Category Archives: Family Dynamics

Addiction is a Symptom of Untreated Trauma

melissa-new-post“What is addiction, really? It is a sign, a signal, a symptom of distress. It is a language that tells us about a plight that must be understood.” — Alice Miller, author of Breaking down the Wall of Silence

I am a recovery coach. A recovery coach or sober companion is often called in to work with the most difficult addict, the chronic relapser. A chronic relapser is an individual that has been to several rehabs, often 7, 8 or 9 visits in less than five years. Who has not been able to put together 90 sober days, except in treatment. Whose family, spouse or children have given up on them. In reality, a chronic relapser is an addict that is acting out in their addiction. Their addiction is just a symptom of untreated trauma.

Often, calling a recovery coach is the last resort.

My first job, of course, is to make sure this person doesn’t drink, use or act out. And to find some redeeming qualities of this addicted person so I can approach healing the behaviors driving the addiction. This is the key point that brought me to the understanding that many of my clients have experienced some form of trauma, early in their childhood or adolescent lives.

I always ask the client for their story. I provide all of my clients the ACE study questions. ACE means Adverse Childhood Experiences. The ACE study is an ongoing collaboration between the Centers for Disease Control and Prevention and Kaiser Permanente’s Health Appraisal Clinic in San Diego. It started in 1976 with the purpose of finding more about childhood trauma, and the later-life health and well-being of participants. (For more information on ACE, see my blog post dated August 20, 2015). The ACE study poses such questions as: Did you move a lot? Did you ever go hungry? Did you experience a childhood that was less than nurturing? Did you ever have a moment that overwhelmed you? Did you live through an ordeal that changed how you think about people, places or things? The results of the ACE questions, and the addict’s story that comes after it, always profoundly moves me. I get a much more honest story than most clinicians, mainly because of these questions.

The reason it’s significant for me to identify and acknowledge trauma, is because research proves that trauma can activate behaviors that lead to addiction. My clients are using a drug or alcohol as a way of self-protection, of calming down, as life preservation. Everyone in the rooms (AA, NA meetings) knows addicts “use” in order to “numb out.” Well, let’s rethink that, turning it a bit to say: victims of trauma are really using a drug or drink to:

  • Stay safe: After trauma the addict’s own mind can feel like a danger zone, which makes being “out of it” feel safer than being in it.
  • Escape memories: Unwanted and unresolved memories have a way of popping up incessantly after trauma; addictions offer the mind a different area of, or reduced capacity for focus that helps suppress reminiscing.
  • Soothe pain: Substances or the adrenalin rush of self-destructive behaviors change the addict’s body chemistry, releasing endorphins and other mood enhancers that reduce discomfort.
  • Be in control: Sometimes, engaging in addictive behaviors can lead an addict to feel strong, resilient and courageous, an experience that is tremendously alluring when trauma from the past intrudes on the present.
  • Create a world the addict can tolerate: The intense feelings brought on by fear, memories and anxiety can make any moment seem overwhelming. The release of tension brought on by addiction-oriented behavior helps facilitate a manageable experience.
  • Treat yourself the way you feel you deserve: Trauma can leave an addict feeling less-than, worthless, hopeless, and damaged. The more self-destructive the addict behaves, the more it can feel like he or she is living in alignment with who they truly are. While this is false, it can help reduce feelings of otherness and disconnection.
  • Redefine who the addict really is: Trauma changes an addict’s identity all the way down to the core of their beliefs and self-definition. It can seem as if no one understands them. Engaging in addictions can help create a sense of community by connecting the addict to others who feel, see, think and behave as they do. Addictions can help the addict revise their self-perception by allowing them to engage in and act out behaviors that allow them to feel stronger, more courageous, capable, etc., than trauma has left them feeling.[1]

This puts the addiction-trauma link into perfect perspective for me, and I hope it opens some eyes for other addicts, alcoholics, and clinicians that are reading this post. Next week’s post will go on to explain the scientific research that backs up this discovery that addiction is just a symptom of untreated trauma.


Research used in this blog:

Centers for Disease Control and Prevention, http://www.cdc.gov/violenceprevention/acestudy/about.html

Adverse Childhood Experiences Study, Posted on August 20, 2015 by Melissa Killeen, https://www.mkrecoverycoaching.com

[1] Trauma and Addiction: 7 Reasons Your Habit Makes Perfect Sense, by Michele Rosenthal. Published on March 30, 2015 in Behavioral Health, Living in Recovery, Living with Addiction and at http://www.recovery.org

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

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Melissa Killeen

I published my book Recovery Coaching – A Guide to Coaching People in Recovery from Addictions in 2013. Since then, recovery coach or peer recovery specialist training 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?

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.

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

  • What are the guidelines I must meet to apply for recovery coaching training?
  • What kind of training do I need to be a recovery coach?

What are the guidelines 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)

What kind of training should I look for?

Certification boards require the coach to receive outside training that fulfills the requirements mandated by the state board. These requirements are often a certain amount of hours training in topics such as addiction recovery theory and models, coaching ethics, motivational interviewing, relapse prevention, nicotine cessation, suicide prevention and HIV-AIDS education. Each state and organization has different requirements. So first check with your state to ensure the course you take will be accepted by the state credentialing board.

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 were: conflict management, anger management, intervention training, co-occurring disorders, behavioral addictions, the pharmacology of addiction, and psycho-pharmacology as well as knowledge about coaching families in relationships with addicted persons. There are also training organizations that offer three different levels of recovery coaching training: novice-, intermediate- and master-level coaching certificates.

The places in which you receive this training are quite diverse. In the links section of this web site, I list over 250 organizations offering recovery coach training. The courses can be online, 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. 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 one international credentialing organization, the International Certification and Reciprocity Consortium, commonly known as the IC & RC (http://internationalcredentialing.org/) that 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.

Are there any additional requirements for recovery coaching certification?

NAADAC, the Association for Addiction Professionals, and the National Certification Commission for Addiction Professionals (NCC AP) http://www.naadac.org/NCPRSS offer the Peer Recovery Support-Specialist Certification. Similar to the requirements of the IC & RC, the NCC AP recommends, in order to receive certification, a coach read and sign a statement on the application affirming adherence to the Peer Recovery Support-Specialist Code of Ethics. Credentialing boards require supervisors of the coaches-in-training to sign a document verifying they have supervised the coach during the period of the coach’s training. Letters of recommendation are also items required by some credentialing boards. Other state boards require a recent photograph. As always, check with the state credentialing board for specific requirements for credentialing.

Next week’s post will review what certification is required to be a peer-to-peer support-specialist working with people in mental health recovery

 

 

 

 

 

 

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

melissa-new-post

Melissa Killeen

I 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 https://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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