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    <title type="text">David Clark &#45; Personal Blog</title>
    <subtitle type="text">Wired In Member Blog</subtitle>
    <link rel="alternate" type="text/html" href="http://wiredin.org.uk/member/profile/13" />
    <link rel="self" type="application/atom+xml" href="http://wiredin.org.uk/member/feed/13" />
    <updated>2010-09-02T19:54:56Z</updated>
    <rights>Copyright (c) 2010, David Clark</rights>
    <generator uri="http://expressionengine.com/" version="1.6.0">ExpressionEngine</generator>

    <entry>
      <title>Two excellent reads</title>
      <link rel="alternate" type="text/html" href="http://wiredin.org.uk/member/blog/13/entry/8717/two-excellent-reads" />
      <published>2010-08-30T17:43:08Z</published>
      <updated>2010-08-30T17:44:09Z</updated>
      <author>
            <name>David Clark</name>
                  </author>
      <content type="html"><![CDATA[
        	<p>Just been looking at a July issue of Drink and Drugs News and came across two interesting and thought provoking articles. Well worth a read!</p>

	<p>In the first, <a href="http://www.drinkanddrugsnews.com/magazine/80b3539e177c4588898d85f1e74b9d07.pdf">Time to Change</a>, David Best and colleagues describe a training programme for recovery-oriented treatment that could help break down artificial barriers. I&#8217;m really pleased to see great things happening in North Wales. </p>

	<p>In the second, <a href="http://www.drinkanddrugsnews.com/magazine/aa41e91787c847b48f64949b02e7ad18.pdf">Models of Compliance</a>, Alex Boyt comments on how the treatment system is failing those most at risk and looks at potential dangers of the recovery agenda in the current climate. Some very interesting words of caution from someone who has been there and back.</p>

	<p>Hope you enjoy these!</p>
              ]]></content>
    </entry>

    <entry>
      <title>&#8216;The Future Redefinition of Treatment&#8217; by Bill White</title>
      <link rel="alternate" type="text/html" href="http://wiredin.org.uk/member/blog/13/entry/8700/the-future-redefinition-of-treatment-by-bill-white" />
      <published>2010-08-26T09:48:31Z</published>
      <updated>2010-08-29T09:15:32Z</updated>
      <author>
            <name>David Clark</name>
                  </author>
      <content type="html"><![CDATA[
        	<p>After my long break, I&#8217;m back to writing on recovery. Well, doing the final preparation to get back to the book. Pulled out one of my favourite reads, <a href="http://www.chestnut.org/LI/bookstore/Blurbs/Books/A104-Dragon.html">Slaying the Dragon: The History of Addiction Treatment and Recovery in America</a> by William L White. Found one of my favourite sections which I will quote here: </p>

	<p>&#8220;During the past 150 years, “treatment” in the addictions field has been viewed as something that occurs within an institution – a medical, psychological, and spiritual sanctuary isolated from the community at large.</p>

	<p>In the future, this locus will be moved from the institution to the community itself. Treatment will be viewed as something that happens in indigenous networks of recovering people that exist within the broader community.</p>

	<p>The shift will be from the emotional and cognitive processes of the client to the client’s relationship in a social environment.</p>

	<p>With this shift will come an expansion of the role of the clinician to encompass skills in community organization. Such a transition does not deny the importance of the reconstruction of personal identity and other cognitive and emotional processes – or of the physical processes of healing – in addiction recovery.</p>

	<p>But it does recognize that such processes unfold within a social ecosystem and that this ecosystem, as much as the risk and resiliency in the individual, tips the scale towards recovery or continued self-destruction.</p>

	<p>As these new community organizers extend their activities beyond the boundaries of traditional inpatient and outpatient treatment, they will need to be careful that they do not undermine the natural indigenous system of support that exist within the community.</p>

	<p>The worst scenario would be that we would move into the lives of communities and – rather than help nurture the growth of indigenous supports – replace these natural, reciprocal relationships with ones that are professionalized, hierarchal, and commercialized.&#8221;</p>

	<p>You can certainly see the positive shifts described here in the UK and US!</p>


              ]]></content>
    </entry>

    <entry>
      <title>Back after a long break</title>
      <link rel="alternate" type="text/html" href="http://wiredin.org.uk/member/blog/13/entry/8620/back-after-a-long-break" />
      <published>2010-08-10T07:58:50Z</published>
      <updated>2010-08-13T18:42:51Z</updated>
      <author>
            <name>David Clark</name>
                  </author>
      <content type="html"><![CDATA[
        	<p>My sincere apologies that I have been away from the community so much over the past four months. As I said in a blog some time ago, I’ve had to deal with a serious family problem. The problem ended up taking over my life during the past months.</p>

	<p>Anyway, time to start working again and contributing to the community. I’ve been reading members’ contributions, just not had the opportunity to contribute myself. All other aspects of my Wired In work have also had to be put on hold.</p>

	<p>Obviously, I’ve been very grateful to Michaela for all her hard work in captaining the ship. We’ll be having a long Skype meeting shortly, discussing where we are and planning for the future.  </p>

	<p>I’m also planning more writing about recovery. Had a head-load of stuff that I wanted to write about before the personal problem arose. </p>

	<p>Now need to get my head together and strap myself to my new writing seat outside (overlooking the river) or in the study downstairs. Moved into this new house in Perth (West Australia) nearly four months ago and not yet had chance to write.  </p>

	<p>I was looking back at some of my old blogs this morning and got really inspired by the <a href="http://wiredin.org.uk/member/blog/13/entry/7439/guiding-principles-of-recovery-from-pennsylvania/">Guiding Principles of Recovery from Pennsylvania</a>. Thought I would remind you of their first principle: </p>

	<p><strong>&#8216;There are many pathways to recovery</strong></p>

	<p>Individuals are unique with specific needs, strengths, goals, attitudes, behaviors and expectations for recovery.</p>

	<p>Pathways to recovery are highly personal, and generally involve a redefinition of identity in the face of crisis or a process of progressive change.</p>

	<p>Furthermore, pathways are often social, grounded in cultural beliefs or traditions and involve informal community resources, which provide support for recovery.</p>

	<p>The pathway to recovery may include one or more episodes of psychosocial and/or pharmacological treatment. </p>

	<p>For some, recovery involves neither treatment nor involvement with mutual aid groups.</p>

	<p>Recovery is a lifelong process of change that permits an individual to make healthy choices and improve the quality of his or her life.</p>

	<p>There is so much in that little section that informs us about how to move forward in transforming the way that we help people overcome serious substance use problems and mental health problems.</p>

	<p>It’s good to be back.</p>
              ]]></content>
    </entry>

    <entry>
      <title>Apologies</title>
      <link rel="alternate" type="text/html" href="http://wiredin.org.uk/member/blog/13/entry/8211/apologies2" />
      <published>2010-05-04T07:43:58Z</published>
      <updated>2010-05-04T07:48:59Z</updated>
      <author>
            <name>David Clark</name>
                  </author>
      <content type="html"><![CDATA[
        	<p>I just wanted to take this opportunity to apologise for not being on the site recently, and not being able to attend the Recovery conference this week.</p>

	<p>I have been completely tied up for over a month now dealing with a serious family problem. It&#8217;s been stressing, distressing and all consuming of time, so it has been difficult to spend time on the community. And impossible to travel to the UK as planned.</p>

	<p>I also lost the internet for two weeks &#8211; some people would never believe I could survive without the internet for two days &#8211; after we moved house to a new part of Perth.</p>

	<p>I have not forgotten you. And I am so excited about the conference on Friday. This is a major moment for the Recovery movement in the UK, and worldwide. Well done the <span class="caps">UKRF</span> for putting this together.</p>

	<p>I am also very grateful to Michaela for running the community so well. There are some new community activities coming soon which I am very excited about.  </p>

	<p>I&#8217;m trying to get some balance with this problem so I can be back contributing to the community and some writing on Recovery. Hopefully, that will be soon.</p>

	<p>My very best to you all. For you who will be at the conference on Friday, have fun, enjoy, network and plan &#8211; and shout loud about Recovery! </p>

	<p>And please give Michaela, Alistair and Annemarie a big hug from me!</p>
              ]]></content>
    </entry>

    <entry>
      <title>&#8216;Farewell&#8217; to Daily Dose</title>
      <link rel="alternate" type="text/html" href="http://wiredin.org.uk/member/blog/13/entry/7980/farewell-to-daily-dose" />
      <published>2010-03-25T07:17:18Z</published>
      <updated>2010-03-25T23:19:19Z</updated>
      <author>
            <name>David Clark</name>
                  </author>
      <content type="html"><![CDATA[
        	<p>After nine years continuous service, Daily Dose makes a last entrance today, 26th March 2010. Sadly, we have been unable to attract sufficient sponsorship to continue operating. </p>

	<p>The site will remain so that you can continue to use our archive, which dates back to 1st January, 2002.</p>

	<p>As Editor and Founder of Daily Dose, I would like to take this opportunity of thanking our 8,000 subscribers for their continued support. We are sorry that we cannot continue to provide you with a service. I would also like to thank our current sponsors for their support over the past year.</p>

	<p>My sincere thanks to Nathan Pitman, who developed our current website and content management system. I am also grateful to Jim Young, Sarah Davies and Ash Whitney for their help over the years in making Daily Dose such a success.</p>

	<p>Finally, I would like to thank the Trustees of our charity Wired International Ltd – Mike Ashley, Tony Beddow, Wynford Ellis Owen, Canon Peter Williams and Jeff Zorko – for all their help and support during this time. You have my deepest gratitude.</p>

	<p>Wired In will continue to maintain and further develop our online recovery community, which is going from strength to strength. We also intend to develop new services in the future.</p>

	<p>I leave you with just a few of my favourite links.</p>

	<p>Thank you.</p>

	<p>My best wishes.</p>
              ]]></content>
    </entry>

    <entry>
      <title>Daily Dose to close</title>
      <link rel="alternate" type="text/html" href="http://wiredin.org.uk/member/blog/13/entry/7884/daily-dose-to-close" />
      <published>2010-03-20T09:28:21Z</published>
      <updated>2010-03-21T00:13:23Z</updated>
      <author>
            <name>David Clark</name>
                  </author>
      <content type="html"><![CDATA[
        	<p>After nine years continuous service, our beloved Daily Dose will be closing at the end of this week. Sadly, we have been unable to attract sufficient sponsorship to continue running the service. </p>

	<p>Despite the large number of subscribers &#8211; over 8,000 at present – and continued appreciative comments from our readers, we have always had to work very hard to attract sponsors. This year our luck finally ran out. </p>

	<p>As Editor and Founder of Daily Dose, I would like to take this opportunity of thanking all our subscribers for their continued support. We are sorry that we cannot continue to provide you with a service. </p>

	<p>I would also like to thank our current sponsors for their support over the past year. </p>

	<p>Thanks to Jim Young, Sarah Davies, Ash Whitney and Nathan Pitman (who developed our current website and content management system) for their help over the years in making Daily Dose such a success. </p>

	<p>Finally, I would like to thank the Trustees of our charity Wired International Ltd – Mike Ashley, Tony Beddow, Wynford Ellis Owen, Canon Peter Williams and Jeff Zorko &#8211; for all their help and support during this time. You have my deepest gratitude.</p>

	<p>Wired In will continue to maintain and further develop our <a href="http://www.wiredin.org.uk">online recovery community</a>, which is going from strength to strength. We also intend to develop new services in the future.  </p>

	<p>Thank you.</p>

	<p>My best wishes.</p>


              ]]></content>
    </entry>

    <entry>
      <title>My apologies, no DD for two days</title>
      <link rel="alternate" type="text/html" href="http://wiredin.org.uk/member/blog/13/entry/7688/my-apologies-no-dd-for-two-days" />
      <published>2010-03-09T09:43:17Z</published>
      <updated>2010-03-09T09:44:19Z</updated>
      <author>
            <name>David Clark</name>
                  </author>
      <content type="html"><![CDATA[
        	<p>I&#8217;ve come away to the wilds for a couple of days to take a break, having checked I would have reliable internet access. Sadly, reliable is a relative term. It&#8217;s taking a lifetime to find anything so I&#8217;ve decided to give up. My sincere apologies for this interruption in your service. I will be back&#8230; Thursday.  </p>
              ]]></content>
    </entry>

    <entry>
      <title>Role of the treatment professional</title>
      <link rel="alternate" type="text/html" href="http://wiredin.org.uk/member/blog/13/entry/7586/role-of-the-treatment-professional" />
      <published>2010-03-02T07:48:59Z</published>
      <updated>2010-03-02T07:55:00Z</updated>
      <author>
            <name>David Clark</name>
                  </author>
      <content type="html"><![CDATA[
        	<p>I have previously emphasised the primary importance of treatment and treatment professionals: to facilitate the person’s natural healing processes to help them find personal recovery.</p>

	<p>I recently found an excellent description of what is required of professionals working in the field in <a href="http://www.amazon.co.uk/Alcoholic-Family-Recovery-Developmental-Model/dp/1572308346/ref=sr_1_1?ie=UTF8&amp;s=books&amp;qid=1267495486&amp;sr=8-1">The Alcoholic Family in Recovery: A Developmental Model</a> by Stephanie Brown and Virginia Lewis.  </p>

	<p>“It is absolutely vital for therapists to know what is normal over time in the process of recovery or they may inadvertently try to treat, stop, or fix what is normal and necessary for growth. </p>

	<p>It is the therapist’s job to stay out of the way of the natural healing process, to monitor progress, and to recognize past or current roadblocks that might interfere with people’s ability to remain abstinent and engaged in recovery.</p>

	<p>It is also the therapist’s job to know the path, anticipate the seemingly unresolvable conflicts families will face, and to help them cope with these challenges in ways that will minimize secondary trauma.</p>

	<p>The complicated task for the therapist is to constantly assess what is part of growth – for this person and this family – and what is a sign of difficulty that requires intervention. The individuals and the family hopefully are doing the same.</p>

	<p>It is the therapist’s task to listen, interpret, advise, educate, and coach all along the way. It is not the therapist’s job to dictate what change should be. </p>

	<p>For example, the therapist is not approaching the family with a  goal of helping people express their feelings more or less, based on the therapist’s idea of what constitutes good therapy. </p>

	<p>The therapist instead wonders how the expression of feeling <em>at this point in time</em>, in this particular family, will facilitate or inhibit the developmental process of recovery.”</p>

	<p>Excellent stuff!</p>

	<p>[NB. Of course, whereas the authors have talked about the family, this also refers to the individual person accessing treatment].</p>
              ]]></content>
    </entry>

    <entry>
      <title>Elements of a Recovery&#45;Oriented System of Care (ROSC): From Pennsylvania</title>
      <link rel="alternate" type="text/html" href="http://wiredin.org.uk/member/blog/13/entry/7489/elements-of-a-recovery-oriented-system-of-care-from-pennsylvania" />
      <published>2010-02-25T21:55:34Z</published>
      <updated>2010-02-26T22:56:36Z</updated>
      <author>
            <name>David Clark</name>
                  </author>
      <content type="html"><![CDATA[
        	<p>In my last blog, I introduced a seminal White Paper recently been published the Recovery Oriented Systems of Care (<span class="caps">ROSC</span>) Subcommittee of the Drug and Alcohol Coalition in Pennsylvania. This White Paper is entitled, <a href="http://www.facesandvoicesofrecovery.org/pdf/White/rosc_community_perspective_2010.pdf">Recovery-Oriented System of Care: A Recovery Community Perspective</a>.</p>

	<p>I described the Guiding Principles of Recovery outlined in this excellent White Paper in my last blog. These principles are being used to help transform the addiction and mental health care system in Pennsylvania, so that it is based on recovery and a chronic care model of care.</p>

	<p>As earlier. I have taken the liberty of copying a chunk of this report rather than try to paraphrase what is being said – why mess around with words in a quality document?! This time I focus on the proposed elements of a Recovery-Oriented System of Care (<span class="caps">ROSC</span>). </p>

	<p>For those of you working in this field, I ask you to consider how close your organisation is to operating on these principles. How valuable do you think they are? Here we go:</p>

	<p>“The elements of a system, much like the Guiding Principles, are rooted in the very core of the system’s values. They are the individual components that make up the whole. The elements of a system are those smaller parts that are similar to the larger system in that they can be described as common in value, behaviors and identity. Therefore, the elements of a <span class="caps">ROSC</span> broken down into their individual parts have recovery as their fundamental ingredient. </p>

	<p><strong>Person-centered</strong> – A <span class="caps">ROSC</span> is person-centered. Individuals will have a menu of choices that fit their needs throughout the recovery process. </p>

	<p><strong>Participation inclusive of individuals and families in recovery</strong> – An essential characteristic of a <span class="caps">ROSC</span> is the importance it places on the participation of people in recovery in all aspects and phases of the care delivery process, including financial support for individual and family involvement. </p>

	<p><strong>Family and other ally involvement</strong> – A <span class="caps">ROSC</span> acknowledges the important role that families and other allies can play. Family and other allies will be incorporated, with the permission of the individual, in the recovery planning and support process. They can constitute a source of support to assist individuals in entering and maintaining recovery. </p>

	<p>Additionally, systems address the prevention and early intervention, treatment, recovery and other support needs of families and other allies. </p>

	<p><strong>Inclusion of the voices and experiences of recovering individuals and their families</strong> – The voices and experiences of people in recovery and their family members contribute to the design and implementation of <span class="caps">ROSC</span>. People in recovery and their family members are included among decision-makers and system-level monitoring. </p>

	<p>Recovering individuals and family members are prominently and authentically represented on advisory councils, boards, task forces and committees at the federal, state and local levels. </p>

	<p><strong>Promoting access and engagement</strong> – Each person who seeks services should be afforded every opportunity to access appropriate addiction treatment and recovery support. A <span class="caps">ROSC</span> promotes access to care by facilitating swift and uncomplicated entry and by removing barriers to receiving services (i.e. no wrong door). </p>

	<p>Engagement involves making contact with the person (as opposed to their disease), building trust over time, attending to the person’s stated goals and needs and, directly or indirectly, providing a range of services in addition to clinical care. This involves linkages. </p>

	<p><strong>Linkages</strong> – For many individuals, recovery sustainability is not achieved through short episodes of treatment currently authorized by funding entities or through sporadic participation in self-help programs. There is often a misconception that individuals can remain in recovery without additional services and support. </p>

	<p>Linkage to recovery support services can serve to expand the capacity of formal treatment systems by promoting the initiation of recovery, reducing relapse, and intervening early when relapse occurs (Kaplan, 2008). Participation in these services will enhance long-term recovery outcomes, regardless of involvement in formal treatment. </p>

	<p>It is also critical for individuals and families to be connected to ancillary forms of support to address additional needs that directly affect the recovery process (housing, employment, medical care, etc.). </p>

	<p>By collaborating with a wide range of service and resource providers, individuals will gain access to a wider array of resources critical to the recovery process. </p>

	<p><strong>Individualized and comprehensive services across the lifespan</strong> – A <span class="caps">ROSC</span> offers a menu of comprehensive services which are individualized, stage-appropriate, and flexible across the lifespan. Systems will adapt to the needs of individuals, rather than requiring individuals to adapt to them. They are designed to support recovery across the lifespan. </p>

	<p>The approach to alcohol and other drug-related issues will change from an acute-based model to one that manages chronic diseases over a lifetime. </p>

	<p><strong>Systems anchored in the community</strong> – A <span class="caps">ROSC</span> is nested in the community for the purpose of enhancing the availability and support capacities of families, intimate social networks, community-based institutions and other communities in recovery. </p>

	<p>These systems should establish and maintain effective formal and informal linkages throughout the state to connect individuals and families to clinical, community-based and recovery support services. </p>

	<p><strong>Ensuring continuity of care</strong> – A <span class="caps">ROSC</span> offers a continuum of care, including pre-treatment, treatment, continuing care and recovery support. Individuals should have a full range of stage-appropriate services from which to choose at any point in the recovery process. </p>

	<p><strong>Partnership-consultant relationships</strong> – A recovery-oriented system of care is patterned after a partnership-consultant model that focuses on collaboration, and less on hierarchy. Systems will be designed so that individuals feel empowered to direct their own recovery with safety being a paramount concern. </p>

	<p><strong>Strength-based</strong> – A <span class="caps">ROSC</span> emphasizes strengths, assets and resiliencies. </p>

	<p><strong>Culturally responsive</strong> – A <span class="caps">ROSC</span> is culturally sensitive, competent, responsive and aware of recovery language. There is recognition that beliefs and customs are diverse and can impact the outcomes of recovery efforts. </p>

	<p><strong>Responsiveness to personal belief systems</strong> – A <span class="caps">ROSC</span> respects the spiritual, religious and/or secular beliefs of those they serve and provide linkages to an array of recovery options that are consistent with these beliefs. </p>

	<p><strong>Commitment to peer recovery support services</strong> – A <span class="caps">ROSC</span> provides opportunities for ongoing participation of peers in the planning, implementation, and delivery of services throughout the full continuum of care. </p>

	<p><strong>Integrated services</strong> – A <span class="caps">ROSC</span> coordinates and/or integrates efforts across service systems to achieve an integrated process that responds effectively to the individual’s unique strengths, desires and needs. </p>

	<p><strong>System-wide education and training</strong> – A <span class="caps">ROSC</span> ensures that concepts of recovery and wellness are foundational elements. Training, at every level, will reinforce the tenets of recovery-oriented systems of care. </p>

	<p><strong>Ongoing monitoring and outreach</strong> – A <span class="caps">ROSC</span> provides ongoing monitoring and feedback with assertive outreach efforts to promote participation, motivation and reengagement in order to continually improve the system. </p>

	<p><strong>Outcomes driven</strong> – A <span class="caps">ROSC</span> is guided by recovery-based processes and outcome measures. These measures will be developed in collaboration with individuals in recovery. </p>

	<p>Outcome measures will reflect the long-term global effects of the recovery process on the individual, family and community, not just remission of biomedical symptoms. Outcomes will be measurable and include benchmarks of quality of life changes. </p>

	<p><strong>Research-based</strong> – A <span class="caps">ROSC</span> is informed by research. Additional research on individuals in recovery, recovery venues and the processes and phases of recovery, including cultural and spiritual aspects, is essential. Research will be supplemented by the experiences of people in recovery. </p>

	<p><strong>Adequately and flexibly financed</strong> – A <span class="caps">ROSC</span> must be adequately financed to permit access to a full continuum of services, ranging from detoxification and treatment to continuing care and recovery support. </p>

	<p>The service delivery system will be flexible enough to provide the establishment of an array of programming around long-term recovery support to augment those already provided within our drug and alcohol service system. </p>

	<p><strong>End stigma and discrimination</strong> – A <span class="caps">ROSC</span> works toward the eradication of stigma and discrimination. Stigma and discrimination toward individuals and families seeking treatment and recovery will be eliminated and no longer serve as barriers in obtaining necessary services or progressing in their recovery. </p>

	<p><strong>Promote the highest level of autonomy</strong> – A <span class="caps">ROSC</span> promotes the highest degree of functioning and quality of life for all individuals in our system. The system recognizes that individuals may need to learn new skills to survive in the larger society. </p>

	<p>Success at an expanding array of life tasks and the assumption of new or enhanced roles in the community as they are defined by the person in recovery over time, both derive from and contribute to sustained recovery. </p>

	<p>The system provides emotional and financial resources, social support and skill building opportunities for individuals to achieve their individual goals (<span class="caps">CSAT</span>, 2005). </p>

	<p>The elements of any system are the heart and soul that goes into its creation. The elements are what maintain the integrity of the system. </p>

	<p>As in any system, precious parts can be lost over time if those monitoring the system are not vigilant and focused on the true purpose of the system. </p>

	<p>Therefore, it is essential that the elements are reviewed frequently, especially during system transformation and change and that special care is taken to always maintain their authenticity.”</p>
        		<p><a href="http://www.wiredin.org.uk/files/pdfs/blog/ROSCElementsPenn_v1.01_Final_DC_250210_.docx_.pdf" title="Download the full blog entry in PDF Format">Download the full blog entry in PDF Format</a></p>
		      ]]></content>
    </entry>

    <entry>
      <title>Guiding Principles of Recovery: From Pennsylvania</title>
      <link rel="alternate" type="text/html" href="http://wiredin.org.uk/member/blog/13/entry/7439/guiding-principles-of-recovery-from-pennsylvania" />
      <published>2010-02-23T07:48:06Z</published>
      <updated>2010-02-23T07:53:07Z</updated>
      <author>
            <name>David Clark</name>
                  </author>
      <content type="html"><![CDATA[
        	<p>A seminal White Paper has recently been published the Recovery Oriented Systems of Care (<span class="caps">ROSC</span>) Subcommittee of the Drug and Alcohol Coalition in Pennsylvania. This White Paper is entitled, <a href="http://www.facesandvoicesofrecovery.org/pdf/White/rosc_community_perspective_2010.pdf">Recovery-Oriented System of Care: A Recovery Community Perspective</a>.</p>

	<p>For those of you who don’t know, the state of Pennsylvania has been transforming its addiction and mental health care system to be one that is based on recovery and on a chronic care model of care. Along with Connecticut, which led the way, Pennsylvania is playing a key role in the States in the development of recovery-oriented systems of care. </p>

	<p>I have indicated on numerous occasions that we need to learn from what is going in the US. I believe strongly that a significant number of recovery advocates, researchers, practitioners and policy makers across the pond are carving a pathway that we can follow, adjusting it for cultural and any other differences. </p>

	<p>We can save a great deal of time, energy and anguish by following this lead.</p>

	<p>This White Paper contains some key information that I want to present to you. It is core to what we are doing. Given the quality of this document – it really is <span class="caps">THAT</span> good – I’m not going to mess about and paraphrasing. I will quote key parts in this and forthcoming blogs. </p>

	<p>A number of people have indicated on this community site that they do not know what material they should be reading about recovery, and giving out to other people. We will be providing guidance over time in regard to this matter. Can I suggest you read the rest of this blog, print it off and hand around, and read the original document?</p>

	<p>For now, I hand you over to the Recovery Oriented Systems of Care (<span class="caps">ROSC</span>) Subcommittee of the Drug and Alcohol Coalition in Pennsylvania [I&#8217;ve altered paragraphing in this version of blog to make it easier to read].</p>

	<p>“As in any system, there are Guiding Principles that are the ideals or code of conduct that defines the system’s core values and priorities. Guiding Principles filter through every aspect of a system clearly identifying the moral values embedded within the system. </p>

	<p>Guiding Principles are the fundamental beliefs that guide the operation of a system throughout its life in all circumstances, irrespective of changes in its goals, strategies, type of work, or the top management. </p>

	<p>Therefore, once established, a <span class="caps">ROSC</span> should remain intact and authentic to the original vision, values and principles regardless of changes that occur in the implementation/execution of this system. </p>

	<p>Those values that form the Guiding Principles of a <span class="caps">ROSC</span> include the following beliefs about recovery:</p>

	<p><strong>There are many pathways to recovery.</strong> Individuals are unique with specific needs, strengths, goals, attitudes, behaviors and expectations for recovery. Pathways to recovery are highly personal, and generally involve a redefinition of identity in the face of crisis or a process of progressive change. </p>

	<p>Furthermore, pathways are often social, grounded in cultural beliefs or traditions and involve informal community resources, which provide support for recovery. </p>

	<p>The pathway to recovery may include one or more episodes of psychosocial and/or pharmacological treatment. For some, recovery involves neither treatment nor involvement with mutual aid groups. </p>

	<p>Recovery is a lifelong process of change that permits an individual to make healthy choices and improve the quality of his or her life. </p>

	<p><strong>Recovery is self-directed and empowering.</strong> While the pathway to recovery may involve one or more periods of time when activities are directed or guided to a substantial degree by others, recovery is fundamentally a self-directed process. </p>

	<p>The person in recovery is the agent of recovery and has the authority to exercise choices and make decisions based on his or her recovery goals that have an impact on the process. </p>

	<p>The process of recovery leads individuals toward the highest level of autonomy of which they are capable. Through self-empowerment, individuals become optimistic about life goals. </p>

	<p><strong>Recovery involves a personal recognition of the need for change and transformation.</strong> Individuals must accept that a problem exists and be willing to take steps to address it; these steps usually involve seeking help for alcohol and other drug dependence. </p>

	<p>The process of change can involve physical, emotional, intellectual and spiritual aspects of the person’s life. </p>

	<p><strong>Recovery is holistic.</strong> Recovery is a process through which one gradually achieves greater balance of mind, body and spirit in relation to other aspects of one’s life, including family, work and community. </p>

	<p><strong>Recovery has cultural dimensions.</strong> Each person’s recovery process is unique and impacted by cultural beliefs and traditions. A person’s cultural experience often shapes the recovery path that is right for him or her. </p>

	<p><strong>Recovery exists on a continuum of improved health and wellness</strong>. Recovery is not a linear process. It is based on continual growth and improved functioning. It may involve relapse and other setbacks, which are a natural part of the continuum but not inevitable outcomes. </p>

	<p>Wellness is the result of improved care and balance of mind, body and spirit. It is a product of the recovery process. </p>

	<p><strong>Recovery emerges from hope and gratitude.</strong> Individuals in or seeking recovery often gain hope from those who share their search for or experience of recovery. They see that people can and do overcome the obstacles that confront them and they cultivate gratitude for the opportunities that each day of recovery offers. </p>

	<p><strong>Recovery involves a process of healing and redefinition for self and family.</strong> Recovery is a holistic healing process in which one develops a positive and meaningful sense of identity. </p>

	<p><strong>Recovery involves addressing discrimination and transcending shame and stigma.</strong> Recovery is a process by which individuals, families and communities confront and strive to overcome discrimination, shame and stigma by advocating for self and others. </p>

	<p><strong>Recovery is supported by peers and allies</strong>. A common denominator in the recovery process is the presence and involvement of people who contribute hope and support and suggest strategies and resources for change. Peers, as well as family members and other allies, form vital support networks for people in recovery. </p>

	<p>Providing service to others and experiencing mutual healing help create a community of support among those in recovery.</p>

	<p><strong>Recovery involves (re)joining and (re)building a life in the community.</strong> Recovery involves a process of building or rebuilding what a person has lost or never had due to his or her condition and its consequences. Recovery is building or rebuilding healthy family, social, spiritual and personal relationships. </p>

	<p>Those in recovery often achieve improvements in the quality of their lives, such as obtaining education, employment and housing. They also increasingly become involved in constructive roles in the community through helping others, productive acts and other contributions. </p>

	<p><strong>Recovery is a reality.</strong> It can, will, and does happen. </p>

	<p>Guiding Principles are the blueprint that sets the course by which a system navigates (<span class="caps">CSAT</span>, 2007). Protecting and honoring the Guiding Principles of a <span class="caps">ROSC</span> are integral to its ongoing success and growth. </p>

	<p>Although they may be altered as necessary over time, in essence the Guiding Principles should always remain true to the original vision.”</p>

	<p>Hope you enjoyed!</p>


        		<p><a href="http://www.wiredin.org.uk/files/pdfs/blog/RecoveryPrinciplesPenn_v1.01_Final_DC_230210_.pdf" title="Download the full blog entry in PDF Format">Download the full blog entry in PDF Format</a></p>
		      ]]></content>
    </entry>

    <entry>
      <title>To those we have lost &#45; and those left behind</title>
      <link rel="alternate" type="text/html" href="http://wiredin.org.uk/member/blog/13/entry/7354/to-those-we-have-lost-and-those-left-behind" />
      <published>2010-02-19T01:39:46Z</published>
      <updated>2010-02-19T08:39:47Z</updated>
      <author>
            <name>David Clark</name>
                  </author>
      <content type="html"><![CDATA[
        	<p>Six years ago today, Elizabeth Burton-Phillips lost her son Nicholas Stephen Mills. Elizabeth is a remarkable woman who has written a book, developed a website, set up a support group, and done many other things since her tragic loss.   </p>

	<p>This week, Susan C buried her son Michael. She has blogged her thoughts for the last two weeks, which has left many of us deeply moved. This remarkable lady has shown so much courage and has impacted massively on our community.</p>

	<p>I would like you all to take some time to think about these special ladies. I would also like you to think of others who have lost loved ones to drugs and alcohol, such as Irene and Ian Macdonald who set up the Cheltenham Parents Support Group after the loss of their son. </p>

	<p>There are many others and a significant proportion of these people have gone on to make important contributions to the recovery field and to helping people negatively affected by a loved one&#8217;s substance use. </p>

	<p>Today, I have devoted <a href="http://www.dailydose.net">Daily Dose</a> to people who have lost loved ones to drugs and alcohol, the people we have lost, and to all those people who are helping families, friends and carers of those people affected by substance use problems.</p>

	<p>You will find information about Elizabeth Burton-Phillips&#8217; work, a series of blogs written by Susan, articles written by the Macdonalds and Kerry Manley, and links to some special books. </p>

	<p>There is also a link to a very special video by Chase Johnston-Lynch of Owen Allen singing <a href="http://www.vimeo.com/5257905">Letting Go</a>. Watch this deeply moving performance.</p>

	<p>I hope you spend some time with this material and find it useful. </p>
              ]]></content>
    </entry>

    <entry>
      <title>Recovery: The bridge to integration? Part two</title>
      <link rel="alternate" type="text/html" href="http://wiredin.org.uk/member/blog/13/entry/7202/recovery-the-bridge-to-integration-part-two" />
      <published>2010-02-12T07:04:37Z</published>
      <updated>2010-02-12T07:05:38Z</updated>
      <author>
            <name>David Clark</name>
                  </author>
      <content type="html"><![CDATA[
        	<p>In my last blog, I looked at a paper written by my two recovery &#8216;heroes&#8217;, Bill White and Larry Davidson, which focused on recovery as a potential bridge for integration of the addiction and mental health field.</p>

	<p>In the first paper, the authors described some of the reasons for why the mental health and addictions fields have had trouble integrating in the past. They also discussed how recovery could be a conceptual bridge to the integration of the fields. </p>

	<p>In the second article, they examine how emerging recovery systems are different from traditional models of care. I have taken some highlights from this article, but I strongly urge you to also read the full article.</p>

	<p>&#8216;Understanding that system change, like recovery, must be led by people with lived experiences of recovery, the Connecticut Department of Mental Health and Addiction Services consulted with statewide recovery advocacy organizations to develop a set of core recovery values (e.g., self-sufficiency, dignity, and respect) and principles to drive their system transformation process. </p>

	<p>These principles included the following admonitions:</p>

	<ul>
		<li>Focus on people rather than services</li>
		<li>Monitor outcomes rather than procedural performance</li>
		<li>Emphasize strengths rather than deficits or dysfunction</li>
		<li>Educate the public to combat stigma</li>
		<li>Foster collaboration as an alternative to coercion</li>
		<li>Promote autonomy and decrease reliance on professionals.&#8217;</li>
	</ul>

	<p>White and Davidson go on to describe some of the major changes in practice in both the addiction and mental health fields in states like Connecticut and cities like Philadelphia. I&#8217;ve summarised where I can.</p>

	<p><strong>Roles of clients, families, and recovery advocates</strong><br />
People in recovery are considered valuable assets and partners, rather than problems, with involvement at all organizational levels and across major functions. Their decisions are crucial to long-term recovery, and a philosophy of choice guides all levels of care.</p>

	<p><strong>Identification, engagement, and retention</strong><br />
Assertive outreach programs shift from pain-based to hope-based intervention strategies and have lowered thresholds of admission, increased use of case management to resolve obstacles to participation, and used motivational enhancement and contingency management to lower the number of clients disengaging from services against medical advice or being administratively discharged.</p>

	<p><strong>Assessment</strong><br />
Assessment protocols shift from being categorical (specialized), pathology-based, and individual-focused to being global, strengths-based, family-centered, and continual.</p>

	<p><strong>Service goals</strong><br />
Symptom reduction/remission shifts from a goal to a strategy, focusing on quality of life, achievement of personal aspirations, and meaningful participation in and service to the community.</p>

	<p><strong>Service planning and service team</strong><br />
Transition from professionally directed treatment plans to client-driven recovery plans, along with a move to multiagency, interdisciplinary service models and an inclusion of family and indigenous healers (clergy, folk healers, recovery peers, etc.) in treatment and recovery planning processes.</p>

	<p><strong>Role of the community</strong><br />
Emphasis on local recovery education and policy advocacy. The community is no longer viewed as a context for or precipitant of relapse, but rather as a reservoir of resources, hospitality, and support. The focus is on collaboration with existing recovery support resources and community development strategies to expand the scope and quality of such resources.</p>

	<p><strong>Service timing</strong><br />
The system shifts from crisis-based contact to long-term support focused on critical windows of peak functioning (to acknowledge and celebrate recovery) and critical windows of vulnerability (to provide support through situations that pose a risk for relapse). Regular recovery checkups are employed.</p>

	<p><strong>Locus of service delivery</strong><br />
Instead of institutional environments, the locus of service delivery is the client&#8217;s natural environment. Considerable focus is on the “ecology of recovery” (helping clients create recovery-conducive physical and social environments).</p>

	<p><strong>Service relationship</strong><br />
This shifts from an expert model of diagnosis and treatment to a sustained healthcare partnership. The relationship isn&#8217;t hierarchical, transient, and highly commercialized, but rather less hierarchical, sustained, and natural. Peer-based models of recovery support increasingly are being used.</p>

	<p><strong>Service evaluation</strong><br />
Service evaluation significantly involves clients, family members, and community elders. The emphasis shifts from pathology measures to key recovery indicators. Instead of evaluating discrete service episodes, evaluation focuses on the impact of service combinations and sequences on a person&#8217;s overall life over time.</p>

	<p>Wow, there is a lot of stuff there yo think about it. I would suggest taking these points (from the original manuscript) and sticking them up on your wall or on your desk as a reminder. They are critical benchmarks. </p>

	<p>I will finish off talking about these papers &#8211; well, I haven&#8217;t done much talking, just copied these words of wisdom &#8211; in a third blog.</p>

	<p><a href="http://www.behavioral.net/ME2/dirmod.asp?sid=9B6FFC446FF7486981EA3C0C3CCE4943&amp;nm=Archives&amp;type=Publishing&amp;mod=Publications%3A%3AArticle&amp;mid=64D490AC6A7D4FE1AEB453627F1A4A32&amp;tier=4&amp;id=E4EE84BCE13846F5A802F9BDE0D70F03">Recovery: The bridge to integration? Part two</a></p>
              ]]></content>
    </entry>

    <entry>
      <title>Recovery: The bridge to integration? Part one</title>
      <link rel="alternate" type="text/html" href="http://wiredin.org.uk/member/blog/13/entry/7131/recovery-the-bridge-to-integration-part-one" />
      <published>2010-02-10T09:08:18Z</published>
      <updated>2010-02-10T18:07:19Z</updated>
      <author>
            <name>David Clark</name>
                  </author>
      <content type="html"><![CDATA[
        	<p>Some of you will know that I am a great fan of William W White (addiction field) and Larry Davidson (mental health field). I have been actively promoting the research, writing and ideas of these individuals and their colleagues.</p>

	<p>I have recently realised that I missed a two-part article they co-authored on recovery and the integration of the addiction and mental health fields. This is a particularly important article for various reasons and I strongly suggest that you read both parts (see links below). </p>

	<p>For now though, I’ve taken some quotes to give you some idea of what was covered in this excellent article. I&#8217;ll start with the first part, which contains some useful descriptions of recovery and recovery-oriented care.  </p>

	<p>&#8216;The purpose of this two-part series is to explore whether the concept of recovery could serve as a conceptual bridge through which the treatments of addiction and mental illness could be integrated within one recovery-oriented system of care.&#8217;</p>

	<p>Historically, these two systems of care have not been integrated and the authors provide some of the reasons why this has been the case. As many of us know, the failure of these system to be integrated means that people with co-occurring addiction and mental health problems often fail to get help for their problems from both care systems.</p>

	<p>&#8216;Recovery refers to the ways in which persons with or affected by a mental illness and/or addiction tap resources within and beyond the self to move beyond experiencing these disorders to actively managing them and their residual effects to build full, meaningful lives in the community. </p>

	<p>Recovery is more than the elimination of symptoms from an otherwise unchanged life. It is about regaining wholeness, connection to community, and a purpose-filled life. </p>

	<p>A number of overarching ideas are at the core of these new recovery advocacy movements:</p>

	<ul>
		<li>Recovery is a reality in the lives of millions of individuals and families.</li>
		<li>There are many pathways and styles of recovery.</li>
		<li>Recovery is a voluntary process.</li>
		<li>Recovery flourishes in supportive communities.</li>
		<li>Recovery gives back (to individuals, families, and communities) what addiction and mental illness have taken away.&#8217;</li>
	</ul>

	<p>&#8216;Behavioral healthcare must move beyond emergency and palliative care to care oriented to promoting long-term recovery.</p>

	<p>Recovery-oriented care is what psychiatric and addiction treatment and rehabilitation practitioners offer in long-term support of the person&#8217;s/family&#8217;s own recovery efforts. </p>

	<p>Recovery-oriented care shifts the design of the addiction treatment system from an acute care model, focused on serial episodes of biopsychosocial stabilization, to a model of sustained recovery management.</p>

	<p>That same recovery orientation in the mental health field shifts the service design beyond cyclical crisis intervention and “sustaining care,” aimed at symptom suppression and reduced hospitalizations, to one of recovery enhancement. </p>

	<p>Recovery-oriented care focuses on the acquisition and maintenance of recovery capital (internal and external assets required for recovery initiation and self-maintenance), global health (physical, emotional, relational, and spiritual), and community integration (meaningful roles, relationships, and activities).&#8217;</p>

	<p>I&#8217;ll look at Part 2 in another blog.</p>

	<p><a href="http://www.behavioral.net/ME2/dirmod.asp?sid=&amp;nm=&amp;type=Publishing&amp;mod=Publications%3A%3AArticle&amp;mid=&amp;id=275C497AD93D4F3AA4EB10C64B0D12E1&amp;tier=4">Recovery: The bridge to integration? Part one</a><br />
<a href="http://www.behavioral.net/ME2/dirmod.asp?sid=9B6FFC446FF7486981EA3C0C3CCE4943&amp;nm=Archives&amp;type=Publishing&amp;mod=Publications%3A%3AArticle&amp;mid=64D490AC6A7D4FE1AEB453627F1A4A32&amp;tier=4&amp;id=E4EE84BCE13846F5A802F9BDE0D70F03">Recovery: The bridge to integration? Part two</a></p>
              ]]></content>
    </entry>

    <entry>
      <title>Promoting mindfulness</title>
      <link rel="alternate" type="text/html" href="http://wiredin.org.uk/member/blog/13/entry/6202/promoting-mindfulness" />
      <published>2010-01-06T00:51:32Z</published>
      <updated>2010-01-06T09:20:33Z</updated>
      <author>
            <name>David Clark</name>
                  </author>
      <content type="html"><![CDATA[
        	<p>First of all Happy New Year to you all! I&#8217;ve spent three weeks with my children here in Perth, who came over from Dubai where they live with their mother and step-father. It was wonderful &#8211; well most of time!</p>

	<p>As most of you know, I have now stepped back from running the community, handing over to Michaela and Sarah. They&#8217;ve been doing an excellent job. We&#8217;ll soon start talking about and planning the future for the community. </p>

	<p>I&#8217;ll be playing a very much more minor role in running the community, although I am not lost to the recovery field. I am planning to write a book and make a film on recovery. As there is lots to learn, read and research, I&#8217;m going to be quiet for some time whilst I move forward on these challenging ventures.</p>

	<p>I wanted to take this opportunity to tell you about the links to content about mindfulness on Daily Dose yesterday. </p>

	<p>The Mental Health Foundation (<span class="caps">MHF</span>) have launched a new website called <a href="http://www.bemindful.co.uk/">Be Mindful</a>, which contains content on the experience of mindfulness and the evidence showing that it can help people deal with a variety of physical and psychological problems.  </p>

	<p>A <a href="http://www.bemindful.co.uk/about_mindfulness/mindfulness_evidence">Surgery Toolkit</a> can be purchased for a small sum (£20) which is of use to health professionals and Primary Care Trusts, and others. I provided a link to the <a href="http://www.bemindful.co.uk/media/downloads/Executive%20Summary.pdf">Executive Summary</a> of a report on the effectiveness of mindfulness. You can purchase the report.</p>

	<p>I have also provided links to two key books on mindfulness and depression, one <a href="http://www.amazon.co.uk/Mindful-Way-Through-Depression-Unhappiness/dp/1593851286/ref=sr_1_1?ie=UTF8&amp;s=books&amp;qid=1262652896&amp;sr=8-1">self-help guide</a> (with accompanying CD) and the other a <a href="http://www.amazon.co.uk/Mindfulness-based-Cognitive-Therapy-Depression-Preventing/dp/1572307064/ref=sr_1_5?ie=UTF8&amp;s=books&amp;qid=1262652907&amp;sr=1-5">guide for professionals</a>. These books are not just relevant to depression, but to all aspects of life.   </p>

	<p>There is no doubt in my mind that mindfulness is a powerful tool in helping people find recovery from addiction. I have written a <a href="http://wiredin.org.uk/member/blog/13/entry/1046/peace-and-mindfulness/">past blog</a> on mindfulness and I will be talking more about the topic in the future. </p>

	<p>That&#8217;s all for now. Be back soon.</p>
              ]]></content>
    </entry>

    <entry>
      <title>Daily Dose Highlights of the Year</title>
      <link rel="alternate" type="text/html" href="http://wiredin.org.uk/member/blog/13/entry/5948/daily-dose-highlights-of-the-year5" />
      <published>2009-12-20T14:14:21Z</published>
      <updated>2009-12-20T14:21:22Z</updated>
      <author>
            <name>David Clark</name>
                  </author>
      <content type="html"><![CDATA[
        	<p>Some of our favourite content on Daily Dose since we launched the new site on May 1st.</p>

	<p><a href="http://www3.interscience.wiley.com/cgi-bin/fulltext/122382468/PDFSTART">Exposure of children and adolescents to alcohol advertising on metropolitan free-to-air television</a><br />
The self-regulation system in Australia does not protect children and youth from exposure to alcohol advertising, much of which contains elements appealing to these groups [Addiction, UK]</p>

	<p><a href="http://www.actiononaddiction.org.uk/news_and_campaigns/news/158_new-estimates-predict-that-between-3-4-3-5-million-children-live-with-at-least-one-binge-drinking-parent">Estimates predict that between 3.4-3.5 million children live with at least one binge-drinking parent</a><br />
A new piece of research launched today shows that the number of children living with substance misusing parents is greater than previously thought [Action on Addiction, UK]</p>

	<p><a href="http://www1.salvationarmy.org.uk/uki/www_uki.nsf/0/58A56A802FEAE3EC802575E5004A2FED/$file/The%20Seeds%20of%20Exclusion%202009.pdf">The Seeds of Exclusion 2009</a><br />
The research, produced with the University of Kent and Cardiff University and involving a series of clinical assessments of 967 homeless adults using Salvation Army hostels and day centres around the UK and Ireland, reveals particularly alarming results for 18-25 year-olds than for any other age group [Salvation Army, UK]</p>

	<p><a href="http://www.facesandvoicesofrecovery.org/mp3/Faces&amp;VoicesofRecovery_Haberle_6-30-2009.mp3">Audio of 2009 Recovery Teleconference Series: Building Bridges to Long-term Recovery</a><br />
Audio presentations from William L White, Beverly Haberle and Phillip Valentine: Mutual support groups / Peer and other recovery support services / Clinical treatment services, their differences and relationships [Faces &amp; Voices of Recovery, <span class="caps">USA</span>]</p>

	<p><a href="http://wiredin.org.uk/users-ex-users/articles/entry/2638/what-treatment-meant-to-me/">What treatment meant to me</a><br />
“Treatment changed my life. Because it changed my life, it has effectively changed the lives of those I love and come into contact with: my partner, my family, my friends and, of course, my clients.” [Androcles, Wired In]</p>


              ]]></content>
    </entry>

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