Is Peer Support More Effective than Professional Treatment for Addiction?

By Andrew Dobbs 11/10/15

The steady rise of campus recovery centers.

When it Comes to Recovery, Colleges are Turning to Peers First

In 2011, Sierra Castedo came to the University of Texas at Austin to earn a doctorate in physical anthropology, studying human evolution. Four years later, her career has taken a sharp turn for the very different—she is now the director of one of the country’s most well-established campus-based centers for addiction recovery.

“It happens when a peer becomes a professional, or a paraprofessional, which is what I am,” Sierra said.

Sierra’s journey from the archaeological dig to the front lines of helping students recover from addiction is not as strange as it may sound. It took a detour familiar to millions of Americans—she hit bottom in her alcoholism and entered long-term recovery, and like many students facing a substance use disorder she didn’t feel like leaving school for treatment was an option. She found recovery meetings and peer support on campus at UT’s Center for Students in Recovery, a dedicated space at the university charged with helping students dealing with addiction.

“I started as a graduate assistant, helping around the center, and most importantly just being a friendly face when someone came in for the first time,” Sierra said. After the last director left, the center conducted an extensive search for a new leader only to land upon that friendly face up front. “I definitely had a lot of impostor syndrome feeling at first, which is really common for people in recovery, and for young professionals in general. But I found out later that they had asked nearly two dozen people if they thought I could do this job, and they had confidence in me. That helped me believe that I could do this work.”

Nationwide, collegiate recovery has expanded rapidly: In 2010, there were about 20 campus recovery centers around the country, and five years later there are 145 and counting. With these centers has come a demand for qualified, capable staff to direct their programs and facilitate their work with students, faculty, and the broader recovery community. Very often these centers are finding that their best bets for leadership are recovered addicts in their midst, even when these people in recovery have no background in the addiction health field.

The idea is a revolutionary one for big bureaucratic institutions like universities, but not for those in recovery: peers can often provide help that even “experts” can’t. The collegiate recovery movement is betting millions on this idea—the University of Texas alone has announced a first-of-its-kind expansion of campus recovery centers to all academic campuses across its university system. While some of these centers and others around the country will be led by clinicians without any direct addiction experience, most staff dedicated to these programs are not clinical professionals. Many of them are staffed and led by people in recovery, and this sort of leadership means a different sort of focus: today, more than three-quarters of all the centers in existence nationwide are peer-based, putting the emphasis on students in recovery helping other students. Even at those centers with a more clinical focus they still have peer recovery support components. At an increasing number of campuses, addicts are being treated not as a disciplinary problem to be expelled, or even as a mental health problem to be treated, but rather as a community worthy of its own space and resources.

“Just having a place on campus where you know you can find people who are dealing with the same challenges is huge,” Sierra said. “Showing people that it is possible to do the student thing, to be happy and engaged in this environment while staying sober and maintaining a program of recovery—that’s a big deal.”

To be sure, nobody is expecting these staffers to do the work of helping addicts without any training or credentials whatsoever. Sierra took part in a national program directed by the federal Substance Abuse and Mental Health Services Administration (SAMHSA) called Project LIFT (Leadership Initiatives For Tomorrow) which helped her and other young mental health and substance abuse professionals from around the country develop new skills in serving others with addiction and other mental health challenges. The Center for Students in Recovery actually helps university students gain certification as Peer Mentor/Peer Recovery Specialists by pairing them as mentors with younger students attending a charter high school for teenagers in addiction recovery. And UT’s center and most others maintain close relationships with counseling resources on their campuses—it was a therapist in the campus mental health center that first pointed Sierra to the center she now directs. This past month, she actually joined that very counselor in a continuing education presentation on collegiate recovery for Texas mental health professionals.

“Clinicians and specialists are obviously a critical component in most people's recovery journey,” Sierra said. “But leveraging the power of peer support not only allows for greater flexibility and a very different kind of healing relationship, it also helps us change the way we view recovery throughout our community as a whole.”

And collegiate recovery is not the only place where people are finding that the best help available may not come from formal professionals, but rather from peers going through the same sorts of challenges. Military veterans have created peer-based support networks around the country to assist combat veterans reintegrating into civilian society, stroke survivors are helping one another navigate life after they have become disabled, and many big institutions—not just universities, but hospitals, school districts, and social service agencies as well—have realized that peer-based programs not only provide more bang for their bucks, they may provide more bang, period. They can help when no one else can, and while there will always be a place for clinical help from professionals who never served in war, had a stroke, or struggled with addiction, the place for peer-based support is growing. “It's a team effort,” Sierra says.

This is a testament to the influence of 12-step programs even beyond their own immediate membership. The idea that the best expertise for helping an addict is addiction itself was revolutionary in 1935 when Alcoholics Anonymous first started coming together. Seventy years later, it has provided the model for a myriad of support groups and group therapies which have helped addicts and non-addicts alike. Collegiate recovery centers are closely associated with 12-step recovery—almost all of them either host 12-step meetings of their own or refer their students to meetings off campus—but 12-step fellowships do not formally affiliate with them as they are part of higher education “institutions.” Furthermore, the staffers in recovery at these centers are being paid, meaning their work cannot be part of their 12-step service, and they are accountable for helping students struggling with substance abuse on their campus regardless of whether they want a spiritual awakening or not. Collegiate recovery programs are very open to hosting non-12 step meetings, though they often lack the demand or community support to sustain them.

“I would love to host those groups, and we have talked to students that want them, we are here to help them do whatever it takes to recover,” Sierra said. “It’s just that here in Austin, Texas, we don’t have the critical mass in the community to sustain those meetings. I hope that we can provide more options for our students in the future, though.”

In the end, the emergence of collegiate recovery and its development as a predominantly peer-based movement is reflective of a broader shift in how addiction is addressed in the US. Sierra points out that Michael Botticelli, the director of the White House Office of National Drug Control Policy—an office known in the past as the “Drug Czar”—is himself in recovery from addiction. And for Sierra, her background as a physical anthropologist studying human evolution has actually been a great preparation for her work in collegiate recovery after all. In particular, she points to the famous “Rat Park” study, where Canadian scientists found that rats isolated in “rat prisons” were far more susceptible to substance abuse than those allowed to freely socialize in a “rat park” setting.

“My studies had a lot to do with how our brains work, and how we resemble other animals,” Sierra said. “One thing that sets us apart is that humans can create prisons inside our own minds. Even when we are surrounded by healthy influences and loving people—like I was when I was growing up—we can still feel lonely and isolated and drugs and alcohol can become compelling ways of dealing with that... What we are doing is creating a space on our college campus where we can break through that isolation and help students grow and mature both in their studies, and in their recovery.”

Thankfully for Sierra, the community she’s serving in Texas, and college students in recovery across the country, you don’t need a Ph.D. to create that space—just a willingness to join others in their healing journeys. That’s something the recovery community has never lacked.

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Andrew Dobbs is an Austin, Texas-based organizer and writer whose writing has appeared in the Daily Beast, the New York Observer, War is Boring and the Huffington Post.