The alternative peer group: What can winners from this program teach us about recovery from adolescent substance use disorder?

Purpose Treatment for adolescents with substance use disorders (SUDs) can be successful, but first year relapse rates range from 60% to 85%. Environmental contexts greatly influence adolescents, yet few treatment models include the peers, a prominent influence on teen behavior. A novel approach to adolescent treatment is the Alternative Peer Group (APG), which integrates peers and fun into clinical practice to promote engagement in and support of recovery. The aims of this study were to identify how successes from one APG program perceive and describe the process of recovery; and to identify patterns and themes regarding elements that promote the recovery process for adolescents. Method A focused clinical ethnography was accomplished, involving prolonged immersion in the APG recovery community; in-depth interviews with recovering alumni; and focus groups. Data Analysis Data were analyzed using inductive thematic content analysis with comparison of findings across groups. Findings Participants describe recovery from adolescent SUD as a quest-like journey which entails a prolonged preparation phase; strategic relationships with recovering role models; and perceived paradox (a truth that seems contradictory e.g.: surrender leads to control ) Elements cited as key for promotion of the recovery process include unconditional love; belonging; fun; hope; time; structure; accountability; journey narratives; their higher power, the spiritual program of the Twelve Steps; and family support. Elements that delay or jeopardize the process include fear, premature removal from the program by parents, pain, and isolation or stigma. Conclusions Findings suggest engagement in sustained recovery from adolescent SUD requires much more time and investment in establishment of recovery assets than our current treatment system allows. The described formula for success in establishment of sustained adolescent recovery is consistent with Bronfenbrenner\u27s Bio-ecological theory for human development. Further investigation of adolescent recovery oriented systems of care is recommended