Measuring Recovery from Substance Use or Mental Disorders Workshop Summary (2016) / Chapter Skim
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6 Measures of Recovery
6 Measures of Recovery
Pages 57-70
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From page 57... ...
discussed existing measures of recovery from substance use. Mark Salzer (Temple University)
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From page 58... ...
Laudet described three measures of recovery from substance use disorder that were discussed in a prior review of measures she prepared for SAMHSA.2 She noted that research on mental health recovery has a much longer tradition and there are more measures and instruments available for that area than for recovery from substance abuse. The first measure she discussed was the Modular Survey, an initiative with the goal to identify and develop common indicators and measures of consumer perception of care.
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From page 59... ...
, but the instrument measures aspects of what is needed to achieve recovery, not recovery itself. The Client Assessment Inventory was the third measure discussed by Laudet.4 This instrument was developed to measure clients' self-reports and staff evaluations of clients' progress in the therapeutic community environment.
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From page 60... ...
The U.N. Treatnet Group, for example, recommended that in the absence of a dedicated measure of addiction recovery, both the ASI and the WHOQOL be used to measure the following domains: maintenance of abstinence or reduction in substance dependence, improvement in personal and social functioning, improvement in mental and physical health, reduction in risky behavior that could affect health, and overall improvements in increasing access to livelihoods assets and recovery capital.
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From page 61... ...
. Laudet summarized the advantages of the WHOQOL BREF: • in the public domain • capitalizes on decades of field work • cross-culturally validated in 15 centers worldwide • strong psychometrics • assesses domains that are highly relevant to recovery • assesses both positive and negative aspects of life, objective and subjective ratings • published norms for well and ill persons • relatively short -- the 26 items require 20 minutes to administer or 15 minutes to self-administer • developed to be broadly applicable across disorder types, vary ing severity of illness, and diverse socioeconomic and cultural subgroups • serves as a precedent for methods to develop supplemental pop ulation-specific or disorder-specific modules to best capture rel evant dimensions for a given group Laudet noted that the World Health Organization defines quality of life as being close to one's expectation of an ideal in one's own context.
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From page 62... ...
In conclusion, Laudet argued that quantifying the problem is not particularly difficult because one can produce estimates of the number of people who meet the Diagnostic and Statistical Manual of Mental Disorders criteria for substance use, which could be done through the National Survey on Drug Use and Health (NSDUH)
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From page 63... ...
Some of the studies discussed during the workshop illustrate that there might be variation in these measures among those who have not had any substance use or mental disorder. Peter Gaumond (Office of National Drug Control Policy)
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From page 64... ...
Another category of recovery measures focuses on perceptions of the extent to which policies, programs, and practices create a recovery-promoting environment, and these are used in numerous states and systems. These measures include recovery-oriented systems indicators that measure the extent to which people feel supported in the areas of meaningful activities, basic material resources, peer support, choice, social relationships, formal service staff, formal services, and self or holism.8 Another measure in this category is the Recovery Self-Assessment, which has four versions; it assesses the degree to which programs implement recoveryoriented services.9 The measure has five factors: (1)
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From page 65... ...
In terms of measures focused on the subjective experience of recovery, Salzer noted that there have been several reviews published. A review by Burgess and colleagues looked at how measures fit nine criteria: • explicitly measures domains related to personal recovery, • brief and easy to use (50 or fewer items)
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From page 66... ...
The IMR has 15 items that assess personal goals, knowledge of mental illness, involvement of significant others, impaired functioning, symptoms, stress, coping, relapse prevention, hospitalization, medication, and use of drugs and alcohol.14 The scale has no specific subscales. The MARS has 25 items, and a 12-item version is also available.15 The scale measures six domains: self-direction or empowerment, holistic, nonlinear, strengths-based, responsibility, and hope.
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From page 67... ...
He argued that several of the principles could be measured with existing measures, or subscales, if measuring them is the goal. Those principles include hope, person driven, peer support, relational, strengths/responsibility, and respect.
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From page 68... ...
Salzer noted that he likes the purpose component of SAMHSA's definition and particularly likes the idea of a community participation approach to measuring it because it reflects a focus on what happens to a person who is in recovery. Finally, to measure community, Salzer said that a large number of measures exist that measure social network size and aspects such as perceived social support.
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From page 69... ...
He added that in some of his research measuring recovery among people with serious mental illness, he and his colleagues found that objective environmental influences, such as the amount of crime in the neighborhood, had very little influence on recovery. The team is now in the process of conducting follow-up studies that assess the subjective experience of these environmental factors.
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From page 70... ...
said that he is still wrestling with the question of how to operationalize recovery. If someone who used to have no social contact moved toward slightly more social contact but still falls far short of what one would like to see, would that be considered recovery?
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