The recovery perspective has gained increased prominence following a re-evaluation of the meaning of recovery and further questioning of the methods used to measure treatment progress (White, 2009). This development can be described as a transition from a deficit to a strengths model predicated on the idea that recovery is a process that takes time, and happens between people and within communities (Best, 2019).
One illustration of the theoretical developments regarding recovery is the concept of recovery capital. Recovery capital represents the different types of resources an individual can draw upon to initiate and sustain recovery (Cloud & Granfield, 2008). Cloud and Granfield (2008) divide an individual’s resources into four categories: social, human, cultural and physical capital. These categorizations have developed since the concept was first introduced, and different categorizations have been used to classify the resources. White & Cloud (2008), for example, suggest social, personal and community capital.
To advance the recovery-oriented perspective, a number of assessment tools have been developed to assess recovery capital taking a strength-based approach (Best et al., 2012, 2016; Burns & Marks, 2013; Groshkova et al., 2013; Sterling et al., 2008). Hennessy (2017) conducted a systematic review of the literature on recovery capital, focused primarily on the principles of recovery capital as a theoretical framework. This overview suggests that multiple recovery capital models are being used involving a variety of resources from the individual, micro- and meso-levels, although individual-level resources are the most prevalent. Developments can also be seen in the interpretation of different resources, which now includes both general recovery-related factors, as originally outlined by Cloud and Granfield (2008), and more narrow, treatment-specific interpretations (Palombi et al., 2019).
Hennessy suggests that recovery capital is dynamic, in that it can either increase or decrease over time, and that factors in recovery capital tend to interact with each other, and with other external factors. Witbrodt et al. (2019) examines the effectiveness of Motivational Interviewing Case Management (MICM), and whether this varies according to levels of recovery capital. Clients with high levels of recovery capital were found to be likely to improve as a result of participation in MICM, whereas clients with low recovery capital performed no better than other, more common treatments.
Recovery capital is likely to vary at different stages of the recovery change process (Hibbert & Best, 2011; Laudet & White, 2010) and across different sub-populations. Growth in recovery capital should therefore be viewed as an ongoing process rather than a stable state, and should be considered bi-directional (Hennessy, 2017). Other factors shown to influence the level of recovery capital and change potential include gender (Neale et al., 2014; Neale & Stevenson, 2015), age (Hennessy et al., 2019) and whether the client is considered ‘marginalized’ or ‘integrated’ (e.g. Skogens & Greiff, 2014).
Best et al. (2016) developed a Recovery Capital measurement model (REC-CAP). The overarching purpose of the REC-CAP is to measure barriers and unmet needs, as well as resources that the individual can use in recovery. To measure levels of recovery capital, REC-CAP combines the Assessment of Recovery Capital (ARC) (Groshkova et al., 2013), the Recovery Group Participation Scale (RGPS) (Groshkova et al., 2011), the Commitment to Sobriety Scale (Kelly and Greene, 2014) and the Social Support Scale (Jetten, Haslam and Haslam, 2011). The REC-CAP measure has been shown to be a reliable tool for measuring commitment to cessation of alcohol and drug misuse. It is therefore believed to possess the ability to predict future needs in terms of resources to increase motivation. Lynch et al (2021) have shown that, in a cohort of opiate use disorder patients accessing treatment, there are significant improvements in recovery capital as measured on the ARC, with means scores rising from 37 at enrolment to 43 around three months later (the scale ranges from 0–50). However, change measures have not previously been reported for recovery housing residents.
Recovery residences provide residential care for people in recovery and help to build recovery capital. These residences focus on the broader aspects of reintegration and community engagement, such as employment and living situations (Polcin et al., 2016, p. 52), while also addressing the needs of a marginalized client group (see e.g. Skogens & Greiff, 2014). The term recovery residences cover a variety of housing models. The National Association of Recovery Residences (NARR) has outlined four levels of recovery residence, based on how they are administered and the level of staffing. Common to all levels is the attitude to abstinence and recovery support, and the provision of communal living arrangements (Polcin et al., 2016). The current study focuses on Fellowship Living Facilities, which provides recovery residences that are categorized as level 2, or Sober Living Houses (SLH). While residing in recovery residences managed by Fellowship Living Facilities, all residents are obliged to attend regular 12-Step meetings. According to the house guidelines, the resident is also required to actively seek employment, and to secure a job within two weeks. Fellowship Living Facilities has a strict zero tolerance of drug and alcohol use, and only sober visitors are allowed to visit the residents. Longitudinal studies on recovery residences (Jason et al. 2006; Reif et al., 2014) and Sober Living Houses (Polcin et al., 2010a, 2010b; Mericle et al., 2019) have shown that increased rates of employment and lower levels of involvement by criminal justice entities are associated with long-term stays in the residences, but that the social dynamics and networks of residents might influence the amount of time retained (Jason et al., 2014, 2019).
As well as examining recovery capital change in recovery residence settings, there is a need for further research into changes in recovery capital, based on sub-group characteristics and on support engagement factors. This paper addresses three research questions:
1. Which recovery capital factors near the time of admission are associated with retention in the recovery residences?
2. How does recovery capital change during the first six months of residence?
3. What demographic and behavioral characteristics are associated with changes is social and personal recovery capital?