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March 29, 2012 Volume 3, Issue 12
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The RTP Webinar on culture and spirituality in recovery-oriented practice will be held April 4, 2012. Read the tips below to help ensure a positive experience for all participants.

From Harm Reduction to Recovery: Exponents
by Howard Josepher, LCSW
Exponents is a community-based organization in New York City that consists of 14 programs focused on improving quality of life for people affected by drug addiction, incarceration, and HIV/AIDS.

Most of Exponents' clinical practices were developed as a result of a successful experience with its first and longest running program, ARRIVE. Now in its 24th year, ARRIVE was one of the earliest initiatives in the U.S. to address the devastation that HIV/AIDS was causing in the injecting drug-using community.

ARRIVE held its first class in a church basement with seven recently released parolees. It was 1988 and the AIDS epidemic was at its height. Tens of thousands of drug addicts, their lovers, and family members were becoming infected and dying from AIDS-related illnesses. AIDS medications had yet to be discovered and the stigma surrounding the disease was severe. Addicts with Wasting Syndrome were refused treatment at hospitals and those known to be HIV positive were barred from drug treatment programs. HIV was considered a death sentence—a challenge only intensified by the crack epidemic and draconian prison sentences for possessing relatively small amounts of drugs.

I was hired to develop the ARRIVE pilot project because of my experience as a clinical social worker and staff trainer for prison-based drug treatment programs. I was also a person in recovery and had a fairly traditional background in addiction treatment. ARRIVE's mission was to prevent people from becoming infected or spreading the virus to others. If individuals were already living with the virus, we aimed to help them take better care of themselves. Naturally, I wanted to help these people overcome their addiction, but it was clear to me traditional methods would not be effective.

There were numerous factors that influenced the design of the program. Because participants had recently been released from prison, they were not open to long-term commitments. For ARRIVE to have an impact and change behaviors, participants had to be invested. We created a brief intervention model with 24 classes held over an 8-week period. Before enrolling, prospective students could see a clear beginning, middle, and end. We felt it was a manageable commitment—something people could feel good about upon completion.

Considering the daunting challenges our participants faced, we wanted them to have role models—individuals who had grappled with the same challenges and persevered. Peers, people in recovery, and those with HIV/AIDS would lead the program so we could ignite the hope and spirit so desperately needed to address these issues. We adopted a social learning approach where positive, healthy behavior was practiced by staff and peers. It became a community of recovering individuals supporting one another—similar to the one that helped me overcome my addiction. I was very familiar with the concept, but when it came to AIDS, we were all learning together.

Back in those days, if you wanted to learn about HIV/AIDS, you didn't go to doctors or medical textbooks. You either read about it in the newspaper or spoke to people living with the virus. I found my resources in the gay community, where incredible outreach was taking place. Early on, I learned if we were going to be successful and create a safe space, we had to be nonjudgmental. We adopted a hierarchy of needs: keeping people alive and healthy took precedence over getting them off drugs. We simply could not tell someone he had to get clean before we would educate him about HIV/AIDS. A decision was made that all students—whether they were active addicts or in recovery—would be welcome, as long as they weren't disruptive. Our "open arms" policy resulted in one of the first harm-reduction programs in the country. To make everyone feel welcome and safe, we loosened the requirements for participation and began meeting people where they were at.

Most people who came to the program had many failed drug treatment efforts, and we intended to break that cycle. Rather than focusing on what was wrong with them, we chose to focus on their strengths and what was right. We certainly wanted to address their problems (for example, if they were using or in relapse), but would not lose sight of the fact that they were showing up for classes. We saw power in their ability to overcome what seemed like insurmountable obstacles to get high every day. Addicts could move mountains when the goal was getting high. We wanted them to realize what their minds could accomplish if they focused on something positive. We developed a client-centered approach, supporting multiple recovery pathways while maximizing the importance of good health and well-being.

Given treatment limitations at the time and the chronic and mental health conditions our participants faced, we adopted a holistic approach to teach about complementary and alternative medicines. In our efforts to address the whole person—the body, mind, and spirit—we taught students how to self-manage conditions and provided them with skills and tools to cope with stress. We held classes on nutrition, diet, exercise, and positive thinking. We developed relapse prevention and psychoeducation training to address underlying conditions like depression, which goes hand in hand with drug misuse. And we discussed spiritual and philosophical concepts that questioned if nature, God, a higher power, or whatever it is that's out there is trying to teach us something through life's experiences.

Most importantly, we wanted our students to learn about the self-destructive and self-sabotaging nature of their illness—that recovery is about self-healing, from a fragmented sense of self to wholeness. From self-condemnation to self-love and self-respect.

ARRIVE enrolls more than 500 participants each year and typically sees 75 percent complete the course. At the end of 2011, the program had conducted 117 cycles of 24 classes, with more than 9,770 graduates. Studies show that recently released inmates who become involved with ARRIVE are more socially adjusted and exhibit safer behaviors than those who do not participate. SAMHSA has also listed ARRIVE as a best-practices model in Treatment Improvement Protocol 44.

When the original research grant for ARRIVE came to an end in 1990, my clinical team and I refused to let the project die. We founded Exponents to keep ARRIVE going. Over the years, we have added drug treatment, recovery, and re-entry programs to fill gaps and better address the needs of people who seek us out. Today, Exponents has 14 evidence-based programs designed to work with and engage individuals at whatever stage they have reached in the addiction–recovery continuum. We have 50 full-time staff members and a thriving peer component. Exponents receives Federal, State, and city funding, as well as contributions from foundations and private donors.

Howard Josepher is the President and CEO of Exponents. Contact him at hjosepher@exponents.org or visit the Exponents Web site to learn more about available programs.

Register Now

One Week Left to Register for
"Understanding and Building on Culture and Spirituality in Recovery-Oriented Practice"
The next RTP Webinar will describe three components of culture and spirituality in recovery-oriented care: cultural and spiritual assessments, culturally appropriate interventions, and ways in which spirituality and culture can shape an individual's recovery journey. Our presenters will introduce a range of strategies that ensure care is responsive to a person's cultural identity and discuss approaches for fostering cultural strengths and spirituality in care planning and recovery practices. An important facet of culture and spirituality in recovery-oriented care addresses the aging process—how can practitioners be cognizant of person- and family-centered culturally specific needs?

Date
April 4, 2012

Time
3–4:30 p.m. EST

Description
Three multidisciplinary specialists will share their perspectives. Reverend Laura Mancuso, M.S., CRC/CPRP, will describe practical tools for making assessment culturally and spiritually oriented. Dee Bigfoot, Ph.D., Assistant Professor of Pediatrics at the University of Oklahoma Health Sciences Center, will discuss recovery-oriented interventions that have spiritual and cultural components. Finally, National Association of Peer Specialists President Gladys Christian will address how spirituality and culture have affected her recovery journey.

Registration
Click here to register for the free Webinar.

Helpful Hints
  • Make sure to install the Live Meeting software and test the Webinar link before the event. If you experience technical difficulty downloading the software or logging in, please contact the Verizon Support Team at 866-449-0701.
  • If others will be participating at your location, please use the registration form to note who will attend. Log in from a single computer in a conference room or large office, which will enhance the group's listening and viewing experience.
  • Note that the audio portion of the Webinar is only available through your phone, not your computer speakers.
  • When you ask a question, please speak clearly and ensure there is no background noise, which can be very distracting to presenters and participants.
  • Webinar materials will be posted on our Web site before and after the Webinar. Click on past Webinars to access archived presentations.
*RTP does not offer CEUs for Webinar participation. Certificates of registration (not attendance) are available upon request.

Road to Recovery Series Continues in April
Scientific research on mental and substance use disorders—particularly prevention, treatment, and recovery—has led to many exciting discoveries in recent years. Premiering April 3, "Advancements in Science Are Helping People With Mental and Substance Use Disorders" will highlight breakthroughs in cognitive–behavioral techniques, brain science, recovery-oriented treatment and services, peer support, and trauma-focused care. The episode will illustrate how practitioners contribute to innovative research by generating data outcomes, participating in evaluation and services studies, and sharing their experiences with others.

Watch the trailer to learn how health information technology can support better decision making.

World Association for Psychosocial Rehabilitation
11th Congress
"Change thinking, change practice, change services" is the theme of this year's World Association for Psychosocial Rehabilitation (WAPR) conference, which will be held November 10 to 13 in Milan, Italy. Keynote lectures, plenary sessions, and symposia will address major mental health care milestones, as well as the current outlook and future prospects for long-term treatment and rehabilitation. See the full list of topics that will be discussed at the meeting.

Abstract Submission
WAPR welcomes abstract proposals for symposia, workshops, posters, and oral and video presentations by May 31, 2012.

For more information, click here.

Salt Lake County Opens Mobile Units for Mental Health Emergencies
When mental health crises occur, Salt Lake County, Utah, residents now have somewhere to turn besides the emergency room.

This week the county will deploy mobile crisis outreach teams to help people struggling with suicidal thoughts, panic attacks, and nervous breakdowns.

The teams—two devoted to adults and one solely for children—will tend to callers at their homes, workplaces, or (if necessary) on the street. Teams consist of a licensed social worker or psychologist, peer specialist, and examiner who can determine if the person needs more serious attention. A psychiatrist will also be available by phone.

Mobile units must respond to calls within 30 minutes. After initial contact, they will evaluate the situation and provide therapy or arrange an appointment with a therapist.

Read more.

The RTP Resource Center Wants to Hear From
Recovery-Oriented Practitioners!
We invite practitioners to submit personal stories that describe how they became involved in
recovery-oriented work and how it has changed the way they practice.
The RTP Resource Center Wants to Hear From You, Too!
We invite you to submit personal stories that describe recovery experiences. To submit stories or
other recovery resources, please contact Cheryl Tutt, MSW, at 877.584.8535,
or email recoverytopractice@dsgonline.com.

We welcome your views, comments, suggestions, and inquiries.
For more information on this topic or any other recovery topic,
please contact the RTP Resource Center at
877.584.8535, or email recoverytopractice@dsgonline.com.


The views, opinions, and content of this Weekly Highlight are those of the authors, and do not necessarily reflect
the views, opinions, or policies of SAMHSA or the U.S. Department of Health and Human Services.