Most dealt with severe health afflictions, endured mental health difficulties, relationship issues and many died at relatively young ages, sometimes by way of suicide. The study design used repeated measures analyses to test how study measures varied over time. Because the two types of houses served residents with different demographic characteristics, we conducted disaggregated longitudinal analyses for each. For a more complete description of the study design and collection of data see Polcin et al. (2010), Polcin et al. (in press) and Polcin, Korcha, Bond, Galloway and Lapp (in press).
- We suggest knowing how, where, and why social model originated and the conceptual framework of some of the early proponents can help current SLH providers implement social model more broadly and creatively.
- Someone living in a halfway house is under the supervision of probation or parole.
- Recognizing stakeholder views that hinder and support SLHs will be essential if they are to expand to better meet the housing needs of persons suffering from alcohol and drug disorders.
- Though not directly addressed on the RHES, sharing personal experiences about the successes and challenges of working a recovery program in the residence is an additional way to help other residents and facilitate one’s own recovery.
- SLHs have their origins in the state of California and most continue to be located there (Polcin & Henderson, 2008).
Main Findings
Some houses use large spaces in the house to offer open 12-step meetings to the surrounding community. Houses also use outdoor areas for social events or barbeques that are open to the surrounding community. From this perspective, facilitating social model environments goes beyond a focus within the household to include the interactive community context emphasized by Kaskutas et al (1998). For a description of ways that house managers can facilitate social model dynamics in recovery homes and between the home and surrounding community see Polcin et al (2014).
- According to the latest statistics from the New York Times, 90% of people who tried heroin in the last decade were white.
- For some those offenders who are motivated for abstinence and capable of handling some degree of autonomy SLHs might be a viable and effective option for recovery that is currently underutilized.
- For a variety of reasons some individuals may want to avoid formal treatment programs.
Residents are usually required or strongly encouraged to attend meetings and actively work a 12-step recovery program (e.g., obtain a sponsor, practice the 12 steps, and volunteer for service positions that support meetings). However, some houses will allow other types of activities that can substitute for 12 step groups, provided they constitute a strategy for maintaining ongoing abstinence. At this level, it is often mandatory for residents to participate in community meetings, house meetings, mutual support groups, buddy systems, and outside clinical appointments. People in recovery receive peer support and accountability in a level-one sober living home. Residents may choose to selghe, author at sober-home engage in community support groups, counseling, and anything else to help them stay sober. Acceptance to a sober living home means residents agree to the rules, schedules, and guidelines that support recovery.
Sober Living Homes Versus Halfway Houses
Yet, King admits to having engaged in such heavy cocaine and alcohol abuse in the 80’s that he hardly remembers producing anything he wrote during that period. He was apparently ingesting so much coke that he had to stuff his nose with cotton so it would not bleed on his typewriter while he was working. His wife staged an intervention in the late 80’s and the King of Horrors has been sober ever since and still producing masterpieces. Data coding emphasized description rather than conceptual refinement or theory development.
Level One
Senior peers also need to role model peer support, including relationship skills and development of supportive social networks. The overall goal is creating household norms of inclusion and engagement also known as belonging or community (Porath, 2022; Parker, 2018). Second is to expand on these findings by considering potential implications of our research for inpatient and outpatient treatment and for criminal justice systems. These include plans to study the community context of SLHs by examining attitudes of community stakeholder groups (e.g., neighbors, local government officials, mental health therapists, criminal justice professionals and practitioners in substance abuse treatment programs). We also describe plans to conduct studies of resident subgroups, such as individuals referred from the criminal justice system. It seems probable that part of what successful residents do when they leave SLHs is to reestablish aspects of social model in their post recovery home life.
Moving Social Model Recovery Forward: Recent Research on Sober Living Houses
According to the latest statistics from the New York Times, 90% of people who tried heroin in the last decade were white. The problem is that even though the bills have been sponsored and pushed for by legislators in these affluent pockets, the result will be laws that affect the entire state. So in order to clear their neighborhood of “those” people, we end up clearing the state of them. I have two schizophrenics that are now in the house… That kind of bugged me a little bit because it’s supposed to be sober living, so I thought these people were just like — now we got like mental patients… They’re crazy and it’s like, this is not the place for them… This is not a mental ward. Other on-site services include meetings, support groups, and life skill training.
NARR and its state affiliates (e.g., the Sober Living Network in California) promote using social model recovery in all four levels of recovery residences (NARR, 2012). However, SLHs (Level IIs) are the most explicit in using social model recovery as a guiding influence for their operations (Wittman & Polcin, 2014). In addition, social model recovery has been studied extensively in these types of residences. For these reasons, we focus our discussion herein primarily on social model issues in SLHs although many of the issues and dynamics discussed may also apply to other types or levels of recovery residences.
Over 24 agencies affiliated with CAARR offer clean and sober living services. Several SLH residents voiced attitudes that suggested a degree of intra-group stigmatization of “guys that are medicated” or “crazy” people with disorders such as schizophrenia, even though some of these same participants spoke frankly about their own histories of mental illness. Stigma toward this specific SLH subgroup merits more attention in future research, particularly in light of a previous study showing that SLH residents had significant increases in a measure of interpersonal tolerance over a 24-month period (Olson et al., 2009). The current paper focused on social model recovery in SLHs because these houses are the most explicit in their adoption of the social model approach to recovery. However, integration of social model principles exists to varying degrees across all four levels described by NARR (2018).
Communities and addiction treatment systems should therefore carefully assess the types of recovery housing that might be most helpful to their communities. It was noteworthy that a wide variety of individuals in both programs had positive outcomes. There were no significant differences within either program on outcomes among demographic subgroups or different referral sources. In addition, it is important to note that residents were able to maintain improvements even after they left the SLHs. By 18 months nearly all had left, yet improvements were for the most part maintained.
Although self selection can be viewed as a weakness of the research designs, it can also be conceived as a strength, especially for studying residential recovery programs. Our study design had characteristics that DeLeon, Inciardi and Martin (1995) suggested were critical to studies of residential recovery programs. They argued that self selection of participants to the interventions being studies was an advantage because it mirrored the way individuals typically choose to enter treatment. Thus, self selection was integral to the intervention being studied and without self selection it was difficult to argue that a valid examination of the invention had been conducted. In their view, random assignment of participants to conditions was often appropriate for medication studies but often inappropriately applied when used to study residential services for recovery from addiction. Originally developed in the study of people with mental illness, the modified labeling theory of Link and colleagues (1989) is also relevant to the issue of stigma among SLH residents.
Study sample
As noted in the results, a number of SLH residents identified themselves as having psychiatric disorders, symptoms of which can manifest as perceptions of stigma-related rejection and personal devaluation. Additional activities assessed on the RHES provide guidance about other ways residents can enhance social model dynamics, particularly a sense of commitment and empowerment. Though not directly addressed on the RHES, sharing personal experiences about the successes and challenges of working a recovery program in the residence is an additional way to help other residents and facilitate one’s own recovery. Recent studies have also begun to assess the influence of the neighborhoods where SLHs are located (Mahoney et al., 2023; Subbaraman et al., under review).
Our purpose here is to summarize the most salient and relevant findings for SLHs as a community based recovery option. We then expand on the findings by considering potential implications of SLHs for treatment and criminal justice systems. We also include a discussion of our plans to study the community context of SLHs, which will depict how stakeholder influences support and hinder their operations and potential for expansion. These measures were taken from the Important People Instrument (Zywiak, et al., 2002). The instrument allows participants to identify up to 12 important people in his or her network whom they have had contact with in the past six months.
Although criminal justice referred residents had alcohol and drug use outcomes that were similar to other residents, they had a harder time finding and keeping work and had higher rearrest rates. Areas for further research include testing innovative interventions to improve criminal justice outcomes, such as Motivational Interviewing Case Management (MICM) and examining the community context of SLHs. Recognizing stakeholder views that hinder and support SLHs will be essential if they are to expand to better meet the housing needs of persons suffering from alcohol and drug disorders. ORS is an outpatient substance abuse treatment program located in Berkeley, California that treats approximately 800 clients per year. Most of the clients are low income and many have history of being homeless at some point in their lives.
Most items on the RHES have clear implications for how house managers can improve social model dynamics in recovery homes. To address low scores on social interaction and peer support, houses could structure regular social and recreational outings for residents. Most important is creating a supportive social climate where senior peers who have been in the residence longer engage new residents in formal and informal house activities.