Purpose

1. Positive Psychology and the Bountiful Life:Adherence to Alcoholics Anonymous During AftercareTerence Singh & Kenneth E. HartUniversity of Windsor • Purpose • Can a bountiful life be “achieved and sustained through peer support groups such as Alcoholics Anonymous [AA] and practices consistent with the 12 steps and 12 traditions”? • (as suggested by the Betty Ford Institute Consensus Panel (BFICP), 2007, p. 222) • Background • The October 2007 issue of JSAT emphasized the importance of demonstrating (and publicizing) that it is possible for former clients to fulfill their human potential and live a bountiful life because of their struggle with AOD, not in spite of it • Eudaimonic Well-Being (EWB) is a popular concept among positive psychologists such as Waterman (2007), who defines EWB as a dynamic state of self-actualizing in which one’s ‘daimon’ or higher human nature is actively engaged in the developmental process of becoming fulfilled • Meta-analyses (e.g., Emrick et al., 1993; Tonigan et al., 1996) and narrative reviews (e.g., Humphreys, 2004; Tonigan et al., 2003) provide convincing evidence that greater adherence to AA-sanctioned processes of change can contribute to better drinking-specific outcomes. However, little attention has been given to the broader impact that AA-adherence might have on the full range of ‘life outcomes’ • By bringing together the BFICP report, popular ‘wellness’ theories (Ryan & Deci, 2001; Ryff & Singer, 1998), and addiction-related quality-of-life research (e.g., Donovan et al., 2005; Longabaugh et al., 1994), we were able to operationalize eudaimonic recovery • Method • Respondents: Participants completed an inpatient AOD program at a Minnesota Model treatment center in England emphasizing abstinence, spirituality, and adherence to AA’s 12-Steps. The average time between post-treatment and follow-up assessment was 2.2 years • Results • Primary Analysis • Improved Adherence to AA Recovery Practices (AA Involvement) was positively correlated with improvement in the overall TDI-EWB-27 (r = .477, p < .001) • AA Involvement was also positively correlated with change scores in all three TDI-EWB-27 sub-domains (Personal Functioning, Interpersonal Functioning, Societal Functioning) • Further Analyses: Stepwise Regression • Step 1 — Background variables • Step 2 — Total score of the 8-item AA Involvement index • Improvements in AA Involvement were associated with improvements in TDI-EWB-27 scores, accounting for 20.9% of the residual variance (ΔF = 16.880, p < 0.001) • Further Analyses: EWB Subscale Impact on AA Involvement • To identify which aspects of EWB were most impacted by AA Involvement, we conducted a second regression in which AA Involvement was set as the criterion variable. • Each of the TDI-EWB-27 sub-scales were entered as separate predictors. Subscales were considered to have ‘research’ significance if they accounted for 10% or more of the variance in AA-Involvement (as suggested by REF) • Implications • This study suggests that greater adherence to AA’s planned program of recovery may contribute to broad improvements in three domains of functioning in the lives of recovering alcoholics • These results provide empirical support which bolsters similar conclusions derived from the testimonial evidence of scholars (e.g., Bewley, 1995; Laudet, 2007) and AA literature (e.g., ‘Big Book’, 2007) • Evidence that greater adherence to AA can facilitate both abstinence and a new and better life may lead to more positive perceptions of AA by affected individuals, their families, health care providers, policy makers, and society in general. • Selected References • Betty Ford Institute Consensus Panel. (2007). What is recovery? A working definition from the • Betty Ford Institute. Journal of Substance Abuse Treatment, 33, 221-228. • Donovan, D., Mattson, M. E., Cisler, R. A., Longabaugh, R., & Zweben, A. (2005). Quality of • life as an outcome measure in alcoholism treatment research. Journal of Studies on • Alcohol, 66, 119-139. • Ryan, R. M., & Deci, E. L. (2001). On happiness and human potentials: A review of research • on hedonic and eudaimonic well-being. Annual Review of Psychology, 52, 141–166. Measures Focus on Dynamic Change: A mailed questionnaire asked participants to provide ratings of their current level of functioning (Time 2) relative to their functioning prior to treatment entry (Time 1). This ‘comparison’ procedure yielded retrospective perceptions of the degree of change (improvement) over time in two domains: EWB and AA-Involvement Outcome Variable:Improved Eudaimonic Well-being (EWB) A 27-item ‘Three Domain Index of EWB’ (TDI-EWB-27) was developed. Improvement scores were obtained in each of the following three life domains: Personal Functioning (9 items measuring 4 subtypes: emotional, quality of life, meaning in life, and alcohol use); Interpersonal Functioning (7 items measuring relational wellness); and Societal Functioning (11 items measuring 3 subtypes: legal/criminal, occupational, and health care utilization) Predictor Variable:Improved Adherence to AA Recovery Practices (AA Involvement) This measure of pre-treatment to follow-up improvement in adherence to AA recovery beliefs and practices consisted of the following 8 items: (1) number of meetings attended, (2) having an AA sponsor; (3) having formally completed both Steps 4 and 5; (4) involvement in Step 11 (prayer/meditation); (5) involvement in AA service; (6) self-identification as a “spiritual seeker”; (7) involvement in ‘Step’ meetings, and; (8) involvement in ‘Big Book’ meetings