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Tag: recovery coach

  • What do I need to be a recovery coach?

    I published the second edition my book Recovery Coaching – A Guide to Coaching People in Recovery from Addictions in 2019. Since the first edition was released (in 2013) there have been several changes in certification requirements for recovery coaches, and peer recovery specialists. The training of coaches has become one of the fastest growing aspects of the coaching field. So what kind of training do I need to be a recovery coach?

    Many of the organizations that offer addiction recovery coach training or peer recovery-support specialist training are listed on my web site . For many people interested in being a recovery coach, the training costs are an important factor. Deciding on the best training organization and the training necessary to fulfill the state certification requirements can be confusing. So I would like to attempt to clear up this confusion and will attempt to answer these questions in this post:

    What are the guidelines I must meet to apply for recovery coaching training?

    Applicants must meet the following guidelines to apply for a training course in order to be a recovery coach or a peer recovery support-specialist. These guidelines are shared by many training organizations and certification boards across the nation as a standard for what a potential recovery coach must have before applying for recovery coaching training:

    High school diploma, GED or higher

    Minimum of one year of direct knowledge of sponsorship and 12-step programs

    Minimum one year of sobriety from substance use or one year sobriety in co-occurring mental health and substance use disorders (self-attestation)

    Have a minimum of one year experience working with a family member, loved one or significant other that is addicted, is attempting to recover or who has loss their life due to an addiction(self-attestation)

    What kind of training do I need to be a recovery coach?

    Certification boards require the coach to receive peer recovery specialist or recovery coach training from an organization that is authorized by the state to give this training. This ensures the training will fulfill the requirements mandated by your state’s certification board. In order to find out what authorized training organizations are, go to your state’s certification board.

    After your research, you will need to complete the following:

    • Each state and organization has different requirements. So first check with your state to ensure the courses you take will be accepted by the state credentialing board.
    • A certain amount of hours in coaching training (46-120 hours depending on the state) in topics such as addiction recovery theory, motivational interviewing, relapse prevention, cultural awareness, suicide prevention and HIV-AIDS education
    • 8-16 hours of coaching ethics.

    The places in which you receive this training are quite diverse. In the links section of this web site,  ( https://www.mkrecoverycoaching.com/recovery-coach-training-organizations/ ) I list over 250 organizations offering recovery coach training. The courses can be virtual, or in a classroom. The costs for this training is diverse as well, from free (in Ohio) up to $4,000 per course. The length of the course could be three days or four months.

    At no time does taking a recovery coaching course give you an immediate state certification board recovery-coaching credential. It gives you a document (called a certificate) that says you completed the training hours. There are many coaches who do not seek state board certification and use this document or certificate from a training organization as adequate proof they are knowledgeable in performing the duties of a recovery coach.

    There is a central international credentialing organization, the International Certification and Reciprocity Consortium, commonly known as the IC & RC, which runs many state credentialing boards and has developed an exam for a Peer Recovery (PR) Certification. The IC & RC suggests applicants check with their state credentialing board for specific test-taking guidelines.

    What differentiates a Peer Recovery Coach from a Professional Coach?

    Why the “Professional Coach” title? The word “professional” will differentiate Peer Recovery Coaches with more coaching experience and more training from other peer coaches with credentials or certifications. Employers ( e.g., hospitals, providers, prisons) employ coaches, and for these employers  the term “Professional” signifies a higher level of competence and expertise.

    There are trainings offered that can give a coach more information that may not be on the state certification board list but are very helpful. The kinds of training I found helpful as a new recovery coach are conflict resolution and management, anger management, intervention training, co-occurring disorders, behavioral addictions, the pharmacology of addiction, as well as knowledge about coaching families in relationships with addicted persons. There are also trainings on how to be a recovery coach in a hospital Emergency Department, working with Narcan revived patients, or working with people in prisons or the homeless. There are also organizations that offer Professional Coach certification (CCAR- Conneticut Community of Addiction Recovery, (https://addictionrecoverytraining.org/ ) and the International Coaching Federation that offers three different levels of life coach training: associate, professional- and master-level coaching certificates https://coachingfederation.org/

    After you receive this initial Peer Recovery Coach training, additional trainings can open up to you. The more time you engage in being a recovery coach and the more educational credentials you receive; you move closer to the “Professional Coach” status.

    Are there any additional credentialing organizations for recovery coaching certification?

    NAADAC, the Association for Addiction Professionals, and the National Certification Commission for Addiction Professionals (NCC-AP) offer the Nationally Certified Peer Recovery Support-Specialist Certification. Similar to the state certification- however- the NAADAC certification is good to use in every state in the union. So a coach does not have to worry about reciprocity from one state to another. The requirements the  NAADAC recommends, in order to receive certification, mandates a coach read and sign a statement on the application affirming adherence to the Peer Recovery Support-Specialist Code of Ethics. The new coach will confirm they have taken the NAADAC six-hour ethics training course and have completed six hours of HIV/other pathogens education and training course (also available through NAADAC).Credentialing boards require supervisors of the coaches-in-training to sign a document verifying they have supervised the coach during the 200-hour period of the coach’s  practice training. Letters of recommendation are also items required by some credentialing boards. Other state boards require a recent photograph.

     NAPS, or National Association for Peer Support is an organization for peers focusing on mental health recovery peer support as well as addiction recovery support. They have education and credentialing standards that are listed at : https://www.peersupportworks.org/.

    As always, check with your state credentialing board for specific requirements for credentialing training. Many states only accept training from an organization that have had their trainings screened by the state and authorized to be used as a credentialing training source.

    What is the next step in the  process of being qualified, getting training, and then credentialed as a recovery coach or peer-recovery support specialist?

    After you have completed the research as to what type of credentialling you want (e.g. state certification board, IC & RC or NAADAC), then seek out the training you can afford. Go to http://www.mkrecoverycoaching.com/recovery-coach-training-organizations/ for a list of addiction recovery coach training organizations

    1. Verify that you meet the qualifications to apply for the course (e.g. be 18-years-old, have a GED or high school diploma, one year sobriety from any addiction)
    2. Take and pass the course, retain the coaching certificate for future purposes
    3. Research places like Recovery Community Organizations or treatment centers to work or volunteer as a recovery-coach-in-training to receive your practice hours.
    4. Complete the recovery-coach-in-training supervised practice hours that are required by the state board or the NAADAC
    5. Apply to your state certification board or the NAADAC for the time to take the recovery coach exam(a fee will apply)
    6. Send in your application with paperwork verifying the completion of practice hours to the state credentialing board with a certification fee (the additional fee varies for every state, from $100-$250)
    7. If you pass the exam and meet all the requirements listed on the application, you will receive your recovery coaching or peer-recovery support specialist certificate
    8. In the next 2 – 4 years take the required courses for renewing this certificate. Refer to your state board or the NAADAC for more information on courses and renewal time frames. A renewal fee will be required.

    So, whether you are working as a coach, looking to become one, if you are a family member, or an ally ready to learn about the recovery process, we can promise you the process to become a coach is a transformational experience.

    Good luck on your journey.

  • What is a recovery coach?

    In 2013, I published Recovery Coaching – A Guide to Coaching People in Recovery from Addictions, since then the duties and responsibilities of recovery coaches, peer recovery support specialists and professional recovery coaches have expanded significantly.

    In this article, I hope to define some different recovery coaching titles for those interested in becoming a recovery coach, what certifications they should seek, the places they could work and what they can anticipate as compensation for their work.

    What kind of certification should a future recovery coach receive?

    Recovery coach training and certification is a requirement in this field. Coaching certification and training is one of the fastest growing aspects of the healthcare field. The number of recovery coaching training and certification courses has expanded to over 300 institutions nationwide. Many employers require recovery coach and peer recovery support specialist certifications. In the links section of this web site is a state by state listing of all the organizations that offer certifications for addiction recovery coaches. If you are reading this to receive basic recovery coaching information, first decide if you enjoy working with people in recovery from substance misuse or want to work with people in recovery from a mental health or behavioral health disorder.

    Are you interested in working with people in recovery from addictions or in recovery from a mental health or behavioral health diagnosis?

    A nearly universal definition of a peer recovery support specialist or a recovery coach is “an individual with the lived experience of their own recovery journey and wants to assist others who are in the early stages of the healing process from psychic, traumatic and/or substance misuse challenges, thus, this peer can aid and support another peer’s personal recovery journey”. Some certifications for a peer recovery support specialist give an individual the training necessary to work with individuals with a behavioral health disorder or a mental health diagnosis. These certifications include more training on the nature of behavioral health disorders, the medications used to treat these disorders, crisis interventions, life/occupational skills, and trauma informed care. A recovery coach working with people in addiction recovery does not necessarily need these types of training. In this article, I will focus on the recovery coach working with people in recovery from substance misuse.

    The individuals that work with people in recovery from substance misuse are called recovery coaches, as well as peer recovery support specialists (PRSS), peer recovery support practitioners (PRSP), recovery support specialists (RSS), sober companions, recovery associates or quit coaches. In all cases, they support individuals in recovery from addiction(s), which can include alcohol, drugs, gambling, eating disorders as well as other addictive behaviors.

    The basic recovery coaching credential is required. If you want recovery coaching certification, google this term with the region you live in. For addition recovery coaching education, I suggest: adding certification for treating co-occurring disorders, training on the application of Narcan which includes the certification for coaching persons detoxing from an opioid overdose, also certification for counseling individuals in Suboxone or Methadone treatment also called Medication Assisted Treatment (MAT) and Medication Supported Recovery (MSR), certification for spiritual recovery coaches and credentials for coaches working with individuals with behavioral addictions such as sexual compulsivity, internet gaming and gambling disorders. If you would like to work in an inpatient treatment center, drug and alcohol counseling certification maybe required.

    Recovery coaching credentialing has expanded to include coach supervision certification, which is training for individuals who want to manage other recovery coaches. Also there is an elevated level of certification called professional recovery coaching. A professional recovery coach is an individual that has been coaching for several years, has hundreds of coaching hours under their belt, manages other coaches and/or has received other coaching credentials. A professional recovery coach is sometimes referred to as a life recovery coach. A professional recovery coach can receive training from any of the organizations that train peers or recovery coaches, and in addition, they can receive training from the International Coach Federation’s accredited life coach training program or a professional recovery coach certification from Recovery Coaches International. Recently, Connecticut Community of Addiction Recovery (CCAR) has started developing a Professional Coaching Certification.

    Where do you want to work?

    Some recovery coaches seek to work at a recovery community organization (RCOs) or a recovery support center. An RCO is an independent, non-profit organization led and governed by representatives of local communities of recovery. The recovery coaches at these recovery community organizations work with people of all financial means, addicts that are homeless, offenders, even professionals like nurses, teachers, lawyers and highly educated individuals, who have hit bottom. Sometimes, the recovery coaches at these centers receive a salary from the RCO. RCO recovery coaches can also be volunteers, opting to perform their coaching duties for no reimbursement at all.

    Recovery coaches can be employed by treatment centers coaches, developing a coaching relationship with a client outside of the clinical treatment. They can escort a client home from a treatment center and stay with the client for a period of time, insuring they do not relapse after discharge. More half way houses or sober living environments are employing recovery coaches. In fact, many recovery coaches have opened a transitional living home or a supportive sober living environments. They act as a recovery coach and a house manager at the same time, their presence adds to the quality of the recovery experience for the residents. Recovery coaches can work in emergency departments in hospitals, detoxification centers or sobering centers; working with individuals in crisis, either detoxing from an alcohol or opioid overdose.

    Lastly, some recovery coaches run their own coaching business. They will visit clients or talk with them over the phone or on SKYPE. These recovery coaches market themselves by contacting a treatment center’s aftercare coordinator or will seek referrals from therapists. The client is billed directly for the coaching services, there is no insurance coverage for a recovery coach.

    How much do you want to be paid for your services?

    Recovery coaches are paid a variety of rates. A recovery community organization, a treatment center, sober living environment or social services agency recovery coaching rates are from $12-$18 per hour. If a recovery coach receives their salary from a social services agency, or a recovery community organization that agency may have received a grant to run a peer program from the State or Federal government.

    A professional life recovery coach can bill from $35 up to $100 an hour for their coaching services. These professional recovery coaches bill their clients directly and incur expenses for running their coaching practice such as insurance, travel and overhead. This ‘pie in the sky’ $100 per hour fee of a professional recovery coach is not for the inexperienced or newbie coach. There are significant responsibilities a recovery coach has for their client, primarily keeping them free from relapse or overdose, or in other words- keeping them alive.

    Soon, there will be reimbursement from health insurance companies for recovery coaching for individuals who are diagnosed as dependent on a substance. New York 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, Pennsylvania, Maryland and Massachusetts, are formulating similar Medicaid payment plans, but these reimbursements are not yet in place. However, currently, private independent health insurance companies do not cover the services of a recovery coach working with an individual in recovery from an addiction.

    In less than five years the field of recovery coaching has grown significantly. With the advent of the Affordable Care Act and the legislation to fight addiction, the 21st Century CURES and the CARA Acts, recovery coaching is now recognized as one of the most important tools to initiate and maintain long term recovery. This recognition will continue as the benefits from recovery coaching continue to be realized.

     

  • Lions, Tigers, Bears and the Yellow Brick Road to Recovery

    This is a guest post by Steve Devlin, a recovery coach from Philadelphia PA, and a long time friend. I chose to post this over the Holiday weekend, because it brings me such joy, and brings back wonderful memories of watching the Wizard of Oz on TV during the 60’s. Thank-you Steve, and Happy Holidays to all of my readers.

    Over the past week, I have been thinking about the Serenity Prayer and its connection to the Wizard of Oz.  Some of you might be looking at your computer and wonder if I have lost my mind.  I beg for your patience and to hear me out.  First a caveat or two.  I represent only myself in this message.  The second caveat is this message was inspired by a share I heard at a 12-step meeting.  The person who said it gave me permission to use it.  So here we go!

    We all know the Serenity Prayer.  “May God grant me the serenity to accept the things I cannot change, the courage to change the things that I can, and the wisdom to know the difference.”  And almost everyone knows the story of the Wizard of Oz or at least the movie version of the story. Dorothy is not happy with life on the farm, runs away, is swept up in a tornado, lands in a strange place, and gathers three companions on her journey to the Emerald City to meet the Wizard.  On the way, she must deal with witches – good and bad – flying monkeys, and castle guards before she finds she always had the power to grant her wish of returning home.

    So what does this story have to do with the Serenity Prayer, let alone recovery?  We cannot find fulfillment, happiness, or peace in our lives. We run away and just when we realize that we have run too far, we are swept up in the tornado (or drug of our choice).  Its path of destruction destroys the landscape of our lives and carries us far away. Thankfully, when the storm passes we land in a new brightly-colored world filled with sober people singing about the blessings of recovery.  Yet our own work is just beginning.  There is a road we must follow with steps leading to the Emerald City of sobriety.  We also learn that we cannot walk the path alone.  There are still temptations, flying monkeys, people, places, and things calling us back to the darkness.  However, as we follow the path we first find the companion of serenity – the heart to love ourselves and others.  A new heart also gives us the gift of forgiveness and acceptance.

    The second companion is the courage to move forwards even when encountering lions, tigers, and bears.  It is courage which lets us turn over our lives, let go of character defects, and make amends.  It is also courage that lets us pick up the phone or go to a meeting.

    Finally, there is wisdom, which gives us the ability to see choices in our lives and to know what we can and cannot change.  After long periods of feeling tied up like a scarecrow on a post, we are set free to walk a brick road of new life.  Of course, finding these three companions to fight back addiction is only part of the story and the Emerald City is not the ultimate destination.  Our companions bring us to the shining light of recovery, but we must take the gifts back home and use them in our daily lives outside of the rooms.

    I wish recovery was as easy as clicking our heals together.  Finding our way home takes work but with heart, courage, and wisdom we can overcome all the flying monkeys and stay out of the way of tornadoes.  We also learn that the greatest companion of recovery is gratitude which was always just in our own backyard.

    Question: Who are your companions on the brick road?

  • What is a recovery coach?

    What is a recovery coach, a peer recovery support specialist or a professional recovery coach?

    In 2013, I published Recovery Coaching – A Guide to Coaching People in Recovery from Addictions, since then the duties and responsibilities of recovery coaches, peer recovery support specialists and professional recovery coaches have expanded significantly.

    In this post, I hope to help define for those interested in becoming a recovery coach what certifications they should seek, the places they could work and what they can anticipate as compensation for their work.

    What kind of certification should a future recovery coach receive?

    Recovery coach training and certification is a requirement in this field. Coaching certification and training is one of the fastest growing aspects of the healthcare field. The number of recovery coaching training and certification courses has expanded to over 300 institutions nationwide. Many employers require recovery coach and peer recovery support specialist certifications. In the links section of this web site is a state by state listing of all the organizations that offer certifications for addiction recovery coaches.

    If you are reading this post to receive basic recovery coaching information, first decide if you enjoy working with people in recovery from substance misuse or want to work with people in recovery from a mental health or behavioral health disorder.

    Are you interested in working with people in recovery from addictions or in recovery from a mental health or behavioral health diagnosis?

    A nearly universal definition of a peer recovery support specialist or a recovery coach is an individual with the lived experience of their own recovery journey and wants to assist others who are in the early stages of the healing process from psychic, traumatic and/or substance misuse challenges, thus, this peer can aid and support another peer’s personal recovery journey.

    Some certifications for a peer recovery support specialist give an individual the training necessary to work with individuals with a behavioral health disorder or a mental health diagnosis. These certifications include more training on the nature of behavioral health disorders, the medications used to treat these disorders, crisis interventions, life/occupational skills, and trauma informed care. A recovery coach working with people in addiction recovery does not necessarily need these types of training. In this blog, I will focus on the recovery coach working with people in recovery from substance misuse.

    The individuals that work with people in recovery from substance misuse are called recovery coaches, as well as peer recovery support specialists (PRSS), peer recovery support practitioners (PRSP), recovery support specialists (RSS), sober companions, recovery associates or quit coaches. In all cases, they support individuals in recovery from addiction(s), which can include alcohol, drugs, gambling, eating disorders as well as other addictive behaviors.

    The basic recovery coaching credential is very broad. If you want more specific training, one can add certification for treating co-occurring disorders, the application of Narcan which includes the certification for coaching persons detoxing from an opioid overdose, certification coaching individuals in Suboxone or Methadone treatment also called Medication Assisted Treatment (MAT) and Medication Supported Recovery (MSR), certification for spiritual recovery coaches and credentials for coaches working with individuals with behavioral addictions such as sexual compulsivity, internet gaming and gambling disorders.

    Recovery coaching credentialing has expanded to include training for individuals that want to supervise other recovery coaches, or an elevated level of certification called professional recovery coaching.

    A professional recovery coach is an individual that has been coaching for several years, has hundreds of coaching hours under their belt, manages other coaches and/or has received other coaching credentials. A professional recovery coach is sometimes referred to as a life recovery coach. A professional recovery coach can receive training from any of the organizations that train peers or recovery coaches, and in addition, they can receive training from the International Coach Federation’s accredited life coach training program. Recently, Connecticut Community of Addiction Recovery has started developing a Professional Coaching Certification.

    Where do you want to work?

    Some recovery coaches seek to work at a recovery community organization (RCOs) or a recovery support center. An RCO is an independent, non-profit organization led and governed by representatives of local communities of recovery. The recovery coaches at these recovery community organizations work with people of all financial means, addicts that are homeless, offenders, even professionals like nurses, teachers, lawyers and highly educated individuals, who have hit bottom. Sometimes, the recovery coaches at these centers receive a salary from the RCO. RCO recovery coaches can also be volunteers, opting to perform their coaching duties for no reimbursement at all.

    Recovery coaches can be employed by treatment centers coaches often escort a client home from a treatment center insuring they do not relapse in the first 30 days after discharge. More half way houses or sober living environments are employing recovery coaches. In fact, many recovery coaches have opened a transitional living home or a supportive sober living environments. They act as a recovery coach and a house manager at the same time, their presence adds to the quality of the recovery experience for the residents.

    Recovery coaches can work in emergency departments in hospitals, detoxification centers or sobering centers; working with individuals in crisis, either detoxing from an alcohol or opioid overdose.

    Lastly, some recovery coaches run their own business. They will visit clients or call them over the phone or use SKYPE. These recovery coaches market themselves by contacting a treatment center’s aftercare coordinator, maintaining a web site or will seek referrals from therapists. These coaches meet face to face with the client weekly and will work with them over the phone or face to face on a regular basis. The client is billed directly for the coaching services.

    How much do you want to be paid for your services?

    Recovery coaches are paid a variety of rates. A recovery community organization, a treatment center, sober living environment or social services agency recovery coaching rates are from $12-$20 per hour. If a recovery coach receives their salary from a social services agency, or a recovery community organization that agency may have received a grant to run a peer program from the State or Federal government.

    A professional life recovery coach can bill from $35 up to $100 an hour for their coaching services. These professional recovery coaches bill their clients directly and incur expenses for running their coaching practice such as insurance, travel and overhead. This ‘pie in the sky’ $100 per hour fee of a professional recovery coach is not for the inexperienced or newbie coach. There are significant responsibilities a recovery coach has for their client, primarily keeping them free from relapse or overdose, or in other words- keeping them alive.

    Soon, there will be reimbursement from health insurance companies for recovery coaching for individuals who are diagnosed as dependent on a substance. New York 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, Pennsylvania, Maryland and Massachusetts, are formulating similar Medicaid payment plans, but these reimbursements are not yet in place. However, currently, private independent health insurance companies do not cover the services of a recovery coach working with an individual in recovery from an addiction.

    In less than four years the field of recovery coaching has grown significantly. With the advent of the Affordable Healthcare Act and the newest legislation to fight addiction, the 21st Century CURES and the CARA Acts , recovery coaching is now recognized as one of the most important tools to initiate and maintain long term recovery. This recognition will continue as the benefits from recovery coaching continue to be realized.

  • Recovery Coach Training Organizations – Free Listing

    adultlearnersDoes your organization want a free listing for your recovery coaching certification training? Every year this website updates the list of over 300 agencies, organizations and schools that offer certification training for recovery coaches working with people in recovery from addictions. This list receives over 45,000 hits a year. Please fill in the comment section below if you offer certification in recovery coaching, and your organization will be presented in this free listing.

    Provide all of the pertinent information: institution name, address, email, web site, the person in charge of the training registration and their phone number, date of training and costs. Clarify that this training is for recovery coaches working in the addictions field. This listing is free.

    You can fill out the comment section below or send an email to: melissakilleen@mkrecoverycoaching.com

  • Recovery Coaching Texas Prison Style

    Kyle Gage PhotoKyle Gage lives in Longview, Texas, and he is a recovery coach. Longview is a little oil and manufacturing town a couple of hours east of Dallas-Ft Worth and about an hour west of Shreveport, Louisiana. The small town has had some illustrious citizens: Forest Whitaker was born in Longview, and Matthew McConaughey went to Longview High School in the ‘80s. Kyle had less of an illustrious impact on Longview.

    A Hard-Earned Recovery 

    Kyle entered his first rehab at 17. He enrolled in a boarding school for troubled teens. He continued in and out of rehab many times, trying to do it his way. At twenty, he knew he had to change, so he attended some NA meetings, through which he stayed clean for about 6 months. Then he used. He tried to keep things under control, and managed to avoid any serious consequences for about a year, but then one day he was pulled over by the police, who found methamphetamine.

    In lieu of jail time, he agreed to treatment. After his treatment episode he remained clean on probation, in part because he was receiving regular tox screens. Staying clean was motivated by his desire to stay out of jail. For 7 months he was sober, but then he started to drink. Eventually, drinking turned to using drugs. Because of his fear of failing a tox screen, he stopped reporting to probation and went on the run. Kyle was picked up a few months later for the probation violation and was sent to the James Bradshaw State Prison in Henderson, Texas.

    He got no help for his recovery in the state prison, drugs being as easily available there as they were on the streets. Upon his release he began using again and was eventually arrested for burglary. He went to treatment but left against medical advice. He went to live at an Oxford House, and remained clean for 2-3 months. The stinking thinking eventually returned, so he drank and drinking led to using. In a very short time, he was arrested. At 26-years-old, he was facing two consecutive ten-year convictions for burglary and grand theft auto. Kyle knew this was serious.

    He asked the judge for help, and the judge gave Kyle ten years of deferred adjudication. Deferred adjudication is a form of a plea deal, where a defendant pleads “guilty” or “no contest” to criminal charges in exchange for meeting certain requirements laid out by the court. In Kyle’s case, these terms were that he go into an inmate drug-treatment program, attend Drug Court upon his release, make a commitment to outpatient treatment, perform community service and complete probation within the allotted period of time ordered by the court.

    Kyle was sentenced to six months at the Clyde M. Johnston Unit, the Texas correctional institution’s Substance Abuse Felony Punishment Facility in Winnsboro, Texas. This facility is Texas’s drug treatment program for offenders. He received a lot of treatment and therapy at the Johnston Unit, where Kyle realized that he needed to embrace recovery.

    Embracing Recovery

    For Kyle, embracing recovery in prison began by helping others: helping others gave him hope. He was the person that led the NA meetings in his dorm. The counselors at Johnston announced that a recovery coaching certification course for the inmates would start at Johnston. They said they only had room for ten men. Kyle applied. He was hoping they would pick him, but he was nervous because he knew that it was very competitive and they were only picking one person per dorm.

    Kyle’s mother found the book Recovery Coaching—A Guide to Coaching People in Recovery from Addictions on Amazon.com and sent it to Kyle. Kyle read it before he even got accepted into the class, which he eventually was. He excelled in helping others in the Unit embrace recovery. He graduated the recovery coaching class and was even invited to talk to the Unit’s next class of recovery coaches.

    Coaching Other Offenders

    The primary counselor notified Kyle that he wanted him to talk to an offender that was a disciplinary problem. Jason was 19-years-old, (his named has been changed for this post) and faced 10-15 years for aggravated assault. Jason was a first-phase client, which meant he had only been at the Johnston Unit for 30 days. He was a meth addict, and he was having trouble adjusting to the Unit: He had issues with people in his dorm. He didn’t attend AA or NA meetings. He didn’t want to be in recovery. He wanted to give up, and fantasized about “rendering his sentence.” The inmates call it “getting sent back to county.” Rendering a sentence means to go back to the original courthouse and say to the judge “Thanks, but I would rather serve 10 years for aggravated assault than spend any more time in therapy and treatment for my drug addiction.” Sound crazy? According to Kyle, that is what goes through the heads of many offenders. The grip of the addiction is so strong that living life sober is frightening. Many choose to self-sabotage by creating problems, by assaulting or threatening another inmate and receiving an extension of their sentence.

    Jason was referred to Kyle specifically as Jason reminded the counselors of Kyle, with his sleeves of tattoos just like Kyle. Kyle met with him and talked to him about meth, since they shared the same drug of choice. Kyle asked for Jason’s story, and listened. It was different from Kyle’s, but there were many similarities. Kyle shared many of Jason’s traits: Being an outlaw, an outcast, and a gang member. Jason didn’t think the meetings would be beneficial to him. Kyle shared that it was in the 12-step rooms where he truly felt alive.

    Kyle asked Jason about his plan when he gets out of Johnston and allowed Jason to self-actualize as to where he wanted to be in 5 years. Jason broke down and cried during this meeting. He was frightened at what he was facing, he had a lot of anger issues, and he didn’t know what to do. So, Kyle told him what worked for him.

    During the six months that offenders were at the Johnston Unit, there was no chance of them using drugs. The coaches assisted the offenders with embracing recovery, working the 12 steps and learning to use the steps in their daily prison life. Kyle coached men that were violent, had assaulted another men, were disciplinary problems, and where coaching was the last step before they were “sent back to county.” Kyle was there to stop them from rendering their sentence and losing everything. Sometimes an inmate had a family member pass away and the inmate was not granted permission to attend the funeral.  Although this coaching had nothing to do with recovery from drugs or alcohol, the recovery coaches are assigned to console these inmates through the grieving process.

    When inmates were close to being released, having  no experience with 12-step meetings or recovery on the outside, and  having no intentions of asking for help, Kyle gave them some “recovery capital.” He would give them lists of AA and NA meetings near the half-way house to which they were being released.  Kyle would give them information on Community HealthCore, which is a large, social services agency in Texas with outpatient drug and alcohol treatment programs. He would tell them about drug court classes and behavioral health counseling. Kyle and a few of the other recovery coaches in the Johnston Unit were from the Dallas area. When a prisoner would be going to back to the Dallas area, the coaches would refer the offenders to people on the outside who could take them to a meeting.

    Another prisoner, Caleb (his real named also changed) was in the reentry process—in a few weeks he was being released to a half-way house in Beaumont, Texas. Caleb had been in this position before.  As he got  closer to the “door” he became scared, and he was afraid of going back into the real world. He was so sure that he could to do things his way, but in the back of his head, he knew that doing things his way was what had gotten him into prison several times before. Kyle ran the 12-step meetings, and Caleb would attend as a “woodworker” (working wood means doing the absolute minimum, not participating, not getting involved and not believing this program would work for them).

    Kyle was assigned to speak to Caleb.  Kyle asked him what happened after he drank a beer, and Caleb admitted that after he drank one beer, it would soon be a dozen and very shortly, he was thinking about using crack (his drug of choice). Kyle knew this story very well, because it was Kyle’s story. So he shared his story with Caleb. It didn’t seem to work. Caleb kept wood working and didn’t really engage in the program. Caleb was antagonistic, he would challenge the tenets of the program, ask questions about will power, saying recovery was a choice, and that he was “not an addict forever.” He didn’t think that any program would help him, but he knew that if he went out into the real world, he would use again.

    Many offenders self-sabotage their release process by getting into fights and end up staying in prison a few months longer. This happened to Caleb. He remained at the Johnston Unit a few months longer, which was just enough time to let Kyle’s work with him penetrate. Upon his release, Kyle gave Caleb the information on 12-step meetings in Beaumont and he agreed to attend the meetings. Kyle continues to communicate to Caleb, who is sober and has not re-offended.

    At this point, Kyle Gage has been out of the Johnston Unit for about a year. He is wrapping up his Drug Court commitment. He is enrolled in a community college to get his Associates Degree and also works as a new car salesman. Kyle will continue recovery coaching to help himself and others maintain the recovery that he loves.

  • Recovery Coaches to the Rescue

    Recovery Coaches to the Rescue

    FBI PhotoIt is 5:30 am and a band of FBI and local sheriff authorities pull up to a New Jersey suburban house in a development not far from Philadelphia. Adorning Kevlar vests, and windbreakers with the yellow letters FBI on their backs, they storm past a toy doll stroller in the sidewalk. They bang on the door with their fist, demanding “Open up this is the FBI”. After a few more wraps, a bleary eyed woman about 40 years old opens the door a crack and peers out. With a burst of energy, five FBI agents and two local police enter her foyer, issue her a search warrant and spew out demands, only one she actually hears, “Your husband is under arrest for child pornography, where are the computers?”

    Emily, (all real names in this story will be withheld for privacy purposes) is dazed. She is in her bathrobe, and slippers, her hair is mussed, her eyeglasses crooked. She is barely awake. She glances at the stairs. She sees her two children at the top of the stairs, as a troop of agents make their way up to them. The agents ascend, as her girls descend squeezing towards the wall making way for the army of six foot, 250 pound men barreling past them. They are asking “Mommy, what is happening?” A sheriff from the local police department asks where her husband is. She says he is at work; he works the midnight shift at a local hospital. The Sheriff gets on his walkie-talkie and bursts out some demands, heralding a similar event at her husband’s workplace.

    It is 6:00 am, and Tom is just wrapping up from his shift as a nurse. His supervisor walks up to him and a force of blue windbreakers flank him on either side. “Tom,” his supervisor says, “these gentlemen want to see you in my office”. As they turn to go to the office to FBI agents take Tom at the elbows and nearly lift him off his feet. He arrives in the supervisor’s office, is placed in an arm chair and the door slams. Tom hears the words he has feared for the past two decades. “You are under arrest for the possession of, and the suspected distribution, copying, or advertising of images containing sexual depictions of minors.” For some strange reason, Tom is relieved. He thinks “It’s over, it is finally over.”

    It is Monday night, a steady stream of middle aged men drift into a hospital conference room, and take a seat. One of them opens a gym bag and starts to place books, pamphlets and tri-fold fliers on the table. A clear plastic envelope stuffed with one dollar bills is placed next to a thin loose-leaf binder. He sits down, opens the binder, checks the time on his cell phone and says, “Welcome to the Monday night meeting of Sex and Love Addicts Anonymous, my name is Ken, and I am a sex and love addict.” The seemingly normal cohort of men reply, “Hi Ken”.

    The Monday night meeting of Sex and Love Addicts Anonymous begins. The reading is on Step Three; made a decision to turn our will and our lives over to the care of God, as we understood God. During the share a newcomer tells his story about what brought him into the rooms tonight. He is not sure he can be helped. He knows he has been a porn addict for all of his adult life. He says he has just been found out and he has no idea what will happen next, to his life, to his marriage, to his kids. He was advised to go to a 12 step meeting, and luckily he saw this meeting listed.

    The members of this unlikely band of brothers looks at Tom. His head is down. His focus is on the ravaged cuticles of his right thumb. As he raises his thumb to his mouth, a tear rolls down his cheek. They know how he feels. Each one of them have felt this same despair. Joe raises his hand to share. Joe is almost 45, yet one would think he is no older than 35. His Goorin Brothers Slayer cap is on backwards, his flannel plaid shirt is unbuttoned revealing an LA Dodgers vintage t-shirt. Appropriately ripped skinny jeans end in Vans pull ons. He gets current, talking about his therapist, his groups and what the third step means to him. Then he looks directly at Tom. “I know there is no cross talk in this meeting, so let me just say this, Tom, can we talk after the meeting?”

    Joe knows what has happened to Tom. Tom need not even say the word ‘legal’ for the subliminal message to be delivered. Joe knows because it happened to him, less than two years ago. The Cop Knock. The end of life as he knew it. The opening up of a new world. A new life without any more hiding.

    Relief.

    Joe and Tom walk to the café and Joe buys Tom a coke and a sandwich. It is the first thing Tom has eaten in two days. The café is empty, so they find a corner table and sit down. After just a few minutes, Tom’s experience from the last week is told. Joe’s head was nodding the whole time, but he lets Tom talk.

    Before an hour was up, Joe had given Tom the name of three men, Michael, Steve and Mike. Also, the number of an attorney and of a therapist that specialized in treating offenders. As they walked out of the hospital, Joe said the first call should be to Michael. Michael will coordinate everything. And Joe was right, Michael coordinated everything.

    Michael answers the phone at 9:15, and Tom was on the line. Michael was already prepared by Joe’s call, just minutes before. By 10:00, Michael assembled the team and briefed us all. The attorney appointment will be made by Tom. The therapist introduction will be on the phone, and the first group therapy meeting is tomorrow and Joe will bring Tom. Mike and Steve will call Tom daily for support. I am assigned to work with the wife.

    Every one of us responds to this call. It initiates a recruitment effort that rivals the Avenger’s response to Ultron’s threat to eradicate humanity. This team is committed to  respond to any sexual addiction crisis- the family affected by a patriarch’s incest, the individual devastated by sexual abuse, or the man that has heard the “Cop Knock”. We know they feel alone, whether they have been abandoned by their family, abused by loved ones or in this case, arrested for an illegal act. Tom needs his Avengers team to help him, because this is territory he is not familiar with. But this team is very familiar with it; the family dynamics, the law, the courtroom, treatment and therapy, prison and re-entry. We have walked this path, and emerged on the other side, as healthier and better people for the experience. So we are there, in order to keep our sobriety, we are doing service to give back what we have freely received.

  • Child Pornography – Part One

    Child Pornography – Part One

    manhattan_bridgePossession of child pornography is a felony under federal law, as well as every state. Because I am a recovery coach, I know some offenders, and I had some questions. I wanted to know more about these viewers of child pornography. Are they all potential hands-on offenders? Is this a victimless crime? What is the demographic of the users of underage pornography? I found there were some staggering statistics about child pornography. That billions of dollars are generated annually by child porn. The volume of pornography shared for free is incredible. That one image is all that is required to be convicted and eventually spending 15 years on probation under Megan’s Law. I wondered what were the costs to maintain the non-violent offenders of Megan’s Law, for life? This blog post, as well as others that follow, will explore the issues.

    How is child pornography viewed?

    Peer-to-peer (P2P) computer platforms are the most likely portal to view underage or child pornography. These are sites that share files for free. There are also for-profit pornography sites, which charge viewers a monthly membership fee. The for-profit pornography sites do list child porn sites, but are well hidden, because to do so is illegal. A person really has to dig and search diligently to find these child porn sites. Then there is the Dark Web.

    How does a P2P Network work?

    Peer-to-peer Networks or file sharing networks are vast global systems that can be located anywhere in the world. P2P networks are used by millions of people in order to acquire, for free, popular music, current television shows, movies, electronic books, and other digital material. The software allows users to log onto any P2P network and download files from other P2P network users.

    Limewire, Gnutella, or other file sharing programs are downloaded to your computer in order for you to view files. Users create copies of movies, book or photographs, and place them into folders that are accessible to other peers. Users search by using keywords, just like you search on Google, to find these folders. Type in what you are looking for, and these keywords are broadcast to the network of participating peers and again, just like Google, files appear below the search box.

    There are several reasons P2P networks are particularly attractive to child-pornography traffickers. First, child pornography on P2P networks is free. Any person with access to the Internet can connect to a P2P network. Secondly, P2P networks do not make use of servers, which means users can transmit illegal material without oversight from an online service provider like Google, EBay or NetFlicks. P2P networks are an anonymous way used to view, buy or sell anything online. The Dark Web, however, is more anonymous.

    What is the Dark Web?

    The “Dark Web” is an encrypted network that exists between Tor servers and their clients. These Tor servers are set up to be anonymous. After downloading a Tor browser bundle, clients can search the Dark Web, a supermarket of illegal activity, for drugs, weapons, murder for hire or pornography. For a porn addict, the Dark Web has anything that addict could want. Porn mixed with anonymous high-speed Internet is a lethal mix.

    Next week, I will discuss more detail the demographic of the average child-pornography viewer and the legal consequences.

    If you know of anyone producing, promoting or possessing child pornography, please report them through the National Center for Missing & Exploited Children’s CyberTipline: 1 (800) 843-5678

     

  • What kind of certification do I need to be a recovery coach?

    What kind of certification do I need to be a recovery coach?

    manhattan_bridge_post_versionI published my book Recovery Coaching – A Guide to Coaching People in Recovery from Addictions in 2013. Since then, recovery coach or peer-recovery specialist certification training has become one of the fastest growing aspects of the coaching field. So what kind of certification do I need to be a recovery coach?

    In 2013, the organizations that offer recovery coach or peer-recovery specialist training numbered around 50. Today, the number has grown to 250. Many state certification boards have established recovery coach and peer-recovery support specialist certifications. Yet, for many people that seek to be a recovery coach the qualifications, the training, the requirements for certification, or credentialing seem baffling. So I would like to attempt to clear up this confusion and will answer these questions in this post:

    • What is the process for certification as a recovery coach or peer recovery specialist?
    • What kind of certification should I be focusing on?

    What is the process of being qualified, getting training and then credentialed as a recovery coach or peer-recovery support specialist?

    If you are investigating becoming a recovery coach, I suggest you follow these steps:

    1. Research the training organizations that offer recovery coach training you can afford. Go to http://www.mkrecoverycoaching.com/recovery-coach-training-organizations/ for a list of addiction recovery coach training organizations
    2. Verify that you meet the qualifications to apply for the course (e.g. be 18-years-old, have a GED or high school diploma, one year sobriety from any addiction)
    3. Take and pass the course, retain the coaching certificate for future purposes
    4. Research places like Recovery Community Organizations or treatment centers to work or volunteer as a recovery-coach-in-training
    5. Apply to your state certification board for recovery coach certification (a fee may apply)
    6. Complete the recovery-coach-in-training supervised practice hours that are required by the state board
    7. Send in your application with paperwork verifying the completion of practice hours to the state credentialing board with a certification fee (fee varies for every state, from $100-$250)
    8. Receive your recovery coaching or peer-recovery support specialist certificate
    9. In the next 2 – 5 years take the required courses for renewing this certificate. Refer to your state board for more information on courses and renewal time frames. A renewal fee will be required.

    What kind of certification do I need to be a recovery coach?

    For an addiction recovery coach, the certification and training is prefaced with the terms: peer-support specialist, certified peer-recovery practitioner, recovery coach or peer-recovery specialist. Every state is different and every state uses different names for these certifications. Look for courses that offer the training needed for an addictions coach and a peer working with people in mental health recovery certification. It is the exact same training, in the same exact classroom, for two different jobs descriptions! It may be confusing now, and quite possibly the content and descriptions of  these courses may change going forward. But I would have to have a crystal ball to predict that for certain.

    I suggest you first take a certification training course. You can make the decision after the training is completed to apply for state board certification. As a coach if you are interested in being your own business person, certification by a training organization should be adequate. If you want to work in a treatment center, with a recovery community organization, social services agency or hospital, certification issued by the state’s certification board or the International Certification and Reciprocity Consortium (IC&RC) is required by the institution hiring you. If you want to carry professional liability insurance, or be reimbursed by Medicaid for your services, certification by a state certification board is mandatory.

    What is a state certification board?

    The process for receiving a certificate as a recovery coach is overseen by a state’s certification or licensing board. A state certification board tests and renews practitioner’s (coaches, therapists, nurses, etc.) certificates to ensure their knowledge is up to par. Also, that they have the ethical knowledge to practice in their profession. These processes for certification, such as training, educational requirements, exams and renewal guidelines, varies from state to state. These certification standards are recognized by health care companies, insurance companies, Medicaid, Medicare as well as companies that hire these practitioners.

    These state certification boards are the same boards that issue licenses or certifications for drug and alcohol counselors, and therapists. Some states have combined licenses and certifications boards all in one office, so it could be the same office in which nurses or hairdressers receive their licenses. I suggest you search the Internet for drug and alcohol certification for your state. Then search for the state board website for recovery coach or peer-recovery support specialist certification. As of May 2008, thirty state credentialing boards had developed criteria for the training and deployment of recovery coaches and peer-recovery specialists, so you should have no trouble finding these boards on the Internet.

    What is Reciprocity?

    Reciprocity is a term you will see used often on these board sites. When you are certified through your home state’s certification board, you may have the ability to transfer that credential to another state. This is called reciprocity. State certification boards may offer reciprocity to certified coaches in other states. The state boards have the authority to set reciprocity requirements for coaches to practice in their state. Not all certifications are eligible for reciprocity. It is vitally important that you investigate reciprocity guidelines prior to relocating to another state, because it can be a very complicated process.

    There are national and international recovery coach certifications available. In 2013, the International Certification and Reciprocity Consortium (IC&RC) developed a peer recovery credential. The application for the peer-recovery certification appears on the IC & RC web site. An IC & RC credential is accepted by many agencies and treatment centers when they are hiring recovery coaches.

    In next week’s post I will review what kind of training you need to have in order to apply for recovery coach certification.

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  • 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.

  • On the Role of Peers in Recovery

    This article was published in thefix.com on June 10,2015. Click here for the article:

    http://www.thefix.com/tags/professional-voices

     Do peers have a unique way of connecting with clients?

    As the treatment of addiction moves inexorably toward inclusion in the larger healthcare system, with its standards of evidence-based care, there is also a movement towards the use of peer counselors with “lived experience” with addiction. Are peer counselors able to connect with and help persons struggling with addiction in a unique way? Do the outcomes achieved in employing peers suggest that they should be more widely used, and supported by public funding? Melissa Killeen opens the conversation and highlights a case in which peer counseling played an integral role…Richard Juman

    A peer recovery support specialist has many job titles across the United States and around the world. They may be called certified recovery support practitioners, recovery advocates, peer mentors or recovery coaches. They tend to be employed at recovery community support centers, at hospitals, behavioral health agencies or addiction treatment centers. The peer recovery support specialist may be working with substance misusers, traumatic brain injury clients, behavioral health clients or clients that identify with all of these diagnoses. Certified peer recovery support specialists are generally employed by the facilities at an hourly rate for their services; for the client, peer recovery support services are typically free. In this article, I will focus on the peer recovery support specialists working in the addiction field.

    Recovery community support centers, financed with state and federal funding, some with funding from churches or individuals, are slowly taking hold and becoming more prevalent. The recovery advocacy organization Faces & Voices of Recovery, developed the Association of Recovery Community Organizations that unites and supports a growing membership of over 100 recovery community support organizations, although there are many organizations which have not yet become members of ARCO. For example, in my neck of the woods, there are currently 12 recovery community support organizations in Pennsylvania and 10 in New Jersey. Recovery community support centers can provide computer training, job interviewing skills training, resume writing, legal assistance, parenting skills training, social services linkages, 12-step meetings and even haircuts! It is important to highlight that these are non-clinical settings. Treatment is not provided—these are healthy places where people with current or past histories of addiction can go as an alternative to hanging out at a bar or on a street corner. Recent research completed by Chyrell Bellamy, MSW, PhD and Michael Rowe, PhD, both assistant professors at Yale University, concluded that working with peers in a recovery community environment may reduce alcohol use, drug use, and criminal justice charges for at-risk populations.

    In my view, the most important service that a recovery community support center offers is the assignment of a peer recovery support specialist or recovery coach to work with each client that comes to the center. At the outset, the peer recovery support specialist meets the client and sets up a schedule upon which the client and peer will meet. The format and structure varies widely, with some relationships based on daily phone calls and others on weekly face-to-face visits. The actual length of a coaching engagement will also vary. The McShin Foundation suggests that, as at the community recovery support centers run by the Virginia-based foundation, a 90-day limit is placed on the coaching assignment. However, other organizations, like the Hartford-based Connecticut Community for Addiction Recovery, does not place an arbitrary limit on the length of coaching time. Instead, it recommends that standards of goal achievement, like drafting a recovery plan, a relapse prevention plan and/or attaining sobriety goals, be used to determine the length of engagement.

    What do peer recovery support specialists actually do for their clients? Here is one example:

    In 2013, I helped create the first community recovery center in southern New Jersey, one of only a handful of recovery centers in New Jersey at the time. Heather Ogden-Busch was one of the first people we hired at the Living Proof Recovery Support Center in Voorhees, NJ. At the time, because she had many years of sobriety and experience in sponsorship, she naturally fell into the role of a peer recovery support specialist, or recovery coach. On Heather’s first day at the recovery support center she received a call from a member of her 12-step group. This member relayed the story about another member from the meeting, Beth (not her real name), who had relapsed on heroin. Beth was living in a trailer with her boyfriend, who was also addicted to heroin, and she was not doing well. Beth wanted to stop using. Heather called her immediately.

    At the time, Heather was aware that there was some really powerful heroin circulating in the Philadelphia/Camden region. Several young people had overdosed recently, including one of Heather’s sponsees. She relayed this information to Beth, and asked Beth what she wanted to do. Beth said she wanted to get out of her boyfriend’s trailer and go into rehab. She had no job, no money and no connection with her parents, with no possibility of financing a rehab stay. Heather and her colleagues at the Living Proof Recovery Center jumped on the phones to find a detox and a treatment center that would have an opening for Beth.

    Within one day, Heather had scheduled an intake appointment for Beth at a detox hospital in New Jersey. Beth would also have a bed reserved for her at a Christian-based treatment center in Brooklyn, NY, if she successfully completed detox. Luckily, Heather knew of another treatment center, also faith-based, in Chicago, with the financing available for the treatment as well as funding for the airplane flight.

    Beth was not particularly religious, but knew she needed treatment and agreed to go to detox then to treatment in Brooklyn. Over the weekend, Heather and Beth met together at the recovery center, called the detox hospital and went through the intake process. The same procedure was necessary for the Brooklyn treatment center. Heather and Beth made those calls together. By Monday of the next week, two days after Beth consented to go to detox, Heather had arranged for a sober friend to drive Beth to the northern New Jersey detox hospital. She also had arranged for the same person to drive Beth from the detox to Brooklyn when Beth was discharged.

    One week passed, and Beth was being discharged from detox. Unfortunately, the Brooklyn treatment center did not have an immediately available bed, but Beth was next in line for a bed as soon as it was available, in a few days. Beth had to return to her boyfriend’s trailer to wait for the call from the treatment center. Beth did not have a phone, so it was Heather that would field the call from the treatment center. Beth had at least three days to wait and hopefully, remain clean. Heather pulled in all of the support she could muster. Beth had escorts to every NA and AA meeting in the area. Members of the 12-step community drove Beth to Suboxone maintenance appointments. Every night, Heather and Beth talked. Every morning Heather called the treatment center to find out if the bed was available. By Wednesday morning, Beth and Heather were driving up the NJ Turnpike to Brooklyn, and Beth was still clean.

    The story doesn’t end there, because the job of a peer recovery support specialist is as important after the client comes out of treatment. Beth was in Brooklyn for 28 days. While Beth was working on her sobriety, Heather was lining up a room at an Oxford House, miles away from the trailer and the addicted boyfriend. Within one day after being discharged from the Brooklyn treatment center, Beth was in an Oxford House, had a temporary sponsor and was enrolled in an intensive outpatient program. Her parents were so proud of Beth’s achievements they had paid for the first two month’s rent at the Oxford House.

    Heather remained Beth’s peer recovery support specialist and required Beth to come to the recovery center every day to volunteer. Beth answered the phone, made copies, attended 12-step meetings, and learned about co-occurring disorders. She participated in a resume-writing workshop and a financial planning workshop. Beth got a job as a waitress at a local family-style restaurant that did not serve alcohol and for the first time she opened her own checking account. By her third month at Oxford House, she was able to pay her own rent.

    Heather guided Beth to enroll in a co-occurring program associated with her outpatient program. Beth now sees a therapist every week, and a psychiatrist monthly for her psychiatric disorders; because of her low income these services and her Suboxone treatment are free. She came to understand that her drug and alcohol usage was a form of self-medicating her mental illness. Nine months later, Beth remains an active participant in a local recovery support center and she is sober. Every month, her Suboxone dosage is reduced and she will celebrate one year clean from heroin in 60 days. Her goal is to be free from Suboxone and after one year of total sobriety, she can begin the 156-hour training to be a certified recovery support practitioner (CRSP), which is the peer recovery support specialist certification in the state of NJ (www.certboard.org).

    Melissa Killeen is a recovery coach, author of the first book on Recovery Coaching: Recovery Coaching a Guide to Coaching People in Recovery from Addictions and the recipient of the 2015 Vernon Johnson Award from the Faces & Voices of Recovery.

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  • How does a Recovery Coach work with a Treatment Team?

    How does a Recovery Coach work with a Treatment Team?

    manhattan_bridge_post_versionRecovery coaching services are starting to be more widely used, more often within the finest treatment centers. Yet, there are still addicts in crisis, or families with loved ones in inpatient substance-abuse treatment that are unaware that such services exist. Many therapists, re-unification specialists’ psychiatrists and LCSWs specializing in addiction treatment have not worked with a recovery coach, even though the recovery coaching profession has existed for over a decade. So it is important for more clinicians, outpatient coordinators, aftercare coordinators and other treatment professionals to understand how a recovery coach can benefit the client’s recovery and how the entire treatment team can work together.

    75% Will Relapse!

    Leaving an inpatient treatment facility, a client is very vulnerable to relapse during the initial days and weeks following their discharge. In fact, within a ninety-day period after discharge, seventy-five percent will have experienced one or more relapses (Godley, Dennis, Funk, & Passetti, 2002). Hiring a recovery coach can keep a client sober, and it is important to link a client to a continuing care program as early as possible. Both of these aftercare tools can be coordinated prior to discharge so the client can extend their sober life style after discharge.

    Research has shown, that coordinating this continuing care program does not guarantee a client will see a therapist, embrace a 12-step program or attend intensive outpatient treatment after discharge. This is where a recovery coach comes in. A recovery coach is called in to meet with the client either at the treatment center and then escort them home, or meet with the client at their home to take them to their first 12-step meeting, the continuing care program, or even therapist appointments. And always, the coach begins working with the client on their recovery plan.

    Who is the Treatment Team?

    Post discharge, or during outpatient treatment the Treatment Team consists of a variety of people, dependent on the client’s case. Key participants on the team can include the recovery coach, frontline clinicians and doctors from the treatment organization; the client’s primary care physician, psychiatrist or therapist; a staff member/social worker from a recovery-based agency or a representative from a community organization such as public housing; child protective services or any religious-based recovery program. The legal system may be involved so a lawyer, a probation officer, or a social worker assigned from the courts, the state’s drunk driving agency or child protective services can also be included. Many times the family is involved as well, whether it is a spouse, or in the case of an adolescent client, the parents or caregivers will participate on the team. (In all aspects of coordinating within the treatment team, a HIPAA disclosure form must be signed by the client allowing the coach and the team to discuss the client’s case).

    In early recovery, I cannot overstate the value of a recovery coach who is a hands-on partner and support person to help a newly sober addict learn all of the life skills that addiction robs from its victims. After 30-60 days in treatment, even a 45-year-old college-educated person has forgotten how to prepare and abide by a basic family budget; how to write a resume; how to do healthy things such as yoga; how to shop in a store and avoid the liquor aisle; have the confidence to walk into a 12-step meeting; or ask the right questions of a 12-step sponsor. These skills are not found in the “manual of the newly recovered” (a manual which does not actually exist). And even when such structure does appear in aftercare plans, sending an addict with 30 or 60 days of new found recovery out into the world to go forth and execute on such a plan is a big challenge, in many cases, one doomed to failure.

    The recovery coach will primarily be responsible for the provision of general treatment and recovery maintenance support in collaboration with the treatment team. The recovery coach responsibilities will include program support, connecting clients to recovery activities in the community, transportation of participants, helping clients get their basic needs met, assistance with navigation of the substance abuse, social services and mental health service systems, facilitation of attendance at support groups, or 12-step meetings and taking toxicology screens. The recovery coach can have daily contact with the client through telephone support and often meets weekly with the client in face-to-face sessions.

    David Loveland, PhD. and Michael Boyle, MA, wrote in the 2005 Manual for Recovery Coaching and Personal Recovery Plan Development an outline specifying that a recovery coach should also provide guidance to create a personal recovery. This personal recovery plan development is the first assignment a client completes when working with a coach.

    In order to work in the same manner that a clinician or a treatment center team member would expect, a recovery coach adopts the same system of notes, documentation and paperwork a clinician uses. The coach will provide the treatment facility and/or the client with documentation on billable services. The coach will complete thorough documentation or progress notes on the client’s recovery process, written in the guidelines required by the facility or that is acceptable to the clinician, such as DAP notes (data, assessment and plan). The coach will communicate frequently with the lead clinician and in the event of a crisis, more frequently with the team.

    Working through Potential Conflicts

    The role of a recovery coach is described in the Recovery Management and the Assertive Continuing Care models. These models may be new to most service providers and front line clinicians. It is important to address potential misconceptions and resistance that can be encountered by a recovery coach and the team. Here are some examples of potential conflicts between a recovery coach and the people they work with:

    • Establishment of clear guidelines of communications.
    • Who speaks to who — The recovery coach speaks to the client and the primary clinician
    • Everything a recovery coach discloses to the primary clinician is to be discussed with the team and the client
    • In the case of a relapse communication guidelines are to be established as to who in the team receives this information
    • Conflict between the treatment goals of the addiction treatment program and recovery coach can happen. It is best if treatment goals are discussed with the coach. The coach will defer to the clinician, most generally.
    • The team will establish guidelines or a contract with the client in the event there is the possibility a client will leave treatment against medical advice/orders (AMO) or be administratively discharged.
    • Sometimes there are ideological conflicts between the professional-based primary addiction treatment model and the strengths-based model, the Assertive Continuing Care or the Recovery Management model used by recovery coaches. These conflicts should be discussed with the team.
    • Rules within treatment facilities may conflict with recovery coach services, such as signing a HIPAA agreement, leaving a therapeutic group to work with a coach, working on other issues before completing specific phases of treatment or treatment programs that discourage working with other people during treatment. The coach is encouraged to work through these differences as best they can.
    • Changes in peoples’ treatment needs as a result of receiving recovery coaching services during a waiting period (e.g., no longer needing residential treatment after achieving some success with a recovery coach and the client can move to a PHP or IOP program).

    As a recovery coach, I enjoy working with a treatment team, and doing so allows me to work with a “net” while bouncing ideas or concerns off of an actively involved person with great interest in the client’s well being. When I am introduced to a clinician and team, it is often the first time the clinicians have worked with a recovery coach. If I am able to speak to the lead clinician prior to beginning a contract, I attempt to do so. Often, I attend the therapeutic sessions, after the client has their sixty-minute session, I will enter the room and spend a half hour or so discussing things with the client and the clinician. At other times, there are separate meetings with the treatment team that do not include the client. Frequently, there are daily and sometimes hourly conversations, text messages or emails with the lead clinician. Every assignment varies.

    The availability of recovery coaches is increasing. Clients can find recovery coaches for free or can pay anywhere up to $250 per hour for a coach. Many coaches have a website and can be found by using a search engine such as Google’s. There is an organization of Recovery Support Centers (http://www.facesandvoicesofrecovery.org/who/arco ) that offer free recovery coaches to clients. Often a treatment center has a recovery coach suggestion.

    In the end, the clinician, lawyer and client will benefit from the collaboration of the recovery coach with the treatment team, and often the coaching relationship with the client continues.