Twelve-step sponsorship is so twentieth century—or so The New York Times would have us believe. In an article published last month in the newspaper’s Fashion and Style section, author Marisa Fox made the case that “recovery coaches,” “once consigned to Hollywood entourages to keep celebrities on the straight and narrow,” are currently trending among upper-class women “from the Upper East Side to the beachfront homes of Boca Raton.”
Last weekend, NPR’s All Things Considered followed the trend, offering a more inclusive description of recovery coaches’ clientele (the stock image that accompanied the report was still a view from the beach).
The historical angle adopted by both news outlets was obvious. The old-fashioned practice of sponsorship—defined by Alcoholics Anonymous as the process by which a person “who has made some progress in the recovery program shares that experience on a continuous, individual basis with another alcoholic who is attempting to attain or maintain sobriety”— presents shortcomings in today’s treatment marketplace. The women featured in the Times have the ability to buy their way out of the social awkwardness and fear of exposure that twelve-step meeting attendance invites. The NPR piece notes that people in early recovery don’t always gravitate toward the most adept supporters— coaches, who are trained to provide practical as well as spiritual guidance, can help solve this long-standing problem.
As historian and clinician Bill White explained, coaches are not sponsors (they don’t do voluntary twelve-step work on “paid time”) and they’re not quite counselors (they don’t diagnose or probe underlying psychological issues). They occupy a new niche in the service economy that employs more than 75 percent of today’s American workers. They are “the new Pilates instructors,” one coach told the Times. They are compensated to be both “cheerleaders” and “beacons of hope,” another told NPR.
Like NPR reporter Martha Bebinger, I think coaches can produce tremendous benefits, both for people in recovery and for the treatment system as a whole. But the proper role of recovery coaches in today’s health service sector also deserves a systemic critique—and not the trolling, “New York Times Style Suction” sort.
The positive qualities of peer-based support services are well documented. An investment in the prevention services delivered by recovery coaches shifts the focus away from the acute care provided by residential treatment or emergency room visits; this saves the system money, while sparing sufferers the agony of addiction-related crises. And coaching works: in mental health settings, trained peer supporters have produced impressive results in randomized clinical trials.
Still, my research on treatment paraprofessionals in the 1960s and 1970s gives me pause. Some of the earliest “ex-addict” professionals who emerged in that era made a living wage, but within a few decades, the combined forces of credentialism, wage compression, and emotionally taxing working conditions put community-based addiction treatment workers on a career path for burnout. Researchers and advocates for “recovery oriented systems of care” know that today’s coaches face many of these same challenges.
If peer-based support works so well, and professionalizing it runs the real risk of exploiting peer providers, it’s tempting to consider a return to traditional, twelve-step voluntarism as a possible solution: today’s coaches could take regular, middle-class jobs, and answer twelve-step calls after hours. Or it would be tempting if—as scholars like Arlie Hochschild have argued—the gift economy hadn’t recently collapsed along with the global one. Hochschild has detailed how, like the recovering clients profiled in NPR’s report, we all need to be taught “how to manage our emotions” in order to be successful in business; how the line between work and home, and between compensated and uncompensated labor, has all but vanished; and how our intimate relationships have been delegated to consultants and service workers. The “sponsored self” in the twentieth century may have been over-psychologized; in the twenty-first century, it’s been outsourced.
What did you make of the recovery coach coverage? Let’s get a conversation going in the comments below.