Collegiate Recovery Communities Programs: What Do We Know and What Do We Need to Know?

As the broad construct of recovery increasingly guides addiction services and policy, federal agencies have called for the expansion of peer-driven recovery support services. The high prevalence of substance use and abuse in colleges and universities in the United States constitutes a significant obstacle to pursuing an education for the unknown number of youths who have attained remission from substance use dependence. Collegiate recovery programs (CRPs) are an innovative and growing model of peer-driven recovery support delivered on college campuses. Although no systematic research has examined CRPs, available site-level records suggest encouraging outcomes: low relapse rates and above-average academic achievement. The number of CRPs nationwide is growing, but there is a noticeable lack of data on the model, its students, and their outcomes. We review the literature supporting the need for the expansion of CRPs, present information on the diversity of CRP services, and outline key areas where research is needed.     

Dual Relationships: The Challenges for Social Workers in Recovery

ABSTRACT

Over the last ten years there is increasing focus in social work literature about non-sexual dual relationships. This has included consideration of different types of dual relationships that occur primarily during or after the establishment of professional social worker-client relationship. However, the specific concerns facing social workers who are themselves in recovery from substance use disorders remain absent from these discussions. This article identifies challenges facing social workers in recovery from substance use disorders who also work with clients dealing with these disorders. Recommended actions and policies that can assist professionals and agencies in balancing personal and practice issues are presented.     

Recovery Processes in a Treatment Program for Women

ABSTRACT

Recovery processes of 32 women were explored in six focus groups following completion of treatment in a community based women-specific substance abuse group program. Grounded theory analysis yielded an over-arching theme of Building a House of Recovery and several sub-themes describing women's perceptions of the processes that were central to their recovery.     

"It Has Made College Possible for Me": Feedback on the Impact of a University-Based Center for Students in Recovery

Objective: The authors aimed to gain information on (1) the challenges for recovering students on a university campus and (2) the most helpful components of a collegiate recovery program.

Participants: The 15 students in the study were all in recovery from substance abuse. They entered the university and also entered the campus recovery program either in fall 2002 or fall 2003.

Methods: Semistructured interviews were conducted with students multiple times during their first academic year.

Results: Participants identified several challenges on the university campus. Many believed they would have dropped out of school or relapsed without the support of the recovery program, and they described aspects of the program that were particularly important to them.

Conclusions: Support from a campus recovery program is essential for many recovering students. There are a variety of recovery program components that can foster the sense of community that was so important to the students in this study.     

Bridging the gaps: Intergenerational findings from the substance use disorder and recovery field

The substance use disorder and recovery field has undergone rapid transformation over the last 40 years. It currently has a workforce that includes three generations—Baby Boomers, Generation X, and Millennials. The current study sought to identify generational differences among those involved in the substance-use disorder and recovery profession using an embedded design and grounded theory approach. Findings suggest that generational differences do exist across the three generations in regard to ideologies, value of formal and informal knowledge, training, and education. Results from the current study provide a further understanding of how we may bridge perceived contentious ideologies and knowledge gaps between generations to better develop current and future professionals within the field.     

Building,Engaging, and Sustaining a Continuum of Care From Harm Reduction to Recovery Support: The Rutgers Alcohol and Other Drug Assistance Program

Since 1983, the focus of the Rutgers Alcohol and Other Drug Assistance Program (ADAP) has been developing policies, training staff to identify students at risk, developing and implementing evidence-based screening and brief interventions, providing short-term counseling by professionals trained in alcohol and other drug abuse to assist students beyond brief interventions, identifying effective treatment for college students, developing a campus recovery program, on-campus recovery housing, and other supports for students in recovery. This article presents a case study of the Rutgers ADAP program, of building and sustaining a program committed to engaging students in both evidence-based risk reduction interventions and an on-campus recovery community given their stage of change and motivation to make changes. Historical milestones are described as part of a creative model for intervention. We identify the challenges of integrating substance abuse recovery into campus mental health programs, and of integrating recovery into other university communities.     

Bipolar disorder and the college student: A review and implications for universities

Abstract

Objective: This brief report provides a review of the prevalence and expression of bipolar disorder in the college student population. Implications for college teachers and universities working with students with bipolar disorder are presented. Methods: Responses from the National College Health Assessment (2009–2017) reference groups were collated to estimate whether the prevalence of students with bipolar disorder has been increasing over time. Results: Data indicate that although overall prevalence is low, the presence of students with bipolar disorder has increased over the past decade. Conclusions: To help students with serious mental illness, including bipolar disorder, succeed in higher education, practices consistent with the philosophy of supported education should be adopted. Special attention will need to be paid to students’ financial and academic challenges.     

Counseling Brazilian Undergraduate Students: 17 Years of a Campus Mental Health Service

Objective: The authors reviewed demographic and clinical characteristics of undergraduates at a Brazilian public university (UNICAMP) who visited the campus mental health service (SAPPE) and compared their demographics with those from all undergraduate students enrolled in the university. Participants: The authors looked at data from all undergraduates who sought counseling or mental health care at SAPPE over a 17-year period (N = 2,203; 1987-2004). Methods: They obtained this information from clinical charts and a UNICAMP database. Results: Women, students from other Brazilian states, students living in the campus residence hall, and students whose main source of income was a scholarship were overrepresented. Female student-clients complained about family conflicts more frequently than did their male counterparts, and male student-clients reported concern about poor academic performance more frequently than did their female counterparts. Conclusions: Sex, living in a university residential facility, and reliance on a scholarship grant were predictive of undergraduates' mental health-seeking behavior and pattern of complaints.     

Binge Drinking Among Undergraduate College Students in the United States: Implications for Other Substance Use

Abstract

The authors examined the relationship between binge drinking and other substance use among US college students, using nationally representative data from the 1995 National College Health Risk Behavior Survey implemented by the Centers for Disease Control and Prevention. Compared with nonbinge drinkers, current binge drinkers were significantly more likely to report “ever” using and current use of cigarettes, marijuana, cocaine, and other illegal drugs. The researchers also found that the more often students binge drank, the more likely they were to have ever used cigarettes, marijuana, cocaine, and other drugs, and the more likely they were to report current use of cigarettes and marijuana. Those who design programs to prevent binge drinking and use of other substances should take into account the reality that many students use more than one substance and that the more frequently students report binge drinking, the more likely they are to be using other substances as well.     

Academic Underachievement and Recovery: Student Perspectives on Effective Career Interventions

Academic achievement has a significant influence on various career development and decision‐making factors. Therefore, it is important for career counselors to understand how past academic underachievement affects students’ current lives and to develop interventions that might ameliorate negative effects. This study examined the experiences of 9 ethnically diverse college students who had experienced and overcome academic failure. Data were collected by individual interviews and analyzed based on the consensual qualitative research method. Four themes emerged in relation to participants’ academic underachievement and recovery: attitude, study strategies, external support, and coping difficulties. The results suggest that underachieving students are better able to cope with and overcome academic difficulties when they set clear career goals, use effective learning strategies, consciously put forth more effort, and receive external support.     

ADHD,depression, and substance abuse risk among beginning college students

Abstract

Objective: This study examined differences in substance use, depression, and academic functioning among ADHD and non-ADHD college students. Participants: Included 1,748 students (ages 18–25; women 68.4%; Caucasian 71.3%) with and without history of ADHD. Methods: We assessed the relationship of ADHD to substance use variables, controlling for depressive symptoms and examined relationships with GPA. Results: ADHD students were more likely to have engaged in frequent alcohol use, binge drinking, regular marijuana use and to have used other drugs in the last year. They reported higher depression symptoms than non-ADHD students, although substance abuse risk remained high even when controlling for depressive symptoms. ADHD students had lower overall GPA than those without ADHD. However, this difference was no longer significant when controlling for depression and marijuana use. Conclusions: College campuses should consider programing aimed at identifying ADHD students at risk for developing substance abuse problems and emotional difficulties.     

Risk Factors for Chlamydia Trachomatis Infection in a California Collegiate Population

Abstract

Chlamydia trachomatis infection in college students has not undergone a detailed large-scale evaluation. The authors undertook a cross-sectional study of 4,086 students enrolled on the campuses of California State University, Sacramento, and 3 local community colleges from fall 2000 through spring 2002. They used an outreach screening model to determine the presence of infection by testing urine for chlamydial DNA by polymerase chain reaction. Participants completed demographic and behavioral risk questionnaires and a chlamydia knowledge assessment. Overall, 3.4% of participants tested positive for infection. Screening of male and female students was evenly distributed and incidence rates for males (3.03%) and females (3.78%) were similar. Variables associated with significantly increased risk were younger than 25 years, ethnicity other than White, more than one sexual partner in the preceding year or a new partner in the preceding 2 months, and current symptoms. Innovative outreach programs to screen a majority of at-risk college students should be developed.     

Comparing the effectiveness of behavioral interventions in adults with co-occurring tobacco and substance use disorders: a systematic review of literature

ABSTRACT

This systematic literature review compares the e?ectiveness of various behavioral interventions delivered to persons with co-occurring tobacco and substance use disorders. It examines ?ndings of six randomized trials and three secondary analyses from randomized trials. Based on the ?ndings of this literature review, support is given to the following: (1) The consequences of tobacco use and smoking are deadly, costly, and can have an inhibitory e?ect on the progress of people in substance abuse treatment, (2) tobacco cessation options are a preventive intervention that can be easily incorporated into a treatment facility’s standard of practice and should be made available within the context of all substance abuse treatment facilities, and (3) concurrently treating tobacco use disorder and substance use disorder(s) is an e?ort that will help meet the social work profession’s Grand Challenge to ‘Close the Health Gap.’     

Attention-deficit/hyperactivity disorder–specific stimulant misuse,mood, anxiety,and stress in college-age women at high risk for or with eating disorders

ABSTRACT

Objective: To examine the misuse of attention-deficit/hyperactivity disorder (ADHD)-specific stimulants in a college population at high risk for or with clinical or subclinical eating disorders. Participants: Four hundred forty-eight college-age women aged 18–25 at high risk for or with a clinical or subclinical eating disorder. Methods: Participants completed assessments of stimulant misuse and psychopathology from September 2009 to June 2010. Results: Greater eating disorder pathology, objective binge eating, purging, eating disorder–related clinical impairment, depressive symptoms, perceived stress, and trait anxiety were associated with an increased likelihood of stimulant misuse. Subjective binge eating, excessive exercise, and dietary restraint were not associated with stimulant misuse. Conclusions: ADHD-specific stimulant misuse is associated with eating disorder and comorbid pathology among individuals at high risk for or with clinical or subclinical eating disorders. Screening for stimulant misuse and eating disorder pathology may improve identification of college-age women who may be engaging in maladaptive behaviors and inform prevention efforts.     

Posttreatment 12-Step Program Affiliation and Dropout: Theoretical Model and Qualitative Exploration

ABSTRACT

Treatment outcome research has repeatedly demonstrated that involvement in twelve-step (TS) programs (e.g., Alcoholics Anonymous or Narcotics Anonymous) following treatment is associated with improved substance use outcomes. Treatment providers widely encourage TS program attendance during treatment and for aftercare; yet, evidence suggests that minimal and sporadic attendance or complete dropout is the more common occurrence. Providers would benefit from knowledge that would contribute to a greater understanding of factors that influence posttreatment TS program affiliation or dropout to guide treatment strategies. This article reviews the literature on TS affiliation, advances theory and a model to explain affiliation, and reports findings from a qualitative research study focused on understanding what people in TS facilitative treatment report as good (the pros) and not so good (the cons) about TS program involvement. Results suggest that unresolved ambivalence as well as socio-cultural barriers to support contribute to poor TS program utilization.     

Recovery Schools Rise to the Challenge: Shifting Alcohol Norms and Behaviors in Youth and Emerging Adults

Alcohol is a huge challenge for youth and therefore for the field of social work. The confluence of biopsychosocial factors place youth at risk. Early initiation to alcohol use is a serious risk factor for depression, anxiety, and suicide. The focus of this article is on the collaborative use of resources and evidence-based practices and innovative mechanisms for shifting youth mores around alcohol and providing alternative peer groups, especially in abstinence-hostile settings, such as high schools and college campuses. Recovery schools are drawing national attention and becoming a part of the fabric of the advancing recovery movement for youth. This article discusses the Recovery School movement; its impact on youth, families, and communities; and the impact it can have on the Social Work Grand Challenges. It culminates with a case study of a university community that demonstrates how lives and norms around alcohol can shift for youth and young adults.     

Social Networks,Substance Use,and Mental Health in College Students

Abstract

Objectives: The relationship between social network risk (alcohol-using close friends), perceived peer closeness, substance use, and psychiatric symptoms was examined to identify risk and protective features of college students’ social context. Participants: Six hundred and seventy undergraduate students enrolled in a large southeastern university. Methods: An online survey was administered to consenting students. Results: Students with risky networks were at a 10-fold increase of hazardous drinking, 6-fold increase for weekly marijuana use, and 3-fold increase for weekly tobacco use. College students’ who feel very close to their peers were protected against psychiatric symptoms yet were at increased risk for marijuana use. Perceived closeness of peers was highly protective against psychiatric symptoms, adding a natural preventive effect for a population at great risk for mental illness. Conclusions: Results support targeting college students through network-oriented preventive interventions to address substance use as well as mental health.     

Food-Related Behaviors of Women in Substance Abuse Recovery: A Photo-Elicitation Study

The aim of this multi-method qualitative study was to explore the eating behaviors and food choices of nine purposively sampled low-income women aged 29 to 40 years who were engaged in a residential substance use disorders recovery program. Findings were limited to photo-elicitation interviews with the women that focused on nutritional choices and issues outside their family context. Consensual data analysis revealed a recovery process that began with cognitive reawakening and an increased focus on and desire for healthier nutrition-related decisions and lifestyle, particularly in the area of weight gain that many of the women experienced.     

Subjective evaluations of alcohol-related consequences among college students: Experience with consequences matters

Objective: Research suggests college students rate some alcohol-related consequences less negatively than others, yet it is unclear how or when these differences in perception develop. The current study compared college students' subjective evaluations of alcohol-related consequences that they had and had not experienced in order to test the hypothesis that students become desensitized to the consequences they experience. Participants: Participants were 269 undergraduate students enrolled at a large, public, Midwestern university. Methods: Participants completed measures of drinking behaviors, consequences experienced, and subjective evaluations of consequences via an online survey. Results: Participants rated the consequences they had personally experienced more positively than those they had not experienced. Similarly, individuals who reported experiencing consequences rated them as significantly more positive than those who had not experienced the same consequences. Conclusions: Experience with consequences is associated with more positive evaluations of those consequences. Therefore, it may be important to consider individuals' experiences with, and evaluations of, alcohol-related consequences in college student drinking interventions.