Pilot Test of a Communication-Skills Intervention among Individuals in Recovery from Severe Substance-Use Disorders

Abstract

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.