If you have been to treatment, had a family member who has gone to treatment, or you are a counselor or therapist working in the field of addiction, you have undoubtedly had thoughts similar to this question. What is the best treatment for addiction. I personally have asked this question over and over again. Every year I attend conferences with the hope of hearing “we have found the cure for addictions.” Instead of hearing this I often listen to presenters stating “ this is the latest and greatest way to treat addiction.” What I have also noticed in the field is there seems to constantly be a better form of therapy and treatment each year and we should replace all of the other training that we received last year and learn the new model. Don’t get me wrong we need to always be doing the best job we can for our clients and constantly be searching for a better way to treat, help, and support our clients as they find their recovery. Last year in a conference I heard about a new Idea that was not necessarily a new form of therapy but an alternate way of looking at recovery. It’s called Recovery Capital.
Let’s back up for just a minute, before I explain what recovery capital is, and discuss what long term recovery is. Ask yourself what do you think Long term recovery is. Is it abstinence? Is it more than just simply not using drugs or consuming alcohol. Is it a return to “sanity”, as the Big Book states. My current definition of long term recovery is a constant movement to return to who we were before we were affected by shame, trauma, mental health problems, and addiction. I believe this at times can include relapse. I want you to also ask yourself another question. Is your idea of long term recovery free from relapse? For quite some time in this field our measuring stick has been abstinence of a behavior or the use of a substance. I would challenge you to consider another way of looking at this. How often does cancer come back? How often does a person who is diabetic have problems with blood sugar levels? We don’t scream and yell at them and tell them how bad they are. We look at what is causing them to have these problems and support them in changing different aspects of their lives or treatment approaches to best address the problem. In this process there is something that is also happening. We are learning. The diabetic learns what he or she can do to keep their blood sugar down. The doctor is who is supporting the patient is also learning about what works best for the patient. The family, if there is family involvement, learn how to better support the patient. This learning process and development of skills is a great example of recovery capital.
Granfield and Cloud stated, “Recovery capital (RC) is the breadth and depth of internal and external resources that can be drawn upon to initiate and sustain recovery from severe AOD problems.” (Granfield & Cloud, 1999; Cloud & Granfield, 1 2004). What this means is, Recovery capital is a total sum of all the resources the person has at their disposal to support their search for long term recovery. So if we go back to our medical example of a person with diabetes they can gain recovery capital each time their blood sugar level is too high or too low. They also gain recovery capital as they develop a closer relationship with their doctor or start to see a doctor who specializes in diabetes. Furthermore, their recovery capital comes in the form of support when the family learns about their needs and starts to cook meals appropriate for the diabetic at family dinners. Eventually the person gathers enough resources , skills, and support to monitor and manage their blood sugar to the point they rarely ever have problems with their blood sugar level. Its also important to recognize the word I just used. “Rarely” Long term recovery can mean a steady and constant movement in the direction of a better life. As long as the person picks themselves back up after each struggle they learn and get better over time. This does not mean the person becomes free from symptoms or relapse. It means the client has less and less relapses as they are in recovery and learning. It’s a very natural form of recovery.
Ok, so let’s apply this to addiction. For example, a client relapses and at some point hopefully they arrest the relapse and go to work on understanding and changing the way they have handled their recovery. Now, with an understanding of recovery capital a relapse is not a failure for the client it’s a learning opportunity. It builds on the client’s current knowledge of the disease as well as requires the client to change behaviors, gather support, learn and work with others on identifying what may have caused the relapse. As you know, it is hard to watch your friends and family and clients relapse. However, if we can help support them rather than shame them we help them build recovery capital. We get to use our new frame of mind regarding recovery and recovery capital. We get to help the client look at what resources they had and did not have. Once we have recognized the deficient areas we can help them build resources in these areas. I personal believe Maslow’s Hierarchy of Needs is a great starting point to identify what the client needs. If we can take moments with our clients, family and friends and help them learn and build to the point they have all the necessary resources ,instead of shaming them, I believe we will be able to further attack this disease. Cloud & Granfield, in press; Laudet, Morgan, & White stated, “Increases in recovery capital can spark turning points that end addiction careers, trigger recovery initiation, elevate coping abilities, and enhance quality of life in long-term recovery.” (Cloud & Granfield, in press; Laudet, Morgan, & White, 2006). Instead of shame let’s build our clients with each and every relapse and stop shaming them.
Recovery capital may not ben the cure for addiction; however, I do believe it may just be the cure for how we see addiction. Addiction is a disease that is lifelong for most. Life long diseases require a lifelong perspective. Long term recovery and recovery capital might just be the next right step in the treatment of addiction and how we see relapse.
Chris Scott, CMHC
Clinical Director
References
Best, D. (n.d.). The Potential of Recovery Capital. Retrieved July 4, 2017, from https://www.thersa.org/globalassets/pdfs/blogs/a4-recovery-capital-230710-v5.pdf
White, W. & Cloud, W. (2008). Recovery capital: A primer for addictions professionals. Counselor, 9(5), 22-27.