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Harnessing the Power of Smartphone Applications in Rehabilitation Alumni Services

by Samuel A. MacMaster

Addiction is isolation. Individuals in the throes of addiction develop primary relationships with inanimate objects that can’t give back and instead steal their lives and distort their relationships with others.

Connection is the antidote to addiction, and is vital for ongoing recovery. Alumni services are all about facilitating a healthy connection to self, others, and a larger community and sense of spirituality. This is the basis for twelve-step programs and the basic building block for psychological health.

As individuals leave primary treatment, they tend to be very vulnerable and likely to struggle with experiences of loneliness and disconnection. Isolation often precedes a relapse, whether that is a behavioral relapse, a slide into a new process of addiction, or a full chemical relapse. All of these pitfalls are often preceded by a lack of connection to others. “If only I had called my sponsor, gone to a meeting, or connected with a fellow addict or alcoholic,” are laments we often hear after a relapse. To assist individuals in maintaining connection in early and ongoing recovery, most treatment centers have developed alumni services to ensure that individuals have opportunities to stay connected.

Today, connection is more available than it has ever been; yet more and more we find ourselves increasingly isolated due to technology. This is true for all humans, but particularly true for those of us who struggle with addictions. Smartphone addiction is now an issue that presents in the literature (Kwan, et-al, 2013)—and individuals in early recovery can certainly be susceptible. It is therefore important to focus the use of smartphones to further assist connection in recovery rather than isolation. Technology does not replace human connection—it merely facilitates it.

What do we know from the research world? Early studies used smartphone applications and technology primarily for assessment — self-assessment in particular. It was often seen as an efficient way to administer questionnaires and assessment tools to save time and reduce the stigma of discussing uncomfortable topics. This was followed by the development of brief interventions and booster sessions to improve treatment adherence and outcomes. The current wave of smartphone use in the recovery world has been focused on connection. In 2012 there were only 87 recovery-oriented applications worldwide (Savic, et-al, 2013), this number has grown to the thousands in just a few short years. While many of these applications simply direct individuals to meeting lists, provide sobriety or clean time countdowns, or provide access to daily meditation or recovery readings, there is a new wave of highly sophisticated applications that can assist in alumni services to bridge the gap between treatment and life in the community. Importantly this type of application has been shown to be more effective than treatment as usual in aftercare in clinical trials (Gustafson, 2014).

Harnessing the potential power of these innovations for use with alumni groups will go a long way to improve connection. An application does not replace alumni services, nor does it replace the power of face-to-face human connection. At it’s best it simply facilitates these connections. Ultimately these applications can do four things:
1) maintain contact with an alumni base.
2) provide accurate information on recovery topics.
3) track progress and provide accountability
4) provide the ability to reach out at any time and potentially connect to a support person.

At the most basic level, the current generation of smartphone applications allows alumni services to quickly make and maintain contact with alumni as a group. This can be a quick “thought for the day” or a meditation topic to maintain connection and remind someone of recovery in the moment. It can also be utilized for group messaging. Email has replaced phone chains and now group texts are quickly replacing email. Recovery applications typically allow group messages, notifications, and updates on events to be quickly distributed in a confidential manner. While this is all at the group level, it can foster a sense of connection for participants.

Smartphone applications also allow alumni services to sort and deliver information for alumni. The amount of information on health, recovery, and support options can be overwhelming to individuals leaving treatment who may already feel vulnerable and overwhelmed by the prospect of their new life. Not only does the sheer amount of information appear overwhelming, but unfortunately a large portion of it is inaccurate, useless, and opinion-based information (often propagated by treatment providers in hopes of improving SEO, but this is a topic for another blog). The volume of information on recovery-related topics makes the task that much harder for someone seeking clear concise information to improve their lives. Suggestions or links to basic information can often be helpful in sorting fact from fiction and supporting ongoing health and recovery.

Almost all applications allow participants to track progress and provide accountability. There are many values to tracking progress in real time (just make the mistake of asking someone about their fitbit). For individuals in recovery the value is not just the positive personal feedback of tracking another day clean or the number of meetings attended; it effectively allows concerned others to verify progress. One of the largest obstacles that individuals leaving treatment often face is the complete lack of trust that family members may have in their recovery. The ability of a support person to see in real time that their loved one is doing what they say they are doing can be a game changer. Parents, spouses, significant others, employers, and even the court system are often exhausted by the inability to believe what they see and hear from someone battling addiction. The ability to quickly verify drug screen results, meeting attendance, and aftercare participation, allows support members to retire from the detective role and lean into a healthier relationship with their loved ones. Barriers to connection are dropped, trust is built, and the focus is no longer on determining whether someone is actually taking action, but instead on building and strengthening the relationship in healthy ways.

Applications are always available. They are never sleeping, too busy, or taking vacation days or weekends off. At any point in time, users can reach out to either a wider community or an alumni support person. There is power in simply reaching out. Sometimes just reaching out can assist someone in crisis to avoid a relapse. Applications tied to a larger community allow someone from the support group to reach back out. Applications that are directed by a facilitator allow the facilitator to be notified and reach back out the individual. It can also be beneficial to have access to good information, interactive activities and support, if a live person is not available or not necessary.

At JourneyPure we have had great success with our application assisted coaching service, JourneyPure Coaching. The use of the smartphone application has assisted our staff in developing and maintaining connections with alumni, and improved the quality of their recoveries. It has importantly allowed us to maintain contact and deliver interventions to individuals both before a relapse occurs and in some instances after it occurs. Addiction is a chronic illness requiring ongoing support to maintain a full and sustained recovery. Smartphone applications provide yet another tool to alumni professionals in supporting recovery for the people we serve.

Samuel A. MacMaster, Ph.D. is co-founder of JourneyPure and serves as Executive Vice President and Chief Clinical Officer. He has 26 years of experience in addiction treatment.

References

Kwon M, Lee J-Y, Won W-Y, Park J-W, Min J-A, Hahn C, et al. (2013) Development and Validation of a Smartphone Addiction Scale (SAS). PLoS ONE 8(2): e56936. doi:10.1371/journal.pone.0056936

Michael Savic, M., Best, D., Rodda, S., and Lubman, D, (2013). Exploring the focus and experiences of smartphone applications for addiction recovery. Journal of Addictive Diseases, 32, (3), doi./10.1080/10550887.2013.824331

Gustafson DH, McTavish FM, Chih MY, Atwood AK, Johnson RA, Boyle MG, Levy MS, Driscoll H, Chisholm SM, Dillenburg L, Isham A, Shah D. (2014). A smartphone application to support recovery from alcoholism: a randomized clinical trial. JAMA Psychiatry. 2014 May;71(5):566-72. doi: 10.1001/jamapsychiatry.2013.4642.

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