Recovery and Recovery Support
By Ina A. Ramos, Ph.D.
Senior Technical Associate, The MayaTech Corporation
Recovery1
The Substance Abuse and Mental Health Services Administration (SAMHSA) defines recovery as “a process of change through which individuals improve their health and wellness, live a self-directed life, and strive to reach their full potential.” Recovery is an important step for individuals who experience a mental or substance use disorder or co-occurring disorders of the two, as it can indicate a shift in the expectation for positive outcomes. SAMHSA has identified four major dimensions necessary to support individuals in recovery:
- Health: overcoming or managing one’s disease(s) or symptoms—for example, abstaining from use of alcohol, illicit drugs, and non-prescribed medications if one has an addiction problem—and for everyone in recovery, making informed, healthy choices that support physical and emotional well-being.
- Home: A stable and safe place to live.
- Purpose: Meaningful daily activities, such as a job, school, volunteerism, family caretaking, or creative endeavors, and the independence, income and resources to participate in society.
- Community: Relationships and social networks that provide support, friendship, love, and hope.
In addition, there are 10 principles that serve as a guide for individuals through their recovery journey.
| 1. | Recovery emerges from hope. | The belief that recovery is real provides the essential and motivating message of a better future—that people can and do overcome the internal and external challenges, barriers, and obstacles that confront them. Hope is internalized and can be fostered by peers, families, providers, allies, and others. Hope is the catalyst of the recovery process. |
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| 2. | Recovery is person driven. | Self-determination and self-direction are the foundations for recovery as individuals define their own life goals and design their unique path(s) toward those goals. Individuals optimize their autonomy and independence to the greatest extent possible by leading, controlling, and exercising choice over the services and supports that assist their recovery and resilience. In so doing, they are empowered and provided the resources to make informed decisions, initiate recovery, build on their strengths, and gain or regain control over their lives. |
| 3. | Recovery occurs via many pathways. | Recovery is personalized and built on the multiple capacities, strengths, talents, coping abilities, resources, and inherent value of each individual. This may include professional clinical treatment; use of medications; support from families and in schools; faith-based approaches; peer support; and other approaches. Recovery pathways can be enabled by creating a supportive environment, especially for children, who may not have the legal or developmental capacity to set their own course. |
| 4. | Recovery is holistic. | Recovery encompasses an individual’s whole life, including mind, body, spirit, and community. This includes addressing self-care practices, family, housing, employment, transportation, education, clinical treatment for mental disorders and substance use disorders, services and supports, primary health care, dental care, complementary and alternative services, faith, spirituality, creativity, social networks, and community participation. |
| 5. | Recovery is supported by peers and allies. | Peers encourage and engage other peers and provide each other with a vital sense of belonging, supportive relationships, valued roles, and community. Peer-operated supports and services provide important resources to assist people along their journeys of recovery and wellness. Professionals can also play an important role in the recovery process by providing clinical treatment and other services that support individuals in their chosen recovery paths. Peer supports for families are very important for children with behavioral health problems and can also play a supportive role for youth in recovery. |
| 6. | Recovery is supported through relationship and social networks. | An important factor in the recovery process is the presence and involvement of people who believe in the person’s ability to recover; who offer hope, support, and encouragement; and who also suggest strategies and resources for change. Family members, peers, providers, faith groups, community members, and other allies form vital support networks. |
| 7. | Recovery is culturally based and influenced. | Culture and cultural background in all of its diverse representations—including values, traditions, and beliefs—are keys in determining a person’s journey and unique pathway to recovery. Services should be culturally grounded, attuned, sensitive, congruent, and competent, as well as personalized to meet each individual’s unique needs. |
| 8. | Recovery is supported by addressing traumas. | The experience of trauma (such as physical or sexual abuse, domestic violence, war, disaster, and others) is often a precursor to or associated with alcohol and drug use, mental health problems, and related issues. Services and supports should be trauma-informed to foster safety (physical and emotional) and trust, as well as promote choice, empowerment, and collaboration. |
| 9. | Recovery involves individual, family, and community strengths and responsibility. | Individuals, families, and communities have strengths and resources that serve as a foundation for recovery. In addition, individuals have a personal responsibility for their own self-care and journeys of recovery. | 10. | Recovery is based on respect. | Community, systems, and societal acceptance and appreciation for people affected by mental health and substance use problems—including protecting their rights and eliminating discrimination—are crucial in achieving recovery. |
Recovery Support2
Recovery support services are key to helping individuals in recovery navigate systems of care, reduce or remove barriers, stay engaged in the recovery process, and live to their fullest potential in their communities of choice. All services, whether provided by professionals or peers, should be culturally and linguistically appropriate services that assist individuals and families working toward recovery from mental and/or substance use disorders. Recovery support services may be provided before, during, or after clinical treatment, or to individuals who are not in treatment but seeking support services.
Using a broad range of service delivery options, including community and faith-based groups, peers, treatment providers, schools, and other specialized services, ensures the life experiences of all people are valued and represented. For example, there are 43 recovery high schools that are specifically designed for students in recovery from a substance use disorder or co-occurring disorders. These secondary schools help reduce the risk in high school environments for youth with substance use disorders and provide support for families learning how to live with and support their teens in recovery. Regardless of setting, recovery support services should incorporate coordination of recovery, wellness, and linkage activities among service providers to effectively improve the quality of life for people (and their families) in and seeking recovery.
SAMHSA has bolstered its recovery support systems through the Bringing Recovery Supports to Scale Technical Assistance Center Strategy (BRSS TACS). The BRSS TACS was designed to provide basic and advanced tools and resources to behavioral health professionals, peers, parents, and families across the country. The various recovery support tools and resources include core competencies for peers; shared decision-making tools; a share your story feature; information for parents, families, youth, and young adults; and training videos. To learn more, access these resources.
SAMHSA’s Commitment to Recovery and Recovery Support
The Office of Recovery3
To advance its commitment to supporting recovery for all Americans, SAMHSA launched the Office of Recovery in 2021. The Office of Recovery was established to evaluate and initiate recovery-focused policy, programs, and services, and ensuring the voice of individuals in recovery are represented. As a national clearinghouse and resource for recovery-oriented care across the mental health, substance use, and co-occurring domains, the office supports the growth and expansion of recovery support services across the country and promotes a recovery-oriented system of care working in partnership with recovery community leaders, tracking progress over time, and identifying and resolving barriers to system transformation. The office objectives include:
- Ensuring that recovery is a guiding principle in SAMHSA’s policies, programs, and services.
- Promoting the involvement of people with lived experience throughout agency and stakeholder activities.
- Identifying health disparities in high-risk and vulnerable populations and ensuring equity for recovery support.
- Fostering relationships with internal and external organizations in the mental health and substance use recovery field.
- Promoting training and public education opportunities on recovery.
- Exploring opportunities to partner with the philanthropic and private sectors to support innovative programming to address disparities and advance recovery transformation.
- Supporting implementation of any dedicated recovery resources to states for recovery support services.
Recovery Innovation Challenge4
On May 18, 2022, SAMHSA announced its first-ever behavioral health Recovery Innovation Challenge. The goal of this challenge is to identify innovative practices and models developed by individuals, peer-run or community-based organizations, and entities that may partner with them (e.g., local or state governments, health systems, hospitals, etc.) that promote and advance recovery. SAMHSA will also use the challenge to increase its engagement with a larger and more diverse number of organizations that provide recovery services across the continuum of care for Americans in various stages of recovery from mental health and substance use challenges.
“We are excited to introduce SAMHSA’s first-ever Recovery Innovation Challenge and are eager to give voice to those doing innovative work in this space,” said Miriam E. Delphin-Rittmon, Ph.D., HHS Assistant Secretary for Mental Health and Substance Use and the leader of SAMHSA. “By using this vehicle, we hope to gain a better understanding of effective and innovative recovery practices from a very diverse field. We aim to take what works for a small group and scale up to a larger population.”
The challenge encourages participants to share details about the practices they are using to advance recovery and demonstrate how these practices have: 1) expanded upon SAMHSA’s definition of recovery, or 2) helped them overcome challenges in incorporating recovery into their behavioral health services or systems.”
Key Dates:
- Submission Deadline: July 15, 2022
- Judging Period: July 15, 2022 - August 5, 2022
- Finalists Announced: August 6, 2022
- Finalist Presentations: September 2-9, 2022
- Awards Announced: October 2022 (up to 10 awards with the purse prize up to $400,000)
All submissions must be made through the SAMHSA Recovery Innovation Challenge application page on the challenge.gov website. For more information, visit SAMHSA’s Recovery Innovation Challenge webpage on SAMHSA’s website.
Peer Recovery Center of Excellence5
In 2020, SAMHSA established the Peer Recovery Center of Excellence to provide training and technical assistance (T/TA) related to substance use disorder recovery. The mission is to serve as a resource for peer recovery support workers through T/TA services to peers, organizations, and communities across the country. The center is a peer-led national center that is housed at the University of Missouri-Kansas City (UMKC) in collaboration with the National Council for Mental Wellbeing (NCMW), University of Texas–Austin (UT-A), and University of Wisconsin–Madison (UW-M). The center’s T/TA strategies organized into the following core areas:
- Integration of peer support services into new and expanded settings. Led by UMKC.
- Capacity building for Recovery Community Organizations. Led by UW-M.
- Workforce development of the peer and peer supervision fields. Led by UT-A.
- Bridging the gap between evidence-based and practice-based guidance. Led by NCMW.
The center is guided by a Peer-Led Steering Committee to ensure its mission, training, and events align with peer recovery support specialists’ needs and visions for enhancing the field. The committee comprises experts in the field from across the nation who are also peers in recovery from substance use disorder(s). The center can provide no-cost training and assistance to individuals, organizations, and systems working to advance the successful implementation of the peer support model of recovery in an array of settings. A plethora of resources are available on the center’s website, including videos; podcast sessions; information on trainings, communities of practice sessions, and becoming an organization stakeholder; and a resource library. Learn more about the Peer Recovery Center for Excellence.
Help is Available
If you or someone you know is in need of support, SAMHSA’s National Helpline is a free, confidential, 24/7, 365-day-a-year treatment referral and information service (in English and Spanish) for individuals and families facing mental and/or substance use disorders. Call 800-662-HELP (4357) or visit the online treatment locator at findtreatment.samhsa.gov. You may also find more SAMHSA publications and resources on recovery and recovery support by visiting the SAMHSA Store.
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