How should we study residential recovery homes?

Persons with serious alcohol and drug problems who are attempting to maintain abstinence often lack an alcohol- and drug-free living environment that supports sustained recovery. Residential recovery homes, called “sober living houses” in California, are alcohol- and drug-free living environments that offer long-term support for persons with addictive disorders. They do not offer formal treatment services but usually encourage or mandate attendance at self-help recovery groups such as Alcoholics Anonymous. The paper aims to discuss these issues.

The approach involved analysis of the strengths and weaknesses of different research designs for studying residential recovery homes. Alternatives to randomized designs that are able to capture “real world” data that are readily generalized are described and understudied topics are identified.

A significant limitation of traditional randomized designs is they eliminate mutual selection processes between prospective residents and recovery home residents and staff. Naturalistic research designs have the advantage of including mutual selection processes and there are methods available for limiting self-selection bias. Qualitative methods should be used to identify factors that residents experience as helpful that can then be studied further. Innovative studies are needed to investigate how outcomes are affected by architectural characteristics of the houses and resident interactions with the surrounding community.

Use of the recommended strategies could lead to findings that are more informative, intuitively appealing, and interpretable.

Recovery homes and similar programs will be more responsive to consumers.

This paper represents one of the first to review various options for studying recovery homes and to provide suggestions for new studies.