Spreading the evidence

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Grace Ball discusses how the UK recovery movement is continuing to evolve, and reports back from the UK Recovery Academy’s recent Manchester conference.

These are turbulent times in the addiction field, with some ill-conceived government initiatives and outspoken comments from some recovery advocates leaving many in mainstream addiction treatment feeling resentful and even distrustful of the ‘new recovery agenda’. Not only that, but there have been disputes and arguments within the recovery movement itself, which has led to frustration and confusion across professional groups and people trying to achieve that bridge between active addiction and active recovery.  

In some respects, ideological and territorial disputes are inevitable in a fluid new movement containing a variety of beliefs, philosophies and views on the nature of recovery. It’s true that the UK recovery movement looks far more cohesive than its US counterpart, but this seems to be partly because that movement is largely dominated by the 12-step fellowship and has a different social context (an insurance-led market rather than NHS provision, and fewer social safety nets). It has also existed for longer there.

That’s not to say that we should simply accept the rancour as inevitable. But we should recognise it for what it is and work towards its elimination, because we all have a vested interest in maintaining cohesion and defending everyone’s right to recovery, not our individual subjective orthodoxy or personal doctrine.
An important aspect of achieving understanding of the recovery landscape is transparency regarding the roles and remits of various component organisations. The Recovery Academy set out a clear mission statement back in 2009, the key element being to help develop the evidence base and bring it to a wider audience, and to encourage the practitioner community to develop its own evaluative skills to demonstrate, and report, what works.  

With welfare reform and health and social care policy changes, there’s more scrutiny for positive outcomes and responsibility to the public purse, but above all a focus on what can be done to improve the chances of initiating and sustaining an individual’s recovery journey within their community. The objective understanding and application of the recovery evidence base becomes paramount within a framework of limited funds and challenging decision making.

The evidence underpinning rhetoric should not be underestimated, although rhetoric can have negative connotations. It’s often thought to refer to speech that, if it isn’t wholly untrue, is at least misleading or perhaps simply vacuous – at times some people within the recovery movement have been critical of ‘empty rhetoric’.  However, rhetoric should not just be empty words or dramatic presentations – recovery rhetoric has a place in the study and art of writing and speaking well about recovery, being persuasive and knowing how to transmit logical objective arguments.  Rhetoric should be a fundamental building block of recovery education and workforce development.  

The Recovery Academy conferences reflect on communal dimensions of recovery, highlighting the importance of proactively nurturing recovery cultures in order to reap the full social benefits of recovery success. These are not vacuous intellectual exercises – the intention has always been to demonstrate living, material expressions of the diversity and richness of UK recovery cultures.

The academy focused exclusively on the nature of evidence as the theme for its 2012 conference, held in Manchester. We believe in the importance of highlighting what is currently known in order to make a space for what is emerging, new and innovative, and we welcomed more than 15 presenters and workshop facilitators to support and develop the thinking of a full house of delegates. The academic approach helped to define and evidence recovery within different settings, with  presentations scoping out how to measure and evidence change and outlining the challenges.  

Ian Wardle talked about the uncertainty, defensiveness and rhetoric of a multitude of small recovery organisations representing various interests and viewpoints, a multi-million pound treatment industry that has learned to speak the language of recovery and devolved commissioning with no master template. He also discussed how the threat of disinvestment prompts worthy, but defensive, lowest-common denominator lobbying, the unimaginative approach to the scale of challenges facing our industry and persistent strategic isolation and insularity.  

Delegates were encouraged to consider an individual’s recovery through strength-based case management focussing on the client/patient’s strengths, personalisation of care and improvement of the therapeutic relationship, and using the community as a resource – assertively reaching out to people and maintaining contact.

Themes of care and treatment converged with a focus on recovery in the community.  Dr David Best highlighted recovery to mean a sense of hope, purpose and belonging, and a sense of identity and pride within three levels – a personal recovery journey, recovery as a social contagion and recovery as a social movement where people experience connectedness, meaning and empowerment. Mark Gilman developed the evidence for recovery as an asset in community development and Andy Perkins led a workshop in tools for building recovery orientated community capacity.  

The translation of objective rhetoric to operational commissioning was highlighted as challenging, but not impossible, and delegates reported greater confidence in their operational practice with the broadening of their knowledge base. With this in mind we look towards the future role of the academy – we’re in the process of extending our board directorship and look forward to the variety of experience, knowledge and skills this will bring to the Recovery Academy table.

We will continue to produce bulletins and plan for our conference in 2013, which addresses the challenges of ‘what now’ – how do people take the rhetoric and make operational change that makes a difference? We want to support people demonstrating viable and visible actions – whatever system of treatment and community they are in – because significant change is only going to come from consensus and flexibility, where treatment compliments a range of opportunity and support garnered from the community.

We will be using the skills and knowledge of our directors and wider networks to identify and report areas of good practice, and support where we can the development of the evidence base. We would strongly encourage anyone who is interested in the principles, ethos and philosophy of the Recovery Academy to get in touch with us.

Grace Ball is a Recovery Academy director and treasurer.
Please contact Grace or Linda Swift on recovery.academy@hotmail.co.uk for further information, or if you want to become part of the Recovery Academy wider network