Young People in Recovery: Recovery Schools and other Supports

1. 1 Young People in Recovery: Recovery Schools and other Supports Faces & Voices of Recovery 2009 Recovery Advocacy Teleconference Series August 18, 2009 www.facesandvoicesofrecovery.org

2. 2 Speakers Lora Passetti, Chestnut Health Systems Monique Bourgeois, Association of Recovery Schools Greg Williams, Connecticut Turning to Youth and Families

3. 3 Recovery Meetings for Youths Lora L. Passetti Chestnut Health Systems lpassetti@chestnut.org Preparation of the presentation was supported by funding from the Center for Substance Abuse Treatment, Substance Abuse and Mental Health Services Administration, Department of Health and Human Services through the Strengthening Communities-Youth project (grant no. TI13356) and the National Institute on Drug Abuse, National Institutes of Health (grant no. 1 RO1 DA 018183 and fellowship no. 5 F31 DA17406 03). The content of this publication does not necessarily reflect the views or policies of the Department of Health and Human Services or the National Institutes of Health.

4. 4 Overview Following addiction treatment, most youth struggle with recovery and relapse. Peer-led community-based recovery groups are a potential support. Participation of young people in recovery support meetings is a promising yet largely understudied area.

5. 5 Overview Purposes of this presentation are to: summarize current research on young people and recovery support groups discuss issues members of the recovering community may want to consider when working with youths Focus on Alcoholics Anonymous (AA) and Narcotics Anonymous (NA) because of their: longevity membership size geographical dispersion and availability number of scientific studies of their relationship to long-term recovery outcomes

6. 6 Current Research Majority conducted with adults attending 12-step groups Research with youth is in beginning stages To date, indicates youth who attend AA and/or NA after residential substance abuse treatment are more likely to: remain abstinent engage in less frequent substance use have better post-treatment outcomes than those who do not

7. 7 Current Research Conclusions limited small number of studies no studies with youth treated in an OP setting research designs prevent conclusions of causation 12-step involvement largely measured in terms of attendance

8. 8 Current Research Many youth who begin going to 12-step meetings eventually stop 75% at 3-months post-res. discharge; 59% at 6-months (Kelly, Myers, & Brown, 2000) 60% at 3-months post-res. discharge; 38% at 12-months (Kennedy & Minami, 1993) Youth more likely to attend 12-step meetings and/or become involved: have more severe substance abuse problems have friends who use little to no substances have been admitted to treatment more than once experience more feelings of hopelessness receive less family participation in their treatment

9. 9 Current Research Common reasons to drop out boredom lack of fit with the group relapse lack of perceived need to continue low motivation removal of external pressures to attend

10. 10 Can Attendance Harm Youth? Concern that groups with large numbers of youth may contribute to problem behaviors large gathering of newcomers without long-term sobriety lacking the ability to offer recovery-related wisdom or advice in some cases, lacking investment in recovery could form inappropriate relationships with other adults or adolescents Research with youth who have substance use disorders has failed to identify peer contagion effects of group interventions run by clinicians No detailed research identified in effect of same-aged or older recovery support group members on youth Members of recovering community may want to help youth structure their time before and after meetings

11. 11 Ages of Meeting Members Less than 3% of AA, CA, and NA members are < 21; rates in 12-step alternative support groups are largely unknown Youth substance use and related problems often differ from adults Youth who attend meetings with at least a substantial proportion of same-aged peers after inpatient treatment have: significantly better substance use outcomes higher frequency of attendance greater perceptions of the importance of meeting attendance Members of recovery support community may want to: guide youth to meetings with larger percentages of other youth; however, help with structuring time before and after groups speak with youth about comfort level at meetings with mostly adults recognize that some youth could opt to attend a mixture of meetings (i.e., some with more youths and some with mostly adults).

12. 12 Ability of Youth To Understand And/Or Buy Into Program Concepts Concern that youth may have difficulty understanding and embracing ideas framed in adult language, particularly ones grounded in 12 steps acceptance, surrender, spirituality powerlessness over alcohol or other drugs and commitment to lifelong abstinence Little exploration of how young people perceive and interpret common concepts in recovery support groups; Preliminary research indicates: some young people acknowledge powerlessness and recognize lives are unmanageable �hitting bottom� harder to identify with struggles with spirituality and comprehending 12-step literature steps related to making a fearless moral inventory and direct amends to people harmed were sometimes confusing or frightening Members of recovery support groups may want to: review the language, concepts, and practices in support groups to prepare youth for what meetings and to correct any misconceptions that may interfere with willingness to attend Encourage youth to discuss any concerns, confusion, or anxiety with other group members or sponsors

13. 13 Working with Treatment Centers Recognize how youth are oriented to recovery support groups Volunteer to work with young people; become familiar with how to work within agency procedures Encourage treatment staff to learn more about your group invite them to open meetings do presentations familiarize them with group concepts and how meetings work Work with staff to identify meetings that: tend to have more young people have more members with long-term abstinence have adult members that welcome young people in the case of AA, have members that are OK with talking about other drugs

14. 14 Working with Treatment Centers Encourage staff to ask youth to try a variety of meetings Encourage staff to work with your group�s service structures and procedures Encourage staff to bringing youth to sober social activities sponsored by support groups (e.g., young peoples� conferences and sober dances, picnics, and retreats) Create a network of volunteers willing to make a personal connection and introduce youth to a support group Host youth-oriented events Create a youth meeting if one does not exist

15. 15 Additional Information Passetti, L. L., & White, W. L. (2007). Recovery support meetings for youths: Considerations when referring young people to 12-step and alternative groups. Journal of Groups in Addiction and Recovery, 2, 97-121. Kelly, J. F., & Myers, M. G. (2007). Adolescents' participation in Alcoholics Anonymous and Narcotics Anonymous: Review, implications, and future directions. Journal of Psychoactive Drugs, 39, 259-269.

16. Recovery Schools Monique Bourgeois Executive Director Association of Recovery Schools mbourgeois@recoveryschools.org

17. 17 Presentation Overview Defining a Recovery School High Schools Collegiate Recovery Communities Number of Recovery Schools Role in the continuum of care for substance use/dependency Association of Recovery Schools Additional Resources & Contact Information

18. Two types of Recovery schools Schools at the secondary level (High school) Collegiate Recovery Communities (Colleges/universities)

19. 19 Recovery High Schools High schools offering credits toward a diploma Continuing care, not primary treatment Although may have affiliation with a treatment center Enroll students recovering from substance use disorders Generally voluntary (rather than mandated) admission criteria Require abstinence and active recovery Most do not have pre-determined �lengths of stay�

20. 20 Recovery High Schools (continued) Structure: Most are embedded organizationally and physically, attempt to separate students from other programs. Funding: Combinations of public school money, fees, tuition, donations. Varies with state and local policies. Size: Small (12-25 students) and prefer to remain small. Official/budgeted enrollments larger than observed attendance.

21. 21 Recovery High Schools (continued) Referrals: Primarily from treatment programs, parents, and in some settings juvenile justice. Admission requirements Sobriety Duration (none to at least 30 days) Recovery (Contemplation through active recovery) Treatment history (none required though some�undefined� prior treatment program) Voluntary though coerced

22. 22 Recovery High Schools (continued) Generally eclectic orientations reality therapy brief therapy cognitive-behavioral client/student centered family systems behavior modification (threat of incarceration) psychopharmacology (for mental health issues)

23. 23 Recovery High Schools (continued) Frameworks of Recovery Most include daily group plus available one-on-one counseling. All use some variant of Twelve Step/Minnesota Model, some also incorporate harm reduction. All have counselor/therapist involved, some contracted/outsourced to treatment programs Counseling staff credentials vary (most have licensed A&D counselors, LPCs, LMFTs, and/or social workers).

24. 24 Collegiate Recovery Communities �Recovery communities provide a nurturing, affirming environment in which students recovering from addiction can successfully pursue academic, personal, and professional goals for the purpose of enhancing their quality of life and becoming productive students in your college/university community.� � CSAR, Texas Tech University, 2006 SOURCE: Center for the Study of Addiction and Recovery, Texas Tech University

25. 25 Collegiate Recovery Communities (continued) Types of Support Emotional Demonstrations of empathy, love, caring and concern Informational Health, wellness, educational, employment information for recovering individuals Instrumental Direct, concrete assistance in task accomplishment (i.e. securing financial aid, job placement, completing applications, housing, academic advising) Companionship Helping people in early recovery feel connected and enjoy being with others�recreational activities in alcohol and drug-free environments Source: Center for the Study of Addiction and Recovery, Texas Tech University

26. 26 Recovery Schools as a Part of the Continuum of Care Youth in recovery are in educational settings (high schools and colleges/universities). Traditionally, treatment (and school) systems have approached substance use and dependency as an acute condition. In reality: �The progress of many patients is marked by cycles of recovery, relapse, and repeated treatments, often spanning many years before eventuating in recovery, permanent disability, or death� (Dennis & Scott, 2007, p. 45). A recovery school program addresses students with their recovery support needs and helps them sustain their recovery.

27. 27 NIDA Study by Dr. Finch and Dr. Moberg found the following in students attending a recovery high school:

28. 28 Number of Recovery Schools and Locations High Schools Approximately 30-35 known to Association of Recovery Schools California Indiana Massachusetts Minnesota New Hampshire Oklahoma Pennsylvania Texas Wisconsin

29. 29 Number of Recovery Schools and Locations Collegiate Recovery Communities Approximately 15-20 known to Association of Recovery Schools; at various stages of development Georgia Maryland Minnesota New Jersey Ohio Oklahoma Texas Virginia Washington

30. 30 Association of Recovery Schools Mission The Association of Recovery Schools advocates for the promotion, strengthening, and expansion of secondary and post-secondary programs designed for students and families committed to achieving success in both education and recovery. The Association of Recovery Schools exists to support such schools which, as components of the recovery continuum of care, enroll students committed to being abstinent from alcohol and other drugs and working a program of recovery.

31. 31 Association of Recovery Schools 9th Annual Conference July 2010 in Boston, Massachusetts Visit www.recoveryschools.org for details

32. 32 Additional Resources Starting a Recovery School - A How-To Manual by Dr. Andrew Finch Written expressly for high school educators and administrators, Starting a Recovery School provides a blueprint for developing an effective recovery school. Statistics show that less than 20% of youth who have completed chemical dependency treatment maintain sobriety after returning to their home, school, and old peer group. Recovery schools provide an environment that supports students new-found sobriety. Written by a leading expert in the field, this guide addresses key issues including: School format options Facility and staffing needs Student recruitment Academic and therapeutic programming Program evaluation Source: Association of Recovery Schools, 2009

33. 33 Additional Resources Journal of Groups in Addiction & Recovery (JGAR) Volume 2, Numbers 2-4; 2007 Special Issue on Approaches to Substance Abuse and Addiction in Educational Communities: A Guide to Practices that Support Recovery in Adolescents and Young Adults Recovery High Schools as Continuing Care for Substance Abuse: Final Report (Available soon on ARS website) By Dr. Paul Moberg, Ph.D. (School of Medicine and Public Health, University of Wisconsin), Andrew J. Finch, Ph.D. (Peabody College at Vanderbilt University) and Amanda Lawton Krupp, M.S (School of Medicine and Public Health, University of Wisconsin)

34. 34 Sources Association of Recovery Schools website. Retrieved August 10, 2009 from http://www.recoveryschools.org/products.html Center for the Study of Addiction and Recovery. (2006). Collegiate Recovery Communities curriculum: Recovery and inclusiveness. Washington, D.C.: Substance Abuse and Mental Health Services Administration and the U.S. Department of Education. Dennis, M., & Scott, C. K. (2007). Managing addiction as a chronic condition. Addiction science and clinical practice, 4(1), 45-55.

35. 35 Additional Resources Association of Recovery Schools www.recoveryschools.org Monique Bourgeois, Executive Director Association of Recovery Schools mbourgeois@recoveryschools.org Mobile: 612.219.9470

36. Connecticut Turning To Youth and Families (CTYF) Making Youth-Guided, Family-Centered Recovery a Reality!

37. Youth Recovery Support �As We Have Experienced It� What We See Is Working for Young People (13-25) In Sustained Recovery: Youth Peer-to-Peer Support Early Intervention Family Involvement and Support Environmental Solutions and Recovery Support Services: Housing, Social Supports, Employment, Education, etc.