Tag Archives: Faces and Voices of Recovery

Recovery Contagion within the Family

Posted on March 10, 2022 by Melissa Killeen

By Bill White

Addiction runs in families, but far less known is the fact that recovery also runs in families. Recovery Contagion is a phenomenon have captured my attention in recent decades and been the focus of numerous articles. Recovery contagion is defined as the recovery from a disease spread by close contact.

Scientific studies are unravelling the factors that combine to elevate risk of intergenerational transmission of addiction and related problems. These mechanisms of transmission include genetic and neurobiological influences, fetal alcohol spectrum disorders, assortative mating (attraction of those exposed to parental addition to individuals who share this family history), co-occurring conditions, temperament, developmental and historical trauma, family dynamics (e.g., parental/sibling modeling and collusion), early age of alcohol and other drug (AOD) exposure, and disruption of family rituals. (See Here for review of studies). Rigorous studies have yet to be conducted on the prevalence, patterns, and mechanisms through which addiction recovery of one family member increased the probability of other addicted family members also initiating a recovery process. The purpose of this article is to offer some observations on these issues drawn from decades of observation of families impacted by and recovering from severe and persistent Alcohol or Drug misuse problems. The following suggestions should be viewed as hypotheses to be tested via scientific studies and more expansive clinical observations.

  • Innumerable patterns of recovery transmission exist within families. Recovery transmission may occur intergenerationally (e.g., parent to child) and Intragenerationally (between siblings) and reach the extended family and social network. The recovery influence may also be bi-directional, e.g., mother in recovery to addicted child, child in recovery to addicted mother). Recovery transmission, like addiction, can also skip generations.
  • The probability of recovery initiation of an addicted family member increases as the density of recovery within an addiction-affected family network increase. The contagiousness of recovery and the push and pull forces towards recovery increase exponentially as other family members initiate recovery and as overall health of the family system improves.
  • The mechanisms of recovery transmission within affected families include:

1) infusion into the family of increased knowledge about addiction and recovery by the family member(s) in recovery,

2) withdrawal of family support for active addiction,

3) truth-telling about the addicted family member’s behavior and its effects on the family, 4) elicitation of hope,

5) recovery role modeling,

6) active engagement and recovery guidance by family member(s) in recovery,

7) assertive linkage and co-participation in recovery mutual aid and other recovery support institutions,

8) assistance when needed in accessing professional treatment,

9) post-treatment monitoring and support, and

10) adjustments in family life to accommodate recovery support activities for recovering members and family as a whole.

These individual mechanisms achieve heightened power when sequenced and combined over time.

  • Recovery of a family member can spark personal reevaluations of AOD consumption of other family members, resulting in a potential decrease in AOD use and related risk behaviors, even among family members without a substance use disorder. This may constitute a hidden benefit of recovery in lowering addiction-related costs to community and society.
  • The recovery contagion effect on other family members exists even when the recovering family member isolated themselves from the family to protect his or her own recovery stability. The family’s knowledge of the reality of his or her continued recovery and its effects on their health and functioning exerts pressure towards recovery even in absence of direct contact.
  • One of the most complicated forms of recovery contagion is between intimate partners who both experience AOD problems. The recovery of one partner destabilizes the relationship and increases the probability of recovery initiation of the other; addiction recurrence in one partner increases the recurrence risk in the other partner. Recovery stability is greatest when each partner established their own recovery program in tandem with activities to support “couple recovery.”
  • Where conflict exists between a family member in recovery and a family member in active addiction (e.g., a father in recovery and an actively addicted son), the conflict can serve as an obstacle to recovery initiation of the addicted family member. Though recovery initiation may be slowed, recovery prognosis is still increased, and the conflicted relationship is often reconciled when both parties are in recovery. When not reconciled, conflict can continue to be played out via different pathways of recovery.

It is rare to escape injury to family within the addiction experience. Such injuries increase progressively within families in which multiple people are experiencing AOD-related problems. For those of us who find ourselves in such circumstances, the greatest gift we can offer our family is our own recovery.

Related Papers of Potential Interest

Evans, A. C., Lamb, R., & White, W. L. (2014). Promoting intergenerational resilience and recovery: Policy, clinical, and recovery support strategies to alter the intergenerational transmission of alcohol, drug, and related problems. Philadelphia: Department of Behavioral Health and Intellectual disAbility Services. Posted at http://www.williamwhitepapers.com/pr/2014%20Breaking%20Intergenerational%20Cycles%20of%20Addiction.pdf

Navarra, R. & White, W. (2014) Couple recovery. Posted at http://www.williamwhitepapers.com/blog/2018/03/couple-recovery-robert-navarra-psyd-lmft-mac-and-bill-white.html

White, W. & Savage, B. (2003) All in the Family: Addiction, recovery, advocacy.   Posted at http://www.williamwhitepapers.com/pr/2005AllintheFamily.pdf

White, W. (2014) Addiction recovery and intergenerational resilience Posted at http://www.williamwhitepapers.com/blog/2014/07/addiction-recovery-and-intergenerational-resilience.html

White, W. (2017). Family recovery 101. Posted at http://www.williamwhitepapers.com/blog/2017/12/family-recovery-101.html

White, W. Addiction/Recovery as a family tradition. Posted at http://www.williamwhitepapers.com/blog/2017/12/family-recovery-101.html

White, W. (2015) All in the family: Recovery resource review. http://www.williamwhitepapers.com/blog/2015/11/all-in-the-family-recovery-resource-review.html

White, W. L. & Chaney, R. A. (2008). Intergenerational patterns of resistance and recovery within families with histories of alcohol and other drug problems: What we need to know. Posted at http://www.williamwhitepapers.com/pr/2012%20Intergenerational%20Resilience%20%26%20Recovery.pdf

 White, W. L. & White. A. M. (2011).  Tips for recovering parents wishing to break intergenerational cycles of addiction. Posted at: http://www.williamwhitepapers.com/pr/Tips%20for%20Recovering%20Parents.pdf

About the author:

Bill White published this article on his web site on September 05, 2019.. Bill White is a preeminent researcher on addiction and recovery. He received a Lifetime Achievement Award from the Faces and Voices of Recovery in 2015. William L. White is an Emeritus Senior Research Consultant at Chestnut Health Systems / Lighthouse Institute and past chair of the board of Recovery Communities United. Bill has a master’s degree in Addiction Studies and has worked full time in the addictions field since 1969 as a streetworker, counselor, clinical director, researcher and well-traveled trainer and consultant. He has authored or co-authored more than 400 articles, monographs, research reports and book chapters and 20 books. His book, Slaying the Dragon – The History of Addiction Treatment and Recovery in America, received the McGovern Family Foundation Award for the best book on addiction recovery. Bill was featured in the Bill Moyers’ PBS special “Close to Home: Addiction in America” and Showtime’s documentary “Smoking, Drinking and Drugging in the 20th Century.” Bill’s sustained contributions to the field have been acknowledged by awards from the National Association of Addiction Treatment Providers, the National Council on Alcoholism and Drug Dependence, NAADAC: The Association of Addiction Professionals, the American Society of Addiction Medicine, and the Native American Wellbriety Movement. Bill’s widely read papers on recovery advocacy have been published by the Johnson Institute in a book entitled Let’s Go Make Some History: Chronicles of the New Addiction Recovery Advocacy Movement.

His web site is: http://www.williamwhitepapers.com/

*Definition of Recovery Contagion:

The recovery from a disease spread by close contact.

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The Best Book on Recovery Coaching

Posted on September 21, 2020 by Melissa Killeen

The second edition of RECOVERY COACHING- A Guide to Coaching People in Recovery from Addictions – has just been released

http://www.recoverycoachingguide.com/

The second edition of RECOVERY COACHING- A Guide to Coaching People in Recovery from Addictions has 100 new pages of vital recovery coaching ideas aligned with the most up to date, state-of-the-art research on substance misuse treatment models, examples of new recovery support practitioner jobs, discussions about situations that a coach encounters with a patient revived from an opioid overdose and very important information on the medications employed in medication-assisted treatment (MAT) for the treatment of alcohol, opioid or methamphetamine misuse. This second edition demonstrates how using multiple treatment perspectives, including Motivational Interviewing, Harm Reduction, and the Recovery Management Model can be integrated to inform an effective recovery coaching practice. Readers receive sobriety tools that can be used as a guide for the coach to support the person in their recovery process. Poignant, personal stories from recovery coaches pinpoint their experiences and fill the book with bonus coaching material. This second edition includes the Adverse Childhood Experiences (ACE) survey as well as a list of what a recovery coach should anticipate from a recovery coach’s supervisor. However, the resources do not stop there, the book gives practical business advice about how to set up a successful recovery coaching practice.

80% of people leaving a substance misuse treatment center will relapse within the first year of discharge. 9 out of 10 of this 80% relapse within the first ninety days after discharge. Working with a recovery coach or a peer recovery support specialist can significantly reduce the likelihood of relapse during this crucial period. Recovery coaching and peer recovery support is the missing link, bridging the gap between an individual leaving a treatment center and maintaining long term sobriety.

RECOVERY COACHING- A Guide to Coaching People in Recovery from Addictions gives readers something that has not been done before: a thorough explanation of recovery coaching and peer recovery support. First published in 2013, it was the first book on Recovery Coaching, since the field’s inception in the 1990s. This book will be an indispensable resource for the recovery coach or peer support specialist just starting out, the coaching veteran, and any addiction treatment professional.

“My goal is to have clients experience a blend of recovery and life tools to create the skills needed to maintain long term sobriety” states Ms. Killeen. “This book embodies that philosophy, guiding the new coach to know as much as they can learn at the start of their coaching career. This book blends the knowledge of coaching, the models of recovery, life skills, and  several examples of clinical research used in the treatment of addictions.”

Melissa Killeen is an established Recovery Coach with a broad understanding of this new field in addiction treatment. Included in this Second Edition of Recovery Coaching – A Guide to Coaching People in Recovery from Addictions is the knowledge she has received from many years of recovery coaching, developing Recovery Community Organizations (RCOs), training recovery coaches for certification, and working with treatment centers on developing recovery coaching programs for their expanding aftercare program.

Ms. Killeen received her master’s degree in Executive Coaching and a Master of Philosophy in Organizational Dynamics from the University of Pennsylvania, which is where she developed her model of integrating executive coaching with recovery coaching. With many years of personal recovery, she realized when studying executive coaching at this Ivy League university, the impact coaching would have for those that want recovery but cannot seem to achieve a balance of work, relationships, and recovery. Ms. Killeen is the past president of Recovery Coaches International, an international association of recovery coaches. In 2015 she was presented with the Vernon Johnson Award from the Faces and Voices of Recovery, in Washington DC. She is a Nationally Certified Professional Recovery Support Specialist (NCPRSS) and a recovery coach trainer with CCAR. Melissa lives in Southern New Jersey.

Email Melissa at: KilleenMelissa@Gmail.com, call country code: 00-1 US area code: 856.745.4844 (Eastern Standard Time/United States) or SKYPE her at: mkrecoverycoaching.

You can visit her recovery coaching website at https://www.mkrecoverycoaching.com/.

You can purchase this book at: http://www.recoverycoachingguide.com/

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WHO IS BEST QUALIFIED TO PROVIDE RECOVERY SUPPORT SERVICES?

Posted on August 20, 2018 by Melissa Killeen

Written by William White

The explosive growth of nonclinical recovery support services (RSS) as an adjunct or alternative to professionally-directed addiction treatment and participation in recovery mutual aid societies raises three related questions:

1) What is the ideal organizational placement for the delivery RSS?

2) What persons are best qualified to provide RSS?

3) Are RSS best provided on a paid or volunteer basis?

At present, non-clinical RSS are being provided through and within a wide variety of organizational settings by people with diverse backgrounds in both paid and volunteer roles. While research to date suggests that such services can enhance recovery initiation and long-term recovery maintenance, no studies have addressed the three questions above or the broader issue of the kinds of evidence that should be considered in answering these questions.

I have repeatedly suggested that these questions should be answered by methodologically-rigorous research evaluating whether recovery outcomes differ by variations in delivery setting, attributes of those providing the services, and the medium (paid vs. volunteer) through which such services are provided. There are, however, considerations beyond such outcomes that ought to be considered and factored into decisions on the design and delivery of RSS.

As for organizational setting, I have heard such arguments as follows:

  • RSS should be provided by addiction treatment organizations to assure a high level of integration between treatment and post-treatment continuing care.
  • RSS should be provided by criminal justice and child welfare agencies to assure the balance between the goals of recovery support, public/child safety, and family reunification.
  • RSS should be provided by hospitals and other primary care facilities to assure effective integration of recovery support and primary health care.
  • RSS should be provided through public health authorities to assure the integration of prevention, harm reduction, treatment, recovery support, community-level infection control (e.g., HIV, Hep C), and wellness promotion.
  • RSS should be provided by behavioral managed care organizations (or insurance companies) to assure coordination and integration of support across levels of care (and potentially multiple service providers) and the effective stewardship of limited financial resources.
  • RSS should be provided by private professional recovery coaches who can coordinate support across multiple systems and across the long-term stages of recovery.

RSS are now being piloted through all of the above arrangements, but I think a strong argument can be made for providing RSS through and beyond all of the above settings under the auspices of authentic recovery community organizations (RCOs). Allocating financial resources to deliver RSS through these organizations and to the community at large has the added advantages of: 1) maintaining long-term personal and family recovery as the primary service mission, 2) drawing upon the experiential knowledge within communities of recovery to inform the provision of RSS, 3) contributing to the growth of local recovery space/landscapes (i.e. community recovery capital), 4) financially strengthening the infrastructure of local RCOs, and 5) proving greater peer support to the workers providing RSS.

Similarly, RSS are now being provided by people from diverse experiential and professional backgrounds. I think there are many RSS functions that can be effectively delivered across this diversity of backgrounds, but I think the delivery of these services by people in recovery who have been specifically training for this role offers a number of distinct advantages. Through the delivery of peer-based recovery support services, people in recovery can uniquely offer: 1) recovery hope and modeling (living proof of the reality of long-term recovery), 2) normative information drawn from personal/collective experience on the stages and styles of addiction recovery, and 3) knowledge of and navigation within local indigenous recovery support resources. Such hope, encouragement, and guidance is grounded in more than 200 years of history in which people in recovery (i.e., wounded healers, recovery carriers) have served as guides for other people seeking recovery from severe AOD problems (See Slaying the Dragon, 2014). It offers the further advantage of expanding helping opportunities for people in recovery—creating benefits for both helpee and helper through the helping process. (See discussion of Riesman’s Helper Principle). Some of these advantages are limited, however, when the knowledge of the RSS specialist is drawn from personal experience within only one recovery pathway—thus the importance of combing experiential knowledge with rigorous training and supervision.

If we accept the delivery of RSS through recovery community organizations and by people with lived experience of personal/family recovery from addiction, there still remains the question of whether those directly providing RSS should be in paid or volunteer roles. The most prevalent model of delivering RSS is presently through paid roles, with progressively increasing expectations of education, training, and certification—similar to the modern history of addiction counseling. Paying people in recovery to provide RSS has the advantages of expanding employment opportunities for persons in recovery, acknowledging the value and legitimacy of experiential knowledge and expertise, and potentially creating a more stable RSS workforce. That said, the professionalization and commercialization of the RSS role risks undermining the voluntary service ethic within the recovery community, potentially creating an unfortunate future in which people in recovery would expect financial compensation for all service work.

One option is to provide funding to RCOs for the recruitment, orientation, training, and ongoing supervision of RSS, while relying primarily upon trained volunteers to deliver such services. Only time will tell if this option is a viable and sustainable model for the delivery of high quality RSS. If not, great care will need to be taken to avoid the over-professionalization and over-commercialization of recovery support. Questions related to the design and delivery of RSS should be answered primarily through research on RSS-related recovery outcomes, but such research should also examine broader benefits and the potential for inadvertent harm rising from particular models of RSS.

 

 Written by William White and posted on June 22, 2018 at WilliamWhitePapers.com

http://www.williamwhitepapers.com/blog/2018/06/who-is-best-qualified-to-provide-recovery-support-services.html

William L. White is an Emeritus Senior Research Consultant at Chestnut Health Systems / Lighthouse Institute and past-chair of the board of Recovery Communities United. Bill has a Master’s Degree in Addiction Studies and has worked full time in the addictions field since 1969 as a streetworker, counselor, clinical director, researcher and well-traveled trainer and consultant. He has authored or co-authored more than 400 articles, monographs, research reports and book chapters and 20 books. His book, Slaying the Dragon – The History of Addiction Treatment and Recovery in America, received the McGovern Family Foundation Award for the best book on addiction recovery. Bill was featured in the Bill Moyers’ PBS special “Close To Home: Addiction in America” and Showtime’s documentary “Smoking, Drinking and Drugging in the 20th Century.” Bill’s sustained contributions to the field have been acknowledged by awards from the National Association of Addiction Treatment Providers, the National Council on Alcoholism and Drug Dependence, NAADAC: The Association of Addiction Professionals, the American Society of Addiction Medicine, and the Native American Wellbriety Movement. Bill’s widely read papers on recovery advocacy have been published by the Johnson Institute in a book entitled Let’s Go Make Some History: Chronicles of the New Addiction Recovery Advocacy Movement.

 

 

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