Tag: Harm Reduction

  • Ten ways of Improving Your Chances of Keeping that New Year’s Resolution

    calvin-hobbes-new-year-resolution1Make a list and think it through

    It’s that time and everyone is thinking of New Year’s Resolutions. You’re itching to get rid of that bad habit right now, but consider this: think it through. I know you have heard that AA saying “Baby Steps” before…but sticking to a habit change is not trying to be perfect right out of the gate. So before you start trying to change a habit, consider thinking about it thoroughly for a month or two. First, list every reason you want to stop, figuring out what triggers or cues you react to, what routine you fall into as a result of that trigger and experiment with the types of rewards you are looking for from that habit. Write down and record every time you catch yourself doing the habit, and soon a pattern will appear. Maybe checking out a few twelve step programs or a therapy group can give you an idea of outside support options. You will be better prepared to conquer the habit after processing it during the next few weeks.

    2.  Identify your triggers

    By doing this review you will see you do the same behaviors, in the same place, at the same time. If at 3:00, you go on a smoke break in your car, the time and the car itself can become a trigger (or cues as Charles Duhigg author of The Power of Habit calls them). These actions can become a cue to start a habit —sometimes these cues are very subtle to notice. As AA says “Avoid People, Places and Things.” Identify and understand your triggers. These triggers fall into one of the following five categories:

    1. Location, a bar, your ex-girlfriend’s neighborhood, a bakery
    2. Time, 3:00, happy hour, visiting family
    3. Emotional State, Hungry, angry, lonely or tired
    4. Other People, the ex, your Mom, Dad or that annoying co-worker
    5. An immediately preceding action, or what happened just before you picked up that joint? An argument with your spouse? Anticipating that your boss will ream your butt at work this morning for being late? Packing the car to see the folks for the holidays?

    3.  Delayed Gratification and Contingency Management

    There are some other simple psychological tricks you can employ as well, such as delayed gratification and contingency management. The 20-Second Rule is an example of delayed gratification: Make bad habits take 20 seconds longer to start. For example, move junk food to the back of the pantry, or leave the credit cards at home so you don’t over spend on lunch. A program sister suggests a Rule of Five, delaying the behavior until you have 5 glasses of water, or walk for 5 minutes or call five 12 step program people. Consider rewarding yourself for not relapsing, it’s called contingency management. Suggest this to yourself: if I don’t act out for 60 days, I can lead the Sunday night 12 step meeting or if I don’t drink now, later tonight, my wife and I can be intimate, or if I don’t use this week my IOP counselor will give me a free lunch coupon for the Olive Garden.

    4. Reframe that habit thought

    Even if we hate the habit we’re doing, like smoking or over eating, we tend to continue doing it because it provides us with some sort of satisfaction or psychological reward. Catch yourself thinking any positive thoughts or feelings about your bad habits (like: if I have a drink, I will not feel so nervous around my in-laws) and reframe these thoughts to remind you of the negative aspects of your habits. Maybe think this thought instead, “One drink is too many and a thousand drinks is not enough.” That is reframing the habit thought.

    5.  Willpower is in limited supply

    Research has shown that we don’t have unlimited willpower (it didn’t take scholarly research to confirm this for you!) The truth is we’re constantly exercising willpower and self-control. The problem is that willpower is like a muscle, capable of fatigue and a muscle can’t be flexed forever. Researchers placed some study participants in situations in which they had to practice self-control—like not eating chocolate-chip cookies in front of them. While another group could eat as many cookies as they wanted. Then both groups were given a second test that required self-control.

    The results? The group that had to resist the cookies did not perform as well on the second task. The group that was allowed to eat as many cookies they wanted, excelled at this second self-control test. The conclusion was that those who had to exert more willpower in the first task exhausted their willpower strength, and were unable to exert the self-control needed for the second task.

    Just place yourself in a similar situation, think of you controlling yourself from strangling your self-absorbed-narcissistic colleague during a staff meeting, then around to 3:00, a typical smoke break time for you, you are triggered. You want to not smoke, but low and behold, a cigarette seems like just the reward you need.

    6.  Make a plan for relapses

    Chances are you’re going to have bad days. Setbacks are normal and we should expect them. Have a plan to get back on track. Recovery coaches call this a relapse prevention plan (click here to link to Mary Ellen Copeland’s WRAP Plan). Coaches have the client write a relapse prevention plan directly after a slip as a way to understand what happened and how to avoid it next time.

    7.  Harm Reduction Option

    Every recovery coach anticipates a relapse, they acknowledge it will happen and attach no shame or guilt to a slip. Often, choosing an action based on Harm Reduction, (which is most often recognized as distributing clean needles to intravenous drug users to reduce HIV infection) is a good alternative. Some Harm Reduction ideas are: smoke a cigarette instead of a blasting a whole stick, limit yourself to buying a lottery ticket instead of logging on to a gambling web site or eat a cup of fruit yogurt instead of a chocolate chip cookie.

    8.  Change takes a village

    With making a resolution to change, don’t attach it to the ever failing New Year’s Resolution. Attach it to a positive change within you. Let people know about it. Ask for help, even if it is a nagging wife or over- bearing parent. Better yet, join a 12 step group. Research shows change happens when you have support from others.

    9.  Make a Plan

    Once you have figured out your ‘habit loop’, your cues/triggers, the routine you use, and the reward you expect, you can begin to shift your behavior. All you need is a plan. Open your-self up for improved, healthier routines; such as meditation, an afternoon walk, a talk with a co-worker or new way to drive home. These will become very good sources of generating your rewards and within 30, 60 or 90 days it will become a habit. Just give it time and

    10. Don’t give up! Keep trying!! It’s progress not perfection!

     

    Happy New Year!

    Special thanks to Charles Duhigg author of The Power of Habit for supplying all of this excellent information on changing a habit and to Calvin and Hobbes for making fun of it!

     

  • What is the difference between a recovery coach, a peer recovery support specialist and a professional recovery coach?

     

    melissa-new-post

    I published my book Recovery Coaching – A Guide to Coaching People in Recovery from Addictions in 2013. A recovery coach, a peer recovery support specialist and a professional recovery coach’s job descriptions have expanded significantly since then. The organizations that offer recovery coach training numbered around 50 in 2013. Today, the number has grown to 250. Recovery coach certification training is one of the fastest growing aspects of the coaching field, with many states establishing recovery coaching and peer recovery support-specialist certifications. Yet, for many people who seek to achieve basic recovery coaching information, the process of training, certification, credentialing or licensing are baffling. With all of this growth and change, anyone who is interested in being a recovery coach is very confused about the necessary training, what to call this training and even what to call themselves! I want to make an attempt to clear up this confusion and answer these questions:

    • What is the difference between a recovery coach, a peer recovery support-specialist and a professional recovery coach?
    • On what kind of certification should a future recovery coach focus?
    • What are the guidelines for certification of a recovery coach?

    (Some of the answers to these questions will appear in upcoming posts.)

    What is a Recovery Coach?

    A recovery coach is a person that works with and supports individuals immersed in an addiction(s), and coaches people in recovery from the abuse of alcohol and drugs, gambling, eating disorders or other addictive behaviors. Sometimes recovery coaches who work with people with addictions have been referred to as a peer recovery support specialist, a recovery support specialist, a sober companion, recovery associate or quit coach. In all cases these terminologies describe the same job description; a person who meets with clients in order to aid in their recovery from addiction(s). Even though many certifications for recovery coaches are classified as peer recovery support practitioner certifications. I prefer to use the term recovery coach in describing a person coaching an individual in recovery from addiction, instead of using the term “peer,” mainly because there is no requirement that a recovery coach be a peer (meaning they are an addict in recovery). Although it may be believed having experiential knowledge is a best practice for a recovery coach, it could be a recovery coach has knowledge of addiction and recovery perhaps by knowing an addict, having a family member with an addiction or taking courses in the treatment field.

    I have kept the term “non-clinical” out of this definition of a recovery coach because over the course of several years, I have seen drug and alcohol counselors, family and marriage therapists (MFTs), licensed clinical social workers, interventionists (LCSWs), psychotherapists and psychiatrists, train to be recovery coaches and then add coaching to their resume. I hear from these individuals that they embrace the coaching approach, and merge the knowledge they have as a clinician or interventionist with recovery coaching methods.

    Some individuals seek recovery and sobriety from addictions by frequenting a recovery community organization (RCOs) or recovery support center. An RCO is an independent, non-profit organization led and governed by representatives of local communities of recovery. There are recovery coaches at these recovery community organizations. These coaches have very diverse backgrounds. I have met coaches that were addicts, homeless, offenders, teachers, lawyers and highly educated individuals, who choose to help another person in recovery. I have seen these coaches espouse 12-step ideologies as well as non-12-step recovery models such as Buddhist Recovery, Moderation Management, Kundalini Yoga or Harm Reduction. Sometimes, the recovery coaches at these centers receive a salary from the RCO, however, the client is not charged for the recovery coaching services. RCO recovery coaches can also be volunteers, opting to perform their coaching duties for no reimbursement at all.

    Lastly, recovery coaches can be employed by treatment centers or sober living homes and receive compensation from them. In cases such as this, the client is billed for the coaching services from the centers or homes. I know many a recovery coach who has opened a transitional living home or a supportive sober living environment. They coach the people who reside at these locations and their presence adds to the quality of the recovery experience.

    Is recovery coaching covered by insurance?

    Unfortunately, the answer to that question is no. No independent health insurance company covers the services of a recovery coach working with an individual in recovery from an addiction. There is currently only one state, New York, that has an arrangement with the state’s Medicaid offices to reimburse for recovery coaching for individuals who are diagnosed as dependent on a substance. Other states, Tennessee, Maryland and Massachusetts, are formulating similar Medicaid payment plans, but these reimbursements are not yet in place.

    What is a peer to peer recovery support specialist?

    A nearly universal definition of a peer to peer recovery support specialist is an individual with lived experience who has initiated his/her own recovery journey and assists others who are in earlier stages of the healing process of recovery from psychic, traumatic and/or substance-use challenges and, as a result, can offer assistance and support to promote another peer’s own personal recovery journey. A peer to peer recovery support specialist is also called a peer, peer support-practitioner, peer mentor, or a certified peer. All of these terms basically describe the same job description. More and more, this job description is focused on the peer to peer recovery support specialist working with a person in mental health recovery.

    The certified peer to peer recovery support specialist workforce is relatively new in the behavioral health field, with state-recognized certification programs first emerging in 2001. Within this short time frame, states have recognized the potential of peer specialists to improve consumer outcomes by promoting recovery. Many social service agencies pay the peer’s salary, and the client does not pay for the coaching. In the mental health/behavioral health field, when referred by a social services agency or mental health treatment organization, reimbursement for a peer to peer recovery support specialist is covered by a health plan or Medicaid.

    Peer to peer recovery support specialists can also work independently from an agency and be reimbursed by the client or a family. Peer to peer recovery support specialists can also choose to provide these services as a volunteer and receive no financial reward.

    What is a professional recovery coach?

    A professional recovery coach, is sometimes referred to as a recovery life coach. A professional recovery coach has experience and training in the recovery models, and training as a professional coach. These professional and credentialed coaching programs are sometimes referred to as life coaching training. A professional recovery coach can receive training from any of the 250 organizations that train recovery coaches, and select not to receive the certificate from a state certification board or the IC & RC (see the certification information in next week’s post). A professional coach can receive training from the ICF – International Coach Federation’s accredited coach training programs, and apply for a credential issued by the ICF.

    A professional recovery coach can assist a client with a variety of coaching interventions including, but not limited to recovery from addictions, dealing with mental health diagnoses, divorce, financial downturns, grieving, career change and even family relationship issues. The client is billed for the coaching services from the professional recovery coach. Again, healthcare plans do not reimburse for these coaching services.

    Stay tuned for next week’s post on certification for recovery coaches.