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VOLUME 1, ISSUE 1 / HTTP://RECOVERYSCIENCEJOURNAL.ORG/INDEX.PHP/JORS/ARTICLE/VIEW/8 1
ISSN: Pending / Journal Website: http://www.recoverysciencejournal.org/
JOURNAL OF RECOVERY SCIENCE
COLLEGIATE RECOVERY STUDENTS AND PROGRAMS:
LITERATURE REVIEW FROM 1988-2017
Austin M. Brown, Robert D. Ashford, Anne T. Heller, Jason Whitney, Thomas
Kimball
To cite this article: Brown, A. M., Ashford, R. D., Heller, A. T., Whitney, J., Kimball, T. (2018). Collegiate Recovery Students and Programs: Liter-
ature Review from 1988-2017. Journal of Recovery Science. http://recoverysciencejournal.org/index.php/JORS/article/view/8
To link to this article: http://recoverysciencejournal.org/index.php/JORS/article/view/8
Published Online: 07/09/2018
Peer Review: Manuscript published as an editorial paper for the
9th Annual ARHE Conference; no peer review completed.
Handling Editor: Ashford, R. D.
Full Terms & Conditions of access and use can be found at
http://www.recoverysciencejournal.org/index.php/JORS/publishingpolicy
JOURNAL OF RECOVERY SCIENCE - ISSN: PENDING
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Corresponding Author: Brown, A. M.; Kennesaw State University, Center for Young Adult Addiction and
Recovery. abrow563@kennesaw.edu
All authors approve this manuscript and the original submission. The authors report no conicts of interest.
This work is licensed under the CC-BY license.
Copyright (c) 2018, Brown, Ashford, Heller, Whitney, & Kimball
Objectives: To present a review of the existing research on college students living
in recovery, including the research on students in recovery participating in collegiate
recovery programs.
Methods: Studies were included if they: a) were peer-reviewed or archived disserta-
tions, b) were published between 1988 and 2017, c) directly involved students in reco-
very on campus, either with or without involvement in a collegiate recovery program.
Results: From 1988 to 2017, 25 studies met the inclusion criteria. These included 7
studies on students living in recovery within the general framework of higher education
and 18 studies involving students in collegiate recovery programs. Qualitative reports
and quantitative descriptive studies were both included.
Conclusions: Findings identify the gaps in currently available research, and support
rationale for increasing longitudinal and quantitative studies of collegiate recovery
programs and the students they serve.
ABSTRACT
http://recoverysciencejournal.org/index.php/JORS/article/view/8
JOURNAL OF RECOVERY SCIENCE
COLLEGIATE RECOVERY STUDENTS AND PROGRAMS:
LITERATURE REVIEW FROM 1988-2017
Austin M. Brown1, Robert D. Ashford2, Anne T. Heller3, Jason Whitney4,
Thomas Kimball5
1Kennesaw State University, Center for Young Adult Addiction and Recovery, Kennesaw, GA; 2University of the Sciences, Substance Use
Disorders Institute, Philadelphia, PA; 3University of Conneticu, Hartford, CTt; 4Pennsylvania State University, State College, PA; 5Texas Tech
University, Lubbock, TX.
KEYWORDS
collegiate recovery; substance
use disorders; behavioral health;
students; student affairs
Introduction
There has been dramatic growth in the development of collegiate recovery programs and communities (CRPs) over the
last ve years (Laudet, Harris, Kimball, Winter, & Moberg, 2014). The rapid growth in CRP development has made it dif-
cult to identify consistent guidelines for what constitutes an established CRP, as opposed to an emerging collegiate recovery
program effort. Collegiate recovery programs tend to be grassroots efforts, arising from the work of champions and stakehol-
ders within individual university communities. The growth of the CRP eld has resulted in differing reports of how many CRPs
currently operate in the United States. Estimations derived from the website of the Association for Recovery in Higher Educa-
tion and Transforming Youth Recovery website place the total CRP count between 150 and 160 established CRPs, and and
CRP efforts in various stages of development (Transforming Youth Recovery, 2016; Association of Recovery in Higher Educa-
tion, 2016; Laudet, et. al., 2014). Much of the research on CRPs has focused on analyzing the recovering student population
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and, more recently, research has emerged describing the structures and functions of a range of recovery-protective mecha-
nisms, often termed “recovery supports.”
Studies on students in recovery have fallen into two categories: The rst studies students living in recovery without parti-
cipating in a CRP, and the second studies students living in recovery with the support of a CRP. Chronologically, research on
students living in recovery without CRP support was the rst to emerge in the 1990’s (Bratter, Parker, & Bright, 1994; Brat-
ter, Parker, & Pierson,1995), whereas research focused on students within CRPs began to emerge in the mid-2000s (Harris,
Baker, Kimball, & Shumway, 2007; Cleveland, Harris, Baker, Herbert, & Dean, 2007). Additionally, a CRP replication curricu-
lum was developed at Texas Tech, in 2005, to provide an overview of how a CRP might be implemented at other universities
and colleges (Harris, Baker, & Thompson, 2005).
This review aims to examine what knowledge has been produced about the student pursuing recovery within the context
of institutions of higher education, to summarize the features and affordances of collegiate recovery programs, to identify
major ndings that might constitute a rationale for these programs, to identify limitations in the available research, and to
suggest future directions for research.
Purpose and Scope
Many individuals entering treatment for a substance use disorder and many in need of recovery support services are
of a traditional college age between the ages of 18-25 (Brown et al., 2008). In a national survey, SAMSHA (2016) reported
that 1 in 6 young adults between the ages of 18-24 met criteria for a substance use disorder and were considered to be in
need of treatment. Of those, only 7.2% received specialized care, and 92.8% received no formal treatment (Park-Lee, Lipari,
Hedden, Kroutil, & Porter, 2017). A number of studies have examined the unique challenges posed by high-risk collegiate
environments and the essential role that peer-to-peer networks and social supports play in supporting the needs of students
in recovery (Botzet, Winters, Fahnhorst, 2008; Cleveland, Harris, & Wiebe, 2010). Collegiate Recovery Programs, or campus-
-based recovery supports provided by various higher education institutions, have generated a range of studies. The current
literature review explores and organizes previously conducted research on students in recovery within the context of higher
education both with and without direct recovery support.
Methods
We elected to include both qualitative and quantitative studies, as well as archived/published dissertations for the current
review. Studies incorporated into the review met the following criteria: a) included students in substance use disorder reco-
very participating in a collegiate recovery program (CRP); b) included students in recovery from substance use disorders
but who were not supported by, or participating in, a CRP; and c) studies of university programs/efforts designed to provide
substance use disorder recovery support for students. In order to provide a comprehensive and thorough review for future
researchers and CRP program managers, any type of study design was considered suitable for inclusion. Dates of publica-
tion or archival were limited to January 1, 1988 through January 31, 2017. Additionally, the publication must have been origi-
nally published in English.
Search Strategy
The search strategy made use of peer-reviewed literature and archived doctoral dissertations. Literature was located
using electronic databases, such as EBSCO and PsycInfo. The search structure consisted of the following: 1) terms related
to college and university students; 2) AND alcohol and other drugs; 3) AND recovery; 4) OR substance abuse; 5) OR addic-
tion; 6) OR collegiate recovery programs; 7) OR university support services; 7) OR behavioral health; 8) OR counseling and
psychological services. Searches were supplemented by reviewing the reference lists of selected literature to nd any other
relevant sources not located by search terms.
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Results
A total of 25 articles, including dissertations, were reviewed. Articles were sorted into two different categories. The rst
category was of students in recovery who were not participating in CRPs (N=7 articles). The second category was of students
living in recovery who were participating in CRPs (N= 18 articles). A full description of the included articles and characteris-
tics of the studies are available in Table 1.
Research on Students in Recovery
Research examining students in recovery attending college, but not necessarily involved in collegiate recovery programs,
has generated a handful of publications. Research from the mid-90’s by Bratter, Parker, & Bright (1994), Bratter, Parker, &
Pierson, (1995), which were later summarized by Bratter, Coiner, Magee, Liebman, & Alter (2006); were rst to identify the
leadership potential of students in recovery and the positive inuence of such students in collegiate environs such as campus
housing. These studies also identied the specic challenges faced by such students regarding recommendation letters,
spotty academic histories, and the ways admission committees could better evaluate the potential of such students. These
early articles were the rst to really provide guidance to college admissions professionals on how to evaluate the potential
of “gifted, underachieving, students in recovery” (Bratter, et. al 1994; Bratter et. al. 1995) and the contributions that could be
harnessed by admitting such students and supporting them institutionally.
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Doyle’s (1996) ndings examined the consistency of services for students who may be in recovery. Doyle’s ndings
demonstrated the variable and inconsistent types of services accessed by students in recovery, which identied the need
for a cohesive support structures for this population. Doyle’s ndings introduce the concept of accommodations for college
students in recovery as a special population to be considered from a service delivery perspective. Woodford’s (2001) disser-
tation, utilizing a phenomenological methodology, highlighted what he determined were the “hidden population” (p.11) of
students living in recovery, thus further adding to Doyle’s work that students in recovery actually exist, require support, and
have no consistent services delivered to them across higher education. In addition to this, their “hidden” status renders them
as an underserved, marginalized, and overlooked student community forced to locate and utilize various outside resources
available in the region surrounding the university.
Terrion (2012), Misch (2009), and national reports, such as the one conducted by Dickard, Downs, & Cavanaugh (2011),
largely focused on the experiences of students in recovery and the role of education in recovery. Terrion (2012) utilized semi-
-structured interviews to determine how recovery capital (White, & Cloud, 2008) and social capital (Graneld, & Cloud, 2001)
were mobilized by students in recovery, and how challenges were overcome through natural support structures. Misch (2009)
argued for on-campus services for students committed to recovery and found students in recovery served as role models for
other students on campus. Finally, Dickard et al. (2001) reported that the role of recovery support in an educational setting
helped to prevent both relapse and loss of educational achievement. Taken together, the studies dedicated to recovering
students in higher education identify them as a specic subpopulation who are generally underserved, possessing special
potentials and skills, and who face specic barriers and challenges. These studies clearly advocate for dedicated recovery-
-support services for this subpopulation of students.
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Students in Collegiate Recovery Programs
CRPs are a relatively young movement, and spent years prioritizing growth over scientic research. Although many
programs kept in-house statistics, and some researchers wrote descriptive pieces, histories, theoretical arguments and a
replication curriculum, few programs had the capacity to undertake a formal study of their programs and the students served
by them. A single CRP, The Center for the Study of Addiction and Recovery at Texas Tech, is responsible for nearly all the
scientic evidence that informed the eld in the early period of formation. These studies from Texas Tech’s CRP examined
students' experiences and sought mainly to examine the mechanisms by which students remained resilient within high-risk
collegiate environments (Harris, Baker, Kimball, & Shumway, 2007; Cleveland, Harris, Baker, Herbert, & Dean, 2007).
A group of studies that helped to dene what is known about CRPs, Characteristics of a Collegiate Recovery Commu-
nity: Maintaining Recovery in an Abstinence-hostile Environment, was compiled by Cleveland, Harris, Baker, Herbert, and
Dean in 2007. The studies, conducted in 2004-2005, used a novel survey instrument to detail the characteristics of collegiate
recovery community members at Texas Tech University, which was considered the largest CRP in the country at the time.
The demographic data revealed the rst picture of the makeup of a population of students in recovery at a CRP. That popu-
lation (n = 87) was predominantly male and overwhelmingly Caucasian. Most reported signicant consequences as a result
of their drug use, with high rates of incarceration and homelessness. The students ranged in age (18-53) but tended to be
slightly older (mean=23.2), than the average undergraduate student age in the United States (U.S. Department of Education,
NCES, 2003-2004). Nearly all participated in 12-step based recovery programs, and the average length of continuous absti-
nence (57% with two or more years of abstinence) was considerable. Since many students initiated recovery while in high
school, the authors outlined a rationale for communities to serve adolescents and young adults entering into college already
in recovery, citing the “increase in adolescents nationwide entering into and completing treatment”. This article highlights the
perception by students in recovery that the campus ecology is largely hostile to an abstinence-based lifestyle.
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Achieving Systems-Based Sustained Recovery: A comprehensive model for collegiate recovery communities by Harris,
Baker, Kimball, and Shumway (2008), provided a descriptive account of CRP students, relevant demographic information,
and unique needs of this population. Of note, this study identied the developmental, instrumental, and institutional challen-
ges that students in recovery face, such as establishing social networks, accessing and cultivating peer-support, overcoming
barriers to healthy peer relationships. The study provided the theoretical basis for systems-based modeling of CRP structu-
res highlighting the needs of collegiate recovery students in terms of social, academic, and recovery support. This study also
provided a rst look at the quantitative outcomes of CRP students, citing an (8%) relapse rate, (70%) graduation rate, and an
average GPA of 3.18. From the perspective of higher education, which emphasizes services designed to increase retention,
progression, and graduation, Harris, et. al. (2008) provided promising evidence of desirable outcomes in both student perso-
nal recovery and academic success (i.e. graduating at rates higher than the university average).
In 2010, Cleveland, Harris, and Weibe reprised the 2004-2005 survey data and added in additional studies comple-
ted at Texas Tech, resulting in the only major book about collegiate recovery to date, Substance Abuse Recovery in College:
Community Supported Abstinence. In Chapter 6, “Daily Loves of Young Adult Members of a Collegiate Recovery Commu-
nity, Cleveland and Groenendyk tracked collected “daily diary” survey data from students at Texas Tech to analyze the inter-
play of factors and how they contributed to students’ emotional and psychological states as varied over time. Daily diary data
provided insight into how students used 12-step recovery programs and the CRP to create a network of pro-abstinent indivi-
duals that offset the frequent pressures to return to active use of alcohol and other drugs. In Chapter 7, “How CRC Abstainers
Maximize Socialize Support,” Cleveland used 2004 survey results to explore how CRP students stocked their social network
with pro-abstinent individuals, having twice as many abstaining students in their social networks and twice the frequency of
contact with students who abstained, as they had with students who drank. In Chapter 8, Casiraghi and Muslow’s mixed-me-
thods study Building support for Recovery into an Academic Curriculum, employed a survey instrument in tandem with focus
groups, consisting of students from Texas Tech’s CRP, to analyze what students valued about the Texas Tech CRP program-
ming. They found that students found the most value in the seminar, from the emotional support and companionship they
found through attending – more than the informational content.
Between 2010-2016, multiple studies examined relevant aspects of the lives and behaviors of students. In one such
study, by Zheng, Wiebe, Cleveland, Molenaar, and Harris (2013), in an effort to ameliorate high rates of tobacco use in CRP
members, researchers conducted an idiographic and nomothetic study to analyze the relationship between students’ daily
cravings, negative affect, and tobacco use in order to identify areas in which an intervention could be applied. A literature
review by Smock, Baker, Harris, and D’Sauza was published in 2011, which examined social support for student in CRPs and
compiled CRP data in the United States.
A qualitative study by Bell, Kantikar, Kerksiek, Watson, & Anindita, (2009) examined how students conceptualize their
challenges on campus and how CRPs provide helpful support. From these studies, it became clear that targeted research
focusing on the subjective experiences of students in recovery are essential to service design and delivery.
In the mid-2010’s, Laudet, et al. (2015) captured the rst large-scale, nationwide demographic data of students partici-
pating in CRPs, thus further dening the collegiate recovery population. The survey reported demographics of a large sample
of students (N=429, from 29 CRPs across the nation), included previous substance use treatment history, co-occurring disor-
der prevalence, present and historical living situations, and previous criminal justice involvement. Results found that student
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participants had a mean age of 26 years, most were Caucasian, and over (50%) were male. A third of the student sample
reported a previous period of homelessness, and over half had previously been arrested. Strikingly, while students reported
overall positive physical health, over (70%) of students also reported a history of co-occurring mental health disorders and a
small minority reported co-occurring disorders related to disordered eating or sex and love addiction.
Following the national demographics study, Laudet, Harris, Kimball, Winters, and Moberg (2016) analyzed students’
reasons for participating in CRPs. This mixed-methods study found the average length of student participation in a CRP was
seven academic semesters and revealed students’ primary reason for enrolling in a CRP was the desire or need for a suppor-
tive peer network. The study reported over a third of the student’s survey afrmed they would not be in college if it were not
for CRPs, and (20%) afrmed they would not have attended their present university without the CRP. This study also highli-
ghted that students in recovery feel that college life directly challenges their sobriety.
More recently, qualitative analysis has also been conducted to further examine the development of students who parti-
cipate in CRPs. Washburn (2016) completed a doctoral dissertation of a phenomenological study of alumni between 1 and 5
years removed from their institutions who had participated in a CRP. Through interviews, Washburn found the students’ reco-
very processes in college were “messy, dynamic and variable,” (p. 294) and not unitary or consistent. Washburn also empha-
sized, “combinations and congurations of various components of support” and “individual factors” - the individual ways in
which students balanced between autonomy and support within their peer support communities - were important factors in
whether students transitioned successfully or unsuccessfully after graduation. Washburn further warned students should not
get too lost in the insular “bubble” (p. 296) of their communities and advised that students would be wise to gradually increase
their autonomy over time prior to graduation. Students interviewed referenced strong student leadership within their CRPs as
being an important component of their success, and a common thread of participants was they derived their chief source of
strength from relational aspects within the CRPs.
In a late-2016 study, Scott, Anderson, Harper, and Alfonso (2016) explored the concepts of recovery identity and stigma
of CRP students at a rural southern college campus, through an iterative content analysis of interviews with students in the
CRP. The researchers found students struggled with an internalized sense of identity once entering into recovery, however,
the CRP helped mediate these feelings of stigma and shame internalized upon students’ identity.
The most recent study completed by Kimball, Shumway, Austin-Robillard, and Harris-Wilkes (2017), explored CRP
students’ feelings of hope and coping related to their recovery. This phenomenological study found students experienced
hope through the recovery of others, as well as through the connection to a “higher power”. Additionally, students coping skill
themes were centered around the difculty of coping with problems while active in their addiction, and their main coping stra-
tegy in recovery involved reaching out to others for help.
Discussion
As noted, the study of students in recovery on college campuses is limited. Research shows students in recovery are
likely to attend colleges and universities that have implemented a collegiate recovery program, creating a unique proposi-
tion for institutions to both better support its student population and recruit additional students. Students involved in colle-
giate recovery programs have been largely evaluated along demographic lines to date. Social theory and recovery support
phenomena and the impact on students in recovery has not been well studied. However, given the explosive growth of colle-
giate recovery programs, and the ensuing nationwide push to establish CRPs and recovery supports on college campuses,
it is likely the future will present many opportunities for recovery researchers. Additionally, the growth in recovery research in
recent years indicates that CRP research is still in the infancy stage.
From current research it can be surmised the enmeshment of education and recovery offers promising results - both for
students in recovery and universities. Increases in social and recovery capital seem to be at the epicenter of growth for indi-
viduals in recovery. When recovery is properly supported, individuals recover along stable and predictable trajectories. CRPs
offer a rich context for establishing knowledge about recovery and offering recovery supports. Being housed within institutes
of higher learning, CRPs provide an independent and objective place for the study of recovery, and a setting in which reco-
very-related research can be better informed by those personally involved. Furthermore, CRPs that have integrated research-
-related activities within their programs have helped foster the mentoring and training of emerging academia focused on the
behavioral health of youth and emerging adults entering into the educational system. Additionally, many of the recently esta-
blished recovery programs have been created and directed by previous students of the larger CRPs in the country
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(e.g. Texas Tech, Rutgers, Augsburg, etc.).
The largest studies to date have provided valuable insight into the recovering student population, as well as the poten-
tial benets these students receive via participation in a CRP. Recovery quality and length, and the potential for academic
success, seem to be positively enhanced by active participation in a program. However, while the previous research suggests
potential correlations between success and CRP participation, much remains to be studied in so far as it relates to student
outcomes and causal factors.
Limitations
Limitations include the scope of inclusion into the nal review. In an effort to separate out the basic theoretical under-
pinnings of literature supporting collegiate recovery justication and design, from studies specically involving the study of
students involved in CRPs and students in recovery, all theoretical articles were excluded from this review. Additionally, grey
literature was not included in this review (e.g. editorials, popular media articles, etc.). These types of offerings often hold
important insights into the recovering student population and the programs that serve them.
Directions for Future Research
Future directions for research should include direct analysis of outcomes through longitudinal studies. Primary and
secondary outcome research will provide insight into the validity of the theoretical underpinnings of CRPs, and thus reect
the transposition of social support theory as it has been adapted to the programs. This can also further inform CRP program-
ming and design.
Randomized control studies of comparison that examine outcomes should be contrasted against students in reco-
very who are not supported by a CRP, and age-similar non-students in recovery. These studies should also contain longitudi-
nal elements, so outcomes can be examined in a temporal context. Additionally, comparative studies should examine areas
for further transposition along the continuum of care, or laterally across the collegiate environment to examine support of
traditionally marginalized populations, that may have substance use disorders or behavioral health concerns, such as vete-
rans, LGBTQ+, and others. It is reasonable to assume that the broad durability of social support through institutions can and
should be generalized to other populations, and that population-specic support can be tailored to maximize outcomes.
Large-scale studies of efcacy, post-graduation stability, as well as intrapersonal, interpersonal, social, and ecolo-
gical studies are needed to better understand the ways and means by which CRPs assist students and help to protect reco-
very and enhance academic success.
At the institutional level, CRPs should enact retention, progression, and graduation tracking of students, as well as
capturing demographic information, treatment, substance use, and academic histories. As demonstrated by past research,
qualitative data derived from student recovery experiences and educational needs can help design programming and struc-
tures of CRPs to be more responsive to the needs of students in recovery.
Additional structural studies, sustainability studies, and studies involving the longitudinal study of how CRPs evolve
could lead to an updated model for replication. Studies that use recovery-informed approaches, capturing common factors
of treatment histories, can help to further dene the transformative elements of recovery. These common factors could also
be used to better inform the justication for a full continuum of care, including recovery-specic educational or vocational
supports.
Conclusion
Review of current research reveals key areas for future directions, including, but not limited to, longitudinal and rigorous
quantitative studies. Though the existing collection of research examining college students in recovery and students involved
in collegiate recovery programs is small and limited in scope, this review shows the body of knowledge is expanding. Further
research into these topics is essential in order to keep pace with the increasing number of students in recovery entering into
higher education and the continued expansion of recovery support efforts through collegiate recovery programs. Additionally,
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Additionally, research into the characteristics and outcomes of students in recovery, without access to collegiate recovery
programs, should receive increased attention given less than 5% of colleges and universities currently have collegiate reco-
very programs available for students in recovery.
Acknowledgements
The authors would like to thank the Association of Recovery in Higher Education and Transforming Youth Recovery for their
dedication to collegiate recovery. Additionally, thank you to Jessica McDaniel for their assistance.
No funding was reported for this manuscript.
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