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Friendship House


Friendship HouseFriendship House Review

Friendship House of San Francisco, CA is a rehab known for offering treatment designed for Native Americans. The facility is located in the Mission District and what it may lack in luxurious amenities, it makes up for with rich cultural traditions. While Friendship House specializes in Native American recovery, it also provides addiction treatment for all other ethnicities as well. The facility is owned and run by American Indians, though it relies mostly on government funding which allows for a sliding fee scale.

Friendship House, which began as a community drop-in center specializing in dealing with culture shock, discrimination, crime, alcohol problems and poverty, opened in 1963 to help American Indians adjust to city life after the Indian Relocation Act in 1956. Today it focuses mainly on mental health and treating alcohol and drug addiction in a residential setting. It’s also expanded over the years and now has a facility in Oakland for pregnant women and young mothers suffering from alcohol or substance addiction.

Accommodations and Food

Friendship House is located in a 22,400 square foot, four-story building that can hold 80 residents. While the facility is more reminiscent of a hospital than an average house, it still showcases beautiful Native American murals and artwork all throughout which help offset the somewhat sterile appearance.

All rooms are limited to the essentials—in each, clients will find a set of bunk beds, a dresser and carpeted floors. Due to their lack of space and storage, Friendship House urges residents to bring no more than one to two weeks of clothing and other necessities. All rooms also have Native American art accenting the walls, and a bonus is that many have windows allowing for natural light.

Friendship House serves three meals a day with menus planned monthly. Lunch and dinner options may include such options as a tuna sandwiches, lasagna, chicken potpie, beef stew or Indian tacos. Accommodations can be made for allergies.

Amenities include a white-walled common area with a small table and a payphone, group therapy rooms, counseling rooms, a sweat lodge and a yard outside for recreation.

Treatment and Staff

Residential treatment can last up to six months at Friendship House, but the average stay is about four. Friendship House doesn’t provide detox (it requires clients to be clean for 72 hours before admission), so residents will begin a thorough treatment program as soon as they complete their initial assessment. Overall, the program emphasizes a combination of the 12 steps with daily AA/NA meetings, “Red Road” treatment (a therapy based on the integration of Native American and Western cultural ideals), Native American ritual and individual and group counseling.

A typical day generally starts with residents waking at 6 am and doing morning chores, such as helping out in the kitchen with breakfast or cleaning, followed by breakfast. Next is a morning group at  am to look at the schedule for the day and air any concerns, then clinically assigned group sessions until 11:30 am followed lunch. Afterwards there is outside recreation time where staff will take residents to nearby parks, more group sessions until 4 pm, dinner at 5 and usually an AA meeting (required of all residents). Clients who have completed their first 30 days may leave the facility on their own in the evenings, as long as they’ve cleared it with a counselor; the rest will have to simply relax in the evenings. Individual therapy occurs at least once a week and may include CBT, Motivational Interviewing (MI), contingency management and relapse prevention therapy. Lights out is at 10 pm.

Friendship House also offers both on- and off-site AA meetings (after the 30-day blackout) family and marriage counseling, HIV/AIDS counseling, health education, nutritional classes, general alcohol and drug education, employment and life skills training, a childcare program and the opportunity for residents to work towards their GED through the Five Keys Charter School. More unique to this facility is the frequent integration of Native American ritual such as drumming circles, sweats, prayer, singing, smudgings (burning ceremonial herbs and breathing them in for their healing potential) and meetings with Native American Spiritual Advisors or Medicine Men.

The majority of staff and clinical providers at Friendship House are American Indian, which helps reinforce the culture. Altogether there are six licensed counselors, one therapist, one clinical director, four case managers, a handful of phase two transitional resource staff and 24/7 security. Medical referrals are available if necessary, but Friendship House does not have an RN or physician on-site. The staff to resident ratio is about one to six.

Initially, residents cannot write or receive letters, receive phone calls, have visitors or leave the facility unaccompanied for 30 days. After this initial period, they’re free to use the pay phone to call loved ones during off hours and may even leave the facility to visit family if they are local. Visitors are also allowed after 30 days on weekends. Residents are not allowed to bring valuables of any kind other than a small amount of cash for incidental items.


Friendship House provides extensive aftercare support for residents, including an optional second phase of the program for those seeking employment and housing. This phase offers outpatient individual and group counseling, housing referrals, case management and job readiness training.

After completing any of the program tracks, residents are invited to take part in the alumni support program which maintains the rehab’s family vibe. Alumni frequently host events such as the American Indian Market and Powwow, Community Thanksgiving Dinner, Community Christmas Dinner and a Youth Powwow.

In Summary

Friendship House is ideal for Native Americans or those drawn to the culture. It might not be a good a fit for someone needing help as soon as possible, since prospective residents must first interview (in person or over the phone) and then wait for a spot to open up, which takes about two weeks on average and requires calling in weekly to maintain eligible. Still, this is a specialized offering with basic services that some will find highly appealing.

Friendship House Location

56 Julian Ave
San Francisco, CA 94103

Friendship House Cost

Friendship House Cost: Sliding scale. Reach Friendship House by phone at (415) 865-0964. Find Friendship House on Facebook and YouTube

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