Psychology ETDs

Publication Date

Spring 4-13-2023


Recovery from substance use disorder (SUD) is heterogeneous by nature. Yet, over the last 50 years, substance use treatment providers and researchers have often defined success as sustained abstinence from substances. An often overlooked but equally valid pathway to recovery for persons with SUD is non-abstinent recovery. However, the majority of the literature on non-abstinent recovery exists for individuals with alcohol use disorder (AUD) with little empirical inquiry into non-abstinent recovery for other types of SUD. Additionally, there is also no known literature, to date, that explores the mechanisms that lead to non-abstinent recovery for individuals who have engaged in treatment for SUD. As such, the current study aimed to address these gaps by examining non-abstinent recovery profiles for individuals (N =453) who were recruited into two randomized clinical trials examining Mindfulness-Based Relapse Prevention (MBRP), as compared to Cognitive Behavioral Relapse Prevention (RP) and Treatment as Usual (TAU). Using a combined sample, we used latent profile analysis to empirically derive four profiles of recovery following outpatient aftercare SUD treatment (1) high-functioning frequent substance using, (2) low-functioning frequent substance using (3) high-functioning infrequent substance using, (4) low-functioning infrequent substance using. Multinomial logistic regression failed to an association between treatment assignment and recovery profile. Likewise, we found no evidence for interaction effects of race/ethnicity by treatment, and socioeconomic status by treatment, in the prediction of recovery profiles. Trait mindfulness, craving, and psychological flexibility failed to partially mediate the association between treatment assignment and recovery profile; however, there were statistically significant differences in trait mindfulness such that individuals in the low-functioning infrequent substance using profile reported significantly lower levels of trait mindfulness compared to individuals in the two high-functioning profiles. The results from this study suggest that recovery from SUD is heterogeneous, and common forms of recovery based on dimensions of substance use and functioning can be identified across a variety of SUD, including those with co-occurring SUD. Additionally, mindfulness appears to be an important factor in the recovery process, though further research is needed to explore how psychological and social factors may influence both abstinent and non-abstinent forms of recovery.

Degree Name


Level of Degree


Department Name


First Committee Member (Chair)

Katie Witkiewitz

Second Committee Member

Steven P. Verney

Third Committee Member

Matthew R. Pearson




non-abstinent recovery, substance use disorder, mindfulness-based relapse prevention, mechanisms of behavior change, social moderators of recovery

Document Type



Please direct correspondence to David I.K. Moniz-Lewis: