7-23-14 Guiding Principles webinar final...2014/07/23 · 7/23/14 1 USING RECOVERY-ORIENTED PRINCIPLES IN ADDICTION COUNSELING PRACTICE Presented by Cynthia Moreno Tuohy, NCAC II,

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USING RECOVERY-ORIENTED PRINCIPLES IN ADDICTION COUNSELING PRACTICE

Presented by Cynthia Moreno Tuohy, NCAC II, CCDC III, SAP & Dan Griffin, MA

July 23, 2014 Download the PowerPoint slides & access CE quiz here:

www.naadac.org/usingrecovery-orientedprinciplesinaddictioncounselingpractice

A presenta*on by the NAADAC, the Associa*on for Addic*on Professionals

Misti Storie, MS, NCC

WEBINAR ORGANIZER

Director of Training & Professional Development

NAADAC, the Associa5on for Addic5on Professionals

USING GOTOWEBINAR

•  Control Panel

•  Asking Ques:ons

•  PowerPoint Slides

•  Polling Ques:ons

•  Audio (phone preferred)

www.naadac.org/usingrecovery-‐orientedprinciplesinaddic5oncounselingprac5ce

A presenta*on by NAADAC, the Associa*on for Addic*on Professionals

A COMPONENT OF THE RECOVERY TO PRACTICE (RTP) INITIATIVE

www.naadac.org/recovery

OBTAINING CE CREDIT

o  The educa5on delivered in this webinar is FREE to all professionals.

o  2 CEs are FREE to NAADAC members who aJend this webinar. Non-‐members of NAADAC receive 2 CEs for $25.

o  If you wish to receive CE credit, you MUST complete and pass the “CE Quiz” that is located at: (look for TITLE of webinar)


www.naadac.org/webinars

A CE cer5ficate will be emailed to you within 21 days of submi[ng the quiz and payment (if applicable) – usually sooner.

o  Successfully passing the “CE Quiz” is the ONLY way to receive a CE cer*ficate.

Free to NAADAC Members!

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WEBINAR LEARNING OBJECTIVES

o  List the 10 guiding principles of recovery

o  Define at least 5 of the guiding principles of recovery

o  Demonstrate in your prac5ce at least 3 guiding principles of recovery

o  Describe at least 3 new recovery-‐oriented prac5ces, services and/or tools to incorporate into your prac5ce

WEBINAR PRESENTERS

Cynthia Moreno Tuohy Execu:ve Director

NAADAC

Dan Griffin Founder, Owner

Griffin Recovery Enterprises, Inc.

DEFINING RECOVERY SAMHSA’s Recovery Definition

DEFINING RECOVERY

A process of change through which individuals improve their health and wellness, live a self-‐directed life, and strive to reach their full poten5al.

HOME

a stable and safe place to

live

DEFINING RECOVERY

COMMUNITY

a stable and safe place to live

PURPOSE

meaningful daily ac*vi*es, such as a

job, school, volunteerism, family caretaking, or crea*ve endeavors, and the

independence, income and resources to

par*cipate in society

HEALTH

overcoming or managing one’s disease(s) as well

as living in a physically and emo*onally healthy way

According the SAMHSA, there are 10 guiding principles of recovery:

SAMHSA’S GUIDING PRINCIPLES OF RECOVERY

o  Recovery is person-‐driven o  Recovery is supported by addressing trauma o  Recovery emerges from hope o  Recovery is based on respect o  Recovery is culturally based and influenced o  Recovery is holis5c o  Recovery occurs via many pathways o  Recovery is supported by peers and allies o  Recovery is supported through rela5onship and social networks o  Recovery involves individual, family & community strengths & responsibili5es

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AUDIENCE POLLING QUESTION

Which of the following guiding principles of recovery do you find particularly challenging?

DEFINING COMPETENCIES

A set of related knowledge, skills and a[tudes (KSAs) that are necessary to successfully perform job du5es and responsibili5es

COMPETENCIES

RECOVERY IS PERSON-DRIVEN


Self-‐determina5on and self-‐direc5on are the founda5ons for recovery as individuals define their own life goals and design their unique path(s).

DEFINITION

Individuals in recovery are experts in their own experiences, needs, preferences, and life goals.

There are iden5fiable stages of change in the recovery process and individuals may be at different levels of readiness

for addressing different issues.

Treatment and services are tailored to meet the expressed needs and preferences of each person.

Language is powerful.

KNOWLEDGE


Attitudes o  Assumes individuals are experts in

their own recovery and they have learned much in the process of living and working through life struggles.

o  Acknowledges the value and importance of respec5ng personal choice and preferences -‐-‐ in life style and direc5on, as well as in treatment and service decision making.


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Skills o  Engage individuals in

respeciul dialogue as full partners in all assessment, service planning and decision making ac5vi5es


o  Involve family, allies and community in dialogue as useful and desired by individual


Skills

o  Ask the ques5on “How can I help?” in a manner which recognizes and supports that the service user is “in the driver’s seat.”


Skills o  Encourage and support

individuals to iden5fy, recognize, and actualize personal strengths, interests, resiliencies and resources


Skills

o  Frame dialogue to highlight individuals’ strengths, efforts, and resourcefulness


Skills o  Coach individuals on

developing personal recovery approaches that are meaningful and relevant to their personal values, culture, goals, and preferences


Skills

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o  Regularly revisit, review, and revise approaches and plans to ensure that changes in status, needs or preferences are addressed, and to incorporate new informa5on, experiences, and sa5sfac5on


Skills

RECOVERY IS SUPPORTED BY

ADDRESSING TRAUMA


Do you have difficulty addressing trauma with your clients?


Do you feel there is work you could be doing on yourself to address trauma in your

life?

Services and supports should be trauma-‐informed to foster safety (physical and emo5onal) and trust, as well as promote choice, empowerment and collabora5on.

DEFINITION

RECOVERY IS SUPPORTED BY ADDRESSING TRAUMA

The experience of trauma (such as physical,

emo5onal, or sexual abuse, domes5c violence, war, disaster, and others) is omen a precursor to alcohol and drug use, mental

health problems, and other behavioral health issues.

Trauma is linked to social issues such as involvement with the criminal jus5ce

system, homelessness, and dissolu5on of families.

Trauma is about “what happened” to you, rather than “what is wrong” with

you.

Recovery from trauma experiences intertwines with recovery from addic5on or and follows a similar, non-‐linear and

highly individualized course.

KNOWLEDGE


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The impact of trauma5c experiences of an individual can look like as well as s5mulate

other mental health problems and addic5on.

Trauma informed and trauma-‐specific prac5ces can help mi5gate the nega5ve

consequences of trauma.

These include minimizing re-‐trauma5za5on, increasing safety, and

helping individuals to iden5fy triggers and use healthy coping skills and support.

Trauma-‐informed prac5ces include inclusion of service user voice, procedural jus5ce and transparency in prac5ce. I would cover the five principles here: safety, trustworthiness,

collabora5on, empowerment, and coordina5on.

KNOWLEDGE


Attitudes o  Acceptance that trauma in an individual’s life may contribute to

current substance use.


Skills o  Recognize the need for

environmental as well as physical and emo5onal safety


Skills o  Help individuals to develop

ability to recognize emo5onal, physical, environmental and rela5onal triggers and to create and employ a set of coping tools and resources to avoid, reduce, and manage their emo5onal, physical, and behavioral impact


Skills o  Build on “what has worked”

to reduce distress in the past and offer ideas for new or addi5onal approaches


Skills o  Open the door for discussion

of trauma5c experiences, but let individual set the pace for disclosure and how these events have impacted him or her


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Skills o  Seclusion, restraint, and other

coercive prac5ces can be both trauma5zing and re-‐trauma5zing for many service users and can nega5vely impact rela5onships as well as treatment process and outcomes


Skills o  Respect and ensure individual

dignity and safety if/when power-‐based, involuntary, coercive or intrusive interven5ons are used


Skills o  Recognize one’s own vulnerability,

including the poten5al vulnerability to secondary trauma as a response to individual’s experiences of trauma, grief, and loss, and be willing to seek appropriate clinical supervision and other supports. Need to emphasize untreated trauma in the provider community


RECOVERY EMERGES FROM HOPE


The belief that recovery is real provides the essen5al and mo5va5ng message of a beJer future – that people can and do overcome the internal and external challenges, barriers, and obstacles that confront them.

DEFINITION Hope is the catalyst of the recovery process.

Hope is internalized; and can be fostered by peers, families, providers,

and others.

The process of change and recovery takes 5me and may entail setbacks.

Understand the stages of change and strategies for helping individuals to engage in health-‐seeking ac5vi5es.

KNOWLEDGE


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Attitudes o  Values the

poten5al, strength, and resilience of each individual


Skills o  Avoid pressuring individuals

to recover in specific ways or within a par5cular 5meline


Skills o  Help individuals to work

through “stuckness” and setbacks, to learn from them, and to sustain effort and/or try new approaches


Skills o  Help individuals break large

tasks or goals into smaller, do-‐able steps


Skills o  Keep small steps linked to

the individual’s desired larger goal so the pathway is always clear and prac5cal


Skills o  Find many ways to

acknowledge and celebrate progress

o  Have a ready supply of diverse recovery stories that can be used to inspire hope


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Skills o  Be familiar with twelve step

program slogans such as “suit-‐up and show-‐up” “fake-‐it 5l you make it” “progress not perfec5on,” “this too shall pass” “We will love you un5l you love yourself.” that many people use to maintain a hopeful outlook and take appropriate risks


RECOVERY IS BASED ON RESPECT


Community, systems, and societal acceptance and apprecia5on for people affected by mental health and substance use problems – including protec5ng their rights and elimina5ng discrimina5on – are crucial in achieving recovery.

DEFINITION

Many words impart a set of assump5ons by the speaker about individuals, their circumstances,

abili5es, proscribed roles, and future.

Recognize environments, venues, situa5ons and interac5ons that are

respeciul and those that are poten5ally in5mida5ng or

discoun5ng.

S5gma, discrimina5on, and social exclusion can have profound impact on individuals and the process of

recovery.

Understanding and exercising one’s legal, civil, and human rights can be an empowering aspect of recovery.

KNOWLEDGE



Attitudes o  All individuals

deserve respect

o  Views service users as full ci5zens and members of a community, rather than “pa5ents”


Attitudes o  Recognizes one’s

own limita5ons in terms of knowledge, skill, experience, and training and is willing to listen as well as to appropriately refer individuals to others.

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Skills o  See each individual as

a whole person with unique set of circumstances that include a rich and individual history, experiences, cultural norms and world view


o  Trust the authen5city of people’s accounts and takes their concerns and issues seriously


Skills

o  Treat individual emo5ons, passions, disagreements and differences of opinions as personal expressions and important concerns rather than as symptoms or signs of pathology or disease


Skills o  Consistently use

language that is does not s5gma5ze or include assump5ons, judgments, generaliza5ons and characteriza5ons that diminish people


Skills

o  Help people establish and uphold boundaries regarding self-‐disclosure


Skills o  Recognize

discrimina5ng policies and ac5ons as well as situa5ons in which individual’s rights may be directly threatened or violated


Skills

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o  Take steps to protect and uphold rights, or help individuals make decisions about their op5ons to take direct ac5on to enforce their rights


Skills

RECOVERY IS CULTURALLY BASED

AND INFLUENCED

RECOVERY IS CULTURALLY BASED AND INFLUENCED

Culture and cultural background in all of its diverse representa5ons, including values, tradi5ons, and beliefs, are keys in determining a person’s journey and unique pathway to recovery.

DEFINITION Services and supports should be culturally grounded, aJuned, sensi5ve, competent,

and personalized.

All assessment, planning, and service/support ac5vi5es should address individual’s cultural and ethnic

background.

Individuals place different importance and meaning on tradi5onal values, specific elements, and incorporate different prac5ces into their lives.

In addi5on to heritage, race, or ethnicity, culture can include belonging to a group based on gender, age, sexual orienta5on,

disability, faith, occupa5on, financial status, family system, language, or shared

experience

KNOWLEDGE


Attitudes o  Trusts the

authen5city of each individual’s experiences.


Attitudes o  Recognizes that

the context of culture, personal history and experiences, and rela5onships impact and shape the individual recovery process.


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Attitudes o  Recognize how one’s

own socializa5on, a[tudes, and knowledge and biases may affect, expand, or limit a[tudes or approaches to serving different popula5ons.


Skills o  Conduct all

ac5vi5es in a culturally sensi5ve and informed manner, including assessments, planning, and service/support interven5on


Skills o  Provide or ensure

availability of services in the language of a person’s choice


Skills o  Respect not only

the diversity of cultural issues, but the ways individuals understand and incorporate culture into their lives and thinking


Skills o  Recognize and

respect that staff with shared gender, racial, and cultural backgrounds, or lived experiences, may more easily develop trust and rapport with individuals of similar backgrounds


RECOVERY IS HOLISTIC

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Recovery encompasses an individual’s whole life, including mind, body, spirit, and community. The array of services and supports available should be integrated and coordinated.

DEFINITION

Psychological"

Spiritual"

Biological"

Social"

The process of recovery entails more than formal substance use treatment and services

and incorporates many supports, resources, and ac5vi5es that help build and support wellness.

Family, housing, employment, educa5on, addic5ons and mental health treatment services and supports, primary healthcare, dental care,

complementary and naturalis5c services, spirituality, crea5vity, social networks, recrea5on & community par5cipa5on.

The stress of not mee5ng basic needs for food, shelter, safety, and economic security has impacts on physical and behavioral health

including emo5onal health and substance use.

For many these effects are compounded by lifestyle choices and lack of access to physical

and behavioral health services.

KNOWLEDGE


Attitudes o  Believes that the

physical, mental, and spiritual aspects of recovery are intertwined and is willing to apply a broad defini5on of “therapeu5c.”


Skills o  Assist individuals (and

families, allies and supporters) to iden5fy and access those supports and resources they find most relevant and helpful


Skills o  This includes helping

individuals understand and fulfill basic eligibility requirements for needed services and supports, as well as address other access issues or barriers such as transporta5on and communica5on


Skills o  Recognizes common

physical health problems associated with trauma, stress, lifestyle choices, medica5on side effects, and substance use


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RECOVERY OCCURS VIA MANY PATHWAYS


Individuals are unique with dis5nct needs, strengths, preferences, goals, culture and backgrounds, including trauma experiences that affect and determine their pathway(s) to recovery. Abs5nence is the safest approach for those with substance use disorders.

DEFINITION

Recovery is a nonlinear process and the pathways to change are highly personalized.

For many, it progresses through iden5fiable stages, though the pace and pathways through the stages are highly individual.

There are a wide variety of ways and resources to address difficult 5mes and situa5ons, including ac5vi5es individuals undertake and suppor5ve ac5on from

others, including prac55oners.

Appreciates that services and treatment offer tools, supports, and resources that can help individuals move toward more self-‐

sufficient and meaningful lives.

KNOWLEDGE


Skills o  Recognize and

communicate that medica5ons and medica5on-‐assisted treatment are one of many tools and op5ons for healing and wellness


Skills o  Help individuals to

consider the risks/benefits of medica5ons as well as their preferences and to be an ac5ve decision making partner during consulta5ons about medica5on op5ons


Skills o  Help individuals

desiring medica5on assisted treatment to access medica5ons and people preferring not to use medica5ons to u5lize other tools for coping and symptom management


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Skills o  Help individuals to

iden5fy and try out different approaches, ac5vi5es, and prac5ces to see what works best for them


RECOVERY IS SUPPORTED BY PEERS

AND ALLIES

RECOVERY IS SUPPORTED BY PEERS & ALLIES

Mutual support and mutual aid groups, including the sharing of experien5al knowledge and skills, as well as social learning, play an invaluable role in recovery

DEFINITION

Peers – people with lived experience with trauma, mental health issues, and addic5ons – bring unique perspec5ve, experiences and high value as members of a service array or

treatment team.

Peers encourage and engage other peers in recovery and provide each other with a vital sense of belonging, suppor5ve rela5onships,

valued roles, and community.

Prac55oner use of personal disclosure can be used to strengthen rela5onships, validate experiences, and provide examples of other ways of viewing situa5ons and op5ons.

Mutual support and mutual aid groups -‐ including the sharing of experien5al

knowledge and skills and social learning -‐ play an invaluable role in recovery for many

people.

KNOWLEDGE


Attitudes o  Feeling “part of”

something larger than oneself and connec5ons with family, friends, peers, faith communi5es, and other suppor5ve networks are core elements of recovery


Skills o  Help individuals iden5fy,

choose and access peer support op5ons, including peer support from informal sources such as personal rela5onships with family friends, colleagues, and community groups, as well as more formal peer-‐operated agencies


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o  Develop posi5ve collegial rela5onships with peer support staff members working in tradi5onal behavioral health agencies


Skills o  Treat these staff respeciully

as partners in service provision

o  Seek opportuni5es to dialogue with and learn from peer staff


Skills

RECOVERY IS SUPPORTED THROUGH RELATIONSHIP AND SOCIAL NETWORKS


An important factor in the recovery process is the presence and involvement of people who believe in the person’s ability to recover; who offer hope, support and encouragement; and who also suggest strategies and resources for change

DEFINITION

Peers, family members, providers, faith groups, community members, and other allies form vital support

networks.

These rela5onships carry meaning, even if current 5es appear to be

severed or unraveled.

People are intricately woven into their families, community and culture.

Family dynamics are omen significantly impacted when one or more family member has a substance use and/or

mental health problem.

KNOWLEDGE


Some individuals have strong social skills and ability to interact with others; while

others have difficulty ini5a5ng and maintaining healthy rela5onships.

Sexuality is a healthy part of adulthood and an important element of recovery

for many individuals.

It can be challenging for individuals to “let go” of rela5onships that are difficult

or non-‐suppor5ve, to repair or re-‐establish former rela5onships, and to

establish new ones.

This process can be painful and generate feelings of grief and loss, but for some it

is an important step of recovery.

KNOWLEDGE


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Attitudes o  Believes that recovery is not a solitary journey, but omen a journey

toward beJer inter-‐connec5on within one’s community of choice.


Skills o  Help and support

individuals to understand the current status of personal rela5onships and his/her role within them


Skills

o  This may include considering safety, reciprocity, and suppor5veness within the rela5onships


Skills o  Help individuals iden5fy and

address challenges or barriers for developing posi5ve and reliable personal support networks, including social and life skills such as self-‐presenta5on, communica5on, boundary se[ng, problem solving, conflict resolu5on, and so forth.


Skills o  Support individuals to “be a

part of” their networks by assuming or re-‐establishing valued social roles within their networks, as well as finding ways to contribute or “give back” to their rela5onships and networks in meaningful ways



In your experience, which relationships are most difficult for your clients to repair?

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RECOVERY INVOLVES INDIVIDUAL, FAMILY AND

COMMUNITY STRENGTHS AND RESPONSIBILITIES

RECOVERY INVOLVES INDIVIDUAL, FAMILY AND COMMUNITY STRENGTHS AND RESPONSIBILITY

Individuals, families and communi5es have strengths and resources that serve as a founda5on for recovery

DEFINITION

Help individuals find personal purpose and meaning in their lives including encouraging and suppor5ng people to create or reclaim

valued adult life roles such as worker, student, tenant, parent, care-‐taker, ar5st

etc.

Families may undergo their own recovery process, as individual family

members and as a family unit.

(Re)building a life in the community and purpose are cri5cal elements of

recovery.

This may include development of employment venues, crea5ve outlets, paren5ng roles, volunteering and

ci5zenship ac5vi5es.

KNOWLEDGE


Attitudes o  Recognizes and honors that individuals with substance use condi5ons

are able to be effec5ve and caring parents, family members, and contribu5ng members of the community and some5mes need support.



recognize that they are ac5ve agents and decision-‐makers in their own lives; at the same 5me, they are also responsible for the consequences of their decisions and ac5ons.


Skills o  Understand the

individual’s defini5on of “family” which may include children, parents, siblings, and unrelated important others.


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Skills o  Provide or ensure

support to families and significant others to address their own support needs and recovery ac5vi5es.


Skills o  Coach individuals

and families on how to access and engage in community resources and ac5vi5es to support recovery.



understand the history and accomplishments of the addic5on recovery movement.


Skills o  Support individuals’

ac5ve engagement in associated leadership and advocacy ac5vi5es.


CLOSING THOUGHTS According the SAMHSA, there are 10 guiding principles of recovery:

SAMHSA’S GUIDING PRINCIPLES OF RECOVERY

o  Recovery is person-‐driven o  Recovery is supported by addressing trauma o  Recovery emerges from hope o  Recovery is based on respect o  Recovery is culturally based and influenced o  Recovery is holis5c o  Recovery occurs via many pathways o  Recovery is supported by peers and allies o  Recovery is supported through rela5onship and social networks o  Recovery involves individual, family & community strengths & responsibili5es

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THANK YOU!

ASKING QUESTIONS

Ask ques5ons through the Ques5ons Pane

OTHER RTP WEBINARS


Defining Addic*on Recovery •  Thursday, January 9, 2014 @ 3-‐4:30pm ET

What Does Science Say? Reviewing Recovery Research •  Wednesday, February 5, 2014 @ 3-‐5pm ET

The History of Recovery in the United States and the Addic*on Profession •  Thursday, March 6, 2013 @ 3-‐4:30pm ET

Defining Recovery-‐Oriented Systems of Care (ROSC) •  Thursday, April 3, 2014 @ 3-‐4:30pm ET

Understanding the Role of Peer Recovery Coaches in the Addic*on Profession •  Thursday, May 1, 2014 @ 3-‐4:30pm ET

Including Family and Community in the Recovery Process •  Thursday, May 29, 2014 @ 3-‐5pm ET

Collabora*ng with Other Professions, Professionals, and Communi*es •  Thursday, June 26, 2014 @ 3-‐4:30pm ET

Using Recovery-‐Oriented Principles in Addic*on Counseling Prac*ce •  Thursday, July 24, 2014 @ 3-‐5pm ET

Exploring Techniques to Support Long-‐Term Addic*on Recovery for Clients and Families •  Thursday, August 21, 2014 @ 3-‐5pm ET

WEBINARS ON DEMAND

•  Medica:on Assisted Treatment •  Building Your Business with SAP/DOT •  SBIRT •  Billing and Claim Submission •  Ethics •  Co-‐occurring Disorders •  Test-‐Taking Strategies •  Conflict Resolu:on •  Clinical Supervision •  ASAM Placement Criteria •  DSM-‐5 Proposed Changes


CE credit s:ll available!


WWW.NAADAC.ORG OBTAINING CE CREDIT

o  The educa5on delivered in this webinar is FREE to all professionals.

o  2 CEs are FREE to NAADAC members who aJend this webinar. Non-‐members of NAADAC receive 2 CEs for $25.

o  If you wish to receive CE credit, you MUST complete and pass the “CE Quiz” that is located at: (look for TITLE of webinar)



A CE cer5ficate will be emailed to you within 21 days of submi[ng the quiz and payment (if applicable) – usually sooner.

o  Successfully passing the “CE Quiz” is the ONLY way to receive a CE cer*ficate.


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Thank You for Par*cipa*ng!

www.naadac.org/recovery

NAADAC, The Associa*on for Addic*on Professionals 1001 N. Fairfax St. Suite 201 Alexandria, VA 22314 p 800.548.0497 f 800.377.1136

NAADACorg

Naadac

[email protected]

NAADAC

Cynthia Moreno Tuohy [email protected]

Dan Griffin [email protected]

Documents

7-23-14 Guiding Principles webinar final...2014/07/23 · 7/23/14 1 USING RECOVERY-ORIENTED PRINCIPLES IN ADDICTION COUNSELING PRACTICE Presented by Cynthia Moreno Tuohy, NCAC II,