We have a Themes section on the website for which we have posts containing series of films on selected themes. The films have been created by re-editing our original long film into short (generally less than three minutes) clips, and then ‘linking’ appropriate short clips on a specific theme by using YouTube Playlists. In David Best’s case, I have created three posts for this section on: (1) recovery capital; (2) the nature of recovery communities, and (3) outcomes that go beyond the recovering individual.
Recovery Capital [5’33”]
One of the reasons for working with recovery capital is that it gave David and colleagues a metric, something they could use to count things that were meaningful in a person’s life, positive things that people would want to achieve in their recovery journey. Tools to measure outcomes of treatment only focused on the reduction of symptoms or deficits. People in a methadone maintenance clinic may be less likely to die, to get arrested and to get a blo`od borne virus, but their quality of life generally goes down.
The writing of a paper on recovery capital with Alexandre Laudet for the Royal Society for the Arts in 2010 was the beginning of 14 years of David’s work developing and refining measures and metrics based around recovery capital. Wulf emphasises that the essence of the work David has been doing is that there is something beyond treatment that is more important. The positive life-changing aspects of recovery as the person grows and evolves.
Nature of Recovery Communities [6’53”]
David summarises the evidence from research about what is important for recovery: jobs, friends and houses, or somewhere to live, someone to love, and something to do. When he and his colleagues run their Inclusive Recovery Cities workshops, they encourage individuals and groups to engage with four quadrants: sport, art and recreation; employment, training and education; volunteering and community involvement, and mutual aid and recovery groups. They argue for involvement in at least one item of each of these four sectors.
Wulf says you cannot prescribe fixed things for a recovery initiative, like you can for a methadone clinic, but you need to have things that ensure that people help other people, and that address practical issues that people have, such as housing and jobs. You also can’t commission recovery…. But you can commission many of the conditions that allow recovery to flourish.
A wide variety of activities can be arranged in a central hub that can facilitate recovery. It’s important to bring in outside organisations that have nothing to do with recovery, and also get people out of their normal environment. In the early days of recovery, it is good to spend a good deal of time with other people in recovery. However, if someone several years down the line has no social networks outside their recovery world, then something has gone badly wrong.
Beyond the Individual [7’31”]
David mentions William White quoting two small qualitative studies that showed when fathers achieved sustainable recovery, their sons had better scholastic engagement, attendance and milestone achievement. David thinks that we make a mistake if we use an outcome metric that only focuses on the individual; we must consider the wider impact of a person’s recovery.
In his book The Great American City, Robert Sampson uses the term collective efficacy, which refers to two things. One is social cohesion in communities, and the second is shared expectations about the likelihood of your neighbours getting involved in pro-social activities, like stopping somebody graffitiing. David wants to use collective efficacy as the outcomes and evaluation metric for Inclusive Recovery Cities.
Much of this Recovery Voices Conversation has been about challenging orthodoxy, or reclaiming some orthodoxy. David describes two important aims for recovery communities or groups: Can the connectedness of recovery communities inspire similar changes more broadly across the wider community? Can they be the glue or the inspiration for re-engaging a range of excluded and marginalised groups and individuals? Wulf reminds us that treatment is too transactional. The power of recovery is that it is transformational.
David Best is Professor of Addiction Recovery, and Director of the Centre for Addiction Recovery Research (CARR), at Leeds Trinity University. He holds various other senior academic posts internationally. He is a founding member of the College of Lived Experience Recovery Organisations (LEROs) in the UK and of the Inclusive Recovery Cities movement.