Presentation on theme: "How to utilize community as a change agent.. A teenager’s brain “has a well-developed accelerator but only a partly developed brake.” Laurence Steinberg."— Presentation transcript:
How to utilize community as a change agent.
A teenager’s brain “has a well-developed accelerator but only a partly developed brake.” Laurence Steinberg
Recovery Oriented Systems of Care A framework for coordinating multiple systems, services and supports to meet the individual needs and chosen pathway of recovery. We are all on the same team Treating addiction as a chronic illness rather than acute Treatment, therapy, psychiatry, and community based services partnering to create improved outcomes
Continuum of Use Use MisuseAbuseDependence
Diagnose the Problems Genetics/Parents Use LD Mental Health Issues Abuse/Neglect Social Pressure
Environmental Factors We learn what we live with.
Safety Adolescents have safety and supervision needs that adult’s in recovery do not.
Motivation Who is the Client ? Why should they stop using ? Stages of Change
Earning The Right To Be Listened To
The Family System Are primary care givers actively abusing substances ? Are primary care givers capable of enforcing behavior modification plan ? If primary care givers are married or in a relationship, what is the quality of that relationship Does the family need a sick child ?
Different Drugs of Abuse Alcohol is physically the most damaging. Senior stats from TCADA 4,000 students surveyed 2,400 drove after drinking something in past two weeks 1,300 drove after 3 or more drinks
Marijuana THC – half-life 800,000 people a year are admitted into treatment a year for marijuana dependency Cannabinoids (40 + chemicals) Subtle Impairment
Synthetics N Bome K2, Spice
Anti-Anxiety: Benzodiazepines Xanax- “handle bars, bars” Valium Can cause drowsiness, light-headedness, confusion, nervousness, racing pulse rate, low blood pressure, tremors, slurred speech, decreased respiration and pulse, addictive Extremely obvious intoxication-slurred speech, combative behavior When mixed with alcohol, extremely dangerous/risk of overdose Very addictive/dangerous withdrawal
Other Prescription Drugs Oxycontin, Valium, Hydrocodine, Vicodin (for pain) Psycho-Stimulants: Ritalin, (methylphenidate) Adderall, Concerta (ADD, ADHD) Dizziness, loss of appetite, irritability, palpitations, nervousness
Peer Group Influence An Adolescent will not abstain from substance use as long as they associate with a peer group that still uses. What Can We Do ?
Social Life - School Life According to the Association of Recovering Schools 85% of teens returning to their home school campus after completing RTC will return to active substance use. How do we re-integrate recovering teens in to the mainstream of life ?
What is APG?
Alternative Peer Groups (APG) The Alternative Peer Group model was created to address the emotional, psychological, spiritual and social needs of teens struggling with substance abuse issues This unique treatment model integrates the important peer connection with sound clinical practice through intervention, support, education, accountability and family involvement. Baylor College of Medicine, Houston Texas
How do we know APGs work? Objective Kids get and stay sober Academic outcomes improve Subjective Parents are satisfied with the success of APGs Baylor College of Medicine, Houston Texas
APG’s – The Solution? Motivation – Can the same relationships that initiate and support use and dependence prove effective in facilitating recovery? Mission – To create an adolescent specific recovery community for teens. Strongly Encourage – Completion of a substance abuse treatment program, a desire to abstain from drugs/alcohol, willingness to work a 12-step program and agreement to attend meetings and activities. – Parent participation is strongly encouraged. APG is lead by a licensed clinicians. Baylor College of Medicine, Houston Texas
APG Success Factors Accountability & consequences Fun – lot’s of group activities Kids get to be kids (with boundaries) Parents “strongly encouraged” to attend and support recovery Parents achieve personal growth Recovery: Greater than 85% vs. less than 30%
Community Creating a community of support for families is the primary objective of the APG model. Like traditional twelve-step programs, the shared experience and spiritual focus is what creates healing.
Not all adolescents in treatment are Addicts.
After School Program Recreation Center Weekend Social Events Tutoring College Coaching Age Appropriate Twelve-Step Meetings FUN!!!!!!!!!!
Clinical Services Life Skills Group Individual and Family Counseling Psychotherapy Assessment & Referral Multi-Family Parent Psychotherapy Groups Marriage Counseling Psychiatric Testing
Defining a Recovery School Two types of recovery schools: 1. Recovery schools at the secondary level meet state requirements for awarding a secondary school diploma. Such schools are designed specifically for students recovering from substance abuse or dependency. 2. Eligible colleges, similarly, offer academic or residential programs / departments designed specifically for students recovering from substance abuse or dependency.
Defining a Recovery School (continued) Recovery Schools Provide academic services and assistance with recovery. Require that all students enrolled in the program be in recovery and working a program of recovery. Offer academic courses for which students receive credit towards a high school or college degree. Are prepared through policies and protocols to address the needs of students in crisis, therapeutic or other.
The Association of Recovery Schools 22 High School Members 16 Collegiate Members
Alternative Peer Groups: Are they effective? Rochat R 1,2, Rossiter A 1,3, Nunley E 1,3, Bahavar S 1,3, Ferraro K 1,3, MacPherson C 1,3, Basinger S 1,4 Biography 1.Baylor College of Medicine, Houston Texas MSTP Candidate SCBMB Program, Baylor College of Medicine, Houston Texas 3.Physician Assistant Program, Baylor College of Medicine, Houston Texas 4.Graduate School of Biomedical Science, Baylor College of Medicine, Houston Texas
Educational Outcomes for APG Students * : 109 students enrolled (rolling admission) 87% sobriety rate (students who stayed sober the entire school year) 89% school attendance 96% of seniors graduated 18 graduates in 2009 90% of graduates attending college 79% student retention (all grade levels) * Sober High School in Houston Texas
Parent Satisfaction with APG Baylor College of Medicine, Houston Texas
Parent Satisfaction with APG Baylor College of Medicine, Houston Texas
Global Assessment of Functioning Superior functioning in a wide range of activities Good functioning in all areas, occupationally and socially effective No more than a slight impairment in social, occupational or school functioning (e.g., infrequent interpersonal conflict, temporarily falling behind in schoolwork.) Some difficulty in social, occupational or school functioning but generally functioning well and has some meaningful, interpersonal relationships Moderate difficulty in social, occupational or school functioning (e.g., few friends, conflicts with peers or co-workers.) Serious impairment in social, occupational or school functioning (e.g., no friends, unable to keep a job.) Major impairment in several areas such as work or school, family relations (e.g., depressed man avoids friends, neglects family and is unable to work; child frequently beats up younger children, is defiant at home and failing at school.) Inability to function in almost all areas ( e.g., stays in bed all day; no job, home, or friends.) Occasionally fails to maintain minimal personal hygiene; unable to function independently Persistant inability to maintain minimal personal hygiene. Unable to function without harming self or others or without considerable external support (e.g, nursing care and supervision.) 0 Inadequate information.
Global Assessment of Functioning
Global Assessment of Relational Functioning Relational unit functioning satisfactorily from self-report of participants and from perspectives of observers Functioning of relational unit is somewhat unsatisfactory. Over a period of time, many but not all difficulties are resolved without complaints Relational unit has occasional times of satisfying and competent functioning together, but clearly dysfunctional, unsatisfying relationships tend to predominate Relational unit is obviously and seriously dysfunctional; forms and time periods of satisfactory relating are rare Relational unit has become too dysfunctional to retain continuity of contact and attachment.
Global Assessment of Relational Functioning
Acknowledgements Study funded by grants from Archway Academy, Humana, and Discovery Lab IRB approval was obtained through BCM Protocol #H Special thanks to Crystal Collier at The Council on Recovery for contributing to this presentation