In the article “Wellness, Emotion Regulation, and Relapse during Substance Use Disorder Treatment”, Clarke, Lewis, Myers, Henson, and Hill (2020) focus on the role of managing emotions in substance use relapse prevention. The researchers were interested in exploring various relationships between emotion regulation, reappraisal, suppression, and others. In order to introduce the target topic, the authors began with a brief literature review, stating that the previous literature points to the link between lifestyles, wellbeing, and relapses. The research question was not explicitly formulated by Clarke et al. (2020), yet the article allows understanding that the inquiry refers to the mediating role of emotion regulation and healthy lifestyles on substance use disorder management.
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The hypothesis that was made by the identified authors was associated with the existence of the negative correlation between problems in emotion regulation and wellness factors, the quantity of relapse days, and emotional suppression. At the same time, it was expected to discover the statistically significant positive correlation between such variables as reappraisal emotion regulation and wellness dimensions. Another hypothesis was associated with the predictive role of emotions and wellbeing on the number of relapses. The ability of emotion regulation to mediate the link between the number of relapse days and total wellness was also hypothesized in this study.
To make the identified hypotheses, the authors scrutinized the recent academic literature, referring to empirical research and providing proper citations. Since the reference list is given at the end of the article, the readers have the opportunity to access the sources used and better understand the topic of interest. The purpose of formulating these hypotheses was to address the gap existing in the modern literature that is concentrated on treating substance use disorder.
The critical review of the given article shows that the convenience sampling method was used to recruit the participants of the study. The organizations specializing in drug and alcohol treatment and located in the southeastern United States were contacted. The patients receiving outpatient treatment or partial hospitalization programs were offered to contribute to this study. The inclusion characteristics were the enrollment in the mentioned program within one year and 18 years of age.
The exclusion criteria were the participation in the program for more than one year and the current opioid maintenance therapy. Of 194 research packets, 179 were completed, which allows for claiming that the response rate achieved 92.3 percent. Speaking of the demographic characteristics, one should note that the age of the participants was 19-67 years; the majority of them were unemployed; the high school was the highest education. There was an almost equal distribution of males and females; and African-Americans (43.0 percent) and Caucasians (42.5 percent) participants. The diversity in these characteristics seems to promote more accurate results.
The authors verified each of the hypotheses within a separate test, where the relapse of substance use disorder was regarded as the dependent variable. The emotional regulation and wellness factors were taken as the independent variables that can impact the dependent variable. More to the point, depending on the hypothesis being tested, the changes in the dependent and independent variables were made. Among the predictor variables, there also were reappraisal, suppression, and difficulties in coping with emotions. These variables were operationalized by the use of specific clarifications on what exactly the authors planned to measure.
Speaking of the methodology, the study clearly outlines the procedures, instruments, and participants. First of all, the authors received the approval from institutional review boards (IRBs) of the involved organizations. The cooperation with treatment coordinators allowed recruiting participants with the help of software that estimated that 130 people would be sufficient for the sample. Second, the demographic data of participants was analyzed, and their medical data was also taken into account to consider it while interpreting the results. The section related to the instruments contains the discussion of the three questionnaires.
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The demographic questionnaire was applied to measure the social and demographic characteristics of respondents. The Five-Factor Wellness Inventory aimed to evaluate the component-specific wellness of participants, and the Emotion Regulation Questionnaire helped to assess reappraisal and suppression issues. The participants completed these questionnaires by using Likert’s scale and clarifying their agreement with the given statements.
The results of the study demonstrate that hypothesis 1 was verified: there is the correlation between difficulties in emotion regulation and total wellness. Hypothesis 2 was not confirmed since the authors discovered that creative self-wellness was the strong anticipator of the number of relapse days. The next strongest predictive factor was reappraisal that included a range of coping skills. As for hypothesis 3, it was supported partially: the indirect effects on the number of relapse days were noted in the connection between wellness factors and emotional regulation. In particular, coping self and essential self as well as reappraisal and difficulties in emotion regulation can be noted as the correlating factors.
The data collected by the authors was tested for validity and reliability on the sample of graduate students. The satisfactory correlations with the associated measures allowed reflecting the validity of questionnaires. No threats to validity can be observed in this study; indeed, it seems that the authors minimized it. In general, this research article properly discussed all the integral points of the study, making it possible for others to repeat it, which means that their experiment is consistent.
The fact that the authors used the scholarly literature to identify the hypotheses is another issue that makes this study appropriate. The well-structured presentation of methodology and results allows for following the authors’ ideas and evaluating their interpretations. It seems that this article lacks a more comprehensive discussion that could integrate knowledge from previous research. The convenience sampling and a retrospective nature of the study can also be mentioned as the limitations. In further research, one can recommend focusing on a prospective design and purposeful sampling.
The implications for counselors were associated with the practical steps that they can to better understand their patients. For instance, by helping a patient to develop his or her coping skills and regulation strategies, it is possible to enhance the overall wellbeing. At the same time, the advancements in wellness can enhance the emotional regulation of a patient. The awareness of these specific links between the identified variables can equip counselors with valuable and feasible strategies.
In addition, the practitioners may be interested in the detailed exploration of one or several factors that impact a particular patient to a greater extent, and the findings of this article can serve as guideline. Based on this study, the scholars suggest that future research can explore different ways to measure relapse or discuss addiction severity indicators. This study was based on a single experiment, which provides another opportunity to design multi-experiment research in the future.
Clarke, P. B., Lewis, T. F., Myers, J. E., Henson, R. A., & Hill, B. (2020). Wellness, emotion regulation, and relapse during substance use disorder treatment. Journal of Counseling & Development, 98(1), 17-28.