Phil Valentine1
(1)
Connecticut Community for Addiction Recovery, Hartford, CT, USA
Phil Valentine
Email: ccar2005@ccar.us
Abstract
The Connecticut Community for Addiction Recovery (CCAR) has a rich history as a lead Recovery Community Organization. This chapter describes CCAR’s evolution from a pure advocacy organization to a provider of peer-based recovery support services. A key part of this story is the development of recovery community centers (RCCs) that are a grassroots model, conceived in the idea of a “field of dreams – build it and they will come.” CCAR’s experience has certainly proved this to be true. And powerful. RCCs have served as the hubs where an impressive array of peer-based recovery support services were designed and delivered. For example, in 2008, 276 volunteers contributed more than 13,000 h of service mostly within the walls of RCCs. 24,951 outbound phone calls were made by Telephone Recovery Support Calls to 1,285 recoverees. As the CCAR Recovery Coach Academy continues to graduate more and more recovery coaches, the impact on local communities and Connecticut’s recovery-oriented system of care will grow through the continued infusion of the language, culture, and spirit of recovery from alcohol and other drug addiction. The chapter will close on CCAR’s observations and experience with the healing power within communities of recovery.
Introduction
Peer-based recovery support services are activities provided by a volunteer force dedicated to helping and facilitating recovery from alcohol and drug addiction. During the past 12 years, our Connecticut organization has taken significant strides in designing, developing, and implementing these services to the point that in 2009, 268 volunteers contributed 14,697 h of service, and made 36,865 outbound support calls to 1,420 recovering persons, contributing the equivalent of $378,448 in service provision. This chapter describes in detail the origins, growth, and impact of this recovery community organization – the Connecticut Community for Addiction Recovery (CCAR). First, the spark that started this enterprise is described, followed by a brief history of how initial grassroots advocacy grew into vital and meaningful service provision in the heart of the community. This is followed by a description of the Recovery Community Center (RCC) and its ingredients and activities and how such centers can serve as a powerful adjunct to formal treatment services at the local and state level.
The Beginning
I have a dear friend, his name is Arno, and I have dubbed him Shortcast because he doesn’t cast very far when he’s fishing. He fishes in the first wave or just beyond and (I’d never tell him this), he usually catches more fish than me. Every October my buddy Shortcast and I head to the hallowed fishing rounds of Race Point, Provincetown at the end of Cape Cod to get in on the fall migration of the famed striped bass. I left last Saturday afternoon and returned Wednesday. The fishing was spectacular and the weather even more so.
Seems that with our impeccable timing (I say sarcastically), we chose a few days when a couple of tropical storms merged in the Atlantic and descended upon the Cape. One day, we had driven oversand out to the point. Race Point is a huge sand bar and the water moves quickly past it at all times, now add those high winds and you have some torrents! It was frothy, foamy, wild, wild water… I have never seen conditions like this, before or since. Twenty foot rollers steamed by. Rain and sand blasted the truck as it shook in the wind. Arno and I are very bright, intelligent fisherman, deeply devoted to our passion. I looked at Arno and said, “I ain’t going out there.” He said, “Me either.” He turned on the radio.
There was only one other truck foolish enough to be on that tiny strip of sand. We watched in amazement as some very old guy struggled to open the truck door, grab a rod, and fight his way to the edge of the raging torrent. Crap, we’re going to have to rescue him. With great effort, he made a cast, and as soon as his lure hit the water, he hauled back. Fish on! Arno and I looked at each other and being brilliant fisherman, we both yelled “Let’s go!” We caught fish for hours and hours. As other guys drove up and saw us catching, they too, started reveling in the fantastic fishing. We remember it now as one of the best days of surf fishing we have ever experienced.
The CCAR would never have started if some guy did not test the water and take the first cast. That man, a pioneer in the field of establishing recovery community organizations, is Bob Savage. Bob founded CCAR. He had a 30-year career in Connecticut’s state treatment system and when he retired, he set out to answer a couple questions that had nagged him while in public service.
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Working from his home and having his expenses covered by the New England Institute of Addiction Studies (NEIAS), Bob traveled all over Connecticut and New England, speaking wherever he could to rally the recovery community. He began holding monthly Chapter meetings in Connecticut that ultimately evolved into CCAR, while also getting the New England Alliance of Addiction Recovery (NEAAR) going as well. With this effort, he garnered funding from the CT Department of Mental Health and Addiction Services (DMHAS), and then was able to write a successful grant to the federal government for a Recovery Community Support Program (RCSP) under the Center for Substance Abuse Treatment (CSAT), Substance Abuse Mental Health Services Administration (SAMHSA).
Bob was vital to the development of the recovery advocacy movement in New England. The Savage legacy leaves behind many lessons that are still guiding CCAR today: Pick a few things and do them very well. Don’t try to do everything. Quality counts.
· Family, family, and more family. Family members have the potential to be the recovery advocacy movement’s most powerful constituency.
· Be an ally of the Single State Agency. Work with them, not against them.
· Pay people in recovery well. Value their experience. If a recovery community organization doesn’t pay people in recovery well, who will?
· We have a right to be heard and to speak even when it’s uncomfortable to voice our opinions.
· Tenacity works.
· Integrity matters.
· Treat your Board with utmost respect.
· Hire carefully and take your time when hiring.
· Address all personnel situations in reasonable time frames. “20 min of intense discomfort is a small price compared to months, or years, of prolonged pain.”
· Seek help on special issues from people who have more experience than you in a given area.
· Share your challenges as well as your successes.
· Surround yourself with great people.
· The art of true delegation – give someone a task or a project and let them do it.
As CCAR grew, Bob began hiring people as funding allowed. In January 1999, I, Phillip Valentine, was CCAR’s first hire and started as the Associate Director. I think my story of how I was hired lends itself to the spiritual component inherent in this movement. A few months before I heard about the CCAR job, or a new recovery movement, there was a crisis in my marriage. I had been out of full time work for more than 2 years, staying at home with two very young children, while Sandy was working full time at a major insurance company. The crisis was that she wanted to be home with the kids. We sought out marriage counseling to sort out how we were going to do this and the marriage counselor asked me a very provocative question that changed the course of my life. She said, “Phil, you have about 30 good years left, what are you going to do with them?” I started looking hard for a job, any job. I was working the floor at Dick’s Sporting Goods when I interviewed with CCAR. I was hired even though I had little knowledge of treatment or recovery advocacy. All the acronyms baffled me. I quickly absorbed everything I could and discovered that my personal experience with recovery (largely outside of any formal treatment setting) was a valuable and desperately needed voice. This was driven home on my very first day on the job. Bob wanted me to go to the LOB and attend a parity meeting. First, I sheepishly asked, “What’s the LOB?” The Legislative Office Building. “Oh, where’s that?” Next to the Capitol. “Oh, I know where that is… what’s parity?” I made the meeting, quite nervous and insecure not knowing what to expect. There were many people with suits and long initials after their names. The conversation turned to recovery support services and the chair asked me what I thought. I said, “Well in my recovery program, we’re told to go to 90 meetings in 90 days.” I looked around and people were furiously writing. Then they wanted to know more and as I answered their questions, it became apparent that not only did I personally have something to offer, the recovery community needed to be at these tables.
The Early Years: Planning and Organizing
In the early years, we spent all our time organizing. This is a key point. Bob had traversed the state for 2 years and then I joined him. We talked to individuals, groups, sat in on all types of meetings and we gradually established a solid group of volunteers who formed our core and were instrumental in “putting a face on recovery.” CCAR continues to be successful with our advocacy efforts that were started in the formative years.
Frequent speaking engagements – CCAR makes presentations to a variety of audiences such as community organizations, treatment providers, prisons, the legislature, state agencies, etc. The presentations demonstrate to the public that people in long-term recovery do exist. We hold jobs, pay taxes, raise families, and have a voice when it comes to the public’s perception about alcohol and other drug addiction. These presentations also serve as outreach to those who may need recovery support services early in their recovery and to attract persons who may want to volunteer their services for CCAR.
Recovery poster series – Posters were developed using with recovery messages such as “Harvesting the Power of Recovery,” to show the positive aspects of a life without alcohol or other drugs.
Cable public access TV shows – CCAR began using local resources, i.e., local public access TV in 2005 and has aired hundreds of personal stories of recovery.
DVDs, videos – CCAR has developed three video series that capture the lives of persons in recovery. Our first video, Putting a Face on Recovery, featured CCAR members telling their stories of recovery. The second, The Healing Power of Recovery answered the question “Would it be possible to capture the healing power of recovery on video?” This was the question CCAR asked us after the tremendous healing experience of Recovery Walks! 2001, held just 5 days after the now infamous 9/11. On September 16, 2001, over 2000 people gathered at Bushnell Park in Hartford and initially shared their confusion and grief over the tragedy. Yet, as the day progressed, the hope and resiliency of recovery surfaced and brought the walk experience into a dimension of quiet determination and community healing. Our latest project, The Legacy of Hope: Recovery Elders Video Project, documents the lives and recovery stories of people in ultra long-term recovery; i.e., people with 20, 30, 40, or more years.
Recovery Walks!, Rally for Recovery [Faces and Voices of Recovery (FAVOR)] – Every year CCAR hosts a Recovery Walks! event in Bushnell Park, in downtown Hartford. From 700 our first year, to almost 2,000 last year (2009), people are taking notice! The message that “Recovery is possible” is gaining momentum in Connecticut and influencing citizens, legislators, and most importantly, those with addictions. Faces and Voice of Recovery helps raise the national profile of the recovery community by supporting these Recovery Month events collectively called, “Rally for Recovery” where many thousands support recovery from alcohol and other drugs.
CCAR website http://ccar.us – Our website updates information regularly on purpose of a recovery community organization, trainings, events, and resources.
Today, our elevator speech has evolved to this: CCAR organizes the recovery community to: (1) put a face on recovery and (2) provide recovery support services. CCAR has a rich history of advocacy in that we
· Wrote the Recovery Core Values along with Advocacy Unlimited that became the foundation for the Commissioner’s Policy # 83: Promoting a Recovery-Oriented Service System.
· Helped turn “Heroin Town,” a negative Hartford Courant newspaper series, into “Recovery Town.”
· Educated the legislature about the Pardons Process where significant changes have been made.
· Assisted DMHAS through some “Not in My Back Yard” (NIMBY) housing issues associated with Access to Recovery (ATR).
· Involved in FAVOR issues – restoration of RCSP funding, HBO Addiction documentary, insurance discrimination.
About 4 years into our existence, our federal grant program shifted its focus from Recovery Community Support to Recovery Community Services. One wonders if our collective advocacy effort worked so well that the government felt the pressure and shifted to recovery support services. The shift proved to be a blessing. At the time, we were wrestling with a very simple but deep question asked by our membership, “what can I do?” We were often stretched to find something meaningful. They could tell their story (when and where?), or they could attend a Chapter meeting (and then?), etc. You catch the drift. There was also a segment of our membership that wanted to be of service, they wanted to provide support, give rides, lend a listening ear, mentor, etc., and we didn’t have those opportunities available. So when the Recovery Community Services Program (RCSP) switched from Support to Services, we resisted at first and then began to see how this could really be of benefit. We started slowly and as we grew into the delivery of support services, they became much more defined. Now we have volunteer opportunities for those who are wired for advocacy and those who are wired for service. You may describe advocacy as peanut butter, services as jelly – separate, they are each very good, put them together and you have something special.
Foundational Principals
As CCAR developed, an ethical framework gradually emerged that we refer to as “foundational principals,” that steers our work. They are given below.
You Are in Recovery if You Say You Are
Early on CCAR held a series of day-long planning meetings once a month on Saturdays. We debated how CCAR would define recovery and tried to answer questions like “Is abstinence a requirement of recovery? What about medication? What about methadone? Should there be an amount of clean time required for participation and/or membership? How would we determine who was clean and who was not? Drug tests? (we think not). At times, these issues elicited strong, emotional responses. Someone suggested that we base our definition of recovery somewhat on the definition of membership put forth by Alcoholics Anonymous – “all that is required for membership is a desire to stop drinking.” Who determines if a person has the desire? The person. Who determines if a person is in recovery? The person in recovery. Finally, we concluded that “you are in recovery if you say you are.” When I mention that definition to researchers they scoffed and dismissed it, but there’s a lot more to it than would seem apparent at first blush. This definition has served CCAR well over the years. Not to say that it hasn’t been tested. What do you do when a person volunteering at one of our Centers seems to be under the influence (odor) but insists that they are in recovery and their behavior is appropriate?
On the same track, CCAR has never formally defined membership. Our members are people who have agreed to be on our mailing list. Paid membership was something we batted around, but never saw a way to do it. Paid membership also seemed to run contrary to many of our recovery backgrounds. Recovery is free. We decided as an alternative that running an Individual Giving Campaign would give those who wanted to contribute financially the opportunity to do so. We did not want “money” to define membership. We also believe that “you’re a member if you say you are.” Our vision and mission portrayed through frequent presentations attract many people to our organization.
There Are Many Pathways to Recovery
I admit it, I didn’t always believe this. As I mature in recovery, or maybe just mature, I have become much more receptive to alternative pathways. I have seen this on many instances, one experience still resonates. I was facilitating a training, 12 Steps and Religion: Adversaries, Strangers, or Friends, and we had a very diverse audience. There were two African American women in attendance who during introductions said they were in recovery for more than 20 years each. Their eyes were lit up and they talked about the recovery ministry they were leading at their church. As the discussion ensued, a man from a 12-step program challenged them that they were not really in recovery because they hadn’t attended any meetings in many years. Their pathway was the church and as far as CCAR is concerned they are in recovery because… they say they are!
The CCAR philosophy is that “our tent is big enough for everyone.” We don’t really pay attention to what your illness is, your drug of choice, your recovery support, the medication you may be on (or not on), etc. “You are in recovery if you say you are” and you are welcome. Our thriving all-recovery groups support this notion. As a result, we have become an incredibly diverse organization.
Focus Is on the Recovery Potential, Not the Pathology
People that frequent the CCAR RCCs do not go through a formal assessment process of any kind. When someone enters they usually find a volunteer, or other person in the Center, and have a conversation. “What’s going on? What are you looking for? How can we help you?” CCAR’s intention is to help move someone along the road of recovery. We don’t ask what they are recovering from. In 2007, DMHAS was convening a co-occurring conference and was looking for people with co-occurring disorders to speak. A flyer was posted in the Hartford Center. Six people, all regular CCAR volunteers, signed up. We had no idea they were “co-occurring.” They were here working on their recovery while serving and helping others.
Err on the Side of the Recoveree
This is the essence of a person-centered approach. Do you strictly follow the established policy or do you do what you believe is best for the individual knowing that it goes against a policy? Methadone clinics are often forced to choose between these two. CCAR introduced the term recoveree (refugee, employee), coined by Melissa Scheffey, an Administrative Assistant in the early years, to describe a person in recovery. We refrain from using terms like client, patient, consumer, etc.
Err on the Side of Being Generous
When on the fence about making a decision, CCAR asks what the generous thing to do is and that often steers us in the right direction. This principal also supports a person-centered approach. A CCAR staff member (also a person in recovery) says, “I refer often to the “Am I being generous?” question when working with recoverees both in my personal life as well as in CCAR. The easier decision is to play it cautious when faced with a decision if I am concerned someone might be taking advantage or if I question what I suspect might be their real motive. I know what kind of thinking can be behind the actions of recoverees because I am a recoveree. However, when I err on the side of being generous I am giving someone the chance that was afforded to me to do the next right thing. In the process I am changing my own thinking to that of optimism and hope rather than pessimism and doubt. I am also subscribing to the belief that good works multiply.”
Before we discuss specific services CCAR has developed we offer this abbreviated table of Milestones to give you an idea of our evolution (Table 14.1).
Table 14.1
CCAR milestones
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1997 |
CCAR holds Connecticut’s first Recovering Community Organization meeting |
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1998 |
Receiving funding from CSAT’s Recovery Community Support Program laid a financial foundation that was later supplemented by funding from the Connecticut Department of Mental Health and Addiction Services (DMHAS) |
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2000 |
Our first Recovery Walks! held in 2000 was another early milestone and an idea that came from the recovery community. We had never heard of a walk in support of recovery from alcohol and other drug addiction. We did some internet research and found one walk/run for a treatment center in the DC area, so we decided that if we held a walk and 50 people showed up, we would be successful. 700 showed up for that first walk. Currently walks for recovery are held coast to coast. That’s an incredible breakthrough. Recovery is truly becoming more visible |
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We wrote the Recovery Core Values in collaboration with mental health recovery advocates that became the cornerstone of Tom Kirk’s (DMHAS Director) policy on a Recovery-Oriented System of Care that has become a national model |
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We produced a couple videos that are still pertinent and powerful today – Putting a Face on Recovery and The Healing Power of Recovery |
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We held our third Legislative Day and a few legislators revealed for the first time publicly their own personal recoveries |
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2004 |
Opened our first Recovery Community Center in Willimantic. This was in response to a high profile series of newspaper articles in the state’s largest paper, The Hartford Courant, labeling Willimantic “Heroin Town.” We like to say that a few years later, CCAR has had a hand in turning Heroin Town to Recovery Town |
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2005 |
New London Recovery Community Center opened (#2) |
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Another milestone was starting our Recovery Housing Project that inventoried the state’s independently owned, privately operated sober houses, established a coalition, wrote standards, and delivered training |
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2006 |
Bridgeport Recovery Community Center Opened (#3) |
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Hartford Recovery Community Center opened (#4) |
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2007 |
Telephone Recovery Support Program funded. Recoverees receive a phone call from a trained CCAR volunteer once a week for 12 weeks to support the recoveree’s progress. The average time period that each recoveree is involved in Telephone Recovery Support is 20 weeks |
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2008 |
CCAR formed the Recovery Technical Assistance Group (RTAG) to provide consulting, technical assistance to recovery community organizations and other entities |
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The first Recovery Coach Academy was held, a 7-day training that drew 30 participants in a “learning laboratory” model |
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2009 |
Held the fourth annual Volunteer Recognition and Celebration dinner with Mark Lundholm. 209 people attended, 108 of them volunteers, and 27 Presidential awards were given |
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CCAR earned a $100,000 contract from the CT Department of Correction for the Re-entry and Recovery Project for people in the Hartford parole district |
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Recovery Walks! celebrated its tenth anniversary |
The Recovery Community Center
As CCAR shifted from all advocacy to delivering peer-based recovery support services, it became rapidly apparent that we needed a place to operate from. Many of us had seen the movie “Field of Dreams” where Kevin Costner’s character heeds a spiritual whisper “build it and they will come.” We listened to the voice of the recovery community and built our first one in Willimantic, opening up the first floor of a multipurpose house on Main Street. And they started to come. In our first year of operation, our log book had more than 10,000 sign-ins. This is a duplicated number, but is an excellent indicator of the amount of foot traffic this Center generates. In 2009, our four sites drew more than 35,000 visits. So what is a RCC? CCAR was asked this question a lot, in fact, several states have traveled to Connecticut to experience our model. In response to the question, CCAR developed the Core Elements below.
Core Elements of a RCC: Overview
A RCC
· Is a recovery oriented sanctuary anchored in the heart of the community.
· Is visible so local communities of recovery can actively put a face on recovery.
· Serves as a physical location where CCAR can organize the local recovery community’s ability to care, specifically through the provision of a variety of recovery support services.
· Provides peer-based recovery support services using a volunteer force to deliver a vast majority of these services.
· Attracts people in recovery, family members, friends, and allies to serve as CCAR volunteers, who in turn help those coming up behind them.
· Fosters the inherent nature of the recovery community (people in recovery, family members, friends, and allies) to give back.
· Functions as a recovery resource for the local community.
· Is a location where, sometimes, people still struggling with addiction will enter and the RCC will help them navigate the system.
· Is a place to find workshops, training and educational sessions to enhance one’s own recovery.
· Maintains a structured schedule of recovery-related workshops, trainings, meetings, services, and social events.
· Hosts and promotes recovery social events.
It’s important to note what an RCC is not. An RCC is not a treatment agency – no clinical services are provided. An RCC is not a 12-step club. An RCC is not a drop-in center. An RCC is not a place for people to simply hang out, watch TV, and play cards/pool. CCAR is not seeking to duplicate existing resources. Recoverees in the Center are actively working on their recovery, or helping another person with theirs.
CCAR developed these Core Elements of a RCC based on our vision and experience.
Site
· A RCC should be at a minimum 2,500 square feet and have these standard areas:
· Group/Training room that seats a minimum of 50
· Computer room that can comfortably hold at least four computers (high-speed internet capable)
· Two offices: one for the RCC Manager and the other for additional staff
· Reception area
· Telephone Room, private for making Telephone Recovery Support calls with at least three phones and phone lines
· Lounge area for reading, socializing
· Kitchen area
· Location. CCAR believes by having a prominent, visible location whose sole purpose is to promote recovery, we literally bring recovery from church basements onto main street. The location should also be easily accessible to those without personal transportation.
· An RCC should be handicapped accessible.
Administration
· At a minimum, an effective RCC needs the following staff:
· One full time RCC Manager. Ideally, this person will be intimately familiar with the local recovery community and knowledgeable of all local social services, businesses, faith organizations, and neighborhoods.
· One RCC Assistant Manager (note: CCAR received a Connecticut State grant to provide Telephone Recovery Support so this position is filled by the Telephone Recovery Support Coordinator)
· One Administrative Assistant
· The RCC Manager will be given an annual budget to provide programming, training, workshops, and social events.
· The staff and selected volunteers of an RCC will participate in local and statewide fundraising activities.
Programming
· All program efforts at an RCC are overseen by the CCAR paid staff and volunteer force, and significant input is gathered from the recoverees at the RCC, the volunteer force, the RCC Advisory Council and the local recovery community.
· Programming is determined through three sources:
· CCAR Management Team
· CCAR staff
· The Advisory Council representative of the local recovery community
· Currently, programming coming from the Central Office consists of
· Telephone recovery support
· Recovery-oriented employment services
· Referrals to recovery housing
· Recovery and re-entry services (Department of Correction)
· All-recovery groups
· Volunteer trainings
· Recovery training series
· Family/community education
· Family support groups
· Recovery coaching
· Recovery coaching that includes peer one-on-one interaction should be an integral part of every RCC.
· An RCC will provide support of recovery housing through knowledge and application of the Recovery Housing Project database.
· An RCC will provide employment support to recoverees to help build personal recovery capital.
· An RCC will deliver the CCAR Recovery Training Series using peer volunteers and outside facilitators who have been trained to conduct such education programs.
· An RCC will organize and/or host social activities that are member and committee driven and supported by peer volunteers.
· An RCC is welcoming to mutual aid societies (i.e., 12-step), community organizations, recovery-oriented agencies, etc. to host their meetings and/or events at the RCC.
· An RCC will publish a monthly schedule of activities. This schedule will be posted prominently in the RCC itself and available on the internet.
Volunteers
· Volunteers are CCAR’s number one resource and must be treated as such. Each RCC will make an outstanding effort to recruit, train, engage, supervise, and recognize CCAR volunteers.
· All programs and services in an RCC are best implemented by volunteers who are trained and supported through the Volunteer Management System (VMS). Staff is paid to support the volunteers.
· A statewide Volunteer Manager will work with the staff of each RCC and the CCAR Management Team to achieve the goals and objectives of the VMS.
General
· An RCC must be volunteer driven, member-inspired, and premised on peer support.
· An RCC must have clear Policies and Procedures that are readily available to the membership and reviewed every year.
· An RCC will have Rules of Conduct clearly posted.
· Ideally, an RCC would have a van to transport people and to help with access to peer-based recovery support services.
· An RCC will have computers for individuals in recovery with connections to printers and high-speed internet.
· An RCC will have at least one large screen TV, DVD player, and VCR for training, workshops and seminars. The TV will not be hooked up to cable, dish or any other connection that allows for multiple channel TV viewing.
· All RCC staff and appropriate volunteers will be trained to use the online databases and the internet to access services for recoverees. Every RCC will have a Community Resource Book with pertinent forms and applications that is updated quarterly.
· In general, An RCC will not be open on Holidays. Holidays are times for paid staff and dedicated volunteers to take time away for rest and rejuvenation. CCAR understands that Holidays may be a tough time for some individuals and will rely on other natural recovery supports to assist those individuals.
Volunteer Management System
As a person in recovery I have benefited immensely from volunteering at the Hartford Recovery Community Center (HRCC). Whether making Telephone Recovery Support (TRS) calls or recovery coaching I have been given countless chances to promote and enhance recovery in the lives of others. CCAR has afforded me so many opportunities to give back to the recovery community.
CCAR Volunteer
I lost my job just about a year ago and started using the research room at New London Recovery Community Center for job searching. After frequenting the Center for a couple of months, and job searching to no avail, I began to think it was a prime opportunity for me to turn my situation around and give back to the community. I was trained as a TRS caller and started reaching out to others who were in need of support in their recovery. By doing so it has given me back my integrity and purpose in life while maintaining my own sobriety through this rough time. Although I have yet to find a job, once I do, I will continue to give my time and support to others in need because the feeling of knowing that I am helping someone else through their journey in recovery is priceless. Thank you CCAR for being there for me through this rough time in my life. I am forever grateful. God Bless…
Kathy James, CCAR Volunteer
In 2005, CCAR made a conscious decision to move to an organizational culture that completely embraced volunteerism. We hired a full-time Volunteer Coordinator, Normajean Cefarelli and she has been instrumental in CCAR’s success. After researching many venues, we modeled our VMS after large hospitals including applications, interviews, background checks, job descriptions, training, supervision, and celebration. Early on CCAR encountered some resistance to the idea of performing background checks on our volunteers. People argued that most of the people we work with and who were currently helping out with CCAR had a criminal record so they would be disqualified from volunteering. Management assured that this would not be the case. Long criminal histories could be viewed not as liabilities, but as resumes. We also knew that it was important to protect volunteers from situations that might pose a threat to their safety, public safety, and CCAR’s safety. An example would be ensuring that volunteers assigned to working with children at a CCAR event do not have a criminal record involving minors.
Why volunteerism? Simply put, an active volunteer force can generate more positive results than a paid staff could possibly accomplish alone. At CCAR, we focus all our staff efforts on supporting our volunteers. We, then, substantially increase the person-power behind our mission. This also taps into the time-honored recovery principle, “You can’t keep it unless you give it away.” The table below indicates the growth of the CCAR volunteer system (Fig. 14.1).
Fig. 14.1
Growth of the CCAR volunteer system
Telephone Recovery Support
I have volunteered at CCAR since August 2008 as a Telephone Recovery Support person. I have talked to hundreds of people and have heard as many stories. All the recoverees have been unanimous on two counts about their addiction and CCAR. First, they are in recovery now because they absolutely could NOT live their lives as addicts anymore. They all express the strongest desires to have a quality life that allows them to feel emotions, to care for their children and families, and to lead healthy, productive lives. Second, they look forward to receiving the TRS phone call once a week. Some recoverees have developed special bonds with certain TRS volunteers and others simply like to know that someone out there cares about them. In my experience, TRS is tantamount to the all-recovery meetings, RCCs, and the social events because it delivers support to the recovery on an intimate, nonjudgmental level.
TRS volunteer
When asked if I find the TRS calls helpful I can’t say yes enough. There’s something so supportive about knowing that no matter what happens in my life there’s someone who genuinely cares about how my recovery is going. My volunteer has shared in every victory I have had in my recovery since the calls began. I hope to continue receiving these calls for a long time to come.
TRS recoveree
Out of all of the commitments I’ve had – TRS is my favorite way of giving back. Honestly – it’s a toss up as to who gets more out of it…me or them.
TRS volunteer
When I was using my phone never rang and I wanted it to. I remember just sitting there, staring at the phone wishing someone would call me, talk to me…possibly help me. Now I’m in recovery, for me this is the perfect way of giving back… being that phone call that I never got.
TRS volunteer
In this CCAR program, a recoveree receives a phone call from a trained CCAR volunteer (usually a person in recovery) once a week for a minimum of 12 weeks to check-in on the recoveree’s progress. Recoverees have the option of continuing with the phone calls after the 12 weeks and many of them do. Calls are made in English and Spanish. The average length of enrollment for all participants is just under 20 weeks, with one receiving calls for more than 3 years. When a recoveree moves, CCAR keeps calling: for example, three recoverees are receiving calls while residing in Puerto Rico. Our internet-based phone system allows us to do this without additional cost.
The program also resonates with me personally. I recall that back in the early days of my recovery, I was told to get phone numbers. And get phone numbers I did. I had a book full of them. However, I don’t recall being told to actually use the numbers. Now, I know this is probably not true, but I do know that it was very difficult for me to pick up the phone, but when someone called me, I would talk and talk and talk. This is proving to be true as CCAR outreaches to those new in recovery.
As of January 2009, CCAR enrolled 1,285 new recoverees into Telephone Recovery Support that were referred by 37 different providers across the state. 45% of the referrals to TRS come from recovery houses through the Recovery Housing Coalition of Connecticut. Intake is simple, one signed form faxed to a main number. The recoveree is called within 24 h. In 2008, CCAR volunteers placed 32,830 outbound calls to recoverees across the state. Of those calls, we talked to someone 9,046 times. This is a number that usually causes me to pause and comment. Connecticut is a small state, so more than 9,000 connections made by our volunteers, makes me wonder about what that infusion of love, concern and care means. And how do you measure something like that? It’s like a steady pulse of healing electricity that stimulates recovery.
McKay and colleagues [2] provide documentation for Telephone Recovery Support as an evidence-based practice. Their study showed that telephone-based continuing care, in which an addiction counselor supports patient recovery with 15-min calls once a week, can be as good as or better than face-to-face care at helping most patients maintain abstinence after intensive outpatient treatment (IOP). In another NIDA-funded study [3], the benefits of telephone support were evident nearly 2 years after the last call for all but 20% of patients with severe addiction problems that did not resolve during IOP.
CCAR has also had several instances where the call came at the exact right time. For example, in the 2008 CCAR Annual Report, Kevin Hauschulz, lead Telephone Recovery Support coordinator, reported “One volunteer helped to save one of our recoveree’s lives. In this situation, the recoveree said he was having suicidal thoughts, and after conferring with me, the volunteer called Mobile Crisis and told them the situation. After Mobile Crisis, the house manager, and my volunteer talked with the individual, it was determined that this individual needed a higher level of care temporarily. The individual was so grateful that someone actually cared about him, and was very grateful to be a part of Telephone Recovery Support. Subsequent calls to this recoveree have shown him to be in a much better space after a brief hospitalization.”
At each of our RCCs, the volunteers have access to a comprehensive book of recovery-related resources. The book contains support meeting listings and phone numbers for all the treatment providers. Beyond those listings, it contains other system related resources including key local contacts from many of the state agencies like the Department of Social Services, Department of Children and Families, Department of Correction, Department of Labor, etc.
Recovery Coaching
Recovery coaching promotes recovery by helping people overcome barriers to their recovery and develop “recovery capital.” Recovery coaching is provided primarily by a Recovery Coach, a position within the CCAR VMS. Recovery coaches are trained through a 5-day experiential course at the CCAR Recovery Coach Academy, where they learn to become resource brokers, role models, mentors, motivators and cheerleaders, allies and confidantes, problem solvers and truth tellers, advocates and community organizers, friends and equals [4]. The Academy also trains participants in the basics of behavioral health disorders, crisis intervention, communication skills, motivational enhancement, recovery wellness planning, cultural competency, and recovery ethics. Participants learn about some of the components, core values and guiding principles of recovery; build skills to enhance relationships; discuss co-occurring disorders and medicated assisted recovery, learn the stages of change and their applications, and experience wellness planning.
Recovery coaches work with recoverees to develop a Recovery Wellness Plan designed specifically for the Recovery Coach Academy and based on the work of Calori and Wuelfing. Through working this plan, recoverees develop personal goals in regard to connectedness to the recovery community; physical, emotional health, spiritual health; living conditions, education, employment, and daily living management. They list the steps it will take to reach their goals, people they may need to help them, and timelines for achieving goals. The Recovery Wellness Plan helps recoverees take the next steps in their recovery journey and monitors progress made. It also supports personal responsibility, strengths, and resilience of the recoveree.
CCAR trains more than 100 people annually through the RCA with people from many states attending. CCAR has also taken the RCA to other states. If they are being trained to serve as a CCAR volunteer, participants sign an agreement to give 50 h of service upon completing the course. The RCA provides a classic win–win scenario: volunteers give back through recovery coaching activities and, thereby, and if they are in recovery themselves, reduce their own risk of recidivism. It is not a requirement that you be in recovery in order to be trained as a recovery coach. Recovery coaches interact with new recoverees instilling hope and a desire to strive for something better. CCAR works to have a diverse pool of recovery coaches from which the recoveree may choose. In addition, Spanish-speaking recoverees can connect with Spanish-speaking coaches. We have seen new recoverees come full circle when they attend the RCA and become recovery coaches themselves (Fig. 14.2).
Fig. 14.2
The cycle of recoveree to recovery coach as a function of the RCA
In general, recovery coaches can be placed somewhere along a continuum with case manager at one end and 12-step sponsor at the other, with CCAR recovery coaches falling much closer to the sponsor side. Recovery coaches fulfill many of the case management roles described in the SAMSHA/CSAT Treatment Improvement Protocol (TIP) 27, Comprehensive Case Management for Substance Abuse Treatment.In addition to being delivered by people in recovery and therefore qualifying as an additional peer support role, recovery coaching has been suggested and evaluated in relation to individuals with serious mental illnesses by the Yale Program of Recovery and Community Health (PRCH) faculty [1].
CCAR recovery coaches, other volunteers and staff are charged with helping people along their chosen recovery pathway. Besides one-on-one support and encouragement, they have a variety of other peer-based recovery support services to work with. They help new recoverees make informed choices as to what may work best for them.
One of the functions a recovery coach may take on with a recoveree includes navigating the system. Connecticut has one of the best systems in the USA for treatment of alcohol and other drug addiction. Yet, our system can still be daunting for someone new to it. Many of the CCAR recovery coaches, other volunteers and staff have extensive experience with the system, whether it is as clients or years of advocating for individuals to receive the appropriate treatment. A lot of our success working within the system has been our ability to work with the treatment providers. Early on, there was a notion out there that CCAR would be a competitor with treatment providers for a shrinking pool of money. Our recovery community organization utilizes a tiny percentage of the overall dollars and the value added far exceeds, especially for providers, the dollars allocated. For example, the recovery community has more weight with legislators and policy makers, than treatment providers who are sometimes seen as self-serving. The face and voice of recovery is a powerful influence when telling a story of personal transformation. We have seen time and time again, that when someone introduces themselves as a person in recovery, the audience immediately pays attention. As the story is told, often times, a clinical treatment setting was where this person’s recovery was initiated. Discerning providers then see how this advocacy will benefit their work.
Recovery Housing Project
In 2004, following Preliminary meetings and conversations between CCAR staff and the owners of independently owned, privately operated sober houses, it became clear that sober houses filled an important need in Connecticut’s treatment/recovery system. Across the state individuals and couples in recovery quietly opened a number of dignified, safe, and sober recovery environments where people, in early recovery as well as those who have a history of recovery, take the time to rebuild their lives. Sober houses create a homelike, supportive environment where people can not only develop the tools necessary to embark on a life of recovery, but also increase the quality of their sobriety in a safe, secure place for people who are committed and engaged in their recovery. These houses have two things in common; first, they make sure that a person who is in recovery lives in a place that is free from alcohol and drug use and second, the residents themselves reinforce their recovery though support from and with other recovering persons. This environment provides a very important support group function. Residents generally are encouraged to live in the home for as long as they feel the need for group support. There is usually an on-site, live-in manager or couple who are in sustained recovery and responsible for the supervision of residents and adherence to the house rules.
Sober houses are self-supporting as rent collected from the housing residents covers operational expenses and provides income to the individuals who own/operate the house. Sober houses often help to provide transportation for persons seeking or going to work, receiving medication, obtaining proper identification papers, etc. These additional supports often are usually offered on an individual, as-needed basis without an additional charge. CCAR determined that a considerable number of these sober houses were operating across the state yet no one knew how many. With funding from the state, CCAR established the Recovery Housing Project that (1) maintains an inventory of all sober housing in the state, (2) staffs the Recovery Housing Coalition of Connecticut, and (3) provides training to those interested in opening sober housing.
At the end of 2009, CCAR has access to 158 houses with 1,474 beds, and makes about 25 referrals to recovery houses weekly (~1,200 annually). With this capability, CCAR has always been able to find people places to live across the state. We operate a website findrecoveryhousing.com where anyone can search our database. The Recovery Housing Coalition has established standards for sober housing that was particularly useful to the state during the ATR years. CCAR delivers four trainings annually, “So, you want to open a recovery house?” So far, we estimate more than 50 new houses have opened as a result of this training.
Recovery-Oriented Employment Services
In 2008, in collaboration with ADRC, a Hartford-based addiction treatment provider, CCAR established Recovery-Oriented Employment Services (ROES). CCAR’s role is to deliver comprehensive vocational training incorporating recovery principles, establish a recovery-friendly employer database; and train employers on becoming more recovery friendly. CCAR’s in-depth written curriculum helps recoverees build the life skills and attitudes needed to secure employment. Modules include financial basics and time management, employment risks in early recovery, developing a skills inventory and making your cover letter/resume stand-out, internet job searching, work challenges, interview skills, integrating recovery thinking into workplace ethics, and sustaining employment. The ROES curriculum is consistent with the best practices outlined in TIP #38, Integrating Substance Abuse Treatment and Vocational Services.
All-Recovery Groups
A peer-led recovery support group is offered in all our RCCs. The idea for the group originally came from communities of recovery in the Willimantic area, where people wanted an open group welcoming recoverees, family members, friends, and allies to talk about their common goal of recovery. These groups, which are well attended, meet several times weekly in each RCC, and all are welcome to attend.
Winners Circle Support Group
Winners Circle is a peer-led, peer-driven support group designed to address the special needs of formerly incarcerated men and women in recovery and their family members, friends, and allies. The only criteria are a desire to participate in one’s own healing and recovery, and to aid others’ by providing encouragement and support. Winners Circle events, held weekly in each RCC, enable participants to interact in a positive social setting in which they feel free to investigate and develop new life skills.
Family Education and Support
Family Night is an alcohol/drug addiction education and support program for community members, people in recovery, and their families. Recoverees and family members can access information about addiction and recovery and share their experience, strength, and hope through this five-part series.
Recovery Training Series
CCAR hosts a variety of popular workshops, trainings, and conferences to promote recovery and communities of recovery. The following can be scheduled according to need: GED, the Pardons Process; Financial Management; Smoking Cessation; Understanding Addiction and Recovery; Relationships in Recovery; Nutrition and Recovery; 12 steps and religion; Women in Recovery through Enhanced Design (WIRED); Yoga; “Our Stories Have Power” from FAVOR; Hepatitis C Information and Education; and Double Trouble: 12 Steps Meetings for Co-occurring Disorders.
Peer-Led Recovery Social Activities
The recovery community knows the importance of hosting alcohol and drug free social events to maintain and sustain recovery. CCAR activities include comedy nights, open mike nights, spaghetti dinners, super bowl parties, and holiday parties. CCAR recoverees have the opportunity to attend events where they will see that people do have fun in recovery and to help plan and implement them.
Integrating CCAR Activities with Addiction Treatment
CCAR has excellent relationships with a vast majority of the addiction treatment providers in Connecticut. In fact, 57 different providers referred people to our Telephone Recovery Support service. Five of nine Board members work in a clinical addiction treatment setting. CCAR bridges the gap between treatment and sustained recovery. Often, insurance will provide several days of detox and then refer clients to a “partial hospital program” in which they attend Monday–Friday for about 5 h of counseling and groups. After a few weeks, this drops to “outpatient” which consists of several days a week for up to 3 h. The 28 day or longer programs are dwindling with the high cost of inpatient stays unless the individual has the resources to pay privately. Most cannot afford the $1,000 or more per day stays for these programs. CCAR has worked to develop solid relationships with most treatment providers in Connecticut and they refer clients to us for recovery support knowing that detox or treatment is just a beginning. CCAR staff also make regular presentations at treatment programs, sober houses, residential programs, half way houses, and homeless shelters educating both staff and recoverees of the recovery support services we offer. Many are enrolled into Telephone Recovery Support while still in treatment so they can begin receiving phone calls immediately upon discharge. The Recovery Support Services offered by CCAR are not a substitute for clinical treatment but an adjunct. In some cases, recoverees have not received treatment and use the recovery support offered by CCAR to sustain their recovery. Long-term recovery must be accomplished while facing the everyday challenges of work, relationships, family, with recoverees learning how to handle these daily stresses without turning to alcohol or other drugs. CCAR provides some of these tools for as long as recoverees need them, free of charge. People in recovery know we must give it away…in order to keep it.
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References
1.
Davidson L, Tondora JS, Staeheli MR, O’Connell MJ, Frey J, Chinman MJ. Recovery guides: an emerging model of community-based care for adults with psychiatric disabilities. In: Lightburn A, Sessions P, editors. Community based clinical practice. London: Oxford University Press; 2006. p. 476–501.
2.
McKay J, Lynch K, Shepard D, Morgenstern J, Forman R, Pettinati H. Do patient characteristics and initial progress in treatment moderate the effectiveness of telephone-based continuing care for substance use disorders? Addiction. 2005;100(2):216–26.PubMedCrossRef
3.
McKay JR, Lynch KG, Shepard DS, Pettinati HM. The effectiveness of telephone-based continuing care for alcohol and cocaine dependence. Arch Gen Psychiatry. 2005;62(2):199–207.PubMedCrossRef
4.
White W. Recovery coaching: A lost function of addiction counseling? Counselor. 2004;5(6):20–2. http://www.williamwhitepapers.com/pr/2004. Retrieved Jan 2010.