12-step Recovery Research Articles

Comparison of Humor Style Preferences Between Successfully Recovering Individuals and Newcomers Participating in 12-Step Recovery Programs

Background: Humor has long been associated with potential benefits on physical and psychological health and well-being [1]. Identified and developed a tool to measure various functions, forms or styles of humor with either beneficial, adaptive expression or in detrimental, maladaptive operations. The purpose of this study was to explore these humor styles in a population of recovering individuals with substance use disorder attending 12-step recovery programs. Humor style preferences were compared between newer members (less than one year abstinence) versus established, successful members (more than five years abstinence). Methods: Demographics, including age and gender, number of months of complete abstinence and level of 12-step participation including having a sponsor or not, and weekly meeting attendance. The Humor Styles Questionnaire (HSQ) was self-administered, measuring affiliative, self-enhancing, aggressive and self-defeating humor style scores. Hypothesis 1: That adaptive humor expression (affiliative, self-enhancing styles) would be higher in the successfully recovering group. Hypothesis 2: That maladaptive humor expression (aggressive, self-defeating styles) would be higher in the newcomer group. Results: Self-defeating humor style was significantly higher in the newcomer group (p<.05). There was no difference between groups of successfully recovering individuals and newcomers with affiliative, self-enhancing and aggressive styles of humor. Conclusion: Self-defeating humor, considered a maladaptive, negative style is a preferred style of humor early in the recovery. Contributing factors of the self-defeating preference in this group is more recent substance use and the negative consequences of behaviors related to its use. Successful, long term recovery with 12-step program involvement leads to a significant reduction in preference of self-defeating humor. The difference in humor styles may be reflective of improvement in self-esteem in those with long term abstinence.

Characteristics and engagement among English-language online forums for addiction recovery available in the US

In developing public resources for the Networks Enhancing Addiction Recovery – Forum Activity Roadmap (NEAR-FAR), we completed a systematic observational study of English-language online forums related to recovery from alcohol or other drug addiction in late 2021. Among 207 identified forums, the majority were classified as “general addiction” or alcohol-focused, though classifications related to other substances were common on websites hosting multiple forums. Commonly used social media platforms such as Reddit, Facebook, or Quora offered easily accessible venues for individuals seeking online support related to a variety of substances. Forums were related to established recovery programs such as 12-step and SMART Recovery as well as other nonprofit and for-profit recovery programs, and to community forums without formal recovery programming. Among 148 forums with any observed user activity, the median time between unique user engagements was 27 days (inter-quartile range: 2–74). Among 98 forums with past-month posting activity, we found a median of <10 posts per week (inter-quartile range: 1–78). This study compares three metrics of observed forum activity (posts per week, responses per post, time between unique user engagements) and operationalizes forum characteristics that may potentiate opportunities for enhanced engagement and social support in addiction recovery.

The Impact of the COVID-19 Pandemic on Recovery From Substance Use Disorder: Findings From a Qualitative Study.

This study considers how the COVID-19 pandemic impacted individuals recovering from a substance use disorder (SUD). Fifty individuals recovering from SUD in Vermont, a rural New England state (U.S.), were recruited for an interview from 12-step recovery meetings (Alcoholics Anonymous, Narcotics Anonymous) as well as via word-of-mouth. Interviews were transcribed and coded, and qualitative analyses were performed. Many of the participants who were in recovery prior to the pandemic starting remained substance-free and in recovery throughout the pandemic period. Some individuals used substances during the pandemic period, although not typically in the context of a relapse caused by negative emotions (eg, distress over a loved one contracting COVID-19). The majority of those individuals indicated that the risk of catching COVID-19 did not alter their substance use. Many individuals already in SUD recovery before COVID-19 remained in recovery despite the challenges of pandemic era. The role of peer support in recovering individuals managing negative emotions caused by COVID-19 is considered.

Spiritual Awakening in 12-Step Recovery: Impact Among Residential Aftercare Residents.

Spiritually-based interventions in the form of 12-step programs are frequently offered as a part of substance use treatment programs in the United States. Programs based in the 12 steps guarantee that by working their program, an individual will undergo a process of transformation labeled a spiritual awakening. However, the impact of this experience on recovery factors and treatment adherence is unclear. The current study investigated adult residents (n = 115) who experienced a spiritual awakening attributed to 12-step group affiliation during their stay at residential aftercare facilities for substance use disorder. Self-efficacy and hope were greater for individuals who experienced a spiritual awakening versus those persons who did not experience awakening. Awakening was associated with greater affiliation to AA and decreased negative exit from the facility. Results revealed the potential for an awakening to improve treatment behavior and outcomes in a residential environment, as well as benefit an individual's personal recovery resources. Further theoretical and clinical implications are discussed.

Experience of Adults with Substance Use, Mental Health, and Homelessness Issues: A Combined 12-Step Faith-Based Program and Complementary Therapeutic Recreation Interventions

There is a significant association between substance use disorder (SUD) and mental health (MH) issues for adults experiencing homelessness. Therapeutic Recreation (TR) is utilized as a treatment intervention for many populations including individuals experiencing SUD and MH issues through the use of recreation and leisure to address various physical, cognitive, emotional, social, and spiritual needs, as well as improve quality of life and well-being. Thus, the purpose of this study was to examine the experience of 12 adults with SUD, MH, and homelessness issues engaging in a variety of evidence-based practice (EBP) TR led activities involving complementary integrative health (CIH), adventure teambuilding, and creative arts combined with a 12-step faith-based recovery meeting. Twelve sessions took place for 2 hours, twice a week over 6 weeks at a residential treatment Christian mission. The thematic analysis revealed three overarching themes: 1) building a caring community, 2) finding a new enjoyable way out of addiction, and 3) calm healing through creative complementary spiritual activities. These findings indicate that combining various forms of EBP TR activities with peer support 12-step faith-based meeting added value to the recovery process. This case study adds to the current literature on how the combining EBP TR with a 12-step faith-based approach might aide in the healing process for adults with MH, SUD, and homelessness problems.

Recognising the recovering addict with Honneth: an intervention into the stigmatising language debate in the alcohol and other drugs field

PurposeThe purpose of this paper is to assess the impact of the recommendation to replace identity-first language with person-first language on people who self-identify as recovering addicts as part of a recovery programme. Narcotics Anonymous (NA) will be used to illustrate the contextualised nature of the recovering addict identity.Design/methodology/approachTo demonstrate the value of the recovering addict identity and social relations in NA, this paper draws on Axel Honneth’s theory of mutual recognition and self-formation.FindingsPerson-first language overlooks the significance of identity-first language to people in 12-step recovery. This oversight is linked to the logic of stigma reduction which excludes all identity-first language by association rather than assessing the impact of such terms on a case-by-case basis. Honneth’s theory is used to show how the recovering addict identity facilitates self-confidence and self-esteem through relations of mutual recognition in NA.Research limitations/implicationsThe argument excludes people who identify as recovering addicts, but do not attend 12-step groups. Further research would be needed to understand how the recommendation to use person-first language instead of identity-first language impacts upon other recovery communities and pathways.Practical implicationsThe recommendation to replace identity-first language with person-first language might result in 12-step fellowships becoming marginalised within the broader academic and policy and practice arena. Language preferences can become a contentious issue when 12-step groups and their members enter the wider recovery arena where their preferred terminology is viewed as stigmatising and dehumanising.Originality/valueTo the best of the author’s knowledge, this is the first article to propose an alternative theoretical framework to stigma reduction for judging morally appropriate language in the alcohol and drugs field.

Alcohol use disorder treatment delivered outside hepatology clinic.

Alcohol use disorder treatment delivered outside hepatology clinic.

“One Among Many”: Piety Reconstruction in 12-Step Recovery Groups

This article applies Kenneth Burke’s concept of piety to an evaluation of nine recovery stories from members of four different 12-step fellowships. In this theoretical context, recovery can be explained as a process of adopting and remaking pious systems. All nine recovery stories follow a similar pattern: (1) identifying difference and similarity in the community; (2) letting go of old pieties; (3) adopting group piety; and (4) inventing and remaking individual systems of piety. This analysis investigates how individual and group pieties interact to strengthen or threaten individual recovery and group cohesion.

Moral Reconation Therapy

Moral Reconation Therapy (MRT) is a manualized treatment commonly used in correctional settings to address perceived moral failing and associated problematic behaviors (e.g., substance use and criminal conduct). Many social work students are introduced to MRT as a treatment modality during field placements in correctional contexts. As a group modality that draws from cognitive-behavioral interventions and 12-step recovery programs, MRT has been touted as a cost-effective and evidence-based intervention. However, there are substantial reasons to question MRT’s appropriateness as an intervention taught to social work practicum students. Using several of the CSWE EPAS standards as guideposts, this paper addresses several key areas of concern with regard to the role of MRT in the training of social work students. Through our analysis of MRT’s curriculum, we identify areas of concern with regard to MRT’s ability to teach social work students how to ethically practice, engage diversity and difference in practice, or utilize research to inform practice. Despite the widespread use of MRT in correctional counseling contexts, we conclude that MRT is unsuitable for use in accredited social work field placements. Educators and accreditation agencies should critically evaluate the treatment models social work students learn and practice in field placements.

Capacity for Meaningful Relationship in Severe Substance Use Recovery: A Qualitative Study

ABSTRACT The purpose of this study was to qualitatively explore the lived experiences of meaningful relationships among persons in 12-step recovery. The distinction of recovery is important as our study focused less on relational patterns during active substance use and more on their perception within their recovery. This phenomenological study followed Van Manen’s six step approach of qualitative research. Data were collected from 7 participants through semi-structured one-on-one participant interviews. Participants were asked open-ended questions regarding their SUD recovery (e.g., “What is your experience of your capacity to be in meaningful relationships?”). Resulting from the analysis, four themes were extracted from the overarching theme of the Capacity for Meaningful Relationships in Recovery. The four emergent themes included Building the Foundation in Recovery, Sharing a Common Ground of Support, Giving Back – Helping Others, and Bridging Recovery to Family – The Biggest Accomplishment. Limitations and future research are discussed as well as the potential impact and application of these findings as they relate to recovery research and practice.

NIAAA Definition of Recovery Provides Measurable Endpoints for AUD Researchers

NIAAA Definition of Recovery Provides Measurable Endpoints for AUD Researchers

Pandemic Revealed Unique Aspects of Sexual Addictions

Pandemic Revealed Unique Aspects of Sexual Addictions

Exploring the Long-term 12-Step Collegiate Recovery Experiences of Emerging Adults: An Interpretive Phenomenological Analysis

ABSTRACT The aim of this study was to explore the lived experiences of participants’ key attributes of sustaining long-term recovery as an emergent adult in college. Interpretative phenomenological analysis (IPA) was used to identify recurrent themes by analyzing participants’ experiences. Eight participants were recruited from a collegiate recovery program at a university in the southwest United States. Semi-structured interviews were conducted, and data were transcribed verbatim. Data analysis followed IPA guidelines and procedures. Four superordinate themes emerged through the analysis process: Positive Recovery Identity Shift, Achievements and Accomplishments, Transformation of Agency, and Spirituality and Choice. Findings, which were integrated into the discussion, focus on relevant addiction recovery research implications. Limitations, future research implications, and clinical applications are discussed.

Understanding recovery Capital in relation to categorical 12-Step involvement and abstinence social support

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.

Resource Factors Allowing People with Alcohol-addicted Parents to Overcome Their Negative Emotions: A Latent Variable Model and Content Analysis

Background. People with alcohol-addicted parents are at risk of psychoactive addictions, co-dependency, and suicidal behavior. Most studies of these people are aimed at confirming the inevitability of the impact of negative childhood experiences on their lives, and thus do not seek to identify resource factors which would allow them to overcome the negative emotions they experienced. Objective. The purpose of this study was to create a model of resource factors which would allow people with alcohol-addicted parents to overcome the negative emotions they experienced. Design. The participants were 58 healthy individuals (17 men and 41 women; M=25.2; SD=4.4) whose parents were alcohol addicts (they were participants in the 12-step recovery program "Adult Children of Alcoholics"), and 50 healthy individuals (15 men and 35 women, M=24.2; SD=3.7) whose parents were not alcohol addicts. The participants completed the questionnaires "Interpersonal Guilt," "Family Emotional Communication," and "Coping Strategies," and were interviewed on the resource factors which allowed them to overcome negative emotions. We used the content analysis of the interviews and latent variable modeling to analyze the questionnaires. Results. The model of resource factors (CFI=0.895, RMSEA=0.064) showed that the rules set by the parental dysfunctional family (the taboo on the expressing emotions, and external well-being) were associated with being unable to recognize current negative emotions and with avoiding problems. The ability to recognize negative emotions was connected with the participant’s willingness to accept responsibility for his/her life. The resource factors which allowed these subjects to overcome their negative emotions included: communication with relatives and friends; keeping a diary of emotions; and participating in recovery programs. Conclusion. Our model of resource factors explains the mechanism connecting dysfunctional family rules with the resource factors and negative emotions experienced by people with alcohol-addicted parents.

Self-Esteem in 12-Step Recovery; Theoretical History, Evidence, and Implications for Future Research

ABSTRACT Recovery from substance use disorder is a complex process whereby an interplay of personal strengths, interpersonal relationships, and contextual factors come together to make recovery possible. New and emerging theories and definitions of recovery are prompting recovery-informed research that places a premium on operationalizing known features of the recovery process into new instruments and methods. We hypothesize that self-esteem plays a central role in the recovery process such that it may one day serve as a benchmark of recovery growth and progress. In this article, we use a secondary analysis of an existing dataset to examine self-esteem as a central intrapersonal variable in a sample of people in recovery from substance use disorder (N = 113) and identify correlates with psychological and personality factors associated with recovery. Our findings provide additional evidence that self-esteem, and correlates of self-esteem, may represent a bundle of intrapersonal psychosocial variables that should be considered as essential constructs within recovery-related research, therapeutic technique, and treatment outcome expectancies.

The impact of religious affiliation on college students’ 12-step model preferences

ABSTRACT Previous research has suggested that younger generations are reporting lower levels of religious affiliation and are more likely to drop out of traditional 12-step recovery programmes such as Alcoholics Anonymous than previous generations. The present study examined whether 110 millennial- and Generation Z-aged, college-students who were assessed for religiosity and substance use patterns preferred the language used in the traditional 12-step model vs. an alternative version of the model that was designed to emphasise personal empowerment over a higher power. Participants who identified as religious displayed a stronger preference for the wording of the traditional 12-step model when compared to the alternative 12-step model, however, all groups preferred the wording of the alternative 12-step model compared to the traditional 12-step wording. These findings suggest that millennial- and Generation Z-aged individuals may have a preference for language and treatment approaches that are less focused on faith and more focused on self-empowerment.

A Pilot Interprofessional Course on Substance Use Disorders to Improve Students’ Empathy and Counseling Skills

Objective. To implement and assess the effectiveness of an interprofessional course designed to provide pharmacy and nursing students with opportunities to improve their understanding of substance use disorders (SUDs), assess their attitudes toward patients with SUDs, receive instruction and feedback on behavior change counseling, and engage in interprofessional education. Methods. The course consisted of four interactive class sessions that focused on empathy and recognition of personal bias, behavioral change counseling, and SUD recognition, screening, and treatment. Classes were taught by an interprofessional faculty member. Students also attended a 12-step recovery meeting in the community, counseled an authentic patient using behavioral change counseling, and received feedback based on a faculty member's direct observation of their counseling. Students completed validated assessments of their attitudes toward patients with SUDs and interprofessional collaboration. A faculty member used the Behavioral Change Counseling Index (BECCI) to assess students' counseling of SUD patients. Counseled patients were asked their preference for follow-up care for their SUD. Results. Twenty-seven pharmacy and nursing students completed this course, along with 51 students from other professions. The pharmacy and nursing students demonstrated significant improvements in their attitudes toward patients with SUDs and toward interprofessional collaboration, as measured by the Substance Abuse Attitudinal Scale (SAAS) and Student Perception of Interprofessional Clinical Education (SPICE-R2). Approximately 93% of pharmacy and nursing students counseled a patient with a SUD, with 96% of counseled patients reporting their intent to receive follow-up care. Conclusion. An interprofessional SUD course enriched pharmacy and nursing students' understanding, attitudes, and behaviors toward patients with SUDs and interprofessional collaboration. Students demonstrated an ability to provide behavior change counseling to patients, and 96% of counseled patients stated a willingness for follow-up care for their SUD.

Surrender to win: Constructions of 12-step recovery from alcoholism and drug addiction.

This article focuses on the ways in which members of Alcoholics Anonymous and Narcotics Anonymous construct themselves as being in recovery from addiction. In this original study, data were taken from 19 participants. They were analysed using Willig's six-stage Foucauldian discourse analytic method. This method is suited to enabling the analyst to locate discourse resources used by participants within broader, dominant, discourses, and for exploration of the implications of these constructions for subjectivity and practice. This article presents a discussion of analytic findings. Mainstream academia has often constructed 12-Step recovery as a largely totalising discourse. This is likely to have negatively prejudiced health professionals and may help explain relatively low referral rates into 12-Step resources for addicted clients. However, our analysis suggested that participants constructed themselves not as subjected by Alcoholics Anonymous and Narcotics Anonymous discourse, but as drawing on it in ways aligned with agency, in order to practice care of the self in pursuit of various ethical goals. This implies 12-Step recovery to be less antithetical to, and indeed more aligned with, humanistic practitioner values than is perhaps often assumed to be the case. This finding suggests that practitioners may need to consider reappraising their view of 12-Step recovery. The discussion will therefore focus on the agency-structure dialectic that seemed to be at the heart of participant constructions of addiction and recovery. It is also a finding which points to an urgent need for more qualitative studies in the currently under-researched, and hence perhaps poorly understood, area of 12-Step recovery from addiction.

Psychotherapy of Patients with Hypersexuality

The article presents various methods of psychotherapy (cognitive, cognitive-behavioral, behavioral, hypnosuggestive, psychodynamic, existential, paired, group) which are used to treat patients with hypersexuality, including the 12-step recovery program carried out in self-help groups of sexoholics. The correctness of the adaptation to them of the 12-step program for recovering of alcoholics is discussed. It is reported about types of assistance provided to both adults and adolescents who suffer from sexual addiction. Recommendations are given to prevent the development of sexual addiction in the latter. It is also submitted recommendations for wives whose husbands are sexually addicted and identify existing options for assisting them.