Cornerstone Recovery, Inc.

Mission Statement: To give hope and healing to teens and families through early recovery from drug and alcohol addiction.

Vision: To sustain a highly effective treatment program based on scientifically demonstrated best practices, and to provide information and training opportunities to the professional treatment community in order to facilitate effective treatment of adolescents nationwide.

Since 1999, Cornerstone Recovery has been helping teens and parents confront and overcome substance abuse problems. In July of 2001 Cornerstone incorporated and then in 2004 achieved nonprofit status with a mission to provide a safe harbor dedicated to bringing hope and healing to teens and parents in early recovery. From its inception, the goal has been to create and provide the best possible model for treatment of adolescents with addictions. Through a process of constant evaluation, adjustment, and documentation of program elements, Cornerstone has become the “Center of Excellence” that was once a vision. Cornerstone provides effective solutions that are built around current scientific literature regarding adolescent development, family dynamics, and addiction in contrast to programs that offer treatment dictated by the requirements and limitations of third party payment.

Best practices for adolescent programs include:

multiple points of assessment and reassessment with standardized instruments,
involvement of the family in multifamily groups and family therapy,
a requirement that parents be sober and provide a sober home,
treatment of other mental health issues within the treatment plan with qualified professionals,
segregation of adolescents from adults,
the use of a consistent treatment curriculum,
specialized recreational and social programming designed for adolescents,
interaction with the juvenile justice system,
gender-specific groups,
careful referral and integration into community support prior to discharge, and
an adequate length of stay that is not dictated by insurance limitations.

Cornerstone provides all aspects of the best practices identified by the National Institute of Health.

Although adolescent substance abuse is a pervasive problem, only one in ten adolescents with abuse or dependence problems receive treatment. The most commonly reported reason is the cost. Program quality, defined by the services delivered and qualifications of staff, is typically correlated with the cost of the program. Cornerstone Recovery qualifies as a highest quality program, according to industry standards, and maintains a commitment to provide treatment to families who, due to the cost, have no access to treatment elsewhere. The cost to provide Cornerstone’s outpatient and outreach programming to 85 families totals over $1,000,000 per year. Each year the Board of Directors, parents, and program participants organize several fundraising events to meet this large funding challenge.

Cornerstone treatment is based on the understanding that not only do the teens need specialized mental health treatment, they also need family involvement in treatment and peer support with positive peer pressure in order to remain attracted to treatment and motivated to change their choices and lifestyle. Cornerstone provides a full range of outpatient clinical services including assessment and treatment planning, an intensive outpatient treatment program (IOP) and a variety of family, individual, multifamily group, gender, second stage group therapies as well as coordination of care with outside treatment professionals and law enforcement, when applicable.

Cornerstone requires full participation from the family as well as a commitment from the addicted individual to several years of participation in order to stabilize, heal, and grow. Cornerstone nestles adolescent treatment within an alternative peer group, creating the venue for appropriate adolescent social development. The peer program provides positive peer support, engagement in fun sober social activities, strict peer accountability, and opportunities to grow into leadership positions.

Cornerstone offers not only a full range of outpatient clinical treatment by licensed professionals (Clinical Program), but also an alternative peer group with a full calendar of staffed and sober social events to replace the peer environment of the substance abusing teen (Outreach Program). Adolescents who have been using drugs or alcohol are developmentally stunted and require a strong and healthy social system in which they are able to mature. A family will typically complete the Cornerstone in two to three years.

Families matriculate into the Cornerstone program through many channels. There is no formal mechanism to “join” Cornerstone. Adolescents who are desperate to break free of their addiction see their former drug-abusing friends begin to thrive within the Cornerstone program are attracted to the activities and voluntarily begin to participate, only to invite their parents’ involvement later. Parents who see their friends’ families healing in the program sometimes begin to participate and later learn through the program how to engage their teens in the process. The parents and teens at this stage of involvement participate in 12 step-based support group meetings, after-school activities, weekend social functions, and retreats under the guidance of the Cornerstone staff. There are activities six days each week in three or four locations that are available to the clients. Through this open door policy, Cornerstone’s Outreach program serves many teens and families in the community struggling with addiction and abuse issues.

Most of the teens and their parents need more than a supportive peer group and the 12 steps. The chances of remaining sober after treatment increase tremendously when an addict or alcoholic participates in both clinical treatment and a 12 step program. Those who participate in 12 step programs without the clinical aspects have four times the rate of relapse of those who do both (Timko, Moos, Finney, & Lesar, 2000). Cornerstone families undergo an assessment and are offered participation in Cornerstone’s clinical services as appropriate. Parents in the Cornerstone program agree to provide a drug and alcohol-free home for their child, and to focus on their own personal growth as their child works toward building his or her character and finds healthy solutions for their disease.

Initial goals for treatment of Cornerstone’s clients typically focus on relapse prevention and containment of impulses while the brain stabilizes. Cornerstone’s ultimate requirements for successful completion include physical fitness and health, character development, a strong sense of efficacy, the ability to withstand the pressures of life using positive coping strategies, the development of short and long-term goals, and gratitude for the family and community benefits to which most teens feel entitled. Goals for family treatment include forming a united front between the parents, setting boundaries with clear accountability at home, and reuniting the family with new skills for resolving conflict and new respect for each other and parental authority. Adolescents who are actively engaged and committed to completion of the program are offered an opportunity to participate in a three-week wilderness experience that Cornerstone plans and staffs each June. The Cornerstone staff members are experienced in this activity, and divide the participants into 10-person groups to intensify their experience. The wilderness trip is often the capstone experience in which each participant experiences tremendous emotional maturation. Cornerstone offers more services, counseling and meetings in a more cost efficient model compared to other local providers for non-residential treatment. Cornerstone has developed a strong reputation in the recovery community through its many successful “graduates”.

Because professional treatment is provided within a framework of peer accountability, teens and their families most often elect to remain engaged in the process until their treatment goals are fulfilled. Cornerstone’s outcome data from the years 2006 and 2007 indicate that 75% of the clients who began treatment actually completed the Cornerstone program. This retention rate parallels the “best program” among data from the National Treatment Retention Findings from the Drug Abuse Treatment Outcome Study (DATOS) funded by the National Institute on Drug Abuse (Simpson, et al, 1997). In that study retention rates ranged from 16 to 75% nationwide. Of the retained Cornerstone clients, 90% continue to maintain sobriety one year subsequent to discharge. This outcome is unparalleled in the treatment community. In the DATOS studies, follow-up data is taken one year from intake versus discharge. Nevertheless at the one-year anniversary of intake only 29% of adolescents remained sober from alcohol, 57% report no hard drug use, and 43% continue to use marijuana at least weekly (Hser, Grella, Hsieh, & Anglin, 1999).

The majority of the teens (80%) entering Cornerstone have been diagnosed with co-occurring mental disorders, one of which is substance abuse or dependence. The most frequently reported co-occurring disorders are bipolar illness and attention deficit disorder. Other co-occurring disorders that are frequently seen in the Cornerstone population are depression, obsessive compulsive disorder, and oppositional defiant disorder. Because the behavioral side effects of substance abuse mimic the symptoms of other mental illnesses, the accurate diagnosis of the co-occurring conditions is very difficult, and treatment for the co-occurring condition is ineffective without addressing the substance abuse. Substance abuse treatment is not typically provided by a physician without intensive adjunctive behavioral treatment.

Teens often have multiple psychiatric hospitalizations before participating in Cornerstone programs, usually the result of suicide attempts or overdoses. The average length of time they have spent in various psychotherapies is 37 months. The teens that arrive at Cornerstone have typically been using drugs for three to four years and have alienated their families through their dishonesty, manipulations, and disrespect. The spiral into the world of drugs is ugly, as the teen loses self-respect, dignity, compassion, empathy, and any ethical or moral boundaries. Their language is sometimes foul. Sometimes they spit. They are sometimes unclean from days of homelessness after running away from home. The addicted teen is often failing in school and is either on probation or has barely escaped legal problems.

A Cornerstone parent is likely to have watched in horror as their precious child disappeared and was replaced by a hostile and miserable creature. They have spent countless dollars on therapies that are ineffective. They have paid for hospitalizations that result in relapse. They, too, enter the Cornerstone world hopeless, financially drained, afraid for their child's life, ashamed and broken, and with their marriages fragile or disintegrating from the trauma.

Cornerstone recognizes that every adolescent who recovers from substance abuse is one less drug dealer, homeless person, community health services recipient, inmate in the state penitentiary, or preventable fatality. Every adolescent who recovers from substance abuse becomes one more productive adult who can become a role model for healthy choices. Battling drug and alcohol addiction is a very difficult challenge at any age and requires a solid foundation of peer interaction, family support, commitment, and counseling. Cornerstone strives to reach young substance abusers with an intense and comprehensive course of treatment, working with families to regain control of their households and to use their parental leverage to achieve successes closely aligned with their potential. In doing so, Cornerstone can be seen as not only a treatment program, but a prevention program for the voluminous societal problems that ensue as adolescents sink deeply into the abyss of addiction. Instead, participants gain a sense of hope and become recommitted to positive goals. Participants' self-esteem increases, as well as their sense of belonging to community. Families are reunited and healed and teens have opportunities for a successful future.

Addiction places a significant financial and emotional burden on the families of these adolescents as well as on the community at large. Cornerstone’s goal is to provide the most effective model of treatment available for adolescents and their families.

Cornerstone is seeking to document and disseminate information to a broad range of treatment professionals with the intent of providing the Cornerstone model as an effective and replicable treatment model to be used nationwide. Cornerstone has taken several steps toward this goal:

Cornerstone became a certified intern training site in 2006. Qualified students who complete two years of specialty training by Cornerstone have the opportunity to become licensed by the State of Texas and can develop similar programs elsewhere with ongoing consultation and mentoring from Cornerstone staff.
In collaboration with Baylor College of Medicine, Cornerstone is currently engaged in a comprehensive treatment outcome study evaluating the relative salience of various treatment factors for families with adolescent substance abusers. After reviewing preliminary results, several organizations have committed to fund the completion of the project.

REFERENCES

Galaif, E., Hser, Y.I., Grella, C.E., & Joshi, V. (2001). Prospective risk factors and treatment outcomes among adolescents in DATOS-A. Journal of Adolescent Research, 16(6), 661-678.

Harwood, H. (2000). Updating Estimates of the Economic Costs of Alcohol Abuse in the United States: Estimates, Update Methods, and Data. Report prepared by The Lewin Group for the National Institute on Alcohol Abuse and Alcoholism.

Hser, Y., Grella, C., Hsieh, S., & Anglin, M.D. (1999). National evaluation of drug treatment for adolescents. Paper presentation at the College on Problems of Drug Dependence (CPDD) Annual meeting, Acapulco.

Johnston, L.D., O'Malley, P.M., Bachman, J.G., Schulenberg, J.E. (2005). Teen drug use down but progress halts among youngest teens. University of Michigan News and Information Services. Ann Arbor, MI; December 19th.

Schackman, B.R., Rojas, E.G., Falco, M., & Millman, R. (2007). Does higher cost mean better quality? Evidence from highly-regarded adolescent drug treatment programs. Substance Abuse Treatment and Prevention Policy, 2(23).

Simpson, D.D., Joe, G.W., Broome, K.M., Hiller, M.L., Knight, K., & Rowan-Szal, G.A. (1997). Treatment retention and follow-up and outcomes in the Drug Abuse Treatment Outcome Study (DATOS). Psychology of Addictive Behavior, 11(4), 294-307.

Timko, C., Moos, R.H., Finney, J.W., & Lesar, M.D. (2000). Long term outcomes of alcohol use disorders: Comparing untreated individuals with those in Alcoholics Anonymous and formal treatment. Journal of Studies on Alcohol, 61, 529-540.

Staff Bios

Board Members