There are a vast number of recovery residences, sober living homes, and transitional living programs that are currently operating and new ones open up each day. How do you know which programs are providing quality services? The following questions can help you to identify organizations that are operating at a professional level and following industry standards.
1. What is the staff to resident ratio?
The lower the staff to resident ratio, the more attention and care each resident receives. Some individuals are appropriate for programs with low supervision (NARR Levels 1 & 2) and a higher staff to resident ratio, while other individuals need more support and structure (NARR Level 3) and a low staff to resident ratio.
At Hope Homes, we average 1 staff member for every 3 residents. We have 20 full time Counselors, 2 Counselor Supervisors, 1 Drug Screen Coordinator, 1 Administrative Assistant, 1 Office Manager, 1 Outreach Coordinator, 1 Chief Operating Officer, and 1 Executive Director.
2. What structure/support is offered in a given day?
The higher a recovery residence’s NARR level, the more structure and support tends to be offered, i.e. life skills counseling, support groups, accountability level, etc. Is there a curfew? Are in-house support groups offered? How are residents held accountable for 12 Step meeting attendance? Are residents allowed to spend nights away from the residence? How are residents supported in finding employment/educational opportunities? The answers to these questions can tell you a great deal about the amount of support and structure offered by different programs.
Hope Homes offers NARR Level 3 recovery residences and support services. Our professional, full-time counselors live on-site and are available to residents 24 hours a day. They provide in-house support groups; one-on-one sessions; life skill development; employment/education guidance; 12 Step meeting support; fellowship activities; and parent/family support. Counselors collaborate with each resident’s recovery support system, including the referring treatment center and continuing care service providers. Counselors keep extensive chart notes on each resident and conduct frequent, random drug screening to ensure the safety of our communities.
3. What type of education and training does the staff have?
Degrees and certifications are indicators of the degree to which staff can assess and triage presenting situations and needs of residents within the organization.
At Hope Homes, we have staff with the following certifications and degrees:
- Certified Addiction Counselor I & II– SC & GA (NAADAC)
- Certified Substance Abuse Counselor I & II – NC (IC&RC)
- Alcohol & Drug Abuse Counselors – TN (BADAC)
- Alcohol Drug Counselor – AL (IC&RC)
- MA in Human Services
- MA or MEd in Counseling
- Masters of Social Work
- Masters in Addiction Studies
- Licensed Professional Counselor
- Licensed Clinical Social Worker
- Certified ARISE Interventionist
- Licensed Clinical Addiction Specialist – NC
- Master Addictions Counselor
- Certified Clinical Supervisor
- Clinical Supervisor Intern
4. Who makes clinical decisions?
It is important to know who will be making decisions regarding case management, behavioral interventions and discharges. Will these decisions be left solely to the primary counselors/staff or is there a supervisor team that discusses resident issues?
At Hope Homes, we have a three-tier support team that consists of primary counselors, counselor supervisors, and an Executive Director. Each resident has 2 primary counselors who are directly responsible for his/her care. These counselors lead groups, provide one-on-one sessions, keep chart notes and other records on each resident, conduct drug screens, communicate weekly with the family of each resident, and collaborate with the recovery support team of each resident.
Each primary counselor has a regional counselor supervisor who oversees management of each resident. Counselor supervisors assist counselors with clinical assessments, behavioral interventions and discharges. Primary counselors have access to a counselor supervisor 24 hours a day, 7 days a week. The counselor supervisors report to our Executive Director, Beth Fisher.
5. How many residents per bedroom? How many residents share a bathroom?
There are many different types of sober living environments. Some are in single-family homes, others are in converted motels/hotels, and others are in apartment units. Generally, the more residents in a room, the less expensive the program fee should be.
When a resident first moves in to Hope Homes, he/she will share a bedroom with one other resident. Sharing a bedroom allows residents to integrate more quickly into the community and prevents isolating behaviors. After meeting certain criteria, residents are able to move into a single bedroom. At Hope Homes, there are never more than 2 residents sharing a full size bathroom at any time.
6. What is the relapse policy?
It is very important to understand how a recovery residence addresses relapse. Industry standards typically dictate a zero tolerance policy for alcohol and drug use. A recovery residence cannot be safe for recovering individuals if it allows residents who are actively using drugs or alcohol to live onsite.
At Hope Homes, we see relapse as an indicator that the resident needs a higher level of care than we provide. If a resident relapses, we immediately refer him/her to a higher level of care. If the resident maintains sobriety for two weeks after the relapse, he/she can re-interview with the community for re-admittance. Residents are only given this opportunity once.
7. Is the Recovery Residence a member of NARR or the Recovery Residence organization in its state?
Recovery Residences are self-regulating but can choose to join the National Alliance of Recovery Residences and their local state recovery residence organization. In order to join these organizations, recovery residences must go through a review process and meet certain standards. These standards can be found online at www.narronline.org. Belonging to NARR and the state recovery residence organization demonstrates that a recovery residence is willing and able to meet industry standards.
Hope Homes has been involved in the formation of GARR (Georgia Association of Recovery Residences), RROC (Recovery Residences of the Carolinas), FARR (Florida Association of Recovery Residences), and NARR (National Alliance of Recovery Residences). We are currently working to help form the Alabama Association of Recovery Residences. We are committed to providing professionally run recovery residences and believe in the importance of developing and complying with industry standards for recovery residences.
8. What type of services does the Recovery Residence provide?
Each recovery residence varies in the type of residence it provides. Some are located in houses, some are in refurbished motels, and others are in apartment complexes. Ask specific questions about the actual residence. What type of building is it? Who maintains the residence?
Each recovery residence also varies in the type of support services it provides to its residents. The NARR Levels of Care can provide a general idea of what services a Recovery Residences has, but it is also good to ask for a specific list of support services provided. You can also ask to see a resident calendar, which will list groups, fellowship activities, etc.
9. What is the drug screening policy?
What types of screens are used? How often are residents screened? What is the specific screening process?
At Hope Homes, we screen residents on a random basis. Each resident will be screened on average 2 – 3 times per week. We use breathalyzers and 12 panel cups. Counselors observe urine drug screens in a non-obtrusive manner, but in a way that insures the integrity of the screen. Positive screens are always sent to a lab for confirmation.
10. Does the Recovery Residence have any outcome-based data for their efficacy?
At Hope Homes, we conduct an outcome study each year on our alumni. At this time, over 80% of Hope Homes graduates are still in recovery 6 months after leaving our program. We also have developed a cutting edge survey for our current residents as they progress through the program. This monthly survey is designed to engage residents in mindfulness and self-reflection, track changes over time, and provide feedback to our counselors on resident well-being.
