Stigma and Recovery Management Among Addiction Counsellors with Lived or Living Experience of Addiction: A Grounded Theory

Background and Purpose:

The importance of persons with lived, and living experience [PWLE] of addiction and recovery from alcohol and drugs working as professionals in addiction treatment in Canada can not be overstated. The grassroots development of the addiction treatment field has been connected to the members of abstinence-based mutual help groups, notably Alcoholics Anonymous. The more recent emphasis on harm reduction-oriented approaches has been partially driven by PWLE, who remains an essential part of the addiction services workforce. However, little is known about how PWLE navigate the requirements for fulfilling their professional roles while navigating the personal lived experience of addiction and recovery.

The objectives of this paper are to a) enhance our understanding of PWLE experiences to inform the addiction treatment field concerning their recovery management, professional development, training and certification; and b) to discuss the implications of understanding addiction recovery as a continuum of improved health and functioning rather than a sustained cessation of alcohol or drug use.

Methods:

Constructivist Grounded Theory was used to inform data collection and analysis. Twenty-two in-depth, semi-structured interviews were conducted with PWLE who held professional job positions in addiction treatment services; 13 were women and nine were men, ages 30-64; nine participants had a university education, 11 had an addiction related diploma and two had either certificate or primary education. Participants were recruited via posters and flyers shared with addiction treatment agencies in Western Canada. Interviews were transcribed verbatim and coded thematically using the principles of Grounded Theory and inductive data analysis.

Findings:

Data analysis yielded information about participants’ lived experience with addiction as a motivating factor to enter the addiction treatment field professionally; their journey was described as a dynamic endeavour with growth and learning. Experiencing setbacks in their recovery management, facing stigma in the very institutions that address substance use issues, and workplace dynamics were part of the challenges encountered. Additionally, despite the proliferation of the harm reduction paradigm, abstinence-based recovery management is more valued than considering recovery a continuum of improved health and wellbeing. Findings suggest the “stages of maturation” these addiction practitioners experienced, with distinct approaches to managing expectation of their personal and professional development, judicious disclosure of their recovery status, and the need for maintaining professional boundaries.

Conclusions and Implications:

Findings contribute to the research on peer-related issues in treatment services and support, not only in the addiction field but also in the closely related mental health field and provide information for updating postsecondary social work teaching and training curricula related to addiction counsellors and other allied professionals. Given the increasing trend of integrating persons with lived experience into traditional treatments and supports for other health issues (e.g., cancer, diabetes; HIV), the study findings' applicability across multiple fields is warranted.