The world has seen its share of turmoil and disaster in 2017. Social upheaval, political unrest, terrorism, and natural disasters daily have dominated headlines. And as the year ends, we learn that this beloved journal will cease publication. Amidst the sadness we too easily forget the ongoing quiet, steady work of clinicians, researchers, those seeking recovery, and those who love and support them. With mixed sadness and pride, then, I present the Journal of Groups in Addiction in Recovery's final issue, which highlights where we are as a community of researchers (mostly good) and where we are headed (looking better). We end this year and conclude this journal's run on the theme of progress.
My 2017 predecessor guest editors of Volume 12 set the stage for this issue, and they set a high standard. Issue 1, edited by Roy Futterman, focused attention on the relationships between internal states and, well, life. Those relationships are multifaceted and life is multinational and multicultural, and the array of articles published in that issue were multiplex. Issue 2–3 was a special issue focusing on therapeutic communities, an approach to recovery which has been inadequately studied. Wouter Vanderplasschen, Rowdy Yates, and Michal Miovsky's work as guest editors significantly advanced what we know about therapeutic communities, and therefore will enhance the effectiveness of these special groups and their members.
If the theme of this fourth issue of Volume 12 is progress, we necessarily must begin by orienting ourselves: Where are we now? In the first article, “Group Therapy for Substance Use Disorders: A Survey of Clinician Practices,” Wendt and Gone report the results of their survey of 566 members of the Association for Addiction Professionals. Their work reveals most SUD patients receive group therapy and clinicians rely heavily on evidence-based practices. Those results are evidence of the progress we have made, but other results reveal questionable practices which clinicians should jettison. Learning this information, however, is also progress because it shows us where to devote our attention.
The remaining four articles in this issue are all quantitative evaluations of field trials, or interventions implemented in real-world settings, including inpatient treatment facilities in the Southwest United States, an Iranian prison, American Indian Communities in the mountain states, and an Italian cocaine clinic. Field trials are often messy endeavors because they rely on clinicians and patients whose top priority is health-related and not research-related. They often lack the control of extraneous variables that lab researchers claim is essential for scientifically sound conclusions.
Advocates of field trials—and I am one—argue that life does not happen in a lab and controlling too many variables can create an artificial environment that does not actually exist for people struggling with addiction. In reality, clinicians try new approaches all the time and we researchers will miss some valuable lessons if we do not attempt to observe, measure, and report what they are doing and what they are discovering. These final four articles report on four different approaches to treating four different addictions in four different settings. By telling us what worked, and what did not, they inch us along the path to more effective interventions. By any definition, that is progress.
The first of the trials, by Shumway, Schonian, Bradshaw, and Hayes, takes as its premise that treatments focusing exclusively on the substance use or the substance user are inadequate. For too long, family members have been positioned in the research literature as facilitators of someone else's addiction or recovery. In “A Revised Multifamily Group Curriculum: The Need for Family Member Recovery from Addiction,” the authors establish themselves among a small (but growing) number of researchers declaring that family members merit research focusing on their own outcome measures, and merit interventions to alleviate the toll of sustaining relationships with substance users.
The second trial reported in this issue is by Jalali, Hashemi, Hasani, and Fakoor Sharghi and also examines understudied outcomes (self-esteem and cognitive emotion regulation) in an understudied population (addicted prisoners in Iran). “The Effectiveness of Cognitive Group Therapy Based on Schema-Focused Approach on Self-Esteem and Emotion Regulation in Drug Addicted Prisoners Under the Methadone Maintenance Treatment (MMT)” reports measurable improvements among those who received this intervention.
“Assessing the Impact of American Indian Peer Recovery Support on Substance Use and Health” describes the third trial included in this issue. Authors Kelley, Bingham, Brown, and Pepion implemented a systematic peer support program as part of the larger Transitional Recovery and Culture Program, whose broad mission is to improve the wellbeing of Native communities in the upper Rocky Mountain states. Elements of their culturally sensitive adaptation of recovery coaching show promise for sustaining long-term recovery.
The final article is “Rolling Psychodynamic Group for Cocaine Use Disorder: A Single-Group Study Using Multilevel Models.” Closed groups treat patient cohorts who progress at roughly the same rate, and therefore may bond over shared milestones. Rolling groups, however, admit a new member when someone leaves. In rolling groups, coherence is a concern, and the impact of coherence on outcomes among rolling group members has not been well established. Pavia et al. seek clarity on the influence of group process variables like individual and group cohesion. Examining this approach in a clinic for cocaine-dependent people in Brescia, Italy, the authors' findings reveal both the complexity and importance of cohesion in achieving individual recovery.
By my count, over the past 12 years the Journal of Groups in Addiction and Recovery has published more than 200 original articles and more than 30 reviews in approximately 4,000 pages. As a collective body of work, the journal represents a tremendous amount of effort, cooperation, and—yes—progress in understanding how groups contribute to recovery for millions of individuals. I offer special thanks to Jeffrey Roth, both for the opportunity to guest edit this final issue and for the guidance he has offered contributors and guest editors over many years. His generosity has made us better researchers and better writers. I also want to thank those who toil in this field. Research is hard and rejected manuscripts can be demoralizing, but many of us appreciate what you do and encourage you to keep going. The work matters a great deal and my hope is that you will join us as we embrace a new collaboration with Alcoholism Treatment Quarterly.
Harvard psychologist Dan Gilbert offers a truism that those in recovery must never forget when he says, “Human beings are works in progress that mistakenly think they're finished.” We researchers are also human beings (most of the time) so the saying also applies to us. May our new year be filled with wonder, with work, and with continued progress. We are not finished yet.