January 16, 2018

Keeping Your Resolution to Stay Sober in 2018: How Therapeutic Alliance and Other Factors Improve Recovery Statistics

What’s key to keeping a resolution to stay sober in 2018? The question is never more relevant than at the start of 2018 and another New Year.

Getting sober—detox—is a small slice of the battle in kicking an addiction to drugs or alcohol, after all. The far bigger, more challenging part of recovery is keeping a resolution to stay sober, which has a lot to do with the science of positive behavior change— and specifically those mechanisms for positive core change that are most instrumental in making sobriety stick.

This article will therefore introduce you to the concept of “therapeutic alliance” and other factors in drug and alcohol recovery that improve recovery statistics and are associated with lasting freedom from addiction.

The good news is that many people do eventually find freedom, or so the drug addiction recovery statistics suggest. A survey by research psychologist Gene Heyman at McLean Hospital, cited in an interview in The Boston Globe, found that as many as 60 to 80 percent of people who had been addicted to a substance in their teens and 20’s were substance-free by their 30’s and avoided addiction in subsequent decades. This year you can join their ranks—read on to learn how.

Strong Therapeutic Alliance Helps Aid Recovery

Research shows that strong therapeutic alliance is one mechanism for achieving positive core change that endures. “Therapeutic alliance” refers to the level of rapport that exists between a client and their therapist, which can be gauged according to certain attributes in the clinician, such as warmth, genuineness and empathy. For more on how therapeutic alliance can improve your recovery outcomes, visit the “Clinical Excellence Practices” section of our website. Or, explore the article, “How to Find a Good Therapist for Your Recovery – Components of a Strong Therapeutic Alliance,” in our Learning Center.

Specifically how does a strong therapeutic alliance encourage positive behaviors of the kind that improve recovery statistics? Researchers continue to explore this question. What we do know already, though, is that as early as the first days and weeks of treatment, clients with a stronger therapeutic alliance exhibited the following characteristics correlating with lasting sobriety:

Decreased psychological distress about being in treatment – A 2012 study in the Journal of Substance Abuse Treatment found that clients in treatment who developed a stronger therapeutic alliance achieved greater reductions in distress during treatment.
Greater motivation for recovery – In fact, low-motivated recovering alcoholics who developed a stronger therapeutic alliance during treatment saw their motivation for recovery also increase, in earlier findings in the Journal of Substance Abuse Treatment.

AA/NA Attendance Can Help You Stay Motivated

Many people who have successfully found freedom from problem drinking will say that a crucial first step in an alcoholic’s recovery is going to an AA meeting. Research backs them up, by revealing that regular AA attendance is a mechanism for positive behavior change. A 2010 study in the journal, Addiction, sought to understand more specifically how AA attendance functions as a mechanism for positive behavior change. On the basis of previous research that has found a clear correlation between negative emotional states like depression and alcohol relapse, the researchers hypothesized that maybe AA attendance reduces depression, in turn reducing rates of relapse. Here is what they found:

Greater AA attendance correlated with “better subsequent alcohol use outcomes and decreased depression.”
Greater depression was associated with heavier and more frequent drinking (a vindication of earlier research).
And, AA led “both to improvements in alcohol use and psychological and emotional wellbeing, which, in turn, may reinforce further abstinence and recovery-related change.”

Mindfulness-Based Interventions Can Support Recovery

Mindfulness-based interventions like mindfulness meditation are another step to drug and alcohol recovery, the mechanisms of which recent research has sought to understand. Because these interventions often blend various practices, a 2017 study at Brown University set out to isolate the components of mindfulness that lead to positive core change. (The research initiative is an outgrowth of the Mindfulness Research Collaborative that brings together 11 mindfulness researchers from five universities; their findings will appear in the February 2018 special issue of the journal Behavior Research and Therapy, as part of a growing field of scholarship on the science of behavior change.)

Strikingly, the researchers concluded that what makes mindfulness effective at helping those who practice it achieve positive core change (such as recovery) are these two ingredients: open monitoring (OM), or “noticing and acknowledging negative feelings without judgment or an emotional secondary reaction to them;” and focused attention (FA), “maintaining focus on or shifting it toward a neutral sensation, such as breathing, to disengage from negative emotions or distractions.”

For more information on the recovery benefits of mindfulness, explore these articles in our Learning Center:

Evidently, then, when it comes to initiating any healthy new habit—not just sobriety—there is a very strong link between our emotions and behaviors, and this relationship can be mutually reinforcing in healthy and unhealthy ways. By striving for a strong therapeutic alliance, regularly attending AA meetings and practicing a discipline of mindfulness, you can be more successful at keeping a resolution to stay sober in 2018.