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Designing Services for Recovery: Toward Sustained Recovery Management. William L. White, MA Chestnut Health Systems Bloomington, IL USA Email: email@example.com. Presentation Goals .
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William L. White, MA
Chestnut Health Systems
Bloomington, IL USA
White, W. (2008). Recovery management and recovery-oriented systems of care: Scientific rationale and promising practices. See www.ireta.org
White, W. (2009). Peer-based addiction recovery support: History, theory, practice, and scientific evaluation. See www.glattc.org.
1. Cultural/political awakening of communities of recovery
2. Emergence of recovery as an organizing paradigm for behavioral healthcare
3. Call for fundamental changes in the design of addiction treatment: Toward “Recovery Management” and “Recovery-oriented Systems of Care”
Sources: White & Kurtz, 2006, International Journal of Self Help and Self Care; White, 2004, Addiction; Humphreys, 2004, Circles of Recovery.
Source: White, 2008, Counselor.
Cultural Consciousness Related to:
Source: White, 1996, Culture of Addiction, Culture of Recovery
Political awakening of people in recovery
Source: White, 2007, Addiction.
From Pathology (knowledge drawn from studies of addiction) and Intervention Paradigms (knowledge drawn from studies of treatment) to a Recovery Paradigm (knowledge drawn from collective experience & study of long-term recovery)
Call for “Recovery-Oriented Systems of Care”
Source: White, 2005, Alcoholism Treatment Quarterly; Clark, 2007; Kirk, 2007; Evans, 2007
Source: White & McLellan, 2008, Counselor
Vision: medication-assisted metabolic stabilization for chronic opioid dependence as a foundation for long-term biopsychosocial recovery
Model Deterioration: dosing with inadequate clinical & peer recovery support for psychosocial rehabilitation and & community re-integration
Focus: what is subtracted/reduced (drug-related problems, crime, disease risk/transmission) from client’s life rather than what is added (e.g., global personal/family health, productivity, life meaning/purpose, citizenship and service)
Efficacy and effectiveness established via enhanced outcomes compared to no treatment or non-specialized treatment
Lives of many individuals and families transformed through the medium of addiction treatment
Effectiveness influenced by problem severity and complexity and recovery capital
Source: Review in White, 2008 Monograph
Sources: White, 2008 Monograph
--Emphasis on peer-based recovery support services and indigenous community support
Source: White, 2009, Journal of Substance Abuse Treatment
1. ROSC and RM represent not a refinement of modern addiction treatment, but a fundamental redesign of such treatment.
2. Overselling what existing treatment models can achieve to policy makers and the public risks a backlash and the revocation of addiction treatment’s probationary status as a cultural institution.
3. It will take years to transform addiction treatment into a model of sustained recovery support.
4. That process will require replicating what is already underway in many locations: aligning concepts, contexts (infrastructure, policies and system-wide relationships) and service practices to support long-term recovery for individuals and families.