Psychometric properties of the Fletcher Recovery Housing Alliance Measure (FRHAM-12)

ABSTRACT

Background: Recovery Housing (RH), an important resource for substance use disorder (SUD) recovery, centers on shared lived experience. Program evaluation considers the contribution of environmental factors to outcomes, yet most research on outcomes has focused on patient factors and fidelity to protocols. Investigations of process measures reflecting the dynamic interplay between patient factors and the treatment program are limited. Alliance, one’s perceived connection with others, is a process measure associated with mental health outcomes and includes domains “tasks,” “goals,” and “bonds.” We posit that alliance serves as a proxy construct to measure the impact of shared experience in RH.

Objectives: Develop and assess the psychometric properties of the Fletcher Recovery Housing Alliance Measure (FRHAM-12) for RH.

Methods: A cross-sectional survey with the 12-item FRHAM-12 was administered to 271 individuals (60% men, 39% women, 1% other) within six RH centers in Kentucky. Item-total correlations, internal consistency reliability, exploratory factor analysis (EFA), and confirmatory factor analysis (CFA) were conducted.

Results: The FRHAM-12 was found to have a strong internal consistency (0.924 alpha coefficient) and the EFA yielded a single component (56.38% of cumulative scale variance). CFA indicated acceptable levels of absolute and relative fit of a unidimensional scale with values of 0.67 and 0.976 for the standardized root mean square residual and relative fit index.

Conclusion: This study aimed to construct and validate an initial measure for RH alliance resulted in the brief, FRHAM-12; a tool with strong internal and factor validity. Future research should examine the measure’s predictive and concurrent validity.

KEYWORDS:

• Recovery housing
• working alliance
• therapeutic alliance
• factor analysis
• substance use disorder
• brief scale

Acknowledgments

The authors would like to thank all the individuals that participated in the study and leadership of the six recovery houses. The authors would also like to thank Lori Baier, RN, Director of Employment Initiatives, Fletcher Group, and Jennah Baier, RN, BSN, Research Assistant, Fletcher Group for their support with study recruitment and data entry. Additionally, the authors would like to thank David Best, PhD, Professor, University of Derby, for his thoughtful review of the manuscript.

Disclosure statement

No potential conflict of interest was reported by the authors.

Data availability statement

The data that support the findings of this study are available from the corresponding author, Robin Thompson ([email protected]), upon reasonable request.

Additional information

Funding

This research is supported by the Health Resources and Services Administration (HRSA) of the US Department of Health and Human Services (HHS) under grant number UD9RH33631-01-00 as part of an award totaling $13.7 M with 0% financed with non-governmental sources. The contents are those of the authors and do not necessarily represent the official views of, nor endorsed by HRSA, HHS, or the US Government.