Wrexham Recovery from Addiction Pilot Project (WRAPP)

Mutual Aid Engagement

In recent years Government policy on substance misuse in the UK has focused increasingly on recovery and has emphasised the need for service providers to ensure that they and their clients engage with mutual aid groups. Our experience is that some substance misuse professionals benefit from training sessions in which preconceived ideas and concerns about MA can be addressed. (See Training Section).

Twelve Step Facilitation (TSF) has been shown to impact positively on the probability of long-term recovery (Humphreys and Moos, 2001: Humphreys et al, 2004: Laudet, 2010: Kelly & White, 2012) and the intervention is used widely in the US in various forms.

CSARS Group is committed to applying its research findings and experience to assist in the delivery of mutual aid recovery projects for the benefit of individuals, families and communities in the UK and is currently involved with two projects.

Wrexham Recovery from Addiction Pilot Project (WRAPP)

WRAPP is a partnership TSF pilot project recently delivered on behalf of Welsh Government’s North Wales Area Planning Board and involving Wrexham County Borough Council, Substance Misuse Advisory Team (WCBC SMAT), the Association of Voluntary Organisations in Wrexham (AVOW) and the CSARS Group, which is based at the University of Chester. The project team would like to thank local AA and NA groups for their cooperation.

Selected participants, all willing to try an abstinence approach to recovery, were offered a weekly programme (January – March 2014) of WRAPP activities comprising workshops, one-to-one sessions, and facilitated attendance at local AA and NA meetings. They were encouraged to build their own individual recovery by undertaking homework, independently attending additional AA/NA meetings and seeking involvement with other local recovery activities, groups and communities. Where appropriate they were referred to other local support agencies.

At the end of the programme, 44% of participants were still actively engaged with recovery through AA/NA.

WRAP Project Outcomes

Recruitment:

  • Experience to date suggests that there have been significant awareness and resistance issues towards 12-Step recovery amongst local staff involved with substance misuse issues.
  • This contributed to low referral rates to WRAPP from other agencies – 11 people referred, only 5 attended for assessment.
  • The remaining participants found WRAPP through word of mouth, publicity, a service-user event and personal contact with service users by WRAPP staff.
  • Candidates assessed:  19
  • Participants selected:  16. Amongst the group several had significant health, other or motivational issues making completion of the course problematic.

Workshop Sessions:

  • Registration and Introduction
  • Accepting Help and Twelve-Step Spirituality
  • Changing: Characteristics of Addiction and Recovery
  • Changing and Living in the Day
  • Living Clean and Sober
  • Managing Emotions and Living with Others
  • Relapse Process and Prevention
  • Developing Individual Recovery Plans
  • Review Session: Living Sober and Relapse Prevention

Workshops were supported by group and individual sessions, accompanied attendance at AA/NA meetings and encouragement to engage with mutual aid and other recovery groups.

Participant Retention

  • 16 initial participants assessed weekly:
  • 7 (44%) completed the programme and are making good progress. They attended most of the WRAPP sessions, attend between 1 and 4 AA/NA meetings weekly and have engaged with local AA/NA members & groups, several have a sponsor.
  • 9 (56%) dropped out of the programme for a variety of reasons having attended between 1 and 3 WRAPP sessions.
  • Of the 9 participants who dropped out of the WRAPP Programme:
    • 3 have since been in touch with us to let us know that they are pursuing their own path of action within their fellowships
    • 2 were able to get into detox during the running of the course
    • 2 left because they felt they didn’t need it anymore
    • 2 left and have not been contactable since

Positive outcomes for 75% of participants

Feedback from participants on the WRAPP Group:

  • WRAPP is a great support group that also gives you a foot into AA and after-support, which I feel I lacked the last time I attempted to stay sober.
  • I love the talking, sharing and debating in the group, it helps you to understand your own feelings.
  • IT’S NOT JUST YOU!
  • WRAPP is good and I have seen a difference in myself. Going to AA as part of WRAPP is good.
  • I have been sober for a while now and being in group has done me good – I think it would help other people too.

Feedback from participants on their recoveries:

  • It gave me a massive head-start. I got things quickly in the rooms once I found them. I probably wouldn’t have found the rooms by myself anyway
  • I realise that I can have a happy, honest and good life without alcohol.
  • Two choices exist (for me):
    • A life of carnage, no family, no business, no friends, no future
    • A fulfilling life with people I love and the possibility of a good future
  • AA and other support will help me keep sober

Lessons Learned:

  • The low WRAPP referral rates from most Wrexham agencies were disappointing but understandable given historic staff attitudes towards recovery through mutual aid.
  • Feedback suggests that staff training was effective in improving staff understanding of and future commitment to 12-Step recovery through mutual-aid engagement.
  • Despite recruitment problems, WRAPP has confirmed TSF as a cost-effective intervention
  • 7 of 16 participants (44%) are still engaged with the 12-Step programmes and meetings
  • a further 5 participants (31%) are pursuing recovery through different routes
  • There is considerable support amongst graduate participants, partner organisations and local staff to build upon the pilot project and develop a sustainable mutual-aid engagement project in Wrexham.

Staff Feedback

STAFF EXPERIENCE & USE OF MUTUAL AID *

Staff Attendance at AA/NA Meetings

Before Training:

83% (30) had never attended a meeting

After Training:

78% (28) said that they intended to attend a meeting

14% (5) have subsequently attended meetings accompanied by AA/NA members

Staff Referrals of clients to Mutual-Aid Groups AA/NA

Before training:

22% (8) Never

11% (4) Rarely

17% (6) NA

25% (9) Sometimes, when appropriate

25% (9) Regularly/routinely

After training:

94% (34) intend referring clients in future, many with enthusiasm

*   Based on feedback from 36 professionals attending CSARS training during the WRAP Project. Studies elsewhere have shown that follow-up is required in order to translate intentions into regular practice ( eg Best).