Elements That Define Recovery: The Experiential Perspective

Abstract

ABSTRACT. Objective: Although recovery increasingly guides substance use disorder services and policy, defi nitions of recovery continue to lack specifi city, thereby hindering measure development and research. The goal of this study was to move the substance use disorders fi eld beyond broad defi nitions by empirically identifying the domains and specifi c elements of recovery as experienced by persons in recovery from diverse pathways. Method: An Internet-based survey was completed by 9,341 individuals (54% female) who self-identifi ed as being in recovery, recovered, in medication-assisted recovery, or as having had a problem with alcohol or drugs (but no longer do). Respondents were recruited via extensive outreach with treatment and recovery organizations, electronic media, and self-help groups. The survey included 47 recovery elements developed through qualitative work followed by an iterative reduction process. Exploratory and confi rmatory factor analyses were conducted using split-half samples, followed by sensitivity analyses for key sample groupings. Results: Four recovery domains with 35 recovery elements emerged: abstinence in recovery, essentials of recovery, enriched recovery, and spirituality of recovery. The four-factor structure was robust regardless of length of recovery, 12-step or treatment exposure, and current substance use status. Four uncommon elements did not load on any factor but are presented to indicate the diversity of defi nitions. Conclusions: Our empirical fi ndings offer specifi c items that can be used in evaluating recovery-oriented systems of care. Researchers studying recovery should include measures that extend beyond substance use and encompass elements such as those examined here-e.g., self-care, concern for others, personal growth, and developing ways of being that sustain change in substance use. (J. Stud. Alcohol Drugs, 75, 999-1010, 2014

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