The impact of remotely delivered collaborative peer recovery coaching

(CPRC) on recovery capital resources, in subjects with poly-drug use issues.

Presented by Maria Pau

COLLABORATIVE PEER RECOVERY COACHING (CPRC)

Motivation and goals attainment are the key

Contribute to lessening DALY, YLL, YLD

Remotely delivered intervention

International Coaching Federation (1995)

Recovery Coaching International (2002)

CPRC by Maria Pau (2010)

PRIOR LEARNINGMaster of Public Health, UQ

Alcohol, Tobacco and Other Drugs Stream Qld Alcohol & Drug Research Education Centre

I am accredited with the following:www.CoachFederation.org

www.RecoveryCoaching.org

www.Givenow.Com.Au/CoachingWithSubstanceAlmost $50,000 AUD raised on this portal

Community Services Industry Expert at:www.clet.edu.au/about-clet/coaching-with-substance

PRIOR LEARNING

<< Published 4 Books about my life as a peer in recovery

www.Twitter.com/OzRecoveryCoachOver 4,700 followers

www.YouTube.com/AddictionHelpQLDOver 125,000 views

www.Facebook.com/CoachMariaPauAlmost 3000 friends

www.Facebook.com/AddictionHelpQLDAlmost 2000 fans

LEARNING PROFILEPractical Knowledge and understanding of (workshops delivered recognised in community):

domestic violence foster care abuse perpetrator behaviour criminality substance use disorders (SUD) suicide self-harm addictive behaviours such as

gambling, overeating, co-dependence and sex/porn addiction

LEARNING PROFILE Help clients recognise their strengths

and weaknesses

Instil discipline

Extinguish unwanted behaviours

Increase motivation for change

Own self-actualising behaviour and consistent role modelling

Successful governance of Not-For-Profit Board

LEARNING AREAS TO BE ENHANCED

Critical judgement – The ability to demonstrate deeper self-reflection stronger deductive & inductive reasoning better understanding of project management and governance

Analytical Skills Greater understanding and application of statistical research design, methods,

and data analysis

Communication Skills Mastery of dissertation writing skills using academic language in a powerful,

informative yet concise way

Coaching Skills Increase dimensions of intuitiveness and reading of body language Rapport building Mirroring of client language

LEARNING OBJECTIVES Gain a clearer understanding of specific

coaching practices that can increase clients’ recovery capital, emotional stability, mental clarity, heart-brain coherence and overall mental wellbeing

Enable clients to learn to identify and achieve desired personal outcomes (goal attainment) through participation in collaborative peer recovery coaching (CPRC)

PURPOSE OF STUDY Combat substance abuse,

now 5th leading global disease (now at 30% prevalence)

In 2010, 183,900,000 disability adjusted life years (DALYs)

Contribute to lowering DALYs and prevalence of SUD

RESEARCH QUESTIONS Can collaborative peer recovery coaching (CPRC)

enhance recovery from poly drug use?

Which factors are significantly influenced in recovery?

What effect does CPRC have on emotional stability?

Does CPRC improve mental clarity and coherence?

Can the CPRC intervention increase recovery capital resources and over mental well-being?

CULTIVATE RECOVERYTo Increase Recovery capital resources:

1. Sobriety2. Psychological Health3. Physical Health4. Community Involvement5. Social Support6. Meaningful Activities7. Housing & Safety8. Risk Taking 9. Coping & Life Functioning10. Recovery Experience

MENTAL CLARITYHeartmath can be measured (by EmWave) = clarity

Improve decision making

Solve problems

Concentration

Focus and mental aptitude

Express oneself

Memorise & multitask

LITERATURE REVIEW

LITERATURE REVIEW

Grant (2003) pioneered coaching studies, n=20 found significantly increased goal attainment, quality of life and decreased depression and stress when coached

over 13 weeks

LePage (2012) did coaching with treatment clients (3

groups), n=54 (see Table next slide) those coached had

significantly less relapse rates

Increased Self

Esteem Bar

(2014)

Better care

planningIrwin

(2014)

Better social

supportfrom peer

coachAndreas et

al(2010)

Abstinence

Kronenberg

2015Decrease

d Waist Line

Ashbrenner et al

(2015)

High program engagementraes

Simon (2011)

Better outcomes

from offenders

Smyth (2014)

Promote self

determination

Lindgren(2011)

Longer participatio

n in treatmentYoshida(2012)

Smoking cessation, Mantler

(2010)

42 out of 45 studies yielded positive results shown belowAll studies post-2010 except Grant’s (2003) seminal work

Coaching studies were across: offenders; executives; homeless veterans; mentally ill; disabled; obese; with diabetes; chronically ill; youth and children; military; with ADHD; in sports, with offenders and remotely delivered (online or telephone coaching)

RECOMMENDATIONS FROM LIT REVIEW Work with higher sample numbers

Examine different aspects of recovery

Use the EmWave device to actually measure physiological evidence

LE PAGE (2012)

WORK-BASED PROJECT Qualitative Report, n=46

Preliminary findings about CPRC

What factors affected recovery

Provide insights into the proposed study

Case studies of self-efficacy and self-determination

Transcripts, videos and audios examined

METHODOLOGY Post-positivist paradigm

Randomised controlled trial (RCT) to test the efficacy of coaching on long-term recovery

Two groups: no intervention and with CPRC

Measure and Tools: AUDIT, ASSIST, DUDIT, K10, Recovery Capital,Emotional Stability, Mental Clutter Scale and Heart-Rate Variability

Measuring Tools administered three times, in the beginning, middle, and at one year or end of coaching.

Non-parametric test to compare groups

SPSS and Nvivo software

NULL HYPOTHESIS Ho1: There is no statistically significant difference in the

levels of alcohol and drug use scores for poly-drug users who received one year of CPRC compared to those who did not receive CPRC.

Ho2: There is no statistically significant difference in the assessment of recovery capital resources and overall well-being for poly-drug users who received one year of CPRC compared to those who did not receive CPRC.

Ho3: There is no statistically significant difference in the levels of mental clarity, heart-brain coherence and emotional stability for poly-drug users who received one year of CPRC compared to those who did not receive CPRC.

RECRUITMENT 100 to be recruited and randomly split 50/50

GC Bulletin and other rural newspapers

Contact rural and remote area groups Rural Health Workforce Health Workforce QLD

Contact rural and remote area universities, schools and other Not-for-Profit groups

Contact International Coaching Federation, n=20

DATA COLLECTION #1

AUDIT

DATA COLLECTION #2

ASSIST

DATA COLLECTION #3

DUDIT

DATA COLLECTION #4

K10

DATA COLLECTION #5

RECOVERY CAPITAL

RECOVERY CAPITAL

RECOVERY CAPITAL

RECOVERY CAPITAL

Emotional Stability Test Always

Often Sometimes

Rarely Never

 

  1 2 3 4 5  1.  My life is better than most

people around me. 

2.  People seem to like me just as I am.

 

3.  I am afraid of being rejected by my loved one/s.

 

4.  I use whatever means possible to get ahead, even if it seems questionable.

 

5.  I don’t have time to chat to people who are always depressed and gloomy.

 

6.  I don’t feel useful and worthy.

 

7.  I am undisturbed by emotions or panic.

 

8.  I am hopeful.  9.  I think obesity is a personal

choice to be stupid and lazy.

 

10. 

It don’t like it when there is so much diversity in our cultures as it gives way to confusion and many different points of views.

 

DATA COLLECTION #6 EMOTIONAL STABILITY

EMOTIONAL STABILITY SCORESPessismism vs. Optimism Score: _________

Question 1, 8, 11 and 16 Pessimist 20/20 Optimist 4/20Apathy vs. Empathy Score: _________

Question 4, 5, 13 and 17 Apathetic 4/20 Empathetic 20/20Dependence vs. Autonomy Score: _________

Question 3, 6, 12 and 20 Dependent 4/20Autonomy 20/20Anxiety vs. Calm Score: _________

Question 2, 7, 14 and 19 Anxious 20/20 Calm 4/20

Aggression vs. tolerance Score: _________

Question 9, 10, 15 and 18 Aggressive 4/20Tolerant 20/20

MENTAL CLUTTER SCALE #7Circle the one number that best describes problems during the past week:

No problem Severe Problem

Concentration 1 2 3 4 5 6 7 8 9 10

Memory 1 2 3 4 5 6 7 8 9 10 Staying Focused 1 2 3 4 5 6 7 8 9 10

Multitasking 1 2 3 4 5 6 7 8 9 10 Expressing Yourself 1 2 3 4 5 6 7 8 9 10 Thinking Clearly 1 2 3 4 5 6 7 8 9 10 Perceptual Clarity 1 2 3 4 5 6 7 8 9 10 Mental Speed 1 2 3 4 5 6 7 8 9 10

MENTAL CLUTTER SCALECircle the one number that best describes how you frequently experienced the problems below during the past week:

Not at all All the time

Spaciness 1 2 3 4 5 6 7 8 9 10

Haziness 1 2 3 4 5 6 7 8 9 10 Confusion 1 2 3 4 5 6 7 8 9 10

Cluttered Thinking 1 2 3 4 5 6 7 8 9 10 Fogginess 1 2 3 4 5 6 7 8 9 10 Rushing Thoughts 1 2 3 4 5 6 7 8 9 10 Fuzzy Headedness 1 2 3 4 5 6 7 8 9 10 Information Overload 1 2 3 4 5 6 7 8 9 10

EMWAVE DEVICE #8

EMWAVE DEVICE

ADDRESSING LIMITATIONS Attrition

Retention

Delivering high sample numbers

Scheduling

Cancellations

Data Integrity (self-reporting)

ETHICAL CONSIDERATIONS Relationship may be unequal

From vulnerable group

Special care to gain consent

Confidentiality issues

Detox remains dangerous

Referral partners needed

Respect the right to say no to ‘video recording’

STUDY OUTCOMES Decrease or eliminate alcohol & drug

use

Increase recovery capital resources

Increase emotional stability

Increase mental clarity

Increase heart-brain coherence

Increase overall mental well-being

BENEFITS OF STUDY Prevention for the 8.6 million MH/AOD lives lost p.a. (2013)

Addresses the shortage of workers in rural & remote areas

1/3 are victims of alcohol-related abuse in rural areas

There are higher rates of drug & alcohol use in rural/remote

Addresses low retention rates (treatment)

Increase engagement & participation rates (rehab)

In the long-term, reduces $56 billion a year costs (Australia in 2008)

ORIGINALITY First study in Australia on recovery coaching

Measures alcohol & drug use three times over a period of a year

Measures specific factors contributing to sobriety Mental clutter Emotional stability Recovery capital resources

Use of emWave device to confirm physiology of coherence

Findings will broaden insight into purposeful and meaningful recovery

Can be duplicated in wide range of context

TIMELINESRecruit 100, randomly assign n=50, n=50

Mar 2015

Maria to start coaching Til Mar 2016

Listen 46 client video logs & start qual. report

Apr-June ‘16

Start recruitment of coaches and confirm, n=20

July ‘16

Recruit 100 for coaches, randomly assign 50/50

August ‘16

Complete Preliminary Qualitative Report August ‘16Collate and clean all data Sept ‘16Start writing dissertation process Nov ‘16Ensure coaches clients’ are all on track Feb 2017Complete SPSS stats analysis Maria CPRC data

By Jun 2017

Collect coaches data By Aug 2017

Complete SPSS stats analysis of Coaches data

By Oct 2017

Ongoing refinement of dissertation with stats

Jun-Dec 2017

Finalise dissertation with qualitative report By Feb 2018

RESEARCH OUTPUTSActivities and Deliverables AmountResearch Placement Students & Volunteers $1950ICF Application & Admin Fees $500Ads in GC Bulletin & other newspapers & FB Ads

$1950

Online Survey Automation and Admin Fees $500Solicitation of gift vouchers for participants $800Travel Costs – Toowoomba – GC- Ipswich $1000Office supplies, internet & phone $1900emWave Pro + mobile emWave $654Coaching Fees $25000 TOTAL

$34,354

APPENDIX Research Letter to Potential Partners

Consent and Confidentiality

All Measuring Tools

REFERENCE LIST 38 sources