Growing nacBy: Millicent PepionM.S. Family and Human Development, ARIZONA STATE UNIVERSITY

Millicent Michelle PepionNovember 13, 2016FAS 588 Seeley

Hello my name is Millicent Pepion. I am an enrolled member of the Navajo Nation. In our culture it is polite to begin presentations by introducing who are families are. In that spirit, I would like to begin by saying I am member of the Bitterwater Clan of Pinon, Arizona. My father is an enrolled member of the Blackfeet Nation. My great-grandmothers family are Their Forehead is Red People. My great-grandfathers were French fur traders of the Pacific Northwest. I was born in Tuba City, Arizona but was raised primarily in Mesa, a suburb of Phoenix. On December 14, 2016, I will graduate with a Masters degree in Family and Human Development from the T. Denny Sanford School of Social and Family Dynamics at Arizona State University. This presentation is about Native American Connections. That is what the acronym N-A-C stands for. NAC is an organization that aims to help marginalized families by offering programs in addiction treatment and low-income housing. For this presentation we will only focus on NACs treatment program services. This report will discuss how NAC came about, what they currently offer, where they are lacking, and suggestions of how NAC can grow and evolve in to an organization that better meets the needs of their clients. 1

The Childrens Bureau reports that 8.3 million children with parents who abuse alcohol or substances are also more likely to experience child abuse and/or neglect

Alcohol & substance abuse stats

2.3 million incarcerates in federal and state prison(85% drug/alcohol crimes)

In 2005, the National Center on Addiction and Substance Abuse (NCASA) reported that federal, state, and local governments spent $74 billion on incarceration, court proceedings, probation and parole for substance-involved adult and juvenile offenders. Less than 1% of that amount, or $632 million, is spent on prevention and treatment.

NCASA also reports that of the 2.3 million incarcerates in state and federal prison, 85% were there for crimes related to alcohol or substance abuse. Even more, at least 1.5 million incarcerates can be clinically diagnosed as suffering from substance abuse or addiction diseases under the standards put forth by the Diagnostic and Statistical Manual of Mental Disorders (2016).

Probably most disturbing, however, are the number of children affected by alcohol and substance abuse nationwide. The Childrens Bureau reports that at least 8.3 million children live with a parent who is either substance dependent or abuses substances, and that they are more likely to experience child abuse and/or neglect as a result.

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Arizona

From 1995-2005 the prison population grew by 52 percent.

Department of Corrections spending increased by 100% between 1997-2007 51.6% AZ residents consume alcohol27,455 DUI arrests in 2010206 traffic deaths DUI related (27%)$23,826 annually per inmate !!

In Arizona, a 2010 survey found that 51.6% of Arizona residents drink alcohol. In 2010, it was also reported that there were 27,455 DUI arrests. MADD reported 206 traffic deaths that year were drunk driving related. This accounted for 27% of all traffic deaths in Arizona in 2010.

Other facts about alcohol and substance abuse are being reported by the Justice Center and Council of State Governments (JCCSG). JCCSG found that from 1995 to 2005 the prison population grew by 52% (2012). In 2012, JCCSG also reported that the Department of Corrections spending increased by 100% between years1997 to 2007. Currently, Arizona is paying an estimated $23,826 annually per inmate.

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CASA of Arizona Statistics2014-2015As of 2015, neglect is the #1 reason children are placed in the child welfare system

85.6% children are removed for neglect

Causes for child deaths in 2014

120 child deaths involved drugs and/or alcohol

38 children successfully committed suicide

More troubling are the statistics above taken by Arizonas Court Appointed Special Advocates (or CASA). CASA reports that as of 2015, neglect remains the number one reason children are placed in Arizonas child welfare system. An embarrassing 85.6% of children in Arizona were removed for neglect. CASA goes on to reveal the causes for child deaths in 2014. In 2014, 120 child deaths involved drugs and/or alcohol. Tragically, that same year, 38 children successfully committed suicide.

What is being done to address this problem?4

Arizona department of Health services

Division of behavioral healthIn 2014, over half (52.6%) of all alcohol and substance abuse treatment members entered treatment on their ownMost substance abuse treatment members are adults (92%). 34.7% are employed (full or part time)42.5% have slowed down or do not use80.8% have no recent incidents or charges93.5% are not homeless

This takes us to the Arizona Department of Health Services (ADHS), and its Division of Behavioral Health Services Annual Report on Substance Abuse Treatment Programs Fiscal Year 2014. The ADHS reports that over half (52.6%) of all persons who enter treatment for alcohol or substance problems do so voluntarily (ADHS, p. 3). That means there is no criminal element for over half the people who enter treatment willingly. Of those in treatment, Arizona reports that 92% are over the age of 18, 34% are employed either full-time or part-time, 42% of participants have slowed down the use or have chosen to not use at all, 80% report no recent encounters with law enforcement, or no new charges filed with the Criminal Justice System, and finally, 93% of participants in treatment programs are not homeless (ADHS, p. 7).

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NATIVE AMERICAN CONNECTIONS (NAC)Our Vision is to be recognized as an innovative Native American service & development organization.

Helping the lives of over 10,000 individuals and families each year!

Health

Housing

Community Development

All of these reasons prove why we need places such as Native American Connections. NAC is a nonprofit organization with over 17 locations in or around the Phoenix area. NAC grew from a grassroots effort to combat the presence of alcohol abuse among homeless Native American men in Phoenix during 1972.

Today, NAC offers a continuum of behavioral health, affordable housing, and community development services which touch and change the lives of over 10,000 individuals and families each year. Their vision is to be recognized as an innovative Native American service and development organization.

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Nac Behavioral health services

Our Values are embodied in our work: collaboration, empowerment, integrity, stewardship, wellness, compassion, family, spirituality, teamwork and volunteerism.Sweat lodge ceremonies, talking circles, and drum circles are just some of the cultural components to NAC programs.All programs are open to people of all backgrounds excluding, but not limited to, race, color, sex, religion, national or ethnic origin, familial status, or disability.Inpatient programs45 day residential programs

Outpatient programsIOP - intensiveSOP - standard

NACs behavioral health services include recovery and treatment programs that extend to all family members from children to elders. Treatment programs include both inpatient and outpatient program options. Inpatient programs provide residential treatment. Inpatient programs are usually only a 45 day program. Outpatient programs, such as the Intensive Outpatient Program and the Standard Outpatient Program, last around 8-12 weeks. NAC prides itself on its ability to use collaboration, empowerment, integrity, stewardship, wellness, compassion, family, spirituality, teamwork, and volunteerism in to their treatment programs. Keeping with Native American influenced traditions, NAC integrates sweat lodge ceremonies, talking circles, and drum circles as part into their clients treatment.

Surprisingly, NAC programs are open to all of our relations excluding, but not limited to, race, color, sex, religion, national or ethnic origin, familial status, or disability. Everyone should feel welcomed at NAC.

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Jenny chong ph.D.

SOCIAL NETWORKS, SUPPORT, AND PSYCHOSOCIAL FUNCTIONING AMONG AMERICAN INDIAN WOMEN IN TREATMENT (2005)

PREDICTORS OF RELAPSE FOR AMERICAN INDIAN WOMEN AFTER SUBSTANCE ABUSE TREATMENT (2007)

The work NAC is doing was so impressive it inspired a researcher from the University of Arizona. Dr. Jenny Chong, now the Director of Research of the Neurology College of Medicine at U of A,. sponsored two research papers concerning the Native women of NAC. The first research paper involves social networks and social support as it relates to psychosocial functioning among American Indian women at NAC. The second research paper studied predictors for relapse with American Indian women enrolled in NACs Guiding Star program, a 45 residential treatment program for women.8

research in to Social Networks and Social support at Nac

How do social networks and social support effect psychosocial functioning (i.e. self-efficacy, self-esteem, anxiety, depression, and hostility)

No significant relationship with social networks, though negative family members and history seemed to be an influence.

Found that positive social support helps.

Treatment interventions should aim to increase structural support as well as to provide specific support to help maintain abstinence.

What if NAC could envision some way to continue this social support after treatment? Native women in the program might have less of a chance of relapsing after their program.

Beginning around 2004, Dr. Jenny Chong began studying the relationship between social networks and social support as it relates to psychosocial functioning. Pyschosocial functioning are things such as self-efficacy, self-esteem, anxiety, depression, and hostility, all factors known to influence substance abuse and addiction problems. Dr Chong found that there really was no significant relationship with social networks (i.e. families), except that negative family members and negative family interactions (either in the present or past) seemed to influence relapse. Still, there was not enough participants to make this correlation and Dr Chong was left to conclude that whether a Native woman had a positive family network or negative family network didnt seem to matter when it came to whether that person would use again.

This was not the case with social support systems. Social support can be positive friends and family who supported the person while they were in treatment. Those with positive social support, either from friends or family, seemed to do better in the long run. This led Dr Chong to believe that, treatment interventions should aim to increase structural support as well as to provide specific support to help maintain abstinence (Chong, 2005). As a side discussion, Dr Chong noted that observed social support, which included support from therapists and rehabilitation coaches early on in recovery, as well as support from other clients who were sober in the program, seemed to influence the likelihood that a client would remain strong early on in their sobriety. Dr Chong suggested if NAC could envision some way to continue this social support after treatment, perhaps Native women in the program might have less of a chance of relapsing after their program was finished.

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Predictors of relapse for Native women at NAC

Dr Chong interviewed 346 women

99% enrolled in a tribe

Average age 31

55% did not have a high school diploma

23% had completed high school

21% had attended college

60% never married

Next well look at Predictors of Relapse for American Indian Women After Substance Abuse Treatment, which is the other study conducted by Dr Jenny Chong. In this study Dr Chong followed 346 women who had enrolled in NACs Guiding Star treatment center. It is a 45-day residential program for women suffering from substance abuse. 99% of those who participated were enrolled in a federally recognized tribe. The average age of the women in this study was 31 years old, interestingly half of the women studied were between the ages of 25 and 34. In addition, 55% did not have a high school education, 23% had complete high school, 21% had attended college. Lastly, almost 60% had never been married. Chong wanted to know what were the reasons for relapsing after they left Guiding Star.

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Predictors of relapse6 month predictors (186/346)Prior alcohol treatment experienceBeing around others who were usingCraving drugs/alcohol at intake12 month predictors (167/346)Having poor family relationsExperiencing negative life eventsBeing around others who were usingCraving alcohol

I want to mention that of the some 376 women approached to be in the study only 346 agreed to participate. Of those only 186 were available for a 6 month follow up and only 167 were available for a 12-month follow up.

For the 186 women who participated in the 6 month up, those who had relapsed contributed their relapse to these following reasons: (1) They had prior alcohol treatment experience that was unsuccessful, (2) They were around others who were actively using, and (3) They had been craving for drugs and alcohol since during their intake process.

For the 167 women who participated in the 12 month follow up, those who had relapsed contributed their relapse to: (1) Having poor family relations, (2) Having experienced some negative life event, (3) Being around others who were using, and/or (4) They were craving alcohol. 11

22 women were in jail or prison at the 6 month follow up 13 women were in jail or prison at the 12 month follow up

3 women died during Chongs study

What concerned me the most about reading this study was that Dr Chong had found 22 women in jail or prison at the 6 month follow up. She also discovered 13 women in jail or prison at the 12 month follow up. Most disturbingly, however, was that three women who agreed to participate in her study died. 12

There is an urgent need to investigate and address relapse issues in this special population.

Chong, 2007

Of 3 tribes in southwest 1/3 had drug/alcohol problem

74-94% of tribal members relapsed despite treatment in past year

Results from two separate studies

In this report Chong talks about the results from two separate studies she had been apart previously of involving Native populations. The first was a study of three tribal nations in the southwest. In that study conducted in 2002, one third of the population was clinically diagnosed as having an alcohol or drug problem. In a separate study conducted in 1998, 74-94% of tribal members interviewed had relapsed in the last 30 days despite having sought treatment in the past year. The results from these studies led Chong to conclude, There is an urgent need to investigate and address relapse issues in this special population.

Man standing on diving board at public swimming pool. Dreamstime. Retrieved at https://www.dreamstime.com/stock-photos-man-standing-diving-board-public-swimming-pool-above-water-image33431343.

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CRITICISMS of CURRENT APPROACHES

Little or nothing has been done to improve NAC after Chongs research

Chong set up a telephone hotline that failed after one year

There are no long term treatment plans

Lacking child care for parents in recovery

Presently, I have three criticisms with NACs current approaches. Firstly, little or nothing has been done to improve NAC in the years following Dr Chongs research. Dr Chong studied Native American women at NAC for over three years. Several times throughout her research she noted that increased social support was linked with a less likely chance to relapse. Increased social support can be long term treatment programs. Increased social support can also be increased child care subsidies for parents enrolled in a NAC program who have children. The only thing that was done following Dr Chongs departure was a hotline service for former NAC clients. Former clients were allowed to call in and speak to a recovery coach 24/7 if they were experiencing a crisis which could have lead to relapse. This hotline program failed and was defunded after only one year.

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What can nac learn from Drug court

Crime rates are reduced

Families are restored

Taxpayers save money

Longer treatment programs ensure longer lengths of sobriety and increase chances of lifelong recovery

After reading Dr Chongs research I was inspired to do my own research in to how I can help NAC decrease the chances of their clients relapsing. This research led me to drug courts.

Pictured is Judge Reeds. He presides over a drug court in Putnam County, New York. In 2014, NBC Nightly News ran a segment featuring the success Judge Reeds is having with addicts in his county. In Judge Reeds court offenders have to complete a two-year treatment program, but when they graduate their charges will be significantly reduced or dropped. The program includes daily group therapy, weekly personal therapy, personal development seminars, and avid drug testing. New users are sometimes required to test up to 4 or 5 times a week.

But, as a result of these longer, intensive treatment programs crime rate is reduced, families are restored, and drug courts have saved taxpayers a lot of money. In essence, Judge Reeds drug court, and drug courts across the country, have proven that longer treatment programs are not only cost effective; theyre life-changing.

So what can NAC learn from drug courts? Mostly that longer drug treatment programs ensure longer periods of sobriety and increase chances of lifelong recovery.

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One year

This is a one year treatment program I designed for NAC. This program will not only meet the requirements of drug courts, but continuing with NACs vision to inculcate Native culture, this year long program was created using the medicine wheel, a traditional Native teaching tool. Here is an example of how we can envision a year long program using the traditional medicine wheel.

The medicine wheel is a symbol of healing for many Native American tribes. It is a circle divided in four with each section representative of how people heal. Native Americans believe people heal in four ways- physically, emotionally, mentally, and spiritually. These healing elements can be measured in phases. Phase one will focus on healing physically. Phase two will focus on healing emotionally, and so on.

There will be requirements to pass to each phase, and this will allow NAC to measure how clients are progressing in the program. During the first two phases clients will need to routinely pass drug tests while attending increased group sessions, or as they are called now, intensive outpatient program classes. Phase two will also be followed up with bi-weekly meetings with NAC clinicians. These are therapists and recovery coaches that to help clients work on specifics such as personal development and crisis intervention.

By phase 3 clients will move towards a more standardized approach to rehabilitation therapy. Group sessions, still daily, will drop to only one hour per day as they are now. This will also address the lack of follow up care Chong reported after NAC women left NACs Guiding Star program.

Phase 4 empowers clients to give back to NAC through volunteer work. NAC can cater to this group by giving them special projects that will allow them to give back and feel empowered in their renewed status in the community. I think about NACs failed relapse hotline. Perhaps clients can volunteer to answer phones to help revive Dr. Chongs dream.

By the time clients graduate they will have 365 days of sobriety, they will have completed 132 intensive outpatient program classes, they will have completed 32 standard outpatient program classes, they will have met with an NAC clinician at least 12 times, and NAC clients will have volunteered 120 hours giving back NAC and completing the circle of healing. 16

Diploma in NAC Recovery

Fewer associations with negative peers

Increase in positive social support

Support directly related to personal recovery efforts

Confidence in self

All characteristics Chong associates with sobriety

After meeting all the necessary requirements to pass this year long treatment program NAC can offer clients a diploma in NAC Recovery. This diploma will signify that the client had fewer associations with negative peers by instead investing their time in developing a more complex, positive, social support network. This increased social support will come from NAC staff and other NAC clients in the program. This diploma will guarantee that the support they gained is directly related to personal recovery and recovery maintenance efforts. This diploma will no doubt increase confidence in NAC clients. As you may remember, in Dr Chong's 2007 study, over half of the Native women studied at Guiding Star did not even have a high school diploma. A Diploma in NAC Recovery will no doubt encourage clients to continue working on their recovery after they leave NAC. In fact, all of these potential positive outcomes are associated with longer periods of sobriety as reported by Dr Chong in her 2007 study.

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Childcare issues for parents in recovery

Adverse psychiatric symptoms for women who had to provide child care while in treatment.

Childcare cost $10,000 per child annually

DES offers child care for parents in recovery but the wait time is unrealistic Terrible service. Unhappy, unhelpful employees. Very crowded with long wait times

Christopher Ritchie (Cottonwood, AZ)

Shifting gears a bit, Id like to talk about parents in recovery. Parents in recovery have the added stress of providing for child care while they are in treatment. Little is known about how drug dependent parents are meeting their childcare needs while in recovery; only that women studied have reported experiencing adverse psychiatric symptoms because of childcare obstacles that occurred before and after treatment (Stewart et. al, 2007).

Moreover, childcare is expensive. On June 23, 2014, the White House Summit on Working Families met to discuss issues hindering economic progress. Among their concerns was childcare. The White House (2016) goes on to say that childcare is the most costly expenditure for family budgets that include small children. (Rodriguez, 2016). They estimate child care is costing Americans $10,000 per child per year!

The Arizona Department of Economic Security (DES) attempts to address this issue by offering child care services for parents participating in recovery programs, provided they meet their eligibility requirements and there is funding (2016). But then theres Christopher Richey (2016), father located in Cottonwood, Arizona, who this past summer posted his review of DESs Child Care Administration to Google Maps, Terrible service. Unhappy, unhelpful employees. Very crowded with long wait times.

In short, DES child care is not guaranteed, and it is not realistic to have parents in recovery depend on that system to meet their child care needs.

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Childcare recommendationsI created two proposals for NAC

Childcare Voucher Program

$1000 voucher for local child care facilitiesOnly 150 children would be covered

2. Onsite childcare center

Costs would reduce after first yearNumerous children could benefit

Inspired by this realization, I took on a grant writing class this past spring. In my class I developed two grant proposals. Both proposals had an estimated budget of $400,000. The first proposal was to implement a child care voucher program. This voucher program would give parents in recovery at NAC a $1000 voucher check to provide child care needs at local child care facilities. I called Kiddie Kare located near 7th street and Indian School, along with Kinderland at 7th street and camelback. These daycares are a few blocks from NAC s central location where intensive outpatient and standard outpatient programs now meet. Both daycares told me they have voucher programs set up and saw no problem with working with NAC to provide a voucher program for their clients. Problems I had with this program were that only 150 children could benefit per year with a $400,000 budget.

The second proposal I wrote was for an onsite child care center. That was my favorite choice. I researched costs of renting out rooms on the 5th floor of NACs central location and costs in to how we can convert those rooms in to daycare. Firstly, I discovered that it would not be that much more to rent out two rooms. This way NAC could have a nursery/toddler room for children under the age of four, and a school age daycare for kids ages 5-12. What intrigued me the most was that the costs for this program would reduce significantly after the first year. Secondly, numerous children over the year would be able to benefit.

Whether NAC chooses to do either of these child care programs, or something else, NAC will be able to ensure that children and providing child care are not reasons to relapse. Furthermore, if NAC wanted to they could incorporate children more in to their parents recovery. As of now, children are still not a part of their parents recovery at NAC. There are programs for parents and programs for children, but those two programs are not connected. These child care proposals offer a bridge on which parents and children can build a new life together. 19

conclusionOh, Great Spirit,whose voice I hear in the windsand whose breath gives life to all the world, hear me.I am small and weak.I need your strength and wisdom.

Let me walk in beauty and make my eyesever behold the red and purple sunset.Make my hands respect the things you have madeand my ears sharp to hear your voice.Make me wise so that I may understandthe things you have taught my people.Let me learn the lessons you have hiddenin every leaf and rock.

I seek strength, not to be superior to my brother,but to fight my greatest enemy - myself.Make me always ready to come to youwith clean hands and straight eyes,so when life fades, as the fading sunset,my spirit will come to youwithout shame.

Im going to end my presentation with this prayer from Chief Yellow Lark written in 1887. Part of his prayer is written on the backs of these gold coins that NAC currently gives to clients who pass their 8 week intensive outpatient program.

The prayer is.

With and for all of my relations. A he hee! Thank you!

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References (in order by slide)

Slide 2(2016). Prescription opioid overdose data. Centers for Disease Control and Prevention. Retrieved from http://www.cdc.gov/drugoverdose/data/overdose.html.

(2016). Todays heroin epidemic. Centers for Disease Control and Prevention. Retrieved from http://www.cdc.gov/drugoverdose/opioids/heroin.html.

Nelson, L. S. (2015). Addressing the opioid epidemic. The Journal of the American Medical Association, 314(14), 1453-1454. doi: 10.1001/jama.2015.12397

Slide 3

(2010). Behind Bars II: Substance abuse and Americas prison population. The National Center on Addiction and Substance Abuse. Retrieved from http://www.centeronaddiction.org/addiction-research/reports/substance-abuse-prison-system-2010.

Slide 4

(2014). Parental substance use and the child welfare system. Childrens Bureau. Retrieved from https://www.childwelfare.gov/pubPDFs/parentalsubabuse.pdf.

Slide 5

(2012). Recent and projected growth of the Arizona prison population. Justice Center, The Council of State Governments. Retrieved from https://csgjusticecenter.org/wp-content/uploads/2012/12/Arizona_1-pager_v4.pdf.

Arizona Indicators. Retrieved from ArizonaIndicators.org.

Slide 6

(2016). Child Welfare Stats. Court Appointed Special Advocates for Children. Retrieved from http://www.azcourts.gov/casa/Child-Welfare/Child-Welfare-Stats.

Slide 7

(2014). Annual report on substance abuse treatment programs. Arizona Department of Health Services. Retrieved from http://www.azdhs.gov/bhs/pdf/reports/annual/2014-substance-abuse-treatment-programs-annual-report.pdf.

Slide 8

(2015). Phoenix, Arizona drug treatment and alcohol rehab information. Retrieved from http://deserthopetreatment.com/southwest-treatment-guide/arizona/phoenix/#_ftn32.

(2016). Native American Connections. Retrieved from http://www.nativeconnections.org/housing/homeless/. Slide 10

Chong, J., & Lopez, D. (2005). SOCIAL NETWORKS, SUPPORT, AND PSYCHOSOCIAL FUNCTIONING AMONG AMERICAN INDIAN WOMEN IN TREATMENT.American Indian and Alaska Native Mental Health Research (Online),12(1), 62-85. Retrieved from http://login.ezproxy1.lib.asu.edu/login?url=http://search.proquest.com/docview/229398651?accountid=4485

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Chong, J., & Lopez, D. (2007). PREDICTORS OF RELAPSE FOR AMERICAN INDIAN WOMEN AFTER SUBSTANCE ABUSE TREATMENT.American Indian and Alaska Native Mental Health Research (Online),14(3), 24-48. Retrieved from http://login.ezproxy1.lib.asu.edu/login?url=http://search.proquest.com/docview/229343481?accountid=4485

Photo retrieved from http://www.nativeconnections.org/.

Slide 15

http://www.nadcp.org/learn/facts-and-figures

http://www.nbcnews.com/watch/nightly-news/us-drug-courts-favor-treatment-for-addiction-over-jail-time-223845955688

Slide 18Arizona Department of Economic Security (2016). Child Care. Retrieved July 16, 2016 from https://des.az.gov/services/basic-needs/child-care-home. Center for American Progress (2014). The White House Summit on Working Families. Retrieved July 16, 2016 from http://workingfamiliessummit.org/.

Gossop, M., Stewart, D., & Trakada, K. (2007). Drug dependent parents: Childcare responsibilities, involvement with treatment services, and treatment outcomes. Addictive Behaviors, 32 (8), 1657-1668. doi: 10. 1016/j.addbeh.2006.11.019

Richey, C. (2016). Arizona Department of Economic Security: Child Care Administration. Google Maps. Retrieved July 16, 2016 from https://www.google.com/search?q=Arizona+Department+of+Economic+Security:+Child+Care+Administration,+1500+E+Cherry+St,+Cottonwood,+AZ+86326&ludocid=1422744150240782588#lrd=0x872d0f85f29d6507:0x13be9a44415de8fc,1.

Rodriguez, R. J. (2016). Expanding Quality Child Care to Help Working Families Succeed. The White House, United States Government [Blog post]. Retrieved from https://www.whitehouse.gov/blog/2016/02/17/expanding-quality-child-care-help-working-families-succeed.

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Slide 20

(2016). American Indian Lakota Chief Yellow Lark (1887). WorldPrayers.org. Retrieved from http://www.worldprayers.org/archive/prayers/invocations/oh_great_spirit_whose_voice.html.

(2016). Healing spirit of recovery coin. Sober Camel. Retrieved from http://www.sobercamel.com/xcart/WBRM054-Healing-Spirit-of-Recovery.html.

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