What if a loved one was slipping back into addiction to opioid painkillers, alcohol or any drug for that matter? What if you confronted him and he denied it or said that it wasn’t that bad? What if you asked him to go back to rehab and he said he’d think about it but he never brought it up again? Imagine he said he’d get help, but just couldn’t afford to take the time off from work that would be required for residential treatment – but he might consider an outpatient program. Would you know where to look? You might even be the person with the drug or alcohol problem, asking yourself these questions. How might you answer? Who would you turn to?
Why Treatment Providers Aren’t Enough
In my experience, many people, including the healthcare professionals you might turn to, would not be able to adequately answer these questions. First, they are not aware enough of the various treatment options for people with substance use disorders, nor are they aware that some of these treatments are scientifically-validated (i.e., evidence-based) and others are not.
Second, they are often unfamiliar with evidence-based approaches that virtually anyone could learn to motivate individuals who are “resistant” to engaging in treatment – approaches that have been shown to be more successful than traditional “interventions.”
Additionally, treatment providers can’t generally do enough outreach to help those not in treatment. They don’t manage relapses that occur after treatment is completed, aside from having them repeat the same program they already went through. And they don’t have time to get “drop-outs” back into treatment.
This lack of knowledge, I believe, has at least partially resulted in some pretty bleak statistics. Only about eight percent of people with a substance use disorder receive treatment at a specialty facility in a given year, and fewer still get evidence-based treatment. The relapse rate after inpatient treatment is about 50 percent in the first 12 months and the drop-out rate from treatment is approximately 40 percent.
The relapse rate after inpatient treatment is about 50 percent in the first 12 months and the drop-out rate… is approximately 40 percent.-Michael V. Pantalon
To me, this is UNACCEPTABLE because there are trained individuals who work within the addiction arena who could help answer each of the questions we opened with – Professional Recovery Coaches. However, while we often hear about the kinds of recovery coaches – peer recovery coaches and sober companions – popularized by the likes of Lindsay Lohan and Steven Tyler, people aren’t generally aware of Professional Recovery Coaches.
Peer recovery coaches work with others based on their own “lived experience” through addiction and recovery and do not necessarily focus on evidence-based coaching strategies. For example, a peer recovery coach may escort clients to treatment appointments or 12-step meetings, take calls during crises, or just have a cup of coffee with the client, which is almost always the person with the addiction. This could work well if the client’s view of recovery is the same as the coach’s. However, if it is not, then the coaching work is not likely to proceed well. For instance, peer recovery coaches generally tend to focus on a single approach to addiction recovery, usually the 12-steps of Alcoholics Anonymous or Narcotics Anonymous.
A notable exception is the Peer Recovery Manager, who takes a less restrictive view of coaching and focuses on keeping clients in treatment.
…their work nearly exclusively focuses on escorting clients to places and events where they may be tempted to drink or use drugs, and then to intercept any possible use…-Michael V. Pantalon
Sober companions (aka “sober buddies”) are similar in that they, too, are usually peers, but their work nearly exclusively focuses on escorting clients to places and events where they may be tempted to drink or use drugs, and then to intercept any possible use, sometimes physically. Thus, this type of coach shares all of the same potential benefits and drawbacks as do the peer recovery coaches. However, in my opinion, they are further limited by their focus on only one aspect of recovery coaching (accompaniment in high-risk situations), which is far from comprehensive.
While peer coaches and sober companions are reportedly helpful to some, my personal opinion is that we need to make greater use of professional recovery coaches who need not be in recovery themselves (though they can be), who are trained very differently and who can provide a more comprehensive and evidence-based service.
The Professional Recovery Coach
Based on my more than two decades of experience training a wide variety of professionals, including addiction specialists and health and wellness coaches, I have developed the Progressive Recovery Coach Training Program, which adheres to the core competencies and code of ethics of other professional coaches (e.g., life, health and executive coaches.) A progressive recovery coach is a professional coach who adheres to what I call a “progressive model of recovery,” one in which the coaching is:
- client-directed, in that the client decides what he/she will or won’t work on, which has been shown to be an important element of effectively motivating people who are “resistant” to change.
- evidence-based, in that coaches use an approach called motivational interviewing, which has been shown to improve engagement in treatment and outcomes. They also educate clients about which treatment approaches are evidence-based and which are not.
- focused on either individuals with substance use issues or family members and concerned significant others, using their evidence-based coaching strategies to help clients according to what’s best summarized with the acronym, “N.E.A.R.” – because a professional recovery coach is always nearby.
Professional progressive recovery coaches help their clients:
- Navigate the addiction treatment world, helping them understand how to determine what they might need (through guided self-screenings and self-assessments) and how to go about finding evidence-based treatment.
- Engage in treatment in a motivated way, using strategies from motivational interviewing and the Community Reinforcement and Family Training (CRAFT) approach, both of which are more effective alternatives to traditional “interventions.”
- Accompany them to treatment- and recovery-related activities as long as this keeps the client engaged in and successfully moving toward long-term recovery. (Consistent communication with treatment professionals is key.)
- Reduce relapses by being available for calls, texts, emails, etc. when clients are experiencing cravings, urges and/or crises, using coaching strategies to motivate continued recovery and consistent communication with treatment providers.
Help for All
My experience as a clinical psychologist, researcher, trainer, teacher and coach tells me that without helping addicted individuals and their family members with each of these tasks, we will not go very far in achieving my mission, which is addiction help for all. While I commend the work of peer recovery coaches and sober companions, I do respectfully believe that we can help those in need even more comprehensively and effectively by also promoting the use of professionally trained recovery coaches.
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