Research plays a major role in the work of the PROMIS Clinics. Here we describe briefly the background to the work of the PROMIS Research group, and say something about present projects and the impact our work is having on treatment at the Centre, and how it contributes to scientific understanding and treatment of addictions more generally.
For more information on our publications and research, please visit our company addictions research page.
In 1989 the PROMIS Research Trust gave a grant to the University of Kent, to enable Professor Geoffrey Stephenson and Dr. Neo Morojele to undertake an assessment of outcomes amongst patients admitted to the centre. This led to the establishment of the PROMIS Research Group (PRG) which since its first meeting in January 1993 has met on a regular monthly basis to plan, approve and co-ordinate basic and applied research into addiction. The PRG has a core membership of PROMIS and University researchers, but invites visitors and occasional research collaborators as appropriate. The present membership includes Dr Robert Lefever and Robin Lefever from the Centre, and Professor Geoffrey Stephenson, Professor Chris Cook, Samantha Haylett and Louise Hope from the University of Kent.
The quality of the work undertaken on behalf of the PROMIS Research Trust was recognised by the Economic and Social Research Council, who funded additional studies through their Research Grant scheme. The result has been a series of studies and publications in scientific journals of importance to our understanding of:
Evaluating the effectiveness of treatment is a major, ongoing task of the research team. Different aspects of treatment, for example the involvement of family members in treatment, adapting and forming groups according to the addictive orientation, the requirement to write and review a daily dairy of feelings, are selected for special evaluation. Currently we are exploring the extent to which it is possible to see how well patients are progressing in treatment from an analysis of their daily diaries. Computerised techniques of linguistic analysis are being used in this work, and an international dimension achieved with the involvement of research teams at the Hungarian Academy of Sciences in Budapest under the direction of Dr. Janos Laszlo, and at the University of Texas in the Department of Psychology. There, Professor James Pennebaker has developed the Linguistic Inquiry Word Count programme for the analysis and evaluation of written text in treatment contexts, and we are comparing our findings in the two centres. The results of these studies indicate that it is possible to accelerate progress in treatment, and to evaluate more effectively who is responding well, and who is having particular difficulties that require special attention.
Another important ongoing feature of our work is the measurement of addiction problems. PROMIS has pioneered scientific work in the study of cross-addiction. From the time PROMIS was established in 1986 Dr. Lefever used the PROMIS Questionnaire to assess the degree of involvement on some 16 addictive areas. This led to the formulation of the concept of "addictive orientations" evident in two broad factors which we termed Hedonism and Nurturance. The scales were further developed in our work, and results using the revised Shorter Promis Questionnaires have led to new discoveries. Sub-groups of addictive behaviours have been established, and important differences in relation to gender established. These findings all have implications for treatment both at PROMIS and elsewhere, and will achieve maximum influence by their publication in leading scientific journals.
More recently in collaboration with Professor Christopher Cook from the Kent Institute of Medicine and Health Science the activities of the group are being extended into studies of:
Genetics of alcohol addiction
Therapeutic orientation and organisational climate
Other ongoing projects involve collaboration with Dr Mark Griffiths from Nottingham Trent University, and the participation of postgraduate students from the University of Kent. Topics include:
Discourse and progress in recovery
Social identity and progress in treatment groups
The work of the PRG is carefully explained to all patients who come to PROMIS and their co-operation requested after they have settled in. We trust that new patients appreciate that they will benefit from the results of past research, and that by co-operating are helping to establish a sound basis for the treatment of addicts in the future. All patients are asked to complete standardised psychological, psychiatric and addiction questionnaires including the Shorter PROMIS Questionnaire? This and other information is held in strict confidence, and all projects conducted in accordance with ethical guidelines imposed by our respective professional bodies. The data that we are gathering provides an invaluable resource for present and future research.
The content of daily diaries which patients write have been shown to be associated with successful progress in treatment. This has two important practical implications. First, aspects of the treatment programme can be modified to facilitate changes, for example in the expression of feelings towards the treatment programme, which research showed to be important in successful treatment outcomes. Second, the diary material can be more effectively used to monitor patients' progress in treatment, so directing attention to particular needs of individuals.
Research at PROMIS has a wider impact, because we make publicly available all our work through University Libraries and publication in scientific journals. International interest in the application of Twelve-step Facilitation Therapy is increasing. A recent large scale experimental study having shown that it is at least as effective as other standard psychological treatment (Cognitive Behavioural Coping Skills Therapy and Motivational Enhancement Therapy) Copies of our published studies have been requested from Institutes in many countries and it is evident that our work is influencing both research and practice elsewhere. In the next section we list our recent reports and publications, and give a brief description of their contents. We also explain how you may obtain copies of them and seek further information.
A number of reports are in progress and will be available shortly, including a study of cross-addiction using the Shorter Promis Questionnaire (a revised and updated version of the PROMIS Questionnaire). This clarifies the different role played by alcohol in the profiles of men and women, and suggests that reliable clusters of addictive tendencies exist within the broad nurturant and hedonistic factors. A further study examines the therapeutic effectiveness of requiring patients to review their progress using typed transcripts of their diaries written some weeks earlier. The results point to a potentially valuable therapeutic intervention with wide applications.