Recovery Capital
Recovery is a growth process where a person in recovery (PIR) pursues health and wellness over time. Operating from a strength-based approach, MAP’s Peer Recovery Support Specialists (PRSSs) assist PIRs in navigating their recovery journey. PIRs who develop the necessary internal and external resources to grow and develop through the lived experience of recovery not only sustain a life free from alcohol and other drugs, but also improve their health and wellness. The culmination and development of these internal and external connections, resources, and assets is called “Recovery Capital.” (Cloud & Granfield, 2009; Henessy, 2017). Recovery Capital emerged from research and literature on social capital and is closely associated with quality of life and other social determinants of health (Best & Laudet, 2010). The building of recovery capital may be particularly relevant in the first 12-18 months of recovery.
The Elements of Recovery Capital
There are several models of recovery capital presented in the addiction recovery literature, however, Cloud and Granfield’s (2009) Recovery Capital Model fits best with how MAP understands these domains. Their model outlines four areas of recovery capital including social, physical, human, and cultural. These are described below.
Social Capital
is captured in the relationship capacity built over time by a PIR. Social capital is synonymous with the support and the connection a PIR has with family, friends, their local community, and their chosen recovery communities (Cloud & Granfield, 2009; Henessy, 2007; Shumway & Kimball, 2012).
Physical Capital
embraces more concrete resources such as finances, housing, employment, education, and transportation. A PIR earning enough money to meet their needs, live in safe and recovery supportive environment, as well as being gainfully employed and/or pursuing education are all part of building physical capital (Cloud & Granfield, 2009; Henessy, 2017; Shumway & Kimball).
Human Capital
encompasses the development of healthy coping skills to manage stress, making healthy choices, finding purpose and hope as well as viewing oneself in a positive light (e.g., identity). A PIR achieving goals and aspirations are also important in building human capital (Cloud & Granfield, 2009; Henessy, 2017; Shumway & Kimball).
Cultural Capital
includes the adoption of recovery related beliefs, values, and rituals as part of the daily lived experience of recovery. Over time and with proper support, a PIR integrates recovery beliefs as part of how they see the world and their day-to-day behaviors reflect those beliefs (Cloud & Granfield, 2009; Henessy, 2017).
Important to note is that these domains and areas of focus are highly connected and impact each other in important ways. In addition, each person may bring different resources to the recovery journey and recovery capital may vary over time. Recovery Capital is applicable to MAP’s healthy respect for and support of multiple pathways of recovery. With this stated, it is generally understood that as people move forward in their recovery, recovery capital builds and increases.
A Change for MAP Health Management
Over several years, MAP has refined their method of collecting data as well as the questions PRSSs ask of the PIRs they support. Paramount to being able to provide support and gather data is a PRSS’s ability to remain engaged with their PIR. The initial design of MAP questions, both those asked of the PIR as well as questions designed to garner PRSS’s impressions, were asked in an effort to assess a PIR’s risk of relapse. The refining, culling, and narrowing process has revealed several questions that are predictive of a PIR’s likely success in engaging in the MAP program as well as maintaining their recovery. This refining process has also revealed the importance of a PIR developing recovery capital and the importance of the quality of connection/relationship a PIR has with their PRSS as being predictive of success.
In addition, MAP has found that those in the first year of recovery are typically at a high or highest risk for relapse and categorizing PIRs based on their level of risk is less useful than measuring their accumulative growth of recovery capital. MAP professionals believe measuring recovery capital over time is an enhanced and more sensitive way to measure a PIR’s success. Measures of recovery capital also provide more specific direction to PRSSs to assist those who are struggling in their recovery journey. Further, in the past, PRSSs were asked to give their impression of risk of relapse after each phone call. Although mostly effective, MAP believes having PRSS’s assessment of the quality of their connection/relationship with their PIRs is more predictive of engagement and more highly correlated to building recovery capital.
Most current Recovery Capital instruments, scales or measures are too long and unwieldy for MAP’s recovery support philosophy and data collection methods. Thus, MAP has created its own measure of recovery capital. This measure is informed by past MAP question sets and analyses, the recovery literature specifically related to recovery capital, experts within MAP, and feedback from PRSSs. Much shorter and more user friendly, the MAP Recovery Capital Scale, will undergo initial tests of reliability (e.g., internal consistency) and once fully implemented, undergo further tests of validity and reliability (e.g., test-retest). Included in this plan is to validate the instrument as it relates to quality of life and other measures of social determinants of health. Results from these tests will be used to refine the instrument and MAP will be able to show how Recovery Capital shifts and changes over time. MAP is also asking PRSSs to assess the quality of relationship with PIRs after each phone call. As stated earlier, MAP believes that the PRSSs assessment of this relationship will be highly predictive of engagement, the development of recovery capital, and a PIR’s success within the MAP Program.
Recovery Capital is recognized as a construct with tremendous potential within the addiction recovery field in explaining and understanding the lived experience of those in recovery. Measuring and supporting the growth of social, physical, human, and cultural capital for PIRs is essential to long-term recovery success. Recovery Capital, including MAP’s Recovery Capital Scale, is a more enhanced way to measure recovery and will add to MAP’s ability to effectively communicate outcomes through our Executive Reports.
References
Best, D. & Laudet, A.B. (2010). The Potential of Recovery Capital. RSA Projects.
Cloud, W., Granfield, W. (2009). Conceptualizing recovery capital: Expansion of a theoretical construct. Substance Use and Misuse, 42, 12/13, 1971-1986.
Henessy, E.A. (2017). Recovery capital: A systemic review of the literature. Addiction Research an Theory. 25(5), 349-360.
Shumway, S.T. & Kimball, T.G. (2012). Six Essentials to Achieve Lasting Recovery. Hazelden. Press.