This post is different to the others in this series of Favourite blog posts in that I am not focusing on my own blog posts, but on those of my My Recovery Voices colleague Wulf Livingston. The first of my Wulf favourites—More Than Treatment, Living Life Again: My Derry Talk—focuses on the talk that he gave at the 3rd ARC Fitness Recovery in Motion conference in September this year. I will take the opportunity here to say that Wulf is a great blogger. I really enjoy all his posts. Here is Wulf’s brief bio he wrote for our website.
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I recently had the pleasure of being invited to speak at the 3rd ARC Fitness Recovery in Motion conference in Derry/Londonderry. I had been asked by Gary Rutherford, Founder of ARC Fitness, to share some of the understanding I have formed over the last 20 years about what are Recovery Organisations, why they work, and what enables them to flourish. [Please see link to a pdf of my Powerpoint presentation at the end of this post.]
During my talk, I felt it important to initially briefly outline the context from which I had come, and why Gary had invited me. I briefly referenced a liberal family environment with much alcohol, translating into my own hedonistic drink and drug use, before my journeys into social work and academia. [cf. My first Recovery Voices interview]
In particular, I referenced three key learning episodes that directly informed the rest of my talk, an involvement in: the early and formative UK recovery activities of 2008-2012; local North Wales groups DARE and North Wales Recovery Communities (NWRC), and developing with David these Recovery Voices pages.
My early reflections on the first decade of the century was an emphasis on ‘service user involvement’ rather than recovery. It felt like a recovery vacuum, in that there while there were debates between harm reduction and abstinence as treatment goals, there was no real focus on long-term recovery that was to eventually lead to the emergence of such activities as the UK Recovery Forum, the first UK Recovery March, FAVOR UK, etc. Much of this context is brilliantly captured in Ian Wardle’s 2009 paper entitled Recovery and the UK Drug Treatment System: key dimensions of change.
Some 15 -20 years on, we can make the very simple and unambiguous claim that Recovery and Recovery Organisations work. However, it is less clear exactly what constitutes a recovery organisation, how they might work, and what enables them to do so. These were the questions I explored in the rest of my talk.
At one level, of course, recovery can be argued to be that which an individual says it is, the goals they set. Recovery interventions and groups do operate within the treatment services, often either of a 12-step or a cognitive behavioural nature in orientation. However, when I think of recovery organisations, it is important to think beyond these two perspectives. I think recovery organisations are different to these recovery (orientated) interventions. Recovery communities are quite simply independent peer-led collectives, rather than activities or groups within professional agency directed activities. They are sometimes referred to as Lived Experience Recovery Organisations (LEROs].
It feels important to avoid the prescriptive. While recovery organisations do include fellowship and 12-step based groups, they may also include both community and residential based organisations. They can though as equally include residential and community projects, involve change and support, and include any of the following: physical activities, social gatherings, arts (dance, film, music), cooking and eating together, cafés, celebration, and gardening and growing. This list is not, nor should be seen as, exhaustive.
The choice of how and what recovery organisations are and what they do, should just be a consequence of what has emerged among those who come together and the context in which they are doing it. The diversity, rather than standardisation, is as it should be. Perhaps though, what all the activities have in common is an acknowledgement of folk being tired of the old (drink and drug use) lifestyle and missing the important stuff in life. Frequently, as useful as treatment is in providing the sober window, it is itself not enough. It is not the way individuals can meet their wider needs, give back, acquire a sense of belonging, shape new identities, and learn a fresh way to enjoy and share life’s joys.
In understanding what are the core components of what make recovery organisations work, I have since 2008, realised that the notion of ‘commissioning recovery’ is an oxymoron. It is a contradiction, something which is not possible. By this, I mean it cannot be possible to buy, or tender for, the following:
- Individuals – champions, leaders, activists, choice
- Shared – desire, interests, experiences, contexts
- Family and friends – resources, support, time
- Contagion – informal networks, relationships, culture
- Local – difference, environment, resources
The serendipity and synchronicity required to bring all these things together, and the fact that they will be different in any given area, means that the commissioning framework and agencies can at best support the environment and help support that which naturally flourishes. Recovery hugs are, after all, free and freely given.
The recovery movement and recovery organisations present a challenge to the orthodoxy. They suggest different priorities, a different way of going about business, and a different distribution of power and resources. Often, there is a desire to make recovery ‘fit’ the existing treatment frameworks of commissioning and monitoring, rather than those latter frameworks adapt their approaches to take account of what works.
A good example of this tension is to understand that a recovery outcome is not the same as treatment output. The objectives set for the agencies are those which are counted (e.g. s/he turned up) , rather than individual lifestyle goals. For example, where has anyone seen ‘having my first family Sunday dinner’ on a monitoring form, yet such is a true marker of recovery and importantly often an individual’s goal.
Recovery organisations often feel compelled into taking the ‘King’s Shilling’. Doing the systems bidding, as the only way to receive financial support (funding), rather than being supported in what they do best. The pressure is placed on them to contribute to what is often described as ‘treatment completion’, individuals coming off drug teams list of open clients, rather acknowledging their role in developing communities in which post-treatment individuals acquire healthier long-term lifestyles changes. Putting treatment and recovery into the same mix is like comparing apples and pears.
The pre-existing hierarchy of value places the medical, psychiatric, treatment etc over that of lived experience. All too often, the vast majority of local alcohol and drug budgets go into treatment, rather than either recovery or harm reduction. These hierarchies extend to the value given to research, with drug or cognitive behavioural random control trial approaches valued and vastly over-funded compared to the actual lived experience and voices of those who have used or are using alcohol and other drugs.
Despite many of these considerations, recovery organisations grow, flourish and succeed in supporting many people. The success of recovery organisations is not easy to quantify, manualise and hence commission. The success is made up of a myriad of experiences and qualities, what we might call the magic of recovery. At is heart quite simply, is the prospect of hope. This hope often feels as being the dominant piece of fairy dust—change is possible and transformational.
Among the other ingredients of this magic are: fostering a sense of belonging; helping forge new identities; having shared experiences; doing things, filling the time freed from of not using or attending appointments, and the giving back to individuals and the wider community. Hope generates notions of self-belief and improves self-worth. It helps develop an increasing sense of pride in oneself and one’s fellow recoverists
The recovery hug epitomises a distinct set of values. Most of all love. Recovery organisations are a place of activism, honesty (no bullshit), spontaneity, serendipity, and trust. The business is conducted in social media spaces, rather than the text, email and letter of the professional landscape.
However, the success of recovery organisations sometimes leads to some over-reliance on a small number of individuals, and/or to issues of burnout, egos, pedestals, and relapse. This reinforces the need for the policy, commissioning and professional agencies to support recovery organisations and individuals in in doing what they do best, and at the pace they want to do it. Too often the professional world uses the successful groups and individuals as ways to achieve their own policy and strategy goals.
I was keen in my talk to emphasise that while it is possible to have treatment standards and prescribe a treatment intervention, each recovery organisation is unique. It has recognisable characteristics, qualities and components, but each are distinct in reflecting the communities and environments in which they exist. I illustrated this with some different examples of recovery organisations, which have a range of different approaches—one film-based, another working through dance; one that moves from town to town, one built around residential support, one more integrated into the treatment system, and one in its early formulation. Again, these are examples rather than an exhaustive list. I could have equally chosen examples that are built around growing food, choirs, football or rock music.
In drawing the talk to a conclusion, I wanted to suggest that we might think of where recovery organisations operate. In some instances, they are providing (peer-led) interventions within treatment settings and in others they are operating as independent communities. It is also important to recognise that recovery organisations come in many constituted forms, from small and informal to the large and regulated.
Finally, and it is always hard to both put 20-30 years of experience into 20 minutes and 10 slides or so, let alone then try and find a summary message. With the last slide, I tried to summarise my learning and messages. Emphasising first the peer and lived experience- led element. That recovery organisations thrive with friends and supporters. That it is all about collective activity, both the sharing and giving. Importantly, and so distinct from treatment, recovery organisations make the change, to value and strive to create a better world for all. Here is a pdf of Wulf’s talk: Wulf Livingston – ARC Talk, September 2024
My other two favourites of Wulf’s blog posts are: