Toward and International Recovery Research Agenda: An Interview with David Best, PhD

2012·0.25 MB·English

by  White, William L., Best, David

Selected Papers of William L. White
www.williamwhitepapers.com
Collected papers, interviews, video presentations, photos, and
archival documents on the history of addiction treatment and
recovery in America.

Citation: White, W. L. (2012). Toward an international recovery research agenda: An interview with
David Best. Posted at www.williamwhitepapers.com

Toward an International Recovery Research Agenda:
An Interview with David Best, PhD

William L. White
Emeritus Senior Research Consultant
Chestnut Health Systems
[email protected]

Introduction Discovery of Recovery Research

As a new Bill White: David, could you describe your
recovery advocacy initial motivation for specializing in addiction
movement rose in the research?
United States in the
late 1990s and began David Best: Well, I recently read some
to spread around the world, there were calls statistical evidence suggesting one in ten
for the development of a recovery research people in Scotland have an alcoholic family
agenda that could add to the large body of member. My mother’s father was a street
existing studies on addiction-related drinker who was consistently in trouble with
pathologies and addiction treatment the police. My mother was frequently called
methods. One of the scientists outside the on Sundays to bail him out of custody suites
U.S. heeding that call was Dr. David Best. and cellblocks. As I entered my
David was at times catalyst and always close adolescence, my father became an alcoholic
observer of recovery advocacy efforts, first and ended up having to give up his work
in the UK and then in Australia, and led a because of alcohol-related peripheral
series of important recovery-focused neuropathy. So alcoholism was always a
research studies in both countries. It has family issue for me, and I was always
been one of the great privileges of my concerned about those larger issues of
professional career to have collaborated with family well-being and alcoholism and the
David on some of these studies. In August poor quality of treatment services that were
2012, I asked David to reflect on his career available. I mean, you saw your GP, or if it
as a recovery researcher and to share his was bad enough, you’d get sent to detox or
observations about the state of recovery an old psychiatric hospital. Those were
advocacy in the UK and Australia. Please pretty bleak options.
join us in this engaging conversation.
williamwhitepapers.com 1
And entirely unrelated to that, I’d injecting, offending, and risk-taking, but
ended my undergraduate degree in ignored such issues as well-being, purpose,
psychology and philosophy and started work meaning, or connectedness.
on my Ph.D. My primary interest at that point Our services didn’t do well at all: it felt
was about the effectiveness of like our client group really didn’t progress.
communication and how people see things Much of what I wrote at that time was critical
and convey meanings in what they see. of treatment. It eventually took me to the idea
Through that, I got approached by a of medication-assisted recovery, but at that
wonderful eccentric academic at the time, recovery was not the focus. At the
University of Strathclyde, John Booth Department of Psychiatry at the University of
Davies, author of The Myth of Addiction. This Birmingham, we did a large-scale survey
was basically a book about the social and for the first time, really collected the
construction of addiction. Davies was evidence that what we had been calling
interested in how and why people attributed treatment of drug users largely wasn’t really
the addiction concept to themselves and treatment. It was prescribing and a very brief
how much of that was context-specific to chat. There was very little in the way of
deal with the structures of treatment and therapy for clients—no real psychological
support that were available. Davies and I interventions. I was becoming increasingly
worked together on a Scottish Office-funded skeptical and disillusioned about how
grant, which became the subject matter for treatment was being offered and what
my Ph.D. I focused on how people treatment was being offered to people.
understand their own state in and out of
treatment and how they describe their own Bill White: David, was that the beginning of
addiction state. What we were interested in your interest in recovery-focused research?
was five questions: 1) do you see yourself as
an addict, 2) how do you understand yourself David Best: Yes, absolutely. I was very
to have become addicted, 3) why do you skeptical of treatment and then, sparing all
want treatment (or not), and what do you blushes at your end, I came across some of
think it can do for you, 4) why did you see your work and it started me thinking, and I
yourself having a problem, and 5) what does realized this wasn’t the experience that
addiction mean to you and what effect does everybody had. I guess I’d always known
it have on your life? We were very interested there were very different ways people
in the potential therapeutic benefits of trying managed addiction problems, but reading
to change the attributions people have about your work started my search to answer a
themselves and their problems. very simple question: why is there so little
I was then lucky enough to be offered science of success in our field? Why are we
a job at the National Addiction Center in the so insistent on being a science of pathology?
Institute of Psychiatry in London. This was a From that point onwards, six or seven years
major research center for all of psychiatry, ago now, this notion of recovery has been
and I was in a really fortunate position. We my central research concern. There was this
had a significant research unit, but we also review about mental health recovery in the
ran a wide range of clinical services from a British Journal of Psychiatry last year that
large methadone maintenance program to a included the acronym CHIME for
number of residential detoxification and connectedness, hope, identity, meaning,
rehabilitation services, plus a range of and empowerment. That really sums it up for
community support services. It was in the ten me in terms of where I hope the pendulum
or so years I was there that I developed my swings.
focus on recovery. It seemed sometimes like
I was a lone voice in the UK focused on
recovery (which I wasn’t), but most of the
work of this period in the UK focused on very
cold clinical measures of reductions in use or
williamwhitepapers.com 2
Recovery Links to Treatment and Bill White: What do you think about
Prevention mobilizing individuals and families in
recovery as a force for long-term prevention
Bill White: You are one of the few within local communities?
researchers I know whose career has
actually spanned prevention, treatment, and David Best: One of the fascinating social
harm reduction and then ended up with this policy and academic challenges is to
focus on recovery. Did these other areas generate attractive icons of recovery in the
inform your recovery research? community—true recovery champions. I see
these champions as beacons of recovery—
David Best: Oh, absolutely. I feel one of the the walking, living, breathing success icons.
completely unproductive and false In recovery language, the primary purpose of
polarizations is the often portrayed chasm this group is to engage and attract those in
between harm reduction and the recovery active addiction and to engage and attract
movement. You know, I’m still hugely those who are caught in treatment without a
enthusiastic about things like take-home sense of hope or direction. Recovery
naloxone programs to prevent overdose champions can convey the possibility that
fatalities. It seems to me that one of the things can be different and offer living proof
things that recovery literature and evidence of that difference in their own lives. They can
has shown us is a developmental recovery also offer guidance and direction for people’s
perspective. It’s crucial that we offer a range recovery journeys, but I think the point you
of services and supports for different stages make is an absolutely crucial one, that the
of change. Harm reduction interventions like viability and the visibility of those individuals
needle exchanges and naloxone take-home would have an effect beyond people who’re
programs are absolutely essential to the idea initiating their own recovery. They would
of helping people through the initial chaotic become a huge community prevention
stages of addiction and empowering people asset. I think one group that would be
to take control of their own drug use careers interesting to work with would be the
and their own recovery processes. As a aboriginal communities, where there’s
researcher, I have been able to study and anecdotal evidence of precisely that effect—
see the value of a whole range of different individuals who transform themselves and
treatment, prevention, harm reduction, and then help transform their communities.
recovery strategies. What links all of these is
the necessity of interpersonal transmission Early Treatment Outcome Studies
of respect and hope.
Bill White: I’d like to take you to review
Bill White: Has your earlier background in some of the research studies that you’ve
prevention helped you see connections been involved in. A lot of your early work was
between this new recovery focus and in conducting treatment outcome studies.
primary prevention? What were some of the most important
lessons you drew from those studies?
David Best: Absolutely. It seems to me that
the crucial overlaps between recovery and David Best: The vast majority of addiction
prevention are the ideas of empowerment treatment outcome studies show impressive
and social support. These underpinning effects. Treatment can make a massive
social influences are critical processes if you difference in peoples’ lives across a whole
want to understand causes and shape spectrum of measurable outcomes and
effective prevention strategies, early across many modalities, including detox,
interventions, formal treatment rehab, methadone maintenance, and
interventions, and processes of long-term methadone reduction programs. My concern
recovery management. is that we have evaluated such effects on
primarily a short-term basis. We don’t focus
williamwhitepapers.com 3
enough on what comes after the acute attitudes towards those organizations in the
treatments—in short, we study immediate UK. Could you highlight some of your
effects of treatment but not the more findings in this area?
prolonged course of addiction or the
prolonged course of recovery. In the UK and David Best: Yes. One of the fascinating
in the States, we tend to view what happens things around professional services in the
in this longer term perspective in terms of the UK has been their increasing focus on
consequence of the medications or talking technical skills and technical delivery. The
therapies we provide and not broader requirement that staff have professional
influences on addiction and recovery. We qualifications has acted as a barrier to
also still cling to a model that is about former users becoming involved as workers
pathology management, which has two in our field. As a result, there is a mistrust of
implications, the first being that we don’t non-professional community interventions
focus enough on strengths and the second and particularly 12-Step mutual aid groups in
that we reinforce a model that sees addiction the UK and even more so in Australia. There
(and recovery) as incorporated rather than are a whole series of myths that prevent
as being socially mediated and managed. effective cooperation with these groups.
I think we miss two things that matter. There is a pervasive view that cooperation
One is the basic human contact and with recovery mutual aid groups, particularly
relationships that surround addiction AA and NA, are incompatible with a secular
treatment therapies, and the second is the evidence-based model of treatment.
effects treatment can exert on people’s One of things that’s always really
social networks and daily activities. It seems interested me is how little drug and alcohol
to me that the real outcome measures of workers in the UK, and I suspect the same is
value are the social networks people are true here in Australia, actually know about
embedded in, the degree of commitment to the evidence base for linkage of clients to
these social networks, and the things that fill 12-Step groups. Most workers in UK
their daily lives. Services have never been to a 12-Step
The interesting issue for me is much meeting, and the idea that knowledge of
less about what particular therapies and such recovery support resources is a key
modalities we offer and more about whether dimension of one’s professional
we can inspire belief that recovery is development is relatively new. In January,
possible, establish a partnership between we start the first post-graduate diploma
the client and the worker to facilitate that course here in recovery. One of the
change, mobilize recovery supports within requirements for the students, almost all
the client’s natural environment, and link the workers in the field, will be to attend at least
client to those community resources. We one open mutual aid group meeting and
also need to locate recovery within a write a reflection on that experience. I think
developmental perspective that recognizes it will be an enormous challenge for us to
the lengthy (and non-linear) journey that actually get people to do that.
most people experience in recovery. This We did a linkage study that was
means there are plenty of opportunities for a published last year showing, as has been
diverse array of interventions and also that found in the States, people linked from detox
people will evolve in their needs and their services to mutual aid groups have better
resources as the recovery journey recovery outcomes than those not linked to
progresses. such groups. Well, this isn’t really surprising,
but it’s so inconsistent with our prevailing
Studies of AA and NA in the UK treatment philosophies. It seems to me that
one of the crucial parts of the recovery
Bill White: Your reference to community movement is to focus on cultural change in
resources reminds me of the studies you’ve the addiction treatment workforce, and I
done on AA and NA and professional think this is probably more of an issue in the
williamwhitepapers.com 4
UK and Australia than it would be in the prospects of long-term recovery were more
States. We have to first overcome the determined by a person’s recovery capital
suspicions around mutual aid groups and [level of internal and external assets] than by
other community-based recovery support the severity or chronicity of their addiction.
resources. Equally important, we must I’ve become very, very interested in that
address issues around staff burnout, which I issue, particularly the question of what
suggest is related to repeated exposure to constitutes social capital. What constitutes
client relapses without parallel exposure to that connectedness and embeddedness and
clients in long-term recovery. I’m interested belonging that helps people make those
to see if increased recovery orientation in lasting changes? And, because our
treatment helps workers as well as clients. treatment services in the UK and Australia
One of my most disappointing are so typically professionally driven, I
experiences as a researcher was some work became interested in the links between
I did in North Wales a couple of years ago. I treatment and the recovery community and
asked workers in the field to estimate how how the degree of recovery friendliness of a
many people with a lifetime drug and alcohol society affects recovery outcomes.
dependence diagnosis would ever achieve One of the challenges that I still get
long-term stable recovery. Now a recent and I suspect you do also is that recovery is
review from the Center for Substance Abuse just wishful thinking, that there’s not really
Treatment reported an estimated 58% much of an evidence base for it. It seems to
recovery rate. Workers in our field in North me that the potentially predictive power of
Wales estimated that only seven percent, on the growth of recovery capital is one of those
average, would eventually recover. That kind areas where, without having to have a single
of therapeutic pessimism is a major barrier consensual definition of recovery, we can
to the effective implementation of a recovery start to provide a genuine, quantifiable
model and why such a model is so scientific method of measurement of
desperately needed. Too many workers sit change. I’m really quite interested in how
in offices and only see people who’re either recovery capital changes among people who
stuck in active addiction or are in a revolving are and who are not engaged in different
door of treatment services. Rarely do they kinds of recovery groups and other recovery
see the people living full, productive, support activities.
meaningful lives in long-term recovery.
Workers as well as clients need exposure to Community Recovery Capital
these recovery role models.
Bill White: Your work in evaluating recovery
Recovery Stories capital led you back into something you
briefly referenced earlier, which is this notion
Bill White: I’m very interested in the bridge that recovery can become socially
between your work evaluating AA and NA contagious in the life of a community.
and your growing interest in the role of
recovery capital in long-term addiction David Best: I have to say that this has been
recovery. Could you talk about that work? the most exciting experience of this work for
me. It’s what has made this such an inspiring
David Best: It’s just fascinating to me. thing to be involved in—these people who
There’s an interesting thing about doing provide you with such astonishing inspiration
recovery studies, and I’ve collected just over and hope. As soon as you said that, 10 or 15
1,000 recovery stories in total now. And one people’s faces popped into my head almost
of the things I’ve become really interested in as if in a slideshow of people who have just
is the question, “What are the characteristics astonished me, not only with their own
of people who achieve recovery from stories, but their capacity to generate
addiction?” In a paper you did some years change in other people around them.
ago with William Cloud, you argued that the
williamwhitepapers.com 5
I think one of the most astonishing vibrant, and contagious transmitters of
things about recovery is the capacity for recovery in their local communities.
people not only to enable their own recovery
journeys but to give back and make it Recovery Advocacy in the UK
possible for other people to change their
lives. There’s something magical about the Bill White: You’ve had an opportunity to be
coming together of a small group of those both a very close observer and contributor to
attractive, energetic, dynamic, and vibrant the rise of a recovery advocacy movement in
recovery champions. They create such an the UK. How would you describe the rise of
incredibly powerful and positive energy for that movement?
change at three levels—firstly, in their own
communities, secondly among skeptical and David Best: I think one of the fascinating
cynical professional attitudes, and thirdly at and unique challenges of describing this is
the strategic and policymaking that it’s primarily local, and it’s unpredictable.
commissioning level. Those individuals I’m recalling the work we did in a small
really are the recovery movement, and I mining town in Yorkshire where we tried to
regard it as a genuine privilege on my part to generate a small group of people to be
be able to document the experiences of champions for recovery. It was something
some of those individuals. that was astonishingly substantial that
One of the really interesting questions started with a very small group of people
for me at the moment is how we identify and who came together to share their thoughts
support and enable people to become these and ideas. They were from very diverse
recovery icons and recovery champions recovery backgrounds and belief systems,
without threatening themselves, without but they managed to generate a shared set
putting at risk their own recovery. I’ve read of visions and ideas and since then, they’ve
recently quite a lot of literature around the done the most incredible things, including
Social Identity Model of Identity Change, and recovery walks, recovery activities and
there are some really interesting things that events, art days, and family days. It’s been
happen. We know from the literature around such a positive inspiration to observe what
HIV and acquired brain injury that people has unfolded there. But it is dangerous to try
who choose to disclose their status and who, and generalize or to create rules and
as a consequence of that disclosure, are processes about how this happens. It’s very
able to access supportive groups in their idiosyncratic, or perhaps I’m just a bad
local community report higher self-esteem researcher who can’t discover the underlying
and better quality of life. It fits entirely with principles, but one of the fundamental
the notion of connectedness to and components of such movements is that they
belonging within social networks and social have to be locally driven and locally led if
groups, but extends that idea to incorporate they are going to work.
the dynamic influence that a sense of I think one of the beautiful things of
belonging can have on personal wellbeing the emergence of the advocacy movement
and perceived identity—key aspects of the in the UK has been its diversity. In spite of a
recovery journey. And we know such groups couple of attempts to try and homogenize
can support people on their recovery and manage the process, it remains
journeys in terms of a safety net, social wonderfully idiosyncratic and diverse, and
support, quality of life, access to opportunity, incredibly pluralistic in terms of the range of
and access to social resources. I have the opinions and views. I was first frustrated that
most incredible respect for the 12-Step there did not seem to be any central
movement and how people are reconciling movement emerging, but in retrospect, that’s
their anonymity within the mutual aid a genuine strength of what’s happened in the
movement while pursuing concurrent UK. There aren’t any significant national
opportunities to become active, physical, recovery leaders in the UK, and in some
ways, maybe that’s exactly as it ought to be.
williamwhitepapers.com 6
There are important teachers and public health model based on community
documenters, and there are some key assets. The rapid emergence of a recovery
policymakers, but recovery doesn’t have a model at the policy level has forced some
single leader in the UK, and I suspect that’s stumbling as we try and work through what
probably a good thing. The attempts at that means. There is a recognition that this
creating unifying umbrella organizations isn’t more of the same or going back to
have not been convincing to date, and I something we used to do but is instead a
suspect that this is about an intrinsic mistrust fundamental and radical reorientation of how
of professionalization. The movement we view the resolution process from
remains a series of linked networks of addiction. I think the notion of community
powerful, charismatic individuals who come empowerment is part of this, that many of the
together to do some things and don’t come solutions for long-term changes at the
together to do others. It’s much more a primary prevention level as well as at the
series of little cells and units and groups, and level of long-term personal recovery are
that’s a good thing. They share some views community-owned, not professionally owned
and don’t share others. and driven.

Recovery as a New Organizing Paradigm The Recovery Academy

Bill White: In spite of that lack of leadership, Bill White: You contributed to the growing
you have witnessed the elevation of science of recovery in the UK through your
recovery as a new organizing concept at the own research and through your leadership in
policy level. What influence do you see this the Recovery Academy. Could you discuss
new focus exerting on addiction treatment in the work of the Recovery Academy?
the UK?
David Best: Yes. I’m pleased to say we
David Best: It’s been such a fascinating have a Recovery Academy Australia now
process, and it’s a process that I’ve seen gradually coming into fruition. It was officially
also happening and emerging in Victoria launched on September 21, 2012, in spite of
here in Australia. The embrace of the meetings having taken place since
recovery concept has happened much, September 2011 and the walk happening in
much faster by policymakers than by April 2012. The purpose of the Recovery
professionals involved in the treatment field. Academy was to collect existing knowledge
Many of the latter have been resistant to about recovery and build a larger base of
recovery ideas for a whole range of reasons. scientific studies about recovery. There were
It’s been very interesting to watch this so many exciting, innovative activities going
happen in Victoria where the reform road on around recovery in the UK that weren’t
map for alcohol and drug services has being measured or evaluated. The thing I
recovery in its title. That sent shockwaves wanted to do was to bring together
through the field and has led to some unease researchers and academics who are
among workers who see this concept as interested in recovery questions with local
challenging the dominant harm reduction recovery groups. It was an effort to develop
philosophy and leading towards a payment a shared communication and a shared
by results approach. evidence base around what works in the
I think the big advantage of recovery arena of recovery support. And that’s also
as an organizing concept is the rallying cry what we are trying to do with Recovery
for hope that’s allowing recovering people Academy Australia.
who are energetic, driven, optimistic, and Recovery-focused research is
aspirationally based to have a focal point for growing. There are lots of studies that have
their activities. It wasn’t particularly planned been done and more emerging in tandem
that way, but it chimed with a movement for with the mental health recovery movement
localism, for community ownership, and for a and the desistance movement in
williamwhitepapers.com 7
criminology. One of the things that I’d really nervous about the talk of recovery. Many
like to see is a movement towards preparing people thought this was merely a call to
blocks of Ph.D. students to become the return to an abstinence-dominated 12-Step
evaluators, auditors, and researchers who model. I’ve tried to be as conciliatory as
will help answer questions about what works possible because I really don’t see this in
in recovery processes for service either/or terms. It seems to me that in the
organizations and for whole communities. Australian context, the approach one has to
We’ve described the emergence of this take is in expanding options and
recovery orientation of services and opportunities. It’s been very interesting
agencies and workers. It is time to bring that because there are a number of very viable
to an accessible set of measurable tools that recovery agencies and champions. We had
can aid people who’re setting up recovery the first Recovery Walk in Australia. I’ve
communities. championed these events to celebrate the
I think one of the really exciting things astonishing achievement of recovery, to
about recovery is it’s a different paradigm. socially link people in recovery into networks
We can and we will utilize the traditional of mutual support, to help people engaged in
methods and the trials and outcome studies long-term treatment engage in a more
if we need to, but I think recovery science will encompassing recovery process, to engage
be far more diverse and pluralistic in its family members, partners, and children of
research methods and its use of social people in recovery, and to challenge social
media. I think that we can try and develop a stigma and discrimination. So, we had our
core set of beliefs and values and first ever Recovery Walk in Australia with
understandings about the why and the how more than 400 people taking part.
of recovery research. One of the challenges One of the things that’s been of
you and I face is how to articulate and concern for me has been the number of
support the development of a recovery professionals who are in recovery but who
research language that’s credible and will not talk about this because they fear in a
meaningful to policymakers and service harm reduction-dominated system, this
providers while also being consistent with could have significant adverse effects on
the values of the people that we’re working their careers. There still remains a significant
with. barrier to people becoming visible in their
recovery because of fears of adverse
Recovery Research and Advocacy in reactions from a relatively small but vocal
Australia group of militant harm reductionists. That’s
now beginning to change. I did a
Bill White: I’m very interested in your presentation to the Chapter of Addiction
transition from the UK to your work in Medicine in Victoria earlier this week on
Australia and the similarities and differences recovery, and I’d expected a fairly hostile
you’ve found in terms of recovery research time of it as I probably would have had a year
and the comparable status of recovery or so ago. I really need to say that the
advocacy. message is getting through, that the
Recovery Advocacy Movement is making a
David Best: I think one of the things that positive contribution, but it’s a gradual
Australia’s quite proud of is a very effective process. In the book that you edited with
and successful harm reduction movement. John Kelly, several authors noted that this
There’s been considerable commitment and recovery transformation process at a
resources given towards needle and syringe systems level takes five to 10 years. In
programs as well as methadone Victoria, we are at the start of this journey
maintenance programs. Achieving that has and there are other parts of Australia,
been a significant struggle, but it is now well- including New South Wales, where the
established and a dominant model. That’s journey simply hasn’t started yet and where
why a number of people are very, very there’s considerable resistance to it.
williamwhitepapers.com 8
recover from addiction, and I’ve documented
Bill White: Australia would seem to be the how recovery varies from person to person.
ideal setting to conceptually integrate It’s idiosyncratic, but it happens, and we can
recovery and harm reduction perspectives measure the changes involved. I think that
and methods. Do you have hopes that this getting that message through to
will occur? policymakers, practitioners, and the public is
important, but even more important to me is
David Best: Absolutely. I think there’s a real helping increase the visibility of the
opportunity for it here. It’s starting with the advocacy movement and the sense of hope
idea of medication-assisted recovery. How and pride that it is generating among people
can we bring recovery champions and in recovery. Recovering people are
recovery-focused social connections to long- beginning to fully recognize the value they
term prescribing clinics? I think one of the can be to each other, their families, and their
other things that’s potentially quite useful communities. I’d like to think I’ve helped stir
here is that the mental health recovery that recognition.
movement has been well-established and is I’m particularly pleased with what has
well-supported in Australia. Because many unfolded in Yorkshire in the UK. We started
of the large new health providers cover both this fledgling local recovery movement in
mental health and alcohol and other drug Barnsley last year with a group of maybe 20
problems, I think some cross-contamination to 30 interested people. This work has led to
and cross-fertilization is going to be possible. an incredibly vibrant and diverse set of
Australians are generally such an upbeat, activities and events that have inspired all
positive, and enthusiastic group of people. kinds of community groups and individuals
It’s such a young and vibrant country with and have changed the beliefs of people
incredible resources. I realize I’m gushing a about what they can do and what their peers
bit here, but it’s an amazing place, which can achieve. I am currently taking this work
affords the opportunity for innovation and forward in York, where there is enormous
trial. There are just huge opportunities here potential to generate networks and
for trying to do things in a different way that communities of recovery supported and
would be meaningful for individuals, families, inspired by a commissioning team
and communities. committed to recovery and a city that
I have this vision of linked networks of recognizes the enormous potential and
community connectors consisting of three resource of people in recovery. Within only a
levels of people in recovery and members of year, we’ve received a commitment of
their families; workers in specialist agencies; support from the city, we’ve got an
and visionary community leaders, each expanding and growing army of champions,
engaged in growing and binding networks of and we’re seeing this blossoming of hope.
personal and social capital that are linked Any role I could have played in helping
through activities and a common vision. spread this contagion of hope is a far better
Their joint activities and their recovery achievement for me than any of the research
advocacy become beacons of hope and studies I’ve written or published.
hubs of change in deprived communities.
Bill White: David, thank you for taking this
Personal Reflections time to share your experience and
perspective with us, and thank you for all you
Bill White: If you look at your work to date, have done on behalf of people seeking
what do you feel best about? recovery.

David Best: I would like to think I’ve helped
shift the recovery movement forward in the
UK and in Australia. I’ve provided evidence
that challenges the notion that people don’t
williamwhitepapers.com 9