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The conceptual framework underlying peer-to-peer recovery support
services has three components:
- The role and importance of holistic community-based
support services in sustaining recovery
- The conception of recovery along a change continuum
and the role of peer services in supporting lifestyle change along
the continuum
- The notion of social support.
McLellan and other researchers (1998)1 have suggested that providing
holistic, community-based support services enhances treatment outcomes.
White (2001)2 has identified ongoing peer-based community support
as a critically important response to the challenge of chronicity
for
sustaining recovery over the long haul.
Research Base in Mental Health and HIV/AIDS Work
The value of services offered by peers is reinforced by pointing
to the effective work accomplished in the mental
health consumer and HIV/AIDS peer communities.3 The 65-year history
of 12-step groups and, more recently, the emergence of other types
of self-help programs further reinforce the principle that supportive
peers can help sustain recovery.
Relation to Stages of Change Theory
The stages of change model developed by Prochaska and DiClemente
(1982)4 shows that motivation for lifestyle change exists along a
continuum of readiness. Stages of recovery from alcohol and drug
use disorders
are now being clarified in the development of services beyond early-stage
recovery. Peers can play a supporting role along the change continuum,
offering hope, motivation, and a positive role.
Social Support Research Base
One of the factors that helps people move along the change continuum
is social support. RCSP projects are developing peer services to
provide the four kinds of social support identified in the literature
(Salser,
2002)5,6:
- Emotional support - demonstrations of empathy, love,
caring, and concern in such activities as peer mentoring and recovery
coaching,
as well as recovery support groups.
- Informational support - provision of health and wellness
information, educational assistance, and help in acquiring new
skills, ranging from life skills to employment readiness and citizenship
restoration.
- Instrumental support - concrete assistance
in task accomplishment, especially with stressful or unpleasant
tasks such as filling out
applications and obtaining entitlements, or providing child care,
transportation
to support-group meetings, and clothing closets.
- Affiliational support - helping people in early recovery feel
connected and enjoy being with others, especially in recreational
activities
in alcohol- and drug-free environments. This assistance is especially
needed in early recovery, when little about abstaining from alcohol
or drugs is reinforcing.
References
- McLellan, A.T., Hagan, T.A., Levine,
M., Gould, F., Meyers, K.& Bencivengo,
M., et al. (1998). Research report: Supplemental social services
improve outcomes in public addiction treatment. Addiction,
93(10), 1489-1499.
- White, W.L. (2001). A lost vision: Addiction counseling as community
organization. Alcoholism Treatment Quarterly, 19(4), 1-30.
- http://www.mentalhealth.samhsa.gov/consumersurvivor
- Proschaska, J.O. & DiClemente, C.C.
(1982). Transtheoretical therapy toward a more integrative
model of change. Psychotherapy:
Theory, Research and Practice 19(3), 276-287.
- Salzer, M. (2002). Best practice guidelines for consumer-delivered services.
Unpublished paper developed for Behavioral Health Recovery
Management Project. An initiative of Fayette Companies,
Peoria, IL; Chestnut Health Systems, Bloomington, IL; and the University
of Chicago
Center for Psychiatric Rehabilitation.
Web site: http://bhrm.org/guidelines.htm
- Salzer,
M. (2002). Consumer-delivered services as a best practice in
mental health care delivery and the development of practice guidelines.
Psychiatric Rehabilitation Skills, 6(3), 355-383.
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