Maintenance of long-term recovery from substance use: a mixed methods study of self- and treatment-changers

Drawing on a person-centered approach to recovery from substance use that acknowledges recovery pathways as shaped by people’s personal and social context, the purpose of this study was to compare recovery maintenance of two pathways, self-change and treatment-change. A mixed methods design was employed among 229 respondents [134 self-changers (SCs) and 95 treatment-changers (TCs)], with a qualitative subsample of 41 participants. The results indicate significant differences between the groups in terms of sociodemographic and personal characteristics, as well as maintenance factors of recovery. The qualitative findings indicate that the SCs were characterized by an intrinsic locus of maintenance style. They were motivated by future goals, employed self-oriented strategies, and their risk of relapse was related to self-reliance. In contrast, TCs were characterized by an extrinsic locus of maintenance style. They were motivated by past events, employed interpersonal strategies, and their risk of relapse was related to limited self-efficacy. The findings suggest that recovery maintenance is evident irrespective of recovery pathway, but people’s personal and social context may play a special role in shaping their maintenance recovery style. Treatment and recovery systems of care should adopt person-centered approaches and offer multiple recovery pathways that address varying maintenance styles.