May/June 2015 Issue

Recovery High Schools: Getting an Education and Learning to Stay Clean and Sober
By Sue Coyle, MSW
Social Work Today
Vol. 15 No. 3 P. 18

High school can be difficult to navigate. With classes, homework, cliques, extracurricular activities, and social expectations, many young adults struggle through these years.

Recovering from a substance use disorder is also a major hurdle. Individuals of all ages struggle through this during their lifetime. "Addiction is a chronic issue," says Andy Finch, PhD, an associate professor at Peabody College at Vanderbilt University. "For people who have a substance use disorder, it's not easy to just stop using. The reality is that relapse to use is much more the norm than the exception. It is not the norm for someone to go to treatment and then be able to never use again—even if they don't want to ever use again."

Put the two together—high school and recovery—and then throw in adolescence, and what exists is a very real challenge facing an untold number of young people.

Fortunately, there are systems, programs, and people in place attempting to help high school students in recovery. One such type of assistance is the recovery high school, of which there are currently more than 30 in the United States.

Background
Recovery high schools have been in existence in the United States for more than 30 years, developing out of a societal need. "Recovery high schools emerged in the late 1970s and early 1980s, as a response to kids coming out of treatment centers for substance use disorders," explains Lori Holleran Steiker, MSW, PhD, distinguished professor at the University of Texas at Austin. "When kids came out and went back to their regular environment, they were relapsing at almost ridiculous rates—anywhere from 65% to 80% in the first one to three months. Because they were relapsing at such rates, it was undermining the effectiveness of the treatment and the kids were in trouble. Many of the communities with recovery high schools were prompted [to create them] by student deaths," she says.

The number of schools has varied throughout the years, and the schools themselves differ in both form and student body. "Of the 35 [schools], there is a mixture of public charter schools, private schools, and alternative schools, which the Association of Recovery Schools (ARS) identifies as recovery high schools," notes Kristen K. Harper, MEd, LCDC, executive director of ARS. "The largest enrollment this semester," she says, "is at a school in Houston, Texas. They have 111 students ranging from ninth to 12th grade." In contrast, Holleran Steiker's school—University High School, which opened in August 2014—has 10-12 students.

All of the schools, however, focus on four central elements. Those elements, Finch says, are the following:

• the primary purpose is to educate students in recovery;

• the schools meet the state requirements for awarding a secondary school diploma;

• all students who are enrolled are in recovery or are working a program; and

• any student in recovery who meets the eligibility requirements for attendance is allowed to enroll.

The primary focus of education distinguishes the schools from those that exist within treatment centers. "If I'm a person in recovery, and I'm a student looking for a school to attend, I can't go to a school in a treatment center. When a person is done with treatment, you can't keep going to a school in a treatment center. The purpose of those places is to provide treatment," Finch says.

Education
With academics being the number one goal of the recovery high schools, how exactly are they taught? Much like school size, it varies. The students are not all in the same grade, and even when they are, they don't necessarily have the same credit requirements for graduation. As a result, the schools use different methods to communicate the lessons.

"Since University High School just opened and is small [10 to 12 students], our kids utilize an online school platform called the Bridge School," says Holleran Steiker. "The Bridge School specializes in online learning for kids in settings with additional challenges. It's not like some online schools with worksheets and tests. The students [video chat] with teachers; the value of this is that they all work on the same subject at the same time, ninth to 12th graders, from learning disabled to advanced placement, and they can all be learning on their level."

At Independence Academy in Brockton, Massachusetts, which opened in January 2012, students learn through a combination of in-person teachers and online courses. "We have four academic teachers who teach the main disciplines," describes Karin Burke-Lewis, MSW, LICSW, recovery counselor at Independence Academy. "For other required courses, that vary depending on when students enter in their academic careers, we have E2020. It's an online program that our guidance counselor monitors."

Burke-Lewis notes that when Independence Academy first opened, there were fewer in-person teachers; as the school has grown, it has been able to offer more academics in the classroom.

Recovery
Of course, recovery is also a part of the schools. As a recovery counselor, Burke-Lewis is a crucial part of that. "My role is really to be available and/or meet with the students daily, either in a group format or in an individual format," Burke-Lewis says. "I'm available for students who are struggling in the classroom with triggers. My role is to be available in crisis situations, to provide general psycho-education and some counseling.

"I think my role is to support them [the students] in where they are in their struggle with trying to be clean and sober, or trying to be clean and sober for today. [My role] is to help facilitate some thinking, some reflecting," Burke-Lewis adds.

The students also have to be a part of a recovery program outside of the school to help maintain recovery while in school, and to have a base of support in place once they leave school. "We require students to go to two meetings a week—any sort of recovery-based programming. A part of our job in looking toward graduation and beyond is to ask, 'What are you doing? Who is your sponsor? Who are the people you are calling when you're struggling?' We are all about helping the kids transition out of here with as much community-based support, familial support, recovery support, and academic support as humanly possible," Burke-Lewis says.

Similarly, at University High School, the students must be affiliated with an alternative peer group, which provides them with a clinical component beyond the school's recovery coach.

Benefits
This combination of academics and a recovery environment provides the students with a unique experience they would not find elsewhere and offers them a peer group quite different from what may be found at their original school, particularly because the original school can often be a trigger.

"Many of our students report that their 'home' schools or where they started high school is where they found most of their drugs and began experimenting before becoming full-blown addicts. The recovery high schools give these students the opportunity to finish high school in a positive environment where each of the students and their families share in the goals of living a recovery lifestyle," Harper says.

But that's not to say that recovery schools don't encounter relapse. They do. "The big difference is what happens after a kid has used," Finch explains. "If a kid relapses and comes back to school on Monday morning, he is going to find 30, 40 other kids who he can talk to, who will say, 'Why didn't you call us; next time you want to use, call me.' Students will find an awful lot of support and accountability.

"At a traditional school," Finch continues, "either nobody would know they used, there wouldn't be accountability, or the people who do know are celebrating it. There is a real sense of acceptance around drug using [in standard schools]. You can see how the downward spiral goes really fast. So that's the role the recovery school plays. It's not just helping someone be clean and sober, but to provide support, because it's naive to think that a teenager isn't going to struggle."

In addition to the peer group, the staff—not just the recovery counselors at recovery schools—are a huge source of support, because they, too, are committed to the students' recovery. "Each of us brings a part of the expertise; each of us brings an element," Burke-Lewis says. "Our history teacher is working toward his CADC [Certification in Alcohol and Drug Counseling]," she offers as an example. "He is an addiction specialist in tobacco."

"Additionally, our teachers are really in tune with the students, with seeing that this kid is really struggling today," she says. "One of our teachers said, 'I noted that so-and-so was really unfocused and really upset about something. I had to take my teacher hat off and just listen and get to what that thing was.' You can't do that in a public high school."

And then there are the alumni. "We have a morning community meeting and an afternoon community meeting where all the students and all the staff sit in," Burke-Lewis says. "We reflect on the day. Often, we have former students come and participate in that meeting. If a former student wants to come in and say, 'Get your [expletive] together,' they'll come in and take over my recovery group. They reach out to us; they want to give back.

"As we know, just like any other sort of peer model, people learn from each other, from other people in their like circumstances. That's a service we can provide: Kids giving back to kids," she says.

Drawbacks
There are, naturally, drawbacks to recovery high schools. For one, the schools are extremely small compared with many public high schools, which is both a benefit and a limitation. "The average size is about 30 kids," Finch says. "I think it [the small size] is necessary, personally, to allow the students to have cohesion and awareness and trust. The other side of that is it's a very small school. Some people may not be as comfortable. But for a kid who needs help, being invisible [as some often are in large schools] isn't a good thing."

Beyond discomfort, the low student population disallows for many typical high school activities. "In most recovery high schools, there is a lack of extracurricular activities," Harper says. "Students usually have to give up sports or clubs—if their addiction has not already caused them to quit these things before coming to the recovery schools."

Finch adds, "Sometimes, the schools partner with the local districts so the kids can compete, but that puts them right back in the danger zone."

Another challenge is diversity. "As we've looked at the schools demographically, they aren't as diverse. There are some schools where the majority of students are kids who are low income, where the majority are kids of color. But most schools do trend to middle to upper income and primarily Caucasian.

"The question is, how do they become more diverse? How can the schools address what's known as the treatment gap? There are disparities around who gets treatment, what type of treatment they get. For schools set up for kids who completed treatment, you can't get kids if they don't have access to treatment in the first place," says Finch.

Holleran-Steiker agrees. "Diversity is a very challenging aspect of what we do. There are many communities of color that have even more stigma about seeking treatment for substance use. We are trying to break through those barriers."

"But I think one of the biggest challenges is transportation," she continues. "Right now we're getting people who can walk, get dropped off, or take the local bus. The more you get into this, the more the key is community collaboration."

Advocacy
For community collaboration to happen, there needs to be advocacy. "Advocacy is all about education," Harper says. "Unfortunately, there is a stigma that is attached to addiction and addiction recovery. Many people are simply misguided and confused about what recovery means for individuals and what recovery schools are."

To change the perception, much is being done. Finch is approaching it from a research standpoint. "In the early years, there really wasn't any research about recovery schools," he says. "There was a lot of confusion about what they even were. The fact that we haven't had that strong research base makes it very difficult to go in and say we need X, Y, and Z. It's a difficult case to make.

"[In our research] We're looking at outcomes. We are creating two comparison groups of students and we're hoping to statistically compare kids with exposure to a recovery school and those who have not had exposure. It's not as simple as saying, 'does the kid use or not use.' The reality is that's just not realistic and that's not how most modern studies of treatment outcomes measure success. We're looking at everything from academic outcomes, such as test scores, GPAs, and graduations, to therapeutic measures. The preliminary data has been pretty positive—some of it is pretty profound," Finch explains.

And Harper is getting the word out—working to change the image of addiction. "Most of the misunderstanding is related to the media, films, television, and what is portrayed. When I tell those I am working with that I am a person living in long-term recovery for almost 14 years now (having found recovery as a sophomore in college), their first response is, 'You! No way! You are so nice!' I tell them, yes, but I am not the only one who is living testimony that this disease does not mean we are doomed.

"People can and do enter recovery every minute of the day," Harper adds, "But they have to be given the resources to do so. That is what we believe in at ARS, giving communities, families, and students the resources necessary to become the human being that they are truly capable of being."

— Sue Coyle, MSW, is a freelance writer in Philadelphia.