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Browsing by Subject "addiction recovery"

Now showing 1 - 7 of 7
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    Can Measurement of Recovery Be Supportive of Recovery?
    (2022-04-08) Horgos, Bonnie M; Lowery, Channel L; Krentzman, Amy R
    Recently, the field has shifted to define addiction recovery not by abstinence but by improvement in well-being. However, there is little research on the impact of measuring well-being. This poster presents a thematic analysis of control-group interviews derived from a randomized controlled trial of Positive Peer Journaling (PPJ), an intervention designed to increase well-being and reduce relapse in early recovery. The control group (n = 39, 52% female, average 39 years old, 63% with income <$15,000, 26% BIPOC, 43% with a legal issue, and 95% with history of trauma) completed daily questionnaires over 1 month. These questionnaires included the Positive and Negative Affect Schedule (PANAS), the Satisfaction with Life Scale, and the Commitment to Sobriety Scale, as well as single-item questions, such as: “In the last 24 hours I did something to help another person in recovery.” Qualitative thematic analyses showed that the survey alone created improvement in cognition, affect, and behavior; for example, the questionnaires encouraged participants to reflect on the past 24 hours, experience a deeper sense of gratitude, and reach out to others in recovery. The discovery that survey questions might support well-being during recovery is of critical importance. If recovery-oriented survey questions foster improvement in cognition, affect and behavior, they can be leveraged as an easily scalable intervention that can support recovery efforts.
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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.
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    How Are Recovery-Supportive Cognitions and Behaviors Associated with Positive and Negative Affect?
    (2022-04-08) Krentzman, Amy R; Horgos, Bonnie M
    Negative affect is strongly associated with relapse. Few interventions are designed to improve mood during recovery and little is known about the effect on mood of incremental, recovery-supportive cognitions and behaviors (IRSCB), such as wishing others well or writing a gratitude list. In this study, 81 individuals in addiction treatment (52% female, average 39 years old, 26% BIPOC, average 13 years of education) completed surveys for 30 days assessing 16 different past-day IRSCBs and current-moment mood assessed via the Positive and Negative Affect Schedule. Multi-level models showed significant main effects of 15 IRSCBs on increased positive affect and significant main effects of 14 IRSCBs on decreased negative affect. The IRSCBs that had the strongest effect were “I did something enjoyable,” “I felt able to get things done,” “I realized that more good things than bad things were happening,” and “I realized that there is a lot I am grateful or thankful for.” These IRSCBs were associated with both a 2-3 point increase in positive affect and a 1-2 point decrease in negative affect. These results suggest that providers should reinforce pleasant activities and gratitude practices and help clients meet short-term goals. This study shows that IRSCBs have significant association with improved mood, which could protect against relapse.
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    Journaling to Support Recovery from Alcohol and Other Substance Use Disorders: Feasibility Results from a Randomized Controlled Pilot
    (2023-06) Krentzman, Amy; Hoeppner, Susanne; Hoeppner, Bettina; Barnett, Nancy
    Purpose: Positive psychology, behavioral activation, and journaling have been shown to improve affect and decrease addictive behavior among individuals with SUD and AUD. We combined aspects of these approaches in “Positive Recovery Journaling” (PRJ), a daily writing practice, to improve wellbeing in early recovery. In this pilot randomized controlled trial, we sought to determine the feasibility and acceptability of PRJ in a study conducted remotely during COVID 19. Methods: Participants (N = 81; M = 39 years old, 46% indicating alcohol as primary addiction) were recruited from three treatment centers in the Upper Midwest. Individuals randomized to PRJ learned the technique over 8 group sessions and practiced it daily for 4 weeks followed immediately by completion of daily assessment instruments. The control group only completed daily assessment instruments. Feasibility and acceptability were assessed by recruitment, retention, rates of journal upload, and group attendance. We used multilevel models to compare the treatment and control groups’ average ratings of study activities as difficult, easy, satisfying, pleasant, and helpful. Results: Of patients who met inclusion criteria (N = 86), 81 (94.2%) agreed to participate. Attendance at group sessions ranged from zero to eight (M = 5.3, SD = 2.8); three (7.1%) attended zero groups and 15 (35.7%) attended all eight groups. The 42 treatment group members submitted 584 journal entries (ranging from 0 to a maximum of 28, M = 13.9, SD = 9.7). Survey completion rates at the 1-month follow-up were 53.4% for the treatment group and 71.8% of the control group (X2 p = .072). Participants rated study activities as equally easy and not difficult. The treatment group rated PRJ as significantly more satisfying, pleasant, and helpful (all at p < .001), showing high acceptability of PRJ especially since the control group reported benefitting from the daily surveys. Conclusions: This population showed a strong interest in journaling. Despite the challenges of conducting a study remotely during COVID 19, it was still possible to recruit and retain a treatment sample who attended the majority of group sessions and rated PRJ as no more difficult, and yet more satisfying, pleasant, and helpful, than the control group’s activities.
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    Pilot Test of a Communication-Skills Intervention among Individuals in Recovery from Severe Substance-Use Disorders
    (2017-06) Krentzman, Amy R; Westlund, Janet; Tinetti, Tonia
    Purpose: Communication skills should help individuals in recovery to enhance interpersonal relationships. Positive relationships can improve quality of life and reduce relapse risk. This pilot study tested a novel intervention which taught person-centered communication skills to individuals with severe addiction histories in recovery. We investigated 1. Whether person-centered skills could be learned, 2. Whether such skills would be associated with a “standardized friend” (SF)’s communication satisfaction, and 3. Whether the skills would impact broader personal relationships. Method: 19 males (M = 44 years old) with histories of severe substance use disorder (M=39 AUDIT score, M=9 previous treatment episodes), low income (42% earned less than $5k last year), in recovery (M = 111 days sober), and residing in a residential recovery program were randomized to receive either a 10-hour communication-skills class (n=9) or a wait-list control condition (n=10). The communication class covered skills from Motivational Interviewing, social work interviewing, and positive psychology and was grounded in person-centered humanistic philosophy and 12-step community wisdom. All participants were video-recorded having a conversation with a SF pre-post intervention to demonstrate communication skills. Videos were coded using a modification of the Motivational Interviewing Treatment Integrity Coding Manual to count person-centered behaviors including reflections and open-ended questions. After each conversation, the SF rated his satisfaction with the conversation using the Interpersonal Communication Satisfaction Inventory. Post-intervention interviews with participants assessed the impact of the skills on broader personal relationships. Results: The average increase in person-centered utterances as a percentage of total utterances pre-post intervention was significantly higher for individuals in the communication-skills class compared to the control group, 32% versus 2%, (t(15)=2.2, p=<.05). The average increase in the SF’s communication satisfaction pre-post intervention was higher for individuals in the communication-skills class, 22 versus 3 points, (t(15)=1.9, p<.10). Qualitative data suggested that the skills had a positive impact on family and 12-step relationships. Conclusions: Individuals with a history of severe substance use disorder were able to learn person-centered skills in this pilot study, as demonstrated by video-recorded data, perceptions from a SF, and positive exchanges in the social environment. These results suggest that the skills can help enhance positive interpersonal relationships in recovery.
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    Research Participants Describe Recovery-Oriented Surveys as Beneficial to Recovery from Alcohol and Substance Use Disorders
    (2023-06) Krentzman, Amy; Gass, Julie; Lowery, Channel
    Purpose: Although the self-monitoring of substance and alcohol use consumption is included in many treatment protocols, research has been mixed regarding its efficacy for promoting behavior change. Most self-monitoring studies have tracked pathology-oriented constructs. The self-monitoring of recovery-oriented factors (e.g., writing a gratitude list, reaching out to others, happiness with recovery) is rarely investigated but could yield valuable insights for the development of new tools to support ongoing recovery. Methods: Participants (N = 32; M = 40 years old, 47% indicating alcohol as primary addiction) were control-group members in a randomized trial while enrolled in AUD and SUD treatment. They completed surveys daily for 30 days. Surveys included the Positive and Negative Affect Schedule (PANAS); the Satisfaction with Life Scale; and single items assessing abstinence self-efficacy, urges, happiness with recovery, quality of life, commitment to sobriety, and whether participants had engaged in a set of recovery practices that day. Surveys were intended only as measurement but participants described the surveys in exit interviews as supportive of their recovery. This mixed-methods study was designed to answer these questions: Did participants obtain benefit from the surveys, and if so, to what degree? Which instruments, specifically, were most frequently mentioned as impactful? We operationalized categories of benefit (e.g., none, low, moderate, high) inductively based on qualitative interviews and tallied the percentage of participants who mentioned each instrument in the exit interviews. Results: Participants described high (n = 24, 75%), moderate (n = 3, 9%), low (n = 4, 13%), and no (n = 1, 3%) benefit from completing surveys. The top three most frequently referenced questionnaires were the PANAS (mentioned by 84% of the sample), the queries of recovery practices (69%), and items assessing urges (50%). Conclusions: Most control group members described daily recovery-oriented surveys as beneficial. The surveys functioned as a self-monitoring mechanism. These results indicate that recovery-oriented self-monitoring has potential as an intervention and can cause measurement reactivity. Developers of recovery mobile apps should include assessments of affect, recovery activities, and urges, as these queries were most frequently mentioned as impactful by our sample.