Recovery concepts have always run through the fabric of the addiction profession, the members of its workforce, and the services they provide, albeit with varying strength over time. The addiction profession, founded by individuals in recovery, laid the groundwork to provide addiction services within a recovery orientation.

As a part of the federal government’s efforts to promote recovery for all Americans affected by mental illness and/or addiction, in May 2009, the Substance Abuse and Mental Health Services Administration (SAMHSA) announced its Recovery to Practice (RTP) Initiative. The RTP Initiative is designed to hasten awareness, acceptance, and adoption of recovery-based practices in the delivery of addictionrelated services and builds on SAMHSA’s definition and fundamental components of recovery [1].

To guide this effort, SAMHSA desired to learn more about the depth and breadth of integration of recovery and recovery-oriented concepts within the various professions essential to the recovery movement and funded the Recovery to Practice (RTP) Initiative. “By bringing together the major mental health and addiction professions with people in recovery, advocates, and other stakeholders (including experts in curriculum and workforce development), the RTP Initiative begins to address how we can translate the vision, values, and principles of recovery into the concrete and everyday practice of mental health and addiction practitioners” [2].

NAADAC, the Association for Addiction Professionals, received an award for this project in addition to five other professional associations (American Psychiatric Association, American Psychiatric Nurses Association, American Psychological Association, Council on Social Work Education, and the National Association of Peer Specialists).

Through the RTP Initiative, NAADAC was asked to determine the extent to which recovery-oriented concepts, values, and practices exist within all aspects of the addiction profession in order to develop a recovery-oriented training curriculum for the workforce. Examples of recovery-oriented concepts, values, and practices include [1]:

• Recovery emerges from hope: The belief that recovery is real provides the essential and motivating message of a better future – that people can and do overcome the internal and external challenges, barriers, and obstacles that confront them.

• Recovery is person-driven: Self-determination and self-direction are the foundations for recovery as individuals define their own life goals and design their unique path(s).

• Recovery occurs via many pathways: Individuals are unique with distinct needs, strengths, preferences, goals, culture, and backgrounds, including trauma experiences that affect and determine their pathway(s) to recovery. Abstinence is the safest approach for those with substance use disorders.

• Recovery is holistic: Recovery encompasses an individual’s whole life, including mind, body, spirit, and community. The array of services and supports available should be integrated and coordinated.

• Recovery is supported by peers and allies: Mutual support and mutual aid groups, including the sharing of experiential knowledge and skills, as well as social learning, play an invaluable role in recovery.

• Recovery is supported through relationship and social networks: An important factor in the recovery process is the presence and involvement of people who believe in the person’s ability to recover; who offer hope, support, and encouragement; and who also suggest strategies and resources for change.

• Recovery is culturally based and influenced: Culture and cultural background in all of its diverse representations, including values, traditions, and beliefs are keys in determining a person’s journey and unique pathway to recovery.

• Recovery is supported by addressing trauma: Services and supports should be trauma-informed to foster safety (physical and emotional) and trust, as well as promote choice, empowerment, and collaboration.

• Recovery involves individual, family, and community strengths and responsibility: Individuals, families, and communities have strengths and resources that serve as a foundation for recovery.

• Recovery is based on respect: Community, systems, and societal acceptance and appreciation for people affected by mental health and substance use problems – including protecting their rights and eliminating discrimination – are crucial in achieving recovery.

To establish standardization for this project, NAADAC adopted SAMHSA’s definition of recovery: “A process of change through which individuals improve their health and wellness, live a self-directed life, and strive to reach their full potential [1],” and its ten guiding principles of recovery outlined above.

After surveying thousands of addiction professionals about these recovery-oriented concepts and guiding principles established by SAMHSA, members of the addiction profession appear to be very knowledgeable about the concepts of addiction recovery and its components. There is overwhelming agreement among addiction professionals that the core components of SAMHSA’s definition and the ten guiding principles of recovery are embedded in the definition of recovery for most addiction professionals. Further, NAADAC determined that recovery-oriented concepts, values, and skills are widely accepted and practiced within the addiction profession. In addition, members of the addiction profession generally understand recovery- oriented concepts, utilize recovery-oriented practices, and have recovery-related opportunities for education, training, literature, certification, and licensure.

However, gaps in understanding and practice still remain. Many addiction professionals hold reservations about some of the recoveryoriented concepts and principles, such as Recovery is culturally based and influenced; Recovery is supported by addressing trauma; Recovery emerges from hope; Recovery is based on respect; and Recovery is person-driven. Given that these guiding principles are fundamental to addiction treatment and recovery, more education and training is necessary.

Finally, NAADAC discovered there is room for improvement in regards to the use and acceptance of medication-assisted treatment, awareness and integrated treatment of co-occurring disorders, and the role of peer recovery coaches in the addiction workforce. Some professionals report that this apprehension is due to perceived threats to their professional position; general resistance to change, lack of funding, fear of more work, and feeling devalued. Although this apprehension is worrisome, it is not impossible to overcome.

In an effort to bridge the gap between theoretical definitions and practice, NAADAC developed a national training curriculum that will become a part of the national certification process for the addiction workforce. This recovery-oriented training curriculum is designed to educate addiction professionals about a recovery-oriented model of care and addiction recovery (and their specific role in promoting it), as well as teach competencies needed to integrate addiction recovery concepts into practice. NAADAC is currently delivering this educational experience through a multi-level approach that includes nine webinars, articles in NAADAC’s Advances in Addiction and Recovery magazine, an online library of electronic print resources, a certificate program to demonstrate advanced education, inclusion of recovery-oriented test questions into certification test banks, and informational sessions at NAADAC’s annual conference and other state affiliate events. Uptake of this training curriculum has been extremely successful, with over 5,000 addiction professionals trained within the first year.

This curriculum combines education and clinical practice strategies with SAMHSA’s recovery concepts and principles, the Recovery- Oriented Systems of Care (ROSC) model of recovery services, the integration of mental health and recovery support systems to sustain long term recovery (longitudinal view), and the inclusion of other peer providers (recovery coaches) to assist in sustaining long-term recovery for the individual and the family. The curriculum will provide addiction professionals within the context of ROSC with options to serve and interrelate in the larger community of recovery and recovery supports.

The inclusion of the addiction community in SAMHSA’s Recovery to Practice (RTP) Initiative provided a very timely snapshot of the adoption and acceptance of recovery-oriented concepts, practices, and skills within the addiction profession. Even though the promotion of recovery has been a mainstay within the addiction profession, the RTP Initiative represents an opportunity to reaffirm and build upon the addiction profession’s foundational principles of individual, family, and community recovery. The moment is ripe for an addiction-specific recovery-oriented curriculum to bridge the remaining gaps between definition and practice, and all addiction professionals are encouraged to receive this training to further promote recovery among their clients and within their communities.

Recovery to Practice (RTP) Webinar Series Topics

• Defining Addiction Recovery

• What Does Science Say? Reviewing Recovery Research

• The History of Recovery in the United States and the Addiction Profession

• Defining Recovery-Oriented Systems of Care (ROSC)

• Understanding the Role of Peer Recovery Coaches in the Addiction Profession

• Including Family and Community in the Recovery Process

• Collaborating with Other Professions, Professionals, and Communities

• Using Recovery-Oriented Principles in Addiction Counseling Practice

• Exploring Techniques to Support Long-Term Addiction Recovery