Recovery and Community Involvement

PURPOSE: To determine the elements needed to positively support recovery, health, and well-being in individuals living in a permanent supportive housing (PSH) unit within a large health care campus.

RATIONALE: This PSH is peer run, and current expectations are to attend bimonthly community meetings, attend support group meetings, and pay subsidized rent. It was reported by the residential administrator that the community was not functioning as well as it was when there was occupational therapy support. Areas of concern include lack of efficiency and effectiveness of community meetings, lack of enforcement in community rules, and decreased motivation to participate.

Literature shows that peer support, autonomous decisions, empowerment, sense of belonging, and accessibility to resources are key components in addiction recovery. The purpose of this research was to identify specific occupations needed by PSH residents to produce a sober, motivated, and peer-supported sustainable community.

DESIGN: This was a phenomenological and ethnographic qualitative study utilizing semistructured interviews and short questionnaires completed by a portion of past and current residents.

PARTICIPANTS: Twelve of 26 residents of PSH, ranging in age from 22 to 70 yrand recovering from either drug or alcohol addiction, many with diagnoses of mental illness and formerly homeless, were recruited voluntarily from requests at monthly community meetings.

METHOD: The OPHI–II was modified to apply to community living concerns, and two questionnaires were used: Quality of Life Rating Scale (Gust) and a researcher-created survey developed to gain perspective on occupations, roles, and routines of participants.

ANALYSIS: A narrative analysis was used to compare the data generated with the results from “Effectiveness of a Peer-Support Community in Addiction Recovery: Participation as Intervention” (Boisvert, Martin, Grosek, & Clarie, 2008), which also used OPHI–II and QOL Rating Scale within this community.

RESULTS: Because this is an ongoing study to be completed in August 2015, results cannot yet be confirmed; however, hypotheses have been made on the basis of compiled field notes and research team discussion. To create a community within PSH that positively supports resident recovery, health, and well-being, an increase is needed in accountability, responsibility, and communication between the residents themselves and with the staff.

DISCUSSION: An intervention based on developing a new system for incoming residents with well-defined rules and expectations, along with newly structured bimonthly meetings, will improve the overall efficiency, efficacy, and sustainability of the community.

Individual readiness is also an area of priority, because the time needed in each stage of the recovery process is variable. PSH is one of the least restrictive types of supported recovery before transitioning into independent living, so evaluating the requirements for entry and continued residency may be beneficial in creating a successful community with improved motivation and participation. Findings purportedly will ensure decreased relapse rates, higher community involvement, and overall life satisfaction within residents of PSH and recovery communities.

IMPACT STATEMENT: Mental health is an emerging practice for occupational therapists; however, more evidence is necessary to increase reliability and validity of occupational intervention. This research could have far-reaching effects in overall substance abuse/addiction treatment and recovery, because past residents of PSH have benefited from this form of support.

References

Boisvert, R. A., Martin, L. M., Grosek, M., & Clarie, A. J. (2008). Effectiveness of a peer-support community in addiction recovery: Participation as intervention. Occupational Therapy International, 15, 205–220. http://dx.doi.org/10.1002/oti.257