Peer support, engagement boost addiction treatment readiness

Each of us “greet” many people in a day—some with a glance, a nod, a word or two, or maybe a smile. But, how many times do we really connect with another individual?  How often do we speak to them in a way that is so personal, so direct, and so heartfelt that they feel we know them already? 

Sherri, a woman in recovery who supervises the work of “pathfinders” - peer outreach volunteers - at New Pathways for Women (NPW) in Philadelphia, has been on both sides of such greetings. Like many other men and women who have overcome addition, she experienced—in a matter of moments—the critical difference that a transition to Recovery Oriented Systems of Care (ROSC) has made in her home city. It is a difference that touched her deeply enough to involve her in a new life of recovery and in developing outreach efforts to help other women who are at earlier phases in their recovery journeys.   

For women like Sherri, there was a moment when, in the midst of an addiction, they reached for help and experienced “something different.” For her, it happened when she opened the door at the NPW project and experienced a sense of freedom.  “People greeted me, people offered me hospitality, and listened to what I had to say,” she recalled. She felt welcomed, unhurried, and free to make her own decisions. What appealed to her, she realized, was that New Pathways “wasn’t just another program where I’m going to be told what to do.”

Sherri responded positively, just as New Pathways facilitator Eugenia Argires hoped.  Argires launched the NPW project about five years ago, with help from a grant from the Center for Substance Abuse Treatment and space in a vacant, North Philadelphia lamp factory.  In contrast to mandated drug or alcohol treatment programs, the NPW project seeks to build a positive, voluntary bridge to treatment. “Those who come here choose to come,” Argires said, noting that many are not ready to accept or succeed at treatment right away. 

A vital piece of the NPW program, as with many of the recovery-focused programs fostered by the 200 providers who serve Philadelphia’s Department of Behavioral Health and Intellectual disAbility Services (DBHIDs), is to utilize peers like Sherri for “assertive outreach.” Such efforts utilize peers to work in high drug-use areas, where they meet with, invite, and engage others like themselves—both on the street and in programs like NPW— and open up the possibilities of better health and long-term recovery.  In treatment parlance, NPW offers “pre-treatment”—a process of invitation, preparation, and voluntary engagement that “increases readiness” for effective drug or alcohol treatment later on. 

The program invites women to convince themselves that a new life is possible and, when each is ready, invites them to decide to enter the recovery process through a series of individual sessions with a Case Manager. These, in turn, may lead to essential treatment steps, such as detox, if needed, or directly to weekly facilitated group counseling sessions at NPW.  Though the program is equipped to treat alcohol and substance use disorders, NPW recognizes that this treatment is not the only path to recovery.  Thus, it also encourages and helps women to build bridges and lasting relationships with a variety of self-help organizations, including faith and non-faith based groups in the community.  

Sherri’s journey took her through treatment, which has enabled her to build a new and sober life.  The journey also led her to reach out to others through her work with NPW peer pathfinders, who reach to women in city neighborhoods, offering invitations to visit NPW for a cup of coffee, an item of clothing, hygiene supplies, or to resolve a personal health concern with confidential HIV, Hepatitis, or STD testing.  Because these contacts may not want to visit NPW immediately, pathfinders leave behind small packages of information and help, ranging from program cards and emergency numbers to condoms and lubricant.

Sherri and four other pathfinders regularly work the neighborhoods, greeting, walking, and talking. They, together with the peer-professional team at NPW, have posted promising results working with women who face many challenges.  The profile of women involved in the NPW program is:

·         87% African American

·         Average age: 43

·         52% have less than high school diploma

·         94% are unemployed

·         87% are crack users

·         74% had never tried an SUD treatment program

Unlike SUD treatment programs that equate recovery with sobriety, Argires maintains that recovery, for women in the NPW project, begins with new hope and a decision to engage with the program. The journey often begins with simple steps that build over time: a willingness to reach out to others socially, to become engaged in more positive health behaviors, to abstain from or reduce the use of alcohol or illegal substances, to participate in self-help groups, and to set new life, work, or educational goals.

As shown below, women in the NPW project demonstrate significant behavior changes over time, including a reduction in high-risk behaviors and an increase in self-help behaviors.  After six months of involvement with the NPW project, 40 percent of women have elected to enter drug or alcohol treatment.

Intake and six-month follow-up data, New Pathways for Women project (Philadelphia)