The Process of Supportive Communication and its Therapeutic Benefits in a Smartphone-Based Addiction Treatment Group

• Main Author: Moon, Tae Joon
• Format: Dissertation
• Language: English
• Published: ProQuest Dissertations & Theses 01-01-2017
• Subjects: Communication; Health sciences; Mental health
• ISBN: 9780355242331; 0355242338

The objectives of this dissertation are to examine the nature of supportive communication that is exchanged within smartphone-based peer support groups for people with alcohol use disorder (AUD) and to investigate the impact of three elements of supportive communication behaviors on the recovery from alcohol use disorder: (1) support activation, (2) support provision, and (3) receiving social support matched to support activation. As smartphone-based peer support groups are relatively novel phenomena, this dissertation first analyzed the content of messages exchanged between patients by using corpus analysis, which allowed the researcher to provide a detailed description of linguistic characteristics of messages produced by patients. The current dissertation further conducted a sequential analysis to examine the relationships between messages. This analysis provided a detailed illustration of the process in which social support was activated, provided, and received. Measures of supportive communication behavior (i.e., support activation, support provision, and support reception) were created based on the results from corpus analysis and sequential analysis. By using these measures, this dissertation examined how each of the supportive communication behaviors contributed to the reduction of risky drinking days. The smartphone-based peer support group examined in this dissertation is the Discussion Group within the Addiction-Comprehensive Health Enhancement Support System (A-CHESS) at the University of Wisconsin-Madison. Of the 170 study participants who could access the Discussion Groups, 126 participated in a conversation with other patients at least once during the 12-month study period. Messages written by these participants and the structure of conversations among them were interpreted and analyzed through corpus analysis and sequential analysis. The data obtained these analyses were combined with the survey data from pre- and post-test and use log data which included detailed information about the A-CHESS Discussion Group use (e.g., viewing, posting, and replying with a time stamp). The results of corpus analysis revealed that there are four major topics discussed in the A-CHESS Discussion Group: (1) support provision (e.g., emotional support and informational support), (2) self-disclosure of emotional and experiences, (3) public commitment to abstinence and/or recovery principles, and (4) relationship (e.g., greetings, friendship with other members). According to the type of messages that initiated conversations in the Discussion Group, a series of sequential analysis was conducted. The results identified three distinctive sequences in which different messages were statistically significantly connected to others in a sequential manner: (1) Sequence 1: Emotional disclosure/disinhibition → Emotional Support → Public commitment; (2) Sequence 2: Public commitment to abstinence → Emotional support → Public commitment to recovery principles; and (3) Sequence 3: Self-disclosure → Emotional support. Each sequence explained how social support was activated and provided. The results also demonstrated that provision of support contributed to behavioral or cognitive adjustment of patients who expressed negative emotion (sequence 1) and reinforced previously presented attitude of patients (sequence 2). Finally, the prediction model revealed that making a public commitment was the strongest predictor of the reduced risky drinking days, followed by support provision and reception of matched support to emotional/personal disclosure. However, emotional/personal disclosure in itself was not related to the risky drinking days and reception of support to matched public commitment was positively related to reduced risky drinking days, requiring further analysis of the ambivalent nature of public commitment. In sum, this dissertation provides a more comprehensive description of the content and the structure of supportive communication in a smartphone-based peer support group and its therapeutic benefits in the context of AUD treatment. The results of this study provide theoretical and methodological implications to analyze interactions within smartphone-based support groups. Practical implications for developing a more effective peer support communication was also discussed.