At a time of crisis, tragedy, and impulsive activity around addiction and recovery supports, the team at RAW is resolved to hold fast to our values and objectives. Our primary aim is to improve the lives of those who entrust themselves and their loved ones to our care; our secondary aim is to raise industry standards by example. We believe we can achieve both goals by following two rarely conflicting guides – our own ‘group conscience’ and the wisdom of the National Recovery Movement.
The Substance Abuse and Mental Health Services Administration (SAMHSA), in partnership with other prominent national health agencies, released the following defining consensus statement about mental health disorders recovery in 2014. The statement was derived from 110 expert panelists of mental health consumers, family members, providers, advocates, researchers, academicians, managed care representatives, accreditation organization representatives, State and local public officials, among others.
This list of essential recovery components lends practical guidance to the addictions and mental health treatment industries. New England Recovery & Wellness (RAW) translates these observations of recovery into practices and policies governing our services and operations in pursuit of excellence in care for our clientele and community. Some examples of how we put wisdom into practice follow.
The 10 Fundamental Components of Recovery
Consumers lead, control, exercise choice over, and determine their own path of recovery by optimizing autonomy, independence, and control of resources to achieve a self-determined life. By definition, the recovery process must be self-directed by the individual, who defines his or her own life goals and designs a unique path towards those goals.
- At RAW: Clients are consistently presented with options relevant to their treatment and recovery planning to ignite a habit of choice-making, while staff role model and otherwise promote healthy choice-making throughout the therapeutic relationship. We recognize that individual and population-level recovery outcomes improve dramatically when options and authentic choice-making are combined rather than limited.
2) Individualized and Person-Centered
There are multiple pathways to recovery based on an individual’s unique strengths and resiliencies as well as his or her needs, preferences, experiences (including past trauma), and cultural background in all of its diverse representations. Individuals also identify recovery as being an ongoing journey and an end result as well as an overall paradigm for achieving wellness and optimal mental health.
- AT RAW: Clients are met “where they’re at” — period. (Where else would we meet them?). We maintain a diverse clinical and support staff to ensure multiple perspectives on the best treatment approaches for the client in their care at each iterative growth and regression. Though we currently favor a 12-Step foundation for our clients’ recovery planning given that modality’s prevalence in the community, we present an ever-growing suite of long-term recovery ‘tracks’ at each level of care as recognition and celebration of diversity of recovery experience. These ‘tracks’ include secular, spiritual, religious, and holistic pathways of recovery.
Consumers have the authority to choose from a range of options and to participate in all decisions—including the allocation of resources—that will affect their lives, and are educated and supported in so doing. They have the ability to join with other consumers to collectively and effectively speak for themselves about their needs, wants, desires, and aspirations. Through empowerment, an individual gains control of his or her own destiny and influences the organizational and societal structures in his or her life.
- At RAW: Client feedback is our most important asset in crafting not only appropriate treatment and aftercare plans for each client, but also effective programming and organizational practices for the entire client census of today and tomorrow. RAW aims to embody an evolution away from ‘cookie-cutter’ treatment and recovery support. Instead, we aim to engage the primary stakeholders – the client and his/her family – in creating their own recovery experiences, and thereby optimal outcomes to the satisfaction of all parties.
Recovery encompasses an individual’s whole life, including mind, body, spirit, and community. Recovery embraces all aspects of life, including housing, employment, education, mental health and healthcare treatment and services, complementary and naturalistic services, addictions treatment, spirituality, creativity, social networks, community participation, and family supports as determined by the person. Families, providers, organizations, systems, communities, and society play crucial roles in creating and maintaining meaningful opportunities for consumer access to these supports.
- At RAW: We strive to create dynamic partnerships with organizations and communities which offer resources that can support the health, healing, and advancement of our clientele and their families. We know our efforts to bolster outside stakeholders of recovery directly impact the post-treatment lives of those in our care, and visa versa. We are morally and practically obligated to help create a more recovery-supportive world outside our walls for better long-term outcomes for our clientele. RAW offers as much of our resources of time, space, knowledge, talent, in-kind services, and sponsorship to stakeholder communities as we are able.
Recovery is not a step-by-step process but one based on continual growth, occasional setbacks, and learning from experience. Recovery begins with an initial stage of awareness in which a person recognizes that positive change is possible. This awareness enables the consumer to move on to fully engage in the work of recovery.
- At RAW: We avoid strictly-timed phases of care as much as possible. Though insurance providers determine the duration of each level of care they will pay for, we defer to our clinical team and client feedback in crafting responsible transition plans for each client. Our function is to maximize our capacity to support a client’s goal of living a healthier, self-directed life apart from substance misuse; because individuals and circumstances vary, we remain flexible in all aspects of our care within reason.
Recovery focuses on valuing and building on the multiple capacities, resiliencies, talents, coping abilities, and inherent worth of individuals. By building on these strengths, consumers leave stymied life roles behind and engage in new life roles (e.g., partner, caregiver, friend, student, employee). The process of recovery moves forward through interaction with others in supportive, trust-based relationships.
- At RAW: We focus on the recovery potential of a client as much as we labor to unearth and treat the underlying causes of his or her addiction and co-occurring mental health disorders. This means we help each client to identify, honor, and use the assets available to him/her that will help to achieve wellness and wholeness. We look for dormant traits, interests, passions, etc. to resurface under our care and help to nurture those resources. We also aim to redirect seeming barriers to the therapeutic process. For example, humor, sensitivity, stubbornness, competitiveness, analyticity are all traits that can be used to support recovery – with some engaged help.
7) Peer Support
Mutual support—including the sharing of experiential knowledge and skills and social learning—plays an invaluable role in recovery. Consumers encourage and engage other consumers in recovery and provide each other with a sense of belonging, supportive relation- ships, valued roles, and community.
- At RAW: Peer support is the cornerstone of our recovery services. We encourage all of our clients to find their ‘tribe’ and make every effort to facilitate initiation of mutual aid among our clients and between clients and outside communities of recovery. Many of our behavioral health support staff, clinicians, owners, and operators of our organization are in long-term recovery. We share our experiences of recovery with tact and purpose as a means of connection and motivation, wherever appropriate.
Community, systems, and societal acceptance and appreciation of consumers —including protecting their rights and eliminating discrimination and stigma—are crucial in achieving recovery. Self-acceptance and regaining belief in one’s self are particularly vital. Respect ensures the inclusion and full participation of consumers in all aspects of their lives.
- At RAW: Respect for self and others is an indispensable principle of recovery and a requirement for all within our community – from the clientele, to direct services staff, to Admissions and Marketing. We recognize that trauma and negative social impact are often incurred incrementally, unintentionally, and preventably. For this reason we strive to model and enforce healthy boundaries, recovery-positive language, preservation of dignity, self-determination, and safety.
Consumers have a personal responsibility for their own self-care and journeys of recovery. Taking steps towards their goals may require great courage. Consumers must strive to understand and give meaning to their experiences and identify coping strategies and healing processes to promote their own wellness.
- AT RAW: As caretakers for vulnerable parties we identify and accept our own limitations. We determine appropriateness for our services prior to any other consideration during the referral and admissions processes. We make this a rule and a practice to avoid compounding trauma for individuals who may be hurt more than they are helped by our eagerness to welcome in those who contact us in crisis. We also strive to continually improve our services in order to better serve those who seek our help.
- At RAW: Inquiring individuals and prospective clients are directed toward the resources they ask for, and not only those services from which we would directly benefit from offering. Our Marketing and Admissions teams vet and refer to trusted organizations when our services are not viable or appropriate for an individual per his or her preference or needs.
- At RAW: Our staff and volunteers are held to a high standard of self care in order to limit potential harm to self and others. The incidence of ‘burnout’ and recovery regression, as well as collateral damage to vulnerable parties, remains high in our field; reasons for this phenomenon are diverse, but standards of behavior in and out of our work lives ought not be. Integrity of each RAW community member’s recovery and/or wellness is a topic we confront unapologetically when issues are identified.
- AT RAW: We comply fully with the expectations of licensing bodies and state requirements to which our staff and organization are subject, as well as best practices for our service types to which we are not legally bound.
Recovery provides the essential and motivating message of a better future— that people can and do overcome the barriers and obstacles that confront them. Hope is internalized; but can be fostered by peers, families, friends, providers, and others. Hope is the catalyst of the recovery process.
- At RAW: We assume throughout the duration of each client’s care that he or she will achieve sustainable recovery; there is no other worthwhile way to approach a person who has crossed the threshold of securing assistance in his/her recovery after seeking it. We recognize that no matter the circumstances it is within our capacity to improve conditions for individuals, families, our industry, and our society should these remain our principle aims.
This is only a beginning…