Program
- 12.00 - 12.45: Constructing a theory and evidence based approach to support autonomy in addiction.
- 12.45 - 13.30: In pursuit of identity: a grounded theory study on the social motivations for addiction recovery.
Abstracts
Constructing a theory and evidence based approach to support autonomy in addiction.
Johansen, A.B. and Darnell, F.J.
In this article we use theory and empirical evidence to synthesize a model for the analysis of autonomy in people with addictions.
We review research on motivation and denial as accepted addiction constructs that need to be replaced with a non-stigmatizing and autonomy-supportive language when seeking to “treat” addiction. We present 3 main factors involved in relational autonomy in addiction: (1) mentalizing, (2) positive self-concept, and (3) stigma, and illustrate our model by examining variations on these parameters in two case studies of heroin addicts.
We conclude that a growth perspective is needed to assess functioning in populations believed to be “addicted,” and advocate for increased research into autonomy in this population, as well as its inclusion as a key treatment outcome.
In pursuit of identity: a grounded theory study on the social motivations for addiction recovery.
Johansen, A.B., Brendryen, H., Darnell, F.J. and Solberg, P.
Background:
To help more people overcome addictions we need more insight into principles of recovery. Because social relationships are involved in all change processes, understanding how social motivations affect recovery is vital to guide support programs.
Objective:
To develop a model of recovery by examining addicts’ social motivations through longitudinal assessment of non-professional recovery support dyads.
Design:
A qualitative study combining focus groups and in-depth interviews with both addicts and non-professional supportive others (NSOs). Data were analyzed using the principles of grounded theory. Setting An addiction recovery social support program in Oslo, Norway. Participants The informants comprised seven addicts and six NSOs - all recruited from the same integrative recovery and support program. The addicts were adults addicted to either bingo slot machine gambling (1), alcohol (2), benzodiazepines (1), pain killers (1) or polydrug-use 2). The NSOs were non-professional and unpaid, and had no history of addiction problems. Each addict was assigned an NSO.
Results:
Two themes described the initial phase of program involvement including defining the project and power struggle. A substantive theory emerged from the data based on axial coding of the themes of psychosocially integrated relationships, AA/illness beliefs vs. use as self-medication, and self-esteem vs. behavioral self-efficacy. Specifically, the two participants that relapsed completely at the 2-year follow-up both lacked relationships with non-addicts, and their preferred activities with the program NSO was either a poor match for the relationship, or did not involve the learning of skills.
Two participants had lapsed, but had resumed their quitting attempts. Both lacked integration and safety in their relationships with non-using others, espoused to the AA/illness perspective and lacked behavioral self-efficacy.
Finally, three participants were in a process of “active recovery” at follow-up, appearing psychologically healthy. All had important attachments with non-users, and two had maintained their beliefs in self-medication, practicing moderation, and one had maintained belief in AA/illness model, but changed identity from someone without a problem to somebody “addicted” during the process.
The findings appear best understood as a positive identity-model of recovery, indicated by the pursuit of skill building relevant to a non-drug using identity, and enabled by the on-going availability of emotional and instrumental support.
Conclusions:
Addiction treatment services should be based on a positive identity-model of recovery that enable the building of a life-sustainable identity.