse

Recidivism rates are much lower in monitored programs

sustained recovery management1
SUSTAINED RECOVERY MANAGEMENT

Remember – treatment focuses on deficits & pathology

Long-term recovery support emphasis – assisting client to focus on strengths rather than pathology

developmental model of recovery
DEVELOPMENTAL MODEL OF RECOVERY
  • Pretreatment stage
    • Recognition of addiction
  • Stabilization stage
    • Withdrawal & crisis management
    • Regain control of thought processes, emotional processes, judgment, and behavior
developmental model of recovery1
DEVELOPMENTAL MODEL OF RECOVERY
  • Early recovery stage
    • Acceptance & non-chemical coping
    • Moves it from the head to the heart
    • Stops talking about what to do and begins to mostly do what they are supposed to
    • May last from one to two years
developmental model of recovery2
DEVELOPMENTAL MODEL OF RECOVERY
  • Middle recovery stage
    • Focus on balanced lifestyle
    • Reestablishing broken relationships
    • May set new occupational goals
    • Participates in more social & recreational activities
the pareto principle
THE PARETO PRINCIPLE

Roughly 80% of the effects come from 20% of the causes

Identifying your 20%

a word from a twenty percenter
A WORD FROM A TWENTY PERCENTER

“I’m no longer employed by (blank) due to my own ignorance, stupidity, and TnPAP. I can not do an inpatient rehab because it is not warrented and my insurance is cut off. I will be sober 2-1-12 because of my dedication to myself and my conscience. I am free of (blank) and TnPAP to live fron alcohol abuse and the requirement to lie if in my ultimate best interests. I AM FREE!

how do we deal with them now
HOW DO WE DEAL WITH THEM NOW?

Monitoring

Monitoring Agreement Extensions

More treatment

More evaluation/therapy

Non-compliant discharge

recovery coaching1
RECOVERY COACHING
  • Scope of services
    • Monitoring – compliance with MA requirements
    • Drug testing – random testing for enhanced accountability
    • Case management – additional referrals that support client’s goals and choices
    • Life skills coaching – to support personal growth
recovery coaching2
RECOVERY COACHING
  • Qualifications:
    • Credentialing – depending on State requirements (peer based)
    • Ability to establish empathy with client
    • Ability to work with diverse populations & backgrounds
    • Ability to focus on & reinforce positive strengths & behaviors
    • Should not have a single view of pathway to recovery (personal choices)
recovery coaching3
RECOVERY COACHING
  • General professional competencies:
    • Aspects of addiction treatment & how to access
    • Stages of change (Trans Theoretical Model of Change)
    • Motivational interviewing or motivational enhancement techniques
    • Case management activities & knowledge of community resources
strength based recovery planning
STRENGTH BASED RECOVERY PLANNING

Focus on individual strengths rather than pathology

Interventions are based on client self-determination

People suffering from SUD or mental illness continue to learn, grow, and change

Chinese Proverb - “Give a man a fish & you feed him for a day. Teach a man to fish & you feed him for a lifetime”.

working with the participant
WORKING WITH THE PARTICIPANT
  • Motivational interviewing
    • Non-confrontational behavioral intervention used to increase awareness of SUD and assist in transition through first three stages
  • Four therapeutic components:
    • Express empathy (active listening skills)
    • Develop discrepancy
    • Roll with resistance
    • Support self-efficacy (how other people view their own capacities & strengths)
working with the participant1
WORKING WITH THE PARTICIPANT
  • Contingency Management – based on operant learning theory (voluntary actions of human beings)
    • Links consequences with behaviors
    • Behavior is learned by its consequences & can be changed by changing the consequences
    • Motivates people to learn new or alternative behaviors by providing positive reinforcement
    • Used to keep people engaged until the process becomes reinforcing
references
REFERENCES

Manual for Recovery Coaching & Personal Recovery Plan Development – David Loveland, PhD, dloveland@fayettecompanies.org

Slaying the Dragon – William L. White, Chestnut Health Systems/Lighthouse Institute, Bloomington Ill

Escaping From the Bondage of Addiction – John O. Edwards, BS, CEAP, SAP, www.therecoverycoach.co

International Coach Federation, www.internationalcoach.org