Research Publications

  • Brown, A., Ashford, R., Heller, A. T., Whitney, J., & Kimball, T. (2018). Collegiate Recovery Students and Programs: Literature Review from 1988-2017. Journal of Recovery Science, 1(1), 1-11.

    ABSTRACT

    Objectives

    To present a review of the existing research on college students living in recovery, including the research on students in recovery participating in collegiate recovery programs.  

    Methods

    Studies were included if they: a) were peer-reviewed or archived dissertations, b) were published between 1988 and 2017, c) directly involved students in recovery on campus, either with or without involvement in a collegiate recovery program.

    Results

    From 1988 to 2017, 25 studies met the inclusion criteria. These included 7 studies on students living in recovery within the general framework of higher education and 18 studies involving students in collegiate recovery programs. Qualitative reports and quantitative descriptive studies were both included. 

    Conclusions

    Findings identify the gaps in currently available research, and support rationale for increasing longitudinal and quantitative studies of collegiate recovery programs and the students they serve.

  • Ashford, R. D., Brown, A. M., & Curtis, B. (2018) Substance use, recovery, and linguistics: the impact of word choice on explicit and implicit bias. Drug and alcohol dependence.

    ABSTRACT

    Background

    The general public, treatment professionals, and healthcare professionals have been found to exhibit an explicit negative bias towards substance use and individuals with a substance use disorder (SUD). Terms such as “substance abuser” and “opioid addict” have shown to elicit greater negative explicit bias. However, other common terms have yet to be empirically studied.

    Methods

    1,288 participants were recruited from ResearchMatch. Participants were assigned into one of seven groups with different hypothesized stigmatizing and non-stigmatizing terms. Participants completed a Go/No Association Task (GNAT) and vignette-based social distance scale. Repeated-measures ANOVAs were used to analyze the GNAT results, and one-way ANOVAs were used to analyze vignette results.

    Results

    The terms “substance abuser”, “addict”, “alcoholic”, and “opioid addict”, were strongly associated with the negative and significantly different from the positive counterterms. “Relapse” and “Recurrence of Use” were strongly associated with the negative; however, the strength of the “recurrence of use” positive association was higher and significantly different from the “relapse” positive association. “Pharmacotherapy” was strongly associated with the positive and significantly different than “medication-assisted treatment”. Both “medication-assisted recovery” and “long-term recovery” were strongly associated with the positive, and significantly different from the negative association.

    Conclusions

    Results support calls to cease use of the terms “addict”, “alcoholic”, “opioid addict”, and “substance abuser”. Additionally, it is suggested that “recurrence of use” and “pharmacotherapy” be used for their overall positive benefits. Both “medication-assisted recovery” and “long-term recovery” are positive terms and can be used when applicable without promoting stigma.

  • Ashford, Brown, & Curtis (2018)Collegiate Recovery Programs: The Integrated Behavioral Health Model

    ABSTRACT

    Campus-based recovery programs have been shown to support students in recovery from substance use disorders, as well as mental health disorders. However, this support has been historically delivered in isolation. This study highlights preliminary outcomes from a novel collegiate recovery program, one that uses a model of recovery with integrated support services for students in recovery from substance use or mental health disorders, or co-occurring behavioral health disorders. Similar to traditional collegiate recovery programs, beneficial services of the integrated program were most often related to peer-based services. Outcomes were also similar, with students in recovery having higher than average Grade Point Average (M = 3.68, SD = .34) and lengths of recovery time (M = 3.69, SD = 2.87 [years]).

    Suggested Citation

    Ashford, R. D., Brown, A. M., & Curtis, B. (2017). Collegiate Recovery Programs: The Integrated Behavioral Health Model. Alcoholism Treatment Quarterly, 1-12.

  • Ashford & Brown (2017) Bridging the gaps: Intergenerational findings from the substance use disorder and recovery field

    ABSTRACT

    The substance use disorder and recovery field has undergone rapid transformation over the last 40 years. It currently has a workforce that includes three generations—Baby Boomers, Generation X, and Millennials. The current study sought to identify generational differences among those involved in the substance-use disorder and recovery profession using an embedded design and grounded theory approach. Findings suggest that generational differences do exist across the three generations in regard to ideologies, value of formal and informal knowledge, training, and education. Results from the current study provide a further understanding of how we may bridge perceived contentious ideologies and knowledge gaps between generations to better develop current and future professionals within the field.

    Suggested Citation

    Ashford, R. D., & Brown, A. (2017). Bridging the gaps: Intergenerational findings from the substance use disorder and recovery field. Journal of Intergenerational Relationships, 15(4), 326-351.

  • Ashford, Brown, Eisenhart, Thompson-Heller, & Curtis (2018) What we know about students in recovery: meta-synthesis of collegiate recovery programs, 2000-2017

    ABSTRACT

    As a relatively new field of practice, collegiate recovery programs (CRP), have used a practice-informed approach as a means of establishing best practices and pedagogy. While research on collegiate recovery programs and populations of students in recovery is growing, much of the qualitative studies have yet to be synthesized into a useful organizing matrix. This study utilizes meta-synthesis design to explore the leading qualitative research on student experiences in collegiate recovery. From this synthesis, researchers identified six metaphors from ten included studies from 2000–2017. The six metaphors of social connectivity, recovery supports, drop-in recovery centers, internalized feelings, coping mechanisms, and conflict of recovery/student status, support much of the preexisting practices and provide a critical framework for future program design, service delivery, and research.

    Keywords

    Addiction, collegiate recovery, meta-synthesis, behavioral health, higher education, recovery

    Suggested Citation

    Ashford, Brown, Eisenhart, Thompson-Heller, and Curtis. (2018). What we know about students in recovery: meta-synthesis of collegiate recovery programs, 2000-2017. Addiction Research and Theory. Vol. 26 (1), pp. 1-9.

  • Brown, & Bohler (2018) Achieving a 15% Relapse Rate: A Review of Collegiate Recovery and Physician Health Programs

    ABSTRACT

    Evidence from physician health programs (PHPs) suggest that long-term continuums of step-down care are effective at achieving at or near a 15% relapse rate. Parallel to the PHP model, evidence from collegiate recovery programs (CRPs) cite a relapse rate from year to year of 8%. The CRP and PHP models involve long-term, comprehensive components of care and ancillary services oriented toward highly transformative abstinence-based recovery. This article identifies factors between the two models that facilitate recovery and discusses the implications for future research.

  • Austin M. Brown, Robert D. Ashford, Naomi Figley, Kayce Courson, Brenda Curtis & Thomas KimballAlcoholism Treatment Quarterly Vol. 0, Iss. 0, 2018Alumni Characteristics of Collegiate Recovery Programs: A National Survey

    ABSTRACT

    Collegiate recovery programs (CRPs) support students in or seeking recovery from substance use disorders or mental health disorders while enrolled in college. Collegiate recovery has been established as a field of study since the 1970s. To date, a number of qualitative studies have been completed on the programs and students served, along with a single national descriptive survey. This pilot study is the first undertaken exploring the status (recovery, professional, and quality of life) of student alumni that engaged in undergraduate collegiate recovery programs (CRP). Results contain alumni recovery status, primary recovery supports utilized, relapse rates since graduation, and recovery capital/quality of life scores. Similar to previously published works, CRP alumni remain actively in recovery, with relapse rates only slightly higher than the national average of students currently engaged in CRPs (10.2% vs. 6.8%). Findings are preliminary evidence that collegiate recovery programs adequately prepare engaged students for future recovery and professional life.

  • Ashford, R. D. Wheeler, B. & Brown, A.M. (2018) Collegiate Recovery Programs and Disordered Eating: exploring sub-clinical behaviors among students in recovery. Alcoholism Treatment Quarterly. Vol 36.

    ABSTRACT

    The co-occurring prevalence of disordered eating (DE) with substance use disorders is estimated to be high among college students. Collegiate recovery programs (CRPs), primarily used for the support of students with mental health disorders and substance use disorders, are well positioned to potentially provide support for students with DE behaviors. The current study identifies the prevalence of subclinical DE behaviors among college students currently participating in a collegiate recovery program at a U.S. institution. 61 recovering students (Age: M = 29 years, SD = 8.35, 59% male) completed a digital survey inquiring about subclinical DE behaviors using 9 Likert-type scaled questions. Composite subclinical DE scores were significantly different between student genders, as well as full-time and part-time students. Female and full-time students were more likely to experience subclinical DE behaviors than male and part-time students. As subclinical DE behaviors are present among students engaged in CRPs at a high rate, and though behaviors are most pronounced among female students, they are also are present in males. A majority of students engaged in the CRP feel that the CRP can support mental health and DE recovery in addition to serving those in recovery from substance use disorders.

  • Robert D. Ashford, Austin M. Brown & Brenda Curtis (2018) The Language of Substance Use and Recovery: Novel Use of the Go/No–Go Association Task to Measure Implicit Bias, Health Communication.

    ABSTRACT

    Previous research has found initial evidence that word choice impacts the perception and treatment of those with behavioral health disorders through explicit bias (i.e., stigma). A more robust picture of behavioral health disorder stigma should incorporate both explicit and implicit bias, rather than relying on only one form.

    The current study uses the Go/No–Go Association Task to calculate a d′ (sensitivity) indexed score of automatic attitudes (i.e., implicit associations) to two terms, “addict” and “person with substance use disorder.”

    Participants have significantly more negative automatic attitudes (i.e., implicit bias) toward the term “addict” in isolation as well as when compared to “person with a substance use disorder.”

    Consistent with previous research on explicit bias, implicit bias does exist for terms commonly used in the behavioral health field. “Addict” should not be used in professional or lay settings. Additionally, these results constitute the second pilot study employed the Go/No–Go Association Task in this manner, suggesting it is a viable option for continued linguistic stigma related research.

  • Robert D. Ashford. Austin M. Brown & Brenda Curtis (2018) Systemic Barriers in substance use disorder treatment: A prospective qualitative study of professionals in the field. Drug and Alcohol Dependence.

    ABSTRACT

    Background

    The US is in the midst of one of the largest public health crises in recent history with over 63,000 drug poisoning deaths in 2016 and a projected annual economic cost of over $420 billion. With the rise of deaths and economic burden related to substance use, it is paramount that systemic barriers within the treatment industry be identified and resolved.

    Methods

    Data were collected from US substance use treatment professionals (N = 182) in the fall of 2016. Thematic analysis with axial coding was used on anonymized responses to an online open-ended survey. Additional ad hoc testing for variance (education, generation, regional location, and employment) was completed using Monte Carlo chi-square analyses.

    Results

    7 major themes emerged: 1) additional training, education, and use of evidence-based practices, 2) expansion of treatment services, 3) increased resources, 4) stigma reduction, 5) increased collaboration and leadership, 6) reductions in regulations, requirements, and incentives, and 7) expansion of recovery support services. Participant response yielded a significant relationship between employment type (p = 0.002) and regional location (p = 0.046).

    Conclusions

    Systemic barriers in the treatment field are prevalent from the perspective of professionals engaged in the field. While previously identified barriers are still present, newly reported barriers include: 1) lack of treatment services (e.g., capacity), 2) lack of technological resources (e.g., technological support tools), 3) lack of recovery support services (e.g., recovery housing), 4) lack of collaboration and leadership (e.g., communication and partnership), and 5) increasing unethical practices in the field (e.g., incentive-based patient brokering).

  • Ashford, R. D., Brown, A. M., & Curtis, B. (2018). “Abusing Addiction”: Our Language Still Isn’t Good Enough. Alcoholism Treatment Quarterly, 1-16.

    ABSTRACT

    Previous research has found initial evidence that word choice affects the perception and treatment of those with behavioral health disorders. These previous studies have relied on vignette-based methodologies, however, and a more quantifiable index of the stigma words can produce is needed. The current study uses the Go/No-Go Association Task to calculate a d-prime (sensitivity) indexed score of automatic attitudes to two terms, substance abuser and a person with substance use disorder. Participants have significantly more negative automatic attitudes toward the term substance abuser, as compared to a person with a substance use disorder. Consistent with previous research, implicit bias does exist for terms commonly used in the behavioral health field. Substance abuser and its derivatives should not be used in professional or lay settings.

 

 

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