In my clinical experience, people afflicted with substance use disorders enter treatment with rather low expectations for their treatment. It almost appears that the prevailing theme for many people entering recovery is that they are certain to relapse, thereby assuring that treatment will fail. Therefore, it appears that personal beliefs about self greatly impact treatment success. This white paper proposes researching the impact, if any, that Psychological Empowerment can have on treatment success.

For years, concepts based upon Psychological Empowerment have been successfully applied within the business domain such that employee success can be both predicted and developed.   Spreitzer and Quinn (2001) not only developed a concept whereby all members of a group, in effect, become co-owners of the company; but also, developed and employed an instrument called the Psychological Empowerment Instrument that measures an employee’s sense of empowerment. Psychological Empowerment, according to Spreitzer (1995), is the set of four cognitions: 1) meaning; 2) competence, 3) self-determination; and, 4) impact. Meaning is a belief that a job has value and importance to an employee. Competence is a belief that an employee has the necessary skills to perform the job functions. Self-determination is a belief that the employee can decide the ways and means to perform his or her job functions. Impact is the belief that the employee can affect change within his or her context.   Also, Spreitzer (1995) found that when the four cognitions combined into a gestalt, or aggregate sum that cannot be divided, Psychological Empowerment could be accurately measured. Taken individually, each cognition related to a different outcome and only when combined and measured could a researcher be assured that Psychological Empowerment existed. Lastly, Spreitzer (1995) found that employees who exhibited a high degree of Psychological Empowerment performed better in their job duties as measured in performance evaluations.

Cyboran (2005) examined the influences of reflection on the self-perception of empowerment in the workplace. The research group consisted of non-management knowledge workers at a software company headquartered in the United States. The experimental group kept guided journals of their learning activities for three months. Immediately prior to and following the journaling period, both groups completed Spreitzer’s Psychological Empowerment Scale. Between-group analyses revealed that participants who kept guided journals were able to maintain a high level of psychological empowerment, while the psychological empowerment of the control group worsened. Therefore, it appears that teaching concepts pertaining to psychological empowerment can improve outcomes, if guided journaling exercises pertaining to domain-specific are completed during the course of a measurement period.

Based upon the demonstration that psychological empowerment, developed and measured with guided journaling using concepts related to the four cognitions that comprise psychological empowerment, it seems plausible that these same tools may improve substance use disorder treatment outcomes. Improving treatment outcomes should be the basis of all substance abuse disorder treatment research; according to NIDA statistics, well over sixty percent (60%) of those seeking treatment will relapse[1]. These statistics demonstrate and reinforce the idea that treatment is more likely than not to fail. This is a belief that all treatment providers and educators must change. There exists great risk that relapse rates can become a self-fulfilling prophecy; changing the risk requires changing the fundamental beliefs regarding recovery and treatment success.

Therefore, I propose implementing a four (4) week course within an inpatient substance use disorder treatment facility that includes curriculum regarding:

  • Meaning: What recovery means to a respective person, both individually and socially?
  • Competence: What are the tools required to build and maintain recovery, based upon an individual’s own knowledge and cultural basis?
  • Self-determination: How can a treatment provider best support a person’s individualized approach to recovery?
  • Impact: In what ways will a person’s recovery positively change, not only his/her individual world, but also, the world around him/her?

Half of a cohort will receive the psychological empowerment course, while the other half will not (participants will be assigned randomly). Once participants complete their stay within the facility, follow-up will occur over a twelve (12) week period to measure whether or not the coursework in psychological empowerment improved treatment outcomes.

The research proposed herein is long overdue within the substance use disorder treatment field, as many current treatment perspectives are meant to change, not only behavior, but thoughts regarding substance use. However, if a person does not fundamentally believe that he or she is capable of recovery, or if recovery has no meaning to someone in treatment, or if a person does not co-design his or her recovery, or does not see the impact he or she has on the world around him or her, then treatment will simply not work. However, if psychological empowerment beliefs are developed, then it appears that treatment will at least have a better chance of succeeding. The research proposed within this white paper should elucidate my belief that a person’s own language and meaning systems are integral to living a life free of the shackles of a substance use disorder.

References

Cyboran, V., (2005). The influence of reflection on employee psychological empowerment: Report on a exploratory workplace field study. Performance Improvement Quarterly. 18(4), 37-50.

Spreitzer, G. (1995). Psychological empowerment in the workplace: Dimensions, measurement, and validation. Academy of Management Journal, 38(5): 1442-1465.

Spreitzer, G., Quinn, R. (2001). A company of leaders: Five disciplines for unleashing the power in your workforce. San Francisco: John Wiley & Sons.

[1] http://www.drugabuse.gov/publications/addiction-science/relapse/relapse-rates-drug-addiction-are-similar-to-those-other-well-characterized-chronic-ill