Utilizing the Recovery Oriented Systems (ROSC) of Care Model for Addiction
One of the innovative techniques used in the substance use disorder field is recovery coaching. A Recovery Coach (RC) helps support an individuals recovery. This is just one of a growing number of new, innovative, multi-model and holistic techniques now available to the those in the recovery process and for those who provides services.
This form of assistance fills a vital role in the recovery process as it deals directly with those in recovery and is not constrained by many other forms of help such as psychology, psychiatry, counseling and sponsorship in AA and other 12 Step programs. RCs operate in the here and now, the present. Although, the past can influence the present, it cannot be changed. It is better that the recover-er understands his or her past, but not become a prisoner to it. Recovery Coach Training differs from other forms of training and practice in this respect, such as traditional forms of counseling and psychology and psychiatry.
By Nick Cuneo, President and Founder, Clean Recovery Centers
Getting to know the Recovery Coach
Recovery Coaches are trained very well. Sometimes they are paid, sometimes not. They are available to those in recovery many times daily and when needed. They are, in a sense, mentors for those in recovery and perform many of the same functions: advising, suggesting, guiding and encouraging those on the pathway to recovery. They do not impose their views on recovers but put them in charge of their own recovery, making them responsible for their choices. It is a technique which has been used with individuals from different backgrounds, including racial, ethnic and cultural. Notably, it has been used successfully with many in the entertainment field. This unconditional support for recovery is vital to the recovering person in moving beyond the acute phase of treatment and getting family and community to buy in.
It is true, especially in long-term recovery, that the person has made positive changes in their lives. They no longer use alcohol, drugs or gamble. Sometimes they have changed jobs for the better and now view the world differently. They have changed their behavior, changed their beliefs and have different, more supportive and understanding friends.
However, this does not mean that the recovering person’s family or significant others have changed. In several situations they still see and relate to the person in recovery as they once did, perceiving that person to be in active addiction, not as they are now. This can be a very destructive process and can impede recovery or prevent new ways of relating to family members.
Supporting the families, another key to recovery
The new paradigm shift to a Recovery Oriented Systems of Care (ROSC) model tries to address this aspect. Just as the “recover-er” needs support and direction so does the “family” of the recover-er In 2013 Dr. Galer and Dr. R. Davila created and implemented a two day seminar entitled, Recovery Family Mentor (RFM) (Davila, Galer, 2014. Amazon). The idea is to help families dealing with substance use disorder gain an understanding of the family dynamics that go on in a substance use disorder family system. These include co-dependency, differentiation, triangulation, stigma, emotional buttons and living in the story instead of the present to name a few.
So, as we look at the many aspects of a ROSC we see the importance of moving from an acute care intervention model to a disease management approach. To demonstrate our point we have extrapolated a couple of objectives for a ROSC: a continuum of services rather than crises-oriented care, with possible care in the person’s community and home using natural supports and services provided to peoples’ families during the initiation, ongoing and post-acute stages of their recovery. (SAMHSA, 2008).
There have also been studies that support the benefit of Recovery Coach services, mutual aid societies and social supports in achieving long term recovery. (Scott, Dennis, and Foss, 2005; Laudet, Savage and Mahmood, 2002).
Time to look at multiple pathways to recovery
The importance of ongoing individual, family and community support in transitioning to a successful road to long term recovery is well documented. Treatment programs need to move beyond just focusing on the acute stages of recovery. They need to look at multiple pathways to recovery and plan for the long term ongoing recovery of substance use disorder.
A 70% success rate with program graduates
At Clean Recovery Centers, we follow the ROSC model very closely. We emphasize a sense of community, a sense of family in our Level 4 FARR accredited housing, as well as providing vocational support. Since our program focuses on very unique and deep clinical work – yoga, massage, physio therapy, nutrition and a strong 12 step process – we have modified the recovery coach aspects to support this approach.
We utilize this approach because we currently have a 70% success rate with clients who have graduated from our program (clean and sober greater than one year). Should someone want to explore SMART therapy, long term MAT, or another pathway, we will do our best to help the individual find that program.
Substance Abuse and Mental Health Services Administration. (2009). Results from the 2008 National Survey on Drug Use and Health: National Findings (Office of Applied Studies, NSDUH Series H-36, HHS Publication No. SMA 09-4434). Rockville, MD.
Dennis, Michael & A Foss, Mark & Scott, Christy. (2007). An Eight-Year Perspective on the Relationship Between the Duration of Abstinence and Other Aspects of Recovery. Evaluation review. 31. 585-612. 10.1177/0193841X07307771.