Category Archives: mental health

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 and certificate do I need to be a peer recovery support-specialist?

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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 support-specialist training has become one of the fastest growing aspects of the coaching field. So, what kind of training and certificate do you need to be a peer recovery support specialist ?

In 2013, the organizations that offered 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.

The definition of a recovery coach, and a peer recovery support-specialist has changed significantly, as well. Now, the term peer-to-peer recovery support-specialist defines a coach that works with people in mental health recovery and/or people that are in co-occurring recovery (co-occurring describes when a person has an addiction and a mental health diagnosis). Commonly the coach in this job is called a “peer.”

Even though most of the state certification boards issue a certificate with the same “title,” (such as certified peer recovery support-specialist) the agencies that are looking for coaches to work with addicts advertise for recovery coaches and the agencies that are looking for coaches to work with people with behavioral or mental health disorders advertise for peers.

In the treatment field it is common to have states use different terminology and acronyms for a certificate of the same job description. For example, the terminology for a certified recovery coach or peer in New Jersey is Certified Peer Support-Practitioner (CRSP).The Alcohol and Drug Abuse Certification Board of Georgia calls this credential a Certified Peer Recovery Coach (CPRC). The Minnesota Certification Board offers a Certified Peer Recovery Specialist (CPRS) credential. There are several different terms for certificates for the same job description throughout the United States.

As of March 2014, 38 states and the District of Columbia have established programs to train and certify peer-to-peer recovery support-specialist working with people in mental health recovery. Eight states are in the process of developing and/or implementing a peer program. For information on locating these agencies go to the International Association of Peer Specialists at: http://inaops.org/training-and-certification/.

The International Association of Peer Specialists web site features a PDF document that is downloadable, with a list of all of the peer training organizations. This document is entitled: Peer Specialist Training and Certification Programs: A National Overview, and was compiled by the Texas Institute for Excellence in Mental Health, in the School of Social Work at the University of Texas at Austin. This PDF breaks down the peer certifications for every state, gives a web site and email contact for the training organizations as well as the required domains to master, in order to receive the certification. As an adjunct to this PDF, an additional list of recognized peer support training providers is available. The link is: http://inaops.org/training-providers/. If your area is not served by training organizations featured in these two documents, email: training@naops.org to find training in your area.

What are the peer recovery support-specialist guidelines for receiving certification?

The peer recovery support-specialist application for certification will vary from state to state but essentially the guidelines are similar. Individuals can qualify to become certified peer-to-peer recovery support-specialist by meeting the following guidelines:

  • Have a minimum of one year demonstrated recovery time from a significant mental health and/or substance use disorder at the date of application.
  • Be at least 18 years of age.
  • Must have a minimum of at least a high school diploma or GED.
  • Have attended and successfully completed a recognized training curriculum (face to face in a classroom setting or on-line) that totals 40 hours at a minimum and have a valid certificate of completion from that training.
  • Have completed an additional 20 hours of training and have valid certificates verifying attendance and participation in the following training categories: Wellness Recovery Action Planning (WRAP), Person Centered Thinking, Personal Assistance in Community Existence (PACE), Crisis Prevention, Veteran supports and interventions. Applicants can also use other college coursework, if related to the work of a Certified Peer Support-Specialist, if it will enhance the ability to provide services to people with mental health and/or substance use disorders. The applicant must submit an official transcript for review with the application.
  • Acknowledge the peer will follow the ethical guidelines of a peer recovery support-specialist by signing a form stating they have read and comprehend the guidelines
  • Submit two (2) personal reference letters

What are the costs of Certified Peer Recovery Support-Specialist Training?

Costs for Certified Peer Specialist training range from $400-$1,000. There are several ways to pay for Certified Peer Specialist (CPS) training. There are a number of programs and organizations that sponsor free Peer Recovery Support-Specialists certification training, continuing education classes, and supervisor training classes. As follows, are some suggestions:

Offices of Vocational Rehabilitation (OVR) help people with disabilities prepare for and achieve an employment goal. OVR has many offices located throughout United States. If you qualify for OVR services, OVR may pay up to $900 for you to receive certification training.

County Mental Health and Developmental Services is another source of possible funding. Some county MH/DS offices contract with training vendors to provide a Certified Peer Specialist class in that county. When this happens, a county purchases an entire class (20 seats) from a training vendor. The county then accepts applications from people who want to attend the training. In these cases, the training is usually only open to people who reside in that county.

The Mental Health Associations of your state may provide low cost Certified Peer Specialist training.

Review the document, Peer Specialist Training and Certification Programs—A National Overview (http://www.dbsalliance.org/pdfs/training/Peer-Specialist-Training-and-Certification-Programs-A-National-Overview%20UT%202013.pdf ). There are many states, Alabama, Ohio, and North Carolina, to name a few that offer free training and are listed in this document.

Next week’s blog post will review what certification is required to be a professional recovery coach working as a coach that has a variety of coaching credentials.

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