The study, published in Topics in Spinal Cord Injury Rehabilitation, evaluated the first cohort of True Grit, a week-long sleep-away program created by Rutgers School of Health Professions and RWJBarnabas Health’s Children’s Specialized Hospital. The program serves participants between 14 and 21 years old, an age range in which many young people are moving from highly structured pediatric care toward adult health services and greater personal responsibility. Unlike conventional rehabilitation, which often focuses primarily on physical function, True Grit combines clinical therapy with vocational preparation, social development, recreation and education about the complex realities of adult life after spinal cord injury.

Spinal cord injury can disrupt motor and sensory pathways between the brain and the body, affecting movement, sensation and autonomic functions such as bladder, bowel and temperature regulation. The consequences vary widely depending on the level and completeness of the injury, but even individuals with substantial physical recovery may encounter environmental and social obstacles that limit participation. A person may be able to attend school or work yet remain excluded by inaccessible transportation, buildings, recreation programs or limited opportunities to meet peers. These participation barriers are particularly important during adolescence, when identity, independence and social belonging are developing rapidly.

“There is a high incidence of traumatic spinal cord injuries, specifically in young males, in adolescence,” said Keara McNair, a lecturer in Rutgers’ Department of Rehabilitation and Movement Sciences and a co-director of True Grit. She noted that people with spinal cord injuries are increasingly discharged into the community sooner, while existing services are more likely to address adult employment or conventional rehabilitation than the broader transition to adulthood. True Grit was designed to occupy that gap by treating independence as a multidimensional outcome. Participants work not only on physical techniques, but also on decision-making, self-advocacy, emotional adjustment, relationships and the ability to navigate everyday environments.

Each summer since 2024, the program has used dormitories at Rutgers University–New Brunswick’s Livingston Campus in Piscataway, New Jersey, as a temporary living laboratory. Occupational therapists, physical therapists and recreational therapists with clinical experience in spinal cord injury rehabilitation work alongside peer mentors. The setting is significant because participants practice skills in an environment that resembles college or other postsecondary living arrangements more closely than a hospital or outpatient clinic. They must manage schedules, move through shared spaces, communicate their needs and participate in activities with other young people, while clinicians can observe where support is needed and adapt instruction in real time.

The clinical component includes individualized occupational and physical therapy sessions. Occupational therapy may address upper-body function, self-care, wheelchair skills, energy conservation, transfers and strategies for managing daily tasks with less assistance. Physical therapy can focus on mobility, strength, endurance, balance and safe movement across different surfaces. The program also includes adapted recreation, such as wheelchair basketball, community outings and workshops on vocational planning, sexuality, adapted driving and psychosocial adjustment. Together, these activities reflect a contemporary rehabilitation model in which health is measured not only by impairment or physical capacity, but also by the ability to participate in meaningful roles and environments.

To assess the pilot, researchers evaluated six participants from the 2024 cohort using surveys and specialized rehabilitation outcome measures at the beginning of the program and again three months later. The evaluation examined participants’ personal goals, resilience and involvement at home, in school and in the community. Its mixed-methods design combined numerical scores with participants’ reported experiences, allowing the researchers to examine both measurable changes and the ways young people described their developing outlook. Because the cohort was small and the study did not include a comparison group, the findings cannot establish that True Grit alone caused the observed changes. They do, however, provide early evidence about the program’s feasibility and the kinds of outcomes that may be important in future research.

All participants demonstrated progress toward their individual goals. Overall participation scores increased, with the largest gains among young people who began the program with lower levels of participation. In rehabilitation research, participation refers to involvement in real-life situations, including education, social activities, family life, recreation and community engagement. This distinction matters because improvements in strength or technique do not automatically translate into greater independence outside the clinic. A participant may learn a more efficient transfer, for example, but still avoid community activities if transportation is unreliable or accessible venues are difficult to find. The study’s results highlight how targeted practice and peer-supported experiences may help connect clinical skills with everyday participation.

The three-month follow-up also revealed that progress after a residential program depends on what happens when participants return home. Transportation limitations and reduced access to peers influenced both participation and resilience. Resilience in this context is not simply an individual ability to “overcome” injury; it is shaped by access to resources, supportive relationships, inclusive environments and opportunities to exercise control over decisions. Participants described broader views of their futures, including higher education, employment, independent living and becoming peer mentors. Those aspirations suggest that exposure to peers and professionals in an empowering setting may help counter expectations that life after spinal cord injury must remain narrowly defined by medical care.

The researchers say True Grit has continued to expand, with 12 participants enrolled for 2026 and young people traveling from across the United States because comparable programs are rare. The study’s authors—McNair and Aaron Dallman of Rutgers School of Health Professions, along with Kassandra Boyd and Corinne Calvanico of Children’s Specialized Hospital—report no conflicts of interest. Larger studies will be needed to determine whether the program produces lasting improvements in participation, independence, educational and employment outcomes, and quality of life, as well as which components are most effective. For now, the pilot offers a powerful message: preparing young people with spinal cord injuries for adulthood requires more than restoring physical function. It requires giving them opportunities to practice independence, build community and see themselves as active participants in the future they are creating.

Subject of Research: People with spinal cord injuries, particularly adolescents and young adults ages 14 to 21

Article Title: Mixed-Methods Evaluation of the Pilot True Grit SCI Residential Program for Young Adults with Spinal Cord Injury

News Publication Date: 10-Aug-2026

Web References: Rutgers Health; Rutgers School of Health Professions; RWJBarnabas Health’s Children’s Specialized Hospital; True Grit program information; https://www.rutgers.edu/news/camp-teens-spinal-cord-injuries-helps-build-independence

References: McNair K, Dallman A, Boyd K, Calvanico C. “Mixed-Methods Evaluation of the Pilot True Grit SCI Residential Program for Young Adults with Spinal Cord Injury.” Topics in Spinal Cord Injury Rehabilitation. DOI: 10.46292/sci25-00107

Keywords: Spinal cord injury, adolescents, young adults, rehabilitation, occupational therapy, physical therapy, residential program, independence, resilience, community participation, adapted recreation, transition to adulthood

The brief addiction monitor has emerged as a significant instrument in the landscape of addiction treatment and recovery. Its design allows for a nuanced understanding of the recovery process, going beyond mere abstinence to encompass various dimensions of an individual’s functional functioning. This multi-faceted approach reflects the evolving perspective of addiction recovery, which recognizes that healing involves emotional, psychological, and social components, not just the cessation of substance use.

Over the five-year study period, researchers meticulously gathered data from participants enrolled in the community program. The qualitative and quantitative analyses elucidate not only individual recovery trajectories but also larger trends within the population being studied. This long-term perspective is particularly critical in the field of addiction treatment, given the chronic nature of substance use disorders and the complexity involved in achieving lasting recovery.

One of the most profound findings of the research pertains to the diversity of recovery experiences. Participants exhibited varied patterns of recovery, highlighting the need for personalized treatment approaches that cater to the unique circumstances of each individual. This variability underscores the importance of understanding that the journey to recovery is not linear; rather, individuals may experience setbacks alongside progress, an insight that could shape future interventions and support mechanisms.

As the researchers dove deeper into the results, they uncovered significant correlations between the participants’ levels of engagement in the program and their functional recovery outcomes. Those who actively participated in program activities, including counseling sessions and peer support groups, experienced more favorable outcomes in their recovery journey. This reinforces the critical role that community and connection play in the recovery process, suggesting that fostering a sense of belonging can catalyze sustainable change for individuals battling addiction.

Moreover, the evaluation tapped into the impact of co-occurring mental health issues on recovery trajectories. A considerable number of participants faced challenges related to anxiety, depression, and trauma, complicating their recovery process. The study’s findings emphasize the necessity for integrated treatment approaches that address both substance use and mental health, providing comprehensive care that tackles the root causes of addiction.

The researchers also highlighted how socioeconomic factors influenced recovery outcomes. Many participants came from marginalized backgrounds, where access to resources and healthcare was limited. This demographic context further complicates the recovery landscape, necessitating an equitable approach to treatment that considers social determinants of health. Policymakers and practitioners must work collaboratively to ensure that all individuals, regardless of their background, receive the essential support they need for long-term recovery.

Community-based recovery programs are uniquely positioned to bridge these gaps. The evaluation showcased best practices within the community program that could serve as benchmarks for similar initiatives nationwide. Key components such as harm reduction strategies, educational workshops, and skills training were pivotal in enhancing the effectiveness of the program.

Furthermore, the role of technology in recovery was not overlooked. The researchers noted an increasing trend in using digital tools to support individuals in their recovery journey. Mobile apps geared toward self-monitoring and virtual support groups emerged as beneficial adjuncts to traditional methodologies, particularly during the pandemic, when in-person interactions were limited. This adaptation highlights the potential for innovative solutions to foster engagement and accountability among individuals in recovery.

As the study garnered attention, it sparked discussions about the implications of these findings on policy and funding for substance abuse recovery programs. Given the positive outcomes associated with community-based approaches and the evident need for ongoing support, there is a call to action for increased investment in such programs. Advocates argue that by prioritizing sustainable funding, governments and organizations can create lasting change and improve the quality of life for countless individuals affected by substance use disorders.

The findings from this extensive evaluation resonate beyond the confines of academia; they bear relevance for clinicians, policymakers, and community leaders alike. By disseminating these insights broadly, stakeholders can contribute to a cultural shift in how society views and addresses addiction. The emphasis on functional recovery will help dismantle stigmas associated with substance use and foster a more compassionate and informed response to those in need.

As more communities begin to adopt the insights from this study, the hope is to create a ripple effect that enhances recovery outcomes across diverse populations. With continued research and a commitment to innovative practices, the landscape of substance use disorder treatment can evolve, ultimately leading to healthier communities and empowered individuals.

This five-year descriptive evaluation stands as a testament to the resilience of individuals facing substance use challenges and the collective effort of communities to support their recovery. As the research indicates, when people are equipped with the right tools, support systems, and understanding, the path to recovery can indeed be navigated successfully.

As the future unfolds, it remains critical to remain engaged with emerging data and evolving practices to ensure that the fight against substance use disorders is met with scientific rigor, compassion, and inclusivity. In this shared journey toward healing, every insight gleaned from studies like this serves as a building block toward a more effective, humane approach to addiction recovery.

Subject of Research: Functional recovery in community-based substance use disorder programs.

Article Title: Tracking functional recovery in a community-based substance use disorder program: a five-year descriptive evaluation using the brief addiction monitor.

Article References:

Phillips, C., Mejia, M.C., Peters, D. et al. Tracking functional recovery in a community-based substance use disorder program: a five-year descriptive evaluation using the brief addiction monitor.
Addict Sci Clin Pract 21, 4 (2026). https://doi.org/10.1186/s13722-025-00625-3

Image Credits: AI Generated

DOI: https://doi.org/10.1186/s13722-025-00625-3

Keywords: community-based recovery programs, substance use disorders, functional recovery, brief addiction monitor, long-term evaluation, personalized treatment, mental health, socioeconomic factors, digital tools, harm reduction strategies, policy implications.