Predictors of relapse in Filipino male methamphetamine users: a mixed methods approach

Using a simultaneous mixed methods design, this article studies the relapse predictors of Filipino methamphetamine abusers. Results of the quantitative study, with 32 relapsed and 19 abstaining individuals, indicate that self-efficacy, negative affect, motivation, coping, and craving were found to predict relapse and functional social support did not. In-depth interviews with 11 relapse and 10 abstaining individuals supported the quantitative study. Although the results mirror existing literature, the issue of social support was given emphasis in the discussion. Implications for treatment, limitations, and recommendations for future study are also discussed.

The road to recovery: where are we going and how do we get there? Empirically driven conclusions and future directions for service development and research

The term "recovery" is often used in the addiction field. However, we have thus far failed to define the term, to delineate its dimensions, or to elucidate the prerequisite conditions to this outcome. This has hindered service development and evaluation as well as changes in policy. This paper: 1. Reviews empirical findings about how "recovery" is defined and experienced by individuals engaged in the process; 2. Examines factors associated with recovery initiation, maintenance, and sustained lifestyle, and review obstacles to recovery; and 3. Discusses implications for services and research; implications include the need to adopt a long-term, wellness-centered approach to addressing substance use related problems, the importance for society to address the stigma of former addiction and to offer attractive viable opportunities to promote making significant life changes toward recovery from substance use.

What does recovery mean to you? Lessons from the recovery experience for research and practice

Recovery is a ubiquitous concept but remains poorly understood and ill defined, hindering the development of assessment tools necessary to evaluate treatment effectiveness. This study examines recovery definitions and experiences among persons who self-identify as "in recovery." Two questions are addressed: (a) Does recovery require total abstinence from all drugs and alcohol? (b) Is recovery defined solely in terms of substance use or does it extend to other areas of functioning as well? Inner-city residents with resolved dependence to crack or heroin were interviewed yearly three times (N = 289). Most defined recovery as total abstinence. However, recovery goes well beyond abstinence; it is experienced as a bountiful "new life," an ongoing process of growth, self-change, and reclaiming the self. Implications for clinical and assessment practice are discussed, including the need to effect paradigmatic shifts from pathology to wellness and from acute to continuing models.

Replicating the Addicted-Self Model of recovery

The purpose of this investigation is to replicate previous studies supporting a developing model of recovery from alcohol and drug addiction, the Addicted-Self Model [Fiorentine & Hillhouse, 2000c; Journal of Drug Issues 31 (2002a) 395; American Journal on Addictions (2002b) in press]. Data was utilized from the first phase of the Los Angeles Target Cities Treatment Enhancement Evaluation, a 2-year prospective study of 260 alcohol and drug treatment outpatients. The Addicted-Self Model is briefly outlined and four hypotheses are tested. Consistent with the assumptions of the model, low controlled use self-efficacy and a decline in controlled use self-efficacy over time predicts: (1) higher levels of the perceived certainty of negative consequences resulting from continued alcohol and drug use, (2) higher levels of abstinence acceptance, and (3) higher rates of abstinence from alcohol and drug use. Also consistent with the Addicted-Self Model, high controlled use self-efficacy does not predict lower levels of alcohol and drug use for those who relapse or continue to use these substances. These findings replicate previous findings supporting the developing Addicted-Self Model of recovery. Study limitations and directions for future research are discussed.

Why extensive participation in treatment and twelve-step programs is associated with the cessation of addictive behaviors: an application of the addicted-self model of recovery

Applying the Addicted-Self Model of recovery to explain why extensive participation in recovery activities predicts abstinence, it was hypothesized that high levels of participation in treatment and Twelve-step programs promote abstinence because these activities reinforce the notion that controlled use is not possible for dependent alcohol and drug users. Findings from a prospective treatment outcomes study (n = 356) indicate general support for this hypothesis. Yet the cognitive transformation described by the Addicted-Self Model involving acknowledgement of loss of control over alcohol and other drugs is only a partial explanation of why extensive participation in recovery activities promotes recovery. Reiterating the conclusion that "more is better," frequent counseling participation, treatment completion, and weekly or more frequent participation in Twelve-Step programs promote absti- nence independently from their influence on controlled use self-efficacy. Theoretical and clinical implications, and directions for future research are discussed.

Counseling frequency and the effectiveness of outpatient drug treatment: revisiting the conclusion that "more is better."

Replicating and extending previous research, findings from a prospective investigation of outpatient drug treatment (n = 356) indicate that higher frequency of participation in group counseling during treatment predicts higher rates of alcohol and drug abstinence even for those who complete the 6-month treatment program and maintain weekly or more frequent attendance of 12-step meetings during and after treatment. Greater length of group and individual counseling sessions, however, is not associated with higher rates of abstinence, and contrary to previous research, the modest but statistically significant association between the frequency of individual counseling and abstinence was not replicated. With respect to treatment completion, regular attendance at 12- step meetings, and frequent participation in group counseling while in treatment, the evidence suggests that "more is better."