Tribes of the Recovering Community

Celebrate_RecoveryCelebrate Recovery appears to be the most popular faith-based recovery group in the U.S. It’s Christian and evangelical and it’s not limited to people with drug and alcohol problems. Some members use it as a sole source of recovery support, others use it as an adjunct to 12 step recovery.

Celebrate Recovery is a biblical and balanced program that helps us overcome our hurts, hang-ups, and habits.  It is based on the actual words of Jesus rather than psychological theory.  20 years ago, Saddleback Church launched Celebrate Recovery with 43 people. It was designed as a program to help those struggling with hurts, habits and hang-ups by showing them the loving power of Jesus Christ through a recovery process. Celebrate Recovery has helped more than 17000 people at Saddleback, attracting over 70% of its members from outside the church. Eighty-five percent of the people who go through the program stay with the church and nearly half serve as church volunteers.

(The “Tribes of the recovering community” series is intended to demonstrate the diversity within the recovering community. I have no first hand knowledge of most of the tribes, so inclusion in this series should not be considered an endorsement.)

Recover from ==> Recovery to

wellness_wheelCommenter Web Servant responded to the a recent “Sentence to Ponder” from Bill White about the need to expand the scope of treatment and recovery services that create pathways to natural community supports and adopt a wellness model. His comments seem worthy of a post of their own.

The place of treatment in recovery is to help people stop using (ie “recovery from”), the place of mental health and primary care in recovery is to address other issues which may undermine recovery and the place of community in recovery is to help people stay stopped and help sustain and maintain the full change in lifestyle and thinking that is needed “recovery too” – and can only only take place within the community.

I responded:

I like this. And, I’m thinking that this is probably true for any chronic illness where the most effective treatments are behavioral. The chronic disease burden threatens to crush the American health care system. Maybe the biggest factor is not better pills, procedures and systems, but it’s the absence of communities of recovery to support those behavioral changes.

Web Servant responds back:

Your right, nothing about this approach is specific to addiction – it applies equally to mental health, diabetes, obesity, disability maybe even ageing. So many of the struggles we have with these health conditions in the West risen from the professionalization of health care. While professional health care is essential and has had led to great achievements, it has stepped way outside of its rightful place. Especially the notion that professionals have a monopoly on human healing – a notion that has radically undermined and dis-empowered individuals and their communities from what they used to do for themselves.

This phenomenon is beautifully documented in the book The Careless Society: Community and Its Counterfeits by John McKnight where describes how the best efforts of experts to rebuild and revitalize communities can in fact destroying them through the four “counterfeiting” aspects of society: professionalism, medicine, human service systems, and the criminal justice system.

“These systems do too much, intervene where they are ineffective, and try to substitute service for irreplaceable care. Instead of more or better services, the book demonstrates that the community capacity of the local citizens is the basis for resolving many of America’s social problems.”

Bill White has talked about the need to differentiate treatment and recovery. If we fail to make this distinction, we’re more likely to drift into treatment-oriented treatment rather than recovery-oriented treatment. After watching the video below, I’ve often wondered what American health would look like if the health care system invested a little less heavily in stents and more heavily in supporting creating community/social pathways for patients to integrate more physical activity into their lives.

The internal combustion engine of AA

AA meeting sign
AA meeting sign (Photo credit: Wikipedia)

 

Service to others.

 

Bill White posted earlier this week about the evidence base for the benefits of alcoholics helping other alcoholics.

 

Now, National Geographic has posted an article about research into AA that covers some of the same territory:

 

Lee Ann Kaskutas, a scientist with the Alcohol Research Group, has faced skepticism from colleagues for studying A.A., in part because of the numerous spiritual references that go with the 12-step program. It puts A.A. on “the fringe” in the minds of many scientists, Kaskutas said.

Kaskutas, a self-proclaimed atheist, said that the 12 steps bear fruit regardless of one’s spiritual beliefs. “If you don’t believe in God, the way it weasels in is in the help and behaviors that the 12-step group inculcates.”

Helping others, Kaskutas said, “is the internal combustion engine of A.A. I think that is the connection to spirituality.”

People feel better about themselves after helping someone else, Kaskutas said. “So it’s reinforcing—when you help somebody, I think your brain chemistry changes.”

 

 

 

Youth Recovery Contexts

hands by katerha

Another study brings good news about adolescents and 12 step recovery:

Results

The proportion attending 12-step meetings was relatively low across follow-up (24 to 29%), but more frequent attendance was independently associated with greater abstinence in concurrent and, to a lesser extent, lagged models. An 8-item composite measure of 12-step involvement did not enhance outcomes over and above attendance, but separate components did; specifically, greater contact with a 12-step sponsor outside of meetings and more verbal participation during meetings.

Conclusions

The benefits of 12-step participation observed among adult samples extend to adolescent outpatients. Community 12-step fellowships appear to provide a useful sobriety-supportive social context for youths seeking recovery, but evidence-based youth-specific 12-step facilitation strategies are needed to enhance outpatient attendance rates.

Twelve-Step attendance trajectories over 7 years among adolescents

Hmmm. Doesn't look too young to me.

More evidence for the benefits of 12 step facilitation for adolescents:

Results of multivariate logistic GEE models indicated that adolescents with continued 12-Step attendance had better outcomes over time, whereas those in the early but not continued group had no different long-term outcomes compared to those in the low/no attendance group.

A problem, of course, is relatively low participation rates:

The majority (60%) had no or low attendance throughout 7 years. About one-fourth had high probability of attendance in the first year post-treatment entry but discontinued afterwards. Fewer than 15% continued 12-Step attendance throughout the 7 years

Conclusion:

Among adolescents with substance use disorders, overall 12-Step attendance was low post-treatment, but robust connection with 12-Step groups was associated with better long-term outcomes. Findings highlight the importance of 12-Step attendance in supporting long-term recovery among adolescents, and suggest that strategies are needed to facilitate 12-Step attendance. Additional research is needed on how the frequency, intensity and duration of 12-Step meeting attendance, as well as the type of activity, is associated with beneficial effects, and whether the relationships vary for different subgroups. Policies to address specific adolescent subgroups, based on severity, age or other characteristics could then be developed for targeting 12-Step facilitation efforts.

Everyone, from Yale to jail

image credit: http://www.ed2010.com

Greater Good has a nice piece on the benefits of helping others in addiction recovery:

In recent years, a growing body of research has found that helping others brings measurable physical and psychological benefits to the helper. Building on this work, Pagano is exploring the particular and sometimes surprising benefits of altruism for people battling alcoholism and drug addiction. Her studies have shown that addicts who help others, even in small ways—such as calling other AA members to remind them about meetings or making coffee like Victor did—can significantly improve their chances of staying sober and avoiding relapse, among adults and adolescents alike.

As she learned more about the different treatments for addiction, she was surprised that there seemed to be no one looking at the role of doing service.

“It was all about what services to give these suffering patients,” she says, “and nothing about getting them active or about how their own experiences about getting sober and being sober can be useful to others.”

She decided to explore the impact that helping others could have on people in recovery. She started by looking at data from one of the largest studies of addiction to date, with 1,726 participants. Though the study, run out of the University of Connecticut, was not focused on helping behavior specifically, Pagano was able to measure it by looking at how many study participants became AA sponsors or completed the 12th step of AA, which involves helping others in recovery.

When she compared helpers to non-helpers in AA, she found that 40 percent of helpers avoided taking a drink in the 12 months following the 3-month treatment period, while only 22 percent of non-helpers stayed sober—a doubling effect rarely seen in social science research, she says.

In addition, when Pagano looked at the age, gender, income, work status, addiction severity level, and level of antisocial personality disorder of the participants in the study, she found that none of these characteristics predicted helping behavior.

“Someone from Yale to jail had an equal chance of being a helper,” she says.

I also just learned of an organization called Adversity2Advocacy whose mission is, To inspire, to educate, and to facilitate the process of turning personal challenges into service to others facing similar challenges.

Here’s a radio segment about them that includes some discussion about helping and addiction.

It’s very interesting how we’re discovering all of these lifestyle-based mechanisms of change for other problem areas and that AA has been a vehicle for these mechanisms for decades.