Principles of Adolescent Substance Use Disorder Treatment: A Research-Based Guide
Recovery Support Services

To reinforce gains made in treatment and to improve their quality of life more generally, recovering adolescents may benefit from recovery support services, which include continuing care, mutual help groups (such as 12-step programs), peer recovery support services, and recovery high schools. Such programs provide a community setting where fellow recovering persons can share their experiences, provide mutual support to each other’s struggles with drug or alcohol problems, and in other ways support a substance-free lifestyle. Note that recovery support services are not substitutes for treatment. Also, the existing research evidence for these approaches (with the exception of Assertive Continuing Care) is preliminary; anecdotal evidence supports the effectiveness of peer recovery support services and recovery high schools, for example, but their efficacy has not been established through controlled trials.

Assertive Continuing Care (ACC)

ACC is a home-based continuing-care approach delivered by trained clinicians to prevent relapse, and is typically used after an adolescent completes therapy utilizing the Adolescent Community Reinforcement Approach (A-CRA). Using positive and negative reinforcement to shape behaviors, along with training in problem-solving and communication skills, ACC combines A-CRA and assertive case management services (e.g., use of a multidisciplinary team of professionals, round-the-clock coverage, assertive outreach) to help adolescents and their caregivers acquire the skills to engage in positive social activities.75

Mutual Help Groups

Mutual help groups such as the 12-step programs Alcoholics Anonymous (AA) and Narcotics Anonymous (NA) provide ongoing support for people with addictions to alcohol or drugs, respectively, free of charge and in a community setting. Participants meet in a group with others in recovery, once a week or more, sharing their experiences and offering mutual encouragement. Twelve-step groups are guided by a set of fundamental principles that participants are encouraged to adopt––including acknowledging that willpower alone cannot achieve sustained sobriety, that surrender to the group conscience must replace self-centeredness, and that long-term recovery involves a process of spiritual renewal.76

Peer Recovery Support Services

Peer recovery support services, such as recovery community centers, help individuals remain engaged in treatment and/or the recovery process by linking them together both in groups and in one-on-one relationships with peer leaders who have direct experience with addiction and recovery. Depending on the needs of the adolescent, peer leaders may provide mentorship and coaching and help connect individuals to treatment, 12-step groups, or other resources. Peer leaders may also facilitate or lead community-building activities, helping recovering adolescents build alternative social networks and have drug- and alcohol-free social options.77

Recovery High Schools

Recovery high schools are schools specifically designed for students recovering from substance abuse issues. They are typically part of another school or set of alternative school programs within the public school system, but recovery school students are generally separated from other students by means of scheduling and physical barriers. Such programs allow adolescents newly in recovery to be surrounded by a peer group supportive of recovery efforts and attitudes. Recovery schools can serve as an adjunct to formal substance abuse treatment, with students often referred by treatment providers and enrolled in concurrent treatment for other mental health problems.78