As part of their ongoing mission to expand the conversation of recovery capital in the world of addiction treatment, Sigmund Software and Commonly Well recently presented a webinar, COVID Clarity: How the Pandemic Confirmed the Importance of Recovery Capital.
David Whitesock, founder of Commonly Well, gave an insightful presentation that explored the recovery capital system, the challenges COVID-19 has imposed on those in recovery, as well as the story of his own recovery and experience using the recovery capital system.
The webinar ended with a 10 minute Q&A section, where David answered a variety of questions about recovery capital. The attendees asked some terrific questions that quite literally pushed the recovery capital conversation even further, beyond the scope of the webinar.
As a result, we’ve transcribed the Q&A section below to give readers an idea of the kind of discussion we had during COVID Clarity. If you find anything intriguing or resonant in these questions and answers, you can view the full webinar at the bottom of this blog post. Sigmund Software’s Digital Marketing Specialist, Evan Corey, moderated the Q&A.
Evan Corey: What motivated you to try Recovery Capital for the first time?
David Whitesock: Obviously, from my own experience, I had to understand the underlying factors that were either going to be the change in my personal life or not. But, when I was working for the organization I was previously at doing peer coaching, we had a very specific problem. One of our healthcare partners needed data. We were tracking, “Are you satisfied with our service,” and those sorts of things, but that’s not actual change data. So we had to figure out how you do that. And the only way that we could get there, this was 2012, 2013, was Recovery Capital. I read everything and engaged with William White and David Best and Alexandre Laudet, and all the people that have been working in this for a while. We just knew we had to do something there. We looked at the other survey tools and scales that were out there, but we just had to go deeper to really get to the complexity that exists. We had to peel back the layers of the onion and be able to re-put those layers back.
Evan: You mentioned earlier in your presentation how your co-founder gave you 30 days to find the basis for what would become the RCI [Recovery Capital Index]. Did you look into any other systems for tracking addition that fell short in a way that recovery capital didn’t?
David: The first one that we looked at was William White’s Recovery Capital Scale. It’s 50 items, or 50 questions. There’s a shorter version of that called the BARC-10 – we looked at that pretty deeply. We worked with researchers at Baylor University, a neuroscientist from NIH, we also had some professional evaluators that we worked with in the field. What we found was that those particular questions didn’t have the longstanding history of validation that other general wellbeing surveys do. In the world of measuring wellbeing and happiness, there are instruments that have been out there for decades and have been used – there are mountains of data. We were able to go and use those questions because they were in the public domain. There were some areas that we had to reinvent and add new questions, and that’s where we could turn to the Recovery Capital Scale and other places.
But, also what was missing was that those questions didn’t fit into the framework which was being presented, which was personal capital, social capital, and cultural capital. So we had to do that work, too. We had to figure out, okay, if we’re going to take these other questions that exist, how do we actually identify them in that framework? And so that’s kind of what was missing, and that’s where we had to get to say maybe we have to take a different approach to this and make it more structured.
Evan: This is a question I came prepared with myself because, at Sigmund, we’re always thinking about the behavioral health aspect and how we can empower our clients to leverage different approaches through our technology. Are there any other traditional behavioral health treatment approaches that mesh nicely with recovery capital? Can it be used as one tool along with other approaches to get that comprehensive care that people in recovery do need?
David: That’s a really good question, and I might reframe it just a little bit to say, ‘as a clinician, what clinical interventions or what clinical approaches am I using that mesh well with this?’ There’s a couple that come to mind. One of them is very clinical, that’s cognitive behavioral therapy (CBT). So when we think about individuals working through thoughts, actions, and behaviors, when you start to see those responses for those particular questions, you can then intervene if necessary. If the question was “How is my general wellbeing today?” the patient will respond to that question with certain thoughts, and there will be certain thoughts and behaviors attached to that response. As a therapist, I can now dive deeper into this information that was gathered from a recovery capital system using CBT approaches.
Another approach that meshes with recovery capital, on a less clinical end, with something like peer support, is motivational interviewing. As you’re reviewing these items and you’re reviewing the questions and responses, you can use active listening and motivational interviewing techniques to pull a little more out of the individual to get to the core and the root, and then decide what to do next. Motivational interviewing is sort of that leading way to get Evan to say what you want to do, not an option that I (the therapist) devise and lay out for you.
Evan: We have a great question from one of our attendees here and I think you’re the perfect person to answer it. He asks: has the RCI been used in DUI or other drug/criminal cases to help defendants support their case, perhaps as a part of a pre-sentencing report?
David: A great question. So, Face It TOGETHER is the non-profit I was with before, and we had one coach in particular who was on a drug court task force. She was actually on that court and she was always in the court every week. The judge, for a long time, was assigning individuals to AA [Alcoholics Anonymous] and mentors and clinical therapy. Over time, there were some issues and challenges due to some people not wanting to go to AA. Finally, the judge threw her hands up and said, “go to Terry.” Terry was our coach there on the drug court task force. Because Face It TOGETHER was using the RCI, when it was time to write letters of support, we would actually provide their recovery capital history. We could put it in context, but also give the raw data. So that occurred at a lot of different stages of the criminal justice process. Sometimes it was pre-sentencing, sometimes it was sentence modification, sometimes it was individuals who were probably 4 or 5 years removed looking for pardons or commutations. We also collaborated specifically with probation and parole officers – having, in a very consenting way, those conversations with those people. So, yeah, it’s been applied in a lot of different ways.
Evan: That’s great to hear because it just goes to show how having that raw data breeds compassion in how you consider the patient, but also gives you that wider context of everything that may be going on in their life.
This next question I like a lot: is there anything you’re most excited about in the recovery capital world in the next year? In the next 5 years?
David: I think for the first time in a long time, although we are starting to trend this way, we’re going to move the conversation around addiction or substance abuse disorder, away from substances. Every decade there’s always a substance that occupies our attention. Currently, it’s opioids, previously it was methamphetamines, and then it was heroin, cocaine, and underneath all of that is alcohol. But it’s never really the drug that’s the problem. It’s the environmental, behavioral, economic, social fabric elements that carry these conditions from decade to decade. I think we’re going to have a much deeper relationship to the underlying and upstream factors that cause – and I’m using that word carefully – addiction. We’re going to move beyond it and we’re going to start to find community-based solutions or policy solutions that will protect against addiction. I think it’s going to be really exciting to see how that all comes together.
Evan: That makes me recall one of my favorite phrases of yours, where you say that we’ll start curing addiction when we stop trying to treat addiction. And forgive me if I’m getting that wording wrong, but the sentiment resonates with me and really relates to your answer as well.
Our next question is: could the RCI also be used to help professionals regain a lost license, like a medical board or bar of examiners?
David: Yes, in particular with the organization I previously worked with we had a strong relationship with the state’s health professional assistance program. There were a number of nurses, doctors, and others who were required to engage in particular programs, which was in their agreement. So the RCI data was used in helping maintain that case.
Evan: That brings us to our final question: could there be a Recovery Capital Index developed for communities? Can communities become healthier environments and can means be developed to measure community progress?
David: I love that question – the answer is yes. Most of the questions come from general wellbeing surveys. The way that we have written the statements or questions in the RCI kind of hedges on that. It uses terms such as “recovery and/or wellbeing” or “recovery and/or wellness practices.” You can use this survey with people that are not in recovery, it’s the same general type of questions.
So, yes, you could put this survey out into the general population of a city, county, or state, map those responses, and run that in the background. So as policymakers and community organizers and other folks who are trying to change community health, they could have that barometer in the background. And I’ll just say, one of the influencers and a lot of the people I worked with over the years that helped inform the construct of the RCI are the people who work with the Social Progress Index, which is a newer emerging global indexing scale. So the answer to that is yes, and that’s really exciting.