Recovery Coaching and The System
I’ve been with the Connecticut Community for Addiction Recovery (CCAR) for more than 21 years now… I’m tired.
I’m tired of butting heads with “the system”.
At times I get discouraged, I don’t stay discouraged, but I get discouraged. Through years of recovery, I’ve learned to practice some self-coaching. First thing I do is analyze the problem and sit with my emotion.
I needed to define the system … What do I mean by “the system”? Here’s what my thoughts boiled down to…
Cumbersome bureaucracies that block services (from Margaret J. Wheatley’s book Who Do We Choose To Be?).
CCAR runs into cumbersome bureaucracies all the time in many different forms. One example; addiction treatment providers forced to follow guidelines from their funding sources. Other cumbersome bureaucracies include insurance companies, managed care organizations, state agencies and federal agencies whose first line of defense is to often deny services.
So tell me…
- How did the payers for services end up having more influence than the providers of care?
- Why do we allow health insurance companies, managed care organizations and others to profit from illness?
- When did it become ethical for health insurance companies to profit from illness? (I found the answer to that one).
These are frustrating dilemmas for those of us in the recovery world; wrestling with them wears me down. I’m getting older, and less tolerant of perceived injustices. In the interest of self-care, I occasionally let them go.
Yet still, I repeatedly hear stories from recovery coaches struggling to navigate a broken system. Within CCAR, we have incredible, caring, compassionate, gifted Emergency Department Recovery Coaches. A few left the profession and not because of compassion fatigue (burnout). They left discouraged, the emotional burden too frustrating to bear. Too often the following scenario played out – a recovery coach would connect with someone in the Emergency Department who desperately wanted, and needed, ongoing care. But they couldn’t step into the next level of care because of wrong insurance, or no insurance, or the provider that honored that insurance had no availability.
As a profession, recovery coaches consistently deal with setbacks, obstacles, barriers and cumbersome bureaucracies. Yet, we keep moving forward. We must. And in some pockets across America, people are beginning to realize that the recovery community offers something unique and valuable. Our presence offers hope and as Michael Askew says in the documentary “Anonymous People”,
“When hope is in the mix anything is possible.”
Recovery carriers spread recovery contagion and healing occurs. Please note the exclusion of any reference to an evidence-based practice.
We, as a national recovery community, continuously react to a broken, cumbersome, bureaucratic system. It hinders our work and decimates our funding. We hunger and beg for scraps off the table. We compete with each other, submitting 100’s of applications for a handful of grant awards. Currently, recovery advocates are lobbying for Medicaid billing.
Squeezing the recovery coach service into a billable box destroys the role. Increasing administrative and documentation requirements reduce the time coaches spend with recoverees. We’ve conducted this experiment before, one need only look at how the modern addiction treatment system evolved.
Better models than fee-for-service have emerged; the best one being a Recovery Community Organization (RCO) providing recovery support services through general grant funding. Plus RCO’s have the flexibility to innovate and diversify funding. Another option, work with your state. In Connecticut, we are blessed with a state agency who have always viewed an RCO as a partner. CCAR does not bill for individual service units. Our state provides grants for specific services. How we deliver the services is up to us. Plus, we take the responsibility of being excellent stewards of our funding quite seriously. This leads to trust between funder and provider. Grant funding works. Then let the RCO diversify, latch onto an entrepreneurial spirit and be self-sufficient.
Advocate for this model please.
Finally, I dream of the day when an organized national recovery community grows so effective, so loud, so powerful that we can no longer be ignored or cast aside. Instead of the recovery community reacting to “the system”, I yearn for the day when the system responds to the recovery community and our needs.
A glorious day indeed.
In 2015, I finished a thruhike of the entire Appalachian Trail, a trek of 2,189.2 miles. It took 189 days and 6 pairs of boots. During that sacred time, my purpose in life became more precisely defined. I am, simply, to coach recovery. Recovery saved me from an early demise and brought purpose to my tattered life. I have learned that I’m a coach to my very core. I am blessed to put the two together. I started work at the Connecticut Community for Addiction Recovery (CCAR) in January 1999. I became the Executive Director of this recovery community organization in 2004. I have trained the CCAR Recovery Coach Academy© dozens of times and have a hand in modifying, improving and adapting various recovery coach curricula. I’m old enough now to start considering my legacy. This is one way for me to share lessons learned in my recovery, in my role as Executive Director and a trainer. When I engage with others, I present the same messages repeatedly. It’s time to write them down.
Phil “Right Click” Valentine
Recovery established 12.28.87