Models of Campus-based Relapse prevention and student characteristics

National Development And Research Institutes, Inc., New York NY

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Abstract

DESCRIPTION (provided by applicant): Drug and alcohol use disorders (i.e., 'substance use disorders', SUD) triple from adolescence to young adulthood, making this transitional period critical to SUD onset and progression. Research supports the need for early intervention, ongoing monitoring, support, and continuing care to minimize SUD duration and impact. Yet unlike for adults, the youth continuum of care system remains underdeveloped. College attendance is key to financial stability but the high prevalence of drug/alcohol use on campus, paired with the normative challenges of this life stage (new freedoms, less supervision) make college a high relapse risk context for youths in SUD remission ('in recovery'). Universities started campus-based Collegiate Recovery Programs (CRPs) 30 years ago to allow recovering students to extend their participation in continuing care without having to postpone or surrender their educational goals. CRPs combine sober housing, onsite peer support groups and counseling provided by a small staff. Growing concerns about substance use on campus and federal agencies' focus on building a community-based youth continuum of care system have fueled a 5-fold increase in CRPs in the past decade, from 4 in 2000 to 21 in 13 states today with 8 new CRPs opening in Fall 2011. CRPs are consistent with the continuing care paradigm experts recommend, and notably, with the Department of Education's goal of ensuring a continuity of care from high school to college to post-graduation. CRP site-level records suggest promising outcomes but the model has not been systematically examined. The rapid CRP growth underlines the need for such services but individual programs, all started independently, likely vary greatly on key dimensions that may influence student outcomes - e.g., drug/alcohol use monitoring practices, participation requirements, comprehensiveness of services. The lack of CRP standards, formal model and systematic evaluation are increasingly noted as hindering wider adoption. The Department of Education recently called for prospective studies on CRP students' substance use and academic outcomes to inform the higher education system's response to recovering students. Thus the time has come for a systematic and rigorous evaluation of CRPs. However a large scale resource-intensive evaluation is premature as we lack important knowledge to guide the planning of a hypothesis-driven study: Data are needed about the diversity of CRPs and their common elements, about the students CRPs serve, their specific relapse risks and service needs. This developmental R21 study is designed to provide that knowledgebase preparatory to a full scale systematic evaluation through an R01. Capitalizing on our unique access to CRPs and our research expertise, we will address the following developmental aims: (1) Characterize the diversity of CRPs (N = 29) to identify common elements that will be subsequently subjected to systematic evaluation; (2) Describe CRP students' (N = 700) clinical history to guide the selection of a suitable comparison group, and their CRP experience, specific relapse risks and service needs to inform hypotheses about CRP elements underlying student outcomes in the evaluation study.