POSITIVE PSYCHOLOGY AND TREATMENT FOR

SUBSTANCE USE DISORDERS

IN A RESIDENTIAL FACILITY

Javier LeyMississippi College

ADDICTION

• Addiction is understood as a primary brain disease that affects reward circuitry, motivation, and memory and that becomes manifested in multiple dimensions, including biological, psychological, social, and spiritual (ASAM, 2011).

• Within the broad range of addictions, Substance Use Disorders (SUD) represent a heavy burden on our society with over 22 million people in the United States meeting diagnostic criteria in 2012 (SAMHSA, 2013).

IMPORTANT FACTORS

• Co-occurring disorders: out of the US population with any mental illness (AMI), 19.2% also met diagnostic criteria for a SUD, while only 6.4% of those without AMI met diagnostic criteria for a SUD (SAMHSA, 2013).

• Criminal Justice System: about half of all prisoners meet diagnostic criteria for a SUD (Chandler, Fletcher, & Volkow, 2009)

IMPORTANT FACTORS

• Suicide: the risk of suicide for individuals with a SUD is more than six times the average risk for suicide (CSAT, 2008).

• Deaths: around 3.5 million people around the world lose their lives in alcohol and drug related deaths per year (UNODC, 2013; WHO, 2014).

DEVELOPMENT OF THE DISORDER

• Risk factors that can lead to the development of the disorder: gender, psychiatric disorders, age of onset, family, and stress in early life.

• Experiencing early life stress in the form of maltreatment or other stressful events can be associated with early problem drinking and substance dependence in the early adult years (Enoch, 2010).

NEGATIVE AFFECT

• Research has shown that people in recovery from drug addiction score higher on measurements of shame, depression, and maladaptive guilt (Meehan et al., 1996).

• Being engulfed in these negative affective consequences can lead to difficulty in identifying and acknowledging positive aspects of their personalities and of their lives.

SELF-HELP OR MUTUAL-HELP

• Self-help or Mutual-help movement has historically been a common pathway to recovery from SUD. Among these self-help options, Alcoholics Anonymous (AA) is the most commonly known.

• 58% of those entering SUD treatment had attended AA meetings (Magura, 2007).

• Higher rates of abstinence for those who attended both formal treatment and 12 step programs versus those who attended only one or the other (Fiorentine & Hillhouse, 2000).

• AA involvement following treatment resulted in better outcomes 16 years after (Moos & Moos, 2006).

POSITIVE PSYCHOLOGY

• Positive Psychology (PP) is a field that represents a supplementary perspective to traditional psychology’s concentration on psychopathology and human deficit. Its focus is on the positive aspects of human experience above and beyond the removal of suffering, psychopathology, or deficit.

• It seeks to provide a more complete vision of human beings and their experience (Seligman, Steen, Park, & Peterson, 2005).

PP AND ADDICTION

• SCARCE LITERAURE INTEGRATING PP AND ADDICTION

• Two PP interventions with potential for benefit among those with SUD: the three good things exercise and the best future self (you at your best) exercise. Also of importance is that those with low affect, physical illness, or who are highly self-critical could benefit more than healthier individuals from gratitude interventions (Krentzman, 2013).

• Akhtar and Boniwell’s (2010) article “Applying positive psychology to alcohol-misusing adolescents: A group intervention” was the only article found on specific interventions applied to people with SUD of any age, in any setting. It was a pilot study.

• The authors assumed that PP could be an alternative route to seeking happiness, resilience, and positive emotions for young people, instead of drinking and/or drugging.

• Findings from quantitative and qualitative measurement instruments suggested a significant increase in well-being and decrease in alcohol use.

PROPOSAL

Develop a model integrating the theoretical

premises and interventions of Positive Psychology

(PP) with Treatment as Usual (TAU) which utilizes

components of the Twelve Steps of Alcoholics

Anonymous / Narcotics Anonymous.

STATEMENT OF THE PROBLEM

The problem of this study is developing a

model integrating Positive Psychology with

Treatment as Usual for Substance Use

Disorders in a Residential Facility in

Nicaragua.

PURPOSE OF THE STUDY

The purpose of this study is:

1. To determine the components of Positive Psychology that could be beneficial for those in treatment for SUD

2. To determine the components of the Twelve Steps of Alcoholics Anonymous / Narcotics Anonymous used in Treatment as Usual

3. To examine the process of integration between the selected components of Positive Psychology and those of Treatment as Usual, specifically those that include the Twelve Steps of Alcoholics Anonymous / Narcotics Anonymous?

SIGNIFICANCE OF THE STUDY

• This study could be useful in providing an integrated framework that attempts to balance the individual’s self-concept and narrative through a more complete perspective and with an inclination towards the positive aspects of human nature.

• Treatment as Usual utilizing the Twelve Steps of Alcoholics Anonymous / Narcotics Anonymous could present the individual with the negative aspects and consequences of their alcohol and/or drug use. This could prove a heavy emotional burden for some.

• The proposed integrated framework is intended to help individuals identify and recognize in themselves positive aspects of their personalities and their lives that could have easily been obscured by addiction, therefore providing a more balanced view of themselves and their histories.

RESEARCH QUESTIONS

1. What are the selected components of Positive Psychology that could be beneficial for those in treatment for Substance Use Disorders?

2. What are the core components of the Twelve Steps of Alcoholics Anonymous / Narcotics Anonymous used in Treatment as Usual?

3. How can selected components of Positive Psychology be integrated with the core components of Treatment as Usual, specifically those that include the Twelve Steps of Alcoholics Anonymous / Narcotics Anonymous?

METHOD

Developmental Research and Utilization Model (DRU; Southern, 2007))

• DRU is a phase model designed to direct the dissemination of knowledge, along with the development, implementation, and adoption of new innovations or programs.

• The DRU consists of two stages—research and utilization—divided into five phases.

• The research stage consists of three phases: analysis, development, and evaluation. The utilization stage has two phases: diffusion and adoption.

DRU

DRU

DEFINITION OF TERMS

• Addiction: a primary brain disease that affects reward circuitry, motivation, and memory and that becomes manifested in multiple dimensions, including biological, psychological, social, and spiritual (ASAM, 2011). For the purpose of this study, the term Addiction will be used specifically to designate a Substance Use Disorder.

• Positive Psychology: the field that represents a supplementary perspective to traditional psychology’s concentration on psychopathology and human deficit. This supplementary perspective directs its focus to the positive aspects of human experience above and beyond the removal of suffering, psychopathology, or deficit. (Seligman, Steen, Park, & Peterson, 2005).

• Treatment as Usual: is defined in this study as all interventions used in the treatment for those with Substance Use Disorders and which utilize some form of the Twelve Steps of Alcoholics Anonymous / Narcotics Anonymous. This could include Twelve Step Facilitation Therapy, readings from Alcoholics Anonymous / Narcotics Anonymous texts, homework utilizing content from Alcoholics Anonymous / Narcotics Anonymous, individual and/or group counseling utilizing content from Alcoholics Anonymous / Narcotics Anonymous.

ORGANIZATION OF REMAINDER OF STUDY

• This proposal represents Chapter 1.

• Chapter 2: extensive review of the literature related to Substance Use Disorders, its treatment, and Positive Psychology.

• Chapter 3: detailed research methodology.

• Chapter 4: results of the research.

• Chapter 5: discussion of the results, implications of findings, and recommendations for future application.

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