Getting to know Mark, a homeless alcohol-dependent artist, as he finds his way out of the river

Managed Alcohol Programs (MAPs) are a relatively recent addition to the repertoire of harm reduction approaches for persons experiencing severe alcohol dependence. In these settings, clients, who are typically homeless, are provided with a maintenance amount of alcohol while residing in a shelter setting. This case study examines the living experience of a homeless alcohol-dependent client of a MAP in an effort to articulate the process factors related to engagement with this form of treatment. The participant, a 48-year-old white male, participated in a series of qualitative interviews that took place prior to admission, immediately following admission, following re-admission, and after completion of the program over the course of 18 months. A grounded theory approach to data analysis was undertaken. The findings suggest that the primary utility of the MAP was in stabilizing a range of problems such that he was provided with the time, energy, and resources necessary to engage in the critically important task of constructing valued identity, place, and meaning and purpose in life.