While the benefits of exercise – on mood, stress levels and depression, weight, and health – are uncontested, sticking to an exercise program can be difficult for anyone.
Exercise has increasingly been added into substance use disorder treatment, with additional benefits of decreased craving, eased withdrawal symptoms, and less substance use itself, yet adherence rates are still low. Is this because people in treatment are particularly uninterested, given other, pressing issues within treatment? Or do they face specific barriers? How can future interventions address these barriers proactively?
These are the questions researchers at the Clinical Alcohol Research Unit in Odense, Denmark wanted to answer while implementing a large randomized control trial of exercise or treatment as usual among outpatients.
17 participants who dropped out were interviewed after the trial finished, and SERAF’s PhD student Ashley Muller contributed to the qualitative analysis of the interviews with her experience of exercise among substance use disorder treatment.
Low motivation was not the issue. Rather, shame and a lack of support came to the fore. Participants´ confidence in their own ability to stick with the intervention was weakened when their partners and families did not believe they could, and particularly when they had no prior experience exercising.
On the other hand, participants who were used to being active said they were too ashamed of their current fitness levels and weight to exercise in the presence of others.
Participants suggested a variety of improvements. In designing future interventions, not only should participant preferences and schedules be taken into account, but their previous exercise experience, their expectations of themselves, and the support they feel from those around them should all be topics.
Based on this qualitative analysis, alcohol outpatients as a group do not appear particularly different than other groups who struggle to maintain exercise – but they were able to elucidate a lack of confidence and significant feelings of shame that, if recognized from the beginning, can be addressed.