“Longitudinal studies have repeatedly demonstrated that addictions treatment (particularly for 90 or more days) is associated with major reductions in substance use, problems and costs to society … However, post-discharge relapse and eventual re-admission are also the norm …The risk of relapse does not appear to abate until 4 to 5 years of abstinence … Retrospective and prospective treatment studies report that most clients undergo 3 to 4 episodes of care before reaching a stable state of abstinence … In spite of this evidence of chronicity and multiple episodes of care, most … treatment continues to be characterized as relatively self-encapsulated, serial episodes of acute treatment with post discharge aftercare typically limited to passive referrals to self-help groups.”

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES – Substance Abuse and Mental Health Services Administration Report to Congress

REC CAP: Bridge from Treatment to Self-Directed Recovery

An evidence-based assessment & recovery planning instrument developed by Dr. David Best that:

-Assesses an individual’s recovery strengths, barriers and unmet service needs

-Supports trained navigators to guide individuals in the execution of concrete recovery goals

-Delivers longitudinal measurement of recovery capital gains over quarterly intervals

REC CAP is appropriate for implementation in both clinical and peer settings, bridging the gap often experienced by persons who are exiting addiction treatment and assuming responsibility for self-directed recovery.

What is Recovery Capital?

Recovery Capital is the breadth and depth of internal and external resources that can be drawn upon to initiate and sustain recovery from AOD problems. (Granfield and Cloud 2004). Recovery Capital is conceptually linked to natural recovery, solution-focused recovery therapy, strengths-based case management, recovery management, resilience and protective factors, and the ideas of hardiness, wellness, and global health.

Recovery Capital: A Primer for Addiction Professionals, William L. White, MA and William Cloud, Ph.D (2008)

Collaborative Effort

William White, MA, Alexandre Laudet, Ph.D., David Best, Ph.D. and John Kelley, Ph.D. are a few of the most notable members of the academic community responsible for championing Recovery Capital as a quantitative measurement of internal and external resources necessary to sustain resiliency from substance use disorder. While the term “Recovery Capital” has become rooted in the fabric of Recovery Oriented Systems of Care, application of the science is just beginning to find its way into assessment and recovery care planning instruments. The SHU-FARR REC CAP Pilot Study represents a major step forward.

Recovery Strengths

“Operationalising the recovery concept within behavioural health systems transformation initiatives hinges on the ability to deﬁne recovery and measure recovery capital.” –The Assessment of Recovery Capital: Properties and psychometrics of a measure of addiction recovery strengths, Groshkova, Best & White – Drug and Alcohol Review (2012). Now translated into seven additional languages, this peer-reviewed study empowers recovery champions worldwide and supports Recovery as an organizing approach to chronic disease management.

REC-CAP

REC CAP is an instrument that is owned by the client and the worker jointly, or by the client on their own, and allows people to map what they do so that it becomes both a marker of progress using the currency of recovery capital and a mechanism for determining what strengths you have to take you to the next step. – David Best, Ph.D. during interview conducted before FARR Training Session in 2015.

REC-CAP ASSESSMENT

Assessment Completion

The first step in the REC CAP process is the Assessment.

The process begins with the client’s completion of the REC-CAP Assessment. The client is re-assessed on a quarterly basis which allows the client, program, and anyone permissioned to identify recovery capital gains and any persistent barriers or unmet service’s needs.

REC CAP assessment is organized under nine sections: Demographics, Quality of Life & Satisfaction, Barriers to Recovery, Services Involvement & Needs, Personal Recovery Readiness, Social Recovery Capital, Involvements with Recovery Groups and Local Community, Commitment, and What do you See As Your Needs?

Typically requiring approximately 15 minutes to complete, a significant majority of the 630 pilot study participants report a positive experience with the process resulting in “feeling good about myself and my commitment to my own recovery”, as it focuses primarily on measurement of strengths as opposed to deficits.

Assessment Results

Recovery Capital is defined as the breadth and depth of internal and external resources that can be drawn upon to initiate and sustain recovery from alcohol and other drug problems. REC CAP quantifies recovery strengths, identifying potential barriers and unmet service needs. Participants in the SHU-FARR REC CAP Pilot Study confirm, by overwhelming consensus, that the assessment process is intuitive, encouraging and builds confidence.

Navigational Support

REC CAP Navigators, trained to evaluate assessment results, mentor participants in setting concrete recovery goals to overcome barriers by accessing existing strengths as well as external resources. The SHU team, including Dr. David Best, led these training sessions from the onset of the pilot study.

Quarterly Assessments

Participants complete assessments in ninety-day intervals to measure recovery capital gains and to identify any persistent barriers or unmet service needs. This process encourages continued focus on achievement of recovery goals.

Strengths, Barriers & Needs Mapping

REC CAP quantifies participant strengths in four categories: personal, social, well-being and support & commitment. The node-lnk map helps trained navigators to visualize assessment results and guide participants in establishing concrete goals to achieve resiliency. When indicated, navigators also guide participants towards professional services to address unmet needs.

Collaborative Process

Navigational support is frequently vital to sustain resiliency during early stages of the participant’s recovery journey. Navigators mentor, monitor and measure goal achievement as participants execute their self-directed recovery plan.

Participant Owned

Participants own their recovery plan. REC CAP travels with them as they transverse their individual continuum and, with execution of confidentiality releases, allows for sharing their continuing progress with service providers, family members and other supports as they deem appropriate.

Evidence-Based Outcome Measurement

Recovery often progresses across a continuum of professional, peer, family and community support systems. REC CAP provides evidence-based measurement of recovery capital gains over time, including reductions in barriers and unmet service needs. REC CAP provisions the ability to invite service and support contributors to share visibility to longitudinal outcome data. Navigators, peers, family members and service providers, engaged at various stages along the participant’s continuum, all benefit from gaining access to this data.

Recovery Capital Research Project | Sheffield Hallam University & FARR