The growth of recovery capital in clients of recovery residences in Florida, USA: a quantitative pilot study of changes in REC-CAP profile scores

Background: There is a growing evidence base around predictors of retention and completion in the effectiveness of a range of recovery residence models, particularly Oxford Houses and Sober Living Houses, and recovery housing is recognized as a clearly evidenced area of recovery intervention. The aim of the study was to quantitatively assess recovery capital in a sample of recovery residence clients.

Method: The study used a repeated measures self-completion of a standardized recovery capital instrument (REC-CAP) for clients retained across various houses within one Level 2 recovery residence provider whose program was based on a 12-step approach. While 823 clients participated in the baseline assessment, a sample of 267 clients was achieved for six-month follow-up interview, based on those retained in the residence. A logistic regression model examined factors associated with retention and a repeated measures marginal mixed model evaluated the factors associated with changes in recovery capital between the baseline and the follow-up assessment.

Results: Members of the group that remained in recovery residences were more likely to be older males with a record of high participation in recovery groups, with greater drop-out among younger residents, female residents and those with low levels of recovery group engagement at baseline and identified with a housing need. For those retained to follow-up, greater recovery capital growth was associated with employment, higher levels of social support and more recovery group involvement, as well as age and a higher quality of life. The need for family support was shown to reduce levels of recovery capital. The recovery residence found it harder to retain younger clients, women and those with less prior involvement in recovery groups. However, those younger people who were retained reported better recovery capital growth during the initial six months of residence.

Conclusion: The key conclusion is that while recovery capital generally increases during a stay in a recovery residence, it does not do so consistently across the sample population. This has implications for how pathways to recovery group engagement are supported for women and young people and how social support (encompassing housing, employment and family issues) is provided to those populations emphasized during periods of residence, particularly for younger and female residents, and the This suggests the potential need for training and guidance for house managers developing specialist supports for these populations working with these groups.