Advancing understandings of remission and approaches to treatment through an examination of untreated remission from alcohol problems

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Copyright: Mellor, Richard
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Abstract
Remission from alcohol problems is often studied in association with treatment, yet most people who resolve their alcohol problems do so without seeking support. The concept of remission has traditionally been understood in relation to abstinence and binary changes (from an ‘addict identity’ to a ‘recovery identity’), but analysing the lived experiences of people in untreated remission warrants a rethink of these prevailing concepts. Researching untreated remission also has the potential to inform the development of formal and informal treatment across the globe; knowing how many people remit without treatment is vital for treatment planning approaches, and understanding which services are accessed outside of formal alcohol treatment forces a reconsideration of what constitutes ‘alcohol treatment’. This thesis is made up of three components, each one addressing some or more of these aspects, using both quantitative and qualitative methods. A systematic review was conducted covering the rates of untreated remission, and based on this research, a planning tool analysis was conducted (using the Drug and Alcohol Services Planning Model), detailing the impact untreated remission data has on the projected costs and resources required for treatment service planning. An online survey method was used to understand the characteristics of people in remission from alcohol problems in Australia, and it was concluded that untreated remission occurs frequently in Australia, and in general does not discriminate based on socio-demographic factors. Participants reported a range of remission behaviours (abstinence and otherwise) and reported accessing various types of treatment (formal alcohol treatment, mental health treatment, self-help groups, and digital support services). People in untreated remission were interviewed using a life-curve methodology, and the accounts participants gave of their lives invoked various narratives and identities (of discovery, emancipation, mastery, and coping), and within these the process of resolving an alcohol problem figured in complex ways. This thesis has demonstrated that people experience remission in a variety of ways, often without treatment (but also in connection with a range of formal and informal services outside the scope of formal alcohol treatment). This research complicates straightforward notions of remission, and highlights the importance of diversifying the treatment response.
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Author(s)
Mellor, Richard
Supervisor(s)
Ritter, Alison
Lancaster, Kari
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Publication Year
2020
Resource Type
Thesis
Degree Type
PhD Doctorate
UNSW Faculty
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