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Culturally specific treatment programs help people of color achieve, maintain sobriety

Such programs often have higher success rates with members of minority populations, who frequently struggle to reach and maintain sobriety using traditional treatment programs.

Photo by Tim Mossholder on Unsplash

In 2018, when Katy Armendariz decided she needed residential treatment to recover from her alcohol addiction, she went. But from the beginning she never felt that she belonged in the program. As far as she could tell, she was the only person of color there, and that fact left her feeling alone and isolated. Plus, she wasn’t certain that the program’s 12-step-based approach aligned with her worldview.

Katy Armendariz
Katy Armendariz
Later, in 2019, when she heard the news of a racially motivated mass shooting in an El Paso, Texas, Walmart, Armendariz came to her recovery group fired up and ready to talk about how the incident made her feel. She said it triggered her racial trauma.

“I walked into that group treatment room,” Armendariz recalled, “and I saw that there was no one there who looked like me and no one who wanted to talk about this racist thing that had just happened.” While the other people in the program had tried their best to make Armendariz feel welcome, she realized that they’d never see the world from her perspective. That disconnect felt significant.

“I was the only one in the room who had the same feeling of fear, of not being safe,” Armendariz recalled. “I was visibly traumatized, but one of the ladies in the group said, ‘He was clearly mentally ill. There’s usually a lot of mental illness that’s leading up to this.’” The response made Armendariz feel invalidated, dismissed and angry. Racism, Armendariz said, is not a form of mental illness.

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“I got to the point of thinking,” she said, “‘How’s this helpful for me in recovery? How can I do this work in a place where I don’t belong?’”

Though she has remained sober ever since completing outpatient treatment, Armendariz said that the experience has taught her that recovery isn’t a one-size-fits all experience. Many people of color struggling with addiction also say that traditional treatment programs don’t work well for them. Armendariz wanted to create a space that would.

As founder and CEO of Minnesota CarePartner, a social-justice-focused agency providing mental health services, Armendariz realizes that she is in a unique position to influence change. Through Roots Recovery, the addiction-treatment arm of Minnesota CarePartner, she knew she could offer substance use and addiction treatment that focused on meeting the specific needs of people of color, taking into account racism, white privilege and historical trauma — issues that are often not addressed in traditional treatment programs.

“One of the things that sets Roots Recovery apart is our focus,” Armendariz said. “We have counselors of color and that draws clients of color. In our treatment process we address how historical trauma and systemic racism impacts addiction for the clients we serve, just like it did for me.”

Unique needs

Armendariz considers Roots Recovery’s approach to addiction treatment to be culturally specific, or focused on the unique needs and backgrounds of specific cultural groups other than the needs and backgrounds of the white male founders of the Minnesota Method.

Angela Reed
Turning Point
Angela Reed
Because they are designed with the needs of specific groups in mind, culturally specific treatment programs often have higher success rates with members of minority populations, who often struggle to reach and maintain sobriety using traditional treatment programs.

Angela Reed, director of the support services and training divisions for Turning Point, Inc., a culturally specific addiction treatment program based in north Minneapolis, said that her program’s long-time focus on the African-American community has proved successful for many of its participants.

“We’ve served over 27,000 people in our history,” Reed said. While some African-Americans can and do achieve sobriety using traditional 12-step methods, Reed explained that the fact that Turning Point’s programming was designed with an awareness of the struggles and achievements of the community in mind helps participants feel that they can succeed, that the organization will be there to support them for years to come.

“The difference between a culturally specific organization and an organization that aims to reach a broader audience is that staff in a culturally specific organization often have an innate understanding of the impacting factors that members of this group face on a daily basis,” Reed said. “When that understanding is clear, recovery can happen.”

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Community-focused recovery

Since co-founder Peter Hayden first opened a sober-living house at 1523 Emerson Ave. N. in Minneapolis back in 1976, Turning Point has been a recovery program focused on meeting the needs of the African-American community. Hayden, who’d found recovery with the help of a mainstream treatment center, felt pressured that if he wanted to stay sober he’d need to distance himself from his family and friends.

He tried that approach for seven years, moving away from his community and focusing on sobriety, but he felt drawn back and eventually relocated to his north Minneapolis home, with a plan to create an addiction treatment program that would meet the needs of African-Americans. He didn’t want to think that the only way to stay sober was to stay away.

The program Hayden eventually created with the help of his friend, colleague and co-founder, Henry Sullivan, takes a different approach from mainstream treatment centers. Unlike other programs that advise clients to move away from the source of addiction, Turning Point treatment involves the whole family structure in the treatment process.

Mainstream programs, Reed explained, “are based on dynamics that fit the needs of people who are not of color. That’s really not our community. We’re impacted by disparities that traditional treatment programs don’t always understand how to address.” Hayden, Reed said, “knew it was necessary to create an organization where everybody can get help, even family members, where we understand that the family system is interconnected and can’t be dismissed.”

Turning Point has been around for nearly 45 years, Reed said, because it works from a unique model for recovery that extends from the individual in treatment to the family and ultimately to the larger community.

“Our programs have continued and stayed successful because we adjust them to the needs of African-Americans,” she said. “We have to believe that the approach we take and the service we provide has led to our longevity. That’s a big accomplishment for an African-American organization in Minnesota.”

Founded and run by African-Americans

Because Turning Point was founded and is run by African-Americans, it is built with an innate understanding of clients’ needs. The program offers inpatient and outpatient treatment options, an aftercare program, social-services support, case management, peer recovery support, legal support, and individual and group counseling.

“Our model for recovery is completely different,” Reed said. “We are a recovery-oriented system of care. All of our programming is built to support the sobriety of our clients. Our mission is meeting the needs of the community, starting with chemical health. We build our programs off of the individual needs of the client.”

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Reed explained that all of Turning Point’s services are focused on educating clients about their addiction and understanding ways to break the cycle of addiction: “We talk about the reasons why they use, the circumstances when they use, the resources they have around them to help them stop and maintain their sobriety.”

The program’s success in the community is evidenced in the loyalty of its former clients, Reed added.

“When people do fall out of care, they tend to come back. Clients tend to stick with our aftercare program. Our goal is to keep them connected for between three to five years. We have yearly events for alumni. We have yearly family picnics. It is about building a whole separate recovery community that is keeping people connected. They keep coming back, and that keeps us strong.”

Designed for success

Two decades ago, members of the Karen community of Burma began coming to Minnesota fleeing persecution and displacement to refugee camps in Thailand. There are now as many as 17,000 Karen living in St. Paul, making it one of the largest Karen communities in the United States.

While St. Paul’s Karen community has settled in, found work and made homes for themselves in their adopted home, the pressures of the refugee experience and creating a new life for themselves had led some members of the community to struggle with addiction.

From the beginning of their move to St. Paul, many Karen people sought medical care at M Health Fairview’s Roselawn Clinic. Shana Sniffen, a physician at the clinic, noticed that many of her patients and their families were struggling with the impact of addiction. After being awarded a Bush Fellowship in 2013, she brought together a group of community organizations to create the Karen Chemical Dependency Collaboration, and championed the creation a culturally specific addiction-treatment program known as the Karen Recovery Program (KRP) focusing on the unique needs of Karen people struggling with addiction.

Rik Lundgren, M Health Fairview chemical health counselor, explained that the treatment program was designed with the Karen community in mind. “The program is a low-intensity outpatient program,” he said. After a four-hour onboarding session, participants continue to live at home and go to work, but meet in group settings two afternoons a week.

“People are new to this country,” Lundgren said. “They need to go to work, but they also need help fighting their addiction.”

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Lundgren, who is white, leads the program with Ta Da, his Karen co-facilitator, who created the program’s curriculum. “He is also a refugee,” Lundgren explained. “He had been running a treatment program at a monastery in Thailand near one og the refugee camps for 10 years.”

Rik Lundgren
Rik Lundgren
So far, roughly 150 Karen men have completed the program. The completion rate is higher than average for outpatient treatment, Lundgren said. Some men came to the group after attempting treatment in more mainstream settings. It can be hard for anyone who is new to the United States and struggles with English to make it through most treatment programs, he explained.

“We’ve had guys who’ve been referred to an English-language program but left and came here. In those cases, they’ve had an interpreter sitting next to them in the group and trying to interpret everything that’s said instantaneously. It’s almost impossible.”

A few of Lundgren’s clients have also tried traditional residential treatment programs for their addiction. But it’s been hard to make progress in programs that are designed to meet the needs of the dominant culture.

“The first couple of times Karen folks went through residential treatment,” Lundgren said, “they had interpreters but they had no rice with their meals.” This slip-up may seem minor to an observer, but for a member of the Karen culture, it was a major error. “For the three weeks these guys were in treatment they weren’t given rice even once. It is an absolute staple of the Karen diet. Why would it not occur to anyone? They are from Southeast Asia. Rice is the primary staple of their diet. Why would you not give them rice?”

Karen clients say they find success through KRP because its founders made a point of designing their program with their specific needs in mind.

“This program works not just because it is in their language,” Lundgren said. “We are really very focused on an approach that fits Karen culture and ways of thinking. We are truly focused on their language, their culture, what they need to find sobriety. It’s unique to them. Is not just The Big Book translated.”

Responding to white supremacy

When civil unrest erupted after George Floyd was killed by Minneapolis police, Armendariz decided to take a closer look at the way Minnesota CarePartner and Roots Recovery conducted business. Even though it was founded by a person of color, was her organization doing enough to dismantle white privilege?

“Minnesota CarePartner’s mission has always been around social justice,” Armendariz said. She decided to take a closer look at the way the business was structured, to see if there were policies they’d taken for granted that needed to be adjusted to make sure the organization was truly working from a culturally specific framework. “We’re trying to create actual practical methods for dismantling white supremacy in the social work field,” she said.

One area that Armendariz and her colleagues decided needed attention was their benefits structure.

“We agreed that we needed to change our paid holidays,” she explained. “We took a company poll to find out the traditional holidays that are rooted in whiteness, in Christianity, in heteronormality. Then we adjusted our paid holidays and offered a number of floating days so people can adjust to the days that suit their individual culture.”

Turning Point’s paid holiday structure has long been focused on the African-American experience, Reed explained. “We take holidays for Rosa Parks’ birthday, for Malcolm X’s birthday. We do Kwanzaa celebrations. With the organization itself we want to make sure we promote African-American culture.”

Armendariz also wanted to make sure that her organization attracted a diverse staff. In Minnesota, qualified mental health professionals of color are in high demand. She decided to make attracting more a priority.

“We pay staff of color more compared to the market rate,” Armendariz said. “It is part of our equity effort to level the playing field.” Because there are so few mental health providers of color in the Twin Cities, she wanted to encourage as many as possible to work at Minnesota CarePartner and Roots Recovery.

“We know it is important to our clients that they can see a provider who looks like them,” Armendariz said. “To attract staff of color and retain them, we are actively creating avenues for staff of color to be in leadership positions.”

It’s a way the organization can put its money where its mouth is, she said, to put sincere effort into creating a culturally specific program focused on the needs of communities of color.

“We are actively out there recruiting clients of color so they can come into a place where we recognized how systemic racism plays into mainstream treatment,” Armendariz said. “We think that when we do this we will ultimately find better outcomes for our clients.”