What approach do you think works best for people in recovery?
I felt compelled to write a brief note around a couple treatment and recovery models (or approaches) associated with the disease of addiction and one of the unfortunate consequential characteristics of active addiction: homelessness.
My interest in this subject matter is directly related to the work we do here at Mariners Inn, my years of experience as a social worker working in the field of addiction, and the admirably necessary work done by programs providing services where homelessness is the primary or “presenting problem” (as we say in the field).
Programs that serve the homeless, where homelessness is the presenting problem, practice what is known as the Housing First model. Simply put, this model concludes that housing is the immediate and primary problem to solve, while the type of supportive services necessary to help individuals or families remain housed come later. Treatment and Recovery programs that serve people with a desire to arrest the disease of addiction as a primary focus practice the Recovery Oriented System of Care (ROSC) model.
It is important to note that some of the guiding principles of the Recovery Oriented System of Care (ROSC) support the process of healing by acknowledging that:
- There are many pathways to recovery
- Recovery is supported by peers and allies
- Recovery involves (re)joining and (re)building a life in the community
- Recovery is a reality.
ROSC identifies specific elements that are paramount to the implementation of the principles that promote long-term recovery. Some of those elements conclude that services must be:
- Strength-based, and
- have a Commitment to peer recovery support services
Adversely, the Housing First model:
- does not require residents to achieve certain milestones (e.g., abstinence from substances, treatment attendance, clinical stability) to acquire or maintain housing
- Advocates harm reduction; limiting the risks and harms associated with unsafe drug and alcohol use by promoting infrequent use versus abstinence
A number of my colleagues in the field and I fully support and believe that peer recovery support services, including recovery housing as a transition to independent living, are essential to the successful community reintegration needed by recovering people seeking long-term sobriety. One of my esteemed colleagues wrote; “Personally, I believe that you have to separate the two approaches of housing first and "recovery first". Recovery goals must be clearly identified and services have to be available to help those who are striving to recover. To allow people to continue to use drugs in a facility that advocates being drug free is a contradiction to recovery.”
What do you think?
- David Sampson, CEO, MSW, LMSW