As a person who has been through the process, a peer specialist recognizes that recovery is a complex and dynamic process. Race, ethnicity, gender, sexual orientation, family history, life-cycle stage, environment, culture, and other factors combine with an individual’s unique experiences, strengths, values, perspectives, needs, and desires to yield a recovery process unique to each person.
The recovery process begins when persons with a substance use and/or mental health condition accept that there is a problem, that they need help to overcome that condition, and that they must take individual responsibility for making the changes that will take them back to a functional life. Individuals must address their issues according to their own abilities and needs. Maintaining mental, emotional, physical and spiritual wellness is a lifelong process.
Module 2 Reflection Activity: Your Definition of Recovery
As a peer specialist, you will be asked what recovery means to you. Take a minute to think about your personal definition of recovery. Check your definition to see if it includes the elements suggested in the key. Note: This activity is for reflection only and does not need to be submitted along with your workbook.
Key: Does your definition
- Talk about recovery as a lifelong or everyday process?
- Include having a plan that addresses personal recovery issues?
- Include abstinence from alcohol, illicit drugs or other problem behaviors?
- Focus on wellness?
Talk about multiple dimensions – physical, mental, emotional, spiritual?
Changing Views about Recovery
Changing viewpoints about recovery are based on new understandings about substance use and mental health disorders and how to manage them. This changing perspective takes a broader view of how to support a person with a substance use or co-occurring mental health condition in working toward goals that they define and taking responsibility for their own life.
Historically, recovering individuals began the delivery of “recovery services” through organizations such as Alcoholics Anonymous and other 12-Step groups. As treatment for addiction became more researched and practiced, the recovery aspect of care became secondary. Today, there is a movement to have better alignment between treatment for substance use conditions to recovery services and communities. The increased unity among members of once dissimilar or competing groups has led to a stronger voice for the recovery community and better linkage of services for service recipients.
This module will use several videos from a presentation given by recovery advocate, William White. This first series of videos from William White: Experiencing Recovery sets s a foundation to help you put into perspective where the addiction treatment and recovery movements began to where they are now.
Video: Rob Whitley – Recovery in Mental Illness (10:00 minutes)
Co-Occurring Substance Use and Mental Health Conditions
As you have just seen, the mental health and addiction fields have different historical roots related to treatment and recovery. These differences naturally led to there also being two distinct groups of service providers for persons with these conditions who had little to do with the other specialty. If a person had both a mental health and a substance use condition, it would have been difficult for him or her to receive the best care.
Several important developments have changed this picture. First, both fields have come to recognize the high prevalence of what are now called “co‐occurring disorders” or “behavioral health conditions,” meaning that many people with mental health conditions also have problems with substance use, just as many people with substance use problems have mental health conditions. Research has shown that instances of co-occurring disorders appear to be just as much the rule as the exception.
- For individuals with serious mental health conditions, for example, estimates of co-occurring substance use conditions are as high as 65%.
- For persons with substance use conditions, estimates of co-occurring mental health disorders are only slightly lower.
- It is safe to say that if a person has one of these types of disorders (mental health or substance use condition), his or her chances of having the other type is about 50/50 or one in two.[i]
The recovery movement offers a new way of bringing these two worlds together through a focus on the processes of recovery, healing, and community inclusion. This module will show you how the core principles of both recovery movements recognize that, while mental health and substance use conditions might be different from each other in important ways, the processes of recovery are highly similar—especially when viewed from the perspective of the person in recovery.
Many individuals who seek treatment in behavioral health settings have histories of trauma, but they often don’t recognize the significant effects of trauma in their lives. Likewise, service providers may not ask questions that elicit a service recipient’s history of trauma, may feel unprepared to address trauma-related issues, or may struggle to address traumatic stress effectively within the limitations of their scope of service.[ii]
Individuals who have experienced trauma are at an elevated risk for: substance use disorders; mental health problems (e.g., depression and anxiety symptoms or disorders, impairment in relational/social and other major life areas, other distressing symptoms); and physical disorders and conditions, such as sleep disorders.[iii] There are specific interventions, called trauma-informed and trauma-specific strategies, which build upon resilience, develop safety and skills to minimize the impact of trauma, and address mental and substance use conditions to enhance recovery. This course does not teach these strategies, but SAMHSA’s TIP 57 Trauma-Informed Care in Behavioral Health Services is available online for those who wish to learn more about trauma and trauma-informed care.
Regardless, peer specialists need to be aware of and attentive to the impact of the trauma and tailor the care they offer to the person’s unique history.