The Four Levels of Recovery Residences

Levels of Recovery Residences

Recovery Residences (RRs) are organized into four categories, or “levels,” by the NARR. The levels describe the intensiveness of the program and the level of care provided. Level 1 houses provide almost no recovery-orientated structure (other than requiring residents to attend mutual support groups or the like), while Level 4 houses are considered “Therapeutic Communities” and share much in common with residential inpatient treatment. In-house therapy and sometimes even medical services are provided. While there are fundamental differences between the levels (discussed below), their basic purpose is all the same – to provide a substance-free environment where people can continue their recovery while relying on support from their peers. Additionally, they share the following features in common.

  • Peer Support: Forming relationships with others who are in the process of recovery can provide encouragement and inspiration – especially from those who are further along in the process.
  • Drug-Free Environments: Many patients who have been through treatment have no other option but to return to living environments where drug or alcohol use is either present or readily available. RRs provide a place to live where drugs and alcohol are neither present nor allowed.
  • Full-Time Residential: All levels of RRs require residents to stay there full time. While some may allow a day or two away occasionally, most require a 100% commitment to living at the home. Most homes have two or more beds per room, and all living spaces are shared.
  • Shared Cost: The basic principle of RRs is that each resident pays a portion of the rent and utilities, as well as other expenses. While most RRs are self-sustaining, some houses do receive federal or state funding to offset the cost, especially level 3 or 4 houses. Many RRs require the residents to work, or at least be actively looking for work.
  • House Rules: Each RR has it’s own house rules about who can move in and what’s required of residents. Common rules include regular chores, random drug and alcohol tests, and strict rules regarding activities like stealing and sexual conduct. Many houses also require residents to regularly attend some sort of therapy, such as AA or NA meetings, 12-step alternatives, or counseling sessions.

Level 1 Recovery Residences include and closely resemble Oxford Houses

Level 1 houses provide the least amount of oversight and services. A good example of Level 1 houses is the Oxford House model. Oxford Houses are governed by a charter and rules that are agreed upon at the outset, but those are kept to a minimum and decisions are made democratically. For instance, house members vote on whether to allow a certain individual into the house. Each member has one vote, and no outside supervisor or manager is hired.

Many houses require residents to attend some sort of recovery, be it a 12-step program or outpatient counseling sessions. However, most Level 1 RRs don’t provide onsite recovery services, with the possible exception of an optional 12-step recovery meeting held weekly at the home.

The cost of a Level 1 home is simply the cost of rent, utilities, and other shared expenses divided by the number of residents. A small association fee is often required to maintain membership in the affiliate’s network.

Level 2 houses generally elect a supervisor, but don’t offer recovery services

The main difference between Level 2 homes and Level 1 homes is with the way that they are governed. Most often, a supervisor is elected, and he or she is responsible for ensuring that residents comply with the rules and works to resolve any community complaints.

While Level 2 homes don’t have recovery services onsite, there’s usually a strict requirement for maintaining membership in a recovery group or sticking to an aftercare plan with a counselor. Additionally, strict sobriety test requirements are typically enforced. This differs from Level 1 homes which tend to have more relaxed policies on how often drug or alcohol tests are required.

Aside from each resident’s portion of rent, utilities, and shared expenses, a small fee may be required for network membership and for the services of a supervisor and drug testing, which usually make them slightly more expensive than equivalent Level 1 houses.

Level 3 homes offer professional management and some recovery services

While Level 3 houses are still considered “sober living homes,” they do incorporate aspects of clinical treatment. Their primary purpose is still to provide a substance-free environment for people to live in, but the programs are more structured than Level 2 homes. They often include paid counselors and staff to assist patients in developing and following through with their aftercare plans. Most of the actual treatment doesn’t happen on site, but certain life skills and support groups may be provided at the house.

Most Level 3 houses are overseen by paid staff, rather than self-governing like Level 1 and 2 homes. As a result, the cost of Level 3 homes often includes the expense of paying counselors and administrative staff, in addition to the shared expenses of living in the home.

Level 4 houses are considered residential inpatient rehabilitation facilities

While Level 4 homes are included in “recovery residences” they wouldn’t typically be considered “sober living homes” since they fall into the category of inpatient treatment, rather than aftercare. They are most often referred to as Therapeutic Communities (TCs). TCs are a structured, clinical environment and are usually full-service, meaning that residents don’t have to go offsite for treatment.

Residents in Level 4 homes are usually not able to work (at least not full-time) since they are engaged in recovery activities throughout the day. Often residents are not allowed to come and go as they choose.

If you’re ready to apply to one of our sober living locations, submit your application today or contact our admissions team at (908) 946-0005 for more information about men’s sober living with Cambridge Recovery or visit our website at www.cambridgerecoveryestates.com

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