Perceived Social Support from Counselors and Client Sobriety During Aftercare: A Pilot Study of Emotional and Functional Support

Abstract

In an empirical study, we asked whether client perceptions of the degree of emotional support and functional support provided by counselors during treatment are related to client sobriety during the aftercare phase of clients' recovery. Functional support was assessed using a scale that tapped the degree to which clients felt encouraged to become actively involved in six key components of Alcoholics Anonymous. Results derived from 76 former inpatients showed associations linking abstinence at the point of 2-year follow-up to counselor provision of both kinds of social support in early-stage recovery. Mental health service providers may be able to strengthen their client's long-term ability to maintain sobriety by providing them, in the short term, with high levels of esteem support and abstinence-focused “instrumental” support.

KEYWORDS:

• Social support
• substance abuse
• alcoholism
• treatment
• recovery
• Alcoholics Anonymous

Notes

¹The countless residential treatment centers around the world that are based on the MM model can be rightfully viewed as indigenous examples of TSF programs (Borkman et al., 2007; Reis et al., 2008). These “naturalistic” TSF programs have existed globally for more than 50 years (Anderson et al., 1999). Their popularity and perceived efficacy actually served to inspire American scholars who recently designed and tested the well known TSF used in Project MATCH. As a TSF, long-standing MM-based treatment programs ought not to be confused with experimental TSF programs. The later have only recently been developed by treatment researchers interested in “grafting” MM principles into interventions to study their effects in controlled trials with AOD-abusing clients who are at risk for relapse. For examples of research-based experimental TSF programs, the reader is referred to Reis et al. (2008).

²AOD scholars are referred to similar scholarship being conducted on adherence in the area of health compliance behavior Glasgow and colleagues have developed theory and assessment tools that tap “treatment-specific” social support. Their functional model of instrumental support seeks to understand and facilitate patient involvement in diabetes self-care behaviors (e.g., Glasgow & Toobert, 1988).

³In an early study reviewed by Miller (2000), the magnitude of the Pearson correlation coefficient connecting level of “manifest empathy” in therapists and client involvement in drinking at 6-month posttreatment follow-up was huge, at r = −.82!