Is Lived Experience Necessary to Working in Addiction Treatment?
By Kevin Doyle, EdD
NOTE: This was published for the Hazelden Betty Ford Foundation’s monthly Recovery Advocacy Update. If you’d like to receive our advocacy emails, subscribe today.
I get this question a lot: “To work in addiction treatment, do you need to have experienced addiction yourself?”
The answer is: Of course not!
Before commenting further, I first need to acknowledge the contributions that people in recovery have made to the addiction treatment workforce. Having begun my career back in the 1980s, I can attest to the fact that without the contributions of people in recovery, there might not be any addiction treatment workforce at all. For most of history and for many reasons — low pay, stigma, difficult clients/patients, challenging work environments — people with no personal history of addiction and recovery were not attracted to working with people who had alcohol or other drug problems. Were it not for the recovery community — which had a pure motive to serve based on the intimate knowledge that recovery was possible and often transformative — treatment programs may never have been started, might not have remained open, and may not have evolved into the health care institutions that some leaders, like Hazelden Betty Ford, are today.
With that said, let us return to the original question of whether helping others overcome addiction requires first having done so oneself. Again, the answer is no. And when you think about it, the question is kind of strange. With what other physical or mental health disorder is it even suggested that a personal history of having that condition is necessary to treating it? Professional training — that’s what is necessary. Training programs for physicians, counselors, nurses, social workers, and psychologists offer wide-ranging preparation, both academic and experiential, to ensure that practitioners are well-prepared to address conditions with which their patients and clients present. Passion to do the work is helpful, of course, but can come from many sources, not just personal, lived experience. Empathy and the ability to establish a strong, therapeutic alliance and rapport are also important but can come from, or be developed through, many sources as well — starting with professional education and training.
This is not to suggest that connecting with other people in recovery from a substance use disorder is unimportant to the treatment and recovery process. Quite the contrary — it is essential, in my view. The question is: where do peer connections occur? Integrating these connections into the treatment process is what’s important, not hiring only people who identify as “in recovery.” Whatever your opinion of Twelve Step programs, starting with the integration of large, global fellowships like Alcoholics Anonymous or Narcotics Anonymous is a reasonable strategy. Introducing other mutual aid groups such as SMART Recovery, Refuge Recovery, Secular Organizations for Sobriety, and a myriad of others, can also provide connections for patients/clients. Including peer recovery coaches and specialists on the treatment team is another sound strategy. Supportive peers are essential to most people who seek and sustain recovery, and one way or another, should be part of any good treatment experience.
But imagine if we only hired people with schizophrenia to treat people with that mental health disorder, or people who had experienced a heart attack to treat those with cardiac problems. Over-the-top examples, perhaps, but you get the point. Yet, for some in the addiction treatment universe, lived experience is almost seen as a mandatory requirement to work in the field.
I choose to take an “attitude of gratitude” here rather than one of judgment. Were it not for individuals in recovery, as noted above, literally millions of people with substance use disorders would not have received treatment and become the people in recovery that they are today. And while we honor and definitely need those ongoing contributions, imagine what the workforce could look like if more people without lived experience were educated, recruited, and welcomed into this important work. With statistics consistently indicating that only 1 in 10 people who need professional substance use disorder treatment actually receive it, an expanded workforce would provide tangible benefits to this critical societal need.
Kevin Doyle Ed.D., is the president and CEO of the Hazelden Betty Ford Graduate School of Addiction Studies in Center City, Minn.
