The Role of Social Ties in Recovery in a Population of Homeless Substance Abusers

Objectives: Strong social ties are protective of substance abuse and predict greater odds of recovery among those affected. However, social ties are often disrupted among homeless men. The objective of this study was to determine the effects of social ties on the decision among homeless men to enter and continue treatment for substance use disorders. Methods: Ten participants in a residential therapeutic community treatment program were interviewed using a semi-structured format. Interview notes were divided into discrete "data units''; common themes, concepts, words, and phrases were identified; and, finally, relationships between categories were delineated. Results: Qualitative analysis showed that, through confrontation and ongoing emotional support, family members, specifically mothers, played the most significant role in the participants' decision to enter treatment. Members of the recovery network provided empathic emotional support; coworkers, outside friends, health professionals, and romantic relationships were also mentioned, each possessing a characteristic role. Several themes emerged suggesting mechanisms by which relationships may affect the recovery process: effects on attitude, focus, and motivation; emotional and instrumental support; knowledge; and preentry support. Conclusions: Social ties among homeless substance abusers are complex and play an important role in recovery. Understanding these relationships and their perceived importance may help to leverage underutilized resources in the treatment of substance abuse among homeless individuals.