Learning Objectives
- Define addiction as a chronic, treatable brain disorder rather than a moral failing
- Identify the stages of change and where individuals may be in their recovery journey
- Recognize at least three evidence-based approaches to addiction treatment
- Describe how family members and communities can support long-term recovery
Slide 1
Title Slide: Recovery 101 — Understanding the Journey
- Presenter name, credentials, and organization
- Date and location
- "Recovery is not a destination. It is a direction."
Speaker Note: Welcome the audience. Acknowledge that this topic can feel heavy or personal. Establish that this is a judgment-free space. If you are comfortable sharing a brief personal connection to the topic, this builds trust early. Keep it to one or two sentences.
Slide 2
What Is Addiction?
- ASAM definition: "A treatable, chronic medical disease involving complex interactions among brain circuits, genetics, the environment, and an individual's life experiences"
- Not a choice, not a character defect, not a lack of willpower
- Comparison to other chronic conditions: diabetes, hypertension, asthma
- Relapse rates for addiction (40-60%) mirror relapse rates for diabetes and hypertension
Speaker Note: This is often the most important slide for family members. Many people in the audience may still carry the belief that their loved one "chose" this. Emphasize the ASAM definition slowly. The chronic disease comparison is powerful because it reframes relapse as a medical event rather than a personal failure. Pause here to check for reactions. You may see visible relief from some family members.
Slide 3
The Brain on Addiction
- Reward pathway: dopamine and the nucleus accumbens
- How substances hijack the brain's natural reward system
- Tolerance, dependence, and withdrawal explained simply
- Prefrontal cortex impairment: why "just stop" does not work
- Good news: the brain can heal. Neuroplasticity supports recovery
Speaker Note: Keep the neuroscience accessible. Use analogies: "Imagine your brain has a volume knob for pleasure. Substances crank it to maximum. Over time, the brain turns the baseline volume way down to compensate. That is why people in active addiction feel unable to experience pleasure from everyday activities." The last bullet about neuroplasticity is the hope point. Brain imaging studies show significant recovery of function after sustained abstinence.
Slide 4
Stages of Change
- Precontemplation: Not yet considering change ("I don't have a problem")
- Contemplation: Aware of problem, ambivalent about change
- Preparation: Planning to take action, gathering resources
- Action: Actively making changes, entering treatment
- Maintenance: Sustaining new behaviors, building a recovery life
- Change is not linear. People cycle through stages multiple times
Speaker Note: Draw or show a spiral rather than a straight line. Emphasize that returning to an earlier stage is not failure. For family audiences, this is critical: their loved one may be in contemplation, and pushing them toward action before they are ready can backfire. Ask the audience: "Think about a habit you have tried to change. Did you succeed on the first attempt?" This builds empathy.
Slide 5
Pathways to Recovery
- 12-Step Programs: AA, NA, and other mutual aid societies
- Clinical Treatment: Inpatient, outpatient, IOP, MAT (medication-assisted treatment)
- Alternative Approaches: SMART Recovery, Refuge Recovery, faith-based programs
- Peer Support: Recovery coaches, sober living, recovery community organizations
- There is no single right pathway. What matters is finding what works for the individual
Speaker Note: Avoid presenting any single pathway as superior. People recover through many different routes, and the research supports a "multiple pathways" approach. If your organization uses a particular model, you can mention it here while still honoring the broader landscape. For new staff, emphasize that dismissing a client's chosen pathway undermines the therapeutic relationship.
Slide 6
By the Numbers
- Over 20 million Americans are living in recovery (faces of recovery are everywhere)
- Substance use disorders affect every demographic, socioeconomic group, and geography
- Only about 10% of people who need treatment receive it (treatment gap)
- Recovery rates improve significantly with sustained engagement in support services
- After 5 years of sustained recovery, relapse risk drops below 15%
Speaker Note: Let the numbers speak. The 20 million figure surprises most audiences because recovery is often invisible. People do not wear signs announcing their recovery. The treatment gap statistic (only 10% receiving treatment) is a call to action, not a reason for despair. The 5-year statistic is the hope anchor. It tells families and newcomers that sustained recovery is real and measurable.
Slide 7
How You Can Help
- For families: Learn about enabling vs. supporting. Set boundaries with love. Take care of yourselves (Al-Anon, therapy, support groups)
- For communities: Reduce stigma in language. Say "person with a substance use disorder," not "addict" or "junkie"
- For employers: Employee assistance programs, recovery-friendly workplace policies
- For everyone: Carry naloxone (Narcan). Learn the signs of overdose. Respond without judgment
Speaker Note: This is the action slide. People leave feeling empowered when they have something concrete to do. Spend extra time on the families section if that is your audience. The language piece is simple but transformative: words shape how we think about people. If naloxone training is available locally, provide that resource information here.
Slide 8
Questions, Resources & Next Steps
- Open floor for questions
- Provide local resource list (treatment centers, meeting schedules, family support groups)
- SAMHSA National Helpline: 1-800-662-4357 (free, confidential, 24/7)
- Crisis Text Line: Text HOME to 741741
Speaker Note: Have printed resource sheets available. Be prepared for emotional responses during Q&A. Some people may disclose personal struggles. Respond with warmth, validate their courage, and point them toward appropriate support. Never provide clinical advice in a community presentation setting. Close by reminding the audience that recovery is real, recovery is possible, and that hope is always appropriate.
Discussion Questions
- What beliefs about addiction did you hold before this presentation? Has anything shifted?
- What is one thing you can do this week to reduce stigma around addiction in your community?
- If you have a loved one in recovery, what is one way you can support them without enabling?
- What barriers to treatment exist in our community, and how might we address them?
Suggested Handouts & Takeaways
- One-page "Myths vs. Facts About Addiction" sheet
- Local resource directory with treatment centers, meeting schedules, and crisis lines
- SAMHSA's "What Is Recovery?" brochure
- Person-first language guide for talking about substance use disorders
Learning Objectives
- Define trauma and identify its prevalence among individuals with substance use disorders
- Articulate the six principles of a trauma-informed approach (SAMHSA framework)
- Identify at least three common clinical pitfalls that retraumatize clients
- Apply trauma-informed practices to daily interactions in recovery settings
Slide 1
Title Slide: Trauma-Informed Care in Recovery Settings
- Presenter name and credentials
- "The question is not 'What is wrong with you?' but 'What happened to you?'"
Speaker Note: Begin with a content advisory. This training discusses trauma, and staff members in the room may have their own histories. Normalize this: "Many of us entered this field because of personal experience. If you need to step out at any point, that is not only okay, it is modeling the self-care we ask of our clients." This sets the tone for a safe training environment.
Slide 2
What Is Trauma?
- SAMHSA's three Es: Event, Experience, Effect
- Trauma is defined by the individual's experience, not the event itself
- Types: acute (single event), chronic (repeated), complex (multiple types over time), developmental (childhood), historical/intergenerational
- Key distinction: Big-T trauma vs. little-t trauma. Both matter clinically
Speaker Note: Emphasize that two people can experience the same event with very different responses. This prevents the staff tendency to rank or minimize traumas. The three Es framework is helpful because it moves the focus from "Did something bad enough happen?" to "How did this person experience it, and what are the lasting effects?" This reframe is foundational for everything that follows.
Slide 3
The Trauma-Addiction Connection
- Up to 75% of people entering addiction treatment report histories of trauma
- ACE (Adverse Childhood Experiences) study: dose-response relationship between childhood adversity and later substance use
- Substances as self-medication: managing hyperarousal, numbing pain, controlling intrusive thoughts
- Trauma and addiction share neurological pathways (stress response, reward circuits)
- Treating one without addressing the other leads to poor outcomes
Speaker Note: The ACE study data is compelling for clinical audiences. A person with four or more ACEs is 7 times more likely to develop alcoholism and 4.7 times more likely to use illicit drugs. Frame substance use as an adaptive survival strategy that made sense in context, even though it has become destructive. This reframe helps staff move from frustration ("Why do they keep using?") to curiosity ("What purpose is this serving?").
Slide 4
SAMHSA's Six Principles of Trauma-Informed Care
- Safety: Physical and emotional safety for clients and staff
- Trustworthiness and Transparency: Operations and decisions are conducted openly
- Peer Support: Mutual self-help as a key vehicle for recovery
- Collaboration and Mutuality: Leveling power differences between staff and clients
- Empowerment, Voice, and Choice: Shared decision-making, client strengths recognized
- Cultural, Historical, and Gender Issues: Moving past cultural stereotypes and biases
Speaker Note: Spend time on each principle with a concrete example from your setting. For Safety: "Do clients feel safe in our waiting room? Is it calm, or is it chaotic and triggering?" For Trustworthiness: "Do we explain the rules before enforcing them, or do clients feel ambushed by consequences?" For Empowerment: "When a client disagrees with their treatment plan, do we make space for that, or do we label them as resistant?" Each principle should lead to a practical self-assessment.
Slide 5
What Trauma-Informed Care Looks Like in Practice
- Environment: Calm spaces, clear signage, predictable routines, choices in seating
- Language: "What would be most helpful for you?" instead of "You need to..."
- Intake: Explain every step before it happens, ask permission, allow breaks
- Groups: Establish group agreements collaboratively, offer pass options, respect pacing
- Crisis response: De-escalate rather than confront, regulate your own nervous system first
Speaker Note: Ask staff to think of a recent interaction that did not go well. Walk through how applying these principles might have changed the outcome. The environmental piece is often overlooked: fluorescent lighting, lack of windows, institutional furniture, and locked doors can all be triggering for people with trauma histories involving institutions or incarceration. Small changes (lamps, plants, artwork) can have an outsized impact.
Slide 6
Common Pitfalls That Retraumatize Clients
- Forced disclosure: Requiring clients to share trauma details before they are ready, especially in group settings
- Punitive responses: Using discharge as a threat, punishing relapse with loss of services
- Power dynamics: "I know what's best for you" attitude, ignoring client preferences
- Inconsistency: Different staff enforcing different rules creates unpredictability
- Ignoring cultural context: Applying one-size-fits-all approaches across diverse populations
- Vicarious trauma in staff: Burned-out staff cannot provide trauma-informed care
Speaker Note: This slide often generates the most discussion. Staff may recognize themselves in some of these patterns, and that can be uncomfortable. Normalize it: "We have all done some of these things. The goal is awareness, not shame." The forced disclosure pitfall is especially important. Many programs historically required clients to share their story in early group sessions. For trauma survivors, this can feel like a violation and drives people out of treatment. Instead, let clients choose when and how much to share.
Slide 7
Caring for the Caregiver
- Vicarious trauma, compassion fatigue, and burnout are occupational hazards
- Warning signs: emotional numbing, cynicism about clients, dreading work, physical symptoms
- Organizational responsibility: manageable caseloads, regular supervision, peer support
- Individual strategies: boundary setting, personal therapy, mindfulness, physical activity
- A trauma-informed organization takes care of its staff, not just its clients
Speaker Note: Staff often feel guilty discussing their own needs. Reframe it: "You cannot pour from an empty cup, and you cannot be trauma-informed while you are dysregulated." Ask the room: "When was the last time you did something intentionally for your own wellbeing?" If there is a long silence, that is your answer. Discuss what the organization can do systemically, not just what individuals should do on their own time.
Slide 8
Moving Forward: Organizational Self-Assessment
- Rate your organization on each of the six principles (1-5 scale)
- Identify one area for immediate improvement
- Identify one area for long-term strategic change
- Assign accountability: who will champion each change?
- Schedule a follow-up to review progress in 90 days
Speaker Note: End with action, not just awareness. If possible, do the organizational self-assessment as a group exercise right now. Have each person rate the six principles independently, then discuss as a group. Where there is disagreement, that is where the most important conversations live. The 90-day follow-up is critical. Without accountability, trainings become feel-good events that change nothing.
Discussion Questions
- Think of a client interaction that went poorly. How might a trauma-informed lens change your understanding of what happened?
- Which of the six principles does our organization do well? Where do we have the most room for growth?
- What policies or procedures in our setting might inadvertently retraumatize clients?
- How are we currently supporting staff wellness? What could we add or improve?
- How do we balance structure and accountability with trauma-informed flexibility?
Suggested Handouts & Takeaways
- SAMHSA's "Concept of Trauma and Guidance for a Trauma-Informed Approach" summary
- Organizational self-assessment worksheet (six principles rating scale)
- Trauma-informed language cheat sheet (reframes for common phrases)
- Staff wellness self-check questionnaire
- Recommended reading list: "The Body Keeps the Score" (van der Kolk), "In the Realm of Hungry Ghosts" (Mate)
Learning Objectives
- Define motivational interviewing and its four guiding principles (the "spirit" of MI)
- Demonstrate the OARS technique (Open questions, Affirmations, Reflections, Summaries)
- Identify and respond to change talk vs. sustain talk
- Practice MI techniques through structured role-play scenarios
Slide 1
Title Slide: Motivational Interviewing Essentials
- Presenter name and credentials
- "People are generally better persuaded by the reasons which they have themselves discovered than by those which have come into the mind of others." — Blaise Pascal
Speaker Note: Start by asking: "How many of you have had a client who you knew needed to change, but they just would not do it? How did that feel?" Most people will relate. Then say: "Today we are going to explore a different way of having those conversations, one where the client discovers their own reasons for change." This frames MI as a solution to a real frustration they already have.
Slide 2
What Is Motivational Interviewing?
- Developed by William Miller and Stephen Rollnick (1983, refined through 2013)
- Definition: "A collaborative, goal-oriented style of communication with particular attention to the language of change"
- MI is not a trick or technique. It is a way of being with people
- Core assumption: motivation for change already exists within the client. Our job is to evoke it, not install it
Speaker Note: Emphasize the word "collaborative." MI is fundamentally different from the confrontational approaches that dominated addiction treatment for decades. The "motivation already exists" assumption is a paradigm shift: instead of trying to convince someone to change, we help them explore and articulate their own reasons. This is both more respectful and more effective.
Slide 3
The Spirit of MI: Four Elements
- Partnership: MI is done "with" someone, not "to" or "for" them. You are alongside the client, not above them
- Acceptance: Absolute worth, autonomy, accurate empathy, affirmation. Acceptance does not mean approval of harmful behavior
- Compassion: Actively promoting the client's welfare and prioritizing their needs
- Evocation: Drawing out the client's own motivations, strengths, and resources rather than supplying them
Speaker Note: These four elements are the foundation. Without the spirit, the techniques become manipulative. Spend a moment on Acceptance, as it is the most misunderstood. Acceptance means you honor the client's autonomy to make their own choices, even choices you disagree with. You can express concern while respecting their right to decide. This is the hardest part for many clinicians. Practice saying: "I care about what happens to you, and I respect that this is your decision."
Slide 4
The OARS Technique
- Open Questions: "What concerns do you have about your drinking?" (not "Don't you think you drink too much?")
- Affirmations: "It took courage to come here today." Recognize strengths, effort, and values
- Reflections: The core MI skill. Simple reflection mirrors content. Complex reflection adds meaning, feeling, or implication. Aim for a 2:1 reflection-to-question ratio
- Summaries: Collecting bouquets. Gather change talk together and present it back: "So let me make sure I understand..."
Speaker Note: Demonstrate each skill live. For Open Questions, ask someone in the audience a closed question ("Did you have a good weekend?") and then rephrase it open ("What was your weekend like?"). Notice the difference in the response. For Reflections, practice with the group: have someone make a statement and go around the room generating reflections. Emphasize that reflections are statements, not questions. Voice goes down at the end, not up.
Slide 5
Change Talk vs. Sustain Talk
- Change talk: Any client speech that favors movement toward change
- DARN-CAT framework: Desire, Ability, Reason, Need (preparatory) and Commitment, Activation, Taking steps (mobilizing)
- Examples: "I want to be there for my kids" (Desire), "I could probably cut back" (Ability), "My health is suffering" (Reason)
- Sustain talk: Speech favoring the status quo. "I'm not that bad," "I can handle it"
- Your job: reinforce change talk, explore sustain talk with curiosity (not confrontation)
Speaker Note: Think of change talk as gold. When you hear it, slow down, reflect it, ask for more. When you hear sustain talk, resist the urge to argue against it. Arguing with sustain talk amplifies it. Instead, reflect it and gently explore the other side: "Part of you feels like things are fine. And another part of you is sitting in this office today. Tell me about that part." The DARN-CAT framework helps clinicians listen with precision rather than waiting for their turn to talk.
Slide 6
The Righting Reflex: The Biggest MI Mistake
- The righting reflex: the natural desire to fix what seems wrong with people
- When we tell someone why they should change, we take the change argument away from them
- The client then argues the other side (sustain talk) because ambivalence requires both positions to be represented
- Result: we are working harder than the client to make their case for change
- MI flip: Let the client make the argument for change. You explore the status quo
Speaker Note: This is the single most important concept for people new to MI. Ask: "Have you ever told someone they should quit smoking, go to the gym, or eat better? How did that go?" Everyone laughs because everyone has experienced the futility of unsolicited advice. Now connect it to clinical work: every time we lecture a client about why they should stop using, we are doing the same thing. And it works just as well, which is to say it does not work at all. The counterintuitive move in MI is to step back and create space for the client to make their own case.
Slide 7
Role-Play Exercise: Practice Scenarios
Pair up. One person plays the counselor, one plays the client. Switch after 5 minutes. Use OARS and listen for change talk.
- Scenario A: A 35-year-old parent referred by child protective services. They are angry about being forced to attend treatment and insist they only drink socially. They love their children deeply.
- Scenario B: A 22-year-old who recently overdosed and was revived with naloxone. They say they are "not an addict" and that it was a one-time mistake, but their hands are shaking and they have not made eye contact.
- Scenario C: A 50-year-old professional who has been drinking daily for 20 years. Their spouse gave an ultimatum. They say: "I know I need to cut back, but I don't think I need rehab."
Speaker Note: Give pairs 5 minutes per scenario, then debrief as a group. Ask the person playing the client: "What did the counselor do that made you want to open up? What shut you down?" Ask the counselor: "When did you feel the righting reflex? What did you do instead?" Expect some awkwardness. That is normal. Learning MI is like learning a new language. Encourage participants to be patient with themselves and to keep practicing. The key takeaway is experiential, not intellectual.
Slide 8
Putting It All Together
- MI is a skill that improves with practice and feedback, not just knowledge
- Start small: try using one more reflection and one fewer question in your next session
- Record and review sessions (with client consent) to identify your patterns
- Seek supervision or peer consultation focused on MI fidelity
- Recommended: MINT (Motivational Interviewing Network of Trainers) resources and coding tools
Speaker Note: A one-hour workshop cannot make someone proficient in MI. Be honest about this. What it can do is plant seeds and give people a taste of a different way of working with clients. Encourage ongoing practice, reading, and training. If your organization can support ongoing MI supervision groups, recommend that. Close with: "The best way to help someone change is to stop trying to change them and start trying to understand them."
Discussion Questions
- When do you notice the righting reflex most strongly in your own practice?
- How would your sessions change if you doubled your reflections and halved your questions?
- Think of a client who is "resistant." How might reframing resistance as ambivalence change your approach?
- What systemic or organizational factors make it difficult to practice MI in your setting?
Suggested Handouts & Takeaways
- OARS quick-reference card (wallet-sized)
- Change talk (DARN-CAT) identification worksheet
- Role-play scenario cards for continued practice
- Recommended reading: "Motivational Interviewing: Helping People Change" (Miller & Rollnick, 3rd edition)
- Self-assessment: "MI Spirit Checklist" for post-session reflection
Learning Objectives
- Distinguish between a lapse (single use event) and a relapse (return to pattern of use)
- Describe the Gorski model of relapse as a process with identifiable warning signs
- Identify emotional, cognitive, and behavioral warning signs across the relapse continuum
- Facilitate group exercises that help clients develop personalized relapse prevention plans
Slide 1
Title Slide: Relapse Prevention — A Facilitator's Guide
- Presenter name and credentials
- "Relapse is not a sign of failure. It is a sign that the treatment plan needs adjustment."
Speaker Note: Frame this presentation as a tool for facilitators, not a lecture for clients. The goal is to give facilitators the knowledge and exercises they need to lead effective relapse prevention groups. Acknowledge that relapse is one of the most emotionally charged topics in recovery settings, for clients and staff alike. It can trigger feelings of failure, frustration, and hopelessness. Our job is to normalize it as part of the recovery process while taking it seriously.
Slide 2
Reframing Relapse: Process, Not Event
- Common misconception: relapse is the moment someone picks up a drink or drug
- Reality: relapse is a process that begins days, weeks, or even months before use occurs
- Emotional relapse: Isolation, bottling emotions, poor self-care, not going to meetings
- Mental relapse: Romanticizing use, bargaining ("maybe just once"), lying, planning
- Physical relapse: Actual use of substances
- Intervention is possible at every stage. The earlier, the easier
Speaker Note: This three-stage model comes from Steven Melemis and is accessible for both clinicians and clients. Draw it on a whiteboard as a downhill slope. Most of the prevention work happens in the emotional and mental stages. By the time someone is in physical relapse, the window for prevention has passed. Ask facilitators: "How often do your groups focus on the emotional stage?" Usually the answer is not enough. That is where the real work happens.
Slide 3
The Gorski Model: CENAPS Relapse Prevention
- Terence Gorski identified 37 warning signs organized into 11 phases
- Key phases include:
- Internal change (feeling "off" without knowing why)
- Denial of the change
- Avoidance and defensiveness
- Crisis building (problems stack up)
- Immobilization (feeling stuck and overwhelmed)
- Confusion and overreaction
- Depression and loss of daily structure
- Loss of control over behavior
- Recognition of loss of options
- Active use or emotional collapse
- The model emphasizes that post-acute withdrawal symptoms fuel early warning signs
Speaker Note: You do not need to cover all 37 warning signs in a group session. Focus on helping clients identify which phases resonate with their personal experience. The Gorski model is especially useful because it validates what many people in recovery already feel intuitively: "Something was wrong before I picked up." It gives language to that experience. For facilitators, the model provides a structured framework for group exploration. Consider using Gorski's warning sign checklist as a group exercise over multiple sessions.
Slide 4
Warning Sign Identification Exercise
Group Exercise (15 minutes):
- Distribute the warning sign checklist (emotional, mental, behavioral categories)
- Ask participants to privately check the signs they recognize from their own experience
- In pairs, share the top three warning signs that are most dangerous for you personally
- As a group, discuss: "What is your earliest warning sign? The very first thing that shifts?"
- Help each person identify their personal "red flag" that tells them the process has started
Speaker Note: This exercise is powerful because it moves from abstract knowledge to personal application. Common early warning signs that people identify include: sleep disruption, stopping prayer or meditation, canceling plans with support people, increased irritability with loved ones, and "forgetting" to eat. The earliest warning sign is often the most subtle, which is why it gets missed. Encourage participants to tell their sponsor or support person what to watch for. External accountability catches what self-awareness misses.
Slide 5
High-Risk Situations: The HALT+ Model
- Hungry (physical needs unmet, including sleep deprivation)
- Angry (unresolved resentments, boundary violations, feeling disrespected)
- Lonely (isolation, disconnection from support, feeling misunderstood)
- Tired (physical exhaustion, emotional depletion, burnout)
- Plus: Bored, Stressed, Celebratory (positive emotions can also trigger relapse), Grief
- Teach clients to do a HALT check multiple times daily, especially when something feels "off"
Speaker Note: HALT is popular because it is simple and memorable. The "plus" additions are important because they expand beyond the original four. Many people relapse during celebrations or positive life events because they let their guard down. Grief is another underappreciated trigger; the loss of a loved one, a relationship, a job, or even the loss of the using lifestyle itself. For facilitators: consider making a HALT check a standard opening ritual for every group session. It normalizes self-monitoring.
Slide 6
Building a Personal Relapse Prevention Plan
Every participant should leave with a written plan that includes:
- My top 5 personal warning signs (specific to me, not generic)
- My high-risk situations (people, places, times, emotional states)
- My coping strategies (at least 3 for each high-risk situation)
- My support contacts (who to call, in what order, with phone numbers)
- My daily non-negotiables (the things I must do every day to stay in recovery)
- My "break glass" plan (what I do if I have already used: who to call immediately, where to go)
Speaker Note: A plan that sits in a filing cabinet is worthless. Help clients make their plans practical and portable. The "daily non-negotiables" section is often the most useful for ongoing recovery. Common non-negotiables include: morning prayer or meditation, attending a meeting, calling a support person, physical exercise, and going to bed at a consistent time. The "break glass" plan reduces shame: it says "if relapse happens, here is what you do next" rather than pretending it could never happen.
Slide 7
When a Client Relapses: Facilitator Response
- Do: Welcome them back. Express concern for their safety. Ask what they need right now
- Do: Help them analyze what happened without shame. "Walk me through the days leading up to it"
- Do: Revise the relapse prevention plan based on new information
- Don't: Lecture, express disappointment, or use it as a cautionary tale for the group
- Don't: Minimize it ("It's no big deal") or catastrophize ("You've thrown everything away")
- The goal: extract maximum learning from the experience while preserving the therapeutic relationship
Speaker Note: How we respond to relapse determines whether the client stays in treatment or disappears. Shame drives people underground. Compassion keeps the door open. The phrase "Walk me through the days leading up to it" is deliberate: it focuses on the process, not the event. Often the client will identify warning signs they missed, and this becomes the most powerful learning moment in their recovery. For facilitators: your emotional regulation matters here. If you feel frustrated or disappointed, manage that outside the session. The client needs your steadiness, not your feelings.
Slide 8
Summary & Ongoing Group Integration
- Relapse prevention is not a one-time topic. It should be woven into every group session
- Open every group with a check-in that includes warning sign awareness
- Revisit and update relapse prevention plans monthly
- Celebrate maintenance: acknowledge clients who identify and manage warning signs
- Remember: the opposite of relapse is not just abstinence. It is engagement in a meaningful life
Speaker Note: Close by reinforcing that relapse prevention is not about fear or white-knuckling through life. It is about building a life that supports recovery. The final bullet point is key: people do not stay sober just to avoid using. They stay sober because they have built something worth protecting. Help your groups focus on what they are moving toward, not just what they are moving away from.
Discussion Questions
- What is the difference between a lapse and a relapse, and why does the distinction matter clinically?
- How do you currently handle relapse in your groups? What would you change after this training?
- What role does post-acute withdrawal syndrome (PAWS) play in relapse, and how do you educate clients about it?
- How do you balance honest discussion of relapse risk with maintaining hope and motivation?
Suggested Handouts & Takeaways
- Personal relapse prevention plan template (fillable)
- Gorski warning sign checklist (abbreviated version for group use)
- HALT+ daily self-check card (wallet-sized)
- "What to Do If I Relapse" emergency response card
- Recommended reading: "Staying Sober" (Gorski & Miller)
Learning Objectives
- Define recovery capital and explain why it predicts long-term recovery outcomes
- Identify the four types of recovery capital: social, physical, human, and cultural
- Complete a personal recovery capital assessment to identify strengths and growth areas
- Develop at least two actionable strategies to increase recovery capital in their weakest area
Slide 1
Title Slide: Building Recovery Capital
- Presenter name and credentials
- "Recovery is not just about what you stop doing. It is about what you start building."
Speaker Note: This presentation is designed for a peer-friendly audience. Use accessible language and personal examples where possible. Start by asking the group: "What does the word 'capital' mean to you?" Most people think of money. Then expand: "Capital is any resource that you can draw on when you need it. Today we are going to talk about the resources that support your recovery, and how to build more of them."
Slide 2
What Is Recovery Capital?
- Coined by Robert Granfield and William Cloud (1999), expanded by William White
- Definition: The breadth and depth of internal and external resources that can be drawn upon to initiate and sustain recovery
- Research finding: The amount of recovery capital a person has is one of the strongest predictors of sustained recovery
- Recovery capital can be built. It is not fixed. This is the empowering message
- Think of it as a bank account: the more you deposit, the more you can draw on in difficult times
Speaker Note: The bank account metaphor works well. "When you were in active addiction, you were making withdrawals from every area of your life. Recovery is about making deposits again." Be sensitive to the fact that many people in early recovery have very low recovery capital. The point is not to highlight what they lack but to show them where they can start building. Even small deposits matter.
Slide 3
Social Capital
- Definition: The relationships and social networks that support recovery
- Includes: Sober friends, family relationships, sponsor/mentor, recovery community, faith community, support groups
- Why it matters: Connection is the opposite of addiction. Isolation is the number one risk factor for relapse
- How to build it:
- Attend meetings or recovery events regularly
- Get a sponsor or mentor and use them
- Volunteer or do service work
- Repair relationships where safe and appropriate (amends process)
- Let go of relationships that threaten your recovery
Speaker Note: Social capital is usually the area people need to work on most urgently in early recovery. Their using network is gone (or needs to be), and their recovery network is not yet established. This gap is dangerous. Practical tip for the group: "Your phone should have at least three recovery numbers in it that you can call today. If it doesn't, that is your homework." For people who are introverted or struggle with social anxiety, acknowledge that building social capital is harder, not optional, but harder. Start with one person, one meeting, one phone call.
Slide 4
Physical Capital
- Definition: Tangible resources and assets that support recovery
- Includes: Safe housing, reliable transportation, financial stability, healthcare access, employment, identification documents, legal status
- Why it matters: It is hard to focus on recovery when you do not know where you will sleep tonight
- How to build it:
- Pursue stable housing (sober living, transitional housing, Section 8)
- Secure employment or education (even entry-level is a start)
- Address legal issues (warrants, probation, child custody)
- Establish primary care and dental care
- Open a bank account and start a small budget
Speaker Note: Physical capital is where systemic barriers become most visible. People of color, people with criminal records, people without family wealth, and people in rural areas face structural obstacles that are not their fault and cannot be solved with individual willpower alone. Acknowledge this honestly. The role of recovery support services, case management, and advocacy is critical here. Help participants identify the resources available to them through your organization or community partners. Something as simple as helping someone get a state ID can unlock multiple other resources.
Slide 5
Human Capital
- Definition: Personal skills, knowledge, health, and internal resources
- Includes: Education, job skills, physical health, mental health, problem-solving abilities, emotional regulation, self-efficacy, hope
- Why it matters: Human capital is what you carry with you regardless of external circumstances
- How to build it:
- Pursue education or vocational training (GED, certificates, degrees)
- Address co-occurring mental health conditions with professional help
- Develop daily health habits: nutrition, exercise, sleep hygiene
- Learn coping skills: mindfulness, emotional regulation, conflict resolution
- Set and achieve small goals to build self-efficacy
Speaker Note: Human capital includes something that often gets overlooked: hope. A person's belief that recovery is possible for them is itself a form of capital. For people in early recovery who feel they have nothing, point out the human capital they already possess: they showed up today, they have survived difficult things, they have the courage to try. These are not trivial. Self-efficacy builds through small wins. Help participants identify one achievable goal for this week, not this year, this week.
Slide 6
Cultural Capital
- Definition: Values, beliefs, and cultural connections that support recovery
- Includes: Cultural identity, spiritual practice, sense of purpose, community belonging, cultural traditions, recovery identity
- Why it matters: People recover in cultural context. A recovery program that ignores culture will fail people it should be serving
- How to build it:
- Reconnect with cultural or spiritual traditions that give meaning
- Find recovery communities that reflect your identity and values
- Develop a personal sense of purpose (service, family, creativity, faith)
- Embrace a recovery identity: "I am a person in recovery" becomes a source of strength
- Explore how your culture views healing and integrate those practices
Speaker Note: Cultural capital is the least discussed and potentially the most transformative. For many people, addiction stripped them of their cultural connections and sense of belonging. Recovery offers a chance to reconnect. Be sensitive to the fact that some cultural contexts include substances (e.g., drinking cultures, certain social traditions). Navigating cultural expectations while maintaining sobriety requires support and planning. For Indigenous, Latino, Black, LGBTQ+, and other communities, culturally specific recovery resources can make the difference between engagement and dropout.
Slide 7
Recovery Capital Self-Assessment Exercise
Group Exercise (10 minutes):
Rate yourself 1-10 in each area. Be honest, not harsh.
- Social Capital: ___/10 (Do I have people I can call? Am I connected to a recovery community?)
- Physical Capital: ___/10 (Do I have stable housing? Income? Healthcare?)
- Human Capital: ___/10 (Am I physically healthy? Do I have skills? Do I believe in myself?)
- Cultural Capital: ___/10 (Do I have a sense of purpose? Am I connected to my culture? Do I have a spiritual practice?)
Then: identify your strongest area and your area with the most room for growth. Share one strategy to build capital in your growth area.
Speaker Note: Frame this as a strengths-based exercise. The first thing to notice is what is already there, not what is missing. Many people in recovery underestimate their own resources. After individual reflection, invite sharing. When someone identifies a growth area, ask the group: "Who has a suggestion? Who has grown in that area and can share how?" Peer support in action is more powerful than any lecture. For the formal assessment tool, the Assessment of Recovery Capital (ARC) or the Recovery Capital Index (RCI) can be used in clinical settings.
Slide 8
Your Next Deposit: Action Planning
- Choose one action from each type of capital to work on this month:
- Social: _________________________
- Physical: _________________________
- Human: _________________________
- Cultural: _________________________
- Tell someone your plan today. Accountability increases follow-through by 65%
- Revisit your recovery capital assessment in 30 days and notice the growth
Speaker Note: End with action. Abstract knowledge without concrete next steps fades quickly. Have participants write their four actions down and share at least one with the group or a partner. The 65% accountability statistic comes from the American Society of Training and Development and resonates with people. Close with: "Every single day in recovery, you are making deposits. Some days the deposits are small. That is okay. Small deposits compound over time."
Discussion Questions
- Which type of recovery capital feels strongest for you right now? Which feels weakest?
- How has your recovery capital changed since you began your recovery journey?
- What is one resource in our community that you wish more people in recovery knew about?
- How can we as a recovery community help each other build capital?
Suggested Handouts & Takeaways
- Recovery Capital Self-Assessment worksheet (four domains, 1-10 scale with prompting questions)
- Monthly recovery capital action plan template
- Local resource directory organized by capital type (social, physical, human, cultural)
- Recommended reading: "Recovery Rising" (William White) and "Recovery Capital" research summaries
Learning Objectives
- Define professional boundaries and explain why they exist to protect both clients and staff
- Identify dual relationship risks specific to recovery settings (where staff may share recovery status)
- Articulate guidelines for appropriate self-disclosure in peer support and clinical roles
- Apply ethical decision-making frameworks to real-world case scenarios
Slide 1
Title Slide: Ethics & Boundaries in Recovery Work
- Presenter name and credentials
- "Good boundaries are not walls. They are gates that let the right things in and keep the harmful things out."
Speaker Note: Begin by normalizing the topic. "Boundaries and ethics can feel like dry, administrative topics. But in practice, they are some of the most emotionally complex challenges we face in this work." Ask the room: "How many of you have been in a situation where you were not sure what the right boundary was?" Most hands will go up. This is not a sign of incompetence; it is a sign that the work is complex. Today is about developing the judgment to navigate that complexity.
Slide 2
Why Boundaries Matter in Recovery Settings
- Clients in recovery are in a vulnerable position. They are sharing deeply personal material with people who hold power
- Boundary violations erode trust, and trust is the foundation of the therapeutic relationship
- Boundaries protect clients from exploitation, even unintentional
- Boundaries protect staff from burnout, enmeshment, and ethical complaints
- The recovery field has unique boundary challenges because many staff are themselves in recovery
Speaker Note: Emphasize the word "protect." Boundaries are not about being cold or distant. They are about creating a safe container for the work. When a client knows where the boundaries are, they can relax and trust the relationship. When boundaries are unclear, clients are anxious because they do not know what to expect. For staff, boundaries prevent the slow erosion that leads to burnout. The person who never says no, who gives clients their personal cell phone, who stays late every night, is not being heroic. They are heading toward a crisis.
Slide 3
Dual Relationships in Recovery Settings
- Dual relationship: when a professional has more than one role with a client
- Common in recovery settings:
- You and a client attend the same recovery meetings
- A client is your neighbor, your child's teacher's spouse, or someone you knew in active addiction
- A former client applies for a volunteer or staff position
- You sponsor someone who later becomes a client at your agency
- Not all dual relationships are harmful, but all require careful management
- Key question: "Does this dual relationship impair my objectivity or exploit the client?"
Speaker Note: In small communities and in the recovery world, dual relationships are nearly impossible to avoid entirely. The goal is not zero dual relationships but rather awareness, transparency, and management. When you encounter a dual relationship, bring it to supervision immediately. Do not try to manage it alone. The meeting scenario is especially common: "What do I do when I see my client at an AA meeting?" The answer involves clear agreements about confidentiality, acknowledgment of the situation, and prioritizing the client's comfort. Never pretend it is not happening.
Slide 4
Self-Disclosure: How Much Is Too Much?
- Self-disclosure in recovery work is not inherently wrong. It can be a powerful therapeutic tool
- Before disclosing, ask yourself:
- Is this for the client's benefit, or am I meeting my own need to share?
- Will this normalize the client's experience without shifting focus to me?
- Am I sharing general experience or specific details? (General is usually safer)
- Have I processed this material in my own recovery? (Unprocessed material does not belong in client sessions)
- Peer support specialists: Sharing your recovery story is part of the role, but how and when you share matters
- Licensed clinicians: More restrictive standards apply. Check your licensing board's ethics code
Speaker Note: Self-disclosure is the boundary area where recovery professionals struggle most. The instinct to say "I've been there" is strong and often comes from genuine compassion. The four-question framework gives people a practical tool. Role differences matter here: a peer support specialist's job description includes lived experience. A licensed counselor's role is different. Neither is better; they are different, and the disclosure guidelines reflect that difference. Red flags for problematic self-disclosure: sharing war stories, competing with the client's experiences, using session time to process your own issues, and disclosing to create a sense of indebtedness.
Slide 5
Mandatory Reporting & Confidentiality
- 42 CFR Part 2: Federal regulation providing extra confidentiality protections for substance use disorder treatment records. Stricter than HIPAA
- Cannot confirm or deny that someone is a client without written consent (with limited exceptions)
- Mandatory reporting obligations still apply:
- Child abuse or neglect (suspected, not confirmed)
- Elder or vulnerable adult abuse
- Imminent danger to self or others (duty to warn/protect)
- Explain these limits at intake, not when they come up. Surprises destroy trust
- When in doubt, consult your supervisor before acting
Speaker Note: This is the slide where people's eyes glaze over, but it is critically important. A confidentiality violation can end careers and harm clients. The key practical takeaway is this: explain the limits of confidentiality at the very first session, clearly and in plain language. Do not bury it in a consent form. Say it out loud: "Everything you tell me stays between us, with three exceptions..." When a mandatory reporting situation arises, be transparent with the client: "I care about you, and I am required by law to report this. Let me explain what that means and what will happen next." Whenever possible, make the report with the client, not behind their back.
Slide 6
Social Media & Digital Boundaries
- Do not accept friend or follow requests from current clients on personal social media
- Be aware that your public social media presence is visible to clients
- Do not search for clients online (unless there is a specific clinical or safety reason discussed in supervision)
- Text and email communication: use only agency-approved platforms with documentation
- If a client contacts you through personal channels, redirect them to professional channels and discuss it in the next session
Speaker Note: Social media has created boundary situations that did not exist ten years ago. Many staff, especially younger staff and peer support specialists, have not received formal training on digital boundaries. Be direct: "Your personal Instagram is not a clinical tool. Clients do not need access to your vacation photos, your political opinions, or your Friday night plans." For peer support specialists who use social media for recovery advocacy, the lines can blur. Help them develop clear policies: separate professional and personal accounts, do not discuss clients even vaguely, and do not respond to client messages on personal platforms.
Slide 7
Case Scenarios for Group Discussion
Discuss each scenario in small groups (5 minutes per scenario). What would you do? What principles apply?
- Scenario A: A client gives you a handmade thank-you card and a $25 gift card to Starbucks after completing treatment. Do you accept it?
- Scenario B: You run into a current client at a 12-step meeting. They wave and sit next to you. After the meeting, other members ask how you know each other.
- Scenario C: A client tells you they drove to your house last night because they were in crisis. They say they did not knock because they did not want to bother you, but they felt better just being near someone who cares.
- Scenario D: During a group session, a client discloses that they left their three children (ages 2, 5, and 7) home alone last night while they went to buy drugs. They did not use, and the children were fine. Are you required to report this?
Speaker Note: These scenarios are designed to generate disagreement. That is the point. Ethics rarely has clear-cut answers. For Scenario A: most agencies have gift policies. The thank-you card is generally appropriate; the gift card is more complex. For Scenario B: the meeting scenario requires an advance agreement with the client about how to handle it. For Scenario C: this is a significant boundary violation that requires an immediate, compassionate, direct conversation. For Scenario D: yes, this is a mandatory report. Leaving children under a certain age (varies by state) unsupervised constitutes neglect. This scenario often generates the most heated discussion because the client "did the right thing" by not using. Validate the recovery behavior while being clear about the reporting obligation.
Slide 8
An Ethical Decision-Making Framework
When you face a boundary or ethics dilemma, work through these steps:
- Identify the issue: What exactly is the ethical concern?
- Consult your code of ethics: What do your professional standards say?
- Consider all stakeholders: How does this affect the client, their family, other clients, your colleagues, your organization?
- Identify your options: What are all the possible courses of action?
- Consult: Talk to your supervisor, a colleague, or an ethics hotline before acting
- Decide and document: Make your decision, document your reasoning, and follow up
The golden rule of ethics in recovery work: If you are wondering whether something is a boundary issue, it probably is. Bring it to supervision.
Speaker Note: Close by normalizing ethical uncertainty. The most ethical practitioners are not the ones who never face dilemmas. They are the ones who recognize dilemmas, seek consultation, and make thoughtful decisions. The biggest ethical failures in the recovery field come from people who were too afraid or too proud to ask for help. Create a culture where supervision is valued, not stigmatized. And remember: the purpose of ethics is not to restrict you. It is to ensure that the people who trust us with their most vulnerable moments are treated with the dignity they deserve.
Discussion Questions
- What is the hardest boundary you have had to set in your recovery work? What made it difficult?
- How do you handle the tension between being "real" with clients and maintaining professional distance?
- What boundary issues are unique to peer support specialists compared to licensed clinicians?
- How does your organization support staff in navigating ethical dilemmas? Is it enough?
- What would you do if you saw a colleague crossing a boundary with a client?
Suggested Handouts & Takeaways
- Ethical decision-making framework (one-page flowchart)
- Self-disclosure self-check card (four questions to ask before sharing)
- 42 CFR Part 2 summary sheet (plain language overview)
- Dual relationship management plan template
- Case scenario cards for ongoing team discussions (include the four from this training plus additional scenarios)
- Recommended reading: "Ethics for Addiction Professionals" (NAADAC) and your state's peer support specialist ethics code