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Recovery Support Services |
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Faith, Compassion and Recovery Support Section Headings:
“One of the most clinically significant breakthroughs in the modern addictions field is the recognition that there are multiple legitimate pathways of long-term recovery from severe alcohol and other drug problems. These pathways can be broadly categorized into frameworks of resolving problems that are: Religious, Spiritual, and Secular. Interest is increasing in explicitly religious frameworks of recovery due to: 1) dramatic growth of recovery ministries and 2) President Bush’s recently implemented program Access to Recovery (ATR).” William White and David Whiters, “Faith Based Recovery: Its Historical Roots,” Paradigm Shift A paradigm shift has taken place in the addictions field that is changing the perception of addiction from an acute health crisis such as appendicitis, to a chronic disorder like diabetes that requires various levels of long-term care and support. This new paradigm defines treatment as an event within the larger long term process of recovery. The goal of treatment is typically stabilization and the absence of symptoms of a clinically defined substance use disorder commonly called addiction. The goal of recovery is holistic health which comes about over time, happens out in the community and involves many types of Recovery Support Services provided by many types of groups. Addiction professionals refer to the services needed to impact substance abuse as a “continuum of care.” Four major areas are included: Prevention, Detoxification, Treatment and the newly designated category of “Recovery Support Services” (RSS) which includes a broader range of services than activities referred to as “Aftercare”. Clinical Treatment is often understood as a system of professional addiction protocols and practices that mirror the medical and mental health fields. These practices were developed to address the unique needs of addicted persons seeking help. Components of Treatment typically include: intake, clinical assessment, treatment plans, medical detoxification, behavioral therapy such as counseling, cognitive therapy, or psychotherapy, medication as needed, in addiction to clinical case management and referral to medical, psychological and social services. Clinical Treatment often includes Evidence Based Practices (EVPs) based on research that are delivered in various settings like in patient, out patient, and through brief interventions. Recovery Support Services are designed to 1) support people during treatment, 2) help people to begin and/or sustain recovery from alcohol and drug abuse and 3) deal with related problems by providing support services. RSS are often low-cost or free, such as peer-support groups, recovery mentors/coaches, recovery check-ups, etc. which can be delivered in non clinical settings. Need for Expanded Services State and national governmental agencies dealing with substance abuse and mental health are exploring ways to promote the expansion of RSS because research has clearly shown that these services help people to achieve long-term stable recovery. The Center for Substance Abuse Treatment (CSAT) reports that 23.6 million Americans need treatment services while only 2.5 million people receive treatment. The resulting “gap” is 21.1 million people struggling with addiction issues who often come in contact with community or faith based organizations that can point the way to recovery. Effective public health strategies take a variety of informed community resources. Faith Based Contributions Many churches, synagogues, mosques, grassroot ministries, and other faith-based organizations (FBOs) have traditionally been involved with activities that provide for the physical and social support of people in need or in crisis, including natural disasters. These services have been called by various names such as mercy or rescue missions, relief, outreach, benevolence or compassion ministries. Proper assessment reveals that a great majority of people receiving “benevolence” or faith based social services are affected by substance abuse and its host of negative effects: hopelessness, family breakdown, domestic violence, crime, incarceration, underemployment, poverty, mental illness, homelessness, academic failure, etc. People rebuilding lives devastated by addiction often need empathetic, caring services that attend to distressing life circumstances. They are now being valued specifically as “Recovery Support Services”. In Florida, FBOs provide approximately 1,500 to 2,000 recovery beds in a variety of independent programs with little or no name recognition or government funding. Federal and state governments typically do not define “faith based” but allow an organization or individual to self identify. One distinction of FBOs pertains to the MOTIVE for providing services, which may be stated as personal religious commitment, denominational mandate, spiritual calling, and/or social justice issues. Another distinction is the METHOD of providing services, which may or may not include religious and/or spiritual materials and activities such as prayer, meditation, religious studies, worship, etc. Some FBOs with historic religious roots or names may have adopted strict clinical protocols that now make them indistinguishable from secular agencies. Florida has FBOs that provide clinical treatment. Many are individuals licensed under Chapter 491, Florida Statutes, as a Licensed Mental Health Counselor (LMHC), Licensed Clinical Social Worker (LCSW), or Licensed Marriage and Family Therapist (LMFT) and run their own agencies that effectively integrate faith based methods. Historically, FBOs have a long tradition of providing direct services to addicted people and their families. Recognized organizations include the Salvation Army, founded in 1880, which operates Adult Rehabilitation Centers (ARC) to address recovery from substance abuse. Florida has six ARC’s which serve 6,000-7,500 people annually along with other Salvation Army centers that care for significant numbers of people with substance use or co-occurring problems (co-existing mental and substance use disorders) within their general client populations. In 1913, a former alcoholic and violent criminal named Jerry McCauley, who found recovery through his personal religious conversion, began the Water Street Mission in New York City. (White). Today, 295 Rescue Missions in North America serve the poor with 13 million lodging nights every year and 19,000 people graduate from rescue mission drug rehabilitation programs annually! Florida has ten affiliated missions. The Association of Gospel Rescue Missions has launched a DETC accredited online Bachelors degree program in faith based addiction counseling created by the NET Training Institute located in Orlando. Teen Challenge, which began in 1961, has 170 long-term residential recovery programs serving 10,197 people each year internationally. Florida has nine programs serving over 500 people. Teen Challenge staff and volunteers provided over 960,000 units of service in outreach programs in jails and prisons, in addition to prevention efforts in schools and churches. Since the late 1980’s, more FBOs are sponsoring support group programs like Alcoholics Victorious, Turning Point and Overcomers. “Celebrate Recovery” groups are offered in 3,500 churches each week in the United States. This indicates a commitment of time and staffing that goes far beyond providing space in the “basement” for traditional 12 step programs like Alcoholics Anonymous. The Johnson Institute co-sponsors “Faith Partners” which mobilizes recovering people for service within their own congregations. Recovering people now have more options than ever before to explore and reconnect with their religious roots and pursue their own spiritual journey and personal growth. “So Help Me God” was the most popular event and white paper ever presented by the National Center on Addictions at Columbia University in New York City (CASA). The World Health Organization measures six domains of recovery: physical, psychological, independence, social, environmental and spiritual (Betty Ford Institute Recovery Consensus Panel, 2007). The restoring power of spirituality in recovery is well documented across faith traditions. Access To Recovery: Outcomes and RSS In 2004, a federal program called “Access to Recovery” (ATR) provided unprecedented opportunities for faith based organizations across the nation to partner with their state governments and other community agencies to provide a range of Recovery Support Services. Clinical assessment defined levels of client care. Genuine, free and independent consumer choice was ensured through the use of a voucher for clinical treatment and/or recovery support services offered through state recognized provider networks. Florida was among the first cohort of 14 states and one tribal organization to receive ATR funding. Part of Florida’s success was based on a workgroup and collaboration between several strong FBOs and the Florida Alcohol and Drug Abuse Association (FADAA), the Southern Coast Addiction Technology Transfer Center (SCATTC) and the Florida Certification Board (FCB). The Florida Department of Children and Families Substance Abuse Program Office provided notable leadership in implementing this unconventional program. Accomplishments include:
National Outcome Measures, or NOMS, www.nationaloutcomemeasures.samhsa.gov, were used to track the progress of ATR clients in seven “Domains”. The domains were: abstinence, social connectedness, family and living conditions, employment and education, criminal justice involvement, access to and retention in needed programs and services. Positive outcomes in these domains required states to organize effective RSS. Technical assistance helped ATR providers to focus their services, utilize an online voucher system, incorporate documentation and adhere to federal Health Insurance Portability and Accountability Act (HIPAA) regulations. Use of “Recovery Coaches” in two districts improved client outcomes. Through ATR’s voucher program, Florida offered the following Recovery Support Services: Transitional Living Facilities, Support Groups, Support Counseling, Family Support/Parenting, Supportive Housing/ Living Services, Employment Coaching, Alcohol/Drug Testing (Urinalysis), Recovery Coaching, Recovery Support Services / Care Coordination, Transportation, Daycare, and Incidental Expenses. The following RSS definitions from CSAT include four (4) categories that proved useful to Florida’s providers as they were organizing their services with the ATR framework: Emotional Support
Informational Support
Instrumental Support
Companion Support
When clinical treatment, the recovery community, the faith community and government work together, people have more options for recovery/change and more families receive care. The array of available services and ministries increase as creative resources and human potential are tapped through new partnerships and collaborations. Across the nation, there is a growing synergy between clinical treatment and recovery support services that are grounded in a strength-based approach that focuses on wellness and full reengagement with the community. These services build on capacities that already exist within communities and involve many supportive people motivated to serve over an extended period of time. Building on a long tradition of service to addicted people and their families, faith based individuals and organizations are finding new ways to work within the continuum of care. Hope is increasing thanks to a new definition of practical care and a powerful paradigm shift whose time has come. |
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