Recommendations for improving adolescent addiction recovery support in six northwest tribal communities

American Indian and Alaska Native (AI/AN) communities offer tangible and intangible resources, including centuries of indigenous wisdom and resiliency, to support their young people in recovery from substance use disorders. At the same time, tribal youth returning home from residential or inpatient treatment are vulnerable to relapse, especially if they encounter the same environmental triggers in which their substance misuse developed. This study endeavored to learn about community stakeholder perceptions of existing strengths and needs for supporting recovering adolescents among six tribal communities of the Inland Northwest. Using a Tribal Participatory Research approach, we conducted Group Level Assessments with key stakeholders representing educators/coaches, medical and behavioral health providers, social service providers, cultural leaders/elders, and legal professionals among each participating tribe (N = 166). We used content analysis to identify emergent themes among participants' recommendations for improving recovery support. The five emergent themes were (1) Communication, Collaboration, and Accountability among Tribal Departments and Agencies; (2) Community-wide Education; (3) The Importance of Providing Wraparound/Supportive Services; (4) Youth-focused Education, Services, and Events; and (5) Recovery Coaching Model. AI/AN culture was infused within nearly all recommendations for improving recovery support that composed these themes. We discuss specific ways to implement these recommendations, including the forthcoming development of a culturally-grounded community-wide mental health training program developed specifically for, and with, these tribes.