Recovery principles: challenges for practitioners

Recovery principles and challenges to practitioners (Best, 2012)

Recovery principles turn the system of care and treatment for substance misuse on its head - from provider-led to user-led:

– Substance misuse was seen as a ‘disease’.

– Then it was seen as a public health threat (e.g. AIDS, Hep B & C) emphasising harm reduction.

– Then the focus was on getting people into treatment, reducing associated crime. Hitting targets for treatment ‘completions’.

Recovery principles and challenges to practitioners (cont.) (Best, 2012)

• The recovery approach means the focus is now on ensuring access to a range of treatments at all the stages of recovery – from pre-contemplation of change to maintaining abstinence or reduced harm use.

• So, at every level of access to help agencies, practitioners need to be able to facilitate movement to the next step...

A stepped approach to an individual seeking help: a possible journey to recovery

Engaging

with help

Contact with help

Wanting to change

Using harmfully

A stepped approach to help for professionals: at what stage would you be able to help?

Accepting referr

al

Asking someone

Having more information about it

Encountering opportunistic brief intervention

Challenge for the person with a substance use problem

There are barriers to access that come from the person themselves:

– They may have suspicions about engaging with services.

– They may have little expectation of themselves in being able to change.

– They may expect ‘traditional’ approaches to treatment – ‘you get what you’re given’!

So, a stepped approach (Laudet, 2007; White, 2009)

In brief, evidence suggests that there may be three stages to being in recovery:

• Early stage recovery– Where someone is looking for support and needs guidance.

• Later stage recovery– Where someone is comfortable in working their own journey and

making their own decisions.

• Possibly established, long term recovery – Where someone has found out what works for them and is the

expert on their recovery journey.

The challenge for the practitioner

• At whatever step a person may encounter help, the practitioner needs to appreciate where the person is on their journey of recovery.

• It helps to consider the stages of change, where the person thinks they are in the change process, and discuss with them what help they will accept – rather than what you think they need!

References• Best D (2012) Addiction Recovery. Brighton, Pavilion.

• Laudet A (2007) What does recovery mean to you? Lessons from the recovery experience for research and practice. Journal of Substance Abuse Treatment. 33, 243-256.

• White W (2009) Peer based addiction recovery support: theory, practice and scientific evaluation. Great Lakes Addiction Technology Transfer Center and Philadelphia Department of Behavioral Health and Mental Retardation Services. Chicago. Available at: http://findings.org.uk/PHP/dl.php?file=White_WL_19.txt