ACT Peer Recovery™ (ACT-PR) is a new form of mutual aid recognised by Public Health England.
WHAT IS IT?
ACT-PR is very simple. So simple it takes just 60 seconds to get started. Try it for yourself on the website – push the ‘start learning’ button. However, just because it’s easy to learn doesn’t mean it’s lightweight or not backed up by research.
ACT-PR is based on Acceptance and Commitment Therapy (ACT), which has an evidence base on a par with CBT. The peer model is based on the ACT Matrix, which is a simpler training format.
It was developed in Portsmouth from 2008 and eventually grew to 20 groups per week across the whole community, from the general hospital to the library. In 2013 the peers wanted to make it available more widely, and a community interest company was established. Information days were held in Manchester with Emerging Futures and it also caught the attention of PHE in relation to FAMA (facilitated access to mutual aid). ACT-PR was approved for inclusion in the new policy guidelines in July 2015.
Since then ACT-PR has grown steadily, and there are over 40 meetings a week (excluding Portsmouth) across 12 local authority areas, with a further 15 areas developing. A new group opens on average every week, and that is accelerating.
‘ACT-PR is so simple it takes just 60 seconds to get started.’
SO HOW DOES IT WORK?
The unique feature of ACT-PR is its simplicity, achieved via focus on behaviour (see the short introductory videos). Behaviours are divided into two categories – those that take you towards recovery, and those that take you away. By learning to notice this difference, peers begin to reduce the ‘away’ behaviours and increase the ‘towards’ behaviours. In a nutshell, that’s it.
Recovery is defined as building a life of meaning and purpose in the community. The backbone of the programme is the monthly challenge in which each peer chooses to make a significant behavioural change. Sometimes it’s successful, sometimes it isn’t. But what’s important is to learn by a trial and error approach in which failure leads to success.
‘Of course there are obstacles – we call these “lemons”.’
The only requirement for attending an ACT-PR meeting is that you commit to a challenge. Of course there are obstacles – we call these ‘lemons’, summed up in the programme’s key metaphor ‘passengers on the bus’:
‘Building your life can be like driving a bus (behaviour) in a certain route (direction). However, when you start driving the passengers (lemons) get upset and bother the driver, who usually responds by trying to get them off the bus. Problem is, then the bus doesn’t go anywhere, or even crashes.’
This is where acceptance comes in – some painful thoughts and feelings like anxiety, sadness or guilt are part of life. The commitment part is driving the bus with the passengers on board. So you learn to become ‘comfortable with being uncomfortable’ – the key to freedom and a better life.
Meetings are arranged at different levels, each divided into eight lessons delivered from a manual by the peer facilitator. The facilitators are trained, supported and licensed to ensure quality. The meetings are always open access, voluntary and independent.
The new videos mean that anyone can be introduced to ACT-PR in 60 seconds, and connected to mutual aid. This can be built into the assessment process so that everyone has access to mutual aid right from the start. Licensed peers also run basic level ‘introduction to ACT-PR’ meetings as part of their service roles, providing a joined-up pathway into mutual aid. ACT-PR fits very well with the 12 steps and SMART so it is another choice for people entering recovery.
An online version of ACT-PR is being rolled out, with the first level a simple introduction, followed by an interactive version of the lessons. This makes ACT-PR available to anyone with internet access, and in time individual peer-to-peer support will also be available online.
As a behavioural approach, ACT-PR can be applied to many conditions that people face in recovery, from anxiety and depression to diabetes and pain. The peer approach can work with anything that is behavioural.
Mark Webster is CEO of ACT Peer Recovery. To find out more visit www.act-peer-recovery.com
ACT IN ACTION…
‘Life has got a lot more peaceful and relationships have improved all round.’
ACT-PR in Bristol
by Jamie Freeman
I first came across ACT-PR at a FAMA training day in 2015. What appealed to me was the focus on behaviour and I also liked the fact that it wasn’t measured in terms of success/failure. I followed it up and if memory serves, the first conversation went like this:
Me: We don’t have any peer organisations in Bristol.
Mark: Set one up.
Me: How do I do that for ACT Peer Recovery?
Mark: You’re doing it right now.
We agreed that an information day would be a good place to start, and in spring 2016 Bristol City Council gave us a small sum to host it. Mark came with four peers and they presented ACT-PR to us – everyone got it straight away and the first group was set up in October 2016. Twelve of us started in a space at Bristol Drugs Project, and it was amazing how things suddenly began to click.
We’ve now finished the group leader training and have four new ACT meetings, including an LGBTQ+ meeting. We’ve formed a small charitable organisation and found office space. We have several people interested in doing the next round of group leader training in September.
With my peer colleagues we have worked hard to get ACT-PR off the ground because we have all benefitted from the model ourselves – developing our noticing muscles, loving our lemons and changing our lives. We really have ‘just done it’.
The peer experience
by female parent, 40
‘Past/present/future’ is a format from the meetings:
Past: I used to react, get angry and be confrontational which caused arguments at home, filtered down to my children and rippled out to the rest of my life. It caused problems everywhere, including work.
Present: ACT-PR helped me get a pause button so I could notice my behaviours in advance and stop myself. Now I talk instead of shouting and choose my words carefully. Future: Life has got a lot more peaceful and relationships have improved all round. I am no longer this ogre that people are frightened of. I have become more approachable, and get on so much better with everyone.
by BRIC worker
After assessment we started to tell people about ACT-PR. They could attend a short introductory session that is held every week at the same time, so staff know when it is.
From the beginning it has been well attended and we have seven or eight people coming each week to learn the basic principles. In the year we have seen over 200 different people at these introductory sessions. Half go on to the full mutual aid meeting that we also run in the building. After that there are the community groups which attract a wide range of people.
We are now getting ready to use the video introductions at assessment time, and expect the numbers to grow even further. The results speak for themselves, and many people have stayed the course and developed recovery in the mutual aid groups.
The facilitator experience
By Lancashire male, 36
I attended a meeting and had a lot of ‘penny-drop’ moments – it really made sense to me, so I wanted to see if I could help out. I started by doing small parts of the meeting while the leader supported me, like a mentor, until my confidence improved. Once I was comfortable doing that I attended the six-week training course.
I enjoyed the course because it was very practical. We didn’t just sit there and listen – we had to have a go and get out of our comfort zone. As the weeks went by my confidence improved and by the end I was ready to start my own group, which you have to do to get a licence.
Now I run my own group and have watched the attendance slowly build. It makes me feel very proud to see people starting out on the process that I followed. One day I’ll hand it over to them and go on to the next level. And yes, it’s still scary – but it works.