Social Climate in Treatment Centers Predicts Outcome

The two most popular residential treatment settings for substance abuse recovery are therapeutic communities (TCs) and Oxford Houses (OHs). Both of these climates provide social support as a tool for recovery. “Sharing a living space with others in substance abuse recovery might encourage mutual self-help participation and increase social support, which are associated with longer periods of abstinence,” said Ronald Harvey from the Center for Community Research at DePaul University in Chicago, and lead author of a recent study comparing the social climate of TCs versus that of OHs. “Supportive social relationships within such settings might protect people in recovery from relapse and improve overall substance abuse recovery rates.”

TCs accommodate more people than OHs and offer self-help strategies and programs that are taught by trained staff members. “In contrast to TCs, OHs are limited in size with usually 7–10 people in each residence, are entirely self-run without staff or supervision, and all follow the same basic rules and philosophy that emphasize mutual self-help principles,” said Harvey. “Although most mutual self-help settings share similarities, OHs structurally differ on two primary dimensions from TCs in that they tend to be smaller and are self-run rather than professionally or staff-run.”

Harvey and his team analyzed data from residents in OHs and TCs and found a distinct difference between the two. “The main findings of this study were that residents living in smaller, self-run OHs in comparison to a larger, TCs reported significantly higher scores on the following social climate scales: Involvement, Support, Practical Orientation, Spontaneity, Autonomy, and Order and Organization.” He added, “Social control processes might be more engaging in smaller, self-governed OHs that require participants to be directly involved in decision-making, enforcing house rules, admission of new residents and performing administrative tasks that affect the entire house.” Harvey believes this study shows that the smaller, self-run settings provide a more fertile environment for social control, a factor that directly influences treatment outcome.

Harvey, Ronald, and Leonard A. Jason. “Contrasting Social Climates of Small Peer-Run Versus a Larger Staff-Run Substance Abuse Recovery Setting.” American Journal of Community Psychology 48.3 (2011): 365-72. Print.

© Copyright 2011 by By John Smith, therapist in Bellingham, Washington. All Rights Reserved. Permission to publish granted to

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  • Joan Chandler

    Joan Chandler

    November 16th, 2011 at 5:05 PM

    For many it is a whole lot easier to get involved and to feel touched in a smaller setting than it is in a larger one. There is more one on one interaction with others who will make the effort to get to know you and to really understand the issues that could have led to your addiction. Some people, and I am one of these people, get pretty stressed in large communities. I feel over whelmed and like I can’t make a connection with others. Sounds like the TCs can reach more people at one time but that the OH setting could potentially be a little more of a positive setting for showing addicts the skills that they are going to need to survive sober in the real world.

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