1. Understanding Maryland’s Recovery Oriented Systems of Care

3. John Winslow
National Council on Alcoholism & Drug Dependence-MD’s Recovery Leadership Program

4. What It was Like…
What happened…
What it’s like now…

5. Once Upon a Time… What It was Like…
Early treatment: Virtually no Outpatient programs, no I.O.P.
Just detox & 28 day residential & long-term therapeutic communities for the “druggies” ~ drinking was permissible
My experience: First 5 Steps prior to discharge, in & out-house 12-Step meetings, sponsor encouraged prior to discharge, AA contact essential
Annual reunions and Alumni Associations common practice

6. The “Field” becomes “Professionalized!
What happened… Part I
The “Field” becomes “Professionalized!
Certification emerges around the country-
Counselors obtain needed clinical & ethical training
Recordkeeping overtakes client interaction
Treatment programs evolve to include outpatient & I.O.P. modalities
Residential stays become increasingly scrutinized- 28 day treatment becomes almost the thing of the past
Brief Therapy becomes popularized
Push them out of treatment
Alumni Associations & Annual Reunions become a thing of the past
A disconnect increasing occurs between treatment & the recovery community
Expectation that folks “go get treatment” (often just detox or detox and inpatient) and they should be “fixed”. Programs held graduations, gave pat on the back, told to “go to meetings”, and cut loose from treatment support. If/when the person relapsed, they would recycle back through Tx again and again get cut-loose again.

7. A New Wind Blows Across the Country…
What happened… Part II
A New Wind Blows Across the Country…
About 5 years ago BHA (formerly ADAA) introduced ROSC. Formed a “Learning Community”, ROSC tx liaisons w/I all the LHD Tx programs, formed an Advisory Committee to ADAA to move ROSC forward. There were early adapters, fence-sitters, and nay-sayers. In a sense, it felt to me like “Back to the Future” – reconnecting Tx w/recovery community PLUS building up recovery supports! Client-centered vs Programmatically-centered.

8. Treatment System
How must treatment programs change to become more recovery- friendly?
Treatment must change from an acute care model to a chronic care model, shifting the focus from recovery initiation to support for long-term recovery maintenance

9. context
Recovery System
Treatment System

10. ROSC comes to maryland Two primary concepts:
1 Rebuild bridges from treatment to the recovery community
2 Strengthen the supports within the recovery community

11. What is a recovery oriented system of care?
Wide spectrum of services
Supports all stages and pathways of recovery
Addresses access to services
Includes treatment, alternatives to treatment, and recovery support services
Coordinates multiple services

12. “All pathways lead to Rome” ~ All pathways can lead to Recovery
“All pathways lead to Rome” ~ All pathways can lead to Recovery! No wrong door

13. Recovery-Oriented System Goals
Intervene earlier
Improve treatment outcomes
Support sustained recovery

14. Elements of a Recovery Oriented System of Care
Person centered
Family and other ally involvement
Individualized and comprehensive services across the lifespan
Anchored in the community
Continuity of care

15. ROSC Elements Partnership-consultant relationships Strengths-based
Culturally responsive
Responsive to personal belief systems

16. ROSC Elements Commitment to peer recovery support services
Inclusion of voices and experiences of recovering individuals and families
Integrated services

17. Goals of Recovery Support Services
Remove personal and environmental barriers to recovery
Facilitate participation in the recovery community
Enhance the quality of life of the person in recovery

18. Recovery Support Services
Outreach
Engagement and intervention services
Recovery guiding or coaching
Pre & Post treatment monitoring and support

19. Recovery Support Services
Sober or supported housing
Transportation
Childcare
Legal services
Educational/vocational supports
Employment assistance

20. So….. What it’s like now?
Not Exactly… Ha Ha

21. The state of Maryland remains in a state of transition, with some programs & jurisdictions more deeply embracing ROSC than others, some programs more advanced in some areas/some aspects of ROSC, and in other areas, not having made much change. All-in-All… we’re DEFINITELY moving in the right direction… Back to the Future!