Spirituality and the Recovery Movement - Hogg Foundation for ...

Spirituality and theRecovery MovementJoe Powell LCDC, CASExecutive DirectorAssociation of PersonsAffected by AddictionSpiritual Crossroads: Faith, Mental Health and the African American CommunityMay 15-16, 2012

God Given to be of Service in our CommunitySAMHSA Peer to Peer Recovery Community Support Serviceso Grant awards : 1998 (3 year grant) and 2003 (4 year grant)Target population:o Peers in or seeking recovery from substance use/addictiono Family memberso Three Guiding Principles - Recovery First, Inclusion & AuthenticityHours of Operation: Mon-Fri 9 am to 8pm, Sat 12-6pmMonthly average services per peer group 2,181Monthly Peer Recovery Coaching sessions 527Average daily visitors 2010 41Peer support groups each week 25-30Staff17 Peers in recovery3 Family member20 Full-time and 101 volunteers

Spiritual Objectives1. Overview of the roles religion and spirituality have playedin mental health/addiction recovery in America over thepast years.2. Highlight themes and lessons drawn from this spiritualhistory of addiction and mental health in the AfricanAmerican Community.3. Show the spiritual impact of the recovery movement at alocal, state and federal level.

In Our Own Voiceby Vanessa Jackson“The depth of spiritual wounding thatcan occur when an individual is cutoff from his or her religiouscommunity or, even worse, whenreligion is used to further abusepeople, is incredible. On the otherhand, the power that spirituality hasto heal and to restore a survivor’ssense of self and serve as a vehiclefor reconnection to community isequally powerful.”

The Power of RecoveryIn Our own Voiceo The telling of stories has been an integral partof the history of people of African descent.o From the griots of ancient Africans to the sometimespainful lyrics of hip-hop artists, people of Africandescent have known that our lives and our storiesmust be spoken, over and over again, so that the peoplewill know our truth.o Over come illness and heal our communities. - JP

The Colored Temperance MovementFrederick Douglass’pledge in 1845 Black Temperance Societies- Role of the Black Church in addressing alcohol problems

FREDERICK DOUGLASSSlave Abolitionist“These holidays serve as conductors, or safety valves, tocarry off the rebellious spirit of enslaved humanity….When aslave was drunk, the slave holder had no fear that he wouldplan an insurrection; no fear that he would escape to thenorth. It was the sober, thinking slave who was dangerous,and needed the vigilance of his master to keep him a slave.”(Douglass, 1855, p. 256)

Our Rationaleo The African American church is the largest andoldest human service provider in the AfricanAmerican community.o It is also the institution with the most credibility.o Untapped resources (human and financial).

Spiritual Support in the Church and Communityo Mental illness and substance use, particularly HIV, HCV,family violence, criminal justice system, homelessness, etc.either directly or indirectly impact the entire Black Church.o The African American church offers an abundance ofresources that can be used for reaching persons who aremarginalized or disenfranchised.o These realities make it imperative that we continue ourcollaboration with churches in the development andimplementation of Recovery Community education andsupport.

History of Addiction/Alcoholismo AA, religion & the evolution of Recovery Mutual Aid SocietiesEleventh Step Groupso Christo Alcoholics Victorious (1948)o Overcomers Outreach (1977)o JACS (1979) Matt Talbot Retreat Movement (1941)o Calix Society (1947) Christ Centered Twelve Step Programso Liontamers Anonymous (1980) Extension of Twelve Stepso Millati Islami

Historical Religious & Spiritual Supporto Harlem Club of Former Alcoholic Degenerates -- Emmanuel Movement& Jacoby Clubo The rise of juvenile narcotic-addiction in urban communities of the1950s sparked the involvement of Christian churches in the addictionsarena. Such activities included outreach programs like:o The work of Father Daniel Egan (the “Junkie Priest”), communitycounseling clinics such as Saint Mark’s Clinic in Chicago (1954) and theAddict’s Rehabilitation Center in Manhattan (1957), and faith-basedtreatment communities and sober-living environments such asSamaritan Halfway.o Society (1958), Exodus House (1958), Teen Challenge (1961), and VillageHaven (1962). The Phoenix House.

Government Response to Addiction Problemso In the late 1960s and early 1970s, a federal, state and localpartnership was forged to create community-based alcoholismtreatment programs across the United States.o Treatment programs initiated by the anti-poverty and mentalhealth programs of the 1960s were significantly expanded inthe 1970s under the sponsorship of National Institute onAlcohol Abuse and Alcoholism (NIAAA) and National Instituteon Drug Abuse (NIDA).

Zero ToleranceRetreat through the 1980s and early 1990s cultural and policy shiftso Re-stigmatization – fear, shame and “crazy”o De-medicalization – addiction not treated as a chronic diseaseo Re-criminalization – prison/jails as the new mental Institution

Historical Treatment & Recoveryo 1980s brought a heightened interest in the history of alcohol andother drug problems in the African American community.(Herd, 1983, 1985)o A growing body of literature calling for cultural frameworks forunderstanding and responding to the treatment of AOD problems(Peter Bell and Evans, 1981), including calls for responses to thespecial needs of addicted African American women.(Corrigan and Anderson, 1982).o This period also witnessed the creation of organizations such as theNational Black Alcoholism and Addictions Council and theInstitute on Black Chemical Abuse.

Spiritual Recovery & Treatmento The 1980s and 1990s witnessed attempts to adapt traditionalrecovery support structures, such as Alcoholics Anonymous andNarcotics Anonymous, for increased cultural relevance, as wellas attempts to develop culturally sensitive and competenttreatment. (Mark Sanders, 1993)o There were also a growing number of indigenous addictionrecovery movements within African American communities.Five such recovery movements include the following.

Religious and spiritual RecoveryAdvocacy Pioneerso Rev. Cecil Williams Glide Memorial &o Father Clements-One Church-One-Addict, Free N’ Oneo New Faitho Faith-based RecoverySupport Structureso Free N’ Oneo Victorious Ladyo Celebrate Recovery

Glide Memorial Methodist Churcho 80% of the congregants are working on recovery.o The program is culturally based.o Pastor Cecil Williams believes that African Americansneed a recovery effort that takes their culture intoconsideration, recognizes their history and sociallyspirited manner of relating to each other.o Most of the members of Glide Church had triedtraditional 12-step groups prior to joining Glide and feltisolated, as many were the only African Americans orthe only individuals addicted to crack in the group.

One Church-One Addicto Founded by the renowned Father George Clements in 1993.o Purpose of the project is to recruit churches to helprecovering addicts maintain their recovery.o Currently, over 900 churches in 31 states are involved withthe project.o At The Million Man March in October 1995, Father Clementstalked about his plans to launch, “One Church-One Inmate.”o The goal is to recruit faith communities (churches, templesand synagogues) to provide post-release aftercare for menand women leaving prison.From source: Father George Clements's Biography

Free – N - Oneo Founded in 1987 by Ronald Simmons in Los Angeles,California.o Christian-centered recovery program that provides supportgroups for addicts and their family members.o Program has spread to African American churchesthroughout the country.o There are over 50 churches in Illinois alone holding Free-N-One meetings weekly.

Nation of Islamo The Nation of Islam is perhaps one of the most successful program inreaching African American male substance abusers in the criminaljustice system.o Efforts in the 1950s and ongoing today.o 1995, the author interviewed 10 African American males who werechemically dependent, with criminal pasts and who credited theirrecoveries to the Nation of Islam.o Some attended 12-step group meetings (Narcotics Anonymous)and were members of the Nation of Islam.

African American Survivors Organizationo Meeting begins with a reading entitled, “Who is aSurvivor?” and “What is an African American SurvivorsGroup Meeting?”o Followed by reading the Seven Principles of Nguza Saba,which are followed during a Kwanzaa celebration, and teachgroup members some of the principles of African culture.o Principles include unity, self-determination, collective worksand responsibility, cooperative economics, purpose,creativity.o Responsibility to do as much as you can to leave yourcommunity more beautiful than how you found it.o Faith.

Public’s Perception Of “In Recovery”From Faces & Voices of Recovery – April 2004/Hart Research and Coldwater Corporation[National Random phone survey N = 801] (APAA-Dallas, TX)When you hear the word “recovery, as in “This person is in recovery froman addiction,” what does “recovery” mean?Person is free fromaddiction/no longeruses D&A22%Person is trying to stopusing D&A62%Person has beendamaged by D&A8%Person has mental illness3%

Recovery by Any Means NecessaryRecovery model is broad enough to embrace us who talk about theiraddictions in terms of disease and recovery, habit and choice, badness(crime) and reformation, sin (demon-possessed) and redemption (Godtouched),cursed (for breaking cultural taboos) and healed, excess andharmony (balance), shame and honor (face), genocide andpersonal/cultural survival, or simply messed up and worn out (“sick andtired of being sick and tired”).~All Roads in Recovery

Recovery Definitiono Recovery from alcohol and drug problems is a process of changethrough which an individual achieves abstinence and improvedhealth, wellness, and quality of life.(CSAT 2005 Nat. Recovery Summit) Faces and Voices of Recoveryo Recovery from substance dependence is a voluntarily maintainedlifestyle characterized by sobriety, personal health, andcitizenship. (Betty Ford Institute, 2007)o Behavioral health recovery is a process of change wherebyindividuals work to improve their own health and wellness and tolive a meaningful life in a community of their choice while strivingto achieve their full potential.(Substance Abuse and Mental Health Services Administration2011)

Recovery Capitalo Recovery capital refers to the amount and quality ofinternal and external resources that one can bring to bearto initiate and sustain recovery from addiction.o A number of factors have been identified as predictors ofrecovery in short-term studies and constitute recoverycapital including: Cognitive recovery readiness Participation in 12-step fellowships Faith/spirituality/life meaning

Preventing Genetic Risk and AcquiredBiological Causes of Substance Use/AbuseFortunately, “risk factors are not predictive factors due toprotective factors,” and the risk of neurobehavioral disinhibitioncan be moderated by the protective factors stemming frominterventions in schools/communities and families(e.g. the Strong African American Families -SAAF Program,Recovery Community Organizations, Church).

President Barack Obama“Solutions to America’s challenges are being developed every day at thegrassroots. Government should not be supplanting these efforts,but supporting them.”

Baseline Spirituality, Religiosity,Life Meaning and Recovery6.05.55.0Mean4.54.03.53.02.5NoYesSustained abstinent recovery at F1Spiritual well-beingLife meaningReligiosity

Pathways PilotSpirituality and religion as recovery supportDescribe any religious/spiritual experience/ support that you have had asa significant part of your recovery hOrganized religion, church3812-step recovery program andfellowshipSpiritual God/HigherPower/spirituality3334Spiritualawakening/experience16Support from peers14God (non-specific)12None10Surrender/admittedpowerlessness8Community invoolvment,volunteer work/service20 5 10 15 20 25 30 35 40h Adds up to < 100% because up to 3 answers were coded

African American MusicArts and Addiction/RecoveryImportant experiences in the life of a people are expressed throughthe cultural media of language, music, literature, dance and art.More prominent African Americans are becoming public about theirrecovery from addiction.o Whoopi Goldbergo Samuel Jacksono Natalie Coleo Ray Charleso Jada Pinkett Smitho Mary J. Bligeo Tupaco Eminemo Whitney Houstono Richard Pryoro Len Biaso Dwight Goodeno Sammy Daviso Miles Daviso Billie Holidayo Charlie Parker

Faith-Based Organizations(FBOs)o FBOs have expanded the concept of choice by offering faith-basedoptions to African Americans who may have a more spiritualapproach to their recovery.o In many cases African Americans consider them trustworthysources that were located within the client’s community and whowere unaffiliated with any formal state or federal structure.o FBOs are particularly effective for engaging and retaining those ofus who had been incarcerated or had criminal records.

Faith & Community-Based Organizations(FBCOs)o FBCOs infused the culturally congruent support networks withrecovery support services such as transportation, child care,scriptural study groups, faith-based counseling, and peer-to-peersupport.o The inclusion of recovery support services has enhanced treatmentoutcomes and has helped peers to remain motivated and engagedin their communities.o FBCOs can counter the “spiritual malaise” or the results from guiltand shame for how addiction/mental health problems has affectedloved ones and, consequently, can hinder recovery.

Factors Pushing Recovery FocusRecovery Movement to a Recovery Oriented System of CareRecoveryTreatmentTXRecoveryVision 1963-1970 Reality 2010

Factors Influencing This Changeo Emerging and energized recovery community–e.g. FAVOR, Christians in recovery, Recovery Centerso Research findings supporting ongoing, continuity of serviceso Value Options Recovery initiativeso Inclusion and evolvement of grassroots faith-based andcommunity-based organizationso Changing norms and expectations as defined by the InstituteOf Medicine Quality Chasm reportso Recognition of many pathways to recoveryo Federal, state and local approaches to person-centered careo Betty Ford Institute – Definition of Recovery

Recovery-Oriented Systems of Care Approacho In the recovery-oriented systems of care approach,the treatment agency is viewed as one of manyresources needed for successful recovery integrationinto the community.o No one source of support is more dominant thananother.o Various supports need to work in harmony with thecommunities of color direction, so that all possiblesupports are working for and with the person inrecovery.Addiction Messenger, November 2007, Vol. 10 Issue 11,published by the Northwest Frontier ATTC.

ROSC support person-centered and self-directed approaches to care thatbuild on the personal responsibility, strengths, and resilience of individuals,families and communities to achieve health, wellness and recoveryfrom alcohol and drug problems.RecoveryIndividualFamily VFaith/spiritualCommunityWellnessHealth

CostEffectivenessPerceptionOf CareROSC require an ongoing process of systems improvement thatincorporates the experiences of those in recovery, theirfamily members and community in health, home and purpose.Evidence-Based PracticePractice-Based EvidenceRetentionSocialServicesHousingAuthorityWellnessChild Welfareand FamilyServicesCultural HealthServicesEducationalHousing/TransportationSpiritualFamily/Child CareFinancialIndividualFamilyCommunityLegalHealth InsuranceAccess/CapacityRecoverySystems of CareServices & SupportsVSO & Peer SupportCase MgtDoD & Veterans AffairsAddictionServices SystemAlcohol/Drug TreatmentVocationalPTSD & Mental HealthOngoing Systems ImprovementHealth CareCriminal JusticeSystemSocial ConnectednessRecovery Support ServicesHIV ServicesMental HealthSystemPrimary CareSystemVocational ServicesEmploymentReducedCrimeSafe & Drug-freeSafe HousingHealth

Five A’s of Healthcare Reform for Africa AmericansAvailabilityooDoes the service exist where people live their lives(live, work, study, play, shop, worship, etc.)Can I learn and about it in the church?Accessibilityo Questions of ease and convenience to obtain and use the serviceso Wait time for appointment, wait time for serviceo Hours and days of operationo Travel time, travel access – by car, parking, public transportation – routes(any transfers? How many?, costs, availability, schedule, cab – ease ofgetting there)o Costso Physical accessibilityo Child careCopyright © 2010 National Centerfor Cultural Competenceo Language, interpreters, translationGeorgetown Universityo Will the Church help me access healthcare?V. Jackson, Ph.D., NCCC, 2008

Affordabilityo Costs to consumer and financial viability of service provider(eg., sliding fee scale, co-payments, deductibles, exclusions).o Ability to acquire third party coverage – eligibility rules, administrativeprocess/requirements to document eligibility (e.g., Birth certificates withraised seal, rent receipt in own name) – relationship between multiplefunding streams.Appropriatenesso Recovery correctness of service & support offered/provided for preventionand treatment- Screening and assessment tools, take cultural issues intoaccount in the construction, implementation.o Diagnoses are accurate and appropriate Interventions including medicationsare designed to achieve optimal outcomes, location of service (e.g., home,facility, school, church, etc.), level of restrictiveness of care, etc.Acceptabilityo Services believes that the services are congruent with cultural beliefs, values,community, recovery and world view.

Religious & Spiritual Recovery1. Transformative religious & spiritual experience constitutes alegitimate catalyst of addiction/mental health recovery2. Living in a community of shared experience, strength and hopeheightens the quality and stability of addiction/mental healthrecovery.3. Recovery is something more than the removal of alcohol &drugs/mental health family problems from an otherwiseunchanged life, e.g., reconstruction of one’s relationship withGod, with others and with oneself.4. Beyond Recovery often involves the embrace of core spiritualvalues, e.g., release, freedom, gratitude, humility, service work,giving back, tolerance and forgiveness

Religious & Spiritual Recovery5. There is a long tradition of recovery carriers, “healers” —wounded healers in the addictions/mental health arena whouse their own healing as a platform to help others.6. There is a long tradition of integrating religion, psychologyand medicine in the treatment and recovery of addictivedisorders.7. The historical import of a single life can be enormous.

The future of our communityIn the future, treatment programs serving African Americanswill pioneer joint service delivery models with these indigenousmovements and will use these movements as part of the menuof recovery support services.The African American community is not a homogenouscommunity and no single recovery support structure can meetthe needs of all its members who need such a structure.

Going Forward in Recoveryo Develop a harmonious place, that allows for open dialogueand honest discussion.o Create a safe place where consumers are encouraged andresponsible for speaking “the truth.”o A place where African Americans of faith can remove theirmask, be transparent and get healing.~McCreary 10/2010

Religious & Spiritual Recovery Local PartnersDallaso Friendship West Baptist Churcho “Free at last” Oak Cliff BibleFellowshipo Concord Baptisto Unity Churcho Corinth AA groupo Narcotics Anonymouso First Africa Churcho Golden Gateo Local Faith Partners of AfricandescentFort Wortho Black Churches Networko Mount Rose Baptist Churcho Greater New Hope MissionaryBaptisto Diocese of Fort Wortho Teen Challengeo Cenikor Treatment Centero Eastside Ministries of Fort Wortho Re-Entry Resources of Fort Wortho Volunteers of Americao MHMR

Religious and Spiritual ResourcesTexaso 12 Step Programo African American Churcho Rev. Dr. Robert GilmoreAmerica Honors Recovery Awardo Involve participants - ask audienceo Black United Fund of TexasNationalo 12 Step Programo African American Churcho July – Minority Health Montho Faces and Voices of Recoveryo NAMI – Sharing HopeAfrican American Leaders

Community Journey of RecoveryOver coming illness, trauma, mental Illness/addictionprovides recovery capital and capacity that must betold as proof that:o Everyone has something tocontribute to the communityo Everyone must be welcomeo The gift of recovery must beshared with family, communityand a Higher Powero If not shared, the community andpersons’ journey is incomplete

ResourcesSubstance Abuse and Mental Health Service Administrationwww.samhsa.gov/Texas Department of State Health Serviceswww.dshs.state.usAssociation of Persons Affected by Addictionwww.apaarecovery.orgRecovery Monthhttp://www.recoverymonth.gov/National Leadership Council on African American BehavioralHealth (NLC)www.nlcouncil.com

Creating newpossibilities to befully human, mostpowerful and livingthe life we love inour community“Recoveryby anymeansnecessary”