College of Science and Health Theses and Dissertations

Date of Award

Summer 8-20-2017

Degree Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

Department

Psychology

First Advisor

Leonard A. Jason, PhD

Second Advisor

LaVome Robinson, PhD

Third Advisor

Molly Brown, PhD

Abstract

Substance use disorders have had an enormous impact on individuals, families, and communities in the United States. The societal cost of substance abuse in terms of health care, crime, and lost wages is over $700 billion annually. Despite advances in evidence-based treatments, the chronicity of substance use disorders underscores the need to explore and expand long-term aftercare options to prevent relapse after acute residential treatment. Oxford Houses offer an affordable alternative to more costly and limited forms of transitional housing. These self-sustaining, democratically-run recovery homes provide a safe and sober living environment with peer support and no professional staff. Provided residents remain abstinent, pay their rent, help with household chores, and are not disruptive, they can stay as long as they want. In addition to the demonstrated effectiveness of Oxford House across populations, research has also identified the minimum dosage required to attain the maximal benefits and has found support for some of the therapeutic components associated with recovery. However, less is known about what the experience of living in an Oxford House is like from the perspective of the residents or how their attitudes regarding expectations and needs influence the impact of the therapeutic components. The current study employed a qualitative design using the Interpretative Phenomenological Analysis approach to explore the subjective experiences of Oxford House residents to gain understanding of how they assign meaning to their experience within the context of their recovery. Ten first-time Oxford House residents who had lived in an Oxford House at least two months were recruited to 2 participate in semi-structured, open-ended interviews related to their experience in the house. Findings indicated that Oxford House was perceived as a positive experience, likely due to the following factors: low expectations, limited resources, and the perception that Oxford House was responsible for providing any resources gained during their tenure (e.g. employment). In line with existing research, participants tended to prioritize basic needs before higher order needs but also highly valued resources they lacked prior to Oxford House entry. Together the governing structure and recovery-oriented communal living in Oxford House created an environment that promoted self-sufficiency, self-regulation, and social support. Additionally, residents tended to help one another to learn coping skills to manage recovery and interpersonal challenges. The adoption of recovery-oriented goals that went beyond abstinence (e.g., becoming a better person) was associated with increasing their length of tenancy. These findings call attention to the importance of expectation management and need fulfillment in the subjective experience of Oxford House residents while emphasizing the importance of personal investment via goal orientation and new relationships to increase the length of stay. Most importantly, this study gave a much needed voice to Oxford House residents and provided insight into the complex interaction of the multiple factors impacting their recovery process.

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