We often expect those we serve to:
But what about changes our organizations can make? Could some peer support of the organizational change process be helpful? Could some coaching tips in attempting system change toward a recovery orientation be useful?
This post will provide a partial overview of some aspects of organizational change, including contextual considerations, specific components of recovery orientation, the scale of change projects, and practical tips in making and supporting change. Examples of changes toward a recovery orientation will be included, along with citations for further study.
One contextual frame for the general guiding of organizational change is the notion of a helpful and effective “facilitating environment” (borrowed from Winnicott, 1974).
Changes consistent with Recovery Orientation can be made at the whole-organization level, entire programs can be modified, and specific practices within programs can be changed at the per-program level. Changes of this scale specific to Recovery Orientation have been achieved and written up for others to study (e.g. Boyle, M., Loveland, D. & George, S., 2010). In this type of planning, consider making changes that target either or both of:
Look for examples of change others have already made. Be sure to look for evaluation of their effectiveness, and for evaluation of the experience of those using the system. Nowadays, examples abound.
Consider both the “New Paradigm” of Care and 5 Year Standard of Effectiveness.
Practical guidance in basic change principles for organizations and leaders to consider are also widely available. Some are general to any change effort, and some are specific to our work.
In reviewing these kinds of materials, you might find important changes consistent with Recovery Orientation can be innovated on a smaller scale as well. For example:
Over the years, I’ve noticed it is helpful to have some support, encouragement, coaching, and guidance when attempting a change project, or moving a system toward a difficult goal. I have also noticed I’m in need of the same when coaching others in support of system improvement.
References
Boyle, M., Loveland, D., George, S. (2010). Implementing Recovery Management in a Treatment Organization. In Kelly, J & White, W. L. (Eds): Addiction Recovery Management: Theory, Research, and Practice. Pp. 235-258.
Coon, B. (2013). Center Uses Technology to Help Patients During and After Treatment. Addiction Professional. May 22, 2013.
Coon, B. (2015). Recovering Students Need Support As They Transition. Addiction Professional. 13(1): 22-26.
Coon, B. (2014). An Addiction Treatment Campus Goes Tobacco-Free: Lessons Learned. Addiction Professional. 12(1): 18-20.
Crowe, K., Hennen, B. & Coon, B. March 31, 2017. A Seamless Transition: Linking College-Bound Emerging Adults with Collegiate Recovery Programs. Recovery Campus Newsletter.
DuPont, R. L & Humphreys, K. (2011). A New Paradigm for Long-Term Recovery. Substance Abuse. 32(1):1-6.
DuPont, R. L., Compton, W. M. & McLellan, A. T. (2015). Five-Year Recovery: A New Standard for Assessing Effectiveness of Substance Use Disorder Treatment. Journal of Substance Abuse Treatment. 58:1-5. doi:10.1016/j.jsat.2015.06.024
Eddie, D., Hoffman, L., Vilsaint, C., Abry, A., Bergman, B., Hoeppner, B., Weinstin, C. & Kelly, J.F. (2019). Lived Experience in New Models of Care for Substance Use Disorder: A Systematic Review of Peer Recovery Support Services and Recovery Coaching. Frontiers in Psychology. 10:1052. doi:10.3389/fpsyg.2019.01052
Hamalainen M. D., Zetterstom, A., Winkvist, M., Soderquist, M., Karlberg, E., Ohagen, P., Andersson, K. & Nyberg, F. (2018). Real-time Monitoring Using a Breathalyzer-Based eHealth System Can Identify Lapse/Relapse Patterns in Alcohol Use Disorder Patients. Alcohol and Alcoholism. 53(4):368-375. doi:10.1093/alcalc/agy011
Hennen, B. & Coon, B. (2020). Recovery Coaching, Breathalyzer Boost Retention in Outpatient SUD Treatment. Addiction Professional. September 23, 2020.
Loveland, D. & Driscoll, H. (2014). Examining Attrition Rates at One Specialty Addiction Treatment Provider in the United States: A Case Study Using a Retrospective Chart Review. Substance Abuse, Treatment, Prevention and Policy. 9(41). doi.org/10.1186/1747-597X-9-41.
McCarty, D., Gustafson, D.H., Wisdom, J.P., Ford, J., Choi, D., Molfenter, T., Capoccia, V. & Cotter, F. (2017). The Network for the Improvement for Addiction Treatment (NIATx): Enhancing Access and Retention. Drug and Alcohol Dependence. 88(2-3):138-145.
Martin, L., Lee, J. L., & Coon, B. (2018). Implementing Tobacco-Free Policies in Residential Addiction Treatment Settings. Physician Health News. 25 (2): 14.
Nehlin, C., Carlsson, K, & Oster, C. (2017). Patients’ Experiences of Using a Cellular Photo Digital Breathalyzer for Treatment Purposes. Journal of Addiction Medicine. 12(2):107-112. doi:10.1097/ADM.0000000000000373
White, W. (2004). Recovery Coaching: A Lost Function of Addiction Counseling? Counselor. 5(6), 20-22.
Winnicott, D. W. (1974). Fear of Breakdown. International Review of Psycho-Analysis. 1(1-2): 103-107.