Peer Support As a Mechanism for Relapse Prevention Among Adolescents in Recovery

Introduction: For students completing treatment for substance use disorders and committing to a sober lifestyle, “recovery schools” offer an alternative ecology to traditional schools (Moberg & Finch, 2007).  Recovery schools support students by focusing on both academics and recovery, balancing educational needs with socio-emotional and mental health needs.  Some researchers question whether grouping students at high-risk for relapse might actually increase the likelihood of relapse through a peer-contagion effect (Gifford-Smith, Dodge, Dishion, & McCord, 2005).  However, research has shown that peer-support based recovery programs, such as NA and AA, do in fact improve adolescents’ treatment-related outcomes (abstaining from drug and alcohol use; Kelly, Dow, Yeterian, & Kahler, 2010).  Given the relative dearth of recovery supports for many adolescents, finding effective ways to support post-treatment success is critical for long-term recovery.  The present paper argues that peer supports are a key resource used by recovery schools to support adolescent recovery.

Methods: Qualitative interviews were conducted with eight staff members at the six current recovery schools in a Midwest area with a relatively large concentration of recovery schools.  Semi-structured interviews lasted approximately one hour and covered a variety of topics including school structure, therapeutic programs, school climate and descriptions of the student body.  Interviews were audio-recorded, transcribed, and coded for both pre-determined and emerging themes.  This presentation focuses only on themes relevant to peer support.

Results: Analyses revealed a number of important themes around peer support.  School staff members were aware of the influence of peers and intentional in cultivating positive peer influence, for example through developing peer counseling programs.  Adults also emphasized the importance of the school community; for example, several staff members discussed the relapse of one student with all students to teach the impact of individuals on the whole school community.  Staff acknowledged that interpersonal relationships in a small school can detract from peer support, but also that the intimacy of a small student body increased accountability among students.  Generally, school staff trusted students to support and positively influence each other, both inside and outside the school walls.

 

Conclusions: Although conclusions from this qualitative study are necessarily limited, evidence suggests that peer support can be a powerful preventive influence for adolescents in recovery.  Future research should continue to explore the potential of peer influence as a preventive mechanism in an effort to understand the contexts when peer influence is a protective - rather than a risk - factor.