White, W.L., Evans. A.C., Ali, S., Abrahams, I. & King, J. (2009). The recovery revolution: Will it include children and adolescents? Philadelphia: Department of Behavioral Health and Mental Retardation Services.

The Recovery Revolution: Will it include children, adolescents, and transition age youth? William L. White, M.A., Arthur C. Evans, Jr., Ph.D., Sadé Ali, M.A., Ijeoma Achara-Abrahams, Ph.D., & Joan King, APRN, BC

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The Recovery Revolution: Will it include children, adolescents, and transition age youth? William L. White, M.A., Arthur C. Evans, Jr., Ph.D., Sadé Ali, M.A., Ijeoma Achara-Abrahams, Ph.D., & Joan King, APRN, BC Executive Summary Systems transformation efforts to shift addiction treatment from a model of acute stabilization to a model of sustained recovery management and to nest addiction treatment within a larger recovery-oriented system of care are underway at federal, state, and local levels, but these innovations to date have focused on the redesign of adult services. This paper explores the potential and limitations of recovery as an organizing concept for services to children, adolescents, and transition age youth, and offers recommendations on how services for these populations can be integrated into recovery- and resiliency-focused, behavioral health care systems transformation efforts. Recovery Revolution Defined  Since 2004, the City of Philadelphia has been engaged in a recoveryfocused behavioral health care systems transformation process that has mobilized the community around a recovery vision and begun aligning concepts, service practices, and contexts (e.g., regulatory policies, funding mechanisms) to support that vision.  Federal, state, and local behavioral health policy and planning bodies are now evaluating the extent to which recovery can be used as an organizing concept for child and adolescent (C & A) services.  There is growing consensus to create a recovery-oriented system of care for youth that is family-driven, developmentally appropriate, culturally nuanced, highly individualized, and focused on youth resilience, strengths, and empowerment.  Questions remain about the potential advantages and disadvantages of the recovery concept applied to C & A services and how that concept can be integrated with the existing concepts that have been used to guide the design of C & A services.  These questions will be explored as they relate to children, adolescents, and transition age-youth. Historical Context: Recovery and Age of Onset of Alcohol and Drug Use

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 The most socially and clinically significant American drug trend of the past century is the lowered age of onset of alcohol and other drug use.  Lowered age of initial AOD use is linked to greater risk of developing a substance use disorder, the speed of problem progression and severity of consequences, and greater levels of post-treatment relapse.  The average age of onset of AOD use of adolescents entering addiction treatment is now below age 13.  The concept of recovery is more applicable to children, adolescents, and transition-age youth now than at any previous time in the country’s history. Family Recovery  Child development can be adversely affected by AOD-related problems of their parents or siblings, and children in AOD-affected families are at increased risk for developing such problems as well as experiencing other adverse developmental outcomes.  The recovery of a parent with AOD-related problems enhances the health and developmental outcomes of his or her children.  Interventions are available that enhance the recovery and resilience of children negatively impacted by parental substance dependence. Recovery of Adolescents and Transition Age Youth  In 2008, 8% of youth aged 12-17 and 21% of transition age youth met diagnostic criteria for a substance use (alcohol or illicit drugs) disorder, but less than one in ten youth received specialized addiction treatment.  There are more than 4,900 treatment programs that specialize in the treatment of