Addiction
Conditions
Brief summary
The main objective of this study is to pilot test the Positive Peer Journaling (PPJ) \[later renamed Positive Recovery Journaling (PRJ)\] intervention and its feasibility and acceptability. A second objective is to compare individuals assigned to PPJ to individuals in a treatment as usual control group.
Detailed description
Many spiritual and religious traditions involve the practice of personal inventory and self-examination. These practices involve conducting a review of the day, spirituality, gratitude, and striving for self-knowledge and self-improvement. The 10th step of Alcoholics Anonymous (AA) recommends that members conduct such a daily inventory. While this practice may benefit AA members, not everyone seeking addiction recovery joins AA. Even for those who do, it can take time to reach step 10 and begin deriving benefits from it. The study PI, Dr. Amy Krentzman, developed Positive Recovery Journaling (PRJ, formerly positive peer journaling) as a simple 10-minute daily practice which reviews the past 24 hours on the left side of a journal page and plans the upcoming 24 hours on the right side of a journal page. The prompts for the left and right sides of the PRJ page are based on principles from positive psychology and behavioral activation. The main objective of this study is to pilot test the PRJ intervention and to examine the feasibility, acceptability, and logistics of treatment delivery. A second objective is to observe whether PRJ is associated with improvement in satisfaction with life, happiness with recovery, and commitment to sobriety
Interventions
BEHAVIORALPositive Peer Journaling (PPJ)
PPJ is a journaling practice to support addiction recovery. PPJ encourages past 24 hour review and upcoming 24 hour planning to improve subjective wellbeing in recovery and reduce relapse. PPJ uses journals with column headings under which individuals make bullet-pointed lists. On the left hand page, past 24 hours is recalled, itemizing good and bad things that happened and things for which one is grateful. Good wishes for others are also expressed on this page. On the right hand page, values-based activities for the upcoming 24 hours are planned via headings representing valued life domains such as recovery, work/school, spirituality, home and household, and health.
Sponsors
University of Minnesota
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* meet DSM-V criteria for past-year Substance Use Disorder as primary or secondary diagnosis, * English literacy sufficient to make short written lists needed to complete PPJ and homework assessments, * minimum 2 weeks sustained abstinence, * completed first 2 weeks of treatment at Nuway (approximately 2 weeks), an intensive outpatient substance use disorder treatment program and the recruitment site, * agree to be audio recorded or transcription recorded in group meetings and in individual meetings with research staff, * currently are clients in the Nuway outpatient program, * participants must be English speaking and literacy must be strong enough to write short lists and to understand the questions asked in the questionnaires, * participants must have an electronic device that connects to the internet and internet connection for online delivery of intervention during COVID-19.
Exclusion criteria
* presence of a psychotic disorder, psychiatric condition (e.g., suicidal ideation), or cognitive impairment (e.g., severe dementia, traumatic brain injury) limiting ability to give consent and/or participate in the study; * severe psychiatric illness (current schizophrenia, major depression with suicidal ideation); * personality disorders that would interfere with satisfactory participation in or completion of the study protocol, * inability to give informed, voluntary consent to participate, * lack of sufficient English literacy to participate, defined as inability to make a list of 5 things they did yesterday and inability to understand questionnaire items, * any impairment, activity, or situation that in the judgement of the research staff would prevent satisfactory participation in or completion of the study protocol.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Satisfaction With Life at Baseline | Baseline | Score on the Satisfaction with Life scale. This scale has 5 items assessed on a 7 point Likert-type response format. Scores range from 5 to 35 with higher scores representing higher satisfaction with life. |
| Satisfaction With Life at 2 Weeks | 2 weeks (after Phase 1, the group phase) | Score on the Satisfaction with Life scale. This scale has 5 items assessed on a 7 point Likert-type response format. Scores range from 5 to 35 with higher scores representing higher satisfaction with life. |
| Satisfaction With Life at 4 Weeks | 4 weeks (after Phase 2, the independent practice phase) | Score on the Satisfaction with Life scale. This scale has 5 items assessed on a 7 point Likert-type response format. Scores range from 5 to 35 with higher scores representing higher satisfaction with life. |
| Satisfaction With Life at 8 Weeks | 8 weeks (the 1-month post-intervention) | Score on the Satisfaction with Life scale. This scale has 5 items assessed on a 7 point Likert-type response format. Scores range from 5 to 35 with higher scores representing higher satisfaction with life. |
| Happiness With Recovery at Baseline | Baseline | Score on a single item, In general, I am happy with my recovery. This item uses an 11 point scale ranging from 0 to 10. Higher scores represent higher happiness with recovery. |
| Happiness With Recovery at 2 Weeks | 2 weeks (after Phase 1, the group phase) | Score on a single item, In general, I am happy with my recovery. This item uses an 11 point scale ranging from 0 to 10. Higher scores represent higher happiness with recovery. |
| Happiness With Recovery at 4 Weeks | 4 weeks (after Phase 2, the independent practice phase) | Score on a single item, In general, I am happy with my recovery. This item uses an 11 point scale ranging from 0 to 10. Higher scores represent higher happiness with recovery. |
| Happiness With Recovery at 8 Weeks | 8 weeks (the 1-month post intervention) | Score on a single item, In general, I am happy with my recovery. This item uses an 11 point scale ranging from 0 to 10. Higher scores represent higher happiness with recovery. |
| Commitment to Sobriety at Baseline | Baseline | Score on a single item, I am willing to do whatever it takes to recover from my addiction. This item uses an 11 point scale ranging from 0-10. Higher scores represent greater commitment to sobriety. |
| Commitment to Sobriety at 2 Weeks | 2 weeks (after Phase 1, the group phase) | Score on a single item, I am willing to do whatever it takes to recover from my addiction. This item uses an 11 point scale ranging from 0-10. Higher scores represent greater commitment to sobriety. |
| Commitment to Sobriety at 4 Weeks | 4 weeks (after Phase 2, the independent practice phase) | Score on a single item, I am willing to do whatever it takes to recover from my addiction. This item uses an 11 point scale ranging from 0-10. Higher scores represent greater commitment to sobriety. |
| Commitment to Sobriety at 8 Weeks | 8 weeks (the 1-month post intervention) | Score on a single item, I am willing to do whatever it takes to recover from my addiction. This item uses an 11 point scale ranging from 0-10. Higher scores represent greater commitment to sobriety. |
Countries
United States
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| Treatment Group Participants in this group will complete the intervention, Positive Peer Journaling (PPJ), while also continuing to attend intensive outpatient treatment for addiction.
Positive Peer Journaling (PPJ): PPJ is a journaling practice to support addiction recovery. PPJ encourages past 24 hour review and upcoming 24 hour planning to improve subjective wellbeing in recovery and reduce relapse. PPJ uses journals with column headings under which individuals make bullet-pointed lists. On the left hand page, past 24 hours is recalled, itemizing good and bad things that happened and things for which one is grateful. Good wishes for others are also expressed on this page. On the right hand page, values-based activities for the upcoming 24 hours are planned via headings representing valued life domains such as recovery, work/school, spirituality, home and household, and health. | 42 |
| Control Group There will be no intervention for those randomized to the control group. However, they will complete assessment instruments throughout the study period while also continuing to attend intensive outpatient treatment for addiction. | 39 |
| Total | 81 |
Baseline characteristics
| Characteristic | Control Group | Total | Treatment Group |
|---|---|---|---|
| Age, Continuous | 39.4 years STANDARD_DEVIATION 10.4 | 39 years STANDARD_DEVIATION 11 | 38.6 years STANDARD_DEVIATION 11.7 |
| Race (NIH/OMB) American Indian or Alaska Native | 2 Participants | 5 Participants | 3 Participants |
| Race (NIH/OMB) Asian | 1 Participants | 1 Participants | 0 Participants |
| Race (NIH/OMB) Black or African American | 1 Participants | 4 Participants | 3 Participants |
| Race (NIH/OMB) More than one race | 2 Participants | 9 Participants | 7 Participants |
| Race (NIH/OMB) Native Hawaiian or Other Pacific Islander | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Unknown or Not Reported | 1 Participants | 2 Participants | 1 Participants |
| Race (NIH/OMB) White | 32 Participants | 60 Participants | 28 Participants |
| Sex/Gender, Customized Female | 19 Participants | 43 Participants | 24 Participants |
| Sex/Gender, Customized Male | 19 Participants | 37 Participants | 18 Participants |
| Sex/Gender, Customized Non Binary | 1 Participants | 1 Participants | 0 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | 0 / 42 | 0 / 39 |
| other Total, other adverse events | 0 / 42 | 0 / 39 |
| serious Total, serious adverse events | 0 / 42 | 0 / 39 |
Outcome results
Primary
Commitment to Sobriety at 2 Weeks
Score on a single item, I am willing to do whatever it takes to recover from my addiction. This item uses an 11 point scale ranging from 0-10. Higher scores represent greater commitment to sobriety.
Time frame: 2 weeks (after Phase 1, the group phase)
Population: The Overall Number of Participants Analyzed reported here represents the study census for this outcome at 2 weeks. In the study flow section of this report, the values reported under completed represent the study census at 8 weeks. That is why the values reported here and the values reported in the study flow under completed do not match.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Treatment Group | Commitment to Sobriety at 2 Weeks | 8.8 units on a scale | Standard Deviation 1.5 |
| Control Group | Commitment to Sobriety at 2 Weeks | 9.1 units on a scale | Standard Deviation 1.7 |
Primary
Commitment to Sobriety at 4 Weeks
Score on a single item, I am willing to do whatever it takes to recover from my addiction. This item uses an 11 point scale ranging from 0-10. Higher scores represent greater commitment to sobriety.
Time frame: 4 weeks (after Phase 2, the independent practice phase)
Population: The Overall Number of Participants Analyzed reported here represents the study census for this outcome at 4 weeks. In the study flow section of this report, the values reported under completed represent the study census at 8 weeks. That is why the values reported here and the values reported in the study flow under completed do not match.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Treatment Group | Commitment to Sobriety at 4 Weeks | 8.8 units on a scale | Standard Deviation 1.5 |
| Control Group | Commitment to Sobriety at 4 Weeks | 8.9 units on a scale | Standard Deviation 1.8 |
Primary
Commitment to Sobriety at 8 Weeks
Score on a single item, I am willing to do whatever it takes to recover from my addiction. This item uses an 11 point scale ranging from 0-10. Higher scores represent greater commitment to sobriety.
Time frame: 8 weeks (the 1-month post intervention)
Population: The Overall Number of Participants Analyzed reported here represents the study census for this outcome at 8 weeks. These values match those reported as completed in the the study flow section of this report.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Treatment Group | Commitment to Sobriety at 8 Weeks | 8.5 units on a scale | Standard Deviation 2.5 |
| Control Group | Commitment to Sobriety at 8 Weeks | 8.6 units on a scale | Standard Deviation 2.1 |
Primary
Commitment to Sobriety at Baseline
Score on a single item, I am willing to do whatever it takes to recover from my addiction. This item uses an 11 point scale ranging from 0-10. Higher scores represent greater commitment to sobriety.
Time frame: Baseline
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Treatment Group | Commitment to Sobriety at Baseline | 8.6 units on a scale | Standard Deviation 1.8 |
| Control Group | Commitment to Sobriety at Baseline | 9.2 units on a scale | Standard Deviation 1.4 |
Primary
Happiness With Recovery at 2 Weeks
Score on a single item, In general, I am happy with my recovery. This item uses an 11 point scale ranging from 0 to 10. Higher scores represent higher happiness with recovery.
Time frame: 2 weeks (after Phase 1, the group phase)
Population: The Overall Number of Participants Analyzed reported here represents the study census for this outcome at 2 weeks. In the study flow section of this report, the values reported under completed represent the study census at 8 weeks. That is why the values reported here and the values reported in the study flow under completed do not match.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Treatment Group | Happiness With Recovery at 2 Weeks | 8.3 units on a scale | Standard Deviation 1.8 |
| Control Group | Happiness With Recovery at 2 Weeks | 8.6 units on a scale | Standard Deviation 1.9 |
Primary
Happiness With Recovery at 4 Weeks
Score on a single item, In general, I am happy with my recovery. This item uses an 11 point scale ranging from 0 to 10. Higher scores represent higher happiness with recovery.
Time frame: 4 weeks (after Phase 2, the independent practice phase)
Population: The Overall Number of Participants Analyzed reported here represents the study census for this outcome at 4 weeks. In the study flow section of this report, the values reported under completed represent the study census at 8 weeks. That is why the values reported here and the values reported in the study flow under completed do not match.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Treatment Group | Happiness With Recovery at 4 Weeks | 8.4 units on a scale | Standard Deviation 2.2 |
| Control Group | Happiness With Recovery at 4 Weeks | 8.4 units on a scale | Standard Deviation 1.9 |
Primary
Happiness With Recovery at 8 Weeks
Score on a single item, In general, I am happy with my recovery. This item uses an 11 point scale ranging from 0 to 10. Higher scores represent higher happiness with recovery.
Time frame: 8 weeks (the 1-month post intervention)
Population: The Overall Number of Participants Analyzed reported here represents the study census for this outcome at 8 weeks. These values match the values reported as completed in the study flow section of this report.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Treatment Group | Happiness With Recovery at 8 Weeks | 8.2 units on a scale | Standard Deviation 2 |
| Control Group | Happiness With Recovery at 8 Weeks | 8.3 units on a scale | Standard Deviation 2.4 |
Primary
Happiness With Recovery at Baseline
Score on a single item, In general, I am happy with my recovery. This item uses an 11 point scale ranging from 0 to 10. Higher scores represent higher happiness with recovery.
Time frame: Baseline
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Treatment Group | Happiness With Recovery at Baseline | 8.1 units on a scale | Standard Deviation 1.9 |
| Control Group | Happiness With Recovery at Baseline | 8.4 units on a scale | Standard Deviation 1.8 |
Primary
Satisfaction With Life at 2 Weeks
Score on the Satisfaction with Life scale. This scale has 5 items assessed on a 7 point Likert-type response format. Scores range from 5 to 35 with higher scores representing higher satisfaction with life.
Time frame: 2 weeks (after Phase 1, the group phase)
Population: The Overall Number of Participants Analyzed reported here represents the study census for this outcome at 2 weeks. In the study flow section of this report, the values reported under completed represent the study census at 8 weeks. That is why the values reported here and the values reported in the study flow under completed do not match.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Treatment Group | Satisfaction With Life at 2 Weeks | 20.5 units on a scale | Standard Deviation 6.8 |
| Control Group | Satisfaction With Life at 2 Weeks | 18.6 units on a scale | Standard Deviation 7.8 |
Primary
Satisfaction With Life at 4 Weeks
Score on the Satisfaction with Life scale. This scale has 5 items assessed on a 7 point Likert-type response format. Scores range from 5 to 35 with higher scores representing higher satisfaction with life.
Time frame: 4 weeks (after Phase 2, the independent practice phase)
Population: The Overall Number of Participants Analyzed reported here represents the study census for this outcome at 4 weeks. In the study flow section of this report, the values reported under completed represent the study census at 8 weeks. That is why the values reported here and the values reported in the study flow under completed do not match.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Treatment Group | Satisfaction With Life at 4 Weeks | 19.4 units on a scale | Standard Deviation 7.5 |
| Control Group | Satisfaction With Life at 4 Weeks | 18.8 units on a scale | Standard Deviation 7.9 |
Primary
Satisfaction With Life at 8 Weeks
Score on the Satisfaction with Life scale. This scale has 5 items assessed on a 7 point Likert-type response format. Scores range from 5 to 35 with higher scores representing higher satisfaction with life.
Time frame: 8 weeks (the 1-month post-intervention)
Population: The Overall Number of Participants Analyzed reported here represents the study census for this outcome at 8 weeks. These values match the values reported as completed in the study flow section of this report.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Treatment Group | Satisfaction With Life at 8 Weeks | 21 units on a scale | Standard Deviation 7.4 |
| Control Group | Satisfaction With Life at 8 Weeks | 21.2 units on a scale | Standard Deviation 7.9 |
Primary
Satisfaction With Life at Baseline
Score on the Satisfaction with Life scale. This scale has 5 items assessed on a 7 point Likert-type response format. Scores range from 5 to 35 with higher scores representing higher satisfaction with life.
Time frame: Baseline
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Treatment Group | Satisfaction With Life at Baseline | 17.8 units on a scale | Standard Deviation 6.6 |
| Control Group | Satisfaction With Life at Baseline | 17.2 units on a scale | Standard Deviation 6.4 |