Evaluating Alternative Aftercare Models for Ex-Offenders.

This study examined the role played by aftercare following (mainly) inpatient community-based treatment in the outcomes of criminal ex-offenders with substance use disorders. Two hundred and seventy individuals who had been released from the criminal justice system were randomly assigned to either a Therapeutic Community (TC), recovery homes called Oxford Houses (OHs), or usual care settings (UA). The OHs and TCs are residential settings that emphasized socialization and abstinence from drugs and alcohol, but OHs do not include the formal therapeutic change interventions common to TCs, nor did they include any on-site access to drug abuse or health care professionals. UA involved what occurred naturally after completing treatment, which included staying with friends or family members, their own house or apartment, homeless shelters, or other settings. Longer lengths of stay in either the TCs or OHs were associated with increased employment, and reduced alcohol and drug use. Those assigned to the OH condition received more money from employment, worked more days, achieved higher continuous alcohol sobriety rates, and had more favorable cost-benefit ratios.

Motivation Among Ex-Offenders Exiting Treatment: The Role of Abstinence Self-Efficacy.

The relationships between motivation, treatment readiness, and abstinence self-efficacy were examined among a sample of ex-offenders exiting inpatient treatment for substance use disorders. Hierarchical linear regression was conducted to examine changes in participants' motivation levels in relation to abstinence self-efficacy beyond what would be expected from treatment readiness and substance use. Abstinence self-efficacy predicted significant decreases in motivation whereas treatment readiness and substance use predicted significant increases. However, there was not a significant relationship between abstinence self-efficacy and treatment readiness. Findings suggest that motivation for change among persons with substance use disorders is related to their self-efficacy for ongoing abstinence.

Development and psychometric evaluation of the Social Justice Scale (SJS).

The study describes the development of the Social Justice Scale (SJS). Practitioners, educators, students, and other members of the community differ on their attitudes and values regarding social justice. It is important to assess, not only individuals' attitudes and values around social values, but also other constructs that might be related to social justice behaviors. The implication of Ajzen in Organizational Behavior and Human Decision Processes 50:179-211, (1991) theory of planned behavior suggests that attitudes, perceived behavioral control, and social norms predict intentions, which then lead to behaviors. A scale was designed to measure social justice-related values, attitudes, perceived behavioral control, subjective norms, and intentions based on a four-factor conception of Ajzen's theory. Confirmatory factor analysis and analyses for reliability and validity were used to test the properties of the scale.

Personality development: continuity and change over the life course.

The development of personality across the human life course may be observed from three different standpoints: the person as actor (behaving), agent (striving), and author (narrating). Evident even in infancy, broad differences in social action patterns foreshadow the long-term developmental elaboration of early temperament into adult dispositional traits. Research on personal strivings and other motivational constructs provides a second perspective on personality, one that becomes psychologically salient in childhood with the consolidation of an agentic self and the articulation of more-or-less stable goals. Layered over traits and goals, internalized life stories begin to emerge in adolescence and young adulthood, as the person authors a narrative identity to make meaning out of life. The review traces the development of traits, goals, and life stories from infancy through late adulthood and ends by considering their interplay at five developmental milestones: age 2, the transition to adolescence, emerging adulthood, midlife, and old age.

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

AIMS: To assess the effectiveness of community-based supports in promoting abstinence from substance use and related problems. DESIGN AND PARTICIPANTS: Individuals (n = 150) discharged from residential substance abuse treatment facilities were assigned randomly to either an Oxford House recovery home or usual after-care condition and then interviewed every 6 months for a 24-month period. INTERVENTION: Oxford Houses are democratic, self-run recovery homes. MEASUREMENTS: Hierarchical linear modeling was used to examine the effect of predictive variables on wave trajectories of substance use, employment, self-regulation and recent criminal charges. Regressions first examined whether predictor variables modeled wave trajectories by condition (Oxford House versus usual after-care), psychiatric comorbidity, age and interactions. FINDINGS: At the 24-month follow-up, there was less substance abuse for residents living in Oxford Houses for 6 or more months (15.6%), compared both to participants with less than 6 months (45.7%) or to participants assigned to the usual after-care condition (64.8%). Results also indicated that older residents and younger members living in a house for 6 or more months experienced better outcomes in terms of substance use, employment and self-regulation. CONCLUSIONS: Oxford Houses, a type of self-governed recovery setting, appear to stabilize many individuals who have substance abuse histories.

Communal housing settings enhance substance abuse recovery.

Oxford Houses are democratic, mutual help-oriented recovery homes for individuals with substance abuse histories. There are more than 1200 of these houses in the United States, and each home is operated independently by its residents, without help from professional staff. In a recent experiment, 150 individuals in Illinois were randomly assigned to either an Oxford House or usual-care condition (i.e., outpatient treatment or self-help groups) after substance abuse treatment discharge. At the 24-month follow-up, those in the Oxford House condition compared with the usual-care condition had significantly lower substance use, significantly higher monthly income, and significantly lower incarceration rates.

The influence of policy on the differential expansion of male and female self-run recovery settings.

The present study used archival data to examine the differential growth among self-governed substance abuse recovery homes for men (N = 443) and women (N = 125). The number of these homes increased dramatically across the U.S. from 1988-1999 when state loan funds were made available to states and technical assistance was utilized by organizations developing the houses. State loan programs and the utilization of technical assistance, however, had the strongest impact on the expansion of women's houses compared to men's houses. The implications of these findings in relation to the scarcity of recovery options for women are discussed.

Children, women, and substance abuse: a look at recovery in a communal setting.

This study explored the sense of community among women (n = 21) and women with children (n = 30) living in Oxford Houses, with emphasis on how the presence of children might affect the household. Sense of community did not vary between participants with more or less than three months residence. Residents reported very high levels of satisfaction with the home, possibly because of a ceiling effect of little room for increases in their sense of community over time. Participants reported that they were getting along with the children in the home, that mothers could count on babysitting help, and that the children had a positive effect on the household and their own recovery process. This effect did not differ between mothers and non-mothers, suggesting that non-mothers might view the children in the home with a sense of responsibility and sensitivity comparable to that of the mothers. Implications are discussed.

Cultivating and maintaining effective action research partnerships: the DePaul and Oxford House collaborative.

In this paper, we review the result of research conducted in the context of a 13-year collaborative partnership between DePaul University and a community-based, self-run, residential substance abuse recovery program called Oxford House. This collaborative effort highlights several examples of the research and action activities fostering a positive alliance that benefited both the research team and the Oxford House community. It also proposed practical guidelines for developing effective action research collaboratives that may be helpful to others who desire to cultivate and maintain similar mutually beneficial partnerships; including such processes as the development of trust, respecting the personal experiences of the community members and group, commitment to serving the community, validating findings with organization members, and accountability.

Attitudes of a community members as a function of participatory research with Oxford Houses.

Citizen participation in research may include involvement in generating original ideas, planning appropriate designs, collecting data, and helping to implement interventions. Unfortunately, little is known about the attitudes of the community members who participate in such research processes. In the present exploratory study, a team of community members (4 men, 3 women; age > 30 years old) who were employed as investigator research associates to evaluate an innovative substance abuse recovery home were asked for their perspectives about their involvement in the research effort. Findings indicated that these community members felt their participation was a positive experience. Moreover, while their understanding and sense of participation in the research process increased, their identification and affiliation with their support organization was not reduced. Results imply that there is a need to better understand how citizen members of community organizations are affected by their involvement in the research process.

This is my neighborhood: comparing United States and Australian Oxford House Neighborhoods.

The number of Oxford Houses, communal-living, mutual help settings for persons in recovery of alcohol and substance abuse, has spread across the United States and recently in and around Melbourne, Australia. In this study 55 US and 6 AU Houses were compared descriptively for their neighborhood characteristics. Across settings, there were greater similarities than significant differences in the locations. Results imply that Australian Oxford Houses are "safe and sober" settings for persons in recovery consistent with the original United States model in physical dwelling settings.

Creating a home to promote recovery: the physical environments of Oxford House.

The interior and exterior physical characteristics of substance abuse recovery program dwellings (11 woman, 44 men) from three geographic sections of the United States were assessed at creating a "house-as-home" for residents. Although each house was independently governed and operated by residents, results indicated vast similarities among the interior characteristics, amenities, and structural aspects. These rented dwellings also had similar well-maintained exterior characteristics, despite their geographic locations. Follow-up interviews of former residents indicated that these house characteristics and amenities helped create a sense of home not found in traditional institutional facilities. Results suggested that residents of self-governed independently operated recovery houses may create and maintain safe and sober settings that elicit a sense of home among residents.

Economic costs of Oxford House inpatient treatment and incarceration: a preliminary report.

The Oxford House model for substance abuse recovery has potential economic advantages associated with the low cost of opening up and maintaining the settings. In the present study, annual program costs per person were estimated for Oxford House based on federal loan information and data collected from Oxford House Inc. In addition, annual treatment and incarceration costs were approximated based on participant data prior to Oxford House residence in conjunction with normative costs for these settings. Societal costs associated with the Oxford House program were relatively low, whereas estimated costs associated with inpatient and incarceration history were high. The implications of these findings are discussed.

Medical care of individuals residing in substance abuse and recovery homes: an analysis of need and utilization.

The current study examined medical care need and utilization patterns among a substance abusing and recovering population (n = 876), investigating factors such as employment and drug use categories (e.g., pharmaceutical use, cocaine use, heroin use, alcohol use). It was found that those who were unemployed needed and utilized greater medical care than those who were employed. Results indicated that heroin, cocaine, and/or alcohol use was not predictive of medical care need or utilization, whereas pharmaceutical drug use was predictive of medical care need and utilization. Trauma and risky use of substances were not significant predictors of medical care need or utilization whereas the suicide severity composite was significant. Potential implications for misuse of medical services (e.g., to obtain pharmaceutical drugs of use) and federal medical care expenditure allocation are discussed.

African American Oxford House residents: sources of abstinent social networks.

The current study found that African American residents of Oxford House (OH) used Narcotics Anonymous (NA) at high rates, and that both OH and NA strongly contributed to abstinent social networks. Having siblings and other family members in one's network predicted substance use among network members, whereas spouses, parents, and children did not have an effect on the rate of substance use. These findings suggest that OH and NA may be effective sources of abstinent social support for African Americans recovering from substance abuse. However, family members are well represented in the support networks of African Americans in OH.

Women leadership in Oxford House: examining their strengths and challenges.

This study examined the perspectives and definition of leadership by women and mothers with children (n = 40) affiliated with Oxford Houses, a communal mutual-help recovery setting. Participants were asked questions relating to their experiences living in an Oxford House including the strengths and challenges encountered and how leadership impacted the stability in their house. Results illustrated the value of female leadership and highlighted the characteristics deemed important for women leaders in Oxford House, as well as some differences between these women's perception of leadership and the standard definition of leadership. The implications of the findings and how they may be useful to women's and mothers' with children houses are discussed.

Heterogeneity among Latinas and Latinos entering substance abuse treatment: findings from a national database.

The current study examined differences in 30-day and lifetime substance use for a sample of Mexican American, Puerto Rican, and Cuban American men and women from the Drug Evaluation Network System, a national database on individuals seeking substance abuse treatment. There were significant gender and ethnic differences in recent and lifetime substance use after controlling for age, years of education, employment, medical, and psychological problems. Lifetime and 30-day substance use rates found in this study do not coincide with prevalence rates found in community samples of Latinas/os, indicating that the patterns of substance use may be different among individuals who seek substance abuse treatment than among those in the general population. The results of this study highlight the heterogeneity of Latinas/os who abuse substances.

Social support and self-efficacy for abstinence: is peer identification an issue?

This study investigated levels of abstinence social support and abstinence self-efficacy in relation to characteristics among recovering substance abusers (57 men, 43 women) residing in Oxford Houses. Significant relationships between treatment and sociodemographic variables were observed on measures of abstinence social support and abstinence self-efficacy. Residence time in an Oxford House and 12-step participation were related to increased levels of abstinence social support and abstinence self-efficacy. However, residents who reported that their veteran status or prior incarceration experiences were issues they perceived as making identification with other recovering peers difficult reported lower levels of abstinence social support. In addition, residents who reported having at least one identification issue (57%) and residents who reported being a parent (73%) also reported lower levels of abstinence self-efficacy. Results of this study have important treatment implications for our understanding of social support and self-efficacy within ongoing recovery.

Optimism, abstinence self-efficacy, and self-mastery: a comparative analysis of cognitive resources.

The relationship between optimism, abstinence self-efficacy, and self-mastery was examined by investigating levels of these cognitive resources among two samples of recovering substance abusers: Oxford House residents who attended twelve-step groups and twelve-step members who had never lived in an Oxford House. Participants 'levels of optimism were significantly and positively related to both abstinence self-efficacy and self-mastery scores, as abstinence self-efficacy was significantly and positively related to participants' number of days abstinent. Participants who reported having more than 180 days abstinent reported significantly higher levels of abstinence self-efficacy than participants who reported having less than 180 days abstinent. In addition, among participants who reported having less than 180 days abstinent, Oxford House residents reported significantly higher levels of abstinence self-efficacy than twelve-step members. Overall, findings suggest that cognitive resources facilitate substance abusers' recovery and that the Oxford House model might provide high levels of support in their ongoing abstinence.

The Community Narration (CN) Approach: Understanding a Group's Identity and Cognitive Constructs through Personal and Community Narratives.

Community program evaluations, visioning and assessments must always endeavor to attain useful information in the most sensitive way. Most community-based organizations form, grow and continue on their own without the help of outside experts. Participatory approaches should respect the historical evolution of these groups and understand the positive factors that underlie their organizational beliefs. A group's mission, values and identity should inform any community program evaluation, consulting project, and the design of any research study. Narrative methods have been used with mutual-help groups and many other organizations to good effect. Such methods have great potential to avoid hierarchical and unidirectional forms of evaluation, encouraging the group's collective psychology and identity-based constructs to emerge. We developed a participatory, narrative technique called Community Narration (CN), which is described here. The technique utilizes personal stories and community narratives as an entry into the evaluation process or other work involved in understanding an organization. The community's participants were able to use the technique successfully, found it enriching, and the constructs obtained have led to many discussions and member-guided research related to the organization.