Context Matters: Home-level But Not Individual-Level Recovery Social Capital Predicts Residents' Relapse

Abstract

The purpose of this study is to contribute to the literature on the prediction of substance use relapse, using sophisticated systems' approaches to individuals and their contexts. In the current study of 42 recovery homes, we investigated the construct of social capital from the perspective of both recovery home residents and the house level. A confirmatory factor analysis found a latent recovery factor (including elements of recovery capital, comprising resources such as wages, self-efficacy, stress, self-esteem, quality of life, hope, sense of community, and social support) at both the individual and the recovery house level. Next, using longitudinal data from homes, an individual's probability of relapse was found to be related to house rather than individual-level latent recovery scores. In other words, an individual's probability of relapse was primarily related to the average of the "recoveries" of his or her recovery home peers, and not of his or her own personal "recovery" status. The finding that resident relapse is based primarily upon the total recovery capital available in the homes highlights the importance of the social environment for recovery.

Keywords: Context; Oxford House; Recovery homes; Relapse; Social capital; Social environment.

Fig. 1

Standardized 2-level confirmatory factor analysis (CFA) model (measurements at respondent’s first observation)

Fig. 2

Fitted hazard curves comparing a high sample relapse rate OH (95th) versus a low sample relapse rate OH (5th)

Fig. 3

Standardized 2-level confirmatory factor analysis (CFA) model (measurements at respondent’s first observation)