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Recovery Oriented Systems of Care
Dr. Dawn-Elise Snipes PhD, LPC-MHSP
Executive Director: AllCEUs Counselor Continuing Education
Podcast Host: Counselor Toolbox, Addiction Counselor Exam Review & Happiness Isn’t Brain Surgery

• Define a Recovery Oriented System of Care
• Discuss the 17 Elements of a ROSC
• Explore the Guiding Principles of Recovery

Recovery Oriented Systems of Care
• Affirms the real potential for permanent resolution of behavioral health problems
• Offers solutions to behavioral health problems on a community and cultural level
• Shift away from risk management and relapse prevention toward encouraging clients to self-define goals and take responsibility for achieving them
• A shift from emergency room/acute care model to one of sustained recovery management which include wrap-around recovery support services
Recovery Oriented Systems of Care
• Emphasis on
• Post-treatment monitoring
• Stage-appropriate recovery education
• Peer recovery coaching
• Assertive linkages to recovery communities
• Early re-intervention
• Maintaining functional ability in all life activities
• Recovery in illness instead of recovery from illness
Recovery Oriented Systems of Care
• Goals
• Foster health and resilience activities
• Increase permanent housing and sense home/belonging
• Ensure gainful employment and access to education to provide a sense of purpose
• Enhance communities by increasing availability of necessary supports from and for peers/family/community
• Reduce barriers to social inclusion
• Counselor functions
• Identify gaps in services
• Identifying emerging trends and needs
• Monitor system effectiveness
ROSC Guiding Principles
• Recovery emerges from hope and is…
• Person-centered – self-efficacy, self-direction
• Non-linear, and occurs via many pathways (methods)
• Holistic – mind, body, spirit, community
• Supported by peers and allies (counselors/case workers)
• Supported through relationships and social networks (family, peers, faith groups, community)
• Culturally based and influenced
• Supported by addressing trauma
• Based on respect of individual, family and community strengths and responsibilities

ROSC Guiding Principles
• Recovery emerges from hope and…
• Involves a personal recognition of the need for change and transformation
• Involves a process of healing and self-redefinition
• Exists on a continuum of improved health and wellness
• Involves addressing discrimination and transcending shame and stigma
• Involves (re)joining and (re)building a life in the community
• Is a reality
Elements of a ROSC
• Person-centered, strengths-based, individualized providing integrated, comprehensive services across the lifespan
• Inclusive of family and other ally involvement
• Anchored in the community
• Continuity of care
• Partnership-consultant relationships
• Culturally responsive /Responsive to personal belief systems
• Commitment to peer recovery support services for client and families
• System-wide education and training
• Ongoing monitoring and outreach
• Outcomes driven
• Research based
• Adequately and flexibly financed.
Recovery Management
• Spans 3 phases
• Prerecovery identification and engagement
• Recovery initiation and stabilization
• Recovery maintenance
Recovery Oriented Systems of Care
• 3 core components
• Collaborative decision making /individual empowerment
• Continuity of services and supports
• No wrong door
• Services available as long as needed
• Service quality and responsiveness
• Evidence based
• Developmentally and culturally appropriate
• Gender specific
• Trauma informed
• Family focused
• Stage appropriate

• Individual
• Family
• Peers
• Community
• Transportation
• Civic organizations
• Community coalitions
• Housing
• Childcare providers
• Business community
• Educational system
• Veteran’s affairs
• Criminal justice (courts, cops, jails, P&P)
• Physicians
• Counselors
• Clergy
• Financial counselors
• Social services
Creating a Recovery Oriented Environment
• Encourage individuality
• Promote accurate and positive portrayals of psychiatric disability while fighting discrimination
• Focus on strengths
• Use a language of hope and possibility
• Offer a variety of options for treatment, rehabilitation, and support
• Support risk-taking, even when failure is a possibility
• Actively involve service users, family members, and other natural supports in the development and implementation of programs and services
• Encourage user participation in advocacy activities
• Helps develop connections with communities
• Helps people develop valued social roles, interests and hobbies, and other meaningful activities.
Implementing a ROSC
1. Integrated system planning process
2. Developing consensus on core values and principles based on the input of people in recovery
3. Establishing a conceptual framework based on this vision of recovery
4. Formal consensus on funding the model
5. Identification of priority populations and locus of responsibility for each
6. Development and implementation of program standards
7. Structures for intersystem and interprogram care coordination
8. Development and implementation of practice guidelines
9. Facilitation of identification, welcoming, and accessibility
10. Implementation of continuous integrated treatment
11. Development of basic DD–capable competencies for all persons involved
12. Implementation of a system-wide training plan
13. Development of a plan for a comprehensive program array.
Recovery Management
• Treatment does not need to be voluntary, but success depends on personal engagement
• Full recovery often comes from episodic, nonlinear treatment
• Previous treatment and relapse is not indicative of poor prognosis
• Relapse is viewed as evidence of the severity of the condition rather than a cause for discharge
• Recovery management is a time-sustained, recovery focused collaboration between consumers and service providers with the goal of stabilizing and managing the ebb and flow of co-occurring disorders until full recovery is achieved or self-management is possible.
Effective Treatment Characteristics
• Individualized
• Available
• Holistic
• Continually assessed and modified
• Of sufficient duration
• Includes counseling
• Includes medication
• Addresses co-occurring issues
• Is a long-term process and often requires multiple episodes of treatment
• A ROSC will help communities provide coordinated services along the continuum from prevention to maintenance.
• ROSCs are effective at helping the whole person recover which has multiple benefits for the communities
• ROSCs inspire hope and connectedness among the millions of people whose lives are touched by addiction or mental health issues.