Engagement and Recovery: Relational Pathways to Healing and Growth

Authors

Frederick Shack, LMSW^1,4
Mardoche Sidor, MD^1,2,3
Gary Jenkins, MPA¹
Jose Cotto, LCSW^1,5
Karen Dubin, PhD, LCSW^2,4
Lesmore Willis Jr, MPA, MHA¹

Affiliations

¹Urban Pathways, New York, NY
²SWEET Institute, New York, NY
³Columbia University Center for Psychoanalytic Study and Research, New York, NY
⁴Columbia University, Department of Social Work, New York, NY
⁵New York University, Department of Social Work, New York, NY

Correspondence concerning this article should be addressed to Mardoche Sidor, MD, Urban Pathways, at msidor@urbanpathways.org

Abstract

Recovery in mental health and supportive housing is often framed as symptom reduction or service utilization. Yet recovery is fundamentally relational, rooted in trust, safety, and empowerment. This article explores how the Four-Stage Engagement Model—Sitting, Listening, Empathizing, Collaborating—provides relational pathways to healing and growth. Drawing on recovery-oriented care, trauma-informed practice, and positive psychology, we examine how engagement fosters meaning, hope, and agency. Composite case examples from Urban Pathways illustrate how relational engagement has the potential to support resident resilience, reduce hospitalizations, and promote long-term stability.

Keywords

Engagement, Recovery, Healing, Growth, Resilience, Trauma-Informed Care, Recovery-Oriented Practice, Supportive Housing

Introduction

Recovery is increasingly recognized as more than clinical improvement; it is about living a meaningful life despite adversity (Anthony, 1993). Research highlights the importance of hope, empowerment, and relationships in the recovery process (Davidson et al., 2006). Yet many systems still emphasize compliance and risk management over relational healing. The Four-Stage Engagement Model re-centers recovery on relationships, ensuring that every staff interaction fosters healing, safety, and growth.

Theoretical Framework

Engagement and recovery are linked through:

1. Recovery-Oriented Care: Emphasizes personhood, meaning, and community participation (Anthony, 1993).
2. Trauma-Informed Practice: Recognizes recovery as relational repair and empowerment (SAMHSA, 2014).
3. Positive Psychology: Growth is fueled by strengths, meaning, and relationships (Seligman, 2011).
4. Common Factors Theory: Alliance and empathy are central predictors of positive outcomes (Wampold & Imel, 2015).

Application/Analysis

At Urban Pathways, recovery is being facilitated through engagement by:

• Sitting: Staff are learning to use presence to reduce isolation and model relational safety.
• Listening: Staff are learning to attune to resident goals to reinforce agency and meaning.
• Empathizing: Staff are learning to use Corrective emotional experiences to help heal relational wounds and support resilience.
• Collaborating: Staff are learning to co-create goals to foster empowerment, community integration, and long-term stability.

Composite Case Example: A resident with repeated psychiatric hospitalizations redefined recovery not as “medication compliance” but as reconnecting with family and pursuing creative interests. Through empathic engagement and collaborative planning, staff is supporting these goals; and this in turn, is expected to lead to reduced hospitalizations and increased well-being.

Implications

• Practice: Recovery is to be measured by meaning, hope, and empowerment, not only compliance.
• Supervision: Supervisors are to emphasize recovery-oriented engagement in case reviews.
• Policy: Funders need to support recovery-based outcomes such as resident-reported hope and empowerment.
• Research: Studies need to examine how engagement predicts recovery outcomes over time.
• Systems: Embedding engagement into all levels of care ensures recovery-oriented transformation.

Conclusion

Recovery is not a destination but a relational journey. The Four-Stage Engagement Model provides pathways for healing and growth by centering presence, empathy, and collaboration. In doing so, it transforms supportive housing and mental health systems into environments where recovery is not just possible, but expected.

References

• Anthony, William A. “Recovery from Mental Illness: The Guiding Vision of the Mental Health Service System in the 1990s.” Psychosocial Rehabilitation Journal, vol. 16, no. 4, 1993, pp. 11–23.
• Davidson, Larry, et al. “Creating a Recovery-Oriented System of Behavioral Health Care: Moving from Concept to Reality.” Psychiatric Rehabilitation Journal, vol. 29, no. 4, 2006, pp. 315–321.
• Substance Abuse and Mental Health Services Administration. SAMHSA’s Concept of Trauma and Guidance for a Trauma-Informed Approach. U.S. Department of Health and Human Services, 2014.
• Seligman, Martin E. P. Flourish: A Visionary New Understanding of Happiness and Well-Being. Free Press, 2011.
• Wampold, Bruce E., and Zac E. Imel. The Great Psychotherapy Debate: The Evidence for What Makes Psychotherapy Work. 2nd ed., Routledge, 2015.

This article is part of a collaboration between SWEET Institute and Urban Pathways.

Read the full scientific version HERE