How Psychosocial Recovery Coaching Differs from Support Coordination
It’s now 18 months since the introduction of Psychosocial Recovery Coaching (Recovery Coaching) under the NDIS. With around 10% of participants accessing the NDIS due to psychosocial disability, there’s a big group to scale up for and support.
Support Coordination and Recovery Coaching are funded under the same Capacity Building budget in NDIS participant plans and sit together under the same NDIS Commission registration group. There’s also some clear crossover in what they can offer participants, so it makes sense that people are wondering about the similarities and differences between them.
While it’s an understandable comparison and question, the truth is that they are quite different supports.
Differences in economics
While Recovery Coaching and recovery-orientated practice getting a home under the NDIS has been widely celebrated, the price controls set for Recovery Coaching have been a hot topic.
Some people feel that price controls below Support Coordination undervalue a workforce with lived experience, even while introducing recommended minimum qualifications. Others have seen it as leveraging Support Coordinators to do the same things for the same people for less per hour (which of course can mean more supports for the same funding from a participant’s perspective).
While we’re not refuting the validity of these views, we choose to focus on a different interpretation. The new price controls have led to new models. This is necessary because you need a model that is sustainable and can grow, and that means a model that is intended to operate under the price controls that were set at Recovery Coaching’s introduction.
The NDIA suggests that Recovery Coaching price controls sit between a Support Worker and Support Coordinator – we can understand why and work with that.
The other key consideration for the economics of Recovery Coaching that we often see overlooked is the anticipated volume of support, along with the duration of time we expect it to be funded for each individual. Generally, we expect NDIS participants with Psychosocial Recovery Coaching funding to get more of it for much longer than Support Coordination funding.
Recovery Coaching also has added flexibility in terms of after hours and weekend rates. While the pay rates to staff increase proportionately, there are also additional functions to consider, like on-call and other leadership support during these times.
The truth is that we think current price controls could increase a bit which would do a lot for things like the growth rate of these nascent organisations and growth of supply, which we understand is currently quite short. It would also support higher pay rates and additional activities, like some more structured ongoing professional development for teams doing this important and often complex and challenging work.
If the trend is that the funding allocation per participant is not higher and for a much longer time, the current price controls start to look more like a long-term challenge.
Differences on the ground
Despite the similarities between Support Coordination and Recovery Coaching – in their budget category, registration group, and some of the tasks on the “may include” list – they are different supports. We think the pull to compare them to each other will start to fade over time as Recovery Coaching firms up its own identity.
For Support Coordination providers who have developed effective models for supporting participants with psychosocial disability, we can see why the introduction of Recovery Coaching would be a bit jarring. They are now faced with doing the same thing for less.
On top of that, they need to think through how to introduce, formalise, improve, or continue their recovery-orientated models of practice and whether current support structures will succeed for a workforce with a lived experience of mental illness.
While doing all of this, Support Coordination providers have to consider new flexibility and functions that are usually not part of their duties. Some of these differences on the ground are as follows:
A workforce with lived experience – While lived experience is already an important concept in Support Coordination, there is a rich history of peer work and the centrality of lived experience and recovery to good policy, programs, organisations, and service provision. It’s more than simply employing people with lived experience – it’s building operating rhythms, support structures, policies, workforce models, and all other things related to organisational design, with lived experience as a central focus. Recovery Coaching organisations or programs who employ 50%, 60%, 70%, and more of Recovery Coaches who identify as having lived experience are getting it right. These kinds of organisations and programs are designed differently at their core, building it into their DNA.
Clear recovery orientation – There’s a rich and important history of recovery-oriented services around the world that matters for people living with psychosocial disability. Recovery Coaching needs to be delivered from a position that is firmly grounded in recovery orientation. A bit like lived experience above, it’s a central organisation design element and needs to permeate everything.
Very relationship focussed – Support Coordinators deliver relationship-based work where rapport is important to doing a good job, because trust and connection are key to good outcomes. Recovery Coaching turns up the dial a bit on the importance of this, because you can’t really do anything valuable without a strong recovery-oriented relationship – one grounded in safety (through non-judgement) and reinforced through being consistent, predictable, and reliable.
More detailed recovery action planning – Recovery Coaches need to explore some specific client-led goals. Sometimes these are short term, very personal, and almost always more specific than broader NDIS plan goals.
Some direct service provision – A Recovery Coach also needs to be able to jump in and bridge any gaps in direct service delivery, most often while a plan is being established and services are being engaged.
Expanded operating hours – Organisations and programs need to consider whether and how they will provide weekend and afterhours support. If they do, they need to determine what oversight and on-call assistance is required.
Supporting people to navigate crises – While not delivering a “crisis service”, Recovery Coaches have a role in supporting people to plan for the episodic nature of mental illness, including potential tough times ahead that require a crisis response. Running scenarios with people respectfully and drawing out how they want to be supported and what resources they will need during these times can really go a long way.
Differences in workforce
As we have said above, one of the many important things about recovery-oriented services is formal recognition of the value of lived experience. Acknowledging and establishing a workforce with personal experiences of living with a mental illness or supporting someone as a carer is essential for Recovery Coaching, not an optional extra.
Psychosocial Recovery Coaches are purveyors of hope, and nothing says “recovery is possible, and it’s possible for you”more powerfully than a bunch of people who are living proof.
Along with having a large proportion of the workforce drawing on their lived experience, learned experience is also valuable. Recovery Coaches with a Certificate IV in Mental Health or Peer Work, people with Diplomas of Community Services, and Alcohol and Other Drugs, Social Work, Counselling, and Psychology qualifications all have things to offer the space.
While this is valuable in many areas of the NDIS, a Recovery Coaching workforce always needs to be trauma informed and draw on other specific evidence-based frameworks like motivational interviewing.
Pay rates for Recovery Coaches vary by organisational model, qualifications, and experience. There is some overlap with the ranges of what some Support Coordinators are paid. Generally, though, lower pay rates for Recovery Coaches are hard to avoid with the current difference in price controls.
Support Coordination and Recovery Coaching can coexist
Support Coordination is an essential service for participants and will continue to be a strong and foundational part of an effective NDIS. This includes people with psychosocial disability – though probably less so now than before.
What’s already clear is what Support Coordinators have become brilliant at: navigating, negotiating, report writing, eligibility testing, momentum building, accountability providing, and overall managing.
Effective Recovery Coaching draws on a lot of what Support Coordination has taught us over the past several years about what leads to good outcomes for NDIS participants. Recovery coaching itself is a beautiful combination of the rich history of recovery-oriented services with this more recent history of how to navigate and maximise the positive outcomes in the NDIS.
Join us on Wednesday for Psychosocial Recovery Coaching vs Support Coordination Webinar where we will uncover the key differences between these two important roles.