"The Oxford House system is deceptively simple!"

  - Professor Leonard Jason, Community Psychology,

DePaul University, Chicago.

 

US Dept Of Health and Human Services –

National Institutes of Health

 

 A Clean and Sober Place to Live:

Philosophy, Structure, and Purported Therapeutic Factors in Sober Living Houses

http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=2556949

Douglas L. Polcin, Ed.D., MFT and Diane Henderson, B.A.

Alcohol Research Group, Public Health Institute, 6475 Christie Avenue, Suite 400, Emeryville, CA 94608-1010

Phone (510) 597-3440, FAX (510) 985-6459, E-Mail: DPolcin@ARG.org

 

Abstract

The call for evidence based practices (EBP’s) in addiction treatment is nearly universal. It is a noteworthy movement in the field because treatment innovations have not always been implemented in community programs. However, other types of community based services that may be essential to sustained recovery have received less attention. This paper suggests sober living houses (SLH’s) are a good example of services that have been neglected in the addiction literature that might help individuals who need an alcohol and drug-free living environment to succeed in their recovery. The paper begins with an overview of the history and philosophy of this modality and then describes our 5-year longitudinal study titled, “An Analysis of Sober Living Houses.” Particular attention is paid to the structure and philosophy of SLH’s and purported therapeutic factors. The paper ends with presentation of baseline data describing the residents who enter SLH’s and 6-month outcomes on 130 residents.

 

Although there are similarities between SLH’s and other residential facilities for substance abusers, such as “halfway houses,” there are important differences as well. Unlike many halfway houses, SLH’s are financially sustained through resident fees and individuals can typically stay as long as they wish. Because they do not offer formal treatment services, they are not monitored by state licensing agencies. However, many sober living homes are members of SLH coalitions or associations that monitor health, safety, quality, and adherence to a social model philosophy of recovery that emphasizes 12-step group involvement and peer support. Examples of SLH coalitions in California include the California Association of Addiction Recovery Resources (CAARR) in the northern part of the state and the Sober Living Network in the south. Over 24 agencies affiliated with CAARR offer clean and sober living services. The SLN has over 250 individual houses among it membership. Outside of California, the “Oxford House” model of sober living is popular, with over 1,000 houses nationwide as well as a presence in other countries (Jason, Davis, Ferrari & Anderson, 2007). However, because there is no formal monitoring of SLH’s that are not affiliated with associations or coalitions it is impossible to provide an exact number of SLH’s in California or nationwide.

 

Newer Models of Sober Living Houses

An important exception to the decline of SLH’s during the 1970’s was the development of Oxford Houses (O’Neill, 1990). When a halfway house for substance abusers in Montgomery County Maryland closed, the clients continued their residence by paying rent and utilities themselves and implementing a shared, democratic style of managing the house. The residents were apparently satisfied with this new arrangement and the model rapidly expanded. While they are common in other parts of the country, they are rare in California, where other types of SLH’s existed before Oxford Houses became widespread.

The Oxford House model offers a “social model” recovery philosophy (Kaskutas, 1999) that emphasizes peer support for sobriety and shared, democratic leadership in managing house operations. In addition, Oxford houses are financially independent of outside organizations and are financially self-sustaining. Although residents are not required to attend 12-step groups, they are generally encouraged to do so. Research in Oxford houses indicates that 12-step involvement is high, with about 76% of the residents attending 12-step meetings at least weekly (Nealon-woods, Ferrari & Jason, 1995).

 

·  Jason, LA; Davis, MI; Ferrari, JR; Anderson, E. The need for substance abuse after-care: Longitudinal analysis of Oxford House. Addictive Behaviors. 2007;32:803–818. [PubMed]

·  Jason, LA; Ferrari, JR; Davis, MI; Olson, BD; Alvarez, J; Majer, J. Need for Community: The Oxford House Innovation; 2005, August; Paper presented at the American Psychological Association Conference; Washington, D.C.

 

 

 

 

 Other links to data and studies 

DePaul University

DePaul Research Team

The DePaul University Community Research Center that had undertaken the two major National Institute of Health Studies – NIDA and NIAAA – is highlighted and has its own webpage.

Communal Housing Settings Enhance Substance Abuse Recovery

This is the publication of major findings from the two-year study of 150 individuals leaving treatment in Illinois with one-half randomly selected for post-treatment Oxford House living and one-half returning to their normal living situation.   At the end of the period the relapse rate for those living in Oxford Houses was much lower than for those returning to “normal” living situations.  (31.3% vs 64.8%).  The researchers from DePaul University in Chicago and the University of Illinois, Chicago were funded by a NIAAA grant. (NIAAA grant AA12218) The research article is printed in the American Journal of Public Health, Oct 2006; Vol. 96, pp1727–1729

An examination of main and interactive effects of substance abuse recovery housing on multiple indicators of adjustment

This research report looks at some of the detail [length of stay, co-occurring bi-polar conditions, criminal behavior] underlying the outcomes of recovery without relapse versus recovery interrupted by relapse.   This NIAAA financed study was conducted by the DePaul Community Research Group and is an outgrowth of the basic study that followed 150 individuals leaving treatment with half randomly selected to go to an Oxford House and the other half going to normal post-treatment living situations.   Publication: Addiction, Vol. 102, 1114–1121 [Final version accepted: February 20, 2007]

The need for substance abuse after-care: Longitudinal analysis of Oxford House

Funded by NIDA [Grant # DA 13231] this research report looks at the outcomes after following 897 Oxford House residents [604 men; 293 women] located in 219 Oxford Houses around the country following an initial interview and follow-up in four waves divided by 4-month intervals.  At the outset, of the research each participant named an “important person” who knew him or her and could be used by researchers to verify abstinent claims of participant.  Major finding include a relapse rate at end of period [approximately two years] of 13.5%.  The 87% clean and sober outcome is four or five times greater than “normal” outcomes following detoxification and treatment.  The study includes a number of other significant inter-relationships including length of stay, age, sex and co-occurring disorders.  Publication: Addictive Behaviors 32 (2007) 803-818 [Final version accepted: June 14, 2006]

Oxford House: Deaf-Affirmative Support for Substance Abuse Recovery

The Oxford House Model works for all recovering alcoholics and drug addicts.  This article by Josefina Alvarez, Ph.D. and others look at the application of Oxford House to those who are deaf.  There is research involving a number of sub-groups with the recovery community.  Dr. Alvarez’s article is included to illustrate the applicability of Oxford House to meet the needs of discrete subgroups of those in recovery.  It is contained in Volume 151, No. 4, 2006 American Annals of the Deaf.

Optimism, Abstinence Self-Efficacy, and Self-Mastery, A Comparative Analysis of Cognitive Resources

This article from Assessment, Volume 11, No. 1, March 2004 57-63 by John M. Majer, PhD and others compares the rate at which recovering individuals gain sufficient self-confidence to likely stay clean and sober forever.  Specifically, he compares a group living in Oxford House and going to AA/NA versus a similar group that just goes to AA/NA.  The findings show that living in an Oxford House make positive self-efficacy and self-mastery happen faster.

Oxford House:  A Housing Solution For Residents With Dual Diagnosis.

This study used a structured diagnostic interview to investigate the prevalence of psychiatric comorbidity among 29 men and 23 women substance abusers residing in 2 [one house for men and one for women] of 11 Oxford House communities located within a Mid-western metropolitan area.
 
 
Researchers in this study tested 897 Oxford House residents [604 men /293 women] using Addiction Severity Index and calculated the Psychiatric Severity Index [PSI] to identify residents with moderate or severe co-occurring disorders.  The results showed that both those with severe and moderate PSI indications did well in staying clean and sober, avoiding hospitalization and functioning well over time. 
 
 

In order to increase the number of these mutual-help recovery homes, two groups of states utilized state funds to hire recruiters and set up a loan fund to establish new OHs.

 

Community - Based Homes Seem to Help Addicts

AP Story in August 2005 reports on the two major studies presented to the National Convention of the American Psychological Association Annual Meeting in Washington, D.C. by the DePaul Research Group.

 

 

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