Teen Challenge Research
Significant research that everybody should know
National Institute on Drug Abuse Report
Teen Challenge claims of a 70% cure rate for the drug addicts graduating from their program attracted the attention of the U.S. Federal Government in 1973. Most secular drug rehabilitation programs only experienced a cure rate of 1-15% of their graduates. The National Institute on Drug Abuse (NIDA), part of the U.S. Department of Health, Education, and Welfare, funded the first year of this study to evaluate the long term results of the Teen Challenge program.
This study focused on all students in the class of 1968 that entered Brooklyn, NY, Teen Challenge, and then transferred to Rehersburg, PA, for the second half of their training. This follow-up study seven years later (1975) sought to determine six variables: what proportion of the program participants were still drug free, no legal involvements, employed or pursuing education, a part of a family unit, participating in church activities and physical and mental health.
The survey was conducted under the leadership of Dr. Catherine Hess, M.D., the former assistant chief of the Cancer Control Program of the U.S. Public Health Service, who had previously served as the Medical Director for the New York Hospital Methadone Clinic. The main premise of the study was to demonstrate that introduction of a religious component into the treatment of drug addicts is the one aspect which produces the large success rate.
The National Opinion Research Center of the University of Chicago developed the survey instrument, located survey participants, conducted the personal interviews, and obtained a urine sample to test for drugs. The National Medical Services, Inc., of Philadelphia, PA, conducted the drug screening detection for this population.
Research results were categorized into three groups.
P1 were students that entered Brooklyn Teen Challenge, but dropped out and never attended the Rehrersburg program.
P2 were students that completed the Brooklyn program who later dropped out of the Rehrersburg program.
P3 were graduates of the Rehrersburg Training Center program.
A total of 186 persons were interviewed for this project, P1=70, P2=52, and P3=64. The P3 group of 64 represented 97% of the total population possible. The results of this survey clearly indicated the success of the Teen Challenge program in the following areas:
The Teen Challenge definition of "drug-free" means abstaining from all use of narcotics, marijuana, alcohol, and cigarettes. 67% of the graduates (P3) are drug-free as indicated by the urinalysis test. (86% stated they were drug-free on the questionnaire.)
72% of the graduates (P3) continued their education upon completion of Teen Challenge. The areas include getting their G.E.D., or pursuing college level education.
75% of the graduates (P3) indicated their current status as employed. 73% of the graduates are self-supporting by earning their own salary. Of those who are currently employed, 58% have been at their present job for over one year.
87.5% of the graduates did not require additional treatment in drug treatment programs after leaving Teen Challenge. Over 90% considered themselves addicted to drugs before entering Teen Challenge.
67% of the graduates are regularly attending church. 57% of the graduates are involved in church work.
92% of the graduates (P3) report good-excellent health, whereas the numbers are significantly lower for the other two groups, P1=59% and P2=75%.
For a more detailed report on these and other research projects on Teen Challenge, contact:
Teen Challenge, Inc.
444 Clinton Avenue
Brooklyn, NY 11238
Teen Challenge's Proven Answer to the Drug Problem
A Review of a Study by Dr. Aaron T. Bicknese
"The Teen Challenge Drug Treatment Program in Comparative Perspective"
2. Demographics of the Study
3. Teen Challenge Rebuilds Shattered Lives
4. Teen Challenge Graduates are Productive Citizens
5. Teen Challenge and "The Jesus Factor"
6. Teen Challenge is a Less Expensive Alternative
... About the Study
... About This Review
... About Teen Challenge, International
The number of federal dollars appropriated for drug treatment has steadily climbed over the past twenty-five years, from $120 million in 1969, to $1.1 billion in 1974, to $3 billion in 1996 (1). This dramatic rise in spending has occurred even though the current group of illicit drug users is half the size of the same group in 1979 (2). Because of this mushrooming of funds in the face of a smaller target audience, in recent years the effectiveness and return on investment of these publicly-funded treatment programs has repeatedly been called into question (3). How effective are these programs, and what kinds of criteria can be used to say a particular treatment is successful? The answers to those questions may surprise you.
For publicly funded programs, there is a core problem in the data collected to assess treatment effectiveness. Up to the present time, it has not been of a uniform nature, which prevents accurate assessments about program effectiveness. The following exchange in 1992 on the effectiveness of federally-funded treatment programs between Mark V. Nadel, the General Accounting Office's Associate Director for National and Public Health Issues, and Charles B. Rangel, then Chairman of the Select Committee on Narcotics Abuse and Control in the House of Representatives, illustrates the severity of the problem.
Mr. Nadel: As we found in our report, because uniform information is not being collected, we are unable to provide you with that information.
Mr. Rangel: How can we compare the success of one [type of treatment] to another?
Mr. Nadel: If you had good uniform data and outcome data on a continuing basis, you would be able to do so. We don't have such data now.
Mr. Rangel: So, you haven't the slightest idea as to whether any of these treatments are working?
Mr. Nadel: We are unable to determine that. That's right, Mr. Chairman (4).
Regarding publicly funded treatment programs, Kweisi Mfume, during his days in Congress said, "I just get a little pain thinking about the lack of success rates for many of these drug treatment programs and the fact that there are a lot of people, quite frankly, who are in that business to make money and they make their money and they make it off of us" (5).
The concern about low cure rates of treatment programs funded by public dollars opens the door to questions about whether such rates are all one can or should expect of any method of drug treatment, whether or not the program receives public funding. If low cure rates and minimal changes in behavior are all that can be anticipated, does the public have the right to demand that improvement in drug and alcohol treatment programs be made? On the other hand, if significantly higher rates of success do exist somewhere in the world of drug treatment programs, then perhaps the public does have the right to demand action.
Because of the vast damage done to the individual and society by drug and alcohol abuse, it is crucial that society evaluate the effectiveness not only of publicly funded programs, but also, for the sake of comparison, programs not using public funding. For these reasons, Aaron Bicknese, a researcher at Northwestern University, decided to explore a drug treatment program which, according to a study done in the 1970's, enjoyed unusually high rates of effectiveness (6). The program is Teen Challenge International, a Christian nonprofit addiction treatment ministry with 130 centers (2885 beds) in the United States.
The study, published in June, 1999 is the most comprehensive statistical analysis of its kind to date. The study surveyed several key areas, including freedom from addictive substances, employment rates, productive social relationships and other tangible factors that lead to a better quality of life. The study was designed to determine how Teen Challenge's treatment centers, funded primarily by nonprofit contributions, compared to organizations funded by public dollars or insurers' dollars. Outcomes based on survey data were statistically compared between samples of Teen Challenge graduates and graduates of publicly funded Short-Term Inpatient (STI) drug treatment programs. As the newest type of treatment to capture the attention of addiction program evaluators, 30 to 60 day hospital stays for STIs funded by private or public insurers have become increasingly common since the early 1980's.
The results show that with at least one very popular type of publicly funded secular drug treatment program, Teen Challenge is in many ways far more effective. The study particularly emphasized Teen Challenge's ability to help students gain new social skills, so that upon leaving the program, the Teen Challenge student, compared to clients of the secular programs surveyed, is productively employed at a much higher rate and has a dramatically lower chance of returning for further residential treatment.
The last statistically significant evaluation of the Teen Challenge program was in 1975, by the National Institute of Drug Abuse (NIDA). Of a sample of 1968 Pennsylvania Teen Challenge graduates, 87.5% of former abusers were abstaining from the use of marijuana seven years after completing the program and 95% of former abusers were abstaining from the use of heroin seven years after completing the program. In 1994, another study was conducted by Dr. Roger Thompson at the University of Tennessee. Dr. Thompson also concluded that Teen Challenge had phenomenal success. Bicknese's research found that 86% of those Teen Challenge graduates interviewed for his study were abstaining from drugs. Says Bicknese, "Society need not write off drug abusers; cures can be expected. Productive participation in society by former addicts is not unrealistic." The study credited the success of the Teen Challenge program to the emphasis on a vibrant faith in Jesus Christ: what some have called "The Jesus Factor." Contrast these research results with the following comments about publicly funded programs from some of today's leading experts in the field of addiction treatment.
Dr. Stanton Peele, of Mathematica Policy Research in Princeton, believes that alcohol treatment lobbyists' assessments of the social costs of alcoholism magnify unrealistically each year, and only serve to create "a costly and ineffective alcoholism bureaucracy" which channels huge amounts of public funding into "the addiction treatment industry" (7). David J. Bellis, author of Heroin and Politicians: The Failure of Public Policy to Control Addiction in America, says lobbying groups of mental health and drug treatment professionals dependent on government funding have created a "social pork barrel" which, through "labor-intensive federal programs," assures the continuation of their livelihood (8).
Professional drug treatment evaluator Edward Senay says, "Just as substance abuse tends to become a career, so does substance abuse treatment. . . . Steps should be taken to orient people to the fact that, while treatment does not need to be applied forever, repeated episodes of treatment are probably necessary for most. . . . People in Alcoholics Anonymous are forever 'recovering', not recovered. This concept applies to the treatment of most intoxicant-related problems" (9). Senay's assessment of the inability of secular programs to create real change in clients is echoed by John Ball and Alan Ross in their book on methadone maintenance treatment. They say, "It seems important to recognize that the goal of complete elimination of criminal behavior among patients in methadone maintenance programs is unrealistic. Such an absolute goal is utopian for this population" (10).
In contrast to publicly or insurer funded STI/AA programs, this study found that Teen Challenge not only was better equipped to help the same people that went to STI/AA programs, but was especially successful with groups such as absentee fathers and some ethnic groups who were severely addicted prior to program entry. In the Teen Challenge sample, these groups emerged much stronger than their STI or Alcoholics Anonymous (AA) counterparts on the outcomes of after-program employment, continued substance abuse, severity of relapse, and severity of depression. On some points, the secular programs showed no positive effect for these groups at all. The study's findings suggest that the concern about low cure rates in publicly funded programs might very well be warranted, because higher rates of effectiveness do exist. This finding has the potential to raise public expectations for treatment, and provides accountability for all drug treatment programs, private or public.
This study's results also raises expectations and provides hope for drug addicts and alcoholics, whose potential is often written off by many social service providers, many researchers, and a large segment of society. Drug treatment specialists in particular may need to revise such assessments as the following: "Given the multiple determinants of a complex physio-psycho-social behavior such as addiction, the generally poor premorbid characteristics of those who become addicted, and the lengthy time course of the addiction, [cures] should not even necessarily be expected" (11). In other words, because of the enormously complex nature of drug and alcohol addiction, these researchers believe it is generally not realistic to expect that a person would ever be cured of one's addiction and be able to lead a full and successful life. Fortunately for those in the grip of addictions, this study's data may pave the way for a new perspective by many treatment professionals.
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Demographics of the Study
The average Teen Challenge respondent was thirty-one years of age at intake. Thirty-one percent of respondents were African American, while eighteen percent were Latino, Native American, or East Indian. Eighty-one percent of the respondents had lived most of their lives in an urban area. Upon entering the program, fifty-six percent had never married, twenty-five percent were married, and the remaining nineteen percent were divorced, separated, or widowed. Fifty-six percent were fathers. Thirty-four percent had not earned a high school diploma before Teen Challenge, fifty-two percent had a diploma only, and fourteen percent had education beyond high school. The average Teen Challenge respondent had been arrested for non-traffic offenses at least three times in the year before entering treatment, while the average comparison group respondent had been arrested twice, and the average member of the aggregate STI pool had been arrested less than once. Before the program, eighty-six percent of Teen Challenge respondents used drugs other than alcohol at least weekly, while forty-seven percent of the aggregate STI pool used nonalcoholic drugs that often.
Prevalence of Pretreatment Frequent Drug Usage in Teen Challenge Sample and Matched Comparison Group (For alcohol, percent daily use during year before program; for other drugs, percent weekly use during year before program) Reference
The above study data show that far more polydrug users are found in the Teen Challenge sample than in the STI/AA comparison group. The average Teen Challenge respondent used 2.29 drugs frequently, but the STI/AA comparison group respondents used only 1.65 drugs frequently. Further, in all of the illicit drug categories plus alcohol, more Teen Challenge respondents were found to have used frequently pretreatment. However, the three drug categories in which higher numbers of frequent users were found in the STI/AA comparison group were tranquilizers, painkillers, and barbiturates (such as sleeping pills), all three of which are categories of legal drugs, either prescription or over-the-counter. Thus, more polydrug users were found in the Teen Challenge sample than in the matched comparison sample, and more frequent users of illicit drugs and alcohol were found in the Teen Challenge sample than in the matched comparison sample.
This study found several tangible areas where Teen Challenge excelled in comparison to STI/AA programs. This in spite of the fact that the general STI population is generally older, less ethnic, less urban, more educated, less criminal, and less severely addicted pretreatment, while Teen Challenge students have fewer productive pretreatment relationships, are using a greater range of drugs, are more severely addicted, and often come from more difficult to reach groups. After extensive analysis of the study data, Bicknese reached several conclusions as to why Teen Challenge is so effective. One key feature of the Teen Challenge program, Bicknese believes, is that it dispels loneliness and emptiness through building productive social skills and equipping students to utilize those skills once they graduate.
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Teen Challenge Rebuilds Shattered Lives
By the time someone enters Teen Challenge, almost every relationship and family tie that might have been helpful in recovering has been shattered, and the individual has usually formed strong relationships with people and/or groups that actually perpetuate the addiction spiral. Those who go to Teen Challenge for treatment typically score far lower in the quality and depth of healthy relationships than those who go to STIs or AA. In spite of the fact that those entering Teen Challenge are generally far less equipped to deal with the daily issues of life, are far more addicted to a greater range of substances, often come from groups that are extremely difficult to treat, and have few or no productive relationships, Teen Challenge graduates after treatment score as high or higher compared to their STI/AA counterparts in every area studied.
The study provides lengthy evidence regarding the reconstruction of familial bonds at Teen Challenge among a population generally without a strong sense of family. Particularly memorable are quotes which speak of the goodness of "sticking it out and spending time with hard-headed people" which "was the most positive thing I'd ever seen, period." Also mentioned was the transcending of racial barriers: "I loved to be around people from different places, I wished I would have got their numbers; it was a beautiful thing, living with them with no prejudice or racism. We loved one another. It was a beautiful thing. We all learn something from each other; I still learn from them today."
What the Teen Challenge Respondents Said About Their Program:
"What Was Positive, What Was Helpful, What Worked. . ."
(59 respondents, most cited more than one category) Reference
Schooling, teaching, or Bible
Advisor, staff, love, encouragement
Fellowship, unity, friends, living with others
Discipline, structure, work
Seeing lives changed
Time to pray
Outings, outreach, helping others
Learning to forgive myself
Changed my thinking; gave me hope
Length of stay
The study data also suggest the following three additional ways Teen Challenge, as opposed to a short-term inpatient hospital program or Alcoholics Anonymous, is more likely to help students build productive social relationships.
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The Staff Contribute to Forming Productive Social Relationships
Much of Teen Challenge's success comes from the level of commitment required in the program. If one is in the program, one must learn to participate in community life, with its hardships, benefits and lessons in the forming of productive social relationships.
When graduates were asked the question, "What works?" the third most frequent response after "Jesus" and "the teaching/the Bible" was a group of responses categorized as "Advisor, Staff, Love, Encouragement." One graduate spoke of the "determination of the staff. It takes a lot of patience, a lot of time, a lot of courage and sacrifice to work there. As a worker you put out a lot." Another observed, "Staff members live there. Their commitment stands out." With gratitude, many respondents remembered the staff with comments such as, "available, caring, loving people willing to put forth the effort to help others." The students understand the sense of mission that Teen Challenge staff feel regarding their work.
The commitment to community among staff may spring from the origins of Teen Challenge. Teen Challenge was started by David and Gwen Wilkerson to help counter the feelings of loneliness and alienation found in the street gangs of New York City. Because the program is staffed primarily by former students, there is continuity of community, and students see that the "cure" is accessible to them. The ex-addict-as-staff member who lives with the students in Teen Challenge is a powerful force for the construction of healthy and productive relationships in the students' lives.
In contrast, a doctor in a STI hospital setting, regardless of formal training in addiction counseling and therapy, generally is at a disadvantage in the treatment process compared to the Teen Challenge staff member. The doctor's presence does not necessarily send the message to the patient that the doctor was once in the patient's shoes and that the patient can get out of an addictive situation and become like the doctor. In the hospital setting, the doctor and the patient do not share meals. The doctor would not generally consider the patient as "family" nor have much to do with the patient beyond the interest required by professional duty. The doctor goes home to a family and carries on a set of social relationships with other groups in which the patient is not included. The patient, also, has a personal network which rarely includes the doctor.
At Teen Challenge, on the other hand, because the staff live at the treatment center and become like family to the students, a tight social network develops. Sanctions against bad behavior are effective, obligations are owed and met, trust and trustworthiness are nurtured, and reputations are at stake. Healthy and productive relationships are built.
The sense of community and character that are built while in the Teen Challenge program is evident in the following quote by a graduate regarding a Teen Challenge staff member: "I really looked up to him. There's a lot of guys that didn't like him because he was hard, and I couldn't stand him at first. And now I look back and I can't help but love the man because I know what he was doing for me, you know, he was guiding me in the right way."
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The "Social Contract" Contributes to Forming Productive Social Relationships
"Social Contract" is a term used by social scientists for the written and/or unwritten agreements which groups use to determine what behavior is important to the group, how the group interacts with itself and others, and the group's core values. This study's data indicates that the social contract in STIs/AA is vague compared to Teen Challenge, thus contributing to a lack of group identity, unlike the strong sense of community reported by graduates of Teen Challenge. An observation made by Robert Wuthnow, who documents a recent small group trend in American society, may apply to AA-style support groups. He writes, "Small groups may not be fostering community as effectively as many of their proponents would like. Some small groups merely provide occasions for individuals to focus on themselves in the presence of others. The social contract binding members to each other asserts only the weakest of obligations. For example, 'Come if you have time.' 'Talk if you feel like it.' 'Respect everyone's opinion.' 'Never criticize'" (12).
One Teen Challenge respondent, of several, tells of such an experience: "I went to a Twelve-Step program, but I knew that wouldn't work; I knew I had to get out of the environment. You go to meetings and you come home and you're still the same. I knew I needed Teen Challenge." In fact, some discomfort may result in a greater sense of community being imparted to the student. Says another survey respondent, "You need a change in yourself right away. It helps you cope with daily problems once you do get out. What really stuck out with me was living with 100 other guys, still being able to get along, living in tight quarters. You still have something in common with everybody; whereas in prison or jail you're going to have physical fights. In jail there's not a way to get that person back on track."
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The Fundraising Structure Contributes to Forming Productive Social Relationships
Forming a grass roots voluntary association that successfully addresses an entrenched social problem is one of the highest forms of civic engagement. Recognition of the effectiveness of Teen Challenge in dealing with shattered lives is also evident at the grass roots level, demonstrated by the fact that Teen Challenge is funded almost entirely by private contributions. The study also suggests that Teen Challenge donors are more emotionally involved in the organization, donating more of their time than volunteers of organizations such as the Environmental Defense Fund or even the American Cancer Society.
Teen Challenge students know that the program is funded through voluntary donations made by "ordinary people." They see this happening as the collection plate is passed when the Teen Challenge choirs go out and perform concerts in churches. This seemed to lead to especially meaningful experiences for many Teen Challenge respondents. The mentality that "I am privileged to be here," rather than "I have a right to be here," is commonplace because of the love students see demonstrated by Teen Challenge volunteers who give so freely of their time and other resources.
Extensive social engagement, the dedicated staff, the structure of the program itself, and the love of many who give freely of their time and money all contribute to a unique environment that has demonstrable effects on the graduates of Teen Challenge. Learning how to have productive social relationships, building moral character, having an "attitude of gratitude"; it is this full participation in the life of the program that has such an impact on students after graduation. These are some of the areas in which Teen Challenge so radically differs from STIs. This study demonstrates that Teen Challenge uniquely empowers the former addict, even welcoming many healed graduates to work as staff members.