‘Peer Support in Mental Health: Exploitive, Transformative, or Both?’ by Larry Davidson

ldavidsonI am a great admirer of Larry Davidson’s work and writings. Three of his books are amongst my favourite reads in the mental health field – please see below. These books provide clear insights into the whys and hows of adopting recovery based care.

Here is Larry’s latest writing, which appeared on the Mad in America website.

‘The first time I tried to write about peer support – that emerging form of “service delivery” in which one person in recovery from what is described in the field as a “serious mental illness” offers support to another person who is in distress or struggling with a mental health condition – was in 1994. The manuscript was summarily rejected from an academic journal as representing what one of the reviewers described as “unsubstantiated rot.”

That same article was eventually published 5 years later (1), and used by the President’s New Freedom Commission on Mental Health to support its recommendation that peer supports be implemented across the country. (2) Now, more than a decade later and as peer support arrives at something of a crossroads, both of these reactions remain instructive.

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‘Personal Failure or System Failure’ by William White

System Failure‘In my writings to people seeking recovery from addiction, I have advocated a stance of total personal responsibility:  Recovery by any means necessary under any circumstances.

That position does not alleviate the accountabilities of addiction treatment as a system of care. Each year, more than 13,000 specialized addiction treatment programs in the United States serve between 1.8 and 2.3 million individuals, many of whom are seeking help under external duress.  Those who are the source of such pressure are, as they see it, giving the individual a chance – with potentially grave consequences hanging in the balance.

Accepting the mantra that “Treatment Works,” families, varied treatment referral sources and the treatment industry itself believe that responsibility for any resumption of alcohol and other drug use following service completion rests on the shoulders of the individual and not with the treatment program. 

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‘The Role of Harm Reduction in Recovery-oriented Systems of Care: The Philadelphia Experience’

images‘While harm reduction can be viewed as an end in itself with a focus on mitigating harm to individuals, families and the community as a whole, harm reduction strategies can also be viewed collectively as a platform or point of access for promoting long-term health, and, for those with severe alcohol and other drug problems, long-term personal and family recovery.

If our goal is to promote health and reclaim lives, then we must understand the direct and sometimes circuitous paths through which individuals and families achieve and sustain such health. We must meet each individual and family with fresh eyes in every encounter with a belief that each encounter is an opportunity for movement, no matter how small, towards health and wholeness.’ Arthur C. Evans, Jr., 2013

‘Bridging the harm reduction and traditional addiction treatment and recovery worlds “requires openness to the possibility that our worldview and the cherished concepts we use to describe it may need to become subtler, more fine-grained, amended or even discarded; and, that approaches which don’t work for one person can, equally, be life-saving for others, when all the time our own beliefs, experiences, perhaps even our entire biography, shouts out that this can’t be so.” Neil Hunt, 2012

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Reflections on recovery – From seven years ago

2007_0116walpole0008This is from the website Articles section. Thought you should see how I was thinking seven years ago:

‘This article comprises two articles I wrote seven years ago for Drink and Drugs News (DDN) in the UK – with a few small changes and additions (including headings).

The original two articles focused on the writing of William L. White and colleagues in the US. I thought it was interesting to look back and see what I was writing at that time.

1. Problems with our treatment system
“Something got lost on our way to becoming professionals – maybe our heart. I feel like I’m working in a system today that cares more about a progress note signed by the right color of ink than whether my clients are really making progress toward recovery.

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Learning from Wired In To Recovery

2007_0118walpole0115Wired In To Recovery (WITR) ran for over four years between 2008 and 2012, attracting over 4,000 community members. A key element of this online recovery community was blogging, providing the opportunity for people from all walks of life to describe their experiences and express this views. The site comprised over 7,500 blogs (from 1,000 bloggers) and 35,000 comments.  

When I was developing WITR, I rationalised that by providing people with the opportunity for people to blog, I would accumulate a wealth of information about the lived experience of addiction and recovery, the needs of recovering people, personal views about the care system, etc.

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It’s not just about the drug

IMG_3429Why not check out my article on drug, set and setting? In this article, I describe how the effects of a drug depend on the interaction between the drug, the person (set) and the social context (setting) in which the drug is taken.

Similarly, these three factors influence both addiction and recovery from addiction. As I describe, this interaction has important implications for developing systems of care to help people recover from dug and alcohol addiction.

Please let me know what you think about It’s not just about the drug.