1
|
Majer JM, Jason LA, Bobak TJ. Understanding recovery Capital in relation to categorical 12-Step involvement and abstinence social support. ADDICTION RESEARCH & THEORY 2022; 30:207-212. [PMID: 36275074 PMCID: PMC9585994 DOI: 10.1080/16066359.2021.1999935] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 10/24/2021] [Accepted: 10/26/2021] [Indexed: 05/28/2023]
Abstract
Background Although recovery capital represents various resources for persons recovering from substance use disorders, measures of this construct examine components that might not necessarily reflect the recovery goals of individuals who base their recovery through involvement in 12-step groups such as Alcoholics Anonymous (AA) and Narcotics Anonymous (NA). It is not clear whether 12-step involvement is related to recovery capital, particularly among individuals living in recovery homes who utilize social networks of recovering peers for their recovery. Thus, categorical involvement in a set of 12-step activities was examined in relation to recovery capital and abstinence social support. Methods Differences in terms of general (recovery capital scores, retention rates) and abstinence-specific (abstinence social support) resources were examined in relation to recovery home residents who were (n = 395) and were not (n = 232) categorically involved in their 12-step recovery. Results Residents with categorical 12-step involvement reported significantly higher levels of recovery capital and abstinence social support, and there was no significant difference observed in retention rates between residents who were/were not categorically involved in 12-step groups. Conclusions Findings suggest community resources such as recovery homes and categorical involvement in 12-step groups are important recovery capital components that help individuals who use a 12-step approach to their recovery. Recovery capital among those involved with 12-step fellowships such as AA and NA should be assessed by examining abstinence-specific components such as representative involvement in 12-step groups and social support that is abstinence-specific.
Collapse
Affiliation(s)
- John M. Majer
- Social and Behavioral Sciences Department, Harry S. Truman College, Chicago, IL, USA
| | - Leonard A. Jason
- Center for Community Research, DePaul University, Chicago, IL, USA
| | - Ted J. Bobak
- Center for Community Research, DePaul University, Chicago, IL, USA
| |
Collapse
|
2
|
Kohen CB, Conlin WE. Ethical Considerations for Psychotherapists Participating in Alcoholics Anonymous. PRACTICE INNOVATIONS (WASHINGTON, D.C.) 2022; 7:40-52. [PMID: 35300049 PMCID: PMC8923620 DOI: 10.1037/pri0000168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
As the demands of professional psychology can be taxing, psychotherapists are not immune to the development of mental health and substance use disorders. One estimate indicates that roughly 30-40% of psychologists know of a colleague with a current substance abuse problem (Good et al., 1995). 12-step mutual self-help groups, particularly Alcoholics Anonymous (AA), are the most widely used form of treatment for addiction in the United States. AA has empirically demonstrated effectiveness at fostering long-term treatment success, and is widely accessible throughout the world. However, psychotherapist participation in AA raises a number of ethical concerns, particularly regarding the potential for extra-therapy contact with clients and the development of multiple relationships. This article attempts to review the precarious ethical and practical situations that psychotherapists, either in long-term recovery or newly sober, may find themselves in during AA involvement. Moreover, this article provides suggestions for psychotherapists in AA regarding how to best adhere to both the principles of AA (i.e., the 12-steps and 12-traditions) and the American Psychological Association's Ethical Principles of Psychologists and Code of Conduct.
Collapse
Affiliation(s)
- Casey B Kohen
- Department of Psychological Sciences, University of Missouri
| | | |
Collapse
|
3
|
Majer JM, Jason LA, Norris J, Hickey P, Jeong H, Bobak TJ. Medications for Opioid Use Disorder Utilization Among Oxford House Residents. Community Ment Health J 2020; 56:925-932. [PMID: 31993842 DOI: 10.1007/s10597-020-00558-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Accepted: 01/24/2020] [Indexed: 02/02/2023]
Abstract
Medications for opioid use disorder (MOUD) and recovery homes that have traditionally served those not taking medications for their recovery are important resources for treating opioid use disorder. However, little is known whether such recovery homes are a good fit for persons utilizing MOUD, and whether residents' characteristics such as drug histories and the composition of recovery homes in terms MOUD and non-MOUD residents are related to attitudes toward MOUD. The present investigation examined characteristics of persons utilizing MOUD, and attitudes regarding MOUD utilization among residents living in recovery homes (Oxford Houses, OH) in the U.S. consisting of MOUD and non-MOUD residents. Residents living with others who were utilizing MOUD reported more favorable attitudes than residents who were not living with such residents, but this was observed only among residents whose primary drug of choice involved heroin or opioids. There were no significant differences observed in terms of abstinence rates, involvement in 12-step groups, or previous MOUD treatments between residents utilizing or not utilizing MOUD. Findings suggest that persons utilizing MOUD benefit by recovery homes such as OHs whose residents have favorable attitudes toward MOUD, especially when living with fellow residents who utilize MOUD.
Collapse
Affiliation(s)
- John M Majer
- Social Science Department, Harry S. Truman College, 1145 W. Wilson Ave., Chicago, IL, 60640, USA.
| | - Leonard A Jason
- Center for Community Research, DePaul University, 990 W. Fullerton Ave., Chicago, IL, 60614, USA
| | - Joshua Norris
- Center for Community Research, DePaul University, 990 W. Fullerton Ave., Chicago, IL, 60614, USA
| | - Patrick Hickey
- Social Science Department, Harry S. Truman College, 1145 W. Wilson Ave., Chicago, IL, 60640, USA
| | - Hayoung Jeong
- Social Science Department, Harry S. Truman College, 1145 W. Wilson Ave., Chicago, IL, 60640, USA
| | - Ted J Bobak
- Center for Community Research, DePaul University, 990 W. Fullerton Ave., Chicago, IL, 60614, USA
| |
Collapse
|
4
|
Mericle AA, Mahoney E, Korcha R, Delucchi K, Polcin DL. Sober living house characteristics: A multilevel analyses of factors associated with improved outcomes. J Subst Abuse Treat 2019; 98:28-38. [PMID: 30665601 PMCID: PMC6605057 DOI: 10.1016/j.jsat.2018.12.004] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Revised: 09/06/2018] [Accepted: 12/13/2018] [Indexed: 12/14/2022]
Abstract
Safe and stable housing is integral to addiction recovery. Across numerous studies, recovery housing has been found to be associated with improvements in a variety of domains. Although procedures for operating some types of recovery housing have been manualized and national standards established, there are few empirical findings identifying which recovery residence characteristics may lead to improved outcomes. Using data from 330 newly admitted residents recruited from 49 sober living houses in California and re-contacted for 6- and 12-month follow-up interviews, this study examines the effects of organizational, operational, and programming characteristics on substance use, criminal justice, and employment outcomes. Results from multilevel analyses adjusting for resident demographics and length of stay indicate that organizational characteristics were associated with outcomes. Residents recruited from houses that were part of a larger organization or group of houses had increased odds of total abstinence (aOR = 3.98, p < 0.001) and drug abstinence (aOR = 3.19, p < 0.001). Residents recruited from houses that were affiliated with a treatment program had increased odds of employment (aOR = 2.92, p = 0.003). Operational characteristics such as where the house was located and whether the house required incoming residents to be sober for at least 30 days prior to entry were also related to improved outcomes, but additional work is needed to develop tools to assess and measure recovery housing characteristics and to better understand how these factors contribute to improved outcomes.
Collapse
Affiliation(s)
- Amy A Mericle
- Alcohol Research Group at the Public Health Institute, Emeryville, CA 94608, USA.
| | - Elizabeth Mahoney
- Alcohol Research Group at the Public Health Institute, Emeryville, CA 94608, USA
| | - Rachael Korcha
- Alcohol Research Group at the Public Health Institute, Emeryville, CA 94608, USA
| | - Kevin Delucchi
- University of California San Francisco, San Francisco, CA 94143, USA
| | - Douglas L Polcin
- Alcohol Research Group at the Public Health Institute, Emeryville, CA 94608, USA
| |
Collapse
|
5
|
Soccol KLS, Terra MG, Padoin SMDM, Ribeiro DB, Siqueira DFD, Canabarro JL. Motivos do abuso de substâncias psicoativas por mulheres assistidas em Centro de Atenção Psicossocial. Rev Gaucha Enferm 2018; 39:e20170281. [DOI: 10.1590/1983-1447.2018.20170281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2018] [Accepted: 07/02/2018] [Indexed: 09/01/2023] Open
Abstract
Resumo OBJETIVO Compreender os motivos atribuídos por mulheres ao abuso de substâncias psicoativas. MÉTODO Abordagem qualitativa de natureza fenomenológica. Foram entrevistadas 12 mulheres usuárias de substâncias psicoativas em tratamento no Centro de Atenção Psicossocial álcool e drogas, no Sul do Brasil. As entrevistas foram realizadas entre maio e junho de 2013. Os dados foram interpretados à luz da Fenomenologia Social de Alfred Schütz. RESULTADOS O abuso de substâncias psicoativas é motivado pela influência das pessoas com as quais as mulheres mantêm um relacionamento ou com as quais conviveram. Ainda, as perdas e os conflitos familiares vivenciados também foram como um estopim para o abuso de substâncias psicoativas. CONCLUSÃO A assistência à saúde das mulheres necessita atender além das demandas, na medida em que deve levar em consideração a história de vida dessas mulheres.
Collapse
|
6
|
Abstract
There have been few efforts to systematically develop reliable and valid measures of social networks, particularly in studies dealing with individuals having substance use disorders. In the current study, individuals living in recovery homes called Oxford Houses completed a 6-item measure of social networks. The Cronbach's alpha was .85 and a confirmatory factor analysis found excellent fit statistics with all items having substantial (> .70) load factors. In addition, the measure was independent of age, sex, and ethnicity and significantly related to length of stay in the recovery homes and quality of life. The authors have found that this instrument works well as an ego network with adequate psychometric properties and empirical relations to other recovery variables.
Collapse
Affiliation(s)
- Leonard A Jason
- Center for Community Research, DePaul University, Chicago, Illinois, USA
| | - Ed Stevens
- Center for Community Research, DePaul University, Chicago, Illinois, USA
| |
Collapse
|
7
|
Russell R, Ojeda MM, Ames B. Increasing RN Perceived Competency With Substance Use Disorder Patients. J Contin Educ Nurs 2017; 48:175-183. [DOI: 10.3928/00220124-20170321-08] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2016] [Accepted: 10/26/2016] [Indexed: 11/20/2022]
|
8
|
Stone A, Jason LA, Light JM, Stevens EB. The Role of Ego Networks in Studies of Substance Use Disorder Recovery. ALCOHOLISM TREATMENT QUARTERLY 2016; 34:315-328. [PMID: 27594761 DOI: 10.1080/07347324.2016.1182818] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Those who study treatment and recovery from alcohol use disorder (AUD) and substance use disorder (SUD) generally agree that an individual's social context impacts his or her success (or failure) in recovery. Recently, as the use of social network analysis has increased, studies on SUD recovery and treatment have adopted ego networks as a research tool. This review aims to tie together a thread of research for an efficient and effective summary. We selected peer-reviewed articles on individuals receiving treatment an intervention for SUD or AUD that used ego network measures of individual social networks. Ego networks have been studied as treatment outcomes, predictors of treatment outcomes in general, and how an individual's ego network might be used to predict what specific treatment is most likely to succeed. We discuss relevant findings of studies using ego networks, the strengths and weaknesses of ego network approaches, and how future studies may benefit from the use of ego networks.
Collapse
|
9
|
Majer JM, Chapman HM, Jason LA. Abstinence Self-Efficacy and Substance Use at 2 Years: The Moderating Effects of Residential Treatment Conditions. ALCOHOLISM TREATMENT QUARTERLY 2016; 34:386-401. [PMID: 28484303 DOI: 10.1080/07347324.2016.1217708] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
The relationship between abstinence self-efficacy and substance use at 2 years was examined among a sample (N = 470) of persons with substance use disorders and recent incarceration histories. Participants were assigned to residential (therapeutic community/TC or Oxford House) or nonresidential (usual care) conditions. The authors hypothesized abstinence self-efficacy would predict decreased substance use, and residential treatments would moderate this relationship. A conditional effect was observed, with low levels of abstinence self-efficacy predicting significant increases in substance use in the TC and usual care conditions. Supplemental analyses revealed significant decreases in substance use over time among participants in the Oxford House condition, and a significant conditional effect (gender x treatment condition) in relation to substance use. Findings point to the need for researchers to examine factors that mitigate the relationship between abstinence self-efficacy and substance use outcomes, and for treatment providers to consider the Oxford House model for this population.
Collapse
Affiliation(s)
- John M Majer
- Harry S. Truman College, Social Science Department, Chicago, Illinois, USA
| | | | - Leonard A Jason
- Center for Community Research, DePaul University, Chicago, Illinois, USA
| |
Collapse
|
10
|
Majer JM, Glantsman O, Palmer JS, Jason LA. Predictors of Abstinence Self-Efficacy: Examining the role of HIV-risk Sexual Behavior. JOURNAL OF SOCIAL SERVICE RESEARCH 2014; 41:39-48. [PMID: 27226672 PMCID: PMC4876641 DOI: 10.1080/01488376.2014.935559] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Abstinence self-efficacy, or the confidence in ones' beliefs in one's ability to effectively engage in behaviors to maintain substance use abstinence, is a crucial recovery resource. However, little research has been conducted on what predicts increases in this recovery resource. Understanding predictors of abstinence self-efficacy could help social service practitioners in creating effective treatment plans/interventions while extending what is presently known in this small body of research. Predictors of abstinence self-efficacy were analyzed among a sample of ex-offenders (224 men and 46 women) who were completing inpatient treatment for substance use disorders. Hierarchical linear regression was conducted to examine changes in participants' abstinence self-efficacy in relation to factors directly related (HIV-risk drug use behaviors, substance use, 12-step meeting attendance) and indirectly related (HIV-risk sexual behaviors, incarceration histories) to substance use. HIV-risk sexual behaviors and substance use predicted significant decreases in abstinence self-efficacy whereas 12-step meeting attendance predicted significant increases. However, incarceration histories and HIV-risk drug use behaviors were not significant predictors of abstinence self-efficacy. Findings suggest HIV-risk sexual behavior should be considered when assessing relapse prevention for persons with substance use disorders, and that researchers should examine behaviors that are not directly related to substance use when investigating recovery resources.
Collapse
Affiliation(s)
- John M. Majer
- Social Sciences Department, Harry S. Truman College, 1145 W. Wilson Ave., Chicago IL, 60640, USA
| | - Olya Glantsman
- Center for Community Research, DePaul University, 990 W. Fullerton Ave., Chicago, IL 60640 USA
| | - John S. Palmer
- Center for Community Research, DePaul University, 990 W. Fullerton Ave., Chicago, IL 60640 USA
| | - Leonard A. Jason
- Center for Community Research, DePaul University, 990 W. Fullerton Ave., Chicago, IL 60640 USA
| |
Collapse
|
11
|
Jason LA, Light JM, Stevens EB, Beers K. Dynamic social networks in recovery homes. AMERICAN JOURNAL OF COMMUNITY PSYCHOLOGY 2014; 53:324-34. [PMID: 24217855 PMCID: PMC4013246 DOI: 10.1007/s10464-013-9610-6] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
Acute treatment aftercare in the form of sober living environments-i.e., recovery houses-provide an inexpensive and effective medium-term treatment alternative for many with substance use disorders. Limited evidence suggests that house-situated social relationships and associated social support are critical determinants of how successful these residential experiences are for their members, but little is known about the mechanisms underlying these relationships. This study explored the feasibility of using dynamic social network modeling to understand house-situated longitudinal associations among individual Alcoholics Anonymous related recovery behaviors, length of residence, dyadic interpersonal trust, and dyadic confidant relationship formation processes. Trust and confidant relationships were measured 3 months apart in U.S. urban-area recovery houses, all of which were part of a network of substance use recovery homes. A stochastic actor-based model was successfully estimated from this data set. Results suggest that confidant relationships are predicted by trust, while trust is affected by recovery behaviors and length of residence. Conceptualizing recovery houses as a set of independent, evolving social networks that can be modeled jointly appears to be a promising direction for research.
Collapse
Affiliation(s)
- Leonard A Jason
- Center for Community Research, DePaul University, Chicago, IL, 60614, USA,
| | | | | | | |
Collapse
|
12
|
Majer JM, Beers K, Jason LA. An Examination of the First Oxford House in the UK: A Preliminary Investigation. DRUGS-EDUCATION PREVENTION AND POLICY 2014; 21:347-356. [PMID: 25368450 DOI: 10.3109/09687637.2013.876974] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
An exploratory investigation was conducted to examine the implementation of the first self-run, communal-living setting based on the Oxford House model, in the United Kingdom (UK). A cross-sectional, mixed methods design was used to examine the Oxford House model's total abstinence approach to recovery from substance use disorders among residents (n = 7) living in the first Oxford House established in the UK. Several measures commonly used in addiction research and personal narratives were used to assess residents' response to Oxford House living. Findings suggest that the Oxford House model is a post-treatment intervention that meets the needs of individuals seeking an abstinence-based recovery from alcohol and/or drug dependence in the UK.
Collapse
Affiliation(s)
- John M Majer
- Department of Social Sciences, Harry S. Truman College, 1145 W. Wilson Ave., Chicago, IL 60640 USA
| | - Kim Beers
- Center for Community Research, DePaul University, 990 W. Fullerton Ave., Suite 3100, Chicago, IL 60614 USA
| | - Leonard A Jason
- Center for Community Research, DePaul University 990 W. Fullerton Ave., Suite 3100, Chicago, IL 60614 USA
| |
Collapse
|
13
|
Bogenschutz MP, Rice SL, Tonigan JS, Vogel HS, Nowinski J, Hume D, Arenella PB. 12-step facilitation for the dually diagnosed: a randomized clinical trial. J Subst Abuse Treat 2013; 46:403-11. [PMID: 24462479 DOI: 10.1016/j.jsat.2013.12.009] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2013] [Revised: 12/05/2013] [Accepted: 12/09/2013] [Indexed: 10/25/2022]
Abstract
There are few clinical trials of 12-step treatments for individuals with serious mental illness and alcohol or drug dependence. This randomized trial assessed the effects of adding a 12-session 12-step facilitation therapy (TSF), adapted from that used in Project MATCH, to treatment as usual in an outpatient dual diagnosis program. Participants were 121 individuals dually diagnosed with alcohol dependence and a serious mental disorder, followed during 12 weeks of treatment and 36 weeks post-treatment. Participants receiving TSF had greater participation in 12-step programs, but did not demonstrate greater improvement in alcohol and drug use. However, considered dimensionally, greater participation in TSF was associated with greater improvement in substance use, and greater 12-step participation predicted decreases in frequency and intensity of drinking. Findings suggest that future work with TSF in this population should focus on maximizing exposure to TSF, and maximizing the effect of TSF on 12-step participation.
Collapse
Affiliation(s)
- Michael P Bogenschutz
- Department of Psychiatry, University of New Mexico Health Sciences Center, MSC09 5030, 1 University of New Mexico, Albuquerque, NM 87131-0001; The University of New Mexico, Center on Alcoholism, Substance Abuse, and Addictions, 2650 Yale Boulevard, SE, MSC11-6280, Albuquerque, NM 87106, USA.
| | - Samara L Rice
- The University of New Mexico, Center on Alcoholism, Substance Abuse, and Addictions, 2650 Yale Boulevard, SE, MSC11-6280, Albuquerque, NM 87106, USA
| | - J Scott Tonigan
- The University of New Mexico, Center on Alcoholism, Substance Abuse, and Addictions, 2650 Yale Boulevard, SE, MSC11-6280, Albuquerque, NM 87106, USA
| | - Howard S Vogel
- Department of Psychiatry, University of New Mexico Health Sciences Center, MSC09 5030, 1 University of New Mexico, Albuquerque, NM 87131-0001
| | - Joseph Nowinski
- University of Connecticut Health Center, 263 Farmington Ave, Farmington, CT 06034
| | - Donald Hume
- Recovery Based Solutions, 3200 Carlisle Boulevard NE, #228, Albuquerque, NM 87110-1664
| | - Pamela B Arenella
- Department of Psychiatry, University of New Mexico Health Sciences Center, MSC09 5030, 1 University of New Mexico, Albuquerque, NM 87131-0001
| |
Collapse
|