Peer Recovery Support Services

1. Peer Recovery Support Services Tom Coderre, Faces & Voices of Recovery Tom Hill, Health Systems Research Beverly Haberle, PRO-ACT Patty McCarthy, Friends of Recovery Vermont April 21, 2007

2. 2 Working Definition: Addiction Recovery No longer using alcohol or other drugs Gaining stability in life Creating a better life Housing Job/Career/Education Health and Wellness Family Community

3. 3 Recovery-oriented Systems of Care Treatment is part of recovery. Recovery is the larger construct. End point of treatment = absence of symptoms of clinical disorder. End point of recovery = holistic health.

4. 4 Recovery-oriented Systems of Care Peer Recovery Support Services (PRSS) are grounded in a strength-based approach that focuses on wellness and a full reengagement with the community. Building on capacities that already exists within individuals and communities. Making it possible for people to gain stability and create better lives Supporting individuals and their families to gain overall wellness

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7. 7 Peer Recovery Support Services (PRSS) PRSS are non-clinical services that assist in removing barriers and providing resources to those contemplating, initiating, and maintaining recovery.

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9. 9 Peer Recovery Support Services (PRSS) PRSS are made available throughout the continuum of care: Pre-treatment During treatment Post-treatment As an alternative to treatment

10. 10 Peer Recovery Support Services (PRSS) Help people initiate and/or sustain recovery from alcohol and other drug problems. Guide individuals into the recovery community. Help individuals who relapse back into treatment and recovery supports.

11. 11 Peer Recovery Support Services Draws on the power of example and lived experience. Largely voluntary: draws on the desire to �give back.� Based on the notion that both people in a relationship based on mutuality are helped and empowered.

12. 12 PRSS Provides Social Supports Social support appears to be one of the potent factors that can move people along the change continuum. (Hanna, 2002; Prochaska et al, 1995) Social support has been correlated with numerous positive health outcomes, including reductions in drug and alcohol use. (Cobb, 1976; Salser, 1998). Four types of social support (emotional, informational, instrumental, companion) have been identified.

13. 13 Rationale for PRSS Research suggests that providing holistic, community-based support services enhances treatment outcomes. (McLellan, 2003; Work Group on Substance Abuse Self-Help Organizations, 2003) Experience shows that ongoing community support is important to sustaining recovery. (White, 2000; 2002) Lessons learned from mental health consumer and HIV/AIDS peer communities support these services. Research on and lessons learned from almost 65 years of 12-step groups. (e.g., Work Group on Substance Abuse Self-Help Organizations, 2003) provide further support.

14. 14 Examples of PRSS Assistance in finding housing, educational, and employment opportunities Assistance in building constructive family and personal relationships Life skills training Health and wellness activities Assistance managing systems (e.g., health care, criminal justice, child welfare) Alcohol- and drug-free social/recreational activities Culturally-specific and/or faith-based support

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19. 19 RCSP Portfolio Currently 14 grants providing PRSS 6 new grants to be awarded in 2007 Recovery community organizations and facilitating organizations Diverse populations served

20. 20 Population-Specific PRSS Services Women Self-defined groups by culture: race, ethnicity, sexual orientation, or religion Co-occurring disorders Formerly incarcerated Trauma survivors Families Age

21. 21 RCSP: Current Issues Currently developing a process to build consensus with RCSP grantees to create standards of quality in peer services in the following areas: Organizational Infrastructure Peer Practice Ethics for Peer Providers and Peer Organizations Evaluation and Research

22. Faces & Voices of Recovery 2007 22 PRO-ACT:Advocacy In Action

23. Faces & Voices of Recovery 2007 23 Our History, Our Purpose: PRO-ACT, (Pennsylvania Recovery Organization - Achieving Community Together), was formed in 1998 by Bucks County Council on Alcoholism and Drug Dependence, which has been providing prevention, intervention, and recovery support services in the community for 31 years. PRO-ACT is a grassroots advocacy initiative founded to promote the rights of - and ensure opportunities for - those still suffering from the disease of addiction, members of the recovery community, and their family members who wish to advocate in southeastern Pennsylvania (Bucks, Chester, Delaware, Montgomery and Philadelphia Counties.)

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25. Faces & Voices of Recovery 2007 25 Recovery Community Organizations like PRO-ACT�

26. Faces & Voices of Recovery 2007 26 Peer to Peer Recovery Support Services Peer-Driven Peer-Delivered

27. Faces & Voices of Recovery 2007 27 PRO-ACT Programs include: Mentor + � Prison Project Family Program Career Transition Safe Sober Housing 24 hr. Information/Support 12 Session Life Skills Program Recovery Coaching

28. Faces & Voices of Recovery 2007 28 Mentor + Volunteer mentoring program offers support to inmates in early recovery as they transition into the community Offers hope, support, counsel and friendship Helps �mentees� make healthy decisions Minimizes the risk of re-incarceration and to sustain and support long term recovery

29. Faces & Voices of Recovery 2007 29 Mentor + Mentoring during incarceration Mentoring continues upon release Mentors are available to mentees: By beeper 24 hours a day Face to face meeting at least once a week

30. Faces & Voices of Recovery 2007 30 Mentor + 2 person same-sex mentoring teams provided for each mentor to: Protect from burnout and over-exertion Provide each mentor with adequate and reliable resources from the mentor and program

31. Faces & Voices of Recovery 2007 31 Mentor + 73 individuals have been mentored since the program started in 2003. 2003: 25 mentees, 3 either relapsed/re-incarcerated (12%) 2004: 25 mentees, 5 either relapsed/re-incarcerated. (20%) 2005: 22 mentees, data still being collected. (National average recidivism rate for same population, 60% or higher)

32. Faces & Voices of Recovery 2007 32 Recovery Coach Community-based. Recovery Coaches understand the array of barriers that make it difficult for people in recovery to stay connected to the recovering community. These barriers, such as emotional, medical and housing, employment and nutritional needs, are just some of the areas that a Recovery Coach can help an individual chart and put into a recovery plan. Recovery Coaches help the person in recovery determine what his or her needs are, what barriers exist and what plan of action needs to be designed to address these issues. Recovery Coaches have a working knowledge of the resources in the community that may help remove barriers.

33. Faces & Voices of Recovery 2007 33 Recovery Coach The Recovery Coach must have at least 2 years of continuous recovery. The Recovery Coach must be trained. The benefit: The Recovery Coach helps design the �Individual Road Map to Recovery� with their �Recoveree�.

34. Faces & Voices of Recovery 2007 34 Telephone Recovery Support A telephone line that operates 24 hours a day, 7 days per week. Those in need of recovery support can call the number provided at any time and speak to a trained representative for resources, referrals to treatment, etc. The �Recoveree� receives a call for 12 weeks for support in their recovery plan. The benefit: A constant resource for assistance with drug and alcohol addiction issues, support for anyone concerned about someone with an addiction issue, or themselves, and a beginning direction on the path to recovery.

35. Faces & Voices of Recovery 2007 35 Family Education Program One of PRO-ACT�s first outreach efforts, started in 2001, an education program for families of those addicted to alcohol or other drugs. A direct service needed within community Volunteers are educators and mentors and the project can be duplicated in other areas. Reduces stigma & increases understanding of addiction and recovery. The benefit: Families can access the support and knowledge of trained facilitators, and other families around them who have had the same experience. In 2006, 800 families were served.

36. Faces & Voices of Recovery 2007 36 Life Skills Program A 12 session program (one session per week for 12 weeks), specifically designed for women in the early stages of recovery. The program teaches women the skills that they need to maintain successful, long-term recovery and how to live independently.

37. Faces & Voices of Recovery 2007 37 Life Skills Program Week One- Understanding Your Illness Week Two- Recovery 101 Week Three- Sustaining Recovery Week Four- Taking Care of Yourself Week Five- The Impact of Addiction on the Family Week Six- Women�s Health Week Seven- Fitness Week Eight- Employability Week Nine- Money Management Week Ten- 4 Steps to Credibility Week Eleven- Spirituality Week Twelve- Nutrition

38. Faces & Voices of Recovery 2007 38 Housing Support Recovery House Association Resource List Consumer Guide to Sober Housing

39. Faces & Voices of Recovery 2007 39 What We�ve Learned

40. Faces & Voices of Recovery 2007 40 Steering Committee Responsibilities: Assure members conduct themselves in a manner consistent with bylaws of program as established by Membership Develop and maintain reporting system Collect data to establish and maintain outcomes

41. Faces & Voices of Recovery 2007 41 Participatory Process for Developing Peer to Peer Services

42. Faces & Voices of Recovery 2007 42 Peer To Peer Service Organizations: Organizational Structure Advisory or Legal Board Qualification/Eligibility for Peers Application Process Policies and Procedures Contract with Peer Providers Risk Management Training Requirements

43. Faces & Voices of Recovery 2007 43 Policies and Procedures Requirements: Contract Confidentiality Pledge Background Reference Check Liability Insurance On-going Supervision

44. Faces & Voices of Recovery 2007 44 Risk Management � Plans are in Place to Protect The Mentee The Mentor The Organization

45. Faces & Voices of Recovery 2007 45 CHALLENGES A new approach Coordination with Treatment Providers Available Funding Ongoing support and supervision for peers, providing one on one activities Time needed to mobilize, train, and support recovery community into a high functioning entity

46. Faces & Voices of Recovery 2007 46 PRO-ACT Over 8500 participants 2,538 members Over 300 volunteers Over 259 new registered voters this year 416 Act 106 cases have received help through the grievance and appeals process since January, 2003. Recovery Community is engaged in advocacy, peer driven problem identification, and resolution. Provide one on one direct support.

47. Faces & Voices of Recovery 2007 47 Bringing Voices and Visibility to Recovery Friends of Recovery- Vermont April 2007

48. Faces & Voices of Recovery 2007 48 Friends of Recovery-Vermont promotes the power of long term recovery to improve the quality of life, health and wellness of Vermonters. FOR-VT believes there are many paths to recovery which lead to rejoining and rebuilding a life in the community for everyone.

49. Faces & Voices of Recovery 2007 49 Since 1998, Friends of Recovery- Vermont has been building a strong recovery community organization. We have engaged many people in recovery from alcohol and drug addiction and have provided a voice for this community of people that has traditionally remained anonymous.

50. Faces & Voices of Recovery 2007 50 FOR-VT is a clearinghouse for recovery information through a website, list serve, and a quarterly newsletter. FOR-VT connects hundreds of individuals seeking support for themselves, their families and friends, through information, referrals, workshops and forums. FOR-VT advocates for the recovery community on state and community level committees and coalitions by bringing awareness to the need for a full range of adequately funded recovery support services within the continuum of prevention, intervention, treatment, continuing care, and recovery.

51. Faces & Voices of Recovery 2007 51 FOR-VT supports the development of community recovery centers (peer run centers across Vermont) where integrated services can be provided. FOR-VT brings visibility to the recovery movement by holding an annual �Recovery Day� legislative awareness event at the State House in Montpelier. FOR-VT offers recovery events such as dinners, dances, performances, and celebrations, including promotion of September as National Alcohol and Drug Addiction Recovery Month

52. Faces & Voices of Recovery 2007 52 FOR-VT is building a membership organization Peer- led (advisory board and membership) Membership through annual contributions Individual ($20), family ($35) and organization ($50) 1600 individuals and organizations (paid and non-paid members)

53. Faces & Voices of Recovery 2007 53 Financial Support RCSP (Recovery Community Services Program) 1998- 2004 VT Department of Health, Division of Alcohol and Drug Abuse Programs (1998- present) Additional grant funding for special projects Membership and other organizational contributions The Vermont Association for Mental Health is the �host agency� for FOR-VT. VAMH is a 501c3 organization with over 60 years in mental health advocacy

54. Faces & Voices of Recovery 2007 54 Vermont Integrated Treatment Initiative (VISI) October 2006 Development of Peer Groups, Leaders and Advocates for Co-occurring Substance use and Mental Health Services Collaboration between FOR-VT and the VT Psychiatric Survivors, two consumer-run advocacy organizations, is educating, training and supporting individuals with co-occurring disorders, and others providing peer services. Focus groups, planning committees, video education groups, and peer leader development has underway in several regions of Vermont with the plan to be statewide over the next year. A Peer Group Facilitation Skills training is scheduled for April 2007.

55. Faces & Voices of Recovery 2007 55 FACES Project Families and Adolescents Driving Care for Effective Services May 2006 FOR-VT and the VT Federation of Families for Children�s Mental Health have become partners in this new initiative made possible through the Adolescent Treatment Enhancement Grant. This SAMHSA grant was awarded to the VT Department of Health to redesign the adolescent treatment system, making it more accessible and effective for Vermont families. FACES provides advocacy and education opportunities through regional groups, currently in Central Vermont, White River Junction and Rutland County. Expansion into Middlebury and Bennington is planned for Spring 2007. The FACES Network 1st Annual Meeting will be held May 17 in Montpelier.

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57. Faces & Voices of Recovery 2007 57 Vermont Recovery Center NetworkData Collection Summary(3rd Quarter, FY2006-2007) 7 Recovery Centers reporting data this quarter Open from 24 to 120 hours per week - open an average of 71 hours per week 247 to 4982 visits per month- average of 1674 visits per month TOTAL VISITS this quarter- 28450 11 paid staff (part or full-time) among the 7 recovery centers ____________________________________ Notes: Two new centers have not yet begun reporting data Data summary prepared April 2007 for months of Jan, Feb, Mar 2007 Data collection program and procedures performed by Friends of Recovery-Vermont.

58. Faces & Voices of Recovery 2007 58 From 3 to 47 volunteers per center- average of 23 volunteers per center- 129 volunteers among the 7 recovery centers 20 - 210 volunteer hours per week/per center- average of 77 volunteer hours per week- total of 1752 volunteer hours per month; 5256 per quarter Between 3 and 27 recovery meetings held at each center each week- a total of 79 recovery meetings per week held at 7 recovery centers in Vermont! _____________________________________ Notes: Two new centers have not yet begun reporting data Data summary prepared April 2007 for months of Jan, Feb, Mar 2007 Data collection program and procedures performed by Friends of Recovery-Vermont

59. Faces & Voices of Recovery 2007 59 Participant Evaluation Summary (3rd Quarter, FY2006-2007) 103 Participant Evaluation Surveys collected this quarter (n=103) 62% of participants surveyed report "the recovery center has helped me FIND my recovery (stop using alcohol or illicit/non-prescribed drugs)" 91% of participants surveyed report "coming to the recovery center has helped me MAINTAIN my recovery (remain substance free)" 95% of participants surveyed report "participating in recovery center activities has ENHANCED my recovery experience." _____________________________________ Notes: Two new centers have not yet begun reporting data Data summary prepared April 2007 for months of Jan, Feb, Mar 2007 Data collection program and procedures performed by Friends of Recovery-Vermont

60. Faces & Voices of Recovery 2007 60 Rate of homeless/couch surfing/staying with friends has decreased from 19% to 7% Rate of independent housing has increased from 67% to 80% Rate of unemployment has decreased from 35% to 16% Rate of probation or parole has decreased from 22% to 17% ________________________________________________ Notes: Two new centers have not yet begun reporting data Data summary prepared April 2007 for months of Jan, Feb, Mar 2007 Data collection program and procedures performed by Friends of Recovery-Vermont

61. Faces & Voices of Recovery 2007 61 69% of participants surveyed have participated in a substance abuse treatment program (residential or outpatient) in the past. 21% have participated in a substance abuse treatment program in the past year. 49% of participants surveyed report "my recovery is currently assisted by medication". 41% report using antidepressant/antipsychotic medication. 17% report using methadone/buphrenorphine. 51% of participants surveyed report "my recovery has been assisted by medication in the past". 47% report using antidepressant/antipsychotic medication in the past. 10% report using methadone/buphrenorphine in the past. _____________________________________ Notes: Two new centers have not yet begun reporting data Data summary prepared April 2007 for months of Jan, Feb, Mar 2007 Data collection program and procedures performed by Friends of Recovery-Vermont

62. Faces & Voices of Recovery 2007 62 Participants have been in recovery (not using alcohol or drugs) for an average of 4.46 years. Participants have been coming to the recovery center for an average of 1.99 years. Average age of participants who identified their age: 43 Gender of survey respondents: 57% Male, 43% Female ____________________________________ Notes: Two new centers have not yet begun reporting data Data summary prepared April 2007 for months of Jan, Feb, Mar 2007 Data collection program and procedures performed by Friends of Recovery-Vermont

63. Faces & Voices of Recovery 2007 63 Friends of Recovery- Vermont Supporting peers, developing peer services Bringing Voices and Visibility to Recovery

64. 64 Contact Information

65. 65 Questions and Answers To listen to this webinar and to read additional background materials on peer recovery support services, please go to http://facesandvoicesofrecovery.org/about/trainings_events/webinar.php