What Are We Measuring? How Nonprofits Shape Recovery

Recovery is deeply personal.

Recovery systems aren't.

They're designed.

I come at this from two perspectives. I've experienced recovery as a neurodivergent person moving through systems that weren't always designed with me in mind.

And I've also spent years helping organizations design those systems, writing grants, building programs, developing outcomes, and translating recovery into something that can be funded, measured, and sustained.

Living on both sides of those systems has fundamentally changed the way I think about recovery.

And even the word success.

When I think about my own recovery, some of the most important moments would never have appeared in a quarterly report.

No one would have measured the moment I stopped blaming myself for every point of friction I experienced in treatment. No one would have measured the moment I realized there could be more than one legitimate pathway to recovery.

Those moments didn't change my sobriety overnight.

They changed my relationship with recovery itself.

Yet they're almost impossible to capture in a spreadsheet.

Like many people entering recovery, I was encouraged to work a 12-step program. I was told to get a sponsor. Call them every day. Build a recovery network. Reach out when I was struggling.

I want to be clear that I don't think there's anything wrong with those recommendations. They've been life-changing for countless people.

But I never even got to the point of having a sponsor.

Every day I'd think, "I really need to find one."

"I'll do it tomorrow."

And then...

I wouldn't.

I wanted recovery.

I wanted to do the work.

I just couldn't seem to get my brain to take that first step.

At the time, I interpreted that as a lack of commitment. Other people reinforced that interpretation, too. The message I absorbed was that if I really wanted recovery, I needed to work the program the way it was intended to be worked.

I believed I was doing recovery wrong.

It wasn't until years later, after being diagnosed with ADHD and then autism, that I started looking back differently.

My diagnosis didn't change my recovery.

It changed how I understood it.

I stopped asking, "Why couldn't I do recovery the way everyone else seemed to?"

And I started asking, "Why did I assume there was only one legitimate way to recover?"

For me, working with a therapist every week became a form of recovery support that was much more accessible than the recovery model I believed I was supposed to follow.

That doesn't make one pathway better than another. It means one fit my brain better. 

Because accessibility isn't lowering the bar.

It's creating more than one way to reach it.

Sometimes what we describe as "low engagement" or "noncompliance" isn't a lack of motivation. It may be evidence of a mismatch between the person and the system we've designed.

I saw another version of that mismatch during my own time in treatment.

There was another participant in the program who had OCD.

Every morning, he struggled to get out of his car because of compulsions that made leaving the vehicle incredibly difficult.

He would get out.

Get back in.

Get out again.

Repeat the process until he was finally able to walk into the building.

Our program had a policy that if you arrived more than a certain number of minutes late to group, you couldn't attend. The rationale made sense. Once group had started, repeated interruptions could disrupt the flow, the trust, and the psychological safety of everyone else.

One day, he arrived too late.

He wasn't allowed into group.

And even though the reason he was late was directly connected to his OCD, his absence still counted against his treatment compliance.

What exactly were we measuring?

Were we measuring his commitment to recovery?

Or were we measuring whether his disability fit within the structure we'd created?

I don't tell that story because I think the staff were uncaring. And I don't tell it because I think the policy was unreasonable.

I tell it because I don't think anyone intended for the system to create that outcome.

The system was functioning exactly as it had been designed.

And that made me start asking a different question:

How often do we mistake a system mismatch for a personal problem?

Because if we assume the problem is always the person, our solution will always be to change the person. But if we recognize that sometimes the system contributes to the mismatch, entirely different solutions become possible.

That shifts the question from:

"How do we help this person fit our system?"

to:

"How can we design systems that support different ways of engaging in recovery?"

The next question becomes:

Who should be helping design them?

Traditionally, we think about expertise in terms of education, credentials, research, and professional experience. Those things absolutely matter. I rely on them every day.

But I think there's another kind of expertise that we often undervalue.

Lived experience.

I'm not suggesting that lived experience automatically makes someone right. And I'm not suggesting that one person's experience represents everyone else's.

What I am suggesting is something different.

We often describe lived experience as anecdotal.

I don't.

I think lived experience is a form of systems data.

Because it reveals where friction exists. Where assumptions break down. Where unintended barriers emerge.

It tells us things that aren't always visible from the outside.

Which brings me back to the word I started questioning in my own recovery: success.

Who gets to define what recovery success looks like?

Attendance is relatively easy to measure. Housing is relatively easy to measure. Employment is relatively easy to measure.

But how do we measure trust?

How do we measure someone finally feeling understood?

How do we measure psychological safety?

How do we measure a person deciding to come back after a relapse because they knew they wouldn't be shamed?

Those things matter. They shape recovery.

They're just harder to fit into a spreadsheet.

Recovery doesn't happen in a vacuum. It happens inside environments.

And if environments shape recovery, then the quality of those environments is part of what we should be evaluating.

Maybe attendance isn't only a measure of whether someone showed up. Maybe it's also a measure of whether we created a place they wanted to return to.

Maybe retention isn't only about how long someone stayed. Maybe it's about whether they experienced enough trust, safety, and belonging to stay.

Maybe treatment completion isn't the only successful ending. Maybe someone leaves because they've built the skills they needed. Or transitioned to another form of support. Or maybe they discover that a different recovery pathway fits them better.

Completion alone doesn't tell us that story.

For many people, abstinence is absolutely the goal.

For others, recovery begins long before abstinence.

It begins with asking for help. With reducing harm. With rebuilding trust. With being honest for the first time. With believing they're worthy of recovery at all.

Those things are progress too.

I don't think recovery success is becoming the person a system expected you to become.

I think it's building a life that is sustainable, meaningful, and authentically your own, with whatever supports, accommodations, relationships, and community make that possible.

And I think our systems should be evaluated not only by the outcomes they produce, but by the conditions they create.

Which leaves me with one more question:

Who gets to define success in the first place?

What might recovery look like if different people had been in the room when we decided what success should look like?

Recovery systems aren't experienced on paper.

They're experienced by people.