![Sample our Health and Social Care journals, sign in here to start your FREE access for 14 days]({"type":"image" , "src" : "/sda/5938/TOC-Subject-Sample-2021-Health-Social-Care.jpg"})
ABSTRACT
Background: The What is Recovery? (WIR) study identified specific elements of a recovery definition that people in substance abuse recovery from multiple pathways would endorse. Objectives: To explain how participatory research contributed to the development of a comprehensive pool of items defining recovery; and to identify the commonality between the specific items endorsed by participants as defining recovery and the abstract components of recovery found in four important broad recovery definitions. Methods: A four-step, mixed-methods, iterative process was used to develop and pretest items (August 2010 to February 2012). Online survey recruitment (n = 238) was done via email lists of individuals in recovery and electronic advertisements; 54 were selected for in-depth telephone interviews. Analyses using experientially-based and survey research criteria resulted in a revised item pool of 47 refined and specific items. The WIR items were matched with the components of four important definitions. Results: Recovering participants (1) proposed and validated new items; (2) developed an alternative response category to the Likert; (3) suggested criteria for eliminating items irrelevant to recovery. The matching of WIR items with the components of important abstract definitions revealed extensive commonality. Conclusions/Importance: The WIR items define recovery as ways of being, as a growth and learning process involving internal values and self-awareness with moral dimensions. This is the first wide-scale research identifying specific items defining recovery, which can be used to guide service provision in Recovery-Oriented Systems of Care.
Glossary
Community: The external public space where the four sectors of civil society, economic exchange, government, and social networks intersect.
Harm reduction: A policy contrasted with abstinence in which the target of intervention and treatment is to reduce the consumption of alcohol and/or other drugs in the service of reducing the problems associated with consumption.
Mutual aid groups: Also known as self-help groups, mutual help groups, self-help/mutual aid groups, mutual aid support groups, among other designations, are voluntary self-determining groups of peers who share a common problem or issue, such as alcoholism, and who self-organize in order to recover and improve their quality of life.
Participatory research: A methodological approach that entails involving the “subjects” or users and stakeholders of the research in the formulation, implementation and application of the research; a key issue is the extent of power participants have in relation to the researchers which affects the extent to which participants' voices influence the research process and outcomes.
Quality of life: As adapted from the World Health Organization's definition refers to an individual's perception of and satisfaction with their situation in life within the context of their culture and value system, their expectations, goals and concerns.
Recovery: Presently has no agreed upon definition. Among addiction researchers and providers it is often operationalized as abstinence (no alcohol or drug use), as fewer substance-related problems and/or as remission from a DSM diagnosis. Among individuals who are addressing their substance use problems, it means more than those limited definitions; the WIR study was undertaken to better understand how recovering individuals specifically defined recovery.
Self-changer: As used in our article, refers to an individual who views himself/herself as having had an alcohol or drug problem in the past but does not have one now and who is unlikely to self-identify as having been or being in recovery.
Spirituality: Left undefined in the study. Participants self-defined spirituality. Spirituality items the researchers designed were modeled after the World Health Organization's material on spirituality, religiousness, and personal beliefs (WHOQOL SRPB Group. Citation2006. A cross-cultural study of spirituality, religion, and personal beliefs as components of quality of life. Soc Sci Med 62(6):1486–1497) and the contributions of recovering alcohol and drug abuser participants.
Twelve-step mutual aid groups: The over 80 mutual aid groups who follow/adapt the spiritually-based twelve steps of Alcoholics Anonymous and usually follow the 12 traditions that define the anonymous group structure; examples are Narcotics Anonymous, Cocaine Anonymous, Al Anon, and Marijuana Anonymous.
Declaration of interest
The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the article.
Funding
This work was supported by the National Institute of Alcohol Abuse and Alcoholism [Grant number RO1 AA017954].
Additional information
Notes on contributors
Thomasina Jo Borkman
Thomasina Jo Borkman, Professor of Sociology Emerita, taught at George Mason University in Fairfax, Virginia for 32 years while conducting research and consultation internationally primarily with self-help/mutual aid groups and related peer-controlled social innovations such as social model alcohol/drug recovery programs or service-user–based mental health services. Recently, she was co-investigator on the WIR research reported in this issue that studied how alcohol and drug abuse recovery is defined by those in recovery rather than by addiction professionals. She may be best known for the concept of “experiential knowledge” —that self-help/mutual aid groups or social model programs collectively evolve shared understandings and wisdom gained from personal lived experience with their addiction or health problem. Her major theoretical work is developed in her book on self-help groups and organizations titled Understanding self-help/mutual aid: Experiential Learning in the Commons. Rutgers University Press, 1999.
Aina Stunz
Aina Stunz worked as a Research Assistant/Associate to J.K. Zawodny at the Center for Advanced Study in the Behavioral Sciences (Stanford) in the early 1960s. She next worked as a technical writer and documentation specialist for a life insurance company which was an IBM beta test site for an insurance system. Her experiences there led to co-founding a service company for computer-output-microfiche which was sold in 1980 to a Dunn & Bradstreet subsidiary; after which she co-founded a computer supplies and accessories catalogue house which was sold in 1997. Having been at a cutting edge of technology for years she returned to her first passion for research when she joined The What is Recovery? Study in 2011.
Lee Ann Kaskutas
Lee Ann Kaskutas is a research scientist interested in nonprofessionalized, nonmedical, nonclinical solutions to alcohol and drug problems. Thus, much of her work has focused on mutual aid groups and on social model recovery, which involve peer helping and support as their driving forces. She developed a program for introducing individuals to the culture and fellowship of 12-step groups, to facilitate and maximize new participants' comfort with the people they will meet at AA, NA, etc; it is called MAAEZ for Making AA Easier. It is led by individuals in recovery and is guided by a manual which is available for free at arg.org. Her most recent study was dedicated to understanding how recovery is defined by those in recovery rather than by addictions professionals. Prior to receiving her doctorate in public health, she worked in the high technology sector. She has lived in Mexico and has travelled extensively in Southeast Asia, and hopes to do both again!