Running head: GROUP AND SELF AMONG RECOVERING SUBSTANCE ABUSERS

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Dynamics of Group and Self among Recovering Substance Abusers in Mutual Support Groups: A Correlational Study Proposal

..... 10 Implications ....... 10 Anticipated Results ................... 4 Statement of Problem ............................................................................................................................................................................................................................................................ 19 ...........…………………………………………………………12 References .................................................................................................................. 11 Summary..............................................................Group and Self among Recovering Substance Abusers 2 CONTENTS ABSTRACT ....................................................................................................................................................................................... 4 Group process .............................................................................................................................. 11 Limitations……………………………………………………………………………........................................................................................................................................................................ 11 Conclusion ........... 4 Literature Review ................................................................................12 Further Research …………...................................................................................................................................................................... 3 Introduction ................................................................. 6 Method ..... 8 Proposed Statistics ............................................................................................................................................................................................................................................................................. 15 Appendix A: Informed Consent Form ............ 4 Self-efficacy........................... 11 Discussion .............................................................................................................................................................................................................................................................................................................................. 8 Procedures ............................................................................ 9 Ethical Considerations ......................................... 7 Materials .......................................................... 5 Hypotheses to be Tested ........................................... 7 Participants......................................................................................................

To reinforce research from previous largely qualitative studies. Self-efficacy. this study proposes to correlate self-efficacy and selfesteem as predictors of the rate of abstinence. It is hypothesized that increases in self-efficacy and self-esteem will predict self-agency in terms of higher abstinence and lower drug craving. but that self-efficacy will be a greater predictor. and continuous online statistical analysis for the benefit of other researchers and those who want to manualize self-efficacy and self-esteem concepts in the group context for substance abuse recovery. the internet. as a component of the conceptual "system of self" works in conjunction with self-esteem to help goal achievement. Participation in mutual support groups is believed to reinforce selfefficacy by giving participants the opportunity to help others. or self-agency. or self-agency. for those with substance disorders. is abstinence. . of a group 30 men with a mean age of 30 who attend mutual support substance abuse programs. which. The study also proposes to explore innovative data collection and statistical methodologies that leverage cell phones.Group and Self among Recovering Substance Abusers 3 Abstract Self-efficacy in those attempting to recover from substance abuse disorders is believed to contribute to abstinence.

Stewart. Mutual support groups such as Alcoholics and Narcotics Anonymous provide effective support and are cost-effective as they are self-supporting. 2009). Literature Review Self-efficacy Self-efficacy is the perception of one's ability to reach goals. mediates the process of achieving goals. implying that it is a growing problem (Hasin. 2007). of abstinence in the context of mutual support groups. This study proposes to quantify the relationships between the "self-system" components of self-efficacy and self-esteem as they help recovering abusers achieve the goal. and. 2010). 2005). as an example of substance abuse..Group and Self among Recovering Substance Abusers 4 Introduction Statement of Problem Alcohol abuse. according to Bandura (1982). & Marsden. or self-agency. Groh. 2008. Non-abstinent substance abusers regularly experience high permanent recovery rates if they regularly attend group support meetings (Gossop. Less than a quarter of alcohol abusers are treated and treatment opportunities have declined.. Drug abuse is also shown to be growing. et al. and treatment is also believed to be declining especially for the young (Terry-McElrath. et al. Related to self-efficacy . Recovery is difficult and relapse is common (DeFulio & Silverman. has a lifetime prevalence of 18% with current abuse highest among the young. or self-agency. The reason given for high success rates is that the groups provide opportunities for those recovering from abuse to increase their self-efficacy (Stevens. et al. 2011).

Group and Self among Recovering Substance Abusers 5 and self-agency (as components of the "self-system") is self-esteem (Phan. & Mogro-Wilson. and it may be that they are taking more supportive roles. (2009) show that recovering abusers who both attend support groups and get further support by living in support communities have the highest self-agency. This study shows increased self-efficacy in a therapeutic context. is enhanced by peer appraisals and support (Bracke. as the perception of self-worth. & Verhaeghe. 2008). et al. Also. This suggests that these multiple group members are doing something different than single-group members. While group efficacy should predict self-agency among members. Strolin. 2008). they specifically show that self-efficacy is achieved when group members take a leadership role by providing support to other members. which. Under some circumstances. or group agency. Self-efficacy is also suggested as a mechanism that reduces the drug craving that leads to abstinence relapse (Matto. Truneckova. & Viney describe group process as the means by which groups provide members with self-system support (2008). but. or abstinence. Groh. could not link self-efficacy to selfagency. Christiaens. 2010). they show that self-esteem can be detrimental to self-agency in the absence of self-efficacy (especially in men) as it signifies peer dependence rather than self-agency. rate of about 90%. Combining these ideas suggests recovering abusers who benefit the most . which would be the patients' progress over time. using a cross-sectional design. Christiaens. and Verhaeghe (2008) show that self-efficacy and related selfesteem can interrelate as mutual mediators among support groups of the mentally ill. and Bandura (1982) describes group efficacy as a group's perception of its ability to reach goals. Group process Bracke.

and that self-efficacy is more predictive of self-agency than self-esteem is. but it is the individual effort of the participant that is the ultimate predictor of self-agency. Clients with high self-efficacy will have lower cravings. and Groh. It also proposes to show that self-efficacy is indeed associated with lower drug craving. 2. 3. Truneckova. Clients who have high abstinence will show higher self-efficacy than self-esteem. et al. & Viney (2008) demonstrated group process as being beneficial for members but failed to connect it to individual efficacy and agency (even though their results seemed to support it). Hypotheses to be Tested This study proposes to show that self-efficacy and self-esteem both directly contribute to self-agency. Clients who participate in mutual support groups by contributing support and suggestions to other group participants (self-efficacy). (2009) showed self-efficacy. giving those who participate in groups a higher rate of abstinence. but not in the context of involvement in group process. which will correlate with higher abstinence (or self-agency). and who receive this kind of support (selfesteem) will have abstinence rates that are higher than those who have low measures in these variables. .Group and Self among Recovering Substance Abusers 6 from group support in terms of self-agency tend to do so because they provide support to others as well as benefit from the group's support in terms of self-esteem. or abstinence. 1. Group support benefits members with self-esteem. in the context of mutually supported substance abuse recovery.

or to accommodate future research by enhancing the statistical software. Christiaens. heroin or methedrine. 2008)." either to increase the n-number as recruits are found. Limiting the study to male clients will solve a control problem which is that women respond to self-esteem at a different rate than men (Bracke. Participants Participants will be drug abuse clients who are referred by probation officers or recruited from Narcotics Anonymous-type mutual support groups with the assistance of group leaders.Group and Self among Recovering Substance Abusers 7 Method The two intended goals are to provide support for correlations between concepts of "system of self" through regression analysis of Likert-type self-report scales in relation to selfreports of abstinence. or "scaled. Participants also need to be frequent mutual support group attendees. the substances for which they have been referred have to be reliably testable drugs such as cocaine. They have to be reliable and drug free. There will be no control group primarily because the study will assess for correlations between self-efficacy and abstinence in the participants. Leaders of the mutual support groups will act as facilitators by reporting the group attendance of the participants and also that the group is functioning moderately well. and to implement a flexible self-report and analysis system that can be expanded. and. . for abstinence testing purposes. & Verhaeghe.

and will be able to convince restaurant owners to donate dinners. and self-esteem will be measured with the Rosenberg Self-esteem Scale. Restaurant coupons will be supplied to participants as a reward for honesty about abstinence and relapse self-reporting based on drug screens. self-esteem.Group and Self among Recovering Substance Abusers 8 Materials Self-efficacy. Both these tests are well-studied and have shown reliability and validity adequate for this study (Bogenschutz. they will be asked if they have concerns about the agreement (by the web server) to assure that they understood it. 2006. It will consist of a cell phone "app" for self-report system. and the group process will each be tested with a separate scale. . When they have agreed to agreement's terms. An online server secured with 128 bit encryption and sophisticated password checking will collect the data and an attached statistical program will analyze it on a continual basis. 2003). Procedures Participants and group leaders will register anonymously with the web server and be given the informed consent agreement form in a format that can easily be understood by them. Greenberger. Self-efficacy will be tested with a modified version of the Alcohol Abstinence Self-Efficacy Scale. & Farruggia. It is perceived that the business community leaders will support a program that seeks to reduce a major problem cost-effectively. The choice of restaurant coupons is to involve the community. Chen. which is a tiny web page that runs on a smart phone. & Miller. Dmitrieva. Tonigan. Self-report and statistical analysis will be conducted by an information system.

Goldberg. Proposed Statistics The test measures are self-efficacy and self-esteem as independent/predictor variables. They can also reach the research staff anonymously this way if they have concerns about their participation in the study. The test will be kept confidential simply by identifying it with the secret cell phone "app" log-in ID. They will be also be asked to access the "app" if they feel craving. These sessions will take a few minutes. As the relationship between the variables is expected to be linear. In the second hypothesis. and will be asked a few questions about the group process to assure that the group is functioning normally. Participants will be given random drug screens solely for the purpose of confirming abstinence or relapse. the multiple regression analysis may not be able to determine whether self-efficacy or self-esteem are more correlated with abstinence if they are closely . group leaders will insert attendance information into the server database. 2006). 2005. 2010). participants will be asked to access the server via a cell phone "app" after group support sessions and will be asked a few questions from the self-esteem and self-efficacy questionnaires.Group and Self among Recovering Substance Abusers 9 Using a secret name or number. This data is inclusion criteria and not intended to be experimental. multiple regressions will be used to create the "r" value that will indicate the level of association between variables (Meyers. Using the same method. They will be only tested for "hard" drugs such as cocaine. methedrine. and the study period will be three months. and abstinence and craving as dependent criteria. and heroin. as some other substances such as marijuana and alcohol will provide either overly-positive or overly-negative results (DuPont. or relapse to drug use.

Likewise the technical innovations are expected to produce data efficiently with little chance of response bias such as response acquiescence and social desirability.Group and Self among Recovering Substance Abusers 10 correlated to each other: the condition of multicollinearity (Berry. and their individual concerns will be solicited and accommodated. and that there are no deceptions in this study. 1985). Anticipated Results It is expected that the three hypotheses will be confirmed. Ethical Considerations The informed consent agreement (Appendix A) has been developed to meet United States federal government and American Psychology Association ethical guidelines (Goodwin. . and that they agree to attempt to stay with the program as they are needed to monitor participant attendance and group process. though the relationship between self-efficacy and self-esteem in terms of abstinence may need further statistical analysis to magnify the differences to show a relationship. how confidentiality will be protected. They will be informed about the content and purpose of the study. that they are volunteers. 2000). It is in terms clients can understand. how they can withdraw. there will be no consequences for withdrawing. 2010. as the self-reports are anonymous and supplied to a device rather than a person. its duration. their privacy rights are fully protected. Group leaders will likewise be given informed consent material with the addition that they agree to protect the privacy of the other participants. Solutions may include obtaining more data or implementing other statistical formulations. Kitchener.

and hence conflicting and often ambiguous. It shown that good group process. which is already in the public domain. The research material will be presented in such a way that it can be further analyzed with the online software with which it is presented.Group and Self among Recovering Substance Abusers 11 Implications The material provided can be directly applied by researchers interested in manualizing group support strategies that leverage "system of self" components as they are enhanced by the normal group process (Stevens. will be made available for modification.. but it is important to understand that the individual may benefit . Statistical software. 2010)." but will be made available to researchers who have participants willing to self-report with cell phones at a cost of pennies per transaction. The anticipated success of the technology innovations will encourage similar efforts. The system will not be "taken down. The technology experience will show that self-report effectiveness can be enhanced by many factors and that collected material and statistical services can be made universally available at little cost. Conclusion This study will help define and "tease apart" the different components of the structures of the "system of self" and use quantitative data to define them in the context of group experience in ways that have largely been qualitative. et al.. et al. Discussion Summary The study will provide needed evidence of the relationships between "systems of self" and the group process for the purposes of policy-making and future research. or group efficacy. 2010). will enhance self-efficacy and selfagency (Stevens.

It has been shown that women are motivated differently by self-esteem. Christiaens. or group-agency.. Figueira- . Individuals do this by contributing to the group in a way that reinforces their selfsystem. though measures are being implemented to control for this through drug screening and with rewards for honesty. 1985. et al. self-efficacy. and also social cohesiveness in terms of group process and especially abstinence (Bracke. 2010). Presumably all the group members will benefit (especially in terms of self-esteem). Another limitation may be the influence of drug screening as they have been shown to mediate abstinence (Sánchez-Hervás. Perceived limitations also relate to relapse and abstinence. & Verhaeghe. The craving variable data may be used in the first and second hypotheses if abstinence self-reporting is too problematic. Ultimately.Group and Self among Recovering Substance Abusers 12 from the group process in ways that are independent of the group's goal-reaching success. Limitations This second hypothesis (which is that self-efficacy and self-esteem are important to selfagency. 2007). 2008. Meyers. Assured privacy and the reward for honesty should minimize this effect. Self-reports for drug use have been shown to be inaccurate (Tourangeau & Yan. these potential problems would best be resolved in future research by developing other variables to use as measures of self-agency. but not as much as individuals who actively contribute. but self-efficacy is more important) presents a possible limitation in that there may be statistical difficulties if the self-efficacy and self-esteem variables are found to be too closely correlated (Berry. Future Research An intuitive next step is to apply the study to women. 2006).

1998. Real world effectiveness needs to be shown in a variety of environments such as different countries to win general support. personal communication. technical focus should move towards the statistical services. 2010)). & Allik.Group and Self among Recovering Substance Abusers 13 McDonough & Sarri. The strongest rationale for this study is the initiation of future research. but terminology is unclear (and often defined in the context of a single study). many researchers criticize their use such as in multi-cultural contexts (Schmitt. Johnson. Further. and often by the same researchers. While most researchers cite most commonly-used "self-system" tests as having high reliability and validity. (A Five Factor Model project can supply much of the software and expertise (J. Evidence is building in different areas for a self-system and group process model. 2007). 2002). participants could be asked open-ended questions such as "how do you feel?" These responses could be converted into questions to be categorized. This will create real-world connections to theoretical abstractions in much the way that the Five Factor Model has been developed. December 6. A general solution is to implement factor analysis software (which is also in the public domain) in place of regression software so that test questions can be used at random (within the scope of self-system and mutual group support) and then "clustered" using Likert-type scales into categories that will relate to components of the self-system (DeCoster. Hojat. and only a small percentage of studies have been applied to major disorders (rather than. business dynamics). With implementation of a cell phone "app" that operates at nearly no cost. A. 2005). the greatest benefit may be the ability to interrelate variables to predict the all- . say. This research should provide better definitions for the "system of self" in terms of gender differences. Ultimately.

in turn. and hopefully accurately predict abstinence honesty (using selfsystem variables) so as to eliminate drug screening as a potential mediator. and expense.Group and Self among Recovering Substance Abusers 14 important abstinence. these." to move towards a group-oriented agency model as group agency will presumably yield a greater volume of beneficial outcomes than individual agency. research should attempt to transcend the singular focus on the "system of self. Also. . or self-agency. so that abstinence success can be used to load variables that simulate group process. source of participant concern. Future software should be developed to further resolve privacy issues by deleting personal data as it is processed. can contribute to developing outcomes that can be used to formulate therapeutic strategies.

and Resistance. J. Journal of Applied Social Psychology. Belmont. Retrieved from http://www.x DuPont. Cengage Learning. 960-967.03364. (1982). Drug testing in schools: guidelines for effective use. (2011). R. Addiction. Multiple regression in practice. (2008). Bracke.1360-0443. A. doi:10. (2010). 38(2). 436-459. Bogenschutz.Group and Self among Recovering Substance Abusers 15 References Bandura.html DeFulio. W. P. Journal of Studies on Alcohol.1111/j. R. Center City. Overview of factor analysis. . Christiaens.2011. K. Tonigan.com/notes. & Verhaeghe. W. and the balance of peer support among persons with chronic mental health problems. doi:10.37. 37(2).1037/0003-066X.1111/j. doi:10. Employment-based abstinence reinforcement as a maintenance intervention for the treatment of cocaine dependence: post-intervention outcomes. A. 67(4). R.. CA: Sage Publications. (1998). (1985). Punishment. & Silverman.1559-1816. 106(5).. P. (2006). (2005). Self-esteem. M.x DeCoster. 562-567. S. American Psychologist.2.2008. (2002). CA: Wadsworth. Drugs across the spectrum. Figueira-McDonough. M.stathelp. Self-efficacy mechanism in human agency. New York: Routledge Goldberg. MN: Hazelden.. J. W. & Sarri... Women at the Margins: Neglect. & Miller. R. self-efficacy.00312.122 Berry. Beverly Hills. Examining the effects of alcoholism typology and AA attendance on self-efficacy as a mechanism of change. 122-147.

doi:10. I. (2007). Archives of General Psychiatry. (2010). S. F. 119–12 Greenberger. Mahwah. F. Hoboken.1080/15560350802712363 Hasin. (2008). (2000).. 103(1). Stewart. Item-wording and the dimensionality of the Rosenberg Self-Esteem Scale: Do they matter?. N. 1241. frequency of attendance and substance use outcomes after residential treatment for drug dependence: A 5-year follow-up study. M. Jason... (2003). J. Personality & Individual Differences. (2007). doi:10. R.. . Erlbaum Associates. NJ: John Wiley and Sons. Gossop. research.J: L. Ogburn. & Grant. C.. M. S. D. R. 64(7). (2009). D. Addiction. Inc. & Davis. Journal of Groups in Addiction & Recovery. J. C. J. K. New York: Springer.. Prevalence. E.). Ferrari.Group and Self among Recovering Substance Abusers 16 Goodwin. L. Empathy in patient care: antecedents. Hojat. 23-31. and outcomes. S. Attendance at Narcotics Anonymous and Alcoholics Anonymous meetings. & Marsden. Stinson. D. 830-842. Foundations of ethical practice. Oxford House and Alcoholics Anonymous: The impact of two mutual-help models on abstinence. J.. A. measurement. and comorbidity of DSM-IV alcohol abuse and cependence in the United States. B. Chen. disability. & Farruggia.. Dmitrieva. and teaching in psychology. correlates.. 4(1/2). Research in psychology: Methods and design (6th ed. E. development. P.. 35(6).. Kitchener.1016/S0191-8869(02)00331-8 Groh. M.

B. (2005). & Allik.4. & Hunter. J.. L. R.. O. Urine testing during treatment predicts cocaine abstinence.1037/0022-3514. S. (2005). Strolin. Y. Students' academic performance and various cognitive processes of learning: an integrative framework and empirical analysis. Ferrari. (2006). . C.623 Stevens.. Thousand Oaks.. 297-322. H. (2010). 42(3). doi:10. Schmitt. García-Rodríguez.. 12(2)... 623-642.1080/01443410903573297 Sánchez-Hervás.. 285294.. H. E. E. Journal of Psychoactive Drugs. R.. Santonja Gòmez. Romaguera. (2010). A pilot study of a dual processing substance user treatment intervention with adults. J.Group and Self among Recovering Substance Abusers 17 Matto. O'Malley.. D. F. 30(3). Substance abuse counseling services in secondary schools: A national study of schools and students. Jason. C. P. L. Self-efficacy and sense of community among adults recovering from substance abuse. Journal of Personality and Social Psychology. Johnston. M. CA: Sage Publication Phan. J. Simultaneous administration of the Rosenberg Self-Esteem Scale in 53 nations: exploring the universal and culture-specific features of global selfesteem. (2010). E. 89(4). Secades-Villa.. R. 255-264. & Yamaguchi. & Yanez. 347-352. (2008). doi:10. North American Journal of Psychology. A. Substance Use & Misuse 43(3-4). P. Educational Psychology.. L. Meyers. Terry-McElrath. D. Applied multivariate research: Design and interpretation. F. B. M.. & Mogro-Wilson.89.

(2008). (2007). 334-341. 5. L.859 Truneckova.17461561.5.1037/0033-2909. Psychological Bulletin. T. 75(9). & Viney.. D..2005. doi:10. .00047.133.1111/j.Group and Self among Recovering Substance Abusers 18 1999-2003. 859-883. Personal Construct Theory & Practice. Small-group counselling with primary school children. 133(5). R. Journal of School Health. L. doi:10.x Tourangeau. Sensitive questions in surveys. & Yan. 139-148.

Group and Self among Recovering Substance Abusers 19 Appendix A: Informed Consent Form .

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