Recovery High Schools: Interview with Lori Holleran Steiker, Ph.D.

[Episode 105] Today's Social Work Podcast is about Recovery High Schools. I spoke with Dr. Lori Holleran Steiker, Distinguished Professor at the University of Texas at Austin’s School of Social Work, and author of the 2016 book, Youth and Substance Use:  Prevention, Intervention and Recovery. We talk about risk factors for addiction, adolescent brain development, how to think about addiction from a biopsychosocial-spiritual perspective, why recovery or sober high schools fit an essential gap in the continuum of care for youth struggling with drugs and alcohol and how you can help to bring one to your community. We end our conversation with Lori making an impassioned plea to join the fight against adolescent addiction.

Download MP3 [50:48]

Bio

Lori K. Holleran Steiker, Ph.D., ACSW, an addictions therapist turned educator/scholar, is a Distinguished Teaching Professor at the University of Texas at Austin School of Social Work. She graduated from Duke University, got her Master of Social Work degree from the University of Pennsylvania, and received her Ph.D. from Arizona State University in 2000.   She conducts federally and foundation-funded research in the area of adolescent and emerging adult substance misuse prevention, intervention, and recovery with an emphasis on peer-to-peer mentorship. She is proud to identify as a person in long-term recovery and she is the driving force behind University High School, Austin’s first recovery high school.  Dr. Holleran Steiker serves actively as the faculty liaison for the University of Texas at Austin’s Center for Students in Recovery (CSR) as well as the founder and liaison for UT’s Drug and Alcohol Public Awareness (DAPA) student group.   She designed and teaches the University of Texas’s first “Young People and Drugs” class, one of UT’s Signature Courses, with hundreds of students a year. Dr. Holleran Steiker has over 90 publications in the area of substance use disorders.   In addition, she has received numerous academic, career, and civic honors.  Her book, Youth and Substance Use:  Prevention, Intervention and Recovery (2016), is now available from Oxford University Press.

Transcript

Intro
Hey there podcast listeners, Jonathan here. Today’s episode looks at an innovative approach to helping kids who struggle with addiction to drugs and alcohol stay sober during high school. When I was first practicing social work in the mid-1990s, I was taught that adolescents could use drugs and alcohol with impunity. In fact, adolescence was the best time for kids to use drugs and alcohol. Why? Because teenagers are healthy, resilient and if they did anything too stupid their criminal records would get expunged on their 18th birthday. I told parents, “look, if your kid is going to get wasted at a house party, better now than later.” This was really bad advice. The brain is way more likely to get addicted during adolescents than adulthood. According to the National Center on Addiction and Substance Abuse, 1 in 4 Americans - that’s 25% of Americans - who began using any addictive substance before age 18 are addicted, compared to 1 in 25 - that’s 4% - who started using at age 21 or older. Why is this? In episode 90 of the Social Work Podcast, Larry Steinberg told us that the adolescent brain is set up to seek out risk and reward. Drugs are risky and rewarding. If you were a teenage brain and you wanted something that was reliably risky and triggered all sorts of reward centers, you’d be hard pressed to find something better than drugs and alcohol. This idea of addiction as a brain disease is going to come up later in the episode, but we don’t really go into detail. So, here’s some ideas from the American Society of Addiction Medicine website about the mechanisms behind addiction as a brain disease:

Drugs and alcohol affect the parts of the brain associated with reward, motivation, memory and related circuitry. The parts of the brain that we think of as the “reward centers” include the nucleus accumbens, anterior cingulate cortex, basal forebrain, amygdala, and Lin-Manuel Miranda. Just kidding about that last one. But I’m not kidding that the Hamilton soundtrack stimulates the brain’s reward centers just like alcohol and drugs. Which is probably why my kids can’t stop signing it. So when someone uses drugs, it affects the way the cortical and hippocampal circuits and brain reward structures communicate. It actually triggers memories of prior use and creates cravings. When we feel cravings, we do whatever we can to satisfy those cravings. Imagine feeling thirsty for the better part of a day. You would be singularly focused on quenching your thirst, even if that meant drinking water that might be dirty. When the craving is for drugs and alcohol, and there are problems with impulse control, judgement and the pursuit of rewards, neurologically speaking, this is a problem with your frontal cortex and the underlying white matter - aka “brain stuff.” The good news is that positive peer, cultural and clinical interventions can be quite effective in altering the course of addiction and actually have been shown to change brain chemistry.  Now, I’m not going to talk any more about the addicted brain, but if you’d like to know more, the American Society of Addiction Medicine website at asam.org goes into much more detail about the neurobiology of addiction.

So where were we? Oh right. High school. Now, popular culture still promotes this idea that adolescence is the perfect time to party. Hit songs and music videos float around in a cloud of pot smoke, red Solo cups, and an endless supply of cheap beer. Remember Rebecca Black? In 2011 she released a video "Friday" about a massive house party with under aged youth “looking forward to the weekend.” It became an internet sensation and universally panned as one of the worst songs of all time.



Later that the year Katie Perry released “Last Friday Night” also about excessive partying. It becomes her 5th consecutive #1 single from the same album and solidifies her status as a pop star legend. Even though Katie Perry isn’t a teenager, and the song wasn’t written about her experience as a teenager, she decides to make a video that places the song squarely in high school. Why? Because she knows that we idealize the high school party. And she knows how to capitalize on a cultural moment. Just as Rebecca Black is getting death threats and viciously attacked online for her terrible song about a Friday night house party, Katie Perry casts her as the cool kid having the ultimate 1980’s-esque house party. Rebecca Black helps Katie Perry’s nerdy alter-ego Kathy Beth Terry go from social reject to sex goddess.  And just like that, Katie Perry’s video flips reality. Online, Rebecca Black is a total social reject and Katie Perry is the ultimate cool kid. But in Perry’s video, Rebecca Black is the cool kid and Katie Perry is the loser. Her pop genius sells us a fantasy that in a world with massive suburban houses populated by rich White teenagers, no parents, endless partying, references to date rape, binge drinking, vandalism, or Kenny G, even the person who in real life is the joke of the party can become the cool kid.  And isn’t that what teenagers want? To be the cool kid?



But here’s the real deal. In the 1980s – the era parodied by Katy Perry’s Last Friday Night – I was a teenager, and I did go to those parties. And I went in part because I wanted to be cool. In the parlance of Hamilton, I wanted to be in the room where it happens. And I’ll never forget the party at my friend Chris’s house where this kid I really looked up to did some really stupid things because he was wasted.  And seeing a cool kid look stupid because of alcohol convinced me that if I wanted to be cool, I should avoid drugs and alcohol. I realize this isn’t a typical reaction. In fact, research suggests that about one-in-eight youth youth meet criteria for a substance use disorder and “90% of Americans who meet the medical criteria for addiction started smoking, drinking or using other drugs before age 18” (http://www.centeronaddiction.org/addiction-research/reports/adolescent-substance-use). In other words, the advice I got when I first graduated with my MSW was wrong. The adolescent brain is incredibly vulnerable to addiction. High school is a terrible time for kids to party.

So what services are out there for kids struggling with addiction? There’s individual, family and group therapy, mutual support groups such as 12 step programs, SMART recovery, and Moderation Management. There’s formal and informal peer recovery supports. There are residential options - inpatient hospitalization with or without detox. There’s intensive follow up in Out-Patient or Partial Hospitalization care; Sober living homes with various levels of supervision. And recently sober schools – recovery high schools and collegiate recovery programs.


In today’s episode I talk with one of the best people on the planet, Dr. Lori Holleran Steiker, Distinguished Professor at the University of Texas at Austin’s School of Social Work. We talk about risk factors for addiction, adolescent brain development, how to think about addiction from a biopsychosocial-spiritual perspective, why recovery or sober high schools fit an essential gap in the continuum of care for youth struggling with drugs and alcohol and how you can help to bring one to your community. We end our conversation with Lori making an impassioned plea to join the fight against adolescent addiction. And now, without further ado, on to Episode 105 of the Social Work Podcast:

Interview

[10:36]
Jonathan Singer: Lori, thanks so much for being here on the social work podcast today and talking with us today. Can you set the stage and tell us what it is typically like for teenagers/high schoolers and substance use?

Lori Holleran-Steiker: Absolutely. Thanks for having me today. I want to start by saying most adolescents can go through high school without a substance use disorder. It’s still a minority that winds up with the full-blown brain disease. That being said, the average age of onset has dropped to 14, which is really really young when you think about the span of time that it takes for an adolescent have that full brain development. The research these days shows that plasticity continues all the way until about the age of 25. We have babies using substances. That’s what usually leads to kids leaning on the substance as a coping mechanism, a medicinal way of addressing depression or fears or insecurities in ways that kids without substances are able to move along in the developmental processes that are necessary for adolescents. We’ve got adolescents that are not able to navigate their life experience in a way that is really tenable and amenable to happy and comfortable life. That being said, peer pressure, it’s a bit of a misnomer in the sense that no one is tying anyone down and say ‘here use these drugs’. It’s a more subtle and insidious thing in high school. So, there are things called “triggers” for kids. There are the kids that are considered cool that are using, there are parties where that’s the predominant activity. There are parents who are using at home and sort of setting the stage for that. So, I think that in a lot of ways it’s the cultural shift towards acceptance of drug use that’s a problem for a kid that’s predisposed because of the brain chemistry. A kid that’s predisposed who experiments, which is normative, they wind up with this compulsion to continue using regardless of consequences and that’s what we see in about 1 out of 4 kids with some kind of issue around drugs and alcohol. 1 in 10 has a full-blown substance use disorder by the time they leave high school.

[13:23]
Jonathan Singer: It’s so interesting because, like you said, there are these things that the brain has to do in development, and then there are the things that we think of typical social development like what’s my group, who are my friends, how do I fit in, all those sorts of things. And you’re saying this idea that kids get into school and they’re pressured to use drugs and that’s what causes teenage addiction, that’s a bit of myth.

[13:56]
Lori Holleran-Steiker: Absolutely. When we look at the issue of adolescence in substance use, we always talk about the biopsychosocial spiritual model; it’s every holistic aspect of self. It’s the genetic disposition, or the biochemistry related to potential addiction, it’s the blackouts and tolerance and all thus biological pieces that are red flags. And then psychological piece, the sense of self, the way of talk, whatever their affect prompts in terms of the way they view themselves in the world, and that of course that blends into social—how they’re interacting with others, whether or not they have self-efficacy--do they feel they’ll be able to accomplish what they set out to do. In terms of the spiritual, I think people make the mistake of thinking we mean religious when we mean—it’s how do you make meaning in the world, what you believe in terms of how the world works and when you start using substances at such a young age it’s like taking silly putty—do you remember when you put it down on a cartoon and you pick it up and as soon as drugs get involved you start pulling and playing with that silly putty and the picture doesn’t resemble what it did in the first place and these kids don’t even know their thinking has changed. So, it’s pretty profound and even the kids that wind up with a problem, the kids whose parents are not in denial –which is pretty common by the way—and they see that issue with their kids and maybe it’s full-blown, maybe there’s some serious consequences, legal or academic, even those families when they send their kids off to treatment, the most conservative finding says that 70% of the kids that go off to treatment and return to their regular high schools go back to using within the first month. Some studies show closer to 80 to 90% returning to that substance use. The problem is that we’re treating this chronic, potentially fatal illness as if it’s acute care and we send kids away and we say we’re going to fix them and then they go back to all of these biopsychosocial spiritual triggers and deeply entrenched ways of navigating with the world substances and we find that they’re just simply unable to make use of whatever they’ve learned, no matter how good that treatment is.

[16:45]
Jonathan Singer: For somebody who doesn’t remember what high school was like, or someone listening internationally, can you describe what a typical scene is in a high school that someone has to negotiate?

[17:02]
Lori Holleran-Steiker: Sure, there’s the developmental piece clearly, you’re a young person desperately trying to figure out who you are, you’re brand new to abstract thinking so you gone to from concrete to layers and layers to any decisions that you make or any perceptions of the world. You’re shifting from your parent orientation to a peer orientation so suddenly your fellow peers are also sort of not having sea legs a life experience are your touchstones and sort of stumbling through trying to figure out who you are and how you’re different from other people because that’s the main developmental task is individuation who am I separate from the rest of the world. Layered on top of that is a culture that is often orientated around substances. Each culture is different. I can’t quintessentially say here is what it looks like in high schools these days with drugs. Some have kids getting high in the bathroom, others have very strict rules, and they’re getting high behind the school or before they come to school. There are others that are very anti-drug and yet drowning in alcohol. There are other settings still that are all about the drugs that can’t be detected in drug tests because there’s a lot more awareness and there are drug-sniffing dogs in the hallways. I can’t tell you what a typical high school looks like in terms of this experience, but I can tell you that it is very rare to have a high school where it isn’t at least an undercurrent if not an incredible undertow. Even the kids that are feeling really really confident and strong in their sense of self tell me that there is a sense of maybe I’m missing out because it looks from the outside to be so much fun to be involved in that scene and there are kids for which it is fun and is considered recreational, of course illegal if it’s an illicit substance so there’s always risk involved. But there are kids for whom can do it with impunity there are other kids where as soon as they’re in it the nightmare begins.

[19:30]
Jonathan Singer: So tell me how this recovery high school works

[19:33]
Lori Holleran-Steiker: Well okay so now that’s the part I’m excited about. There are solutions and it’s just incredible to me the direction we’re going with youth and recovery. We’ve talked for a long time about the horror stories, and they’re still proliferated ad nauseam we hear about the overdoses, we hear about kids walking into schools with guns, we’re hearing about those big, dramatic nightmares and it chips away at parents and parents’ and communities’ sense that there are really effective interventions and things that can be done. What we know to be true is if a young person gets into the nightmare of an addiction and has even a modicum of willingness to consider some type of alternative, what we find is in their desperation is that if you put them in a setting that is truly a holding environment, a wraparound service for this youth that provides for all their needs, they don’t just survive this they thrive. We think that a recovery high school at least in Texas we’ve witnessed, recovery high schools can be a hub for all of the community resources of adolescents with substance use disorders. The reason is that the school itself is exactly that with the primary mission of providing academic services with recovery support serves to bolster that for the youth. Sasha McLean, who’s the director of at Archway academy in Houston would say”, we’re Switzerland, we’re not the treatment center, we’re not marketing that way, we’re not the alternative peer groups that may or not have counselors and family therapy and all of those things. We’re the kids’ school, the safe place where they go from 8AM-3 or 3:30 and then we can sort of assess what other support services are needed for this kid and really tie them in. So we do see it as a hub for the kids’ recovery.

[22:00]
Jonathan Singer: I love this image of a recovery high school as being like Switzerland, this safe place this place they can go where they don’t have to worry about the triggers you were talking about where as they are negotiating these normal developmental tasks, this is not a layer of complexity that’s thrown onto them. When you have kids that have struggled with substance use and they’re in this environment, what’s it like for them, how do people interact with them, how are things done differently.

[22:35]
Lori Holleran-Steiker: I’m glad you asked and part of me wants to say that I will not be able to say, I will not be not able to find words to adequately to describe this. If anyone is interested they need to visit these recovery schools and experience for themselves. I have worked in the addictions field for 20-some years I don’t even want to add it up because people might do math and that will equate with figuring out my age (laughter). I actually have a lot of recovery in my family, I consider myself a person in long-term recovery, and I’ve been around this a long time. When I went to my first association of recovery schools, which was held at a recovery high school in Houston, my mind was blown. The kids were so poised, so comfortable in their own skin—they hugged each other when they saw each other. But when they did check-in in the morning, they were all over keeping each other accountable and saying ‘I’m really worried about you and this is what that looks like’. They are laughing and having fun; they are putting their nose to the grindstone when it comes to their work. There are still recovery schools that are all about dropout prevention. These kids have had a very tough time in their own high schools and academic life, so part of the beauty of the schools being relatively small is we can have an individualized program both academically and the formal and informal support services can supplement their experience at school. We do a typical school day to the surprise of many people who come to witness recovery high schools, other than the check-in in the morning and available recovery coaching when needed during the day, it really appears to be a regular school. There’s teachers, we have a hybrid model at University High School in Houston where we have teachers on-site and individual work and there doing a lot of their courses online as well, so we actually are connected with the charter school, that’s one of the models, so the UT Charter provides our education and we can focus on the recovery support services and partner with them in that respect. But I think the part that people don’t expect is we have something on Friday called Friday Fill Ups and they are mostly orchestrated the students themselves and the leaders in the school. They decide what they’re going to do for Friday Fillups, and they’re mostly fun activities, they’re tie-dying t-shirts, and doing some services--I know that one of the schools to hospitals and does random acts of kindness just helps people carry things and brings flowers to folks and things like that. So I think that the most important piece in all this, if you could put everything in a colander and shake it, some of the things that stay in the colander, the big rocks as some describe it, these kids are having more fun clean and sober they ever had high. The high was no longer a fun place for them, they were absolutely out of fun, and when they come here, they have peers who care about them, who know their experience, and the other big rock is that they are not being judged for who they are. There’s recognition that these are kids with strengths and talents and all kinds of potential and also a brain disease that needs addressing for them to move on and navigate their lives in a successful way.

[26:43]
Jonathan Singer: I think it’s genius that there’s a place where kids can have experiences that provide them with more pleasure than the drugs. Because, as you were mentioning before, brain plasticity and brain development, we know that adolescent brains are wired for pleasure, right? They want experiences that will feel good and boy, drugs feel really good, you know? If there is something that feels better than drugs then the brain’s like, let’s do the thing that feels better! That’s a beautiful way to combat the drugs. It’s profound. At what stage would you say to someone there’s a parent that’s talking to you, I’m concerned about my kid, what point kind of qualify or would benefit from a recovery school like this?

[27:52]
Lori Holleran-Steiker: Yeah, I’m glad you asked. I do want to say that with all the knowledge we have about multiple pathways or roads to recovery, that there are some kids that will age out of this, there are some kids who will find that if they do yoga and mindfulness that’s plenty that’s enough for them, and others that will find their passion or their love being at a sport or a career, and that will be the thing that fills them up, that allows them to move away from substances. But for the kids who have, I think the best cut point is, that which creates ongoing problems is a problem. Many kids come in and say, “I didn’t get in trouble every time I was high, but every time I got in trouble I was high”. It’s for the kids it is such a deep catalyst for their downward spiral. Many times it’s the youth that need to recognize that they need something different. We never have a kid that’s like, “Oh, I can’t wait to go to a Recovery high school, that’s for me! Oh my gosh that exists?!” There’s always ambivalence involved, I think it needs to be a team intervention. I think parents need to say let’s be open with us and see what it looks like. Because at our school we have an executive director who goes out into the community and meets with social workers and clinicians and school to help them understand what it is that recovery high schools do. We also have a director of recovery services who meets with families and with youth, gives them a tour, does the full assessment and can really give them honest feedback as to whether or not this would be a useful place. Because the truth is, if that is not a kid that has an addiction, that would not be a kid for a recovery school, we aren’t going to take kids just to bump numbers; the whole thing is about having a recovery culture. At intake, they’re not going to take a kid who’s not going to be a fit for the school. I would say that the best way to navigate that decision-making is go see the school, go talk to the director or the recovery coach that works there, and feel it out, see if there’s any sense that this is the next right thing.

[30:38]
Jonathan Singer: So for those listening saying, I desperately want a recovery high school in my community, what is their next step?

[30:42]
Lori Holleran-Steiker: The first step is you go to the website of the association of recovery schools. And go to transforming youth recovery, which is an agency that supports recovery schools both on the high school level and the collegiate level. They have something they have done a bunch of research, there’s something called an asset map. You can look at a map of the US and see where the recovery schools are. And related resources. That would be the first thing. You may not have to reinvent the wheel in your community, there may be one that exists, and we’re just at the precipice about raising awareness, so you may not have heard of it. The best thing is to find out if one exists first. The next step is if there is not something in your vicinity, get in touch with the association, AND transforming youth recovery, they are very interested in helping people get started. Andy Finch is the faculty member who is doing the national research on this. He is also the adviser for the association of this, and he’s written a book about how to start a recovery high school. There are a lot of resources that are starting to pop up. There are all kids of new directions to go based on the resources you have available, AND the needs of your community. Let me talk about Austin—we knew that the community of young people in recovery was still fairly scant, that there were some services that attended to these youth, but for the most part it was not that holding environment, not that wraparound services we would want that to be. When we started talking about a recovery high school, it was like a magnet it drew people from the clinical settings, from schools, it drew parents who had lost kids to additions, it drew parents who had kids with addictions, it drew the recovery community and the 12-step recovery communities, it drew people from the university. We couldn’t believe it the first time we had an information session, I remember saying to my husband, go get bagels for the information session, he said how many, and he said between 10 and 150 people. I had no idea how many people who would show up for such a thing. We had over 150 people at that first information session, that just was sent I sent it to the people I knew, and they sent it to the people they knew—if it’s meant to be in your community, start talking about it. Play the podcast, have people listen to it, and if it’s a community that needs it, the right people will start to emerge. In Texas, the model for recovery schools is that we make it mandatory for every kid that comes to our school, to go to some kind of alternative peer group after school and on weekends. There are a variety of models for alternative peer groups—some are free and just offer peer recovery counseling, and meetings to go to, and social activities. Others are much more structured, with clinical interventions available, individual group family work, and so the fact that 8AM-3PM is not going to cover a kid’s full life, they are not going to stay clean and sober probably if it’s just that. And to be very honest with you, we think all of the pieces are important—there’s some studies have come out of Houston—I think Dr. Bassinger was the one that responsible for the study—that it showed that if a kid just comes out of treatment, about 10% of them will achieve some length of recovery of some sort.

[35:00]
If they have instead a recovery high school, an alternative peer group place to go after school with other recovering peers, a place to have fun, that safe place that sort of catches them after the school, and family involvement, the percentage of kids that are able to maintain some sort of recovery jumps up to 75%, which is ASTOUNDING when you think about it, just absolutely astounding, so we think that having all of those pieces in place is really an incredible thing. When we were starting our school, there were a bunch of decisions that had to be made, we didn’t make them perfectly, of course you’re going to make mistakes as you go along, you need to have some sort of plan for sustainability, these schools can be expensive. There are different models—a school that was opened in New Jersey, which is actually funded with some state money. There are new models with that kind of funding. Donors are the primary mechanism, there are people that want to be the foundation for schools like this, so that is absolutely a piece in this. The charter school models I mentioned is often a great partnership because it will take care of the educational component in a way that is accredited and will really make your kid successful. The pieces that we added in Austin that we think is going to proliferate as a new model for recovery schools, is that we have the recovery high school adjacent to the university. I mean, physically it is right up against that university now. Some people might say that’s a little nuts right, what could be more dangerous in terms of the place for trying to build a recovery than a university, which some people consider recovery hostile. The way we’ve navigated that is that we have at least at the University of Texas, a very successful collegiate recovery program, that has been going strong since 2004, so we have college students who are navigating that campus in a way that is not just surviving college but thriving as sober people in that setting. What we’ve done is a formal mentorship between the collegiate program—the UT Center for Students in Recovery—and the recovery HS. We actually get them trained as recovery coaches through the communities for recoveries grant to train them—it’s called YAY program—Youth and Emerging Adults—so they get the full recovery coach training, which is a certified training by the state of Texas, and then by virtue of going through the training, they commit to getting their hours, to complete their certification by giving back to the high school. It is win-win-win-win-win-win. Everybody that’s involved gets something positive out of it. The kids at the collegiate recovery center get this incredible training, this certification they can use in other settings, and an opportunity to give back what was given to them in a way that supports their OWN recoveries. The high school kids get to witness that, get to feel a part of not just the high school, but of the university recovery community. We have sober tailgates, we have sober activities, globe bowl at the bowling, at the union, we have all kinds of fun things going on, and we’re building a solid identity for these kids that they are proud of. We took our student council to the rally in D.C. called Unite to Fight Addiction and there were thousands, thousands, and thousands of recovering people who showed up at that rally. There were rockers in recovery, like Joe Walsh, and Sheryl Crowe, and they were loud and proud about their recovery. So our kids get to see that it’s not something you walk around ashamed of. It’s something you hold your head high, and say, I am a person who’s getting well from addiction. And there’s in people in long-term recovery they get to see who have gotten well from addiction. This is a really new stance for the field. I think we need to start to think, we’ve been thinking about the illness long enough. As social workers it’s our place, it’s our responsibility, it’s our value base to say, “What are the strengths of these kids and how do we promote wellness?” People are doing this, Jonathan; they’re getting well from addiction. These kids even went to the day after the rally was an advocacy day, they went to the Capitol, and they sat down with our representatives and our legislators and said, “These are the services we need bolstered because this is what is changing my life and saving my life.” IF you want to hear it out of the mouths of the kids, if you go to the Recovery Students Facebook page, if you listen to these kids, they talk about how in regular high schools, other kids’ stressors are what peer group they’re going to hang with, what clique. For themselves, they were worried about whether or not they were going to survive high school. And here they are advocating for recovery in D.C. It’s just mind-blowing their transformation and growing sense of self.

[41:16]
Jonathan Singer: This is so inspirational, and the picture that you painted, I got this image of, instead of throwing these kids or making these kids be in an environment during their high school years that are threatening, that they’re in these safe spaces where they can have the same kinds of joys and pleasures that maybe some kids can get in a high school setting, but is really something that people were getting in elementary school, like this sense of “I want to go! I want to be with my friends! I want to experience this, I want to do projects, I want to do these sorts of things!” Which isn’t to say this isn’t developmentally appropriate, but it actually provides a safe enough space where kids can be creative and explore and do those sorts of things.

[42:15]
Lori Holleran-Steiker: Well you know how the drugs and alcohol tends to interrupt the developmental trajectory. People who go into recovery as adults a lot of times say, here I am in this 40-year-old body with a 14-year-old sense of self. So what’s nice is that we get to fill in the gaps pretty early, where they get to get back on track so quickly, that it’s actually beyond back on track, they’re given this new vision for their life and their self that they’re able to really get their arms around. We’ve had two sober gradates, we’re very, very excited about, we just opened two years ago, so we serve 9th-12th graders so one of the kids who got clean and sober at the high school in living in a sober dorm at Texas Tech and is navigating college in a way that he practiced while he was at his recovery high school through transforming youth recovery we know which colleges have supportive environments for our youth, so we can actually use this as part of our way-finding, our advising of our students in terms of as to where they will feel most comfortable as college students. We are paving the way to higher education and to lives in recovery in multiple ways.

[43:40]
Jonathan Singer: And as you mentioned, kids going off to college, the YAY program through UT, and the connection to me it just puts an exclamation point on how for kids we need to think about their health and well-being long-term because if we think of adolescence as extending to age 25 we can say, okay, our responsibilities end at high school graduation, misses the mark in terms of brain development and other things, they’re still adolescents, and so what you’re saying is that if you have a university but that’s actually part of successful, continuing recovering because you can’t set up a kid for 4 years of recovery and now go to the #1 party school in the nation, best of luck to you.

[44:36]
Lori Holleran-Steiker: Absolutely. And we really, I’ve been the faculty liaison to the Center for Students in Recovery and I think that is the most natural partnership in the world and that if we really are going to look at where strategically we would really like to build recovery high schools, the model of having them adjacent to a university, I think it’s smart. Because we have all kinds of potential partnerships, we have a social work intern, a master’s level intern who comes to the school and builds relationships with family, does some group, and is available for hooking kids up with services in the community. We have nurse practitioner internship that we’ve carved out; we have a marketing student intern at the university, which is a natural, right? It’s kind of an exciting role for them to play in college, we have a connection with undergraduate studies, we have a group called the “The Drug and Alcohol Peer Advisors” that comes and helps with tutoring and philanthropy for the school and we even have a connection with the Sanger Learning Center, which brings the same workshops to the recovery high school that are available to college students, one called Study Smarter Not Harder, and one called How Not to Procrastinate. They’re getting a lot of resources that are dream resources for high schools and I think the one other piece we know to be true is with the stigma is inherently woven into this world of young people and recovery, the reputation of a university being linked up with the recovery high school, and studying it, we are doing research at the recovery high school. We’re not just studying the kids’ problems, we use the games and we’re part of the National Study of Recovery High Schools, but we’re also adding strengths-based mechanisms of studying these kids. We’re doing an adolescent version of the recovery capital measure, so that we’re taking a look at what is it that is working for these kids, not just what’s broken.

[47:00]
Jonathan Singer: When you say capital measure, what do you mean?

Lori Holleran-Steiker: A recovery capital is measure is something that has been recently designed and validated—the concept of recovery capital, what you GAIN from being in Recovery and the activities you’re apart of that’s enhancing your life. It’s being connected with peers, it’s reaching out for a sponsor or someone that knows how to help you navigate the world. It’s are you avoiding pitfalls like hungry, lonely, angry, tired. Are you going to meetings? Are you staying healthy? Are you seeing a doctor? All of those are strengths-based measures, what are you doing to bolster your ongoing recovery, as opposed to the factors that are contributing to your relapse? I think those are important things to know about, we do trauma-informed care, we are aware that most of our kids have some form of dual diagnosis. I think it’s important to focus as much on what are those kids capable of, and what are they doing on a daily basis that fills in the gaps in their life experience, that allows them to be stronger every single day?

[48:12]
Jonathan Singer: I have learned so much from talking to you today. You know the way you talked about what it was like for students, you know typically you know in a high school, and some of the struggles both developmental, spiritual, biological, social all those things—this innovative approach to addressing addiction and recovery in high schools is, I think it’s fantastic because we so often get stuck in, “Oh, they’re not enough treatment centers. How do we get these kids to treatment centers?’ when everybody knows that when they come out, they just have to go back to school, and what you’re talking about is, no, let’s talk about what their daily lives are like. And the connections to colleges, and the connections to advocacy and helping these kids really find life’s worth living if I can borrow a phrase we often use in the suicide prevention world—these ideas are just amazing.

[49:15]
Lori Holleran-Steiker: I really appreciate that Jonathan. It’s a great summary of what we talked about. And I think it has to be said that there are kids dying of addiction at rates we can hardly get our heads around. And when they have a place that is safe and joyous and full of love, they become our future in a way that you can’t even imagine. And so I want to say to anyone that’s listening, if this hasn’t touched your life already, it’s going to, one way or another. And you’re going to want a recovery high school there for the kids that are drowning. And it’s my hope that you’ll reach out to the resources that exist. I’m absolutely open to taking phone calls, emails, whatever’s necessary. I am delighted to come visit places, so please, make me useful.

Jonathan Singer: Thank you.

[50:16]
~~End~~

References and Resources

• Steiker, L. H. (2015). Youth and substance use: Prevention, intervention, and recovery. New York: Oxford University Press.
• Steiker LK, H. (2015). Transforming Austin: Augmenting the System of Care for Adolescents in Recovery from Substance Use Disorders. Journal of Alcoholism & Drug Dependence, 3(3). http://doi.org/10.4172/2329-6488.1000203

Relevant Links

• University High School (UHS) website:  http://www.uhighschool.com/
• University High School Facebook page https://www.facebook.com/UHighSchool/
• Video of youth talking about their experience at UHS:  https://www.youtube.com/watch?v=vQYltiZhjT8#t=11
• Association of Recovery Schools:  https://www.recoveryschools.org/
• Young People in Recovery:  http://youngpeopleinrecovery.org/
• Transforming Youth Recovery — Community Asset Maps:  http://www.transformingyouthrecovery.org/resources/community-asset-maps

Recent media coverage

• Social Work Today:  http://www.socialworktoday.com/archive/051815p18.shtml
• The Conversation:  https://theconversation.com/explainer-how-recovery-high-schools-help-kids-with-addiction-39457 [NOTE: This has a ton of great links]
• Pacific Standard:  http://www.psmag.com/health-and-behavior/can-recovery-high-schools-keep-kids-drugs-82184
• UT School of Social Work:  https://socialwork.utexas.edu/featured/helping-teens-into-addiction-recovery-university-high-school/
• Daily Texan:  http://www.dailytexanonline.com/2014/09/10/ut-professor-co-founds-austin%E2%80%99s-first-recovery-high-school
• The Fix:  https://www.thefix.com/content/no-country-addicted-teens?page=all

Related Research

• The Stacie Mathewson Foundation. (2013). The 2013 Market Study for Recovery Schools. Reno, NV. Retrieved from http://transformingyouthrecovery.org/resources/market-study-recovery-high-schools
• Moberg, D. P., & Finch, A. J. (2008). Recovery High Schools: A Descriptive Study of School Programs and Students. Journal of Groups in Addiction & Recovery, 2, 128–161. http://doi.org/10.1080/15560350802081314 [Full text via PubMed]
• Adolescent Substance Use | CASAColumbia. (n.d.). The National Center on Addiction and Substance Abuse. Retrieved August 6, 2016, from http://www.centeronaddiction.org/addiction-research/reports/adolescent-substance-use
• Holleran Steiker, L., & Grahovac, I. D. (2014). Introduction to the Special Issue: Substance Use Problems and Issues in Recovery Among College Students. Journal of Social Work Practice in the Addictions, 14, 1–5. http://doi.org/10.1080/1533256X.2014.872937

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APA (6th ed) citation for this podcast:

Singer, J. B. (Producer). (2016, August 23). #105 - Recovery High Schools: Interview with Lori Holleran Steiker, Ph.D. [Audio Podcast]. Social Work Podcast. Retrieved from http://www.socialworkpodcast.com/2016/08/RecoveryHS.html