Category Archives: Family Dynamics

What is the difference between a recovery coach, a peer recovery support specialist and a professional recovery coach?

Posted on September 3, 2015 by Melissa Killeen
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Melissa Killeen

I published my book Recovery Coaching – A Guide to Coaching People in Recovery from Addictions in 2013. A recovery coach, a peer recovery support specialist and a professional recovery coach’s duties and responsibilities have expanded significantly since then. The organizations that offer recovery coach training numbered around 50 in 2013. Today, the number has grown to 250. Recovery coach certification training is one of the fastest growing aspects of the coaching field, with many states establishing recovery coaching and peer recovery support-specialist certifications. Yet, for many people who seek to achieve basic recovery coaching information, the process of training, certification, credentialing or licensing are baffling. With all of this growth and change, anyone who is interested in being a recovery coach is very confused about the necessary training, what to call this training and even what to call themselves! I want to make an attempt to clear up this confusion and answer these questions:

  • What is the difference between a recovery coach, a peer recovery support-specialist and a professional recovery coach?
  • On what kind of certification should a future recovery coach focus?
  • What are the guidelines for certification of a recovery coach?

(Some of the answers to these questions will appear in upcoming posts.)

What is a Recovery Coach?

A recovery coach is a person that works with and supports individuals immersed in an addiction(s), and coaches people in recovery from the abuse of alcohol and drugs, gambling, eating disorders or other addictive behaviors. Sometimes recovery coaches who work with people with addictions have been referred to as a peer recovery support specialist, a recovery support specialist (RSS), a sober companion, recovery associate or quit coach. In all cases these terminologies describe the same job description; a person who meets with clients in order to aid in their recovery from addiction(s). Even though many certifications for recovery coaches are classified as peer recovery support practitioner certifications. I prefer to use the term recovery coach in describing a person coaching an individual in recovery from addiction, instead of using the term “peer,” mainly because there is no requirement that a recovery coach be a peer (meaning they are an addict in recovery). Although it may be believed having experiential knowledge is a best practice for a recovery coach, it could be a recovery coach has knowledge of addiction and recovery perhaps by knowing an addict, having a family member with an addiction or taking courses in the treatment field.

I have kept the term “non-clinical” out of this definition of a recovery coach because over the course of several years, I have seen drug and alcohol counselors, family and marriage therapists (MFTs), licensed clinical social workers, interventionists (LCSWs), psychotherapists and psychiatrists, train to be recovery coaches and then add coaching to their resume. I hear from these individuals that they embrace the coaching approach, and merge the knowledge they have as a clinician or interventionist with recovery coaching methods.

Some individuals seek recovery and sobriety from addictions by frequenting a recovery community organization (RCOs) or recovery support center. An RCO is an independent, non-profit organization led and governed by representatives of local communities of recovery. There are recovery coaches at these recovery community organizations. These coaches have very diverse backgrounds. I have met coaches that were addicts, homeless, offenders, teachers, lawyers and highly educated individuals, who choose to help another person in recovery. I have seen these coaches espouse 12-step ideologies as well as non-12-step recovery models such as Buddhist Recovery, Moderation Management, Kundalini Yoga or Harm Reduction. Sometimes, the recovery coaches at these centers receive a salary from the RCO, however, the client is not charged for the recovery coaching services. RCO recovery coaches can also be volunteers, opting to perform their coaching duties for no reimbursement at all.

Lastly, recovery coaches can be employed by treatment centers or sober living homes and receive compensation from them. In cases such as this, the client is billed for the coaching services from the centers or homes. I know many a recovery coach who has opened a transitional living home or a supportive sober living environment. They coach the people who reside at these locations and their presence adds to the quality of the recovery experience.

Is recovery coaching covered by insurance?

Unfortunately, the answer to that question is no. No independent health insurance company covers the services of a recovery coach working with an individual in recovery from an addiction. There is currently only one state, New York, that has an arrangement with the state’s Medicaid offices to reimburse for recovery coaching for individuals who are diagnosed as dependent on a substance. Other states, Tennessee, Maryland and Massachusetts, are formulating similar Medicaid payment plans, but these reimbursements are not yet in place.

What is a peer to peer recovery support specialist?

A nearly universal definition of a peer to peer recovery support specialist is an individual with lived experience who has initiated his/her own recovery journey and assists others who are in earlier stages of the healing process of recovery from psychic, traumatic and/or substance-use challenges and, as a result, can offer assistance and support to promote another peer’s own personal recovery journey. A peer to peer recovery support specialist is also called a peer, peer support-practitioner, peer mentor, or a certified peer. All of these terms basically describe the same job description. More and more, this job description is focused on the peer to peer recovery support specialist working with a person in mental health recovery.

The certified peer to peer recovery support specialist workforce is relatively new in the behavioral health field, with state-recognized certification programs first emerging in 2001. Within this short time frame, states have recognized the potential of peer specialists to improve consumer outcomes by promoting recovery. Many social service agencies pay the peer’s salary, and the client does not pay for the coaching. In the mental health/behavioral health field, when referred by a social services agency or mental health treatment organization, reimbursement for a peer to peer recovery support specialist is covered by a health plan or Medicaid.

Peer to peer recovery support specialists can also work independently from an agency and be reimbursed by the client or a family. Peer to peer recovery support specialists can also choose to provide these services as a volunteer and receive no financial reward.

What is a professional recovery coach?

A professional recovery coach, is sometimes referred to as a recovery life coach. A professional recovery coach has experience and training in the recovery models, and training as a professional coach. These professional and credentialed coaching programs are sometimes referred to as life coaching training. A professional recovery coach can receive training from any of the 250 organizations that train recovery coaches, and select not to receive the certificate from a state certification board or the IC & RC (see the certification information in next week’s post). A professional coach can receive training from the ICF – International Coach Federation’s accredited coach training programs, and apply for a credential issued by the ICF.

A professional recovery coach can assist a client with a variety of coaching interventions including, but not limited to recovery from addictions, dealing with mental health diagnoses, divorce, financial downturns, grieving, career change and even family relationship issues. The client is billed for the coaching services from the professional recovery coach. Again, healthcare plans do not reimburse for these coaching services.

Stay tuned for next week’s post on certification for recovery coaches.

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Adverse Childhood Experiences Study

Posted on August 20, 2015 by Melissa Killeen

ACE Pyramid ImageThe Adverse Childhood Experiences (ACE) Study is one of the largest investigations ever conducted to assess associations between childhood maltreatment and later-life health and well-being. The study is a collaboration between the Centers for Disease Control and Prevention and Kaiser Permanente’s Health Appraisal Clinic in San Diego[i].

More than 17,000 Health Maintenance Organization (HMO) members who underwent a comprehensive physical examination were also asked to provide detailed information about their childhood experience of abuse, neglect, and family dysfunction. The initial phase of the ACE Study was conducted at Kaiser Permanente from 1995 to 1997. More than 17,000 participants completed a standardized physical examination and an ACE survey. No further participants will be enrolled, but the study group is tracking the medical status of the baseline participants.

The ACE Study findings suggest that certain experiences are major risk factors for the leading causes of illness, including addiction, leading to poor quality of life,  as well as death. It is critical to understand how some of the worst health and social problems in our nation can arise as a consequence of adverse childhood experiences. Realizing these connections is likely to improve efforts towards prevention and recovery.

Compared to persons with no adverse childhood experiences, the risk of heavy drinking, self-reported alcoholism, and marrying an alcoholic were increased twofold to fourfold by the presence of multiple adverse childhood experiences, regardless of parental alcoholism. Subsequent reviews of the study found that the prevention of adverse childhood experiences and treatment of persons affected by adverse childhood experiences may reduce the occurrence of adult alcohol problems[ii]. Adverse childhood experiences seem to account for one-half to two-thirds of serious problems with drug misuse by adolescents[iii].

Children in alcoholic households are more likely to have Adverse Childhood Experiences. The risk of alcoholism and depression in adulthood increases as the number of reported adverse experiences increases. Depression among adult children of alcoholics appears to be largely, if not solely, due to the greater likelihood of having had Adverse Childhood Experiences in a home with alcohol-abusing parents[iv].

Clearly, children that have experienced emotional, physical or sexual abuse in their early childhood are at a severe risk for addiction. To show you how small an amount of abuse is needed to tip the scales of raising a healthy child or an at risk child, read the last series of questions from the ACE Questionnaire, which are highly revealing questions.

  1. Did a parent or other adult in the household swear at you, insult you, put you down or humiliate you?
  2. Did a parent or other adult in the household push, grab, slap, or throw something at you?
  3. Did you often or very often feel that no one in your family looked out for each other, no one felt close to or supported each other?[v]

This survey gives you an idea how delicate and impressionable a young child is.

For a sample of the ACE Questionnaire, click on this link: http://www.cdc.gov/violenceprevention/acestudy/questionnaires.html

 

References used in this blog:

[i] [i] “The Relationship of Adult Health Status to Childhood Abuse and Household Dysfunction“, published in the American Journal of Preventive Medicine in 1998, Volume 14, pages 245–258.

And

http://www.cdc.gov/violenceprevention/acestudy/index.html

[ii] Addict Behav. 2002 Sep-Oct;27(5):713-25.

Adverse childhood experiences and personal alcohol abuse as an adult.

Dube SR1, Anda RF, Felitti VJ, Edwards VJ, Croft JB.

[iii] Pediatrics. 2003 Mar;111(3):564-72.

Childhood abuse, neglect, and household dysfunction and the risk of illicit drug use: the adverse childhood experiences study.

Dube SR1, Felitti VJ, Dong M, Chapman DP, Giles WH, Anda RF.

[iv] Psychiatr Serv. 2002 Aug;53(8):1001-9.

Adverse childhood experiences, alcoholic parents, and later risk of alcoholism and depression.

Anda RF1, Whitfield CL, Felitti VJ, Chapman D, Edwards VJ, Dube SR, Williamson DF.

[v] Center for Disease Control web site

http://www.cdc.gov/violenceprevention/acestudy/questionnaires.html

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Alcohol Kills One Person Every Ten Seconds.

Posted on July 2, 2015 by Melissa Killeen
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Melissa Killeen

The misuse and abuse of alcohol affect the lives, health and well-being of billions of people. A World Health Organization 2014 report stated the consumption of alcohol led to 3.3 million deaths around the world. In essence, the report says that alcohol kills 1 person every 10 seconds.

Shekhar Saxena, head of the World Health Organization’s Mental Health and Substance Abuse department, reports that there are roughly 3.25 billion people in the world that drink, and these drinkers consume an average of 4.5 gallons of pure alcohol a year. China is estimated to increase it’s per person, per year alcohol consumption ratio by an additional 1.5 liters of pure alcohol by 2025.

According to SAMHSA’s National Survey on Drug Use and Health (NSDUH), more than half of all U.S. adult citizens drink alcohol, with 6.6% meeting criteria for an alcohol-use disorder.

One in 10 deaths among working-age adults aged 20-64 years are due to excessive alcohol use.

A CDC study, published in June of this year, found that nearly 70% of deaths due to drinking involved working-age adults, and about 70% of those deaths involved males. Nearly 88,000 people die in the U.S. from alcohol-related causes annually, making it the third most preventable cause of death in the United States. In 2013, fatal accidents involving an alcohol-impaired driver accounted for 10,076 deaths or 30.8 % of all driving fatalities.

Men are more likely than women to experience alcohol-related deaths. Although more women are drinking today as compared to 2012, of the 88,000 alcohol related deaths, approximately 62,000 were men and 26,000 were women. This study proclaims that excessive alcohol use can shortened the lives of working-age adults by about 30 years.

Alexandra Sifferlin for Time Magazine reported that harmful alcohol use not only leads to addiction, but it can put people at a higher risk of over 200 disorders like liver disease, tuberculosis and pneumonia.

Binge drinking can damage the frontal cortex and other areas of the brain

The CDC report shows that 16% of drinkers partake in binge drinking, which is the most dangerous form of alcohol consumption. Some of the risks associated with binge drinking are well known. It increases the risk for sexual assault, violence and self-harm. But the physical effects of such behaviors on the body are often not discussed. According to the National Institutes of Health (NIH), there’s strong evidence to suggest that regular binge drinking impacts executive functioning and decision making by damaging the frontal cortex and other areas of the brain.

According to the 2013 The National Survey on Drug Use and Health (NSDUH), approximately 5.4 million people (about 14.2%) in the age range of 12-20 years, were binge drinkers (15.8% of males and 12.4% of females).

One in every four families are impacted by alcoholism

More than 10% of U.S. children live with a parent with alcohol problems, according to a 2012 study.

According to Herma Silverstein, author of the book; Alcoholism, one of every four families has problems with alcohol.

The CDC study also found that about 5% of the alcohol related deaths in the U.S. involved people younger than age 21.

In 2012, 58.3% of people who tried alcohol for the first time were younger than 18.

Drinking during pregnancy can cause brain damage to the infant, leading to a range of developmental, cognitive, and behavioral problems, otherwise called Fetal Alcohol Spectrum Disorders (FASD). People/children with difficulties in the following areas may have FASD or alcohol-related birth defects:

  • Coordination
  • Emotional control
  • Learning challenges
  • Socialization skills
  • Focus in class, holding down a job

These statistics are over powering and most definitely build an excellent argument to stop drinking, especially over this Fourth of July long holiday weekend. Please share these statistics with a friend, post on your social media pages, re-publish in your blog, or newsletter.

References used in this blog:

The National Institute on Alcohol Abuse and Alcoholism (NIAAA) is one of the 27 institutes and centers that comprise the National Institutes of Health (NIH). NIAAA supports and conducts research on the impact of alcohol use on human health and well-being. http://www.niaaa.nih.gov/alcohol-health/overview-alcohol-consumption/alcohol-facts-and-statistics

Preventing Chronic Disease (PCD) is a peer-reviewed electronic journal established by the National Center for Chronic Disease Prevention and Health Promotion. The mission of PCD is to promote the open exchange of information and knowledge among researchers, practitioners, policy makers, and others who strive to improve the health of the public through chronic disease prevention. http://www.cdc.gov/features/alcohol-deaths/

The National Survey on Drug Use and Health (NSDUH) provides national and state-level data on the use of tobacco, alcohol, illicit drugs (including non-medical use of prescription drugs) and mental health in the United States https://nsduhweb.rti.org/respweb/homepage.cfm

Substance Abuse and Mental Health Services Administration (SAMHSA), is an agency of the U.S. Public Health Service in the U.S. Department of Health and Human Services. http://www.samhsa.gov/

Alexandra Sifferlin, (2015) What Drinking Does to Your Body over Time, Time Magazine, http://time.com/author/alexandra-sifferlin/

And

Alexandra Sifferlin, (2014) Alcohol Kills 1 Person Every 10 Seconds, Report Says, Time Magazine, http://time.com/96082/alcohol-consumption-who/

Silverstein, Herma. (1990), Alcoholism. New York: Franklin Watts http://allpsych.com/journal/alcoholism/#.VZQkhWPH_VI

 

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