transformation of the culture of recovery in america by william l. white - october 2011
DESCRIPTION
"Transformation of the Culture of Recovery in America" was presented on Tuesday October 18, 2011; by William L. White, MA; Senior Research Consultant, Chestnut Health System. For almost three centuries, people recovering from severe alcohol and other drug problems have found ways to help each other initiate and sustain their recovery journeys. Today, recovering people, their families, and visionary professionals have responded to the stigma, criminalization, and lack of appropriate medical care associated with severe alcohol and other drug problems by creating an unprecedented growth in new structures of recovery support. This presentation will explore recent recovery community building activities and the influence they will exert on the future of addiction treatment and recovery in America. William White is one of the world’s best-know and most influential advocates, authors and public speakers on the subject of recovery from addiction. He has authored or coauthored more than 350 articles and monographs and fifteen books, including "Let's Go Make Some History: Chronicles of the New Addiction Recovery Advocacy Movement," "Pathways From The Culture of Addiction to the Culture of Recovery," and "Slaying the Dragon: The History of Addiction Treatment and Recovery in America" which received the McGovern Family Foundation Award for the best book on addiction recovery. This program is part of the FREE, annual Dawn Farm Education Series. The Education Series is organized by Dawn Farm, a non-profit community of programs providing a continuum of chemical dependency services. For information, please contact Matt Statman, LLMSW, CADC, Education Series Coordinator, at 734-485-8725 or [email protected], or see http://www.dawnfarm.org/programs/education-series.TRANSCRIPT
The Culture of Recovery in The Culture of Recovery in America: America:
Recent Developments & Recent Developments & Their Significance Their Significance
Bill WhiteBill White
Chestnut Health SystemsChestnut Health Systems
Email: [email protected]: [email protected]
Presentation Goals Presentation Goals
1.1. Provide a historical update of the Provide a historical update of the culture of recovery in America to culture of recovery in America to include a review of diverse include a review of diverse communities of recovery and the communities of recovery and the emergence of new recovery culture emergence of new recovery culture institutions. institutions.
2.2. Explore the implications of these Explore the implications of these changes for the future of addiction changes for the future of addiction treatment and recovery. treatment and recovery.
The Handsome Lake The Handsome Lake MovementMovement
• Handsome Lake’s Handsome Lake’s conversion (1799)conversion (1799)
• The Code of The Code of Handsome Lake Handsome Lake
• The rejection of The rejection of alcoholalcohol
• The Longhouse The Longhouse ReligionReligion
Other Abstinence-based Other Abstinence-based Religious Revitalization Religious Revitalization MovementsMovements
• The Shawnee ProphetThe Shawnee Prophet• The Kickapoo ProphetThe Kickapoo Prophet• The Indian Shaker The Indian Shaker
ChurchChurch• The Native American The Native American
Church (Quanah Church (Quanah Parker)Parker)
• ““Indianization of AA”Indianization of AA”• Wellbriety MovementWellbriety Movement
The American Temperance The American Temperance Movement Movement • Early recovery biographies (1830s)Early recovery biographies (1830s)• Washingtonian Movement Washingtonian Movement • Recovery-focused Fraternal Recovery-focused Fraternal
Temperance Societies Temperance Societies • Ribbon Reform ClubsRibbon Reform Clubs• Institution-based Recovery Support Institution-based Recovery Support
Groups (e.g., Ollapod Club, Godwin Groups (e.g., Ollapod Club, Godwin Association, Keeley Leagues)Association, Keeley Leagues)
Blue Ribbon Reform Club Blue Ribbon Reform Club Pledge CardPledge Card
Faith-based Recovery Faith-based Recovery
Early Treatment Institutions Early Treatment Institutions
Early Treatment InstitutionsEarly Treatment Institutions
The Collapse (1900-1920)The Collapse (1900-1920)
• ExposExposéés of fraud and patient abuses of fraud and patient abuse
• Schisms within the fieldSchisms within the field
• Lack of scientific foundation Lack of scientific foundation
• Aging out of leadershipAging out of leadership
• Rising therapeutic pessimism & drive Rising therapeutic pessimism & drive toward alcohol/drug prohibitionstoward alcohol/drug prohibitions
The Transition PeriodThe Transition Period
Mutual AidMutual Aid
• United Order of Ex-boozers, etc.United Order of Ex-boozers, etc.
• Harlem Club of Former Alcoholic Harlem Club of Former Alcoholic DegeneratesDegenerates
Alternatives following Collapse of TreatmentAlternatives following Collapse of Treatment
• Inebriate Penal ColoniesInebriate Penal Colonies
• State Psychiatric HospitalsState Psychiatric Hospitals
• Private Sanitaria & Hospitals Private Sanitaria & Hospitals
Mid-Twentieth Century Mid-Twentieth Century Rebirth Rebirth • Alcoholics Anonymous Alcoholics Anonymous • The Modern Alcoholism MovementThe Modern Alcoholism Movement• New Alcoholism Treatment InstitutionsNew Alcoholism Treatment Institutions• New Addiction Treatment InstitutionsNew Addiction Treatment Institutions• Addicts Anonymous, Hypes & Addicts Anonymous, Hypes &
Alcoholics, Narcotics AnonymousAlcoholics, Narcotics Anonymous• Stage set for rise of modern addiction Stage set for rise of modern addiction
treatmenttreatment
AA Shared with Earlier Groups AA Shared with Earlier Groups (Not Derivative)(Not Derivative)
• Problem admissionProblem admission
• Public or semi-public commitment to Public or semi-public commitment to sobriety sobriety
• Sober fellowshipSober fellowship
• Experience-sharing meetingsExperience-sharing meetings
• Storytelling (3-part style) Storytelling (3-part style)
• Peer mentoring Peer mentoring
AA InnovationsAA Innovations
• Self-surrender versus self-assertionSelf-surrender versus self-assertion
• Focus on long-term recovery Focus on long-term recovery maintenance versus recovery initiationmaintenance versus recovery initiation
• Middle spiritual path between religious Middle spiritual path between religious and secular pathways of recovery and secular pathways of recovery
• Codification of program in writing prior Codification of program in writing prior to explosive growthto explosive growth
AA InnovationsAA Innovations
• Maintained its closed meeting frameworkMaintained its closed meeting framework --import of identification in recovery process--import of identification in recovery process• Unique organizational structure (that all Unique organizational structure (that all
external advisors predicted could not work)external advisors predicted could not work)• Creative management of the 5 Ps: Creative management of the 5 Ps:
personality—particularly charismatic personality—particularly charismatic leadership, power/privilege, possessions leadership, power/privilege, possessions (money and property), press and passion(money and property), press and passion
• Twelve Traditions were/are key to AA’s Twelve Traditions were/are key to AA’s survival survival
AA Remains Standard by which AA Remains Standard by which Pre-AA and Post AA Groups are Pre-AA and Post AA Groups are JudgedJudged• Size (2.1 million members) & Size (2.1 million members) &
Geographical Dispersion (150 Countries)Geographical Dispersion (150 Countries)• Longevity as an Organization Longevity as an Organization • Number & Methodological Rigor of AA Number & Methodological Rigor of AA
Research Research • Adaptation to Other Problems of LivingAdaptation to Other Problems of Living• Influence on Addiction Treatment Influence on Addiction Treatment • Influence on Culture Influence on Culture
Recovery Mutual Aid, 1970-Recovery Mutual Aid, 1970-20002000• Growth of Twelve Step groupsGrowth of Twelve Step groups
• Growing varieties of Twelve Step Growing varieties of Twelve Step experience experience
• Dramatic growth in total membershipDramatic growth in total membership
• Geographical dispersion in U.S. and Geographical dispersion in U.S. and internationallyinternationally
• Diversification of recovery frameworksDiversification of recovery frameworks
Spiritual Frameworks of Spiritual Frameworks of Recovery Recovery Twelve-Step Groups, e.g., -AA (1935) and NA Twelve-Step Groups, e.g., -AA (1935) and NA
(1947, 1953, 1959) (1947, 1953, 1959) Primary Drug Adaptations: marijuana (1968, Primary Drug Adaptations: marijuana (1968,
1989), prescription drugs, (1975, 1998), 1989), prescription drugs, (1975, 1998), cocaine (1982) nicotine (1985), cocaine (1982) nicotine (1985), benzodiazepine (1989), methamphetamine benzodiazepine (1989), methamphetamine (1995), heroin (2004), persons in recovery on (1995), heroin (2004), persons in recovery on methadone (1991) & generic groups i.e., methadone (1991) & generic groups i.e., Recoveries Anonymous (1983) Chemical Recoveries Anonymous (1983) Chemical Dependent Anonymous (1988)Dependent Anonymous (1988)
Non-Twelve Step, Spiritual AlternativesNon-Twelve Step, Spiritual Alternatives --The Red Road to Wellbriety--The Red Road to Wellbriety
Further Specialization Further Specialization
FamilyFamily
Al-Anon (1951), Alateen (1957), Al-Anon (1951), Alateen (1957), Families Anonymous (1971), Families Anonymous (1971), Recovering Couples Anonymous Recovering Couples Anonymous (1988) & Teen-Anon (1999)(1988) & Teen-Anon (1999)
Emergence of Concept of “Family Emergence of Concept of “Family Recovery”Recovery”
Further Specialization Further Specialization
Occupational Occupational
International Doctors in Alcoholics International Doctors in Alcoholics Anonymous (1949), Lawyers (1975), Anonymous (1949), Lawyers (1975), Anesthetists (1984), Nurses (1988), Anesthetists (1984), Nurses (1988), Veterinarians (1990), etc. Veterinarians (1990), etc.
Further Specialization Further Specialization
Co-Occurring ProblemCo-Occurring ProblemDual Disorders Anonymous (1982), Dual Disorders Anonymous (1982),
Dual Recovery Anonymous (1989), Dual Recovery Anonymous (1989), Double Trouble in Recovery (1993)Double Trouble in Recovery (1993)
Criminal Justice Criminal Justice Inner Circle Inner Circle Winner’s Circle/Community Winner’s Circle/Community
Meeting Specialization Meeting Specialization
• GenderGender
• Age or duration of sobriety Age or duration of sobriety
• Ethnicity Ethnicity
• Sexual orientation Sexual orientation
• Smoking statusSmoking status
• Degree of religiosity Degree of religiosity
• Endless varieties of meeting formatsEndless varieties of meeting formats
Secular Recovery Support Secular Recovery Support GroupsGroups
• Women for Sobriety (1975)Women for Sobriety (1975)
• Secular Organization for Sobriety / Save Secular Organization for Sobriety / Save Our Selves (1985)Our Selves (1985)
• Rational Recovery (1986)Rational Recovery (1986)
• Men for Sobriety (1988)Men for Sobriety (1988)
• Smart Recovery® (1994)Smart Recovery® (1994)
• Moderation Management (1994)Moderation Management (1994)
• LifeRing Secular Recovery (1999)LifeRing Secular Recovery (1999)
Religious Recovery Support Religious Recovery Support GroupsGroups
• Calix Society (1947)Calix Society (1947)
• Alcoholics Victorious (1948) Alcoholics Victorious (1948)
• Teen Challenge (1961)Teen Challenge (1961)
• Alcoholics for Christ (1976)Alcoholics for Christ (1976)
• JACS (1979)JACS (1979)
• Celebrate Recovery, Free N’ One, Ladies Celebrate Recovery, Free N’ One, Ladies Victorious, Overcomers in Christ, Victorious, Overcomers in Christ, Liontamers Anonymous, Mountain Movers, Liontamers Anonymous, Mountain Movers, Millati Islami Millati Islami
Important Resource Important Resource
Mutual Support Resources regularly Mutual Support Resources regularly updated at Faces and Voices of updated at Faces and Voices of Recovery Web Site Recovery Web Site
http://www.facesandvoicesofrecovery.org
Current TrendsCurrent Trends
• From recovery community to From recovery community to communities of recoverycommunities of recovery
• Cultural & political awakening across Cultural & political awakening across religious, spiritual & secular religious, spiritual & secular frameworks of recoveryframeworks of recovery
• New recovery support institutions New recovery support institutions
• Cultural development Cultural development
Culture of Recovery UpdateCulture of Recovery Update
• Diversification of Peer-based Recovery Diversification of Peer-based Recovery Support SocietiesSupport Societies
• New Recovery Advocacy Movement New Recovery Advocacy Movement • Spread of Grassroots Recovery Community Spread of Grassroots Recovery Community
Organizations & Recovery Support CentersOrganizations & Recovery Support Centers• Recovery Home MovementRecovery Home Movement• Recovery Industries Recovery Industries • Recovery School MovementRecovery School Movement• Recovery Ministries, Churches & ColoniesRecovery Ministries, Churches & Colonies
New Recovery Advocacy New Recovery Advocacy MovementMovement
HistoryHistory
2001 Recovery Summit in St. Paul2001 Recovery Summit in St. Paul
National Organization National Organization
Faces and Voices of RecoveryFaces and Voices of Recovery
NCADDNCADD
Johnson InstituteJohnson Institute
Legal Action Center Legal Action Center
Movement Goals Movement Goals
• Political/Cultural Mobilization of Communities Political/Cultural Mobilization of Communities of Recoveryof Recovery
• Recovery-focused Public & Professional Recovery-focused Public & Professional Education Education
• Advocacy of Pro-recovery Laws & Social Advocacy of Pro-recovery Laws & Social Policies Policies
• Push for Recovery-focused Redesign of Push for Recovery-focused Redesign of Treatment Treatment
• Promotion of Peer-based Recovery Support Promotion of Peer-based Recovery Support ServicesServices
• Recovery CelebrationRecovery Celebration• Promotion of Recovery Research Promotion of Recovery Research
Cultural Consciousness; Cultural Consciousness; Cultural Development Cultural Development
• Reconstruction of HistoryReconstruction of History
• Identity ReconstructionIdentity Reconstruction
• Language Audit & Construction Language Audit & Construction
• Values Definition Values Definition
• New SymbolsNew Symbols
• Musical AnthemsMusical Anthems
• Artistic ExpressionArtistic Expression
• Literature Literature
Recovery School Movement Recovery School Movement
• High School and Collegiate LevelsHigh School and Collegiate Levels• Association of Recovery Schools (2002)Association of Recovery Schools (2002)• Key ElementsKey Elements --Active recruitment of people in recovery--Active recruitment of people in recovery --Scholarships--Scholarships --On-campus recovery support--On-campus recovery support --Academic mentoring --Academic mentoring * Early Evaluations (high rates of continuous * Early Evaluations (high rates of continuous
recovery & academic excellence)recovery & academic excellence)
Grassroots Recovery Grassroots Recovery Community Organizations Community Organizations (RCOs)(RCOs)• Organized by and on behalf of Organized by and on behalf of
communities of recoverycommunities of recovery• Focus on advocacy, education and peer Focus on advocacy, education and peer
support servicessupport services• Establishing Recovery Support Centers, Establishing Recovery Support Centers,
e.g., CCAR’s Network of RSCs in CTe.g., CCAR’s Network of RSCs in CT• Some contracting to do telephone-Some contracting to do telephone-
based, post-treatment recovery based, post-treatment recovery checkups checkups
Recovery Home MovementRecovery Home Movement
• Halfway Houses (1950s) to Social Model Halfway Houses (1950s) to Social Model Rehabilitation Programs (1970s)Rehabilitation Programs (1970s)
• Oxford House (1975) (1,200 homes, 48 Oxford House (1975) (1,200 homes, 48 states, 24,000 residents per year)states, 24,000 residents per year)
• Federal Anti-Drug Abuse Act of 1988 (Loan Federal Anti-Drug Abuse Act of 1988 (Loan Fund)Fund)
• Broader Recovery Home MovementBroader Recovery Home Movement
• Philadelphia Survey (21 funded; 250 Philadelphia Survey (21 funded; 250 unfunded)unfunded)
Recovery IndustriesRecovery Industries
• Formats range from “recovery friendly” Formats range from “recovery friendly” (Zingerman’s Deli, Venturetech) to “recovery (Zingerman’s Deli, Venturetech) to “recovery exclusive” employers (Recovery at Work)exclusive” employers (Recovery at Work)
• Preparatory or Permanent Employment Preparatory or Permanent Employment • Core Elements:Core Elements: --Skill training--Skill training
--Work-based peer recovery coaching--Work-based peer recovery coaching--Linkage to recovery communities--Linkage to recovery communities
--Establishment of legitimate work history--Establishment of legitimate work history
Recovery Ministries, Churches Recovery Ministries, Churches & Colonies& Colonies• ““Recovery friendly churches” Recovery friendly churches” • Mega-churches with a “recovery pastor”Mega-churches with a “recovery pastor”• Lay leaders of recovery support groupsLay leaders of recovery support groups• recovery-focused worship services and recovery-focused worship services and
workshopsworkshops• Recovery Churches, e.g., Central Park Recovery Churches, e.g., Central Park
Recovery Church in St. PaulRecovery Church in St. Paul• Faith-based recovery colonies, e.g., Dunklin Faith-based recovery colonies, e.g., Dunklin
Memorial Camp in Okeechobee, FloridaMemorial Camp in Okeechobee, Florida• National Association for Christian Recovery National Association for Christian Recovery
Cultural Development Between Cultural Development Between (rather than within) (rather than within) Communities of Recovery Communities of Recovery • Identity Reconstruction Identity Reconstruction
• Reconstruction of History Reconstruction of History
• A New Language A New Language
• Values Definition Values Definition
• New SymbolsNew Symbols
• Musical AnthemsMusical Anthems
• Artistic ExpressionArtistic Expression
• Literature Literature
The Recovery Home The Recovery Home Movement:Movement:2010 Oxford House Convention2010 Oxford House Convention
Recovery & Education Recovery & Education
Recovery within Faith Recovery within Faith Communities Communities
Cultural Visibility & Advocacy Cultural Visibility & Advocacy (with Anonymity)(with Anonymity)
Recovery-focused Community Recovery-focused Community Education Education
Recovery Community Recovery Community CentersCenters
Recovery Media Recovery Media
Recovery & Community Recovery & Community Service:Service:Baltimore Recovery CorpsBaltimore Recovery Corps
Recovery Arts: Philadelphia Recovery Arts: Philadelphia Recovery MuralsRecovery Murals
Recovery Sports: Phoenix Recovery Sports: Phoenix Multisport Multisport
Recovery & MusicRecovery & Music
Implications Implications
• AOD arena at personal/family levels no AOD arena at personal/family levels no longer limited to Tx and mutual aid longer limited to Tx and mutual aid
• Enhanced Tx Effectiveness via potent Enhanced Tx Effectiveness via potent combinations of Tx, mutual aid and combinations of Tx, mutual aid and participation in new recovery support participation in new recovery support institutionsinstitutions
• Increased recovery without treatment Increased recovery without treatment
Implications Implications
Greater focus on role of community in Greater focus on role of community in recoveryrecovery
* Greater focus on community * Greater focus on community recovery recovery capitalcapital
* Growing interest in concept of * Growing interest in concept of community recoverycommunity recovery
Coyhis “Healing Forest” MetaphorCoyhis “Healing Forest” Metaphor
Primary ReferencesPrimary References
• White, W. (2008) The culture of recovery in White, W. (2008) The culture of recovery in America: Recent developments and their America: Recent developments and their significance. significance. CounselorCounselor, , 9(4), 44-51. , , 9(4), 44-51.
• White, W. (2009). The mobilization of White, W. (2009). The mobilization of community resources to support long-term community resources to support long-term addiction recovery. addiction recovery. Journal of Substance Journal of Substance Abuse Treatment, Abuse Treatment, 36, 146-58.36, 146-58.
• White, W. (2009). White, W. (2009). Peer-based Addiction Peer-based Addiction Recovery Support: History, Theory, Recovery Support: History, Theory, Practice, and Scientific Evaluation. Practice, and Scientific Evaluation. Chicago, IL: Great Lakes Addiction Chicago, IL: Great Lakes Addiction Technology Transfer Center.Technology Transfer Center.