There are four basic theoretical approaches taken by halfway houses: democratization, communalism, permissiveness, and reality confrontation. Democratization refers to involvement of the staff and patients in the important decisions made in the running of the house. House administrators who subscribe to this approach believe that democratization may decrease resident dependence on the staff and foster independence and inventiveness in the residents. Halfway houses that follow a communalism model encourage staff and residents to take part in the activities of the home together. The interaction of staff and residents provides more instances to model and teach desired behaviors. Houses that follow the permissiveness model allow a greater expression of emotional and behavioral displays than most traditional settings before physical or behavioral restraints are used. In houses that apply the reality confrontation model, patients receive the same response to and consequence from their actions and behaviors that they would in the community.
Halfway house staff members employ several techniques within these modalities to aid in the adjustment of their residents to community life. Group and individual therapy, 12-step programs, social skills training, development of financial management skills, social outings, job training, and moral support are used by many house staffs to foster the independence of their residents. Many houses use some type of reward system, whether it is a token economy, gaining of privileges as skills are mastered, or acquisition of rewards and privileges with seniority as one moves through the program of the house. These tools are used in many combinations, often depending on the population of residents and the philosophical orientation of the organization, to help the residents to be able to become integrated into the community.
The ideals on which the halfway house model is built may seem quite laudable. Nonetheless, the efficacy of such programs has not yet been adequately demonstrated. There has been a wide array of studies producing various results. Several methodological issues, such as the lack of control groups in research and the lack of random assignment, have been raised in relation to studies done on halfway houses. Also, due to the various modalities of treatment and different populations served, it has been difficult to conduct research and determine effectiveness. Greater emphasis should be placed on using empirically supported methods in working with residents instead of using antiquated methods that may not be appropriate for the population.
Joseph R. Ferrari
DePaul University, Chicago
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