Opportunities for Enhancing Access and Efficacy of Peer Sponsorship in Substance Use Disorder Recovery

Substance use disorders (SUDs) are characterized by an inability to decrease a substance use (e.g., alcohol or opioids) despite negative repercussions. SUDs are clinically diagnosable, hazardous, and considered a public health issue. Sponsorship, a specialized type of peer mentorship, is vital in the recovery process and originates from 12-step fellowship programs such as Alcoholics Anonymous (AA) and Narcotics Anonymous (NA). To investigate sponsorship relationship practices and to identify design opportunities for digitally-mediated peer support, we conducted 27 in-depth interviews with members of AA and NA. We identified five key sponsorship relationship practices relevant for designing social computing tools to support sponsorship and recovery: 1) assessing dyadic compatibility, 2) managing sponsorship with or without technology, 3) establishing boundaries, 4) building a peer support network, and 5) managing anonymity. We identify social computing and digitally-mediated design opportunities and implications

Discovering Authentic Self through Healing Relationships: An Inquiry of Implementing Alcoholics Anonymous Theoretical Philosophies to Parenting in Sobriety

This qualitative research study investigated how recovering mothers implemented Alcoholics Anonymous (AA) theoretical philosophies when parenting their children and explored how healing relationships between sober mothers and their children cultivated authenticity, promoted inner healing and improved parent-child relationships. Sober mothers were asked what twelve step concepts they utilized with their children and reflected on how their own recovery experiences helped them to discover their ‘true’ selves. I conducted eight qualitative interviews with sober mothers who attended Alcoholics Anonymous (AA), Narcotics Anonymous (NA) along with Crystal Meth Anonymous (CMA) and were parenting children, or had previous parenting experiences, to explore any holistic advantages of parenting in sobriety and gain knowledge of the AA theoretical philosophies these sober mothers implemented with their children. This research study primarily focused on how sober mothers integrated concepts and practices from their twelve step recovery experiences with their children to develop healing relationships and examined how these healing relationships impacted the inner healing and self-discovery process for sober mothers. I used content analysis, which generated conceptual themes, and compared these generated themes to understand the implications associated with an interpretative phenomenology approach to self-transformation while parenting in sobriety. This research study demonstrates how twelve step ideologies reflect a holistic philosophy. Additionally, this qualitative research study might help clinical professionals to better understand the needs of sober mothers and the potential utilization of concepts from twelve step recovery programs which, when applied with children, promoted adaptive parenting skills and fostered inner healing as well as family resiliency. As a result, clinical professionals can put into practice the information on the use of AA theoretical philosophies as holistic approaches to endorse healing relationships during sobriety in order to support recovering chemically dependent parents

Relationship between Spirituality and Perceived Social Support with Success in Alcoholics Anonymous

Failure in treatment and Alcoholics Anonymous (AA) leads to continued addiction, but practitioners need to learn which factors predict better outcomes in AA to make better referrals. Here, the predictive relationship between spirituality and perceived social support with success in AA was examined based on Frankl\u27s theory on meaning in life. A quantitative, correlational design was used to determine whether there was a statistically significant predictive relationship between spirituality, as measured by the Assessment of Spirituality and Religious Sentiments, and perceived social support, as measured by the Multidimensional Scale of Perceived Social Support, with success in AA, as measured by the binomal sobriety variable with either totally sober over the last 90 days or not. Data were collected using an anonymous online and in person survey, and logistic regression was used to analyze the data on the final sample of 93. Inclusion criteria was adult age, U.S. residency, and former or current AA membership. The new model\u27s classification table was nonsignificant without improving classification of cases as sober/nonsober. The overall model was significant per the chi-square results and the spirituality odds ratio was significant in predicting sobriety. Therefore, there was a significant predictive relationship found between spirituality and success in AA, but not for perceived social support. Recommendations include AA\u27s value despite spirituality or social support level for recovery and spirituality as still a tool in recovery. Positive social change implications include better understanding of the factors leading to success in AA, and therefore better referrals to AA or other such adjunctive support services needed, which can improve outcomes for clients struggling with alcohol addiction

Understanding the Cultural Utility of Mainstream Addiction Recovery Mutual Support Groups for Indigenous Peoples’: A Case Study of SMART Recovery through an Indigenous Australian Lens

Background: Mutual support groups are one of the world’s most commonly used forms of addiction recovery support. Participation has been associated with reduced substance use and abstinence. There is, however, limited empirical understanding of how suitable or beneficial group participation is for Indigenous peoples in similarly colonised countries (Australia, New Zealand, Canada, United States of America, Hawaii). This thesis aims to improve our understanding of the cultural utility of mainstream addiction recovery mutual support group programmes for Indigenous peoples. The SMART Recovery programme will be used as a case study with Indigenous Australia as a cultural milieu. Methods: This thesis presents findings from three published empirical studies. In Study 1: a PRISMA-informed systematic literature review was performed to determine the number, nature, and scope of internationally available evidence on Indigenous people’s experiences of and outcomes associated with attending mutual support groups. Study 2: used an Indigenous-lensed multi-methods research design to explore: 1) How Indigenous Australian facilitators (n=10) and group members (n=11) experience SMART Recovery and utilise it as a recovery resource; and 2) If the SMART Recovery programme components and operational process are culturally suitable and helpful. In Study 3: a three-round Delphi synthesised with Indigenous research methods was conducted to: 1) Obtain expert opinion on the cultural utility of the Indigenous SMART Recovery handbook; 2) Gain consensus on areas in the SMART Recovery programme that require cultural modification; and 3) Seek advice on how modifications could be implemented in future programme design and delivery. Results: Study 1 revealed a paucity of empirical knowledge on the acceptability and outcomes of addiction recovery mutual support groups for Indigenous peoples of Australia, New Zealand, Canada, United States of America and Hawaii. Study 2 offers first insights into how Indigenous peoples in Australia perceive and use SMART Recovery. Based on their experiences, a range of culturally informed programme modifications were suggested to enhance its cultural utility. Study 3 confirmed that cultural modifications are needed to enhance the cultural utility of SMART Recovery for Indigenous Australian contexts. An expert panel reached consensus on five key programme modifications and developed a set of strategies to help SMART Recovery integrate these into future programme planning and design. Study 2 and 3 also demonstrated the promise of two innovative research methodologies that could be used to involve Indigenous peoples in the design and evaluation of mainstream mutual support group programmes without added burden to personal, community and/or professional obligations. Conclusions: This thesis presents the first series of studies to investigate the cultural utility of mainstream mutual support groups for Indigenous peoples. Findings suggest that culturally appropriate language, culture-based programme activities and less rigid group delivery formats would enhance suitability and helpfulness of existing programmes as a recovery resource for Indigenous peoples. Thesis findings have implications for future planning and development of SMART Recovery and other mutual support groups like 12-steps programmes. There is an urgent need to extend this research to Indigenous peoples of New Zealand, Canada, United States of America, and Hawaii – whose perspectives are not yet documented in the peer-reviewed mutual support group literature

"Connection in isolation... nothing can keep us apart" : COVID-19 and Narcotics Anonymous : a thesis presented in partial fulfilment of the requirements for the degree of Master of Science in Psychology (Health Psychology) at Massey University, Albany, New Zealand

Addiction is a complex phenomenon, which can cause significant harm for individuals, family, whānau, and communities. Treating an addiction requires a fit for purpose, personalised and long-term treatment approach. One option is Narcotics Anonymous (NA), a twelve-step peer support group that is comprised of people with an addiction who help one another to have an abstinent-based recovery from using drugs. In March 2020 Aotearoa New Zealand went into a nationwide lockdown to stop the spread of COVID-19, which drastically changed the way NA had to operate. Currently, there is limited research on NA that is situated in Aotearoa, and none that explore NA during the nationwide COVID-19 lockdowns. This study aimed to investigate how NA members managed their recovery during the COVID-19 lockdowns in Aotearoa between March 2020 to August 2021. Eleven NA members took part in a semi-structured interview to share their stories of addiction, recovery, NA, and COVID-19. A thematic narrative analysis was used to explore how the COVID-19 pandemic impacted on the recovery of NA members, and what role NA played in the lives of its members during this time. The findings suggest that the recovery of NA members was able to continue throughout COVID-19 lockdowns because of the principles and fellowship of NA both prior and during lockdown. By rapidly moving meetings online and with technical support, participants were able to maintain their connections with others in recovery, express gratitude for what they had, experience new opportunities for self-care and sharing, and remain consistent in their recovery practices. Furthermore, the NA fellowship supported members to navigate the challenges of a novel online environment. The findings indicate how technology can be used in a disaster setting to continually provide support for vulnerable populations, highlight how NA is a successful treatment modality, and demonstrate the value of mutual, or peer-based recovery support. This has important implications for the way that we approach and understand addiction and recovery, especially in unusual times such as a global pandemic

To what extent is the spirit of motivational interviewing present in the experience of Alcoholics Anonymous members?

More people tum to Alcoholics Anonymous (AA) in an attempt to recover from alcohol dependence than any other intervention. AA has historical links with confrontational approaches to alcohol treatment, and motivational interviewing (MI) was conceived by Miller in the 1980\u27s as an alternative to these confrontational approaches. There are divided opinions on whether AA is confrontational; therefore, the primary aim of this qualitative study was to gain an insight into how the spirit of AA is experienced by its members. Ten members of AA were interviewed using a semi-structured interview schedule. Thematic analysis from a constructionist perspective was utilised in order to interpret the participants\u27 experiences. Six themes were identified: \u27direct positive confrontation\u27; \u27negative confrontation\u27; \u27authority\u27; \u27collaboration\u27; \u27evocation\u27; and \u27autonomy\u27. Overall, AA was experienced by its members as supportive, mentor-based, and collaborative and the themes identified are largely supported Miller\u27s (2009) theory that AA and MI are compatible in tem1s of their \u27ways of being\u27 with people. Some elements of a confrontational approach were found, but confrontation in AA was chiefly experienced as accurate, helpful, and supportive. Implications and recommendations for future research are highlighted