Imagine if an adult alcoholic were discharged from treatment with post-treatment instructions to continue visiting his favorite tavern for after-work relaxation and support, yet with instructions to keep sober. Or imagine discharging an OxyContin-addicted housewife to the care of the same physician who has written her an inordinate amount of the painkiller to remedy periodic, low-grade back pain.
As unreasonable as these two examples seem, in essence they represent how adolescents are directed upon their discharge from treatment—they are to return to school and the old using people, places and things, yet with orders to stay clean and sober.
It was this reality that led Fairbanks, under the overall leadership of president and CEO Helene Cross, along with guidance from the Association of Recovery Schools, to explore the possibility of establishing a recovery high school in Indiana. In 2006 Fairbanks received a public school charter and opened Hope Academy, the recovery high school at Fairbanks, with its first class of 28 students.
Today, more than 250 students have attended Hope Academy and more than 30 have graduated, with the majority of the alumni attending college or schools offering an advanced technical education. Since opening Hope Academy we have faced challenges and have learned lessons in accomplishing our mission of supporting student recovery and promoting learning and academic success.
Supporting student recovery
There are three critical challenges that must be effectively addressed and managed if the recovery outcomes for our students are to be positive: ambivalence, relapse, and contagion.
Ambivalence: Before opening Hope Academy we repeatedly heard from our treated adolescents that returning to school with its demands, stresses and temptations posed a major threat to their sobriety. With this feedback in mind, we initially believed our students would be relieved to be in a safe, sober and supportive environment, and would readily embrace recovery. We soon found out that, for a good number of our students, this was not the case.
Many came to school with varying amounts of uncertainty about recovery, and it seemed the more removed they were from treatment in terms of time, the more these reservations plagued them: “Am I really an addict?” “Is abstinence and sobriety what I really want for the rest of my life?” “Can’t I use successfully when I am in college?”
One of the lessons we learned is that ambivalence is not necessarily a threat to sobriety. In fact, we found it is at the intersection of students’ need for sobriety and their emerging ambivalence that significant recovery work can take place—if students are given three things: safety and guidance in exploring the ambivalence, a structured way of going about the exploration, and ongoing adult support and monitoring.
Here is where we integrated and applied a number of evidence-based practices and developed student-friendly recovery tools. First, the school retains a recovery coach who provides relational safety and who guides students to explore their ambivalence fearlessly and honestly. Second, a special student personal journal, “90 in 90: A Recovery Tool for Awareness, Accountability and Growth,” was developed, tested and published to assist students in recording and monitoring their successes, issues and reservations. Third, a computer dashboard system was developed where each student’s recovery activities are recorded to indicate a level of risk for relapse or a return to use.
Relapse: The reality is that relapse is part of the post-treatment landscape for most adolescents.1,2 We have learned that the critical issue in students relapsing is the direction to which the relapse leads. Does relapse lead to repair, restoration and growth? Or does relapse progressively lead to a return to use?
After consulting the research literature, we developed our response—Hope Academy’s Relapse Repair and Sobriety Restoration Protocol. The centerpiece of this protocol is an evidence-based practice called node-link mapping.3 When a student relapses, our clinical specialist meets with the student, and together they map the relapse event, memory frame by memory frame, along with corresponding thoughts and feelings. The result is a very dense graphic portrayal, which is recoded on an electronic whiteboard from which copies are printed. These copies are then used by staff and students to compose a recovery repair and sobriety restoration plan.
Contagion: In a review of the literature, K.A. Dodge suggests that when behaviorally deviant adolescents are grouped together, instead of getting better the quality of their behavior generally declines—this is the dynamic of behavioral contagion.4 This observation seems relevant to recovery schools, yet Dodge does point to the exception: When these adolescents are placed in an interventional culture that possesses enough asset-instilling strengths, behavioral contagion is controlled. William White, in his book Pathways: From the Culture of Addiction to the Culture of Recovery, brings to light how the culture of recovery is structurally and dynamically adverse to the culture of addiction. One of the major lessons we have learned is that school culture must concretely reflect key components of the culture of recovery.
Thus, our mission, core beliefs, recovery values and how we interact with others have been professionally produced into posters and are displayed throughout the school. Each year Hope Academy students consider afresh how they are going to enact these principles in the day-to-day operation of the school. They establish the expectations and procedures.