Recovery Community Research Articles

Introduction: The Recovery Community Services Program

This article traces the history of the Recovery Community Services Program (RCSP) from its inception in the Substance Abuse Mental Health Services Administration/Center for Substance Abuse Treatment (SAMHSA/CSAT) 1998 vision of communities of recovery engaged in the public dialogue about addiction, treatment, and recovery through the 2002 programmatic refocus onto the provision of social supports for recovery, designed and delivered by people who share the experience of addiction and recovery, that is, peers. It focuses on the role of peer-to-peer recovery support services in an evolving recovery-oriented system of care, lessons learned as the grant program has matured, and continuing challenges in this latest chapter of the ongoing history of the relationship between communities of recovery and formal systems of care. Following articles represent how these principles are embodied in RCSP communities across the nation.

Recovery Association Project (RAP), Portland, Oregon

The Recovery Association Project (RAP) is a nonprofit organization dedicated to creating a vehicle for people in recovery in the Portland, Oregon, metropolitan area to speak out and challenge the stigma on substance abuse–related issues. RAP's goals are to develop leadership among people in recovery and to support individual recovery through a range of peer-to-peer recovery support services. Core values and principles of RAP include the following beliefs: (1) active citizenship is a stage of recovery—it helps to end the social marginalization that is often involved with a history of addiction; (2) collectively in recovery, we can do together what we could not do alone; and (3) attainment of self-respect, integrity, and development of one's personal gifts is critical to one's recovery. From 2003 to 2007, RAP's Recovery Community Services Program (RCSP)-funded peer recovery services included a recovery center with a drop-in resource center, a wide range of clean-and-sober social and recreational activities, and numerous self-help meetings; a café located in the recovery center that served as a job training program for peers; and leadership training for civic engagement of people in recovery. The feedback RAP gathered from the Government Performance Reporting Act survey of participants during its RCSP grant, and from additional satisfaction questions RAP added to the survey, showed that RAP's services are meeting the needs of participants and helping sustain recovery. At the 6-month follow-up point, more than 85% of participants in RAP services indicated that they had not used alcohol or drugs in the past 30 days.

The Power of Theater to Promote Individual Recovery and Social Change

Although theatrical activities are used in a variety of therapeutic settings, little attention has been paid to the ways that theater can enhance the recovery process and community integration for people living with psychiatric disabilities. Community-based theater involving people with psychiatric disabilities offers unique opportunities for personal growth, social connection, and advocacy efforts. This Open Forum posits that theater has the power to both facilitate individual recovery and improve the social conditions of people living with mental illness. Critical elements of theatrical activities that relate to processes of recovery and community integration are examined. Implications for future research and program development are discussed.

The Power of Theater to Promote Individual Recovery and Social Change

The Power of Theater to Promote Individual Recovery and Social Change

Enhancing equity with public participatory GIS in hurricane rebuilding: faith based organizations, community mapping, and policy advocacy

Ensuring equity in the post hurricane recovery context in New Orleans requires a determined engagement by grassroots organizations in all aspects of redevelopment and policy reform at all scales including the neighborhood scale. Faith based leaders formed Churches Supporting Churches (CSC), a coalition of national and local churches committed to advocating for equitable development policies that meet the needs of low income residents at the neighborhood level. This paper presents a case study that illustrates how CSC has combined community mapping and public policy advocacy to help its pastors achieve the capacity to affect congregational and community transformation. To ensure that the uneven redevelopment patterns be addressed by city recovery officials, pastors mapped the needs and rebuilding status of selected neighborhoods using community enhanced Geographic Information System (GIS) methods. These efforts empowered pastors to involve their communities in systems change that benefits not only their neighborhoods but also other areas throughout the region, thus allowing them to advocate for recovery investment and community development decisions that will bring about broad-based recovery and growth benefits that ultimately will enhance regional equity.

Conversations about Recovery at and Away from a Drop-in Center among Members of a Collegiate Recovery Community

As the population of young adults in recovery from substance abuse increases, colleges are developing collegiate recovery communities. The goal of these communities is to provide students in recovery the opportunity to receive social support for abstinence from other abstaining individuals. To examine how social support in such a recovery community context occurs, this study analyzed 1,304 end-of-day reports made by 55 abstaining college students, 39 males and 16 females (mean age = 22.6). Two “talking with others about recovery” outcomes were examined: recovery talks outside of the community drop-in center and recovery talks at the drop-in center. Preliminary analyses revealed that the majority of recovery talks at and outside the drop-in center varied more between days within participants than they did across participants. Primary results revealed that daily levels of cravings and negative mood predicted same-day variation in recovery talks occurring outside of the drop-in center. In contrast, recovery talks at the drop-in center were not associated with these predictors. By demonstrating that college students in recovery receive more conversational support for recovery though not at the community drop-in center and that this out-of-center support appears more responsive to members' needs, this study provides insight into how social support for abstinence can succeed within college recovery communities.

New Visions of Me: Finding Joy in Recovery With Women Who Are Homeless

Shifting from a problem-based system of supports for those who are experiencing co-occurring substance and mental health disorders, there has been an increased need to explore the importance of fun, play, and pleasure's role in recovery. The following article describes an innovative intervention, New Visions of Me, with women in New Haven, Connecticut, who have experienced homelessness and dual disorders to find new ways of bringing pleasure, play, and joy into their lives. Particular attention is paid to lessons learned during the project. For 6 months, eight female clients of a New Haven homeless shelter worked with four peer mentors in recovery and nine staff members to develop the New Visions program, dedicated to creating opportunities for fun. Participants were asked to brainstorm a list of things they would do if they had unlimited time, money, and freedom in order to (1) try something new, (2) take care of themselves, (3) reconnect with the childlike parts of themselves, and (4) connect with other women in recovery. Joy, fun, and pleasure are often overlooked by people with dual disorders and their providers in the course of the difficult work of recovery, and particularly with women in recovery. While engaging in something fun may require new skills and be challenging at times, the benefits to individual clients and recovery communities is immeasurable, particularly when clients and staff collaborate on program development and implementation.

Identities under construction: Women hailed as addicts

Despite continuing investigations of the efficacy of Canadian addiction treatment services and supports across a range of health care settings and socio-cultural groups, many systemic, geographic and ideological barriers to service provision for women still exist. Determining how current services and supports can become more congruent with women's gender-specific needs is a current research focus. Drawing on Butler's reformulation of Althusser's interpellation, this article explores the power of hailing, where hailing power lies, and how hailing operates in discourses about addiction that appear in women's talk of their encounters with addiction services and supports. The article briefly outlines Butler's understanding of interpellation and examines ways by which gender operates as both condition and effect in women becoming addicts. I argue that women's narratives reveal patterns of interaction that intersect and generate complex social meanings and identities, and serve to get women's attention in terms of seeing themselves as addicts. Further, I argue that powerful competing discourses concerning gender and the medicalization of addiction, hailed through these interactions, are taken up as lived realities by some women and resisted by others. Knowing how women are hailed to take up as their own, or resist, aspects of traditional and gendered discourses within addiction treatment and recovery communities can inform gender-compassionate service provision.

Step by Step: Avoiding Spiritual Bypass in 12‐Step Work

With spirituality as a cornerstone, 12‐step groups serve a vital role in the recovery community. It is important for counselors to be mindful, however, of the potential for clients to be in spiritual bypass, which likely will undermine the recovery process.

Current and Previous Residents of Self-Governed Recovery Homes: Characteristics of Long-Term Recovery

Environmental and social factors are increasingly recognized as critical aspects of recovery from alcohol and other drug abuse over the long term. This study surveyed with quantitative and qualitative methodology current (n = 79) and previous (alumni) adult residents (n = 29) of self-governed, mutually supportive recovery homes for alcohol and other drug abuse. Both groups perceived their recovery environment positively, maintained stable employment, and experienced improvements in their family relationships since being in the recovery homes. Alumni and current residents tended to stay very involved in recovery activities. Alumni were also highly involved in their previous recovery communities, and were in more beneficial circumstances than current residents based on survey results. Implications for future research are discussed.

Estimating Person—Environment Transactions on Intention to Change Drug-Using Behaviors

The community attachment model of addiction is an ecologically based social process model that suggests social context referents (peers, family, neighbors, etc.) will influence attachment to addiction or recovery communities, via cognitive, affective, and behavioral commitments. This study examined the influence of social context referents on intention to change drug using behavior, and examined moderating effects of three contextual indicators (labor market attachment, educational attainment, and family poverty status) on these relationships. The study sample consisted of 302 adults in inpatient and outpatient substance abuse treatment facilities, who completed a set of instruments that included the Ecological Assessment of Substance Abuse Experiences (EASE), a new instrument designed to measure the influence of social context referents on addiction and recovery attachment processes. Results showed that all three contextual indicators moderated relationships among social context referenced attitudes, drug use concern, and intention to change drug using behaviors. Findings suggest that practitioners should attend to both microlevel orientations to social context and macrolevel contextual dimensions (e.g., labor force attachment), as both may influence behavioral change opportunities.

Homeless Men in Alcoholics Anonymous: Barriers to Achieving and Maintaining Sobriety

An exploratory, qualitative study of homeless, recovering alcoholic men in a Twelve-Step program examines the problems they encounter maintaining sobriety. Using semistructured interviews, the experiences of these men were analyzed in order to learn how they stay sober without a formal place to live. Four kinds of special barriers to sobriety are inferred from their narrative histories: identification with a recovery community, sponsorship, step work, and time constraints. Implications for treatment and directions for future research are discussed.

Locating Community in Women's Experiences of Trauma, Recovery, and Empowerment

Feminist interpretive methods informed our understanding of the role of the community and family-based services in women's trauma and recovery. Amy's story illustrates how trustworthy community relationships have a role in healing past experiences of isolation and points to the need for community supports to understand their power and responsibility to facilitate women's individual and family empowerment.

Measuring In-Group and Out-Group Helping in Communal Living: Helping and Substance Abuse Recovery.

With a national U.S. sample of communal-living residents in substance abuse recovery, the tendency to help members inside and/or outside their community was examined. Study 1 (n = 670) developed of the Communal Living In-Group Helping Scale to distinguish helping directed toward housemates vs. others. Study 2 (n = 419) used this communal helping measure and a general altruism scale to explore gender, ethnicity, and 12-Step sponsorship related to in-group (housemates) and out-group (others in the community) behaviors. Results revealed significant sex differences and significantly higher helping for both men and women was reported among 12-Step sponsors along two dimensions. Implications focused on gender-related differences in social helping interactions and in-group formation in recovery communities.

Effectiveness of a peer‐support community in addiction recovery: participation as intervention

The main purpose of the study was to determine whether a peer-support community programme would reduce relapse rates among clients recovering from substance addictions and homelessness and result in increased perceived community affiliation, supportive behaviours, self-determination and quality of life. Mixed methods were utilized including semi-structured interviews, participant observation and a pretest/post-test to evaluate changes on the quality of life rating, the Medical Outcomes Study-Social Support Survey, and the Volitional Questionnaire. Data from the prior year's permanent supportive housing programme were used for comparison of relapse rates. Significant reduction of risk of relapse was found in clients who participated in the programme. Significant differences were found on three subscales of the Medical Outcomes Study-Social Support Survey. Improvement that did not reach statistical significance was seen on the quality of life rating. Qualitative evidence supported improvements in perceived community affiliation and supportive behaviours.Evidence suggests that a peer-supported community programme focused on self-determination can have a significant positive impact on recovery from substance addictions and homelessness. Limitations include a small sample size and lack of a randomized control group.

Achieving Systems-Based Sustained Recovery: A Comprehensive Model for Collegiate Recovery Communities

ABSTRACT The Center for the Study of Addiction and Recovery (CSAR) (a Center within the College of Human Sciences at Texas Tech University, TTU), has developed a comprehensive Collegiate Recovery Community (CRC). This community provides a model of support and relapse prevention for college students recovering from addictive behaviors—primarily alcohol/drug addiction. This model is specifically targeted for implementation in the college/university setting and has been used at TTU for 20 years. The purpose of this paper is to briefly review the literature related to substance use among college-aged individuals, discuss the challenges of recovery within this population, describe existing collegiate programs, and provide an extensive description of the CRC model. The CRC model specifically incorporates recovery support, access to higher education/educational support, peer support, family support, and community support/service in an effort to help individuals attain what we describe as systems-based sustained ...

Lost Luggage, Recovered Lives

Are the lives of persons with psychiatric disabilities better today? Do they have a better chance than the owners of the Willard suitcases did of being listened to empathetically, offered a choice of humane and effective therapies, and regaining control of their lives? The common wisdom is that major advances have been made in psychiatric care over the last 60 years, largely credited to psychotropic drugs, but the evidence paints a bleaker picture. Many fewer people now spend decades in state mental institutions. However, poverty; new institutions such as prisons, nursing homes, and board and care facilities; medications of questionable efficacy and disabling side effects; and the revolving hospital door now rule the lives of millions of Americans with psychiatric disabilities. These stories from Willard State Hospital are still relevant because thousands enter our nation’s mental health system every day with limited chances of emerging unscathed or even improved. Hospital stays are considerably shorter now, but they are no more marked by recovery and full community integration than they were in the days of the large state hospitals.

Refuge or Rehabilitation? Assessing the Development of a Women’s Empowerment Center for People with Severe Mental Illness

Recent calls for psychiatric services to focus upon psychosocial recovery for people with severe mental illness has led to a renewed interest in recovery communities. Hence, Community Connections (Washington DC) set up a Women's Empowerment Center as an intentional recovery community. The aim of this paper is to qualitatively chronicle the development of this center to assess emerging challenges. Focus groups and participant observation were conducted regularly over a 16-month period. Analysis suggested three emerging challenges (i) concern regarding unmet practical and physical needs (ii) the struggle to establish internal rules and corrective mechanisms (iii) frustration regarding differential participation.

Safety and Security in Small-Scale Recovery Housing for People With Severe Mental Illness: An Inner-City Case Study

Safety and Security in Small-Scale Recovery Housing for People With Severe Mental Illness: An Inner-City Case Study

The active ingredients of intentional recovery communities: Focus group evaluation

Background: Recovery amongst people with a severe mental illness is generally defined as a multi-dimensional process of transformation involving positive transitions across various psychosocial domains. Recent work on recovery has focused on addressing deficits in social relationships, social skills and social support. In an attempt to foster recovery and psycho-social rehabilitation amongst people with severe mental illness, four intentional recovery communities have been set up by a mental health services provider in Washington DC, guided by the principles underlying therapeutic communities developed elsewhere.Aims: We set out to explore and elucidate whether components of these communities appeared to assist recovery from the point of view of consumers, and if so which were the most important factors.Methods: Four focus groups were conducted, one for each community. We analysed data using grounded theory techniques.Results: Three themes strongly emerged as important factors within the communities influencing recovery. These were the community as a place of safety, the community as surrogate family, and the community as socialization.Conclusion: These three factors appear to be important components of intentional recovery communities.Declaration of interest: None.