Bjornestad (2021): "And then the rest happened"-A qualitative exploration of the role that meaningful activities play in recovery processes for people with a diagnosis of substance use disorder, Substance Abuse,
Background: Being a participant in longitudinal follow-up studies is not commonly a factor considered when investigating useful self-change aspects for individuals attempting recovery from substance use disorder (SUD). This study reports on how ongoing monitoring, and feedback on data results in a longitudinal follow-up study of SUD recovery were perceived by individuals who had achieved long-term abstinence and social recovery. Methods: Interviewers with first-hand experience with the topic conducted interviews with 30 participants and analysed the data using a thematic analytic approach within an interpretative-phenomenological framework. Results: Analyses resulted in the following themes. 1) Ongoing short text messaging (SMS) monitoring: helped participants by offering recovery milestones and reminders of the past. 2) Feedback on data results helped participants track physical and cognitive recovery: "I am more like myself". 3) Using feedback in treatment: understanding the importance of a functional brain to participants may help with long-term retention in treatment. Conclusions: Self-changes that were challenging to detect on a day-today basis were available for reflection through longitudinal study participation, including ongoing monitoring and feedback on the results, allowing personal consolidation of change processes. Clinical services could benefit from continuing development and implementation of such technology for ongoing monitoring and feedback on assessments to motivate self-change in SUD recovery. The development of guidelines for providing the results of research assessments to individuals could help reduce attrition in research projects and support recovery and healthy choices for study participants.
The longitudinal cohort study is the gold standard in observational epidemiology. A central challenge with this design is the risk of attrition over time, especially in studies of inaccessible clinical populations, such as individuals with substance use disorder (SUD). Research on individuals who have achieved stable substance use abstinence and functional recovery is scarce. 30 participants from a longitudinal cohort study (the Stayer study), were interviewed concerning their experiences of participation over several years to explore retention factors. Interviewers with first-hand experience of recovery from SUD conducted the interviews. Data were analyzed using a thematic analytic approach within an interpretative–phenomenological framework. The analyses yielded the following themes: (1) Individuals’ substance use: adaptation to slips and relapses in treatment and research, (2) “Show that you care”: Developing working relationships in research with study participants by negotiating expectations flexibly, and (3) “You don’t just make dropouts”: A long-term focus on study participation and treatment can increase retention. Several factors were perceived as relevant to participation in a long-term follow-up study with diverse recovery routes, including working research relationships and explicit contracts allowing follow-up participation, even during periods of drug use. Longitudinal studies could benefit from including such factors in the tracking procedures in addition to more traditional tracking techniques. Clinical services could benefit from developing interventions that use knowledge of long-term recovery processes as non-linear, heterogeneous trajectories, and proactive approaches to motivate recovery.
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