Meet the Addiction Predators - Page 2

By Chelsea Carmona 02/03/13

From handlers of addicted celebrities to garden-variety "sober coaches," the addiction treatment world can be a rat's nest of opportunists, charlatans—and worse. 

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Art: Danny Jock

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With companies advertising recovering coaching as a sort of “catch-all” solution for all of the addicts who hate AA and prefer not to take time away from work to check back into treatment after they have been kicked out, Neumann’s message of hard work and personal integrity is not a very competitive one. Companies like Sober Champion aren’t afraid to play up the job’s celebrity reputation, using references to filming schedules and socioeconomic status to lure clients in: “For those who can afford one, a Sober Coach or a Sober Companion is an outstanding addition to any post-acute treatment program.”

While the research of peer-based work is highly limited, studies of the essential services provided by recovery coaches suggest that it is a potentially promising practice as an adjunct to treatment. Leaders in the field also acknowledge the significance of the peer-relationship. According to Michael Walsh, the President and CEO of the National Association of Addiction Treatment Providers (NAATP), “Done well, I believe sober coaching can be the difference between compliance with an aftercare plan and non-compliance and the longer someone is engaged in aftercare the better their chance at sustaining recovery.” But without a uniform accreditation system, there is little accountability to quality assurance, ethical practice, or peer integrity. 

In 2010, the need for greater organizational hierarchy came to a head, so Faces and Voices of Recovery began to establish a national accreditation system.

“Accreditation, not certification,” clarifies Tom Hill, Director of Programs at Faces and Voices. “Most people use the two interchangeably.” The distinction is important, he explains, because accrediting recovery communities, organizations, and programs will allow Faces and Voices to take a comprehensive approach to a range of issues rather than attempting a piecemeal solution by credentialing or licensing individual people. By providing a framework for effective oversight, management, and accountability, the system will work in tandem with current efforts to license individual workers.

A large part of the initiative’s value, which is scheduled to be ready in time for 2014’s Affordable Care Act, is its research potential, which could allow the peer recovery support services industry to achieve higher quality assurance and increased confidence from both the public and the field. But prior to tackling large-scale issues of access, accountability, infrastructure, and public confidence, Faces and Voices must address one of the most fundamental and controversial issues facing peer workers today: role definition and clarification. 

While providing coaching services as a part of his career as an interventionist, Walsh encountered perhaps the most common ethical concern with peer workers: whether recovery coaches are getting paid to sponsor newcomers. “I had a sponsor say that [recovery coaches and other peer workers are just paid sponsors] to me,” he says. “After a few months of watching me work with families who might not have otherwise continued to engage a professional, he told me he understood.” 

The road to mutual understanding and role clarification may not be an easy one, as the debate between experiential authority and formal education has a long history in the field of addiction medicine. But for many addicts looking for peer recovery support services like overeater Erika Alvarez, empathy is a priority: “I was looking for someone I could trust, someone I admired and someone who could understand me fully (someone who had lived an addiction and overcame it). Basically someone who could really guide me effectively.”

Because addicts sometimes feel vulnerable to the power differential between themselves and addiction professionals, and the external accountability that controls the relationship, peer workers are often in the unique position to receive sensitive information from addicts in a way that professional, clinical treatment providers may not. But for Neumann, recovery coaches should work in collaboration, rather than in conflict, with the medical community. “I’m not trying to take anything away from the medical or the research community,” she explains. “That’s not my platform. My platform is about doing the work, and if you need medication or AA to do the work then go get it.”

Salazar, who has been working with addicts since 1995, agrees that there is a place for everybody in the field of addiction, as long as they are licensed and certified. But he has some concerns about the language we have attached to certain peer recovery support services: “I do believe this term ‘coaching’ is terminology used in a different manner so that there’s no need to get licensed and certified," he says. "If you’re just coaching and not treating or counseling, there’s less of a need to get licensing. It’s a manipulation of words.”

When your troubled past is the leading credential for your current career, it's hard not to see the need for an organizational hierarchy with national standards. Both Walsh and Salazar mentioned hearsay concerning inappropriate coach/client relationships. Just a few days before I saw her, Neumann encountered a recovery coach who was still drinking. Without more structure, peer workers who work in private practice in states without certification have little accountability to anything but the law. Efforts to accredit and systematize a service that developed from a mentor-mentee-like relationship must be approached cautiously, though.

“With opportunities also come challenges,” says Hill, expressing his concerns about the potential over-professionalization of the practice. “We’re trying to build systems that will ensure that the ‘peerness’ will stay in tact.” White echoed his sentiments, adding, “Professionalization efforts to date are mimicking other roles whose knowledge sets are based on pathology and intervention paradigms rather than a recovery program.”

White’s work suggests that we take great care in order to avoid over-commercializing the role of peer recovery support specialists. Professionalization efforts can inadvertently undermine the very essence of these services because people tend to detach from their communities when they learn to view themselves and their professional organizations as the source of their authority. Without the support of their recovery communities, and without the full acceptance of the interdisciplinary teams they work with, peer workers can encounter a lack of support for their own recovery. 

While the public’s infatuation with the peer recovery support specialist has almost exclusively centered on the extreme cost of celebrity recovery, Hill does not want us to forget that anyone can be taken advantage of. In fact, treatment centers have a history of financially exploiting those in recovery. “We don’t want peers to become exploited,” he explains. “We want them to be valued for their life experiences and what they bring to the table.”

This isn’t lost on Bill McAdam, an alcoholic who lost 17 years of sobriety with a shocking suicide attempt. “I had always been somewhat skeptical about paying someone to give me information I already knew," he says. "But there was this feeling that I got from Lisa [Neumann] that as much as she was in the coaching business she explained the Universal Law [of Compensation] about what she did and the value I had to apply to it,” he concluded, “Without a shadow of a doubt it’s the best money I have ever spent.”

For Neumann, who is trained and certified through the International Coaching Academy (ICA), experience will always be the greatest teacher; but with all the horror stories, hearsay, and confusion surrounding her profession, she’s looking forward to the clarity and legitimacy the Faces and Voices accreditation system will provide.

“I’m not here to dazzle you or convince you that sobriety is awesome,” she explains, “I’m here to walk you through whatever it is you say you want in your life, and if it doesn’t work I’ll give you your money back.”

Still, for the famous, the busy, and the wealthy, there are plenty of expensive “Motivators and Cheerleaders” available to follow you around and search your belongings.

Chelsea Carmona is a freelance writer whose work has been featured in The Washington Post, Al Jazeera English, The Christian Science Monitor, The San Francisco Chronicle, and The Guardian. She works for The OpEd Project, a social venture founded to increase the range of voices and ideas we hear in the world. Follow her on Twitter: @CarmonaChelsea

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Chelsea Carmona is a freelance writer whose work has been featured in The Washington Post, Al Jazeera English, The Christian Science Monitor, The San Francisco Chronicle, and The Guardian. She works for The OpEd Project, a social venture founded to increase the range of voices and ideas we hear in the world. You can follow Chelsea on Twitter or Linkedin.