Deploying Recovery Coaches: The Best Model

On April 9, 2018, Rebecca, Jennifer and I wrote a blog called No Coach is an Island. As recovery coaching expands across the country, some efforts are not taking full advantage of our profession, so I sense some urgency to retool the following ideas and post again.

Situation– treatment providers, hospitals, drug courts, prisons and other institutions hire one, two or maybe three recovery coaches.

These settings are most likely isolated and function under established, firm policies, regulations and restrictions. Imagine a magnificent stone fortress built on an island – not easy to get in or out, but offers sanctuary and healing. I like the idea of the recovery coach service in this setting, but there is a better way than requiring a recovery coach to work within the walls.

Here are the major difficulties with the coach on an island approach.

  1. The recovery coach only knows what the coach knows.
  2. One coach has one connection to the recovery community – his/her own. It is much more difficult for a single person to be aware of all the recovery support services and recovery resources in their area.
  3. Little to no support from other recovery coaches.
  4. Supervisors in these settings often do not understand the recovery coach role and insist recovery coaches adhere to clinical ethics and boundaries.
  5. Where and how does a coach in this setting continue to develop professionally?
  6. Fortress settings may put restrictions on eligibility for employment in the recovery coach role – lived experience, amount of time in recovery, and below average pay.

At CCAR, we had the luxury of developing another model – to have recovery coaches dispatched to the needs. We have built a dynamic, effective team. Here are the main components of the dispatch model.

  1. To enhance recovery outcomes, work with a trusted recovery community organization (RCO).
  2. The RCO offers a multitude of recovery connections reflective of multiple pathways for recovery.
  3. The RCO develops a team of highly skilled, competent, well paid, professional recovery coaches that represent and believe in all recovery pathways.
  4. The RCO dispatches recovery coaches to Emergency Departments, Police Stations, Fire Stations, prisons, treatment centers, managed care organizations, etc. when requested.
  5. The RCO practices a key coaching principle – it treats each coach as a resource. The RCO trusts the recovery coach to do their job. They have freedom to innovate, adapt and serve.
  6. Leadership does not micromanage.
  7. The RCO allows the recovery coach team to grow dynamically and strengthen one another.
  8. The RCO encourages the team to learn from one another. The team develops linkages with a variety of community recovery supports that they share with one another.This body of knowledge is a powerful, living entity that the team nurtures.  As an example, CCAR Emergency Department Recovery Coaches use group texting to communicate continually with each other.  A day’s thread has 100’s of messages.
  9. The RCO will develop a career ladder (for those interested) – from receiving support to volunteering (offering support) to partaking in quality recovery coach training to earning a Recovery Coach Professional (RCP) designation to employment in the recovery support services field.

When a hospital (or other entity) enters into an agreement with an RCO, it hires a team of coaches, not just one person. The hospital contracts with an organization that embraces multiple pathways of recovery.  The RCO manages compensation, benefits, overhead and supervision for the recovery coaches. The RCO is accountable for the recovery outcomes.

At CCAR, we connect people to ongoing care through our established network. The network is vast, comprehensive and dynamic. It continually expands and shifts.  For example, our coaches know who to call and when to call, for nearly all situations they have faced in the Emergency Department.  If they have a question, they have come to rely on one another. Someone on the team will likely know.

How would an isolated recovery coach have this ability?

No coach is an island.

8 thoughts on “Deploying Recovery Coaches: The Best Model”

  1. Kheninh Daniels

    You couldn’t have explained it no better way. My hope is that more and more emphasis are placed on the establishing RCO’s as you stated in your blog. Big Ups to you. Keep sharing and demonstrating your greatness dear friend.

  2. I wish someone would inform the hospital systems and other agencies that are creating this recovery coach in the ED model and linking the coaches to the local drug and alcohol agency instead of the local RCO. This is beginning to happen in South Carolina instituted by an agency who is working in multiple states setting up these programs and it is rather alarming.

  3. Thank you Phil for providing this much needed insight of the role and function of RCs. I am a single RC at my location and RC at another site. I can only speak for myself but it is a daily struggle to provide my services as a RC while staying in my lane. Luckily I am connected to CCAR and have outside supports in the recovery community. Unfortunately I don’t always have time to access those supports on the job and get caught out being micromanaged. Is there a presentation CCAR can provide to agencies before, during and/or after they hire RCs to help them to understand what our role is and at how we are meant to serve?

  4. Bravo CCAR, you have come a long way and in the right direction.
    Keep it up, the world needs recovery coaching!
    Best to all Staff-

  5. This is so true. Facilities do not want you to connect with a patient in the way that I was trained to do. As you said Phil you have to go by the clinicians and facilities rules. Very limited as to what a RCO is capable of providing

  6. Thank you for this informative article. Any chance you can offer training on best practices to get an RCO startup in a state with several newly CCAR-trained RCs but no RCO to connect them all. It feels bigger than we are. Thanks for all you do.

  7. I have spent considerable time thinking about your recent post- No Coach is an Island 2.0. I am very happy to be have been involved with CCAR, an organization that has found answers and continues to advocate for best practices in the implementation. I hope you are successful steering the movement.
    I say that after several decades in various community “empowerment” projects that seemed to gain traction and then failed on many levels. 30 something years ago when I entered recovery I was encouraged to participate in the “battered women’s” movement. After CT ‘s Tracy Thurman case in 1985, the community building of shelters and the development of advocates in the courts began, Initially the advocates drew from the anti-domestic violence community- women with lived experience in abusive relationships, and others their children, providers that were aware of the challenges, issues and resources involved in moving to safety and health. I was initially very raw and unable to participate as a reliable advocate. When I had healed many years later, the field had changed considerably. Workers and advocates no longer were drawn from survivors and friends but the field had been “professionalized” – practical knowledge was eschewed for an education requirement of a bachelors degree and political and ideological homogeneity. My assessment, from recent work, including volunteering at CCAR, this has not been good for women. There is a great deal of judging and little actual help from the DV movement to women struggling. There have been changes for the good- in laws, and in male responsibility but it is not a survivor driven movement in my humble opinion and that limits it.
    The patient navigator movement took a similar road a few years later. Initially it was drawn from people who had experienced cancer- either themselves or close family and friends- people who knew the challenges, issues and resources involved in moving through care. Again after several years it was “professionalized” and now is often a nurse. The voice of the patient has been weakened despite many new programs and initiatives.
    It was a puzzle to me why this happened. I think your analysis is correct. It is not the job title or the lived experience- it is the whole community that is brought to bear that brings the power- in the early days of DV advocacy , the early days of patient navigation, and today in recovery coaching. That is firm ground to stand.Thanks for the insight.

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