Karen Kranbuehl understands better than most the uncertainty individuals often feel immediately after graduating from a recovery program for substance use disorder. After all, as a person in recovery since 1995, she has experienced that uncertainty first hand.
“Often, people in my life wanted me to do different things and that’s when I realized I had no idea what I wanted to do. That wasn’t something that I was used to thinking about before recovery,” said Kranbuehl, who recently graduated from the School of Social Work’s Triangle Distance Education Program. “I finally realized that I had to do what I thought was best for me. Once I had that realization, then I had to figure out how to communicate that to other people. That can be very hard early in recovery.”
For Kranbuehl, who eventually graduated with a law degree from the College of William & Mary, learning to speak effectively for herself at that time was crucial in her recovery journey. Years later, the experience has also inspired her to fill what she has seen as a critical gap in the treatment process: the need to teach self-advocacy skills to individuals in recovery.
Kranbuehl is now doing just that through her “SAY IT” program, an intervention she developed in 2015. The program, which she originally designed for groups, focuses on goal setting and exercises aimed at helping participants confidently build the language and messaging they need to advocate for themselves in court, with a potential employer, or even with a family member.
“I use a modular curriculum that basically teaches a process that can be repeated,” Kranbuehl explained. “Participants pick something they want to advocate for and then every session, we develop another step in the strategy so that by the end, they have an elevator speech. They have an understanding of the pieces and the details they need to put in their messaging and they have the emotional preparation to deliver it.”
Through her work with Fellowship Health Resources in Raleigh, Kranbuehl initially introduced the intervention to individuals in intensive outpatient treatment for substance use disorder. Over the past year, she also worked closely with clients through the Wake County Recovery Court program, a supervised treatment alternative that aims to help people in the criminal justice system break the cycle of drug dependence and related crime that might land them back in jail. After observing numerous court cases, Kranbuehl said she realized that many clients lack the skills to advocate for themselves and are unsure how to productively share their experiences with the court, including their setbacks.
“For example, if somebody had a positive drug screen, there might be a reason for that, that if the court knew more, would influence the judge’s decision,” she explained. “Maybe the individual was working through PTSD nightmares and through counseling had been told to just get out of the house and get a breath of fresh air. But if they are not living in a safe neighborhood, then they could be putting themselves in a situation where they walk right into a scenario where people are using drugs. These are cases where people are trying really hard in treatment, and are being really brave and doing the things they were told to do, but then that last piece doesn’t work. Do we really want to put them in jail over that when they did so many things that were right up until that point? But, for a person standing before a judge, that situation is hard to communicate.”
The SAY IT program teaches clients to think about their recovery process from a strengths-based perspective, she added. Of the nearly 60 people who have completed the intervention, many shared a common goal: to develop the needed confidence to honestly discuss their addiction problem, and in some cases, criminal record, with a potential employer. The intervention helps clients to work through scenarios and to write a sample speech to get the conversation started, Kranbuehl said.
Because many mandated recovery programs require a time commitment that may affect a potential employee’s availability to work, the SAY IT program encourages participants to find positive ways to discuss their recovery with employers and explain why that treatment time is important to their overall recovery progress. Such conversations, Kranbuehl added, can help employers and employees develop trust and avoid treating recovery as a taboo subject.
“It’s very hard to know how to go in and have that conversation,” she said. “So one of the things that I teach everybody is recovery messaging so that they now have some language to talk about themselves in a positive forward looking way. I think this also helps the person they are talking to because now that person has a better idea of that individual’s recovery and what it looks like for them.”
Kranbuehl, who launched a limited liability company last year, is currently developing an online SAY IT program to broaden the intervention’s reach. Such self-advocacy support services play a vital role in an individual’s long-term recovery success, she said. For a newly graduated social worker, being able to advocate for a community in need is equally important, Kranbuehl added.
“For the groups that I am working with, it’s important that they see somebody fighting for them,” she said. “I’m modeling what they also want to be able to do. So maybe one day, they, too, can speak up at a county commissioners’ meeting or to another group. I know a lot of times they may feel like a number in a system, but I believe they have important things to say and through this work, I’m trying to help them realize that.”