Tag Archives: recovery coach

Alcoholics need detox care

Posted on October 29, 2015 by Melissa Killeen
Melissa Killeen

Melissa Killeen

Alcoholics are not receiving the care they need for detox. As a recovery coach, I have seen a disturbing practice develop within the medical community involving detoxing an individual in extreme alcohol withdrawal. Not everyone who walks into an emergency room in withdrawal from an addiction is transferred to an inpatient detox environment. Detoxing from drugs will last as long as it might take for a person to safely withdraw from a specific substance, often at least 5 days. Drug detoxification can take place in inpatient settings, and according to the National Survey of Substance Abuse Treatment Facilities, about 6.5 percent of inpatient treatment facilities and 4.8 percent of hospitals provide this kind of care. At an inpatient detox treatment program, people have around-the-clock medical supervision that can help them to avoid serious complications caused by withdrawal, and people also have a safe and sober place in which to recover from their addictions, so they aren’t tempted to relapse.

Alcoholics are not treated in the same manner. Alcohol detox could take the same 5 days during which patients may experience a wide range of symptoms depending on the severity of their alcohol dependence. Symptoms experienced during detox may be as mild as a headache and nausea or as severe as delirium tremens (DTs), marked by seizures and/or hallucinations. Emergency Room’s expect alcohol detox to take 24 hours for the physical withdrawal symptoms to disappear, aided by intravenous dosages of phenobarbital. But the mental withdrawal takes much longer.

Most alcoholics are sent home by hospital emergency room physicians, with a script for Diazepam (Valium), lorazepam (Ativan), or chlordiazepoxide (Librium), and asked to return to their family practitioner for a follow-up in two days. Sending an alcoholic client to detox at home is a cop-out on the part of the medical and hospital community.

 
ERs and the behavioral health departments in most major-market hospitals are not equipped, nor do they have the beds, to house clients that are in withdrawal or detox from alcohol. Many of these hospitals have closed their detox centers. A cost cutting practice called “reducing the length of stay” mandates that the ER discharges a client to go home, as it costs too much for them to stay in the hospital, waiting for an bed to become available at a detox center. The client is sent home to make their own plans to enter a detox and/or treatment center.

To complicate matters further, there are very few free or low-cost detox facilities. For example, in the state of New Jersey, only two hospitals can provide Medicaid-covered detox treatment: in Paramus, Bergen County, the Bergen Regional Medical Center  http://www.bergenregional.com/Evergreen/index.html ) and in Atlantic City, the AtlantiCare Regional Hospital (http://www.atlanticare.org/index.php/mission-health-care ). In the private for-profit detox centers, there will be a Medicaid or charity-care bed or two, but these beds have a long waiting list, giving the individual only one option: to detox at home.

Individuals who need help with withdrawing from their alcohol addiction don’t have the time to wait—they are withdrawing now! It is generally assumed by the ER staff that alcoholics will be able to detox at home, with minimal health risks. Detoxing at home poses a significant problem: the maximum likelihood that the client in withdrawal will pick up a drink in their home environment.

This is where a recovery coach can help.

 
As long as these individuals have a recovery coach with them at all times, a coach who can step up and step in if something goes wrong, and to help plan for admission to a treatment center, this can be a safe strategy to follow.

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

Posted on September 10, 2015 by Melissa Killeen
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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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
melissa-new-post

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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