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Arthur C. Evans, Jr., PhD, Director
Philadelphia Department of Behavioral Health and Mental Retardation
Beverly J. Haberle, MHS, Executive Director
Bucks County Council on Alcoholism and Drug Dependence
Bill White has once again given readers a wonderful opportunity to walk through history and learn the healing power that is unleashed when Communities of Recovery work together for the common good. This monograph provides a foundation for those newly engaged in peer-based addiction recovery support activities. It also creates an opportunity for those already involved in providing these services to expand their thinking by exploring the diverse and innovative varieties of peer-based activities that are emerging in the field.
In Philadelphia, as in much of the nation, we are currently witnessing a reawakening of hope, vision, and purpose, as stakeholders call for and strive to implement sweeping changes in the manner in which addictions services are delivered. These changes go far beyond developing new programs or tweaking the ways in which existing services are structured. Recovery transformation is about creating more holistic systems of care that are consistent with what both scientists and people in recovery tell us works. Transformation moves us beyond efforts at short-term stabilization to helping individuals achieve sustained recovery, find meaningful roles in their communities, and fulfill their highest potential.
This monograph can be used as a tool kit to guide the design and delivery of peer-based support services in the context of Recovery Oriented Systems of Care. Included in this work are cautions, questions of ethics, and areas for further exploration. It also provides reassurance and validation that the hard work and careful planning required to implement peer-based and peer-delivered services can pay off in remarkable ways. Sometimes the simplest gesture of kindness and support at the right time by a peer produces tremendous positive change.
This monograph provided for us an opportunity to walk down “memory lane” and reflect on what has transpired during the past few years within the City of Philadelphia. To say, “Recovery is alive and well in the City of Brotherly Love” is an understatement. Philadelphia’s recovery transformation process has employed a participatory, collaborative approach at all levels, including full engagement of local community members, including people in recovery, in strategic planning and program development. Individuals and families in recovery have contributed their time and talents to identify unmet needs, solve problems, provide trainings, put a positive face on recovery to reduce stigma, and deliver one-on-one services. Collectively, these efforts are expanding opportunities for individuals to initiate and sustain long-term recovery.
The Program Profiles are a highlight of this Monograph. These profiles outline different types of peer-based activities, projects, and services. In doing so, they not only provide readers with opportunities to visualize what the services look like and to explore their potential benefits, but they also help promote the development of a learning community by providing contact information so that
readers can access additional information about any particular activity. This is an invaluable resource for communities starting peer-to-peer services. Sometimes it is difficult to grasp how peer-based services and activities actually operate. Bill White's Program Profiles give readers a glimpse of actual services and allow them to benefit from others’ experience in creating new roles and functions. It is
a testimony to the hard work of all involved in the Philadelphia Recovery Transformation that fifteen of the Program Profiles describe activities occurring within the City of Philadelphia. This would not be possible if it were not for the forward-thinking members of the recovery community and the tremendous collaboration that they have had with city officials and providers. This monograph reinforces the importance of having a broad-based approach that addresses the implementation of peer support services from multiple perspectives
From a system administration perspective, this work is enormously important. Bill White has long championed the need for the field to shift from a professionally directed, acute-care model, with its focus on isolated treatment episodes, toward a sustained recovery management approach. In doing so, he has contributed significantly to the sense of urgency and energy that is currently stirring in the field. In this new monograph, White lays another critical building block in the foundation of system-transformation efforts. He masterfully describes how peer-based recovery support services (P-BRSS) can be used prior to, during, and following acute treatment to achieve the fundamental goal of
care: recovery and a meaningful life in the community for everyone. Equipped with this monograph, leaders of the recovery community, providers, policy makers, and system administrators—that is, all those who grapple with how to make the vision of recovery a reality—now have access to the burgeoning scientific evidence that supports the critical role of peer-based recovery support services in addiction recovery.
System administrators and policy makers will find this monograph to be an invaluable resource. In addition to being armed with the scientific rationale to inform their decision-making, they will also have a better understanding of the infrastructure supports that will be necessary to create a seamless continuum of integrated P-BRSS and treatment services. Currently, many stakeholders are keenly aware of the tensions that naturally emerge between P-BRSS specialists and addiction professionals as concerns regarding roles and credibility challenge efforts at collaboration. By outlining the rich history and tradition of peer support within the addiction field, White reminds all stakeholders of the unique contributions that peer-directed services offer. In addition, his vivid Program Profiles take the concept of collaborative P-BRSS and professionally directed services from the realm of abstract aspirations to that of concrete strategies.
Finally, White’s recommendations regarding a research agenda for PBRSS represent some of the most urgent challenges confronting the field. He argues that the current pathology-focused research agenda needs to be expanded to include an exploration of the factors that promote recovery. While
the research base for P-BRSS continues to grow, there remain significant gaps in what is known about how people recover, and specifically the role of P-BRSS in supporting recovery. To be successful in transforming our service systems, we will need to build learning communities based on relevant research, trust, mutual respect, and an understanding that the goal of recovery is not just important for people with substance use challenges and their families. Rather, the hope and
realization of recovery touches every individual, family, and organization in our community. In this, another seminal work, Bill White tears down the walls that have existed between those providing peer-based recovery support and those offering professional treatment and, in doing so, charts a course toward more effective care, and more sustained recovery, for all. The genius of this work is that it simultaneously speaks to the broad range of stakeholders in the addictions field, from those in the recovery community who are inspired to “give back,” to systems administrators who are seeking to ensure the highest possible standard of service delivery.
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