REC CAP assessments are where the journey of Measure Plan and Engage begins. This is part of the transition from a deficits-based to a strengths-based model of recovery in which the growth of assets, and the overcoming of barriers, is mapped to help support positive and sustainable change.
Recovery is a long and challenging but rewarding journey in which people continue to grow and have development needs long after they have stopped using drugs or alcohol. They can also have ongoing physical and mental health problems, issues with relationships and family, and challenges about employment, leisure, and housing, but the goal is to help them live meaningful lives despite those challenges. The REC-CAP is based on the premise that you must deal with acute crises that arise in a recovery journey before you can focus too much on building the strengths and skills that people will need to achieve lasting and stable recovery.
Ideally, the REC-CAP is completed by a client on their own before meeting with a recovery navigator to review it and plan unless it is the baseline assessment. Of course, this may not be feasible in cases where clients have trouble with reading or do not understand English. Recovery navigators should sit with clients when completing the baseline (first) REC-CAP to make sure the client understands the different questions asked and to help guide the client through the process for the first time. The important thing to note is that recovery capital navigators should answer any questions the clients have about REC-CAP completion as objectively as possible and without guiding them to select certain answers, even if they feel a client’s response is not completely accurate. There will be time when reviewing the client’s summary report with them for a recovery capital navigator to further engage with a client in reflection.
When you meet with your client to guide them in completing the REC CAP assessment there are a few foundational principles you should know first.
First, ensure the client is aware of their data protection rights and that they have signed into their portal to review the consents to participate in deidentified research.
Second, assume your client has no knowledge about Recovery Capital, the REC CAP assessment, why they are completing it, and may be apprehensive regarding perceived negative consequences of responding openly and transparently.
The longer it takes the better. Take the time to learn more about your client and we encourage you to share your own lived experience with them along the way too. Ask your client about their recovery journey and to share.
Explain how important it is that they are honest. Honesty is the bedrock or “foundational principles” upon which resilient recovery is built. It is the client that is the primary beneficiary of openness and transparency.
There are no wrong answers in the REC-CAP. The evaluation is designed to help ‘place a pin’ in their Recovery Journey Map so that the client can chart a course towards their next destination point.
Explain the MPE cycle: Evaluations are completed within 72 hours of their due date, starting with enrollment (baseline) and then follow-up evaluations are completed according to your organization’s portal configuration. Results from each evaluation inform the recovery planning process until the next evaluation is completed and this is an ongoing cycle.
REC-CAP Sections
We start the measure by displaying the client’s basic demographics (Section 1: Demographic Characteristics) and then use five brief measures of health and wellbeing to get a 'global' sense of how people feel on that day (Section 2: Quality of life and satisfaction). These indicators are on a sliding scale up to 20 that will to change over time. The total score is summed across these items and totaled out of 100 which provides us with the basic overall metric of wellbeing and quality of life with higher scores indicating stronger well-being on that day. Although the REC-CAP is primarily a strengths-based measure, it is necessary to be aware of acute barriers and unmet service needs. Sections 3 and 5 address these issues:
Section 3: Barriers to recovery deals with recovery barriers and there are five areas which are measured:
(Unstable) accommodation
Substance use
Risk taking
Offending and other involvement with the criminal justice system
(Lack of) employment and training
The goal is to see whether there are areas of acute problems such as housing instability, ongoing drug or alcohol use, involvement with the criminal justice system or lack of any kind of meaningful activities that would stop people from moving on with their recovery journeys.
The evidence suggests that it is very difficult to grow strengths while these acute problems persist so the goal is to address these needs urgently, which may involve new or different engagement with some of the specialist support services outlined in section 4.
Section 4 (Services involvement and needs) further examines potential barriers to stable recovery that come from ongoing specialist help needs in a wider range of areas that extends the list of potential problem areas to include:
Drug treatment services
Alcohol treatment services
Mental health services
Housing support
Employment services
Primary healthcare services
Family relationships
Other specialist help or support
If there are no linked acute problems from section 3, then these can be regarded as chronic and ongoing problems to be addressed as part of a gradual process of change over time. This section is designed with three columns that assess whether the individual:
is currently engaged with any of a selection of services,
is satisfied with the support they are receiving in the selected area(s),
if they need additional help.
Crucially, this section will tell you two things – what ongoing professional support the person is involved with and whether they need additional professional support and help. It is where there are unmet needs that there is an immediate need to respond by supporting the person to access the kinds of help they think are either not being addressed or not being addressed sufficiently by other professionals. Your role, as the recovery navigator, is to support engagement with the relevant resources (effectively, this is a form of case management or care coordination-see unit) and may involve providing contact details, arranging an initial appointment, and helping to prepare the person to engage with the service.
Having addressed potential barriers to recovery the next goal is to switch our focus to strengths! This is the key to the REC-CAP and the resources and strengths identified here are the bases on which further recovery growth will be built. These are addressed in Section 5: Personal Recovery Capital, Section 6: Social Recovery Capital, and Section 7: Involvement with recovery groups and the community.
The basic approach for these three sections is developed from a scale that was written as a collaboration by recovery researchers and writers (William White, David Best and Teodora Groshkova). These measures are known as the Assessment of Recovery Capital (Groshkova et al., 2012) and the Recovery Group Participation Scale which consists of 14 questions measuring a single dimension (Groshkova et al., 2011). In addition to these scales, there are several questions asking about whether a client feels they could use the support of additional recovery groups in their community and four questions on whether they feel they are getting different kinds of supports from their relationships and social networks.
The way these scales are structured is that there are 50 questions in total that break down into 25 questions about personal recovery capital and 25 questions about social recovery capital, with each of these areas further broken down into groups of five questions about specific areas as listed below.
PERSONAL RECOVERY CAPITAL SUB-SCALES
Recovery experience
Global health (physical)
Global health (psychological)
Risk-taking
Coping and life functioning
SOCIAL RECOVERY CAPITAL SUB-SCALES
Meaningful activities
Housing and safety
Citizenship and community involvement
Social support
Substance use and sobriety
All of these areas are about strengths that are relevant to sustaining the recovery journey. Similarly, the Recovery Group Participation Scale is designed to capture involvement and engagement with recovery-specific community supports. Some clients may not feel that recovery-specific supports are available or of interest to them in their community: talking with them about alternative ways to engage in community services and organizations may help get them better connected to support(s) they will successfully engage with.
The second part of community engagement is about general community resources not recovery specific ones. In this section we are assessing active participation in the local community.
Additionally, section 7 also contains an extra four questions social support measure that focuses on social capital and social identity.
Next, our final sections move back to the individual and their own motivations for engaging in the program and on a recovery journey in Section 8: Commitment and Section 9: What do you see as your needs?
In Section 8, clients will be asked to complete the validated scale, Commitment to Sobriety (Kelly & Greene, 2013), to assess how committed they are to their recovery journey, specifically by assessing how they feel about using substances.
Section 9 has a series of open-ended questions where clients are asked to describe their goals, where they see themselves, who they rely on, and what they might need. These questions aim to put the client in a reflective mode where they consider why they personally might be involved in this process and if there are things about their experience that the REC-CAP does not capture and are important to know. The aim of this last section is to ensure that the client’s individual and personal needs are included as well as the shared measures that we know are predictive of recovery. This last part is crucial in supporting the recovery capital navigators to help the participants develop their own personal recovery plans and journeys. Section 9 is crucial because it provides the personal and individual parts of their recovery experience– the job of the recovery navigator is to help to reconcile these aspirations with the profile that they build up with the shared recovery elements of the earlier parts of the picture.
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