Enabling or Engaging? The Role of Recovery Support Services in Addiction Recovery.

Recovery capital-the quantity and quality of internal and external resources to initiate and maintain recovery-is explored with suggestions for how recovery support services (RSS) (nontraditional, and often nonprofessional support) can be utilized within a context of comprehensive addiction services. This article includes a brief history of RSS, conceptual and operational definitions of RSS, a framework for evaluating RSS, along with a review of recent empirical evidence that suggests that rather than enabling continued addiction, recovery supports are effective at engaging people into care, especially those who have little recovery capital, and/or who otherwise would likely have little to no "access to recovery."

Becoming expert and understanding mental illness.

In the process of becoming an expert in the mental health field the newcomer, through reading, lectures, and supervision, is taught what to notice and how to structure and conceptualize that information. A less recognized part of this learning process is that the newcomer is also taught, explicitly or implicitly, what not to notice, what not to pay attention to. Much of the subjectivity of the newcomer and of the patients and clients he or she sees is pushed, purposely or not, out of the way and is then lost to view.

Cascading crises, resilience and social support within the onset and development of multiple chronic conditions.

Objective: To describe and better understand adults' responses to the onset, accrual and influence of multiple chronic conditions and to social support in adapting to consequent difficulties.

Methods: Qualitative study of 33 adults with multiple chronic illnesses randomly sampled from an urban primary care clinic. Semi-structured interviews targeted retrospective accounts of illness onset, consequent loss, as well as current accounts of social support and adaptation.

Self-efficacy and self-care: missing ingredients in health and healthcare among adults with serious mental illnesses.

To help inform the design of a self-management intervention for improving the physical health of adults with serious mental illnesses, we conducted focus groups about their perceived medical care and physical health needs. Adults with serious mental illnesses participated in four semi-structured focus groups conducted at a transitional living facility, a social club, and a Hispanic outpatient mental health clinic. Questions included their recent experiences of seeking medical care, the effect of having a mental illnesses diagnosis, strategies for active self-care, and perceived barriers to better physical health.

Beyond generic support: incidence and impact of invalidation in peer services for clients with severe mental illness.

Objective: This study explored experiences of validation and invalidation among clients with severe mental illness in treatment with either peer providers or traditional providers. Associations between six- and 12-month outcomes and validating and invalidating provider communications were also examined.

Methods: A total of 137 adults with severe mental illness were randomly assigned to either peer-based or traditional intensive case management.

A peer-support, group intervention to reduce substance use and criminality among persons with severe mental illness.

Objective: This study compared the effectiveness of two interventions in reducing alcohol use, drug use, and criminal justice charges for persons with severe mental illnesses: first, a community-oriented group intervention with citizenship training and peer support that was combined with standard clinical treatment, including jail diversion services, and second, standard clinical treatment with jail diversion services alone.

Methods: A total of 114 adults with serious mental illness participated in a 2 x 3 prospective longitudinal, randomized clinical trial with two levels of intervention (group and peer support for the experimental condition and standard services for the control) and three interviews (baseline, six months, and 12 months). Self-report questionnaires assessed alcohol and drug use, and program databases assessed criminal justice contacts.

Sober housing and motivational interviewing: the Treatment Access Project.

This paper describes an innovative program that provides rental subsidies for sober housing and supportive services to persons in early recovery who are homeless and have substance use disorders. Preliminary data point to the success of this program in enhancing recovery and exiting from homelessness. In supporting sober house placements, the Treatment Access Project creates a bridge that supports these individuals in their transition from clinical treatment services to the community.

The treatment relationship in peer-based and regular case management for clients with severe mental illness.

Objective: This study compared the quality of treatment relationships and engagement in peer-based and regular case management. It also assessed the value of positive relationship qualities in predicting motivation for and use of community-based services for persons with severe mental illness.

Methods: One hundred thirty-seven adults with severe mental illness participated in a 2x2 prospective longitudinal randomized clinical trial with two levels of case management intervention (peer and regular) and two interviews (six and 12 months).