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Article
Publication date: 4 September 2017

Friedner Wittman, Douglas Polcin and Dave Sheridan

Roughly half a million persons in the USA are homeless on any given night and over a third of those individuals have significant alcohol/other drug (AOD) problems. Many…

Abstract

Purpose

Roughly half a million persons in the USA are homeless on any given night and over a third of those individuals have significant alcohol/other drug (AOD) problems. Many are chronically homeless and in need of assistance for a variety of problems. However, the literature on housing services for this population has paid limited attention to comparative analyses contrasting different approaches. The paper aims to discuss these issues.

Design/methodology/approach

The authors examined the literature on housing models for homeless persons with AOD problems and critically analyzed how service settings and operations aligned with service goals.

Findings

The authors found two predominant housing models that reflect different service goals: sober living houses (SLHs) and housing first (HF). SLHs are communally based living arrangements that draw on the principles of Alcoholics Anonymous. They emphasize a living environment that promotes abstinence and peer support for recovery. HF is based on the premise that many homeless persons with substance abuse problems will reject abstinence as a goal. Therefore, the HF focus is providing subsidized or free housing and optional professional services for substance abuse, psychiatric disorders, and other problems.

Research limitations/implications

If homeless service providers are to develop comprehensive systems for homeless persons with AOD problems, they need to consider important contrasts in housing models, including definitions of “recovery,” roles of peer support, facility management, roles for professional service, and the architectural designs that support the mission of each type of housing.

Originality/value

This paper is the first to consider distinct consumer choices within homeless service systems and provide recommendations to improve each based upon architecture and community planning principles.

Details

Drugs and Alcohol Today, vol. 17 no. 3
Type: Research Article
ISSN: 1745-9265

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Article
Publication date: 7 May 2019

Rebecca DeGuzman, Rachael Korcha and Douglas Polcin

Persons in the USA who are incarcerated for drug offenses are increasingly being released into the community as a way to decrease prison and jail overcrowding. One…

Abstract

Purpose

Persons in the USA who are incarcerated for drug offenses are increasingly being released into the community as a way to decrease prison and jail overcrowding. One challenge is finding housing that supports compliance with probation and parole requirements, which often includes abstinence from drugs and alcohol. Sober living houses (SLHs) are alcohol- and drug-free living environments that are increasingly being used as housing options for probationers and parolees. Although a few studies have reported favorable outcomes for residents of SLHs, little is known about resident experiences or the factors that are experienced as helpful or counterproductive. The paper aims to discuss this issue.

Design/methodology/approach

This study conducted qualitative interviews with 28 SLH residents on probation or parole to understand their experiences living in the houses, aspects of the houses that facilitated recovery, ways residence in an SLH affected compliance with probation and parole, and ways the houses addressed HIV risk, a widespread problem among this population. Interviews were audiotaped and coded for dominant themes.

Findings

Study participants identified housing as a critically important need after incarceration. For residents nearing the end of their stay in the SLHs, there was significant concern about where they might live after they left. Residents emphasized that shared experiences and goals, consistent enforcement of rules (especially the requirement of abstinence) and encouragement from probation and parole officers as particularly helpful. There was very little focus in HIV issues, even though risk behaviors were fairly common. For some residents, inconsistent enforcement of house rules was experienced as highly problematic. Research is needed to identify the organizational and operational procedures that enhance factors experienced as helpful.

Research limitations/implications

Data for this study are self-reported views and experiences. Therefore, the study may not tap into a variety of reasons for resident experiences. In addition, the data set was small (n=28) and limited to one city in the USA (Los Angeles), so generalization of results might be limited. However, SLHs represent an important housing option for criminal justice involved persons and knowledge about resident experiences can help guide organization and operation of houses and identify areas for further research.

Originality/value

This paper is the first to document the views and experiences of persons on probation or parole who reside in sober living recovery houses. These data can be used by SLH operators to develop houses that are responsive to factors experienced as helpful and counterproductive. The significance of this paper is evident in the trend toward decreasing incarceration in the USA of persons convicted of drug offenses and the need for alcohol- and drug-free alternative living environments.

Details

Therapeutic Communities: The International Journal of Therapeutic Communities, vol. 40 no. 1
Type: Research Article
ISSN: 0964-1866

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Article
Publication date: 1 May 2007

Douglas Polcin

Few debates in the addiction field have been more controversial than the harm and benefit of confronting individuals about their substance use. This article reviews recent…

Abstract

Few debates in the addiction field have been more controversial than the harm and benefit of confronting individuals about their substance use. This article reviews recent publications suggesting confrontation in the addiction field has been poorly defined and unfortunately limited to therapist‐client interactions. A definition of confrontation is presented that focuses on potential harm to the individual using substances. The Alcohol and Drug Confrontation Scale (ADCS) is discussed as a broad, comprehensive assessment of confrontation including an examination of individuals' perceptions of confrontational interactions. The preliminary research of individuals' experiences of confrontation in sober living recovery houses indicated that confrontation is often experienced assupportive and accurate. Previously reported findings are elaborated here by specifying implications for practitioners, families/friends, and users of services. Of particular importance is the confronter's ability to recognise when confrontation is counterproductive and to adjust their interactions accordingly.

Details

Drugs and Alcohol Today, vol. 7 no. 1
Type: Research Article
ISSN: 1745-9265

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Article
Publication date: 14 September 2015

Douglas Polcin

Persons with serious alcohol and drug problems who are attempting to maintain abstinence often lack an alcohol- and drug-free living environment that supports sustained…

Abstract

Purpose

Persons with serious alcohol and drug problems who are attempting to maintain abstinence often lack an alcohol- and drug-free living environment that supports sustained recovery. Residential recovery homes, called “sober living houses” in California, are alcohol- and drug-free living environments that offer long-term support for persons with addictive disorders. They do not offer formal treatment services but usually encourage or mandate attendance at self-help recovery groups such as Alcoholics Anonymous. The paper aims to discuss these issues.

Design/methodology/approach

The approach involved analysis of the strengths and weaknesses of different research designs for studying residential recovery homes. Alternatives to randomized designs that are able to capture “real world” data that are readily generalized are described and understudied topics are identified.

Findings

A significant limitation of traditional randomized designs is they eliminate mutual selection processes between prospective residents and recovery home residents and staff. Naturalistic research designs have the advantage of including mutual selection processes and there are methods available for limiting self-selection bias. Qualitative methods should be used to identify factors that residents experience as helpful that can then be studied further. Innovative studies are needed to investigate how outcomes are affected by architectural characteristics of the houses and resident interactions with the surrounding community.

Practical implications

Use of the recommended strategies could lead to findings that are more informative, intuitively appealing, and interpretable.

Social implications

Recovery homes and similar programs will be more responsive to consumers.

Originality/value

This paper represents one of the first to review various options for studying recovery homes and to provide suggestions for new studies.

Details

Therapeutic Communities: The International Journal of Therapeutic Communities, vol. 36 no. 3
Type: Research Article
ISSN: 0964-1866

Keywords

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Article
Publication date: 8 August 2019

Amrit Mann and Chris Wagstaff

Methamphetamine users commonly experience induced methamphetamine associated mental health symptoms. Currently, psychosocial treatment is implemented to reduce use;…

Abstract

Purpose

Methamphetamine users commonly experience induced methamphetamine associated mental health symptoms. Currently, psychosocial treatment is implemented to reduce use; however, to date, the effectiveness of psychosocial treatment in methamphetamine use and the associated mental health symptoms has not been reviewed. The paper aims to discuss this issue.

Design/methodology/approach

A systematic literature review was performed by searching databases (PubMed, Embase, Ovid MEDLINE, PsychINFO and CINAHL) and following clear inclusion/exclusion criteria.

Findings

In total, 12 studies met the inclusion/exclusion criteria, measuring a variety of psychosocial interventions and measuring a variety of different mental health outcomes. Decreased methamphetamine use was observed in the five studies which recorded this.

Research limitations/implications

Most studies in this review were preliminary trials and only three were RCTs. Additionally, methamphetamine use is a particular problem in Japan and is becoming more prevalent in Europe, yet neither primary nor secondary searching identified papers from these regions.

Practical implications

While the findings may not provide sufficient supporting evidence to instigate changes in clinical practice, this work should be developed further, as it is clear that psychosocial interventions can be successful in treating this population.

Social implications

This review demonstrates that psychosocial treatments can improve symptoms associated with methamphetamine use. Reduction in mental health symptoms has been shown to attract individuals to drug use treatment and thus indirectly reducing methamphetamine use.

Originality/value

Given the consequences of methamphetamine for individuals and communities treatment options must be explored. A review of psychosocial interventions in the treatment of methamphetamine use and associated mental health symptoms had not been done previously. This review provides a foundation for further research.

Details

Advances in Dual Diagnosis, vol. 12 no. 3
Type: Research Article
ISSN: 1757-0972

Keywords

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