Teenagers who enter residential, partial hospitalization, or residential treatment for alcohol or substance abuse disorders face a big challenge when they finish their time in rehab: returning to high school. Life after rehab challenges anyone, young or old, but teenagers who go back to their old school fight an uphill battle. Many teenagers in treatment tell counselors and therapists that high school is the place they first encountered alcohol and drugs, the place they first chose the life-interrupting patterns of addiction over the life-affirming habits of sobriety, and the place they first met alcohol and drug-using peers. Families spend a great deal of time, resources, and emotional energy finding, choosing, and committing to residential programs, and one hard truth of navigating recovery after re-entry is the looming specter of relapse. Progress made during treatment can be undone by the confluence of triggers presented by the original school environment.
Mental health professionals and addiction experts know and understand this better than anyone. That’s why the substance abuse counselors, therapists, and psychiatrists at all high-quality treatment programs begin formulating an exit strategy – in the form of a long-term sobriety plan – almost as soon as treatment begins. They connect teenagers and families with support groups, therapists, and sobriety resources close to home. They lead workshops on the dangers of relapse. They identify common triggers, create strategies to handle triggers when they come up, and spend hours role-playing potentially sticky scenarios to prepare teenagers for life after treatment. They teach teenagers how to identify patterns of thought that lead to relapse, and how to replace these old, self-destructive patterns of addiction with new, positive coping mechanisms of sobriety.
All these plans, made in the relative safety of a treatment facility, can crumble into dust when reality hits. The best-intentioned teenager, completely committed to the work of recovery, can falter when they walk through the front door of their old high school – the place that may have been ground zero for their substance abuse or addiction disorder. Anecdotal data from a study conducted in 1992 indicate that almost all teenagers returning to school after treatment are offered drugs on their first day back in their old school. It’s not just the peer pressure. The combination of sights, sounds, and relationships evoke memories and cravings powerful enough to overwhelm even the most resolute and dedicated teenager.
Many parents think there’s not much choice. Kids need an education to prepare them for success in life. Families can move to a new city or transfer their child to a new school, but that doesn’t change the big picture. Every school has problems, and every school contains a subset of students who use alcohol and drugs. For kids who’ve already been down the road of drug and alcohol use, problems tend to find them whether they like it or not.
Thankfully, there’s an option out there most parents don’t know about: recovery schools. Recovery schools are exactly what they sound like: high schools designed specifically for teenagers who’ve been through professional, residential addiction treatment programs, and want to continue high school in an environment built around maintaining long-term sobriety. To date, there are forty recovery high schools in the United States. Most are private, but several states, including Massachusetts and Michigan, have publicly funded recovery high schools for students who meet the entry criteria.
The Origin of Recovery Schools
The Recovery High School (RHS) movement began in the late 1970s, inspired by the inception of Collegiate Recovery Program (CRP) movement at Brown University in 1977 and Rutgers University in 1983. Recovery High Schools are data-driven and results oriented, and draw their scientific justification and practical utility from the concept of aftercare identified in the continuum of care model by researchers in the late 1970s and mid-1980s. The first RHS, called the Phoenix School, opened its doors in Silver Spring, Maryland, with the goal of providing adolescents in recovery from alcohol and drug addiction a safe, sober, and supportive environment to finish high school. In the ensuing forty years, the RHS movement gained momentum and spread across the country. The Association of Recovery Schools (ARS) currently identifies thirty accredited recovery high schools operating in twenty states.
Key Elements of Recovery High Schools
Recovery High Schools come in many forms. Public recovery high schools tend to serve many districts simultaneously, and may function as charter schools, schools-within-schools, or small, specialty programs within previously established schools. Private recovery high schools are typically standalone schools or exist as separate tracks within a previously established school. In addition to typical academic curricula, recovery high schools address the essential guidelines for effective post-treatment programs established in 2002 by Godley, et al. With some variation, all recovery high schools include the following elements:
- Sufficient intensity and duration of contact between students and therapists or counselors
- Multi-modal approach to total health, with strategies to target the educational, emotional, physical, legal, and psychiatric well-being of students
- Cultural and socioeconomic sensitivity
- Family involvement
- Sober social and leisure activity support
- Communication and coordination with wraparound social services
- Commitment to relapse prevention
- Training in sober coping skills geared toward handling cravings and navigating difficult emotional states such as anger, anxiety, or depression
The criteria for admission to a recovery high school varies from school to school. Some schools require students to have completed a certified, professional substance abuse treatment program, while others admit students who’ve never sought or experienced treatment for substance abuse or addiction disorders. The former generally require students to have maintained sobriety for a period ranging from the time spent in rehab to thirty days post rehab, and the latter have no requirements other than a sincere desire to achieve and maintain sobriety.
Early Post-Treatment: The Critical Window
When a teenager leaves a residential, intensive outpatient, or partial hospitalization treatment program, the transition back into mainstream society can be tricky, delicate, and dangerous. The type, amount, and quality of support provided often sets the tone for the months and years to come, and has a significant effect on whether the teenager relapses or successfully maintains sobriety. Research indicates that “the period right after completion of a treatment program, when the youth returns to family, peers, and the neighborhood, is often the time of greatest risk of relapse.” Therefore, if a teenager returns to their old school, it’s easy for them to slip right back into the habits that landed them in rehab in the first place. This pull is powerful in the early stages of sobriety, because the coping mechanisms they learned in rehab are new, and though the skills and mechanism acquired in treatment may be evidence-based and research verified, the real test comes in the real world.
A Safe Place for a New Beginning
A recovery high school can mitigate the dangers of this crucial period. A teenager returning to their original school, or a teenager entering a new, typical school, will likely feel a sense of difference, alienation, and social isolation if their primary goal in life is sobriety, as opposed to the relatively banal pursuits that dominate the time and energy of their peers. Adolescence is tough enough already, without the additional weight and work of recovery functioning as a social albatross. In a recovery school, recovery is the norm, rather than the exception. Administrators, therapists, and teachers prioritize creating a positive, supportive environment in which nascent sobriety can grow, coping mechanism can be tested, and the teenager can gain experience navigating the challenges of living and embracing a sober, drug free life without negative peer pressure and disruptive social expectations. The recovery school environment may be the final piece of the puzzle for some teenagers, and make the difference between relapse and sustained recovery.
