Snapshot: What's Next--Building a Recovery Culture

The youngest of seven children raised by a single mother, Bobby* had no positive role models. His siblings bounced in and out of juvenile detention facilities on drug charges. None of them finished high school. Bobby followed their lead. Police arrested him on drug charges—for both using and selling. After a short stint in a juvenile detention center, he ended up back on the streets. Street outreach workers and recovery transition advocates from Outside In, a FYSB grantee in Portland, Oregon, approached him, talked with him casually on a daily basis, gave him socks and other essentials, and let him know that food and a shower were available at the drop-in center.

Bobby came in to the drop-in program from time to time and became close to Mark. Both of them knew the intricacies of baseball and enjoyed playing the sport. And both of them liked fixing cars.

Bobby later learned that Mark was also an alcohol and drug addiction counselor, or a recovery transition advocate for Outside In. By this time, they had formed a strong relationship, and Mark understood Bobby’s needs and readiness for treatment.

“It’s not that they don’t know who is an alcohol and drug counselor, but we don’t approach it like, ‘Hey I think you should talk to the alcohol and drug counselor.’ It’s more like, ‘Hey, why don’t you talk to Mark?’ So it’s more relationship based. It is about building a positive connection,” says Heather Brown, Youth Department Director for Outside In.

Like Bobby, many street youth suffer from mental health problems or abuse drugs and alcohol. Often they cannot reconcile with their families because doing so might hurt their recovery. They may have an arrest record or other barriers to gaining employment. And they are often the least likely to reach out for help. These young people, outreach workers and other youth service professionals say, need a wide network of support. All staff members, including street outreach teams, counselors, and health professionals, need to work together and communicate about the young person’s needs.

Outside In builds a culture where the process of recovery is integrated into a variety of services offered to youth. Staff members build strong relationships with youth before beginning treatment and offer peer role models and an alcohol and drug treatment recreation group. In this group, youth may go to the arcade, play Frisbee, or go hiking with drug counselors. They even operate a doggy day care business staffed by homeless youth, which teaches street youth skills and helps them transition to the structure required by a job.

Brown says this sort of familiarity and relaxed atmosphere makes it, “cool when somebody is clean and sober, which is the opposite of what they are used to—having peers engaging in more drug using behavior.”

Staff members at Outside In conduct regular training sessions with community partners to ensure that drug treatment counselors and street outreach workers share a common language. For example, drug treatment counselors should understand terms like “positive youth development” and street outreach workers should understand terms like “pre-contemplation” that relate to a young person’s readiness for treatment.

“Now, with all of the stuff we do before treatment, they are building relationships and are more ready for treatment,” says Brown.

Brown says the system has worked much better than sending youth to specialty clinics because many young people create strong relationships with staff and are reluctant to build new ones at a new facility.

“We would send them out for treatment and they would feel the approach was so different that they would just bolt,” says Brown.

Brown says using this approach has doubled the number of Outside In youth seeking treatment for mental health and substance abuse problems.

What’s more, Brown says, they stay in treatment and complete the program.

“Before we had a really hard time getting people into inpatient treatment or even to follow up with outpatient treatment—they might not stay very long. Not very many people finished treatment,” says Brown. “Now, people try it out. People may make multiple attempts. Our treatment beds tend to stay pretty full and they finish treatment. We see the difference.”

*Names have been changed.