COLLEGIATE
RECOVERY PRIMER:
REDUCING STIGMA AND ENHANCING ACCESS FOR STUDENTS IN ADDICTION AND RECOVERY
DR. REBECCA CALDWELL, UNIVERSITY OF SOUTH CAROLINA
OBJECTIVES
•
The participant should be able to:
•
Describe the key elements of collegiate recovery programs,
including the current literature base.
•
Engage students who are in addition and recovery through
enhanced skills and a stronger working knowledge of relevant
issues.
WHAT IS A COLLEGIATE RECOVERY PROGRAM?
•
“An innovate and growing model of peer-driven recovery
support delivered on college campuses.” (Laudet, 2014)
•
CRP’s strive to create a campus-based “recovery-friendly”
space and supportive social community to enhance educational
opportunities while supporting students’ continued recovery
and emotional growth. (Harris et al., 2008).
WHAT IS A COLLEGIATE RECOVERY PROGRAM?
•
Reflects the national movement in addiction treatment from an
acute care to continuum care model.
• SAMHSA promotes a recovery-oriented chronic care approach to SUDs.
•
Recovery support systems (RSS), including peer-based support are a
key component of a continuum of care model.
• Peer-based RSS are a key component of the ONDCP National Drug Strategy.
• U.S. Dept. of Ed. goal of ensuring a continuum of care from high school to college to post-graduation (Dickard et al., 2011)
OVERVIEW OF COLLEGIATE RECOVERY PROGRAMS
AND MOVEMENT
• There were 4 C.R.P.s in 2003, 29 programs in 2008, and over 100 at this time.
• Early full-service programs: Texas Tech, Rutgers, & Augsburg
• Explosion of start-up programs since 2012
• Many received start-up funds from Transforming Youth Recovery
• What does the future hold?
• Recovery high schools
WHAT CAN COLLEGIATE RECOVERY PROGRAMS
INCLUDE:
• Identified space on campus
• Identified resource person on campus
• Opportunities for formal and informal peer support
• “Seminar” class or program series to address recovery-related issues
• Access for mutual support, such as 12-step meetings, on campus
• Support groups and individual counseling services
• Formal application process and parameters of membership
• Scholarships and other financial support
WHAT MOST COLLEGIATE RECOVERY PROGRAMS
DO NOT DO:
•
Accept mandated referrals from the college, the criminal justice
system, or families
•
Drug test. Core belief that the students and the community will
reveal relapse.
•
End membership or service access when relapse occurs
• Relapse is addressing rapidly with a treatment plan including re-entry into the community in appropriate manner.
ARE COLLEGIATE RECOVERY PROGRAMS
EFFECTIVE?
•
Larger scale studies are underway.
•
Site-level outcomes include:
• Low relapse rate: CRPs report a 0-25% relapse rate, with a 8% average.
• In comparison, over 60-79% of people attending treatment relapse within 1 year of treatment.
• Strong academic achievement: CRP’s often boast a higher average
WHAT DO WE KNOW ABOUT STUDENTS WHO
PARTICIPATE IN COLLEGIATE RECOVERY PROGRAMS?
• First national study published in 2015 (Laudet et al., 2015)
• 486 of 600 possible students from 29 CRPs responded (81% response rate)
• Participants: Most were male (57%), over 91% were Caucasian
• Mean age was 26.
• Most were full-time students who lived off-campus.
• Of those with roommates, half live with someone in recovery, although a quarter lives with someone actively using.
• Mean days without a drink: 952
WHAT DO WE KNOW ABOUT STUDENTS WHO
PARTICIPATE IN COLLEGIATE RECOVERY PROGRAMS?
• Average lifetime severity of addiction was high.
• 75% had been diagnosed with a mental health disorder.
• Top three conditions: depression (74%), anxiety disorders (48%), and bipolar (23%).
• 76.5% were currently taking medications for mental health disorders.
• Most considered themselves in recovery from more than one substance,
including behavioral addiction: disordered eating (15.6%), self-harm (10.5%), and sex and/or love addiction (9.5%).
• Up to 1 in 6 participants considered themselves in recovery from a behavioral addiction.
PROGRAM EXAMPLE:
UNCW CRC HAWKS
UNIVERSITY OF NORTH CAROLINA
WILMINGTON
• Public 4-Year Institution in southeastern North Carolina
• 5 miles from Atlantic Ocean
• Enrollment: 13,000 undergrad, 1,600 graduate
• 65% female, 35% male
• 85% white, 5 % African- American
• 3rd most competitive state institution for
25 year-old substance abuse prevention & education
program
•
Campus-based prevention efforts based on harm
reduction & environmental management
principles.
•
Adolescent substance abuse prevention
programs to prevent & delay initiation of
substance use
•
Evidence-based interventions for student
experiencing consequences, including campus
citations
•
Collegiate recovery program
Mission:
• Offer opportunities for students in recovery to connect with each other and UNCW
• Provide individual consultations and case management
• Reduce stigma associated with
addiction, recovery, and seeking help Currently On Campus:
• The Ripple Effect, SMART Recovery, AA meeting
• Seahawk Strength & Hope
• Weekly seminar series
• Open Hours & Social events (usually connected to campus programs)
• Case Management uncw.edu/recovery @UNCWCRCHawks Facebook: UNCW Collegiate Recovery Community
Have you ever been to treatment for alcohol and drug abuse or addiction?
5.5%Yes
94.5% No
Do you consider yourself addicted to alcohol and/or other drugs? 3.5% Yes
3.7%Unsure right now 92.8% No
Do you consider yourself in recovery from alcohol and drug abuse or addiction?
2.6%Yes
2.4%I have quit drinking or using, but don’t use the phrase “in recovery” for myself
95% No
Source: 2012 UNCW Alcohol & Drug Survey, n = 429 students
UNCW Addiction & Recovery
Data
The following list include resources that some colleges have made available to students in recovery. Please indicate if any of these would help you now or would have helped you, in your opinion:
80% A dedicated space for students in recovery to “hang out” 50% Sober recovery housing off-campus (in partnership with
campus resources)
50% 12-Step meetings on campus
50% Sober activities for students in recovery
40% Alcohol-free activities on campus (open to all students) 20% Sober recovery living on campus
20% Group counseling with professional counselor
UNCW Addiction & Recovery
Data
VIDEO:
• Adaption of dedicated space • Weekly dinner
• Monthly Seahawk Strength & Hope recovery celebration
• Peer education
• Social & educational events • Support campus AA and NA
meetings
• Support group for affected students • “I SUPPORT RECOVERY” campaign • Faces & Voices training
ISSUES FACING STUDENTS IN RECOVERY
• Studying and living in an abstinence-hostile environment
• Internal pressure to succeed/prove oneself worthy
• Transparency of recovery identity; choosing whether to be “out”
• Developing belonging and connection to peers
• Life skills development • Facing stigma
KEY ASSET: RECOVERY CAPITAL
•
Amassing and Retaining Recovery
Capital
• The resources (social, physical, human and cultural), which are necessary to begin and maintain recovery from
substance use, abuse, and dependence.
• Theorized relationship between recovery
capital and addiction remission (Kelly & Hoeppner, 2014)
MANY PATHWAYS TO RECOVERY
•
Professional treatment
•
Mutual support, including 12-step programs
•
Faith-based/religious
•
Medication-assisted
•
Criminal justice/drug court
RESEARCH INSIGHT: MUTUAL SUPPORT GROUPS
AND YOUNG PEOPLE
John Kelly, MGH and Harvard Medical School (2014):
• 12-step participants appears to help young people across time.
• Young people-specific meeting can engage new people, but a mix of ages
and lengths of recovery is therapeutically optimal.
• There is an observed relationships between 3x per week attendance and
complete abstinence early post recovery.
• Weekly or twice weekly meetings may be effective until five years when the relapse rate falls below 15%
EFFECTIVE COMMUNICATION STRATEGIES START
WITH ADDRESSING STIGMA
•
Substance use disorder remains #1 stigmatized health condition
• Americans generally believe that “recovering” alcoholics or drug addicts are still trying to achieve sobriety.
•
Language conveys knowledge and reduces stigma
• “Person with a substance abuse disorder” vs. “addict” • “Person living in recovery” vs. “recovering addict”
LANGUAGE OF RECOVERY
Current Terminology Suggestions
Substance Abuse Substance Use Disorder
Addict A person with substance use disorder
A person who is addicted to (_________)
Drug of choice Drug of use
Relapse is part of addiction Recurrence is common in a chronic,
progressive disease
Clean / sober Drug Free
Dirty test / dirty urine Positive drug test
EFFECTIVE COMMUNICATION STRATEGIES:
• Be curious
• Use non-stigmatizing language
• Affirm strengths and commitment
• Ask about associated issues: recovery from multiple SUDs, active or recovering from behavioral addictions, mental health concerns and treatment
MOTIVATIONAL INTERVIEWING TECHNIQUES
•
A collaborative conversation to strengthen a person’s own
motivation for and commitment to change.
•
Spirit of M.I. is based on 3 key elements:
• Collaboration between the clinician and the client/patient
• Evoking or drawing out the client’s own ideas about change
RECOVERY ADVOCACY
• There is a national recovery movement of people in recovery, their friends, family members and allies telling the story of the millions of people who live in recovery.
• Over 20 million Americans are living in long-term recovery today!
• Recovery Message Training: Learn how to tell your recovery story to your friends and family and in public settings of your choosing.
• Get more information at: facesandvoicesofrecovery.org
• Change your language and confront stigma when you encounter it.
• Become aware of and promote the public policy agenda of the recovery movement.
RESOURCES
• Recovery Research Institute: Massachusetts General Hospital and Harvard Medical School:
www.recoveryanswers.org
• Transforming Youth Recovery: www.transformingyouthrecovery.org
• Association of Recovery in Higher Education: www.collegiaterecovery.org
• Center for Collegiate Recovery Communities, Texas Tech University, including access to their replication manuals “Collegiate Recovery Communities Curriculum”:
https://www.depts.ttu.edu/hs/csa/
• Faces and Voices of Recovery, including Recovery Messaging Training:
REFERENCES:
• Best, D. & Laudet, A.B. (2010). The potential of recovery capital. Retrieved from:
https://www.thersa.org/globalassets/pdfs/blogs/a4-recovery-capital-230710-v5.pdf
• Cloud, W. & Granville, R. (2008). Conceptualizing recovery capita: Expansion of a theoretical construct.
Substance Abuse & Misuse, 43(12-13), 1971-1986.
• Dickard, N., Downs, T., Cavanaugh, D. (2011). Recovery/relapse prevention in educational settings for youth with substance use and co-occurring mental health disorders: 2010 Consultative sessions report. Washington, DC: U.S. Department of Education, Office of Safe & Drug-Free Schools.
• Harris, K.S., Bakers, A.K., Kimball, T.G., & Sumway, S.. (2008). Achieving systems-based sustained recovery: A comprehensive model for collegiate recovery communities. Journal of Groups in Addiction & Recovery, 2, 220-237.
• Kelly, J.F. (2013). Building recovery capital: Addiction, recovery, and recovery support services among young adults.
Presented at the 4th National Collegiate Recovery Conference, Texas Tech University, Lubbock, TX.
• Kelly, J.F. & Hoeppner, B. (2015). A biaxial formulation of the recovery construct. Addiction Research & Theory, 23(1), 5-9.
REFERENCES:
• Laudet, A.B., Harris, K., Kimball, T., Winters, K.C., & Moburg, D.P. (2015). Characteristics of students
participating in collegiate recovery programs: A national study. Journal of Substance Abuse Treatment, 51, 38-46.
• Laudet, A.B., Harris, K., Kimball, T., Winters, K.C., & Moburg, D.P. (2014). Collegiate recovery communities programs: What do we know and what do we need to know? Journal of Social Work Practice in the
Addictions, 14, 84-100.
• Laudet, A.B., Harris, K., Kimball, T., Winters, K.C., & Moburg, D.P. (2014). Nationwide survey of collegiate recovery programs: Is there a single model? Journal of Drug and Alcohol Dependence, 140, e117.
• Miller, W.R., & Rollnick, S. (2002). Motivational Interviewing: Preparing People for Change. 2nd Edition. New York: Guilford Press.
CONTACT INFORMATION
• UNCW CRC Hawks: www.uncw.edu/recoveru
• Aimee Hourigan, Assistant Director, UNCW CROSSROADS, 910-962-7458,
• Dr. Rebecca Caldwell, Director of Strategic Health Initiatives, University of South Carolina, 803-777-4752, [email protected]
