Mixed methods study of help seekers and self-changers responding to an online recovery survey.
OBJECTIVE
To compare self-changers (natural recovery) with help seekers on demographics, pre-recovery problem severity, and recovery beliefs and behaviors; and to augment these quantitative findings with information extracted from the qualitative stories of a subset of self-changers to explore themes in recovery paths as informed by a nascent natural recovery literature.


METHODS
Quantitative secondary analyses were conducted with persons who had responded to a US nationwide online survey called 'What Is Recovery' (WIR) and who reported a prior lifetime alcohol problem (n = 5495). Six men and six women (with longer-term recoveries) interviewed later were asked to tell their 'recovery story from the beginning up to now'. These were coded using a narrative approach.


RESULTS
Compared with help seekers, self-changers were younger and never married: they did not differ on problem severity, gender, ethnicity or education. Self-changers identified with 'used to have a problem' more than in recovery/recovered, reported fewer years in that status, and reported more current, non-problematic substance use. A new concept of shadow help and shadow obstacles to help-seeking emerged from the qualitative analysis. Though self-changers believed that they had overcome their alcohol problem on their own, change actually occurred within a social context that allowed access to information, normative expectations, relationships, and other opportunities that provided important resources for change.


CONCLUSIONS
Findings imply that the concept of help-seeking needs to be re-conceptualized to include the informal help we found in this study.
Alcohol Research Group, Public Health Institute, 6475 Christie Avenue, Suite 400, Emeryville, CA 94608-1010, USA jwitbrodt@arg.org.
Jane
J
Witbrodt
Alcohol Research Group, Public Health Institute, 6475 Christie Avenue, Suite 400, Emeryville, CA 94608-1010, USA Department of Sociology and Anthropology, George Mason University, Fairfax, VA, USA.
Thomasina J
TJ
Borkman
Alcohol Research Group, Public Health Institute, 6475 Christie Avenue, Suite 400, Emeryville, CA 94608-1010, USA.
Aina
A
Stunz
Alcohol Research Group, Public Health Institute, 6475 Christie Avenue, Suite 400, Emeryville, CA 94608-1010, USA.
Meenakshi Sabina
MS
Subbaraman
D000328:Adult; D000367:Age Factors; D064829:Alcohol Abstinence / Q000523:psychology / Q000706:statistics & numerical data; D019973:Alcohol-Related Disorders / Q000523:psychology / Q000628:therapy*; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D017533:Marital Status; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000523:psychology* / Q000706:statistics & numerical data; D012648:Self Care / Q000523:psychology* / Q000706:statistics & numerical data; D016896:Treatment Outcome