A Volunteer Model for Providing Peer Recovery Support
| 2010 - August |
A successful volunteer peer recovery support model was developed and is being implemented by a charitable nonprofit organization called Communities for Recovery (CforR) of Austin, Texas. The purpose of this organization is to provide recovery support for individuals suffering from chemical dependency and mental or emotional health issues. The organization was started in 2003 to serve the Chemical Dependency (CD) and Dual Disordered (DD) in-patients as well as out-patients at Seton Shoal Creek Hospital, Austin, Texas, where WML served as Medical Director. The initial objective was to offer recovery support to patients during their stay in the hospital and after discharge to reduce recidivism in this population. The Volunteers began by concentrating on the resident population which presented approximately 65% CD and 35% DD. Volunteer activities included one-on-one discussions with the patients; accompanying them to off-unit 12 Step meetings in the Hospital; and conducting on-unit informal Q and A and story-telling meetings that came to be known as Cross-Talk meetings.
The volunteer efforts were then expanded to include the out-patients in a new (for us) 4 week, 12 Step educational program authored by Wally P.(1) called Back to Basics (B2B). Attractive features of this program is its ability to introduce 12 Step education to attendees and, as will be discussed later, to generate new candidates for the volunteer force.
As the Volunteer Program grew into other Austin Treatment Facilities, namely Texas Star Recovery, Austin Recovery's Men's Intensive Outpatient Facility and Austin State Hospital, the B2B and Cross-Talk offerings multiplied accordingly and a new 12 Step study program based on the 12 Steps, as modified for persons with dual disorders, was developed by JST between 2008-2009 called Dual Disorders Recovery Achievers (DDRA) and was designed to have the same Volunteer generating feature as B2B. This development was inspired by a substantial increase in the ratio of patients reporting as Dual Disordered vs. those reporting as Chemically Dependent over the period 2003-2009 at the Treatment Facilities served by CforR. Also in this same time period, the skills utilized by the CforR staff and Volunteers increased dramatically. Five day trainings for Certified Peer Specialists to provide support to individuals with mental or emotional problems, and the five day trainings for Recovery Coaches to help people with addiction to alcohol or other mind altering drugs have been made available to the CforR staff and Volunteers and most of the CforR staff and about 30% of CforR's Volunteer Force have taken one or both of them. All of CforR's Volunteers take the four hour orientation and training that provides the minimum skill set needed to begin volunteer work with our host organizations.
Somewhere along the way we began to see the Volunteer Force in a new light. It became clear that it was the Volunteer Force, not the CforR Staff that was responsible for the organization's success. The proper role of the Staff became providing the best possible attention and care for the Volunteers. This includes arming them with new trainings and opportunities so they can pursue their role in bringing recovery to others as well as to themselves. The Volunteers have their own Committee of CforR's Board of Directors so that they have a direct communication link to the Board. The CforR Staff organizes a monthly Movie Night and a monthly Volunteer Breakfast to help stimulate communication amongst and between Volunteers and Staff in a social context. The training programs are designed to educate the Volunteers about their organization and to help enhance their recovery. The Volunteers truly are the thread that binds the fabric of recovery together at Communities for Recovery.
In 2010, the Austin State Hospital (ASH) invited CforR to occupy space on the magnificent ASH campus. This meant that for the first time CforR Volunteers began to provide peer recovery oriented programs to the ASH patients as well as the public from CforR's own facility.
The Volunteer Model
The plan for the Volunteer Model and the motivation to publish its description began with the first meeting of authors with WML's staff leader, Kathy B. in 2003. In this meeting it was decided to start with six volunteers, three male and three female, who were given authorization to meet with patients (male to male and female to female) in their rooms (if invited) or in small groups in the day room or in the process of taking them to one of the AA or NA meetings on the first floor of the Hospital. JST was to be the recruiter and coordinator of the volunteers and their activities. The patients always had many questions about the best AA, CA, NA, etc. meetings in Austin and surrounding communities, how to get a sponsor and how to find a place to stay. To address these questions efficiently, it was decided to have a weekly Cross-Talk meeting in the Day room with the patients and two or four Volunteers or Volunteer Candidates. The question, "will you be my sponsor?" which the volunteers wanted to answer affirmatively, made it clear that to be successful we'd need a much larger number of volunteers or come up with a different model. Since we knew the Hospital could not tolerate dozens of volunteers coming on the patient unit, we opted to turn to a different model. The model that presented itself to WML at precisely the right moment was Wally P.'s Back to Basics. The E.D. of a treatment facility in a nearby community had presented a copy of Wally P.'s book to WML and recommended it for patients struggling for recovery. Wally P.'s B2B is a four week educational program based on the 12 Step Beginners meetings that were conducted in the 1940's. These newcomers to AA were required to attend the Beginners' meetings to become familiar with the Steps before they could attend regular AA meetings. WML saw the advantage of this program and quickly convened a meeting of his recovery friends (old-and not so old timers who were mostly ex-patients) to discuss implementation of B2B at Seton Shoal Creek Hospital. Some of WML's friends turned out to be very familiar with B2B and to-do lists were compiled and a target start date was decided upon. It was agreed that the old timers would get the meetings started while training the Volunteers how to continue the program.
As adapted for Seton Shoal Creek, the four weekly sessions of B2B were conducted starting on the first Wednesday of each month in the evenings from 7:00 to 8:30 with a 10 minute break after the first 50 minutes. The first weekly session was devoted to Steps 1-3, the second to Step 4, the third to Steps 5-9 and the fourth to 10-12.
Each newcomer is helped through the 12 Steps during all of the four sessions by a supportive Sharing Partner and/or a Temporary Sponsor. After going through one full month as a Newcomer the individual then returns to the next month's program to serve as a Sharing Partner helping another Newcomer take the Steps. The Newcomer to Sharing Partner transition happens as the persons' understanding and appreciation of the Steps deepens.
Upon completing B2B for the second time, the Sharing Partner assumes the broader role of Temporary Sponsor for the third month and will help both a new Sharing Partner and a new Newcomer take the Steps. The Figure illustrates the volunteer generating feature of the B2B Program graphically: Two Newcomers (blue figures) are accompanied by a Sharing Partner (in red) and a Temporary Sponsor (in green) attend the First Month and complete the 12 Steps. Then for the Second Month, the former Newcomers both come back as Sharing Partners, the former Sharing Partner advances to Temporary Sponsor and the Temporary Sponsor returns in the same role, the Temporary Sponsor role being the highest attainable in this program.. As shown in the figure, there are four new Newcomers seated at the two tables. In this ideal case, the number of participants doubled from the First Month. In Month
Three, the four Newcomers from Month Two become Sharing Partners and the two former Sharing Partners become Temporary Sponsors joining the two returning Temporary Sponsors to make a total of four Temporary Sponsors. So, the four Sharing Partners and the four Temporary Sponsors create the capacity to help eight new Newcomers take the Steps.
At Seton Shoal Creek in the period 2003-2007 the typical support ratio hovered around 0.70 which is approximately two Temporary Sponsors or Sharing Partners to three Newcomers. The total numbers of weekly attendees averaged 30 with peak numbers in the 60s.
Graduates of the B2B and DDRA programs become prime candidates for Peer Support Volunteer positions with Communities for Recovery.
Even as the B2B program was flourishing WML could see that the needs of the dual diagnosed patients would not be adequately met with B2B and asked the Volunteers to support a Dual Recovery Anonymous meeting at the Hospital. To help the volunteers make that happen he assigned an intern to do the tough part which includes putting up flyers, calling friends who may be dual diagnosed and waiting at the meeting site for folks to show up. Then, as the meeting took form and started to happen it was noticed that Steps 4 and 8 of AA and DRA differed significantly. Older members of this fledging group were concerned that no one in the group would be qualified to be DRA sponsors for others in the group. To meet this challenge CforR Volunteers made contact with the nearest DRA meeting in Beaumont, Texas. The person in charge of the Beaumont DRA meeting came to Austin to give us training and insight on the DRA Steps with special emphasis on the 4th and 8th Steps. So while we had the first Dual Recovery Anonymous meeting in Austin, we didn't have a companion program to bring newcomers rapidly through all 12 Steps until the development and pilot initiation of the Dual Disorders Recovery Achievers (DDRA) program in 2008.
In 2008 WML left Seton Shoal Creek to set up a new Treatment Facility in Austin called Texas Star Recovery. CforR was asked to expand its operations to provide Volunteer Peer Support to Chemically Dependent and Dual Diagnosed Patients for this new hospital. It was decided to offer initially B2B, Cross-Talk and DRA to the patients. The dynamic at this location was very different than SSC because the in-patient treatment periods were longer, generally 2 weeks and most of the meetings at the hospital were closed to the public. To give patients exposure to outside meetings they were transported by van to various meetings in Austin.
The contingent of patients with dual diagnoses at TSR was/is substantially larger than that at SSC and the need for a B2B style program for the DRA Steps became acute. However, there was simply no extra staff time available to create such a program and the DRA 12 Step workbooks were substituted. In November of 2008 JST took on the challenge, over a six month period, to develop such a program by generating a first final draft worthy of testing. The new program was called Dual Disorders Recovery Achievers (DDRA) and went into pilot testing in February of 2009. The program utilizes conversations between Casey and Alex, two androgynous humans, to bring out important points in the text (called the "fine print") and to serve as a model for participant response to discussion questions which relate to dual diagnoses symptoms and to the Casey and Alex conversations.
The popularity of DDRA was so large that CforR management and our Volunteers decided to modify the CforR version of B2B to incorporate discussion questions in that program as well.
In what can be called a 2nd Phase of growth, CforR began to research other organizations that were doing similar or like-minded work in the Peer Services sector and made two benchmark visits. The first visit was with Phil Valentine of the Connecticut Community of Addiction Recovery (CCAR) in Connecticut and the second with Ben Bass of Recovery Alliance in El Paso, Texas. Through these meetings and conversations, CforR engaged and hired Recovery Alliance to provide Peer Recovery Coach and Train the Trainer training to 4 staff and 6 Peer Support Volunteers and who brought in CCAR to El Paso for a subsequent Telephone Outreach training program which was attended by 3 CforR staff and 3 Peer Support Volunteers. CforR has begun implementation of a Peer Recovery Coach Institute, and has trained 14 CforR Peer Support Volunteers who all now are available to provide Peer Recovery Coaching to people in our community seeking recovery from chemical addiction and dual disorders.
The next expansion of the CforR Volunteer operation was a result of being invited to occupy space on the campus of the Austin State Hospital in exchange for providing programming for ASH patients and employees. At ASH CforR is currently providing weekly open sessions of B2B in the "Nifty Fifty" canteen conference facility for the public and escorted patients, morning DRA meetings twice a week on east and west patios, a Wednesday noon DRA meeting located in the CforR Peer Recovery Support Center in Building 635 and a weekly open DDRA program is offered on Thursday evenings also in the CforR Peer Recovery Support Center.
An important new CforR program is providing tele/video internet outreach recovery support services to discharging patients of Texas Star Recovery. The objectives of this new program for our Volunteers are to maintain weekly contact with the patients for a minimum of 90 days, offering recovery coaching or peer support as requested and deemed appropriate, collecting data via their self reports of well being or relapse and providing information about available resources that may help enhance their recovery.
This Volunteer Model can be replicated. Hopefully this will be of interest to treatment facilities who seek cost effective solutions for providing peer support and recovery coaching to the growing population of folks seeking recovery.
( 2 Votes )
