Browsing by Author "Krentzman, Amy R."

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    Experiences of Recovery from Alcohol and Substance Use Disorders and Access to Recovery-Oriented Systems of Care in Rural and Small-Town Minnesota
    (2019) Krentzman, Amy R.; Tillman, Nicole; Staab, Lanae; Banerjee, Rekha
    Methods: In-depth, semi-structured interviews were conducted with 34 long-time (average 30-year) residents of the region. 56% were in recovery from AUD/SUD, 15% were treatment providers, 29% were both. We explored their perspectives of, and experiences with, small-town and rural ROSC. Data: The data were comprised of 34 hour-long, audio-recorded interviews which were transcribed verbatim and coded using thematic analysis, a qualitative data analytic technique. Participants were 56% female, 51 (SD=15) years of age with 14 (SD=3) years of education. 88% were white. Roughly one third were never married (35%), married (27%), and divorced (29%). Length of abstinence for those in recovery ranged from 11 days to 36 years. Providers had 17 (SD=11) years practice experience. Results: Participants described a range of challenges to recovery in rural communities: long distances to travel; scant 12-step meetings; lack of gender, ethnic, and age diversity in recovery communities; difficulty avoiding friends who still drink/use drugs; and social stigma derived from normative small-town gossip. Participants also described strategies for success. They accessed ROSCs such as 12-step meetings, recovery community organizations, recovery churches, and Celebrate Recovery. They carpooled with others to attend recovery-oriented celebrations, joined recovery social groups such as motorcycle clubs, and traveled to distant towns to support fledgling meetings. Some small towns served as “recovery hubs” featuring numerous 12-step meetings, established treatment centers, and sober living homes, while other communities offered less. A local recovery community organization provided recovery celebration events and telephone outreach, which were seen as valuable and sustaining. A number of local churches established “recovery ministries” with special programming and outreach to individuals in recovery, which were also deemed valuable. Surprisingly, online recovery communities were not accessed to fill the gap in service. Conclusions: Features of small-town and rural-community life such as population dispersion, ethnic and age homogeneity, and limited recreational options presented obstacles to recovery, but individuals readily employed strategies to access what is available locally and at a distance, and worked to expand and diversify ROSC in the region.
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    Gratitude and Positive Activity Planning to Support Recovery from Alcohol and Substance Use Disorders
    (2018-06) Krentzman, Amy R.; Goodenough, Karen E.; Banerjee, Rekha; Daughters, Stacey B.
    Purpose: Enhancing quality of life during early abstinence is a compelling strategy for reducing relapse. Gratitude practices have been shown to improve affect, and activity scheduling has been shown to promote enjoyment of daily activities. A simple practice for gratitude and activity scheduling is needed to encourage its regular enactment throughout recovery. We developed a ten-minute-a-day journaling practice to encourage gratitude, goal setting, and positive-activity planning to improve quality of life in recovery and reduce relapse. Methods: In-depth semi-structured interviews were conducted with 33 individuals (57% in recovery from AUD/SUD, 14% treatment providers, 29% both) to ascertain their perspectives of the journaling practice. The journaling practice was presented to and briefly practiced by participants, who were then probed for subjective, qualitative impressions of it. The journaling practice uses standard journals printed with column headings under which individuals make bullet-pointed lists. On the left-hand page, the past 24 hours is recalled via column headings to promote gratitude: “good things that happened” and “things I am grateful for.” On the right-hand page, activities for the upcoming 24 hours are planned via headings representing valued life domains, i.e., work, social, health, joy, household, recovery, spirituality. Interviews were audio recorded, transcribed, analyzed for themes, and interpreted for relationships among themes. Results: Participants were 57% female, mean age 50 years, length of abstinence 11 days to 36 years. Participants found the practice acceptable and easy as well as useful to recovery. Participants stated the practice would enable them to express gratitude, plan activities, and set goals; and also to notice change over time, guide self-discovery, identify issues to work on, gain emotional relief, and acknowledge successes. Negative impressions included that for some, setting multiple daily goals might feel overwhelming, failure to follow through on planned activity might produce negative emotion, and weaker writing skills might cause embarrassment. Conclusions: For many, the journal would function as a mirror, providing perspective on past, present, and future self. Sharing the journal with another person would allow the authentic self to be known. Future work will examine the efficacy of integrating gratitude journaling into existing standardized behavioral activation therapy for substance use, namely LETS ACT.