Perceptions of Chronicity and Recovery Among Youth in Treatment for Substance Use Problems

Abstract

Purpose To explore how youth contextualize substance use problems and recovery, in general and for themselves, in relation to the commonly accepted chronicity framework. Methods Fourteen focus groups were conducted with 118 youth in substance abuse treatment settings (aged 12-24; 78.3% male; 66.1% Latino) located throughout diverse areas of Los Angeles County. Transcribed qualitative focus group data were analyzed for major substance use and recovery themes. Results Most (80%) youth do not accept a chronicity framework that conceptualizes substance use problems as recurring and constituting a life-long illness. Most (65%) view substance use problems as a function of poor behavioral choices or a developmental/social lifestyle phase. Youth perceptions of recovery tend to parallel this view, as most define recovery to mean having an improved or changed lifestyle that is achieved through making better behavioral choices (67%) and exerting personal control over one's behavior (57%) through willpower, confidence, or discipline. Other recovery themes identified by youth were substance use related (47%), wellness or well-being related (43%) and therapeutic or treatment related (14%). Conclusions Findings highlight the importance of considering youth perceptions about substance use chronicity and recovery in making improvements and promoting new developments in clinical and recovery support approaches to better meet the needs of youth with substance use problems. Findings are discussed under a theoretical context of behavior change to provide insights for the treatment and recovery communities.

Substance use recovery outcomes among a cohort of youth participating in a mobile-based texting aftercare pilot program

“…Findings also imply that promoting lifestyle behavior change in a way that meets their needs (i.e., focus on wellness for recovery) can be effective rather than following traditional aftercare approaches that tend to focus on and enforce complete abstinence (i.e., 12-step models). This was supported by qualitative findings with youth in treatment which found very few youth endorsing total abstinence recovery mottos, and instead embracing substance use to be more of a life-style behavior and a matter of personal control/choice (Gonzales et al, 2012)…”

“…The components of this pilot aftercare intervention (i.e., daily self-monitoring/feedback texts, wellness recovery tips, and substance abuse education and social support resource information texts on weekends) were influenced by formative work conducted with youth in treatment (see Gonzales et al, 2012; Gonzales et al, 2012; Gonzales et al, 2013; Gonzales et al, 2013). Previous studies that have used formative research for intervention development with youth populations challenged by diverse behavior issues (Mathews, Everett, Binedell, & Steinberg, 1995; Nichter, Nichter, Thompson, Shiffman, & Moscicki, 2002; Vu, Murrie, Gonzalez, & Jobe, 2006) have shown such approaches to be effective for behavior change as it includes culturally-relevant reflection and experiences of the targeted groups most affected.…”

“…These monitoring areas were identified from previous qualitative research that focused on exploring relapse with youth in treatment (Gonzales et al, 2012). Self-monitoring texts were sent to youth in the late afternoon (4pm) every day.…”

“…The text prompt said: “Today’s a new day in your recovery, think about the change ur working towards…[wellness tip]. The wellness intervention focus for recovery tips was based on exploratory research with youth in treatment who recommended that recovery programs be focused on promoting lifestyle change through wellness (Gonzales et al, 2012). The wellness daily recovery tips addressed four general areas of health/wellness, including personal health, social health, emotional health, and physical health.…”

Academic Disruption and Substance Use Disorders: University-Based Treatment Facilities

“…Another complicating factor is research, which suggests that academic challenges can be a key relapse trigger ( Gonzales, Anglin, Beattie, Ong, & Glik, 2012). This is important because relapse rates are high for young people ages 15 to 24 years, ranging from 60 percent to 79 percent in the first year ( SAMHSA, 2011).…”