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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.

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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:

1 How to utilize community as a change agent.

2 A teenager’s brain “has a well-developed accelerator but only a partly developed brake.” Laurence Steinberg

3 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

4 Continuum of Use Use MisuseAbuseDependence

5 Diagnose the Problems Genetics/Parents Use LD Mental Health Issues Abuse/Neglect Social Pressure

6 Environmental Factors  We learn what we live with.

7 Adult Treatment Verses Adolescent Treatment  Developmental Issues  ?

8 Safety Adolescents have safety and supervision needs that adult’s in recovery do not.

9 Motivation  Who is the Client ?  Why should they stop using ?  Stages of Change

10 Earning The Right To Be Listened To

11 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 ?

12 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

13 Marijuana  THC – half-life  800,000 people a year are admitted into treatment a year for marijuana dependency  Cannabinoids (40 + chemicals)  Subtle Impairment

14 Heroin

15 Synthetics N Bome K2, Spice

16 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

17 Other Prescription Drugs  Oxycontin, Valium, Hydrocodine, Vicodin (for pain)  Psycho-Stimulants: Ritalin, (methylphenidate) Adderall, Concerta (ADD, ADHD)  Dizziness, loss of appetite, irritability, palpitations, nervousness

18 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 ?

19 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 ?

20 What is APG?

21 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

22 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

23 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

24 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%

25 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.

26 Not all adolescents in treatment are Addicts.

27 After School Program  Recreation Center  Weekend Social Events  Tutoring  College Coaching  Age Appropriate Twelve-Step Meetings  FUN!!!!!!!!!!

28 Clinical Services  Life Skills Group  Individual and Family Counseling  Psychotherapy  Assessment & Referral  Multi-Family  Parent Psychotherapy Groups  Marriage Counseling  Psychiatric Testing

29 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.

30 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.

31 The Association of Recovery Schools  22 High School Members  16 Collegiate Members

32 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

33 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

34 Parent Satisfaction with APG Baylor College of Medicine, Houston Texas

35 Parent Satisfaction with APG Baylor College of Medicine, Houston Texas

36 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.

37 Global Assessment of Functioning

38 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.

39 Global Assessment of Relational Functioning

40 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

41 Thank You !


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