There is no single route to recovery. Each of us has to negotiate a complex set of circumstances, and there is a wide range of both internal and external factors to be taken into account in every situation. Equally, we need a certain set of pieces to fall into place to progress in recovery. However, some of these pieces may matter more than others.
One thing many people focus on primarily when starting recovery or considering the recovery of others is motivation. The drive and desire to recover from a mental health condition, such as depression, substance use disorder, or an eating disorder, seems like it should be the only thing that matters. Without motivation, how can recovery last?
However, there is another piece of the recovery puzzle that may actually matter more than motivation. After all, many motivated people still struggle in recovery. Why? The answer could be a lack of feeling safe.
Pieces of the Recovery Puzzle
According to research, certain essential elements contribute to recovery processes [1,2]. This is true for mental health conditions as well as for substance use disorders. One way of thinking of these elements is like pieces of a completed recovery puzzle. Only when all of them are in place can recovery be considered successful in the long term. If a few pieces are missing, the puzzle isn’t going to be complete.
Psychology research has identified some of these pieces as follows:
Motivation
Motivation broadly refers to an individual’s drive to enter and maintain recovery. This encompasses self-awareness (having enough understanding to recognize that there is a problem) and drive (a willingness to address the problem). For many, the strength of motivation is a key element in starting recovery, and in most cases, a person has to be the driver of their own recovery.
Hope
Another essential element of recovery is hope. This is related to motivation, but not the same thing. Motivation is the drive to action recovery, and hope is the feeling that recovery is possible. Hope aligns with spiritual elements of recovery in that it anchors recovery in something larger than oneself. This can carry people through even the darkest, most painful, and most challenging moments of their recovery journey. Hope can also help a person come back to recovery, even if they feel they have failed previously.
Resilience
Resilience is widely regarded as one of the most important tools for good mental health. Being able to keep going after a failure, or to maintain a sense of self-worth and positivity in the face of defeat or even harm, is one of the best predictors for well-being. In this capacity, it is a crucial piece of the recovery puzzle. Those who are resilient have a clear and non-stigmatizing sense of self. In other words, their idea of who they are is not determined by what happens to them.
Empowerment
Related to resilience is empowerment, but unlike resilience, which is predominantly an internal feature of the self, empowerment more often comes from environmental factors, which make a person feel like they have the power to decide for themselves what happens. Very often, empowerment is intertwined with social position, which unfortunately means that those who are marginalized in society as a result of their gender, race, or socioeconomic situation are less likely to have a feeling of empowerment.
Support
One of the most important pieces of the recovery puzzle is support. Studies show that those with a wide network of support behind their recovery have better experiences. Friends and family are a critical part of the recovery process, as they can provide emotional and practical support. Professional support is also important, and some research has suggested that therapeutic support, in particular, is a key feature of individual recovery stories in which the person in recovery has a positive experience.
Safety
One final piece of the recovery puzzle, which is often overlooked, is the overall environmental factor of safety. Recovery can only work for a person who feels secure and safe. This has to do with the strength of support from friends, family, and professionals, but it also includes living situation, job stability, income, and physical health. Someone who does not have these things in place is, perhaps naturally, going to find it difficult to undertake an emotional, challenging, and often time-consuming recovery journey.
Why Safety Might Matter Most
Much of the psychology research has focused on motivation, positioning it as a, or possibly the, key factor in recovery. [3] Particularly in substance use disorder treatment, motivation is viewed as the most important piece of the recovery puzzle. [4] But this might be a misunderstanding of the situation and one with consequences for the success of many recovery methods. While motivation is important, even the most motivated individual is going to struggle to engage with recovery over time if they do not have a secure place to live or access to basic safety.
In 2024, nearly 800,000 individuals were recorded as homeless in the United States. This number only accounts for those who are officially homeless, that is, without any living situation, and does not count individuals who live in overcrowded or insecure housing situations, experience housing insecurity, or live in government-subsidized housing. A further 35.9 million people were living in poverty in the United States in 2024, meaning they were not making enough income to support themselves. [5] Homelessness and poverty are two very obvious and straightforward ways in which a person’s life may lack safety. However, there are other, more abstract and complex factors that hinder safety as part of the recovery puzzle.
Many people in the United States live in insecure family situations, with abusive or controlling partners, parents, or other family members. For these individuals, being at home is not a strong source of support but can, in fact, be a problem. Women in particular often find their safety compromised by a violent or controlling male family member or partner. Others find themselves in social groups or subcultures where risk-taking behaviors like substance abuse are the norm, making it difficult to return to the support of a friend group while in recovery without putting oneself at risk.
In this way, safety is potentially the corner piece of the recovery puzzle. Without it as a starting point, the rest of the picture can never be formed. Perhaps we, as practitioners of treatment for mental health conditions, need to start treating it as such.
[1] Jaiswal, A., Carmichael, K., Gupta, S., Siemens, T., Crowley, P., Carlsson, A., Unsworth, G., Landry, T., & Brown, N. (2020). Essential Elements That Contribute to the Recovery of Persons With Severe Mental Illness: A Systematic Scoping Study. Frontiers in psychiatry, 11, 586230. https://doi.org/10.3389/fpsyt.2020.586230
[2] Laudet, A. B., Savage, R., & Mahmood, D. (2002). Pathways to long-term recovery: a preliminary investigation. Journal of psychoactive drugs, 34(3), 305–311. https://doi.org/10.1080/02791072.2002.10399968
[3] DiClemente, C. C., Bellino, L. E., & Neavins, T. M. (1999). Motivation for change and alcoholism treatment. Alcohol research & health : the journal of the National Institute on Alcohol Abuse and Alcoholism, 23(2), 86–92.
[4] SAMSHA. Enhancing Motivation for Change in Substance Use Disorder Treatment: Updated 2019. Treatment Improvement Protocol (TIP) Series, No. 35. [5] Shrider, E. and Bijou, C. (2025) Poverty in the United States: 2024. P60-287. https://www.census.gov/library/publications/2025/demo/p60-287.html
