Despite the fact that six percent of American adults say they are “in recovery” from an alcohol or drug problem, yet, little is known on how they actually define this concept of “recovery” and if these definitions are consensual or not.
Indeed, even if the concept of “recovery” is widely and easily used within popular discourse, this concept is a complex and multidimensional one that can be broadly define as “a voluntarily maintained lifestyle characterized by sobriety, personal health, and citizenship” (The Betty Ford Institute Consensus Panel, 2007, p. 222). Thus, it is a concept that includes indicators of functioning that go far beyond the mere substance use (or more precisely, the mere abstinence) (Laudet, 2007).
To tackle this issue, researchers like the team of Jane Witbrodt, Lee Ann Kaskutas and Christine E. Grella, have decided to investigate if there would not be different typologies of meanings hiding behind the concept of recovery. To do this, they have realized a secondary data analysis (using the latent class analysis approach) of a previous nationwide online American survey. This survey have been completed by nearly 10,000 individuals who identified themselves as being in recovery, recovered, in medication-assisted recovery, or as having had a problem in the past with alcohol and drugs. For the 39 recovery elements composing thesurvey, participants were asked to report their degree of endorsement: “it definitely belongs to my definition of recovery”, “it somewhat belongs to my definition of recovery”, “it does not to my definition of recovery, but it may belong in other people’s definition of recovery”, or “it does not really belong in a definition of recovery”.
As for the results, the modelisation used by the researchers gave a five-class solution (that is to say: five typologies of meanings) that best fit and gave the best representation for the recovery definitions given by the participants. Based on patterns of endorsement of the recovery elements, these classes were labeled: 12-step traditionalist (n = 4912 participants), 12-step enthusiast (n = 2014), secular (n = 980), self-reliant (n = 1040), and atypical (n = 382). Abstinence, spiritual, and social interaction elements differentiated these five classes most. More precisely, the 12-step traditionalists represented reported the strongest endorsement for both the abstinence and the spiritual elements, reflecting the beliefs seen in the 12-steps of Alcoholics Anonymous. Those inthe 12-step enthusiast and secular classes gave personal endorsement to most elements but their endorsement was less assertive than the 12-step traditionalists’ one. These two classes were similar in multiple ways but the 12-step enthusiasts were more prone to abstinence and spiritual factors than the secular class, the latter being more secular and less committed to abstinence. Finally, self-reliant members showed high tolerance for most elements but they were less likely to personally endorse relational-type elements, suggesting that their recovery definition could be viewed as more independent and less relational (compared to the previous classes). Atypical members clearly stood apart from the other classes for having the lowest personal endorsements for most elements and for having a kind of intolerance for spiritual elements. Despite all these differences, four elements were endorsed by all five classes which were: being honest with myself, handling negative feelings without using any substance, being able to enjoy life and process of growth and development.
The results of this study clearly demonstrate the diversity of meanings that might be disguised by the concept of recovery. As such, self-identifying as “in recovery” does not imply homogeneity in the beliefs about recovery. Put to a broader extent, these results show that individuals seeking help come with unique notions of recovery that need to be considered and recognized by recovery-oriented systems of care. For instance, at their entry in such systems of care, some patients will not be predisposed to see relational or spiritual elements as core and indispensable elements to their recovery. To know that will help clinicians to determine how to best tailor their services and respond in the most appropriate way to their patients’ expectations.
Thus, this study clearly shows that recovering individuals hold varying degrees of identification with specific elements of recovery and this has clinical implications that need further investigation.
Research digest of the following article:
Witbrodt, J., Kaskutas, L. A., & Grella, C. E. (2015). How do definitions distinguish recovering individuals? Five typologies. Drug and Alcohol Dependence, 148: 109-117.
Bibliography:
– The Betty Ford Institute Consensus Panel, 2007. What is recovery? A working defi-nition from the Betty Ford Institute. J. Subst. Abuse Treat. 33, 221–228.
– Laudet, A.B., 2007. What does recovery mean to you? Lessons from the recoveryexperience for research and practice. J. Subst. Abuse Treat. 33, 243–256.
5 words that I have learned:
Scant (adj) = rare, limité
Endorsement (n) = approbation
Nascent (adj) = naissant
Encompass (v) = inclure, concerner
Henceforth(adv) = dorénavant, désormais