Recovery Residences and Providing Safe and Supportive Housing for Individuals Overcoming Addiction

Fostering growth and personal development

Comments about fostering growth and development were further categorized into the aspects of personal growth that the house targeted. For example, many operators talked about helping residents with their emotional development. This was often talked about in terms of helping residents identify the role that difficult or painful life experiences may have played in their substance abuse, teaching residents to take personal responsibility for their actions, raising their self-esteem, and learning “coping skills to deal with regular life on life’s terms” (House 009—OAS-funded female). Operators also talked about fostering personal growth through helping residents with their education and employment skills to be a “productive member of society” (House 179—Unfunded male) and helping residents develop their interpersonal skills and improve interpersonal relationships. For example, as one operator noted,

[Our] mission is to assist all of our individuals who come here with their substance abuse and to encourage them to go to programs and better themselves; we encourage them to go to libraries, get a job, visit their families, anything that would help develop them as an individual. That’s our mission. (House 116—Unfunded male)

Another operator noted that

I guess the ultimate goal would be for somebody to come in here from wherever they were before, whether it be rehab, an unhealthy environment, jail, halfway house, and, you know, it may sound a little cliché, but to transition them back into society—back into work, back into independent living, back into their wife’s house, their parents’ house, you know. The goal would be to, you know, learn how to stay clean and sober, learn how to be productive, and learn how to be responsible. (House 022—Unfunded male)

Providing a safe and supportive living environment

Recovery home operators also talked about their mission being to provide a safe and supportive environment for their residents to achieve these goals. As one operator noted, “Well, we try to just remain a constant in their life of being a clean, safe, drug-free place. And if you give ‘em that, there’s a good chance they might get the other parts they need . . . ” (House 176—Unfunded male). Safety was talked about in terms of ensuring that homes were clean, up to code, and drug free and that residents adhered to the rules of the house. However, safety was also talked about in terms of ensuring that the residents were treated with (and treated each other with) dignity and respect. For example, as one operator put it,

Everyone is talked to with respect . . . We don’t allow people to bully people in here; we don’t allow fighting. We can’t stop people from cursing, but we prefer, you know, if you don’t call each other names ‘cause it could really lead to something devastating. (House 078—OAS-funded female)

Many operators talked about this sort of environment being like a family: “ . . . when you come here, we consider you part of our family” (House 008—OAS-funded male). Some even talked about how this sort of family-like environment promoted other aspects of their mission. For example, as one operator explained,

I think this program sets itself apart from other programs in that the people that are here . . . they feel as though they’re in a family environment, and they’re treated well; they’re treated like, they’re treated with dignity. That’s the main thing; they’re treated with dignity, and they’re also encouraged to be responsible, which is one of the reasons they do chores on a daily basis and so forth so they have a sense of keeping a place clean and helping to cook and do their own laundry and go to a library. All those things that a person should be doing who doesn’t live in a facility like this. So we try to make this as realistic as possible. (House 116—Unfunded male)

Cultivating social relationships and a supportive environment

Operators most frequently talked about how they structured the environment in the house to nurture a warm and welcoming atmosphere and to cultivate interpersonal relationships. For example, as one operator noted,

. . . anybody that come down, we can’t turn away—that’s what we cannot do. We’ll get people things that a normal person would have that make them feel like [home] . . . and we bond. We like eat together; we do things as a unit, as a family, you know? Once you come in, “welcome to the family.” (House 047—OAS-funded male)

Another operator noted that

. . . we [are] not just, um, putting people in houses and, you know, just packin’ people up in ten people in a room, you know, feeding ‘em rice and hot dogs, you know. We [are] not treating people like that; we [are] treating people with dignity and respect. (House 013—Unfunded female)

Another operator explained,

. . . you know, we try to make it family-oriented. I think you kinda restore some things that some people never had, like sometimes we did parties for people that never had a birthday party, or just all that in general . . . that’s something that we do, and it helps out, you know what I mean? It makes people feel good . . . (House 009—OAS-funded female)

Supportive interpersonal relationships were also part of this type of environment. As one operator explained, “You can come here [to] get the things you need, along with the love you need, and we would give you a sense of a family and . . . a support system” (House 216—Unfunded male). How the operators interacted with residents and the notion of supporting other residents in the house were also talked about in terms of the environment fostered. As one operator explained,

. . . well a lot of it is, a lot of what I do here is just trying to build relationships with the guys, so when a guy comes in here and, you know, tells me what he wants to do, I try my best to go get to know him and, you know, just kind of talk to him throughout his stay here and see if he’s, you know, in a good spot moving in the right direction, you know . . . and just to let these guys know that if they need me to help them with anything, and that can range from a million different things, that I’ll do so. If ever anybody needs help, they always know they can knock on the door or call me. And I’m not gonna say I have the answers to everybody’s problems, ‘cause I definitely don’t, but I can at least help point them in the right direction. (House 022—Unfunded male)

Another operator reported that “even when they [residents] leave this program, they always coming back somewhat. The alumni association for instance is a very strong integral part of the program, and they always giving back” (House 212—Unfunded male).

Monitoring

An aspect of programming related to promoting a safe and supportive environment talked about was monitoring of residents, which was often talked about not only in terms of enforcing house rules and drug testing but also in terms of making sure that residents had scheduled activities and that new residents were accompanied by other residents when leaving the house. As one operator explained,

. . . we get up at 6:30 in the morning, they do chores, then they eat breakfast, then they have morning meditation, then they have a little break, [and] then they get to an outside meeting. [After the outside meeting] they come back, they eat dinner, then they go to another meeting, [and] then they have the rest of the night off to watch TV, play cards, [and] do whatever they may do. (House 028—Unfunded male)

One operator talked about this sort of monitoring in terms of “fostering an atmosphere of accountability.” As the operator explained, “Some of the many ways we plan to achieve these goals are by monitoring the attendance of various 12 step programs, keeping our locations out of drug infested neighborhoods, and random urine tests” (House 126—Unfunded female).

Service linkages

With respect to supporting aspects of their mission pertaining to substance abuse and personal growth, operators talked about ensuring that residents were engaged in both formal and recovery supportive services (such as self-help meetings or other recovery fellowships). As one operator noted,

. . . we sit down with each person to see what their needs are, see where they need additional supports, and we try to, you know, get them the referral sources they need, the phone numbers to call, the places to go. (House 017—OAS-funded female)

This sort of case management included not only assessing residents’ needs but also connecting them with service providers and assisting them in performing tasks that would be required of them to live successfully on their own in the community. As one operator explained,

We help them; we drive them to meetings, we take them to doctors, you know, we help them whenever they need help. [We] take them to get a license or stuff like that, go shopping, go to the laundry you know . . . (House 196—Unfunded male)

Funding

As shown in Table 3, funding or staying financially solvent was the most frequently discussed organizational barrier, largely owing to recovery homes serving a clientele that often had few financial resources. Operators whose homes received funding through OAS talked about how indispensable this was, and those operating unfunded homes talked about the challenges they faced trying to keep their doors open. As one operator of an OAS-funded house noted,

. . . the pros of having the funding is, you get to do a lot of things that you couldn’t do because sometimes you can’t make the money stretch, but knowing that you got that funding, you get that extra little stretch to strap you over. (House 008—OAS-funded male)

OPEN IN VIEWER

Table 3.

Obstacles and Strategies to Overcome Them (N = 21).

	Sources	Passages
Organizational obstacles
Funding	16	33
Staffing	5	7
Licensing	3	5
Other a	1	2
Resident obstacles
Stage of change	13	26
Problems with authority	5	7
Social skills/interpersonal relations	2	4
Other b	5	5
Community obstacles
NIMBY	11	15
Politics	2	3
Other obstacles c	2	2
Operational strategies
Good neighbor	11	23
Networking	8	11
Fundraising	6	10
On the “down low”	5	8
Employment	5	5
Professionalizing	3	5
Personal survival strategies
Helping others	14	18
Labor of love/not about the money	10	15
Success stories	9	11
Keeps me clean	6	6
Other d	1	1

Note. NIMBY = not in my backyard.

a

Other organization obstacles included needs for more housing for women and children and to support individuals with mental health issues.

b

Other residents obstacles discussed pertained to the breadth and severity of resident needs (e.g., homelessness, heroin addiction, parenting issues, etc.).

c

Other obstacles mentioned pertained to how generally demanding this work was and how there was no recognition of the role that recovery homes played in providing substance abuse services to those in recovery.

d

One operator talked about the importance of humor and personal boundaries.

Unfunded recovery home operators often talked about operating at a loss and the difficulties they faced in trying to minimize these losses. As one operator noted, “It’s not easy, like I said if we don’t have, if nobody comes here and lives here, this place won’t exist. So it’s basically, we depend on the rent in order to survive, you know” (House 196—Unfunded male). According to another operator,

We’re never in the black, put it that way. Only time we’re even close to coming into the black is in the winter time and we’re at capacity. Even then, you still have to maintain your properties, pay your mortgage, insurance, and you know you always have to have money in savings in case something does happen. (House 176—Unfunded male)

Trying to stay open often put operators in the difficult position of having to turn away residents who could not pay or using their own personal resources to cover those residents. As one operator noted, “ . . . I don’t wanna make them leave because they can’t pay their rent, however, I can’t keep this house running without the rents being paid” (House 126—Unfunded female). According to another operator,

. . . Well actually the director puts a lot of his personal money in it and that’s really what keeps it going, because the gentleman [residents], many of them when they first come here, 9 times out of 10 they don’t have a job you know, or some of them have come here after they spent all their money and they pop up here the next day, you know. We have taken some men on that basis, and then had to wait until they could put something toward their rent. (House 116—Unfunded male)

Stage of change

Operators also talked about obstacles and barriers pertaining to the residents themselves, the most frequently discussed pertained to residents being in the early stages of recovery and generally not being ready or willing to do what they needed to do to prevent relapsing. This was often talked about in terms of willingness and commitment. As one operator noted, “Some people don’t make it, but the majority do if you come in with a will to change, you know” (House 047—OAS-funded male). Similarly, another operator said that “ . . . you have to have a commitment that this is something that you want to do . . . nobody force you to do it; it has to be a commitment that you want to do . . . ” (House 212—Unfunded male). Another operator said that

. . . unless someone makes a decision on their own that they wanna change, then they’re not going to. So they have to see the benefit of the change. We can tell them there’s benefits ‘til they’re blue in the face, but if they don’t see that it’s gonna affect them in any way, they’re not gonna do it. (House 017—OAS-funded female)

Operators also talked about residents not fully understanding the nature of addiction and the challenges that they would face in trying to overcome it. As one operator explained,

I think what it is is they try to . . . a client takes on too much and then they put that thing in front of their recovery and they get sidetracked be it the girlfriend, the family, the children, and stuff like that. They overload themselves a lot of times, so that’s why it’s important that we try to stick to this one day at a time process with them. (House 094—Unfunded male)

Another operator talked about this with respect to residents leaving the program before they might be ready. As this operator explained,

If a guy comes in here and says, you know, [he wants to] save a couple thousand dollars, get his own apartment, [and] have a full-time job, if three months from now he has none of those things and wants to move in with a girlfriend that he just met, all I can do is just say ‘Ehh, probably not a good idea’ but again, you know, if he wants to go he’s gonna go. (House 022—Unfunded male)

Not in my backyard (NIMBY)

Finally, operators also talked about confronting obstacles in the community. The obstacles most frequently talked about were concerns held or voiced by neighbors about recovery homes and their residents negatively affecting the neighborhood and not wanting recovery homes to be located in the neighborhood—the “not in my backyard” or NIMBY obstacle. As one operator shared, “Well, not all the neighbors love us, you know, some don’t want us in the neighborhood . . . ” (House 028—Unfunded male). Another operator commented that “the obstacles are everybody in the neighborhood wants you shut down” (House 176—Unfunded male). As another operator noted,

We had to go to community meetings, and we were literally stoned, you know, just trying to set up a place for these people to come. And at the same time, you’re fighting for their right to come into the community and then you have to make them citizens that people won’t mind giving another chance. (House 216—Unfunded male)

Being a good neighbor

Recovery home operators talked about a variety of strategies they developed to counter these obstacles. Although the most frequently discussed obstacle was funding, far fewer operators talked about strategies to obtain funding (like fundraising and encouraging residents to seek employment) than about strategies to counter obstacles in the community. In this regard, operators talked about what they did to counter stigma and negative perceptions of recovery homes and recovery home residents. The most frequently discussed strategy was the “good neighbor” strategy that pertained to active involvement in the community and being more visible as a positive influence in the neighborhood. As one operator noted, “ . . . we’ve never hidden what we were” (House 017—OAS-funded female). Another operator added that

. . . I do my best just to get to know who the neighbors are say hello to them when I see them. You know, let them know if there’s anything that they need you know to come knock in my office and . . . when people wake up and they see guys cleaning their yards and cleaning up trash, you know, they can’t help but at least see something positive that we’re trying to do here. (House 022—Unfunded male)

Another operator even talked about the home being an anchor for the neighborhood:

Well, the people who’s been there on that block, they know us. The block captain knows us. When she’s having something, we one of the main one of the primary people that she get in touch because she know we gone make it happen. If it’s a block party, we gonna be a part of [it]. We gonna put up the tents, we gonna clean the streets, we gonna have a picnic packed, we gonna bring all our people from our side over there, and they gonna have a block party . . . (House 212—Unfunded male)

Networking

Another strategy talked about to garner support (organizational and community support) was networking with local leaders, businesses, and other recovery homes through active outreach to raise awareness about recovery homes and recovery home residents. For example, one operator noted that

we get petitions before we open a new house we go door to door up and down the streets and let them know what we’re doing we get, you know, community support and they they’ve never stopped us from opening another facility. (House 017—OAS-funded female)

Other operators talked about events that they hosted for the community. As one operator explained, “They might do talent shows and things like that. I think that’s something that’s really good because it shows another side of people in recovery, like they’re just not drug addicts or bad people . . . ” (House 009—OAS-funded female).

On the “down low.”

Although some operators talked about ways in which they engaged with the community, others talked about the ways in which they actively attempted to keep a low profile in the neighborhood. Invoked on their own or in conjunction with good neighbor strategies, these strategies typically involved rules for the homes or the residents to not draw attention to themselves as a recovery home and to interact as little as possible with neighbors. As one operator explained,

We don’t let ‘em hang out on the corner, we don’t let ‘em . . . We don’t mind sitting out on the porch, but just four people at a time, you know, no gangs [and] nobody hanging out on the sides. They have their smoke area that’s in the back that has chairs and a little yard . . . (House 008—OAS-funded male)

Another operator talked more specifically about limiting interactions with neighbors: “ . . . [there is] no loitering, we don’t interact, more than just saying ‘hello, how are you’, with the neighbors. They aren’t allowed to be friendly with the neighbors and things like that” (House 028—Unfunded male).

Personal survival strategies

In addition to talking about the strategies they employed to keep their recovery homes open, operators also talked about why they kept doing what they were doing despite obstacles they encountered. Recovery home operators often talked about a desire to help others with addiction or to “give back” despite the personal and financial costs, often because they found it gratifying to see people succeed in their recovery and because this work helped them in their own recovery (17 operators talked openly about being in recovery themselves and 12 talked about their own experiences as a resident in a recovery home). As one recovery home operator explained,

This is a business of helping people, and these are some of the hardest people in the world to help. But they need it, you know what I mean? So, it’s such a reward to be able to reach people that other people can’t. (House 013—Unfunded female)

Helping people in recovery was also talked about as being consonant with their personal beliefs. As one operator noted, “ . . . it’s part of being in recovery, to stay in recovery or help addicts. It’s part of my faith to help those less fortunate, to serve other people, [and] to provide outreach” (House 175—Unfunded male). Another said that “ . . . I help people, you know, and the rewards of helping people are good for my own recovery” (House 179—Unfunded male). As one operator noted, “ . . . I guess if I was really sane, I would walk away, but it’s the desire to help others” (House 212—Unfunded male). This operator added that “ . . . it’s definitely not about the money ‘cause I haven’t gotten a pay check in months, and I’m still here” (House 212—Unfunded male). As another operator summarized,

At the end of the day, you know, if you’re working in this field and helping people isn’t what you’re in it for, then you’re not in it for the right reasons. As far as I’m concerned, you know, it can’t be about the money. I wish I made a little bit more money, and money definitely helps, and it’s my job, but at the end of the day, you know, helping people is why I do this. (House 022—Unfunded male)