Community as Method

Social isolation stands as one of the largest barriers for individuals on their path toward recovery 42. Interestingly, research supports that socialization is one of the most preferable and rewarding behaviors one can engage in. In fact, when provided choice, social interaction is favored over the use of a drug until that social interaction is associated with a punishment 43. This underscores the deleterious effects that stigma has on an individual’s continued use or relapse. In the truest essence of the word, stigma is a social punishment. It reinforces the notion that individuals are weak and deviate from the norm, thereby contributing to their ostracization. When individuals are socially excluded, there are lower rates of prosocial motivations, greater aggression, and poorer self-regulation 44 45, all of which contribute to difficulties in recovery.

In order to eradicate the destructive effects of stigma on recovery, SanPa targets one of the foundations on which it is perpetuated – that of interpersonal and group isolation. At SanPa, socialization is used to facilitate a sense of belongingness. As examples, individuals are immersed in group living upon their arrival to SanPa. Before having their evening meal, all residents partake in two-minutes of silence to acknowledge those who have completed the program and those now on their journey. These acts of solidarity lead to an increased sense of belonging, which further drives the identity and behavioral changes necessary for recovery.

Belongingness has been found to not only improve greater self-esteem and self-efficacy, it also has been shown to decrease health problems and increase overall happiness 46. According to Baumeister and Leary 47, the four elements necessary to achieve a sense of belongingness within a community include the following: frequency of contact, longitudinal stability, positiveness of the contact, and presence of mutual concern. Duration of stay at SanPa not only is necessary for the long-term treatment of individual recovery, yet it creates familiarity of social contacts who move through their recovery alongside one another. Residents are also expected to stay for the expected duration, which reduces the overall rate of turnover and promotes greater longitudinal contact among members in the community.

Another important facilitator of social belongingness is the peer-based professional staff. All residents engage in communal work to sustain the community’s infrastructure, including its facilities, commercial enterprises, educational, and recreational programs. Through this structure, staff are not separated from the collective ethos of recovery, rather they exist as an integral part of facilitating it. By promoting equal status within the community, the "them vs. us" distinction that formal treatments (particularly those grounded in psychoeducational methods) inherently carry is eliminated.

In addition to the peer-based staff, success in recovery is met through peer-mentoring. Shortly after an individual arrives to SanPa, they are received by a more experienced member of the community. These resident pairs make up a group, which is part of a house, which in turn constitute a specific sector. This creates numerous threads of identification, thereby providing further mutual support and immersion within the community. This unique, peerrelationship is also used as a place of refueling when difficulties arise. It is suggested that addiction professionals in both in-patient and outpatient settings are limited in meeting one of the strongest mediators of change in an individual’s recovery process – that of solidarity resulting from carrying similar experiences. Because residents can identify with experiences of another at SanPa, greater empathy is exchanged. They are not judged or misunderstood for past decisions.


  • 42. Warburton, W. A., Williams, K. D., & Cairns, D. R. (2006). When ostracism leads to aggression: The moderating effects of control deprivation. Journal of Experimental Social Psychology, 42(2), 213-220.
  • 43. Venniro, M., Zhang, M., Caprioli, D., Hoots, J. K., Golden, S. A., Heins, C., ... & Shaham, Y. (2018). Volitional social interaction prevents drug addiction in rat models. Nature neuroscience, 21(11), 1520-1529.
  • 44. Twenge, J. M., Baumeister, R. F., DeWall, C. N., Ciarocco, N. J., & Bartels, J. M. (2007). Social exclusion decreases prosocial behav- ior. Journal of Personality and Social Psychology, 92, 56–66.
  • 45. Twenge, J. M., Baumeister, R. F., Tice, D. M., & Stucke, T. S. (2001). If you can’t join them, beat them: Effects of social exclusion on aggressive behavior. Journal of Personality and Social Psychology, 81, 1058–1069.
  • 46. Pearce, S., & Pickard, H. (2013). How therapeutic communities work: Specific factors related to positive outcome. International Journal of Social Psychiatry, 59(7), 636-645.
  • 47. Baumeister, R. F., & Leary, M. R. (1995). The need to belong: Desire for interpersonal attachments as a fundamental human motivation. Psychological Bulletin, 117, 497–529.

Weill Cornell Medicine Program for Substance Use and Stigma of Addiction 1300 York Avenue New York, NY 10065 Phone: (212) 746-3738