An historical and developmental analysis of social model programs.

This review synthesizes the philosophy, development, history, and current status of the philosophy of social or community model of recovery and of Social Model Programs (SMPs) based on an analysis of the available literature, much of it outside traditional sources. The social-community model of recovery evolved out of Alcoholics Anonymous (AA), and has a distinctive program philosophy with different assumptions, knowledge, and practice than professionally based treatment models. SMPs began in the 1940s in California, evolving by the 1980s into a continuum of recovery services that are publicly funded, legally incorporated nonprofit organizations. The characteristics of SMPs are described and the range of services are presented, including social setting detoxification, residential recovery homes, non-residential neighborhood recovery centers and sober living houses. SMPs are staffed exclusively by recovering alcoholics and their structure is based on the 12 traditions of AA, which emphasize democratic group processes with shared and rotated leadership and a minimal hierarchy. Cost effectiveness data suggest that residential social model programs average approximately $2,700 per stay versus $4,400 for other residential approaches, yet may offer similar outcomes in terms of substance use and improvement employment or family function.