Background: One of my proudest achievements in recent years has been the birth and growth of the College of Lived Experience Recovery Organisations (CLERO) in the UK. We set up the CLERO to provide a forum for recovery community organisations with three primary aims:
1. To chart the innovations and community engagements that lived experience recovery organisations regularly do
2. To start providing an evidence base around ‘what works’ in LEROs and to offer academic credibility to underpin and supplement the testimony of clients and providers of these services
3. To start to build a set of quality standards that can raise the bar and that will reassure commissioners, family members and the users of community recovery organisations.
For much of this work, we have leaned heavily on the work being done in the United States where Recovery Community Organisations (RCOs) are an established part of the recovery landscape and where the Recovery Research Institute is providing a growing evidence base of how and why they have a positive impact on recovery journeys.
Against this backdrop, it was a wonderful opportunity to be offered the chance to visit a number of recovery community organisations in Michigan, as part of a project to adapt the REC-CAP instrument for use in RCO settings as part of a pilot project.
What was the purpose of the visit? The REC-CAP is now widely used in the US, primarily across recovery residences but also in one prison and in two drug courts. However, setting matters to what kinds of information that it is necessary to collect – not only from the service user but also from the organisation around things like assessment and discharge processes, services available, types of support and so on. Furthermore, there is increasing evidence that recovery is embedded not only in social networks but also in community contexts so we need to know quite a bit about the organisation and how it fits in to the overall context – what we hope is that this constitutes a Recovery-Oriented System of Care (ROSC), where all of the services (recovery services, specialist treatment providers and their partners in mental health, justice and so on) work together to create multiple pathways supporting recovery.
So this was a fact-finding trip to review what the provision was in Michigan and to build relationships with providers to prepare for the training and introduction of the REC-CAP across both recovery residences and recovery community organisations in Michigan. In the course of the week-long visit, we were welcomed and participated in five events:
- Echo Detroit
- Rise Recovery
- Home of a New Vision
- Workshop hosted by the Michigan Department of Behavioural Health
- Online forum and workshop
As a result, we were able to undertake three visits, engage with a total of around 10 providers of recovery community organisations, state funders and the CEO of the Michigan Association of Recovery Residences, Jeffrey Van Treese who was a wonderful host and support throughout our travels across Michigan.
So what are RCOs like in Michigan?
The first key observation, at least for the ones we visited, is that they are generally linked to recovery residences and for one of them to a detoxification unit – in other words, the organisation provides specialist treatment, recovery housing and an RCO.
As for what the RCO does, they vary as they should – according to the resources and connections they have, the populations they serve and the connections they have developed with the communities they are based in. Each varied in the extent to which they were inward looking (providing community services primarily for the residents of their own services) and to the extent to which they provided services to the wider community.
This also reflected the extent to which users of the RCO had to be ‘registered’ in some way, with most of them providing a ‘blended’ approach in which ‘events’ were open to anyone but core services (recovery coaching, training, group activities) were restricted to those who had been assessed and signed up. In this blended model, what was really striking was that the outreach focus of events was a means of early engagement that created the connections for more formal engagement.
However, what was most striking at all three venues we visited, was that staff vision, energy and dedication combined with some incredible innovation. The commitment to education through culinary arts classes, tree-trimming and landscaping and to fun through ‘open mic’ nights at Echo Detroit; primary prevention and education through a schools programme, a clubhouse to support social activities and provide a safe space and branded recovery clothing to celebrate recovery and challenge stigma at RISE in Lansing, where there was an astonishing list of partners and activities; and finally at Home of A New Vision in Ann Arbor, where they hosted an annual arts gala, had an events schedule including a basketball league, yoga classes, meditation and hiking, and a newspaper called “The Recovery Advocate”.
There is an astonishing diversity in provision to meet the needs of the clients but also to actively engage with the community. This is both an enactment and an embodiment of a model where the personal capital of individuals grows and flourishes through networks, connections, safety and activity – the primary recovery pillars of Connection, Hope, Identity, Meaning and Empowerment (CHIME).
So what did we learn?
There is remarkable energy, capacity and innovation and, given the close links between recovery residences and RCOs in Michigan, there is a huge potential for creating hubs for recovery that can link to all kinds of community spokes creating in-reach and out-reach to build a strong recovery community and build diverse and extensive community partnerships. This is at the heart of challenging stigma and building strong and sustainable bridges to the wider community that allows personalised pathways to jobs, friends and houses. In doing so, these services provide both recovery and harm reduction services and provide access to recovery services for when people are ready to engage.
However, there is a risk that the funding and co-location of recovery residences, treatment and RCOs create a ‘closed community’ that is inward-looking. From our point of view, there are exciting challenges about working out who is a ‘client’ of RCOs and whether gains achieved are a consequence of the residence or the activities. But we have always known that the benefits of recovery are additive and cumulative.
Conclusion
We are at an incredibly exciting time for the growth of recovery organisations and it is wonderful to have the opportunity to be able to chart some of these successes and achievements. Each time I visit a recovery community centre I am astonished by their innovations and creativity and it will be a pleasure to work with our colleagues in Michigan to support recovery pathways through the use of the REC-CAP and to help build effective recovery interventions to support these pathways.