Mapping Recovery: A Qualitative Node Map Approach to Understanding Factors Proximal to Relapse Among Adolescents in Recovery
Despite data suggesting that current substance use disorder treatments are largely effective in reducing substance use, most adolescents in SUD treatment experience relapse after finishing treatment. Understanding the factors proximal to relapse is crucial to understanding the course of substance use disorder and how best to improve recovery among adolescents. The current study represents part of a novel line of research using qualitative data analysis to examine these factors. Data for the present study were 200 de-identified node-maps, completed by high school students at Hope Academy, a recovery high school in Indianapolis, Indiana. The reported age in this sample ranged from 14-20 years (64.1% male, 89.1% White), with a mean age of 16.8 years (SD = 1.9 years). After a four-phase process of qualitative data sorting, primary people, places, and things most frequently described included using with others (n=153, 76.5%), away from home (n=156, 78.0%), and in response to negative affect (n=93, 48.4%). Eleven relapse pathways emerged: escaping (n=16), self-medicating (n=3), coping with tragedy (n=5), critical mass (n=6), unexpected activation (n=8), unexpected offer (n=22), planned use (n=19), resistant to recovery (n=5), not in recovery (n=22), passive agency (n=30), and acting out (n=15). Recovery is a system made up of many interrelated parts, including those related to the individual person in recovery, their thoughts, beliefs, feelings, and emotions; and those related to external factors, their environment, adverse life events, and the actions of other people. By considering the pathways together for their common features, they can each be said to represent one of three critical failures related to those three overarching facets of the system: failure to cope, failure to guard against temptation, and failure of belief. Identifying these overarching failures in the system is helpful because the failures contain in themselves the seeds of their solution, so by examining them as critical components to a relapse event, it may be possible to gain insight into how to prevent the same type of relapses from occurring in the future.