The Elephant in the purple room

Having worked with a number of recovery communities and services across the U.K over the last decade, it still surprises me how reliant we have become on volunteers. Local authority budgets have been drastically cut in recent years and commissioned treatment provider caseloads in many cases are at unmanageable levels, with recovery workers firefighting complex cases or looking for quick discharges of others with varying levels of ‘sobriety’, it is perhaps no wonder that the integration of volunteer roles has gathered pace. I have visited services with volunteers on reception, running groups, mentoring, providing needle exchange services, doing home visits, and many other roles that were previously paid positions. Whilst this is undoubtedly great to see, and there are clear benefits to both the individual and service as a whole when you treat people as assets rather than just ‘service users’, I am frequently met with frustrations from volunteers, some of which i will attempt to articulate here.

The 2015 UK Life in Recovery survey found that those in recovery volunteer for local services at twice the rate of the general public. ‘we only keep what we have, by giving it away’ is the mantra.

Are service providers over reliant on volunteers? Do those volunteers receive the support and training they need and deserve?

We are frequently reminded, as people in recovery that we should be grateful, and how much ‘giving back’ supports our own wellbeing and recovery. These things are indisputable, I frequently do my own gratitude lists and meditations, as well as volunteer where I can, and I certainly wouldn’t have had a career in substance use without volunteer peer mentoring for my local service at the start of my journey. When I got my first paid position for a local treatment provider I had been volunteering for 18 months, had 27p on the electric meter and was under a sanction from the job centre for missing an appointment while volunteering. I was fortunate to have managers that believed in me, and be given the opportunity to create a job position where there wasn’t one before. That afforded me a pathway back into meaningful employment.

The elephant in the room however is the increasing pressure placed on volunteers in early recovery, and the lack of meaningful support received in many cases. Early recovery as defined by William White is anything under 12 months. Sometimes this period is referred to as the pink fluffy cloud of recovery, often this is the best life has ever been, we are substance free and we start to appreciate life and notice the small things. We want to give back and carry the message that we do recover.

We all love to hear success stories, from despair to hope. It gives us a warm feeling that recovery is possible and helps those earlier in their journey to identify. It is undoubtedly why many of us do what we do. Change is a beautiful thing.

Whilst there is undoubtedly lots of value in sharing our story, to celebrate change, inspire hope and promote visible recovery in our communities, I am often left wondering what support or guidance these brave individuals have in doing so, and also what happens when, as in many cases they serve their purpose, eventually lose their spark, or relapse. We all know that aftercare provision in the UK is in many cases woefully inadequate STILL. There is also an inherent stigma to re presenting at a treatment provider for a volunteer after a relapse. After being placed on a pedestal, overcoming those feelings of shame can be a real barrier. Does the organisation have a relapse policy, and is this equitable and supportive?

Services can be very quick to get their new successes to share their story and get them involved with volunteering. (some would say to evidence their services’ efficacy for future commissioning bids and to tick a ‘service user involvement’ box).

With record numbers of drug related deaths, fewer people entering treatment for alcohol use, and fewer successful exits (whatever successful means in reality) according to PHE statistics, the role of a peer worker is now more important than ever, but it should not compromise your personal recovery.

So what support do we really give these volunteer superstars managing receptions, running groups, facilitating access to mutual aid, mentoring, and generally making working life easier for paid staff and services across the UK that receive millions in contracts to provide services.?

Often, in my experience it is nothing more than inhouse or online training around safeguarding, confidentiality and a DBS to tick the boxes for the provider. I recognise that in the postcode lottery of UK service provision there are areas of really good practice with some great training options including accredited courses and regular supervisions, as well as pathways back into employment, however in my experience this is more the exception than the norm.

So whilst I agree that this recent shift towards enabling those in recovery to empower themselves through volunteering is a positive one on the whole, it must also be balanced with adequate resources and support for them, as well as recognition that their individual recovery is paramount. Volunteering should never be detrimental to personal recovery. Volunteers are more than just free labour, and volunteers should be compensated for the time they give freely.

Whether they are called, recovery champions, peer mentors, peer support workers or volunteers the important roles these individuals play deserve more resources, support and respect than is currently given in many areas. Particularly if they are integral to the delivery of a commissioned service. There is no greater resource than time, and these individuals give theirs freely, the least we could do is give them the skills and support they deserve to;

a) fulfil their role responsibilities to the best of their ability b) build their skills for the future c) have proper supervision d) feel like a valued and respected member of the team

Have local services in your area changed their mindset from ‘fixing and treating’ individuals in recent years to a more person centred community asset based approach? Does your local provider actually provide meaningful volunteer opportunities, as well as adequate support, training and a pathway back into employment? I would love to hear of your lived experiences. Feel free to drop me a confidential message to carlozuccaro@hotmail.co.uk.

Recovery what?

September is celebrated as Recovery month in towns and cities worldwide. It is a visible celebration of recovery from addictive behaviours, where people from various pathways connect, share stories, sing, dance and typically walk through their towns and cities in a show of solidarity. The recovery movement hopes to challenge stigma and act as a beacon of hope and inspiration for our communities, showing that we can and do recover.

This year however it comes around amidst a backdrop of record numbers of drug related deaths, rising suicide rates among almost every demographic and increased social isolation due to the pandemic, which will undoubtedly result in a surge of additional mental health and substance use issues. It is more important than ever to shine some light on a subject that is not a particularly endearing societal problem, despite so many families and communities being affected. There is an enduring stigma that pervades addiction and prevents people talking honestly and openly.

A quick bit about my early experience

I am a person in long term recovery from substance use and mental health issues and now a self employed recovery coach and consultant for a couple of peer led recovery services in the UK. Having worked for almost a decade within both NHS and charity services I want to share my experience as a person seeking recovery, working in treatment, and why i think that recovery coaching may be the answer to some of the issues we face.

The first time I ever sought ‘treatment’ was for my opiate habit and I was aged 18. I’d already dropped out of my A’ level studies after too much house partying in the late 90s, and my substance use had escalated onto harder drugs looking for some kind of escape from myself and my environment. I’d never heard of the concept of recovery then. I was living in a small market town in Lincolnshire, my mum was an addict, her bloke was a dealer and hope was something other people had. It was trainspotting without any of the nuanced relationship dynamics or scenic tourism. It was dawn raids, ODs in the kitchen and methadone not milk in the fridge. Shoplifters half price offerings and a who’s robbing who of giro junkies. I took my feelings of shame to the local surgery, broke down in tears to my GP and begged for some relief.

The well meaning but Ill equipped GP gave me some DFs and a few diazepam for which I was grateful (bless him) it was free drugs after all. The intention was there though, in that moment of clarity between giro days I imagined a life free from withdrawal, anxiety and depression, I was going to do it. Well, I did 3 long days on my grandma’s sofa pretending I had the flu before I necked the rest of the yellow tablets and clucked off to score again. I didn’t re-engage meaningfully with treatment again until I was 21 and left town with a methadone script and my first ever period of (MAT) recovery, and all manner of cross addictions (but that’s another story).

What’s new?

These first interactions of mine over 20 years ago with services raise some important points for me to reflect on today as a person in long term recovery.

Firstly a few questions, Can we honestly say that GP’s and front line services across the UK have the resources and knowledge necessary to provide more proactive interventions over 20 years later? Are traditional treatment services appealing and accessible for those new to them? Are waiting lists for accessing ‘treatment’ still in the future with very little in the present to support people during those brief moments of clarity? The best time to initiate change is when a person feels ready, that feeling is fleeting. Are aftercare services post treatment fit for purpose to maintain long term sobriety? I must say that I do see areas of good practice in some places in the UK with thriving well connected recovery communities, but i’m speaking here in general terms of the treatment system.

Secondly, what would it have looked like if I had access to an experienced guide who could advise me of different pathways and connect me to others in recovery, as well as wider community resources. Someone who could share their story of hope and recovery as well as ask tough questions from a place of experience and understanding?

My belief is that Recovery Coaching should be at the heart of every recovery support service and community. So, what is Recovery Coaching?

It is a form of strength-based, person centred support for people in or seeking recovery, and even their family members. It is similar to life or business coaching in that it is a type of partnership where the person seeking recovery self-directs their plan while the coach provides support, guidance and options. Recovery Coaching focuses on achieving goals important to the individual, without stigma, dogma or an agenda. They help people access recovery and the systems needed to support it and add to an individual’s recovery capital. They are not counsellors or therapists and as such are future focussed and goal oriented. They do not diagnose or treat substance use or any mental health issues, but can absolutely help with signposting to professional services that can, as well as offer an unparalleled level of understanding.

Peer based Recovery support

There are a myriad of different names for volunteer roles in the U.K, from mentor to recovery champion and others in between. These are primarily volunteer roles, and typically taken up by those still in treatment or at an early stage of their recovery. I am in no way dismissing these roles, they play a crucial part, and it is in these roles that I also gave back and volunteered at the start of my own journey. Nor am I speaking of the specific roles of a sponsor which again is a great part of a wider community approach.

There are however some distinct differences between existing unpaid roles of ‘peer support’ or ‘recovery champions’ and that of an experienced recovery coach. Not least a period of stable recovery, but also robust ongoing training and guidelines that incorporate values and ethics. The dynamic of the roles is also largely different, and an understanding of these differences can help ensure each role is maximised to its full potential in order to support existing treatment and public services. Support and development of these roles is critical to building a thriving recovery community.

There has been some great work across the pond by our American friends on peer based recovery support services, and their view is largely that we are very much behind the curve. β€œThe history and future of peer-based addiction recovery support services,”

There are areas of the U.K that have embraced similar models of peer based recovery support services, including rehabs and community organisations, and some great work has been done broadly by FAVOR UK on this as well as regionally by Red Rose Recovery. While this has been a great step in providing opportunities for employment and resources for people, we also need to be mindful to maintain the fidelity of the Coaching lane so these roles do not become appropriated into clinical, or β€œgo-fer” type roles. Many treatment services over reliance on volunteers has reached new levels, sometimes in a way i have seen to be detrimental to their personal recovery. Whilst giving back is undoubtedly an important part of wellbeing and recovery it must be meaningful, and feature appropriate support and guidance. Once trained our experience and expertise provide us invaluable insight and become our tools to help others. There must also therefore be a pathway for volunteers through meaningful volunteer roles to employment when appropriate.

I am grateful to be working with a very proactive CIC in Grimsby that supports recovery through art and mutual aid. They recognise the importance of bringing some of these concepts to their recovery community to help it become a thriving space for people to get well and re-engage with the wider community. I will be initially delivering 8 sessions of recovery coaching based on the great work of many giants before me including William White, McShin Foundation, CCAR and Favor UK to name but a few, as well as including elements from my own experience and coaching practice. This will form a wider bit of co-produced work from which we aim to establish a number of local coaches and implement systems to support the local community.

When i attended my first recovery walk in Birmingham UK in 2013 the theme was ‘make it happen’ and this is a mantra i have continued to aspire to on my own journey. Recovery is not only possible, it is inevitable when we reconnect with a community and find our purpose.

Hope + Opportunity + Purpose = Recovery πŸ’œ

I am also looking to connect with people across the UK who would like to influence their local community to make visible and sustained recovery the new normal.

Contact me; carlo@purplemagpiecoaching.co.uk

If you are in or around Grimsby get in touch.