An episode of “Changing the Conversation” podcast
Tiffinee Scott shares strategies for supporting families navigating recovery with host Ashley Stewart.
July 1, 2024
Ashley Stewart, Host (00:05): Hello everyone and welcome to Changing the Conversation. I’m your host, Dr. Ashley Stewart, the director of the Center for Health Equity at C4 Innovations. We have a very exciting topic planned for today. We’re going to be talking about recovery support and family education. And I am joined by Tiffinee “T” Scott, And T. is the Maryland Peer Advisory Council president and a wonderful advocate joining us from Baltimore, Maryland. Tiffinee, I’m so glad to have you on the podcast today.
Tiffinee “T” Scott, Guest (00:38): Well, thank you for having me and good afternoon to everyone.
Ashley (00:41): Awesome. Awesome. And really leaning into this from a quite practical standpoint, one of the things that I appreciate so much about opportunities to talk to you, Tiffinee, is the authenticity that you bring to the work, to your advocacy and the expertise that you have been now sharing across states and at the national level. So I’m just really grateful for the opportunity to talk about this particular topic with you. And so maybe to get started, would you mind sharing how you got into this work around recovery support and family education? And maybe just a little bit about the Maryland Peer Advisory Council.
Tiffinee (01:22): I’m a person with lived experience from a family perspective. And what that means for me is that my parents have navigated their process of recovery, and that’s what really springboarded my position for advocacy. I began doing some small work in my garage at the age of 13, organizing people who, specifically kids, friends of mine who had lost their loved ones. It was a time when there was a hard worn drugs issue in my community and across the state and young people were being impacted specifically. So in my garage, I charged 25 cents. I talked about it all the time, and young people were able to come in and have conversations around what is going on in our communities and our families specifically through that work.
(02:16): Eventually I was involved in peer recovery support. My role in peer support really was centered on families. So I did some volunteer advocacy work with a Family Drug Dependency Court — at that time it was called, now it’s called Recovery Courts, — and I was able to work with families who were impacted and really talk about education. I saw the disparity of individuals not being knowledgeable, not only the families that were impacted, but the loved ones who were at home.
Ashley (02:48): That is so amazing. I’ve heard you speak so many times and I hadn’t heard you tell that part of your story before. That’s so powerful. That’s so beautiful. And thank you for sharing that with us today.
Tiffinee (03:01): Every time I talk about families, I get energized. I think it has a lot to do with my personal lived experience. And if you see, every time I sent an email, you’ll see a video of my mother and I. And I didn’t know for many years, she preserved that garage.
Ashley (03:20): Wow.
Tiffinee (03:20): I did not know that. And you can see where one of my friends tried to spell mustache and it’s spelled wrong, but the 25 cents is sitting up there and all of our names are like… We did it with a lighter on the ceiling. I mean, I got punished for that for weeks, [laughter], but you can see the garage where I was actually letting people come in. I’m telling you, I thought she painted over it years and years ago.
Ashley (03:47): [Laughter] There might be some folks who are listening who don’t know too much about families getting access to support or even what that means and what family education is. So can you clarify a little bit about what family support looks like and family education?
Tiffinee (04:06): From a lived experience perspective, what I learned from my own family as they were attempting to navigate the recovery process was the loved ones who were extension to me, who were caring for me, in my parents’ absence really didn’t have the educational component around substance use, the impact of that and the recovery process. So when I had the opportunity to get involved in a volunteer capacity, one of the things I thought was really important to let not only the person serve that I was supporting, but also that family member, that extension, what is the disease of addiction like? What is the impact of that? What does it look like for a person who is involved or engaged or interested in recovery? What would that look like for the family and how to connect them with those supports?
(05:02): Families are often absent from the discussion of education. And what that means for the family member or for the listener here is really unlearning everything you know about substance use addiction and to recovery, learning about multiple pathways, learning about resources that are available to you, learning how to get involved and learning about the reunification process for family members who are accessing services and returning home to their families in their community.
Ashley (05:35): Wow, that’s so powerful, Tiffinee. And as you’ve grown in doing this work, starting off creating — I mean you were running counseling groups [laughter], support spaces in your garage to now doing this, I think on a pretty… I know you’re doing this in Maryland, but I certainly see the impact of what you’re doing in a lot of other spaces as well. What do you think are one of the bigger barriers that show up for families, perhaps is it stigma? Is it bias? Is it a lack of information or knowledge? What are you seeing as those gaps?
Tiffinee (06:13): The main gap is the stigma that lies within the conversation around recovery or addiction, right? Just the fact that there’s just an absence for the inclusion of families, and I believe that should be the entry point of any discussion for anyone who is seeking services. Who is your extension? Who is your loved ones? How do we connect and contact them? Do we have consent to talk to them? I believe oftentimes those just simple statements are eliminated in individuals when they are accessing services or in need of care, whether it’s community-based in treatment behind the walls, no matter where you are. Those simple statements can really help. And then initiating that process early on and not at the exit of service. I think that’s where the high level of stigma, high level of boundaries, and the biases that come along with that. Because when persons leave you from the care of your family and go into services, oftentimes they return with more informed and in the process of recovery. And the family member is not on the same page as the person that left them, right?
(07:31): So we need to create the plane equally where they’re collectively getting support at the same time. And I believe that’s where the disparity lies. So if I’m not learning with you, I’m actually waiting for you to pass the torch to me and it’s never passed. So we have to create the inclusion from an equity perspective that people are connected to someone no matter whether you’re blood-related or not. That family is an extension of the person who is receiving supports, and that the access and availability to those supports are on demand. And that’s where we lose. That’s where we need to do more work in that space to make sure families are receiving the services they truly need.
Ashley (08:20): Wow. When you think about equity and folks who are typically represented in the family space and in the recovery space more broadly, who do you see? What are some specific populations that are often not as included or meaningfully integrated into this process?
Tiffinee (08:43): Children. Children are the first ones harmed and the last ones healed. And children need the understanding, such as myself when I came along this work. And if we are able to give children the soft skills of information of learning about your family member, your loved one in a kind and compassionate way, then we’re able to create the space for love, care, and compassion when reunification happens. And I think we miss that. So children often are resistant to the reunification process. And then for the caregiver, that’s serving that child to have that information inclusive to them as well. And that can look different in many ways and in many cultures who that caregiver is and making sure they have the access as well, because it’s often absent or unavailable. So depending on where you’re living, those family resources may not be available and we need to create space for that because everyone has an extension to someone.
Ashley (09:54): Yeah, that’s a very healing centered-approach as we think about reunification. One of the things that I tend to hear a lot are sometimes folks are maybe feeling anxious or some folks have shared different experiences with lived experience and lived expertise where family did not have the knowledge or education or resources or tools or supports appropriate to be supportive to their loved one in that reunification process. And I think oftentimes how that gets discussed or talked about doesn’t always reflect the truth for families. And I know that as we kind of thought about what would be important to talk about for this podcast, that came up a bit. I’m wondering what are your thoughts about that, about how do we create an environment in that reunification process, ensure that people are connected?
Tiffinee (10:56): One of the great ways we can create that inclusion is realizing our community canvas, right? What are the best access points to make this possible? So when we think about reunification, it’s often attached to a system, like a system of care, whether it be department of social services or social child welfare, but reunification can really happen anywhere.
(11:20): So if you think about access points specifically to children, you can think about school, that reunification and learning process or the family healing process can happen with inclusion of an after care group where families can come in and be involved with their children or caregivers or loved ones around who have been impacted. When you think about other social connections, we think about libraries and how fruitful libraries can be and how safe they can be for families to be able to go in and get resources. Libraries exist in every state across the country. They’re great access points for healing and for learning. So when you think about that, you say, “Wow, why can’t we use these spaces.” Our rec centers and our club houses and our neighborhood associations, there’s so many other access points for families to really have the tools they need, and connecting with the local organizations who are offering them as well.
Ashley (12:24): I know that our audience are typically folks who are part of organizations are providing services, and this is always so helpful to think about through that lens. I also recognize that this is a “us” conversation. This is something that impacts likely a significant amount, if not most people who will be listening to this. And just to take it out of the service space for just a moment, as someone might be listening to this and thinking, “I have a loved one who I would love to support, or I have a family that wants to be mindful and very present to learn more and to ensure that I’m a positive part of the recovery of my loved one,” what are some things that you would say to individuals before we start to look at it on the service side?
Tiffinee (13:20): Be open to the possibility of change. And that change is a dual process when you’re healing together through the process of recovery. So I would just open and invite the invitation that recovery is possible and you are a part of that process when your loved one is recovering.
Ashley (13:44): Yeah. I don’t know that we give folks so many opportunities to see themselves as part of the recovery process. And in addition, thinking about supporting family members through what the journey or the process could look like, what advice to organizations would be appropriate to help them prepare to serve individuals and their families?
Tiffinee (14:10): Examine your practices and how you serve individuals when they come into your organization. Is it recovery and family inclusive for the process? Are you just specifically serving the person? And if you are, and if you have been doing it in that fashion, think about revisiting that and creating opportunities for the access and entry points no matter what they are. Making sure it has the family inclusion, even if it’s a questionnaire, creating opportunities maybe if individuals are in treatment. What provisions are you providing for the families that’s external from the treatment process?
(14:54): I know that many individuals who enter treatment have a disconnection for a period of time. Is the access available for them to still communicate with their loved ones? Dually, right? An even exchange. And then also, is there opportunities within their healing process for family members to be involved? Not on the perspective of is something wrong or if a person is being discharged, but actually in the case management and planning. What does it look like from the beginning? Not asked on the end. And I keep stressing the importance of asking on the beginning because over time, as a person is in their process, they could change who that caregiver is.
Ashley (15:41): Yes.
Tiffinee (15:42): And we want to make sure that they have the appropriate person, the appropriate resources, and that both are equally receiving that. So another way that you can do that is offer family supportive groups. There are many that are inclusive in harm reduction or stigma reduction that they can become educated. Even learning about appropriate recovery friendly language so we’re not re-traumatizing the person who just went in for care, right? And that you’re equally learning that language at the same time. You’re both getting on the bike, right? Learning how to reintegrate back into this great world of community.
(16:26): So if you are a provider, really looking at that on your entry level and your exit plan, if you’re specific to treatment, if you’re specific to housing, recovery housing, perhaps you have some opportunities for families or children to get, I call it “parenting time” because you don’t visit your child. So is there any opportunities for parenting time? Are your participants going to parenting classes? Are they learning about anger management? Is the family learning about the disease process specifically to the brain for recovery? I know that’s a lot of unpacking, but it’s a great way to reduce the barriers that can happen for the family in the process of recovery together.
Ashley (17:15): Those are such important points that you bring up, and I’m so glad that you leaned into that space. It makes me also wonder, in your work or in this space, do you ever see conversations about how folks define family or is there an ongoing conversation about what family looks like for individuals?
Tiffinee (17:35): So we have various aspects I see on entry for people who are seeking services, and they may first ask, “Who are your supporters?” So they may reframe the word family and ask, “Who are your supporters?” And then one will have the opportunity and space to talk about, “Well, my supporters are the following.” Are they extended family members that you would like to speak out on? I would give the person, the participant that you’re serving, the ability to do some self-advocacy around that, because that’s really important because they may define the person as their companion, their loved one, their friend, their same-sex spouse, no matter what it is. It’s family to you so it’s family to us no matter how you define it. And really being really true to that because oftentimes we say things on the beginning. And then when it comes down to consent forms or times spent with family members who may be in care in any capacity, that you get a little bit of pushback because they’re not related or blood related. And then I’ll end on the fact of blended families, that blended family inclusion is so duly important.
(18:54): So if you are co-parenting a family and you are involved in that family, ask those questions. Do you have children? Who are their caregivers? Is there any legal things around that or things that we can work on together? Because they may have those concerns, but if you don’t talk about it, nothing’s done about it. And they may be able to address them while they’re in care.
Ashley (19:17): That’s such a beautiful lean in to the importance around inclusivity of it, is asking those specific questions, allowing people to identify their support system. Also asking them, ensuring that folks who might not be named in that process, but the children and the grandchildren that you mentioned are also receiving those support and opportunities to be involved in the recovery journey broadly. I think about folks who their families might not know about their partnerships, but their partners are their family. And creating an environment for folks to be able to identify their support, their loved ones, their partners, even in environments where maybe that might not be something that’s shared with folks who are immediately around them. So I’m glad that you bring that up because the inclusion of it is so important.
(20:12): As we think about resources for individuals and families, what are some resources that come to mind?
Tiffinee (20:19): I want to make sure that people have access to a family navigation line. Also, 988 for those who may be in crisis. And I just want to talk because that’s huge right now across the country, the 988 line that’s available to families and loved ones.
Ashley (20:36): I’m glad that you bring up crisis and 988. And as I specifically think about bringing into the space and naming really explicitly the experiences of LGBTQIA families, and I think emergency and crisis show this is an important intersection, and I’m wondering if you can speak to that briefly.
Tiffinee (20:57): Normally, providers in crisis or in medical emergencies, that’s a really critical time for family members to really self-disclose what’s happening. Like when people have overdose or they’re rushed to the hospital for some type of medical emergency and they find out they have a substance use condition or mental health challenge, and you have to disclose like, “I’m the loved one. I’m the caregiver, I’m their partner,” and then you go into this back and forth with providers, which that’s not the time or the space for that, but it happens and it really needs to be talked about. And that’s where we go into the stigma, right? The stigma surrounding that. And I’m spending more time trying to explain who I am as a partner, as a caregiver, as a wife, as a mother, than the care of the person that’s being served.
Ashley (21:50): That’s so important. And I thank you for bringing that up and honoring that it’s both in helping to ensure that the focus of the emergency is what it needs to be on. And also recognizing that that part of advocacy and self-advocacy comes with a level of emotional utilization, that when folks have to focus on advocating for themselves related to their identity, their loved ones, their partnerships, how is that taking away from the care and focus that needs to be for them and their partner in that emergency. So as a topic that’s very close to me, I’m grateful that you’re able to speak on that and shed light as to what we should be thinking about in response.
Tiffinee (22:33): Especially in emergencies. When you’re serving someone in the self-identify as being a part of the LGBTQ community, spend more time carrying on the person and not stigmatizing the fact that they are a part of the LGBTQ community.
Ashley (22:52): T, I wanted to open up an opportunity for any other things that you want to add or any of your brilliance that has surfaced in between these questions that you want to be sure to leave our listeners with.
Tiffinee (23:05): I want people to know and understand that the possibility of families recovering is truly, truly possible. I’ll invite the listener, the learner, the provider, and even the family or friend, to have patience with your loved one who is navigating their process. Be open and kind when you’re speaking to them. Get on the journey with them. It may take some time for you because you’re not receiving the supports directly. You have the ability for advocacy to ask for what you need and know your rights as well. And for providers, be open to the concept of change and just not limiting the standard of providing the service. Really understand that it’s connected to a human being no matter what it looks like.
Ashley (23:59): The one and only T. Scott. Tiffinee, thank you so much for being here with us today.
Tiffinee (24:05): Such an honor. Thank you for the opportunity.
Ashley (24:08): And to our listeners, join us next time on Changing the Conversation.
Erika Simon, Producer (24:12): Visit C4innovates.com and follow us on Twitter, Facebook, LinkedIn, and YouTube for more resources to grow your impact. Thank you for joining us. This episode was produced by Erika Simon and Christina Murphy. Our theme song was written and performed by Peter Hanlon. Join us next time on Changing the Conversation.
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