Purpose

1
Positive Psychology and the Bountiful
LifeAdherence 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 ones 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 AAs 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 lt .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 (?F
  16.880, p lt 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

AA Involvement
(Improvement in) Pearson Correlation Sig. (2-tailed) N
Personal Functioning
Emotional Functioning .493() .000 81
Quality of Life .360() .001 81
Substance Use .389() .000 79
Interpersonal Functioning .247() .027 80
Societal Functioning
Legal/Criminal .262() .021 78
Occupational Functioning .354() .001 81
Health Care Utilization .252() .026 78
Meaning/Purpose in Life .170 .132 80
Total Eudaimonic Well-Being (EWB) .477() .000 81
EWB Components Beta In T Sig.
(Improvement in)
Emotional Functioning .401 3.155 .003
Interpersonal Functioning -.010 -.067 .947
Legal/Criminal .179 1.389 .171
Health Care Utilization .139 .937 .353
Substance Use .117 .801 .427
Occupational .173 1.287 .204
Meaning/Purpose in Life .257 1.994 .052
Quality of Life .222 1.493 .142
Dependent Variable AA Involvement Dependent Variable AA Involvement Dependent Variable AA Involvement Dependent Variable AA Involvement
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) Predic
tor 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