Journaling and Addiction Recovery: Piloting "Positive Recovery Journaling" (PPJ)

The main objective of this study is to pilot test the Positive Peer Journaling (PPJ) [later renamed "Positive Recovery Journaling" (PRJ)] intervention and its feasibility and acceptability. A second objective is to compare individuals assigned to PPJ to individuals in a treatment as usual control group.

Study Overview

• Status: Completed
• Conditions: Addiction
• Intervention / Treatment: Behavioral: Positive Peer Journaling (PPJ)

Detailed Description

Many spiritual and religious traditions involve the practice of personal inventory and self-examination. These practices involve conducting a review of the day, spirituality, gratitude, and striving for self-knowledge and self-improvement. The 10th step of Alcoholics Anonymous (AA) recommends that members conduct such a daily inventory. While this practice may benefit AA members, not everyone seeking addiction recovery joins AA. Even for those who do, it can take time to reach step 10 and begin deriving benefits from it. The study PI, Dr. Amy Krentzman, developed Positive Recovery Journaling (PRJ, formerly "positive peer journaling") as a simple 10-minute daily practice which reviews the past 24 hours on the left side of a journal page and plans the upcoming 24 hours on the right side of a journal page. The prompts for the left and right sides of the PRJ page are based on principles from positive psychology and behavioral activation.

The main objective of this study is to pilot test the PRJ intervention and to examine the feasibility, acceptability, and logistics of treatment delivery.

A second objective is to observe whether PRJ is associated with improvement in satisfaction with life, happiness with recovery, and commitment to sobriety

• Study Type: Interventional
• Enrollment (Actual): 81
• Phase: Not Applicable

Contacts and Locations

Study Locations

• United States
  • Minnesota
    • Minneapolis, Minnesota, United States, 55413
      • NUWAY

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• meet DSM-V criteria for past-year Substance Use Disorder as primary or secondary diagnosis,
• English literacy sufficient to make short written lists needed to complete PPJ and homework assessments,
• minimum 2 weeks sustained abstinence,
• completed first 2 weeks of treatment at Nuway (approximately 2 weeks), an intensive outpatient substance use disorder treatment program and the recruitment site,
• agree to be audio recorded or transcription recorded in group meetings and in individual meetings with research staff,
• currently are clients in the Nuway outpatient program,
• participants must be English speaking and literacy must be strong enough to write short lists and to understand the questions asked in the questionnaires,
• participants must have an electronic device that connects to the internet and internet connection for online delivery of intervention during COVID-19.

Exclusion Criteria:

• presence of a psychotic disorder, psychiatric condition (e.g., suicidal ideation), or cognitive impairment (e.g., severe dementia, traumatic brain injury) limiting ability to give consent and/or participate in the study;
• severe psychiatric illness (current schizophrenia, major depression with suicidal ideation);
• personality disorders that would interfere with satisfactory participation in or completion of the study protocol,
• inability to give informed, voluntary consent to participate,
• lack of sufficient English literacy to participate, defined as inability to make a list of 5 things they did yesterday and inability to understand questionnaire items,
• any impairment, activity, or situation that in the judgement of the research staff would prevent satisfactory participation in or completion of the study protocol.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Treatment Group; Participants in this group will complete the intervention, Positive Peer Journaling (PPJ), while also continuing to attend intensive outpatient treatment for addiction.	Behavioral: Positive Peer Journaling (PPJ); PPJ is a journaling practice to support addiction recovery. PPJ encourages past 24 hour review and upcoming 24 hour planning to improve subjective wellbeing in recovery and reduce relapse. PPJ uses journals with column headings under which individuals make bullet-pointed lists. On the left hand page, past 24 hours is recalled, itemizing "good" and "bad" things that happened and things for which one is grateful. Good wishes for others are also expressed on this page. On the right hand page, values-based activities for the upcoming 24 hours are planned via headings representing valued life domains such as "recovery," "work/school," "spirituality," "home and household," and "health."
No Intervention: Control Group; There will be no intervention for those randomized to the control group. However, they will complete assessment instruments throughout the study period while also continuing to attend intensive outpatient treatment for addiction.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Satisfaction With Life at Baseline	Score on the "Satisfaction with Life" scale. This scale has 5 items assessed on a 7 point Likert-type response format. Scores range from 5 to 35 with higher scores representing higher satisfaction with life.	Baseline
Satisfaction With Life at 2 Weeks	Score on the "Satisfaction with Life" scale. This scale has 5 items assessed on a 7 point Likert-type response format. Scores range from 5 to 35 with higher scores representing higher satisfaction with life.	2 weeks (after Phase 1, the group phase)
Satisfaction With Life at 4 Weeks	Score on the "Satisfaction with Life" scale. This scale has 5 items assessed on a 7 point Likert-type response format. Scores range from 5 to 35 with higher scores representing higher satisfaction with life.	4 weeks (after Phase 2, the independent practice phase)
Satisfaction With Life at 8 Weeks	Score on the "Satisfaction with Life" scale. This scale has 5 items assessed on a 7 point Likert-type response format. Scores range from 5 to 35 with higher scores representing higher satisfaction with life.	8 weeks (the 1-month post-intervention)
Happiness With Recovery at Baseline	Score on a single item, "In general, I am happy with my recovery." This item uses an 11 point scale ranging from 0 to 10. Higher scores represent higher happiness with recovery.	Baseline
Happiness With Recovery at 2 Weeks	Score on a single item, "In general, I am happy with my recovery." This item uses an 11 point scale ranging from 0 to 10. Higher scores represent higher happiness with recovery.	2 weeks (after Phase 1, the group phase)
Happiness With Recovery at 4 Weeks	Score on a single item, "In general, I am happy with my recovery." This item uses an 11 point scale ranging from 0 to 10. Higher scores represent higher happiness with recovery.	4 weeks (after Phase 2, the independent practice phase)
Happiness With Recovery at 8 Weeks	Score on a single item, "In general, I am happy with my recovery." This item uses an 11 point scale ranging from 0 to 10. Higher scores represent higher happiness with recovery.	8 weeks (the 1-month post intervention)
Commitment to Sobriety at Baseline	Score on a single item, "I am willing to do whatever it takes to recover from my addiction." This item uses an 11 point scale ranging from 0-10. Higher scores represent greater commitment to sobriety.	Baseline
Commitment to Sobriety at 2 Weeks	Score on a single item, "I am willing to do whatever it takes to recover from my addiction." This item uses an 11 point scale ranging from 0-10. Higher scores represent greater commitment to sobriety.	2 weeks (after Phase 1, the group phase)
Commitment to Sobriety at 4 Weeks	Score on a single item, "I am willing to do whatever it takes to recover from my addiction." This item uses an 11 point scale ranging from 0-10. Higher scores represent greater commitment to sobriety.	4 weeks (after Phase 2, the independent practice phase)
Commitment to Sobriety at 8 Weeks	Score on a single item, "I am willing to do whatever it takes to recover from my addiction." This item uses an 11 point scale ranging from 0-10. Higher scores represent greater commitment to sobriety.	8 weeks (the 1-month post intervention)

Collaborators and Investigators

• Sponsor: University of Minnesota
• Investigators: Principal Investigator: Amy Krentzman, MSW, PhD, University of Minenesota

Study record dates

Study Major Dates

• Study Start (Actual): July 7, 2020
• Primary Completion (Actual): November 1, 2021
• Study Completion (Actual): November 1, 2021

Study Registration Dates

• First Submitted: May 21, 2020
• First Submitted That Met QC Criteria: June 30, 2020
• First Posted (Actual): July 7, 2020

Study Record Updates

• Last Update Posted (Actual): June 20, 2024
• Last Update Submitted That Met QC Criteria: May 29, 2024
• Last Verified: May 1, 2024

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Compulsive Behavior; Impulsive Behavior; Behavior, Addictive
• Other Study ID Numbers: STUDY00004619-2

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No