Why Peer Support Can Matter in Residential Addiction Treatment
When someone you love enters residential treatment for addiction, it’s natural to focus on the professional support they’ll receive. Who will be treating them? What sort of therapy is offered? What will their days look like?
Something families may think about less is the other people they’ll be living alongside.
Residential treatment isn’t just a series of appointments. People may spend weeks living, eating and taking part in activities together. That means relationships with other residents can become an important part of the experience too.
Research suggests those relationships may have a role to play in recovery, although they’re only one part of a much bigger picture.
Treatment doesn’t only happen in therapy sessions
Individual counselling, group therapy and structured programmes are obviously important parts of residential addiction treatment. But they don’t fill every hour of every day.
There are meals, breaks and ordinary conversations in between. Residents are spending time with other people who may be dealing with some of the same challenges, even if their individual circumstances are very different.
That can provide something professional treatment can’t quite replicate: the experience of being around people who understand some of what you’re going through.
It doesn’t mean everyone will become friends. In fact, living alongside other people while dealing with addiction and recovery is unlikely to be straightforward all of the time.
But the quality of those relationships may matter more than families realise.
What does the research tell us?
One study published in the Journal of Substance Abuse Treatment looked specifically at interpersonal relationships and outcomes among 189 US military veterans receiving residential treatment for substance use disorders.
Researchers spoke to participants when they entered treatment, again after one month and then 12 months after discharge.
They found that certain problematic interpersonal styles at the start of treatment were associated with poorer relationships with peers after a month. In turn, poorer peer relationships were associated with more substance-use disorder symptoms 12 months after leaving treatment.
The researchers concluded that interpersonal relationships were important enough to warrant consideration as part of treatment.
There are some important limitations, though. This was a relatively small study involving US military veterans at a Veterans Affairs residential programme, with 96% of the sample being male. It doesn’t tell us that making friends in residential treatment guarantees a better long-term outcome.
What it does suggest is that the way people interact with those around them during treatment shouldn’t necessarily be dismissed as something separate from recovery.
Support after treatment matters too
The importance of social relationships doesn’t end when somebody leaves residential treatment.
The large US COMBINE study looked at 1,373 people receiving outpatient treatment for alcohol dependence. Researchers examined participants’ existing social networks and found that alcohol-specific support — including having people within their network who opposed their drinking — was predictive of drinking outcomes during and after treatment.
That’s not the same as studying friendships formed within residential treatment, so the two pieces of research shouldn’t be treated as though they prove the same thing.
Together, however, they add to the evidence that the social environment around someone can be relevant during recovery.
For families, that can be useful to remember. Treatment isn’t necessarily just about what happens between a patient and a therapist. The wider support network matters too.
What should families look for in a residential programme?
When you’re researching treatment for someone you care about, it’s easy to concentrate on qualifications, therapies, facilities and costs.
Those things matter, but it can also be worth asking how a programme approaches relationships between residents.
For example, you might want to find out how staff support healthy interactions between residents, what happens when conflict occurs and whether there are opportunities for people to connect outside formal therapy sessions.
You could also ask what happens after discharge. Does the programme offer alumni support, peer groups or other ways for people to remain connected to a supportive recovery community?
There isn’t one particular approach that’s right for everybody. The important thing is that peer relationships aren’t simply left to chance while all the attention goes towards scheduled therapy.
Peer support is only one part of treatment
It’s important not to overstate the role of peer relationships.
Addiction is complex, and treatment needs will vary enormously from one person to another. Professional assessment, evidence-based treatment, appropriately qualified staff and a suitable aftercare plan all matter.
But when considering a residential program, it can be worth looking beyond the timetable of therapy sessions and asking what everyday life within that programme is actually like.
How are residents supported? How does the programme deal with disagreements? Is there an emphasis on creating a safe and supportive community as well as providing clinical treatment?
These may not be the first questions that occur to a family when they’re trying to find help for someone they love, but research into interpersonal relationships suggests they’re worth asking.
Looking at the bigger picture
Residential treatment brings people together at an incredibly difficult point in their lives. Those relationships won’t all be easy or positive, and peer support can’t replace professional treatment.
But feeling understood, learning to communicate differently and developing supportive relationships can form part of the wider recovery environment.
For families comparing residential treatment options, the takeaway isn’t that the other residents matter more than the counsellors or the treatment itself. It’s simply that the community surrounding someone during recovery can matter too.
A good treatment programme should recognise both.
This article is for general information only and is not a substitute for professional medical advice, diagnosis or treatment. Anyone seeking help with alcohol or substance use should speak to an appropriately qualified healthcare professional.
Sources
- Harrison, A. J., Timko, C., & Blonigen, D. M. (2017). Interpersonal Styles, Peer Relationships, and Outcomes in Residential Substance Use Treatment. Journal of Substance Abuse Treatment, 81, 17–24. View the study
- Longabaugh, R., Wirtz, P. W., Zywiak, W. H., & O’Malley, S. S. (2010). Network Support as a Prognostic Indicator of Drinking Outcomes: The COMBINE Study. Journal of Studies on Alcohol and Drugs, 71(6), 837–846. View the study
About The Author
