Friendship House - Association of American Indians

Native-Led Recovery Grounded in Culture and Community

Friendship House offers residential substance use treatment in San Francisco through a program shaped by Native leadership and community connection. Its focus is on American Indian and Alaska Native healing traditions, with services that reflect culture, spirituality, and shared identity as part of recovery. Rather than separating treatment from culture, Friendship House presents recovery as something supported by ceremony, belonging, and connection alongside clinical care.

Residential Care for Substance Use, Trauma, and Co-Occurring Needs

This facility provides 24-hour residential treatment for adults with substance use disorders, including support for people with co-occurring mental health conditions. Services include individual, group, family, and couples counseling, as well as cognitive behavioral therapy (CBT), motivational interviewing, trauma-related counseling, relapse prevention, anger management, and 12-step facilitation. Friendship House also accepts clients who are using medications for addiction treatment (MAT) prescribed elsewhere. That may be important for people who need a residential setting but do not want to interrupt ongoing medication support. The program also offers mental health services, suicide prevention services, integrated primary care, and health education, creating a broader layer of support for people with complex recovery needs.

Support That Extends Beyond the Residential Stay

In addition to aftercare and discharge planning, the facility provides housing services, transportation assistance, case management, peer support, mentoring, recovery coaching, employment counseling or training, and help obtaining social services. These services can make a real difference for people whose recovery is tied not just to counseling, but also to stable housing, access to appointments, income, and a stronger support network after discharge.

Programs for Women, Veterans, and People Facing Complex Challenges

The facility offers tailored programming for young adults, adult women, adult men, veterans, people with co-occurring disorders, people living with HIV or AIDS, and people who have experienced trauma, sexual abuse, or intimate partner violence. It also provides domestic violence services and support for clients involved with the criminal justice system. Friendship House also offers services in American Indian or Alaska Native languages.

Client Reviews

Reviews point to meaningful long-term recovery outcomes and a strong sense of cultural connection for many clients. Some clients describe uneven communication or limited resources.

• Treatment Quality & Outcomes (70% positive): Many reviewers say the program helped them build sobriety, with some describing lasting progress and a clearer path forward. Some others question whether the approach feels consistent or well-resourced for everyone. "It worked!"
• Support & Community: Several reviews describe Friendship House as especially meaningful for Native clients, with emphasis on culture, belonging, and encouragement during recovery. Family members also describe loved ones leaving with more hope and stability. "Their program is vital for Native People and their recovery."
• Staff & Care Experience: Positive reviews highlight empathy, relationship-building, and staff who made clients feel supported. Some clients describe issues with individual staff members.