Inferential Analyses on Questions of Primary Interest
The impetus for the following analyses was derived from ARF’s interest in capturing the recovery process of those who indicate some level of recovery, but who are not currently in treatment.
Question 1. USE of COPING STRATEGIES. The initial question addressed below focused on attempting to capture behaviors and perceptions that may indicate a “natural history” of recovery within the various groups. Specifically, the question addressed by the analyses was:
Do those who are not compliant currently, but report recovery/in recovery use or indicate the importance of more coping strategies than those who are relapsed and non-compliant and from those who are recovered/in recovery yet also compliant? This analysis can provide some indication of whether those in the “non-compliant — recovered/in recovery” group view themselves as improving perhaps through the use of more non-clinical coping mechanisms than others use or deem important.
*The item related to the importance of various coping strategies (q10) is used as an indication of a non-clinical means of recovery (e.g., 12 step meeting attendance, medications, counseling).
Technical Details. A 2 (recovered/in recovery; relapsed) X 2 (compliant/not currently compliant) independent-groups factorial analysis of variance (ANOVA) was used to predict the number of coping activities used. The groups served as independent variables and the number of coping strategies was the dependent variable. For the purposes of this report, I did not include complex statistical tables. Those are available upon request.
Caution: Caution should be utilized in interpreting the following analyses because of the large inequality in the number of respondents in the categories. Specifically, only 1 participant reported being in relapse and compliant.
Outcome. This analysis demonstrated:
(a) Those who are not compliant, and yet show recovery use statistically significantly more coping activities (mean = 4.19) compared to those who are not compliant and are in relapse (mean = 3.30), p < .05.
(b) Those who are not compliant, and yet report recovery use more coping activities (mean = 4.19) compared to those who are compliant and report recovery (mean = 3.69). While this difference does not quite reach the level of statistical significance, it is enough of a difference to perhaps be clinically meaningful.
See Table 3 and Graph 8 below.
Table 3. Mean number of coping activities deemed important by compliance and recovery and number of respondents in each category.
Compliance Yes No # of Coping Activities # of Coping Activities Mean Count Mean Count Recovery Recovered / In Recovery 3.69 69 4.19 66 Relapsed 7.00 1 3.30 44
Interpretation: A reasonable interpretation of the above analyses is that people may be using a variety of coping mechanisms in addition to clinical therapy and medication to support their recovery efforts. This difference may, however, simply reflect that those Recovered/In-Recovery and Non-Compliant feel they must use a slightly larger variety of coping strategies to remain well than do those who are currently In-Compliance. This is an important question for further investigation.
Graph 8. Mean number of coping activities deemed important by compliance and recovery.
Follow up. COPING STRATEGIES. A follow-up to the analysis above was to examine the data in an all or none fashion. That is, do the two groups differ in their use at all (yes or no) of any coping strategy. In other words, are those recovered/in recovery and who are compliant using any outside coping activities differently from those who report recovery yet are non-clinically compliant. This may provide some indication of whether the additional activities are derived from clinical-directives or encouragement more so than people employing these strategies naturally, of their own accord.
Technical Details. A 2 (recovered/in recovery; relapsed) X 2 (compliant/not currently compliant) chi-square analysis was used to discover whether those groups differed in whether or not they used/deemed important any of the coping activities included in the survey.
Table 4. Number of respondents using / deeming important any coping activities by compliance and recovery.
Compliance Yes No Use Coping Strategies Use Coping Strategies Yes No Yes No Count Count Count Count Recovery Recovered / In Recovery 68 1 63 3 Relapsed 1 0 40 4
Outcome. This analysis demonstrated that those who are not compliant and show recovery are just as likely (n=63) as those who are compliant and report recovery (n=68) to use at least one of the coping activities (shown in Table 2, p. 7).
Interpretation: This analysis further supports our initial interpretation. If the use of the extra-clinical coping strategies were a significant part of one’s clinical protocol or directives, we would expect them to be used much more often or deemed more important than those not currently within a clinical environment. Yet, that is not the case. The fact that those who feel some recovery and yet are not currently in traditional treatment compliance find these activities important just as much as those within traditional compliance speaks to the potential utility of encouraging the use of some of these strategies, either alone or as an adjunctive to clinical treatment.