Category Archives: Recovery Coaching

20 Question assessment — Is this a healthy relationship?

Posted on June 23, 2016 by Melissa Killeen

two people on a beachAs a recovery coach I guide a lot of people in the “realm” of healthy relationships. Many ask — is this a healthy relationship? Some clients have not been in a relationship for several years, and are attempting to dip their toes into dating. Others might have just left a relationship, and are trying to figure out whether to stay away from a former lover. Even more of my clients who are in relationships can’t figure out if the relationship is healthy or not.

Healthy vs. Unhealthy Relationships

My coaching clients know the “type” of person they want, but realize they keep picking the same unhealthy man or woman, just in a different body. They return time and time again to these relationships because they seem comfortable, reminding them of their family, or first marriage etc. When this happens I urge my clients to actively try to change the relationship selections they make. It is often very difficult for someone to see if the relationship they are in is healthy or unhealthy. I often review the qualities of a healthy and an unhealthy relationship with them. Do these attributes describe your relationship?

  • Healthy-Equality — Partners share decisions and responsibilities. They discuss roles to make sure they are fair and equal.
  • Unhealthy-Control — One partner makes all the decisions and tells the other what to do, or tells the other person what to wear or who to spend time with.
  • Healthy-Honesty — Partners share their dreams, fears, concerns with each other. They tell each other how they feel and share important information.
  • Unhealthy-Dishonesty — One partner lies to or keeps information from the other. One partner keeps secrets or withholds information from the other.
  • Healthy-Physical Safety — Partners feel physically safe in the relationship and respect each other’s physical space.
  • Unhealthy-Physical Abuse — One partner uses force to get his/her way (grabbing, hitting, slapping, shoving).
  • Healthy-Respect — Partners treat each other like they want to be treated and accept each other’s opinions, friends, and interests. Partners in a healthy relationship stop what they are doing, look their partner in the eye and listen to each other.
  • Unhealthy-Disrespect — One partner makes fun of the opinions and interests of the other partner. He or she may not show any care for your property or throw out your personal possessions.

Is This a Healthy Relationship? — 20 Question Assessment

I suggest answering these questions to figure out if you are in a healthy relationship?

  1. Has your partner shared their hopes and dreams for the future, such as where s/he wants to live 5 years from now?  Yes [   ]   No [   ]
  2. Do you and your partner discuss what to do regarding a holiday weekend’s activities? Yes [   ] No [  ]
  3. Do you flinch when your partner makes a sudden action with his/her arms?
    Yes [   ]   No [   ]
  4. Do you go to your bedroom in order to avoid interaction with your partner?
    Yes [   ]   No [   ]
  5. Do your feelings matter to your partner?  Yes [   ]   No [   ]
  6. Would you call your partner’s humor cynical, cutting or belittling?  Yes [   ]   No [   ]
  7. When you suggest something to be completed in the manner you would like, are your suggestions ignored?  Yes [   ]   No [   ]
  8. Do you feel like you have to hide things (gifts, clothes, make-up) from your partner? Yes [   ]   No [   ]
  9. Does your partner compliment you in front of others?  Yes [   ]   No [   ]
  10. Can you mention something you like or admire about your partner?  Yes [   ]   No [   ]
  11. Is your partner glad you have other friends and activities?  Yes [   ]   No [   ]
  12. Is your partner happy about your accomplishments and ambitions?  Yes [   ]   No [   ]
  13. Does s/he talk about her/his feelings?  Yes [   ]   No [   ]
  14. Does s/he really listen to you?  Yes [   ]   No [   ]
  15. Does your partner have a good relationship with his/her family?  Yes [   ]   No [   ]
  16. Does s/he have good friends?  Yes [   ]   No [   ]
  17. Do you and your partner spend time with these friends?  Yes [   ]   No [   ]
  18. Does s/he have interests besides you?  Yes [   ]   No [   ]
  19. Does s/he take responsibility for her/his actions and not blame others for his/her failures?  Yes [   ]   No [    ]
  20. Does your partner respect your right to make decision that affects your own life?
    Yes [   ]   No [   ]

If you have answered “NO” to more than 12 of these questions, I suggest you look into how to cultivate a healthier relationship, perhaps by seeking the advice of a counselor or therapist.

Share
Posted in love addiction, Recovery Coaching, relationships | Tagged , , | Comments Off on 20 Question assessment — Is this a healthy relationship?

Disagreements are normal in relationships

Posted on June 16, 2016 by Melissa Killeen

Expect every relationship to have a disagreement along the way. Disagreements are normal in relationships. Disagreements, however, can trigger other feelings, such as loss of control, powerlessness, or feelings of abuse. Mix into this situation your partner’s personality, the triggers the disagreements bring up for both of you, and a dash of how we saw disagreements resolved in our childhood and you may have a very dysfunctional approach to resolving conflict.

Are you willing to change? Most importantly, is your partner willing to change, too?

IntimacySome disagreements are not disagreements but break downs in communication, or misinterpreted statements. Sometimes the way a message is delivered (i.e. in a text or email) can open the door for miscommunication and result in a fight between partners. Your partner may be upset over reading an email, or hearing your message on their voicemail and you may not know why there is such high level of upset. The answer usually is: they misinterpreted your statement.

Simple miscommunication

Miscommunication typically results from not explaining yourself clearly, specifically and completely. All very difficult to do in a voice mail, text or email. So make a rule that all difficult conversations be made face to face. Your partner deserves this quality of conversation and you deserve not to be in the realm of upset over this predicament.

When communicating with your loved one, ask yourself the following, are you:

  1. Communicating with a lack of emotion in your voice?
  2. Leaving out information you assume your partner should know about?
  3. Are you really saying what you want to say?
  4. Is there a hidden agenda lurking behind this communication? Perhaps all of these things you have reviewed, resolved, cleaned up and cleared out. It was a simple miscommunication, end of story. Now, you both can move on to your weekend chores or favorite Netflix program.

It’s a bigger thing . . .

If this is more than a miscommunication problem, the next step is picking a time to discuss it, calmly, quietly and with no interruptions. Maybe at lunch on Sunday, or after the kids go to bed, most definitely when both of you have cooled down. Plan on sitting down with your partner and starting with an opening statement affirming your love and commitment to the relationship. Pledge that this meeting is an attempt to change how you communicate. Make fastidious notes regarding your presentation, because you may have to make an appointment with your partner to discuss this again, in a few days. Chances are you will forget all about your thoughts and feelings about this miscommunication, so keep your notes handy. If your partner is not looking you in the eye, or multitasking on their cell phone while you are attempting a conversation, maybe they had some difficulties coming to this meeting. Kindly ask, with a lack of emotion in your voice, the following:

  1. Ask if they heard your request to discuss this problem
  2. If there would be a better time to have this discussion when you could have their full attention
  3. Are they bringing up old resentments from past conflicts, if so, ask them to set these resentments aside for a time
  4. Is something really bothering them about this problem, and would they like to speak first?

Identify avoidance

Couples become very good at avoiding conflict. Sometimes one partner is so good at it, they teach the other partner avoidance through osmosis. Soon both partners are adept at sidestepping the real issues, and all conflicts because they won’t like the results. Remember your intimate relationship with your partner is not a win/lose proposition. Avoidance leaves one or both partners feeling unloved, not respected and upset that they are not being “heard.” It is important to work through a few of these exercises, so each partner can realize that discussing and resolving conflict is very important for a healthy, intimate relationship.

Avoidance looks and feels like this:

  1. You are so resentful at your partner that you are unwilling to do anything to resolve it
  2. All conversations like this devolve into conflict, anger, shouting and negative outcomes
  3. You don’t see any problem to discuss
  4. These meetings are a waste of time, dull boring and I could be mowing the lawn, paying bills or doing the wash instead of doing this
  5. If you have to have these discussions at the therapist’s office, a common thought is, I would rather spend my money on something other than this.

How to prepare for the meeting to resolve a problem

Before your meeting, identify your “hot button” issues. You know the ones, identify your pattern in most of your arguments. Does talking about money set you off, does mention of your domineering mother make you defensive, does worrying about your partner leaving you bring up actions you would rather not display (like aggression) or when things aren’t going your way do you start to cry? Review your reactions to your hot-button issues before hand, come up with some solutions to control your reactions (bite your lip, light a cigarette, hold a teddy bear) this will help you cope better during this meeting. Here are some ground rules both you and your partner should read and agree on prior to this meeting:

  1. Pick a time to discuss a problem so it can be resolved. Don’t discuss a problem when either of you are angry
  2. In this discussion, stay focus on the one problem. Use the specific example of your “upset” over this problem. Even if you have to repeat this specific example several times, stay focused
  3. Have a goal in mind when you discuss this problem. What are the changes you hope to make by discussing this problem? Why is it important for you to discuss this problem? Is this problem something you and your partner can change? Can you both commit to the change?
  4. Tell your partner what has upset you and what you are willing to do to change things going forward. Ask your partner what he/she is willing to do or change
  5. Be courteous when speaking to your partner, no back stabbing, knife twisting or “I’m better than you” comments
  6. Express positive messages, focus on the good attributes your partner has. As in the Jungle Book, “Accentuate the positive.” Or as in Mary Poppins, “A spoonful of sugar helps the medicine go down.”
  7. Ask for changes to this problem in a positive way, avoid a cynical tone of voice or aggressive body language
  8. Do something nice for your partner, without expecting something in return.
  9. Complain about the things that matter. Attempt to limit your complaints to one thing that will make a difference or has to be acted upon immediately
  10. Let go of the past. Don’t allow yourself to bring up old problems, behaviors or incidents from the past. This will derail this conversation and it will devolve into a shouting match
  11. Be open to compromise. Intimate relationships are not a winner-take-all environment. Be open to your partner’s ideas
  12. Remove ultimatums from your vocabulary. Phrases like “I am leaving you” or “Pack your bags” should be turned into a “Let’s cool down and discuss this at another time.”

Using these tools to improve your intimate relationship is just like going to a board retreat or a workshop to improve your job performance. Isn’t it worth it to improve your intimate relationship’s performance? To advance change with the person you trust more than your boss, manager or administrator?

In an intimate relationship, the ultimate goal is not to dominate, control, or win. It is, instead, to create nourishing and mutually supportive intimacy; that is, to fully see your partner and to be fully seen; to be lovingly held by your partner (and vice versa) and to listen to them. The highest priority is on the relationship itself, on creating and maintaining an empathetic, loving environment. Acknowledging there is no boss, no subordinate, no winners, no losers. In other words, an intimate relationship is a place where two people, sometimes being in direct opposition or conflict, ultimately, trust the other’s predominant values enough to find equilibrium.

Go at it!

Share
Posted in Recovery Coaching, relationships | Tagged , , , , , , | Comments Off on Disagreements are normal in relationships

Is Recovery Coaching Effective?

Posted on June 2, 2016 by Melissa Killeen

20150609_223702 (2)Treatment professionals and researchers are calling for a change in the treatment model for substance use disorders (SUD). This change calls for shedding the acute care model (28 days of SUD treatment will fix you) to a continuum of care models, similar to how chronic diseases like diabetes or arthritis are treated. (Humphreys & Tucker, 2002; Institute of Medicine, 2005; McLellan et al., 2000; White, Boyle, Loveland, & Corrington, 2005).

At the same time, the mental health and the substance abuse treatment fields have merged, creating the behavioral health field. With this merger, the recovery-oriented systems of care model (ROSC) has become the accepted approach to treatment for those with mental and substance use disorders. This holistic approach, rather than focusing on the addiction, considers the whole person and how they interact in real life. ROSC emphasizes that recovery depends on the connection of mind, body, and spirit, motivating addicts to choose to improve their mental health, their physical health, and to embrace a spiritual component of their recovery (SAMHSA, 2011). This multi-system approach has ROSC counselors encouraging visits to the general practitioner, the OBGyn and the dentist. They assess for co-occurring disorders and embrace one-on-one therapeutic treatment and group therapy. And ROSC practitioners embrace mutual support programs, such as AA, NA or even nontraditional mutual support groups like SOS, or Women for Sobriety. A spiritual program is also encouraged. Lastly, the newest introduction to the treatment field is the recovery coach.

As mental health and addiction treatment services are adopting this recovery-oriented approach, the emphasis on incorporating various forms of recovery coaching or peer-based recovery support into treatment services is growing rapidly. Peer-based recovery support services are defined as

“the process of giving and receiving nonprofessional, nonclinical assistance to achieve long-term recovery from mental health and substance use disorders” (Borkman, 1999)

This support is provided by “peers,” “peer-recovery support specialists,” “recovery coaches,” “peer mentors,” or “peer support specialists” who have lived and experienced personal recovery (Borkman, 1999). The peers assist others in initiating, maintaining and embracing recovery from their mental health or substance use disorders.

As recovery coaches and peers begin to infiltrate treatment centers and recovery support, community organizations, there is a needling question that arises: are recovery coaches effective in the recovery process?

Studies have been completed on the effectiveness of recovery coaches aiding in individuals achieving long-term recovery since 2005. Many were small studies, some were not exactly scientific, nor could other studies stand up to researcher’s scrutiny. None of the studies had the critical mass to come to a clear conclusion. Ellen L. Bassuk, M.D., Justine Hanson, Ph.D., R. Neil Greene, M.A., Molly Richard, B.A., and Alexandre Laudet, PhD began examining the 1,221 studies that analyze the effectiveness of peer-delivered, recovery support services for individuals in recovery. They wrote a systematic review called Peer Delivered Recovery Support Services for Addictions in the United States: A Systematic Review.

This compilation of all the current studies is to create an appraisal, and summarization of the success of peer-delivered, recovery support services, using strict scientific criteria. As part of their review process, the 1,221 studies were screened, but only nine studies were deemed to meet the strict review requirements.

The nine studies examined the effectiveness of recovery support services that were delivered by a peer using a wide range of interventions and models. These studies also examined the variety of locations that offered peer support, including peer-run, drop-in centers (Ja et al., 2009), peer-run, recovery community organizations (Kamon & Turner, 2013), and Veteran’s Administration medical outpatient clinics (Bernstein et al., 2005).

This review showed peer-delivered recovery support services accomplished the following successful outcomes:

  1. Decreased alcohol use
  2. Decreased drinking to intoxication by reducing the odds of drinking to intoxication by 2.9 percent (Smelson et al. 2013)
  3. Peer participation lowered re-hospitalization rates, meaning only 62 percent of participants from the peer based support group were re-hospitalized compared to 73 percent of those not receiving peer based support (Min et al. (2007)
  4. Increased post-discharge sobriety time was achieved by the individuals receiving the peer intervention (O’Connell et al. 2014)
  5. If peers led groups in life-skills training, those participants had 14.8 fewer days drinking
  6. Peer recovery support affected those discharged from inpatient treatment by maintaining a post-discharge sobriety rate of 43 percent to 48 percent as compared to 33 percent sobriety for those not receiving peer based support (Tracy et al. 2011)

Overall, the review of these studies indicate that peers involved in recovery support interventions have beneficial effects on participants. While the reviewers can conclude that there is evidence supporting the effectiveness of peer-delivered, recovery support services, they acknowledge that additional research is necessary to determine the usefulness of peer support services. While this knowledge is encouraging, research in this area is just emerging, and there is a strong need to improve outcomes by completing future studies.

References

  1. Humphreys, K., & Tucker, J. (2002). Toward more responsive and effective intervention systems for alcohol-related problems. Addiction, 97(2), 126–132.
  2. Institute of Medicine (2005). Improving the quality of health care for mental and substance use conditions. Washington, DC: National Academy Press.
  3. McLellan, A. T., Lewis, D. C., O’Brien, C. P., & Kleber, H. D. (2000). Drug dependence, a chronic medical illness: Implications for treatment, insurance, and outcomes evaluation. JAMA, 284(13), 1689–1695.
  4. White, W., Boyle, M., Loveland, D., & Corrington, P. (2005). What is behavioral health recovery management? A brief primer. (Retrieved from www.addictionmanagement.org/recovery%20management.pdf).
  5. Substance Abuse and Mental Health Services Administration (SAMHSA) (2011). SAMHSA’s Working Definition of Recovery. (Retrieved from http://www.samhsa.gov/recovery/).
  6. Borkman, T. (1999). Understanding self-help/mutual aid: Experiential learning in the commons. New Brunswick, NJ: Rutgers University Press
  7. Borkman, T. (1999). Understanding self-help/mutual aid: Experiential learning in the commons. New Brunswick, NJ: Rutgers University Press
  8. Ja, D. Y., Gee, M., Savolainen, J.,Wu, S., & Forghani, S. (2009). Peers Reaching Out Supporting Peers to Embrace Recovery (PROPSPER): A final evaluation report. San Francisco, CA: DYJ, Inc. for Walden House, Inc. and the Center for Substance Abuse Treatment, Substance Abuse and Mental Health Services Administration (Retrieved from http://www.dyja./com/sites/default/files/u24/PROSPER%20Final%20Evaluation%20Report.pdf).
  9. Kamon, J., & Turner,W. (2013). Recovery coaching in recovery centers: What the initial data suggest: A brief report from the Vermont Recovery Network. Montpelier, Vermont Evidence-Based Solutions (Retrieved form https://vtrecoverynetwork.org/PDF/VRN_RC_eval_report.pdf).
  10. Bernstein, E., Bernstein, J., Tassiopoulos, K., Heeren, T., Levenson, S., & Hingson, R. (2005). Brief motivational intervention at a clinic visit reduces cocaine and heroin use. Drug and Alcohol Dependence, 77, 49–59
  11. Smelson, D. A., Kline, A., Kuhn, J., Rodrigues, S., O’Connor, K., Fisher, W. Kane, V. (2013). A wraparound treatment engagement intervention for homeless veterans with co-occurring disorders. Psychological Services, 10(2), 161–167.
  12. Min, S. Y., Whitecraft, E., Rothbard, A. B., & Salzer, M. S. (2007). Peer support for persons with co-occurring disorders and community tenure: A survival analysis. Psychiatric Rehabilitation Journal, 30(3), 207–213. http://dx.doi.org/10.2975/30.3.2007.207.213.
  13. O’Connell, M. J., Flanagan, E., Delphin, M., & Davidson, L. (2014). Enhancing outcomes for persons with co-occurring disorders through skills training and peer recovery supports. Unpublished manuscript.
  14. Tracy, K., Burton, M., Nich, C., & Rounsaville, B. (2011). Utilizing peer mentorship to engage high recidivism substance-abusing patients in treatment. The American Journal of Drug and Alcohol Abuse, 37(6), 525–531
Share
Posted in Addiction Recovery Posts, alcohol, Alcoholism, Drug Abuse, Health, Recovery Coaching, Research | Tagged , , , , , , , , , , , , , , , | 2 Comments