Hitting the wrong nail on the head: Comment to Peele

The Addicted-Self Model: An Explanation of “Natural” Recovery?

This investigation examines whether the Addicted-Self Model of cessation of alcohol and drug dependent behavior (Fiorentine & Hillhouse, 2000b; in press) is able to predict unassisted or “natural” recovery. Four hypotheses are tested using a prospective investigation of individuals who drop out in the First week of outpatient treatment, do not re-enter any type of treatment or aftercare, and attend no Twelve-step meetings during the study period (n =78). Consistent with the assumptions of the model, acknowledgement of loss of control over alcohol and drug use, or low controlled use self-efficacy, predicts greater acceptance of the need for life-long abstinence. A decrease in controlled use self-efficacy is associated with an increase in abstinence acceptance. High and increasing abstinence acceptance predicts higher levels of alcohol and drug abstinence. Consistent with the Addicted-Self Model, but contrary to the Relapse Prevention Approach (Marlatt & Gordon, 1980,1985), high controlled use self-efficacy does not predict less severe relapse or lower levels of alcohol and drug use for those who continue to use these substances. Clinical implications and directions for future research are discussed.