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Thesis Format

Integrated Article


Doctor of Philosophy




Forchuk, Cheryl



To date, research that has investigated psychosocial processes and mechanisms, which underpin addiction recovery outcomes are scarce. This study sought to develop and test an integrated addiction recovery model for the recovery process while accounting for an individual’s psychosocial context.


This predictive study used consecutive sampling strategies to recruit 315 participants from tertiary addiction care settings in Rwanda. Data on the hypothesized model variables and individual’s characteristics were collected with self-reported measures. Structural equation modelling techniques were used to test the model psychometric measures and associations between latent variables.


Baseline data analyses showed a mean age at first substance use of 18.6 (SD=6.1). Early age at first substance use and individual’s characteristics, such as post-traumatic stress disorder, had a significant effect on later addiction severity with β= -.130, p=. 013 and β= .363; p=


These results establish psychometric properties of the integrated addiction recovery model. The results demonstrate that retention in the addiction recovery process is underpinned by interactions between therapeutic relationships and supportive social networks through the satisfaction of basic psychological needs. However, future research is needed to conduct the model measurement invariance in a different sample.

Summary for Lay Audience

Research that has examined the psychological and social processes that determine recovery from substance use issues is scarce. The present study sought to develop and test a unified model for engaging and retaining persons suffering from substance use issues in the recovery process in Rwanda.

Over nine months, 315 participants seeking treatment for substance use issues from two only tertiary mental healthcare services in Rwanda were recruited. Information from participants before discharge and one month later on different dimensions of recovery was collected. Statistics were computed to determine the contribution of each of the aspects of recovery to supporting people to engage and stay abstinent from substance use.

Analyses of information collected before discharge showed that the average age of starting substance use was 18.6 years old. People who start substance use earlier in life and those who suffered post-traumatic stress disorder developed more severe substance use issues.

The statistical analysis found a model with five dimensions of recovery from substance use issues. The dimensions, such as good interactions between healthcare providers and patients, support to fulfil basic psychological needs, and social support received from family, friends, and community were found to influence recovery for substance use issues. However, the researcher found that the person's motivation for treatment and level of substance use severity can nullify recovery outcomes.

This research provides valuable information about various aspects to consider while conceiving addiction care programs for sustained substance use recovery. The present study also informs future research of aspects of treatment interventions to examine while investigating the recovery process among people with substance use issues. The statistical techniques utilized warrant that these results may be replicable in other clinical populations.

Creative Commons License

Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.