It is a rainy Monday morning, and Community High School students are filing in from a four-day weekend. As the clock marks 8:30, 13 students, 3 teachers, 2 teaching interns, 2 counselors, and the school director take their seats in the large “group room” in the center of the school. Lucy, a teacher’s dog, curls under a student’s chair — rescued from a shelter, she provides a therapeutic presence to the room. The seats line the perimeter of the room, forming a “circle,” and one of the students, “Jennifer,” begins reading a devotional. Voices hush as Jennifer reads the passage and then asks for “a moment of silence followed by the Serenity Prayer.” After the prayer, each person “checks in” about his or her physical, mental, emotional, and spiritual state. Finally, Jennifer asks if any students have “a relapse, near relapse, or any life-changing events” to report.

A 16-year-old male student introduces himself, “I’m Jim, and I’m an addict and alcoholic. I relapsed this weekend.” He briefly details how he went to a friend’s house, and the people there were smoking pot. After initially refusing to join them, Jim, who has been out of treatment for 30 days, eventually smoked pot himself. A couple of students thank Jim for being honest, and one asks if he has “picked up a white chip” from a 12-Step meeting, signifying a return to recovery. Jim says that he has. The science teacher “Don” says, “Glad you’re here, Jim. We love you.”

And so begins another day at Community High School (CHS), a school for students recovering from alcohol and other drug addictions. Every day at CHS starts and ends with a 15-minute group session to process the night before, the day ahead, and the day just completed. At 10:45 each day the school holds a 45-minute therapeutic group, and two counselors are available during the day to assist with individual student needs as they arise. At CHS, the limits of confidentiality extend beyond the traditional harm to self or others to include reports of relapse. It is expected that such news be shared with the entire school as well as the student’s family.

There are 20 known high schools like CHS in the United States, the first two of which opened in Minnesota in 1989. As one of two employees who started CHS in 1997, I now serve as the school director. Originally, I was hired as the counselor to work with the principal to create a new private school in Nashville, Tennessee. We opened with seven students, and since then, nearly 200 students have attended. These “recovery high schools” have an average enrollment of 30 students, all of whom are in recovery from chemical dependency. More than 95 percent of the students entering recovery high schools have received some form of treatment, and some have received both residential and outpatient services. Thus, these schools have developed as aftercare support rather than primary treatment facilities. While some schools serve as transitional programs, all offer state-certified diplomas. Indeed, unlike treatment facilities, education is a major focus, if not the main component, of recovery schools. They are essentially hybrids, serving both aftercare and academic goals.

I find the students at CHS to be resilient and wise beyond their years. Their families escape a common profile, but many students come from broken homes and have family members who also suffer from chemical dependency. Often, one parent has more difficulty accepting their child’s issues than the other, and there is often one parent more interested in our program than another. Such family dynamics express themselves through conflicted relationships with the child or school staff, denial of the addiction, or even active drug use in the presence of the student. Thus, the idea of chemical dependency being a “family disease” is quite evident. Additionally, about 70 percent of our students have been diagnosed with co-occurring disorders, most commonly attention deficit, eating, and depressive disorders. Across the United States, recovery high school students are predominantly white, with the top minority population represented being Native Americans. This relative racial homogeneity appears to be driven somewhat by access to treatment issues, which skew many adolescent treatment populations toward those families able to afford treatment and aftercare programming. This often reduces the diversity of the programs.

Counselors in the workplace
CHS operates as a school, with one full-time and one part-time intern counselor and a registrar to assist with the creation of transcripts and graduation plans. Though the workplace is cluttered with relational minefields, CHS counselors experience a rich therapeutic environment.

Their tasks include:

• crisis management
• referrals
• individual counseling as needed
• career/college counseling
• academic counseling and course planning
• consulting with staff
• mediation for students
• health/wellness education
• arranging speakers
• facilitating groups
• working with families
• coordinating students to speak
• outside of school
• assisting in coordination of volunteer projects/service work for students
• helping maintain the 12-Step component of the school (especially regarding drug tests and relapse prevention contracts)
• and coordinating assessments (e.g., Myers Briggs, ACT, SAT, PSAT, PLAN, ASVAB, Strong Interest Inventory, etc.)

Counselor duties run the gamut from school counseling to clinical therapy to consultation to career counseling to case management. Grief and loss work sits at the core of everything, as the students have shed an old life, and the families are learning to live with a phenomenologically changed person. All the while, old friends, old schools, and one’s primary coping mechanism all have been lost.

Despite the depth of clinical issues present at CHS, the counselor’s immersion in the day-to-day life of clients makes forming a traditional client/therapist relationship virtually impossible. Ever-present crises make holding to a “once-per-week” session schedule extremely difficult. Thus, a counselor sometimes might go weeks without meeting with a student individually, which can frustrate and challenge the development of rapport.

Furthermore, students experiencing a relationship with the counselor inside and outside of a session can blur the boundaries of the counseling session, as counselor and client co-exist in one building for seven hours a day for up to four years. Whereas many traditional counselors use the “counseling hour” to their advantage by creating a therapeutic experience in which one session builds on the next within the context of the counseling office, recovery schools develop ongoing relationships between counselors and students that can diminish the effect of meeting only once or twice per week. Though this can be positive in that the therapist observes and interacts with clients at a deeper level, it can be negative when the client no longer views the counseling session as a sanctuary in which he or she feels safe to explore troubling issues.

Essentially, realizing that he or she may be “hanging out” with the counselor after the session may hinder the willingness of the client to take personal risks during that session. For this reason, we do not allow our counselors to become the primary therapists for students requiring regular clinical assistance. In addition, the difficulty of practicing traditional methods creates an issue with having Master’s-level counseling interns placed at our school, as they are often challenged by the constraints of a limited number of 50-minute therapy sessions.

As with the therapist’s role, the traditional school counselor’s role is also difficult to emulate. With so few students, the paperwork and turf issues so prevalent in larger schools are not as apparent in recovery high schools. “M-teams,” “S-teams,” filing school records, etc. consume little to none of our counselors’ workdays. Thus, we discourage school counseling interns from being placed at CHS.

Still, the ability to handle a plethora of mental health and relational issues with an intimate group of students makes CHS a fulfilling environment in which to practice counseling. Individual, family, and group counseling opportunities all exist for the counselors, and opportunities abound to develop such core skills as active listening, observing non-verbal communication, understanding transference, appropriate confrontation, and unconditional positive regard. Furthermore, the chances to witness adolescent client growth, so rare in short-term treatment and brief therapy settings, are abundant.

Recovery school directors debate the appropriate credentialing necessary for a recovery school counselor; this discussion is spurred by (a) where the school director philosophically sees his or her school falling on the addiction care continuum and (b) existing state laws and legitimacy around licensure and certification. Today, recovery schools employ licensed or certified chemical dependency/addictions counselors, licensed professional counselors, licensed school counselors, and national certified counselors working toward licensure. However, a few schools employ no therapists at all, depending on contract services with local treatment facilities instead. Other appropriate credentials could include licensed clinical social workers and marriage and family therapists.

This discrepancy among counselor training is complicated by the fact that so little research has been done to determine best practices across schools. I know what we do at CHS works because I have seen it work for seven years, and the data we collect seems to verify that. I also know that, with 186,000 youths aged 12-17 in the U.S. receiving treatment for chemical dependency in 2002 (Substance Abuse and Mental Health Services Administration, 2003), all 50 states could support a recovery high school. Currently, there are only 10 states with such schools.

As I gathered information in the past several years for my dissertation, the lack of systematic data collection across schools was painfully apparent. This lack of research — coupled with the limited amount of programming funding available nationwide for specialized education and adolescent recovery support — presents barriers to the growth of this schooling model. Personally, I am actively seeking funding to launch a large-scale study of recovery high schools, and my goal is to see at least one school in every state someday.

My motivation? The fact that a large proportion of students, like Jim, the student who reported a relapse at CHS on that rainy morning, are using drugs and drinking alcohol following treatment. The therapeutic and peer support available at a recovery high school assists with a student’s ability to (a) refrain from returning to full-blown use and (b) complete school. In Jim’s case, he returned to school immediately and began working on his sobriety the day after using. He also gave the CHS counselors the chance to continue working closely with him to turn his slip into a learning opportunity, and his recovery into a moment of resiliency. Such are the rewards I have experienced regularly since being involved with Community High School. We welcome you to learn more about us at www.communityhighschool.com, and to visit www.recoveryschools.org.

Andrew Finch, PhD ( This e-mail address is being protected from spam bots, you need JavaScript enabled to view it ), a National Certified Counselor and a licensed professional school counselor in Tennessee, directs both the Association of
Recovery Schools (www.recoveryschools.org) and Community High School in Nashville, Tennessee (www.communityhigschool.com).

Reference
Substance Abuse and Mental Health Services Administration. (2003). Results from the 2002 National Survey on Drug Use and Health: National Findings. (Office of Applied Studies, NHSDA Series H-22, DHHS Publication No. SMA 03-3836). Rockville, MD.

This article is published in Counselor,The Magazine for Addiction Professionals, April 2004, v.5, n.2, pp. 30-32.

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