Long-Term Sobriety Strategies for Men With Co-occurring Disorders

Abstract

Objective Roughly half of people with severe mental disorders also experience a co-occurring substance use disorder, and recovery from both is a critical objective for health care services. While understanding of abstinence initiation has grown, the strategies people with co-occurring disorders use to maintain sobriety are largely unknown. This article reports strategies for relapse prevention as described by men with co-occurring disorders who achieved one or more years of sobriety. Methods We analyzed semi-structured interviews conducted with a sample of 12 men with co-occurring psychosis and substance use disorder who achieved and maintained sobriety for at least one year, supplemented with demographic and diagnostic clinical record data. These men were participating in residential or outpatient treatment at a private, non-profit integrated treatment clinic. Results The 12 men were primarily Caucasian (91.7%) and unmarried (100%), and their ages ranged from 23 to 42 years. The two most common psychiatric disorders were schizoaffective disorder (n = 4, 33.3%) and bipolar disorder (n = 4, 33.3%), while the two most commonly misused substances were alcohol and cannabis. Qualitative analyses showed that participants maintained sobriety for at least one year by building a supportive community, engaging in productive activities, and carefully monitoring their own attitudes towards substances, mental health, and responsibility. Alcoholics Anonymous might act as a catalyst for building skills. Conclusions People with co-occurring disorders who achieve sobriety use a variety of self-management strategies to prevent relapse—seeking support, activities, and a healthy mindset. The findings suggest a relapse prevention model that focuses on social networks, role functioning, and self-monitoring, and conceptualizes self-care as critical to extending periods of wellness.

Connection, meaning, and distraction: A qualitative study of video game play and mental health recovery in veterans treated for mental and/or behavioral health problems

“…Most of our sample used video games to cope with or distract from symptoms. Being able to cope effectively with distressing emotions or to plan meaningful activities that replace potentially dangerous unstructured time is important for individuals in recovery from mental health problems or substance addiction (Luciano et al, 2014; Villaggi et al, 2015). Feeling confident in one’s coping ability is an important element of well-being, and feeling that one can cope with suicidal thoughts helps to avert suicidal crises (National Academies of Sciences, 2016; Stanley et al, 2017).…”

Self-Management Support Needs From the Perspectives of Persons With Severe Mental Illness: A Systematic Review and Thematic Synthesis of Qualitative Research

“…The presence of peers or others was described as an encouraging experience for participants. They mentioned the helpfulness of having a buddy or doing activities in a group (Arbour-Nicitopoulos et al, 2011;Graham et al, 2014;Johnstone et al, 2009;Luciano et al, 2014;Rastad et al, 2014), and that peers showed them the possibilities of achieving a different life (Luciano et al, 2014). The presence of peers enhanced accountability, motivation (Graham et al, 2014), and courage (Johnstone et al, 2009).…”

“…I think being part of a group is motivational for me, you're more accountable that way. (Graham et al, 2014, p. 4) The third subtheme for encouragement was the need for confirmation, including receiving positive affirmations (Rastad et al, 2014), expressing faith and confidence in a person's ability (Chronister et al, 2015;Doherty & MacGeorge, 2013;Luciano et al, 2014;Zou et al, 2014), reminding them of accomplishments and progress (Doherty & MacGeorge, 2013), or getting reassurance such as being told that what one wants to do sounds like the right thing (Fisher et al, 2017). The confirmation enhanced confidence (Zou et al, 2014), boosted self-esteem (Doherty & MacGeorge, 2013), and reduced stress (Chronister et al, 2015).…”

“…Conclusions drawn in the research report do appear to flow from the analysis or interpretation of the data. (Cruce et al, 2012) Coping with symptoms, and relapse prevention (Chronister et al, 2015;Luciano et al, 2014); getting to and sticking to a regular schedule, stabilizing daily structure, and routines (Cruce et al, 2012;Doherty & MacGeorge, 2013) Coping with symptoms in general (Chronister et al, 2015;Cruce et al, 2012;Doherty & MacGeorge, 2013;Fisher et al, 2017;Poremski et al, 2016;Rusner et al, 2010;Thomas & Rickwood, 2016;Todd et al, 2012;Topor et al, 2006;Whitley & Campbell, 2014;Zou, Li, Nolan, Wang, & Hu, 2013), keeping up awareness (Poremski et al, 2016) Substance abuse Alcohol and drugs, and how to remain sober (Thomas & Rickwood 2016) Coping with craving (Whitley & Campbell, 2014) Understanding difficulties in periods of misuse (Cruce et al, 2012) Staying clean…”

The construction of meaning in alcohol addiction: A narrative study of socially excluded people’s stories about alcohol

“…For mentally ill persons with addiction, it has been found that Dual Diagnosis Anonymous (DDA) is a good alternative to AA, as DDA creates a space for acceptance and understanding for people struggling with similar issues, providing hope of overcoming both illnesses ( Roush et al, 2015 ). Others have argued that the psychological state is influenced by whether the person stops drinking or reduce his or her intake ( Green et al, 2015 ), and that self-help strategies have an important influence on obtaining sobriety ( Luciano et al, 2014 ).…”