Just as our own methods of recovery shift throughout the course of our healing journey, so too have models of substance use treatment evolved since the advent of twelve step programs in the 1930s. Historically, the expectation for substance use and addiction treatment was hyper focused on finding and following a particular self-help pathway (like the twelve step model) that may have been initiated in inpatient or intensive outpatient treatment, or picked up independently, and continued into an outpatient level of therapy. These days, the process of recovery is often still referred to as a pathway—which may seem like the appropriate term, however, it implies that there is a singular chosen path of recovery which is not always the case. In the past, there were far fewer self-help and treatment program options for people seeking recovery, as well as less access to resources, so limitations weren’t always challenged. Post pandemic, the recovery landscape has changed  dramatically via increased innovation, technology, accessibility, and variety. Movement has been made towards a fluid and adaptive approach to recovery that resembles a patchwork of non-linear layers and choices, weaving pathways with patchworks of recovery creates a more diverse, inclusive, durable, and healing fabric that benefits all. 

So what has shifted? If you are in early recovery and/or are pursuing sobriety, a pathway or singular patch might be necessary for you to feel a sense of containment and stability or you may have a need for consistency or struggle with change. If so, stick to what works for you. If you are in the maintenance stage of your recovery, you may have the desire to add some more patches to your recovery fabric by exploring different healing modalities or maybe you have already integrated new support groups, spiritual practices, or self-care activities to your existing self-help program. In long-term recovery you may experience acclimation to your current pathway and may seek something to reinvigorate your program and enhance your recovery. At any stage in your recovery journey, you may encounter resistance from peers and/or leaders in the spaces you currently occupy because the philosophy of weaving multiple pathways and patchworks of recovery is still very new in our society. It is important to remember that:

• Everyone’s recovery patchwork is unique
• It is okay to think outside of the box and add or shift your process
• Including a therapist, recovery coach, or mentor in these adjustments to discuss if they feel comprehensive enough to support your specific recovery needs can help you make the most informed decisions for your continued growth.

What are some possible patchwork options? They may include shifting, adding, or changing self-help groups and clinical resources to adapt to your evolving recovery lifestyle needs. This can involve re-evaluating your recovery wellness domains: physical, psychological, vocational/academic, interpersonal, spiritual, and home environment. It is also possible to be involved in a self-help program while adding in meetings from other sources—especially in this age of virtual meeting options. Different programs and offerings have been created to satisfy the differing needs of individuals recovering from substance use and include but are not limited to:

• Alcoholics Anonymous: 12-step and peer-led spiritual program for alcohol use disorder
• Celebrate Recovery: 12-step and peer-led Christian program
• LifeRing: A secular, non-profit organization providing peer-run addiction recovery groups.
• Narcotics Anonymous: 12-step and peer-led spiritual foundation for other substance use disorders
• Dharma Recovery: Buddhist-based program
• Secular Organization for Sobriety (S.O.S): Atheist and agnostic peer-led program
• SHE RECOVERS: Professionally facilitated,women-centered online gatherings, recovery support groups, and in-person sharing circles for women and non-binary individuals in or seeking recovery from mental health issues, trauma, substance use, eating disorders, and related life challenges
• SMART Recovery: Cognitive Behavioral skills-based trained peer-led program without a spiritual component
• Women for Sobriety: Spiritual peer-led program for women

Patchwork options can also include the pursuit of deeper layers in your mental health healing process such as: therapy, healing arts, embodied movement such as recovery-focused yoga and dance, meditation, breathwork, medication management, lifestyle changes etc. Spiritual pursuits can be another patch on your quilt and based on your current religion, ancestral beliefs, more general spiritual pursuits, exploring new ways to connect with source/higher power/creator/the universe. For some, connecting with nature allows them to sense something greater than themselves. Others have found different pursuits that allow for feelings of awe and recharge. 

What is most important in the process of recovery is to find folks in the therapeutic and self-help worlds that value individualized care. While there are certain frameworks and levels of care that may apply to most people in recovery, there are also variations that should be respected. Each individual will have their own experience (positive, negative, or neutral). Exposure to the concept of a patchwork as well as new options to integrate into a robust support framework can encourage longer-term recovery by making it more stimulating and dynamic. This concept can also be a relief for those who have already been creating their own patchwork but had either received negative feedback or were concerned about others opinions.

Where can you go? It is important to have open discussions with potential recovery support providers, treatment programs, and self-help organizations and ask questions. If their vision of recovery care doesn’t fully align with your values, find out where they stand on redefining recovery and creating systems of support that evolve with their clients. Do they have a broad enough scope of recovery care – one that is inclusive, equitable, and empowering for all? Can you supplement with other modalities? Do they seek to remove barriers to wellness and see recovery as a holistic experience? This inquisitive approach allows you to practice personal agency in defining what recovery looks like for you. Whatever framework you choose, ensure the structure evolves with you, and that it provides connection, support, and empowerment along your healing journey.

Examples of organizations that use a patchwork method in supporting recovery are Aware Recovery Care and SHE RECOVERS. Aware offers individualized one-on-one in-home addiction treatment that welcomes multiple recovery options, and supports their clients over a 52-week-long program. They transform the home into the treatment center, delivering comprehensive, innovative, and individualized recovery services to those in need right where they live. The program was founded as an alternative to more traditional levels and forms of care.

SHE RECOVERS was co-founded by Dawn Nickel who was, and still is, a member of a 12-step program who also sought out additional individualized, empowering, and holistic opportunities for connection to support her recovery. The SHE RECOVERS offerings are largely offered for free due to the support of their donors and are intended for women and non-binary individuals who identify with women’s groups in or seeking recovery from mental health issues such as anxiety and depression, trauma, substance use, grief and loss, overworking, codependency, eating disorders, burnout and moral injury, love addiction, chronic illness, and related life challenges. All pathways and patchworks of recovery are supported in their trauma-informed and welcoming spaces, and community members are invited to experience the connection, support, and empowerment through online gatherings, in-person sharing circles, self-help and identity-based support groups, trauma informed yoga and dance offerings, and more—adding their own unique and diverse patches to create a truly inclusive and individualized recovery quilt which they can wrap around themselves.