The community orientation of social model and medical model recovery programs

This paper examines the ex-rent to which two social model programs and one medical model program operating in the same county were able to establish links between their programs and the community at large. Emphasis on community and environment is a hallmark of social model programs, suggesting that more effective links will have been established at those programs than at the medical model program. Items from the community orientation subscale of the Social Model Philosophy Scale provide a guide for this qualitative analysis. Community resources considered include self-help 12-step programs, as well as community agencies chartered to address employment, education, family counseling, and housing. All three programs were found to have a strong emphasis on Alcoholics Anonymous (AA)/Narcotics Anonymous (NA). At the medical model program (MMP), patients were exposed to three to five AA or NA meetings per week during their 10-day stay, although for the most part, meetings in the MMP had few, if any, outsiders. The social model programs exposed residents to a number of different AA and NA meetings, both at the program and in the community over a period of months. The MMP program was found to have minimal links with the community for employment, education, or other services. The MMP program counselors did try to make referrals to other substance abuse programs upon release from the hospital, and to insure that patients had somewhere to go for-shelter after being discharged. In contrast, social model programs encouraged residents to utilize community resources for health, education, and social service needs. (C) 1998 Elsevier Science Inc.