Not long ago, I was talking with a colleague of mine, Travis,* who told me that he had been hired as a paid peer recovery coach for clients who are actively using drugs and/or alcohol and living in a subsidized housing program for people who have experienced chronic homelessness, addiction issues, mental health challenges and/or disability. In his new role Travis will be providing support to clients with addiction issues by sharing his lived experience of recovering from drugs, alcohol and homelessness himself.
Travis told me, too, that he’d earned state certification to provide peer recovery support and that he would be making an hourly wage providing this service. Travis has been in Alcoholics Anonymous (AA) for five years and has completed the 12 steps of AA.
As a social worker myself, I was surprised by what he said next: that he was facing a lot of pushback from the AA community for his willingness to be paid to be a recovery coach. I don’t follow why Travis is facing accusations that he’s commercializing the 12 steps. To me, this as a perfect opportunity for him to couple his passion for recovery with the need to earn a living. Just as important, these coaches and mentors are offering what may be a very useful new treatment option to those who want it.
What Are Paid Peer Recovery Coaches?
Peer recovery has been a part of addiction treatment since the founding of AA. The organization is completely predicated on the notion of one alcoholic helping another, after all, though this “service” was, until recently, always an unpaid one. Over the past few decades, though, more people in recovery are being paid to provide this service. The Betty Ford Institute Consensus Statement on Recovery Support Services, published in 2012, acknowledges the reality of this more recent role. It states, “In the past two decades, a type of addiction recovery support has emerged that does not fit perfectly in either the category of peer-led recovery organizations or professional addiction treatment. This service form encompasses new social settings (e.g., recovery community organizations, recovery community centers, recovery homes, recovery schools, recovery industries, recovery ministries) and service roles (variably called recovery coaches/guides/mentors, recovery support specialists, or peer support specialists).”
The Substance Abuse and Mental Health Services Administration (SAMHSA) website explains these coaches this way: “Peer support services are delivered by individuals who have common life experiences with the people they are serving. People with mental and/or substance use disorders have a unique capacity to help each other based on a shared affiliation and a deep understanding of this experience. In self-help and mutual support, people offer this support, strength, and hope to their peers, which allows for personal growth, wellness promotion, and recovery.” In the vast majority of U.S states peer support services are licensed or certified positions one can earn to qualify as a peer recovery coach.
AA and Paid Peer Recovery
To learn more about why AA is hesitant to embrace paid peer recovery I reached out to David F.,* a long-time AA veteran. David grew up around AA; his mom gained sobriety when he was 10 and David’s twin brother recovered when his brother was 17. David is skeptical of paying for peer recovery coaches and feels that the spirituality many experience in AA is not compatible with paid services . David was celebrating his 10-year sober anniversary on the day he answered my questions.
“Why do you think there’s push-back in the [AA] recovery community against paid recovery coaches/peer advocates?” I asked. “I need to point you to one of our important texts, 12 steps and 12 traditions,” David responded. “Traditions were [formally adopted] in 1949, when the program was having some serious growing pains. Those 12 [traditions] are the only hard and fast rules of the program, but they were designed to hold together a fractious and occasionally bullheaded group of folks — alcoholics and drug addicts.”
David pointed me to tradition eight in particular: “Alcoholics Anonymous should remain forever nonprofessional, but our service centers may employ special workers.” The text continues, “We have discovered that at the point of professionalism, money and spirituality do not mix. Almost no recovery from alcoholism has ever been brought about by the world’s best professionals, whether medical or religious. … Every time we have tried to professionalize our Twelfth Step, the result has been exactly the same: Our single purpose has been defeated.” (The 12th step of AA states, “Having had a spiritual awakening as the result of these Steps, we tried to carry this message to alcoholics, and to practice these principles in all our affairs.”) Simply put, Alcoholics Anonymous holds that AA is about a spiritual awakening that happens as a result of working through the 12 steps and through no other means, including any sort of paid help.
Although peer recovery coaches are a relatively new option compared to AA, they’re increasingly being used in a variety of treatment settings. Even more important, for anyone wanting to recover these coaches offer another treatment option. Since the use of peer recovery coaches is a relatively new method, research is now being conducted to better understand whether or not they’re effective and for whom. A 2014 article entitled “Treatment Process and Participant Characteristic Predictors of Substance Use Outcome in Mentorship for Addiction Problems (MAP),” published in the Journal of Alcohol and Drug Dependence, analyzed the efficacy of one type of peer-support program, MAP.
The analysis found a correlation between mentor supervision (meaning the help of someone similar to a peer recovery coach, group attendance (how often someone attended support meetings and the number of days a client was able to abstain from using. This is an early, promising indication that having a mentor/coach could be an added support in helping people reduce or eliminate their use of drugs and/or alcohol. Yet, researchers studying peer services for addiction treatment do emphasize peer services still need to be researched a lot more .
Given the urgency with which many people seek recovery, and the increasing number of peer-support programs out there, coaches like Travis and many others around the country appear to be a viable option to explore if someone is looking to take the next step in their recovery.
*Name has been changed.