title: Elements that define recovery: the experiential perspective.
abstract: OBJECTIVE
  Although recovery increasingly guides substance use disorder services and policy, definitions of recovery continue to lack specificity, thereby hindering measure development and research. The goal of this study was to move the substance use disorders field beyond broad definitions by empirically identifying the domains and specific elements of recovery as experienced by persons in recovery from diverse pathways.
  
  
  METHODS
  An Internet-based survey was completed by 9,341 individuals (54% female) who self-identified as being in recovery, recovered, in medication-assisted recovery, or as having had a problem with alcohol or drugs (but no longer do). Respondents were recruited via extensive outreach with treatment and recovery organizations, electronic media, and self-help groups. The survey included 47 recovery elements developed through qualitative work followed by an iterative reduction process. Exploratory and confirmatory factor analyses were conducted using split-half samples, followed by sensitivity analyses for key sample groupings.
  
  
  RESULTS
  Four recovery domains with 35 recovery elements emerged: abstinence in recovery, essentials of recovery, enriched recovery, and spirituality of recovery. The four-factor structure was robust regardless of length of recovery, 12-step or treatment exposure, and current substance use status. Four uncommon elements did not load on any factor but are presented to indicate the diversity of definitions.
  
  
  CONCLUSIONS
  Our empirical findings offer specific items that can be used in evaluating recovery-oriented systems of care. Researchers studying recovery should include measures that extend beyond substance use and encompass elements such as those examined here--e.g., self-care, concern for others, personal growth, and developing ways of being that sustain change in substance use.
authors.affiliation: Alcohol Research Group, Public Health Institute, Emeryville, California, School of Public Health, University of California Berkeley, Berkeley, California.
authors.forename: Lee Ann
authors.initials: LA
authors.lastname: Kaskutas
authors.affiliation: Alcohol Research Group, Public Health Institute, Emeryville, California, Department of Sociology and Anthropology, George Mason University, Fairfax, Virginia.
authors.forename: Thomasina J
authors.initials: TJ
authors.lastname: Borkman
authors.affiliation: Center for the Study of Addictions and Recovery, National Development and Research Institutes, Inc., New York, New York.
authors.forename: Alexandre
authors.initials: A
authors.lastname: Laudet
authors.affiliation: Alcohol Research Group, Public Health Institute, Emeryville, California, Department of Public Affairs & Administration, California State University East Bay, Hayward, California.
authors.forename: Lois A
authors.initials: LA
authors.lastname: Ritter
authors.affiliation: Alcohol Research Group, Public Health Institute, Emeryville, California.
authors.forename: Jane
authors.initials: J
authors.lastname: Witbrodt
authors.affiliation: Alcohol Research Group, Public Health Institute, Emeryville, California, School of Public Health, University of California Berkeley, Berkeley, California.
authors.forename: Meenakshi Sabina
authors.initials: MS
authors.lastname: Subbaraman
authors.affiliation: Alcohol Research Group, Public Health Institute, Emeryville, California.
authors.forename: Aina
authors.initials: A
authors.lastname: Stunz
authors.affiliation: Alcohol Research Group, Public Health Institute, Emeryville, California.
authors.forename: Jason
authors.initials: J
authors.lastname: Bond
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000592:standards*; D019966:Substance-Related Disorders / Q000523:psychology*; D055815:Young Adult