• Home
  • Law


  • Category:
  • Document type:
  • Level:
  • Page:
  • Words:


Factors Prompting and Supporting Untreated Change

Edith Cowan University

Unit code: Unit name

Tutor: Name of your tutor/lecturer

Table of Contents


4Untreated Change

5Factors prompting and supporting untreated change

5Self-efficacy, Life history, and Demographic factors

5Self-efficacy and drinking patterns

6Social support, life situations, and coping strategies



Factors Prompting and Supporting Untreated Change


Reducing the risks associated with the participation of alcohol and other drugs (AOD) in offending is an ongoing principal concern for crime prevention specialists and health practitioners in Australia (Gottfredson et al. 2008; Commonwealth of Australia, 2004; NSW Health, 2008). While it is unfeasible to decisively establish the extent of crime ascribed to using AOD, the relationship between crime and AOD use has been broadly investigated by criminology and psychology scholars and institutions (White, 2012; Australian Government, 2015). A recent study of the AOD in 2012 established that some 50% of the detainees blamed their recent crime to AOD use. This presents a concern and a need to treat individuals with AOD. Scholarly pieces of research have also established that change, which is untreated, is a significant and prevalent path for a range of individuals, who change or renounce their AOD use (Moos & Moos, 2006a; Klingemann & Carter-Sobell, 2007).

Studies on untreated change have focused on the triggering mechanisms, which set off cognitive appraisal processes that facilitate remitting from alcohol problems (Klingemann & Carter-Sobell, 2007; Tucker & Simpson, 2008). Factors like the advantages and disadvantages of AOD use are significant in motivating individuals to refrain from alcohol use (Tucker & Simpson, 2011; Rickwood et al., 2008). Still, being motivated to refrain from alcohol use does not sufficiently predict successful cessation.

This essay discusses the concept of untreated change and the factors associated with facilitating and supporting behaviour change, among individuals who chose the path of untreated behaviour change.

Untreated Change

It refers to the recovery from AOD without any formal intervention or assistance. Klingemann et al (2011) also describe it as ‘natural recovery,’ ‘untreated change,’ and ‘maturing out.’ From the psychological point of view, untreated change refers to a situation where an AOD user emphasises own cognitive achievement using a behavioural change intervention he self-initiates (McCrady & Epstein, 2013). From the sociological perspective, untreated change refers to a treatment option where the key consideration is exiting from the deviant behaviours with no formal assistance or intervention (Smith et al., 2012; White, 2012).

Since the seminal researches in “natural” recovery from AOD use were carried out in the 1970s and early 1980s (Roizen
et al., 1978; Waldorf, 1983), there has been a growth of appreciation by subsequent scholarly pieces of research on
recovery processes without professional help as a practicable and universal phenomenon. Past findings from epidemiological researchers have demonstrated that untreated change is the principal pathway to recovery from AOD use, showing 66.7 percent recovery rates in Germany to as high as 77 percent in Canada (Bischof et al., 2000). This instigated intensified research in
efforts on untreated change, often significantly directed by the objective of
developing more innovative treatment options (Cairney & Streiner, 2010). A vital element in scholarly studies on untreated change is whether AUD users who rely on this pathway apply explicit maintenance factors.

According to Moos and Moos (2006), there are three categories of factors linked to natural remission among untreated AOD users: drinking patterns and associated indices of functioning, life history, and demographic factors and lastly, coping and life situational factors.

Factors prompting and supporting untreated change

Self-efficacy, Life history, and Demographic factors

Moos and Moos (2006) explain that life history and demographic factors prompting and supporting behaviour change among individuals who have opted for the pathway of untreated behaviour change. These factors have also been examined by Beresford and Gomberg (1995) and Matheson (2015).

Moos and Moos’ (2006) study of untreated alcohol users showed that age facilitated untreated remission of older individuals, who were also likely to be women who are married and in active employment. These individuals, as Ries et al (2009) explain, also had a later onset of alcohol-related complications, like addiction. A related study by Matheson (2015) also established that being married, older, as well as having higher self-esteem supported the pathway to untreated recovery.

Self-efficacy and drinking patterns

Moos and Moos (2006) all established that untreated individuals with self-efficacy to refuse to give in to alcohol use in high-risk situations were likely to have a higher probability of successful remission. These individuals, as Moos and Moos (2006) explains, tended to use less alcohol, as well as report less serious drinking problems. The age factor was also examined and validated by Beresford and Gomberg (1995). Their study established that being older prompted successful outcomes in untreated change. Regarding drinking patterns, Moos and Moos (2006) made a comparison of untreated individuals who tend to consume less alcohol and established that those who consume less alcohol tend to have less serious drinking problems and report successful recovery. Moos and Moos (2006) also found that untreated people with frequent alcohol consumption, as well as more social and psychological drinking problems were likely to have a lower possibility of remission.’

Social support, life situations, and coping strategies

Moos and Moos (2006) found that social resources like providing untreated individuals with supportive family relationship, or support from friends helped prompt and support untreated behaviour change. Similarly, dependence on approach coping is also associated with a higher probability of natural remission (Cunningham, 2005). Additionally, Tucker and Simpson (2008) asserted from his findings that untreated individuals with supportive family relationships who did not rely on avoidance coping tended to report successful outcomes. White and Evans (2012) also established that supportive peers were instrumental in the pathway to successful recovery outcome.

Another cross-sectional study of untreated individuals by Charney et al. (2010) also demonstrate that long-term recovery is facilitated and supported by maintenance factors like more dependence on approach coping and less on avoidance coping, positive life events and constructive support from family and friends.

Tucker and Simpson (2008) also explored social support as a factor supporting untreated change. Their findings suggested that positive behaviour change is attainable when the AOD user’s social network encourages discourages heavy drinking. Among them includes social stigma attached to alcohol use and alcohol problems. According to Moos and Moos (2006) and Kuria (2013), social stigma is supportive when social stigma is specifically attacked to alcohol use by female gender. Kuria (2013) also identified older age and being married and good social support as being supportive.


The factors associated with facilitating and supporting behaviour change, among individuals who chose the path of untreated behaviour change include self-efficacy and dependence on approach coping and less on avoidance coping, and constructive support from family, friends and peers. Additional factors include female gender, elderly age during assessment, less consumption rate and amounts, late onset alcohol dependency, and the state of being married.


Australian Government. (2015). Spotlight on alcohol and other drugs and crime. Retrieved: <http://www.aic.gov.au/publications/current%20series/facts/1-20/2012/8_spotlight.html>

Beresford, T. & Gomberg, E. (1995). Alcohol and Aging. Oxford: Oxford University Press

Bischof, G., Rumpf, H., Hapke, U., Meyer, C. & Ulrich, J. (2000). Maintenance factors of recovery from alcohol dependence in treated and untreated individuals. Alcoholism: clinical and experimental research 24(12), 1773-1777

Cairney, J. & Streiner, D. (2010). Mental disorder in Canada: An epidemiological perspective. Toronto: University of Toronto Press

Charney, S., Zikos, E. & Kathryn, G. (2010). Early recovery from alcohol dependence: Factors that promote or impede abstinence. Journal of Substance Abuse Treatment 38(1), 42–50

Commonwealth of Australia. (2004). Alcohol and other drugs: A handbook for health professionals. Retrieved: <https://www.health.gov.au/internet/main/publishing.nsf/Content/E5203E6D5CBAA696CA257BF0001E02ED/$File/aodgp.pdf>

Cunningham, J. (2005). Short-term recovery from alcohol abuse or dependence: Any evidence of a relationship with treatment use in a general population sample? Alcohol & Alcoholism, 40(5), 419–421

Gottfredson, D., Kearley, B. & Bushway, S. (2008). Substance Use, Drug Treatment, and Crime: An Examination of Intra-Individual Variation in a Drug Court Population. The Journal of Drug Issues,

Klingemann, H. & Carter, S. (2007). The third wave of research on self-change. Nordic Studies On Alcohol And Drugs 24(1), 662-663

Klingemann, H. & Carter-Sobell, L. (2007). Promoting self-change from addictive behaviors: practical implications for policy, prevention, and treatment. New York: Springer Science & Business Media

Klingemann, H., Sobell, L., Blomqvist, J., Ellinstad, A. et al. (2011). Promoting self-change from problem substance use: practical implications for policy, prevention and treatment. New York: Springer Science & Business Media

Kuria, W. (2013). Factors associated with relapse and remission of alcohol dependent persons after community based treatment. Open Journal of Psychiatry, 3, 264-272

Matheson, C. (2015). Natural Recovery from Alcohol and Drug Dependence. Retrieved: <http://www.hi-netgrampian.org/wp-content/uploads/2015/03/national_recovery_from_alcohol_and_drug_dependence_11062015.pdf>

McCrady, B. & Epstein, E. (2013). Addictions: A comprehensive guidebook. Oxford: OUP

Moos, R. & Moos, B. (2006a). Rates and predictors of relapse after natural and treated remission from alcohol use disorders. Addiction, 101(2), 212–222.

Moos, R. & Moos, B. (2007). Treated and untreated individuals with alcohol use disorders: Rates and predictors of remission and relapse. International Journal of Clinical and Health Psychology, 6(3), 513-526

NSW Health. (2008). Drug and alcohol psychosocial interventions professional practice guidelines. Retrieved: <http://www0.health.nsw.gov.au/policies/gl/2008/pdf/GL2008_009.pdf>

Rickwood, D., Magor-Blatch, L., Mattick, R., Gruenert, S., Zavrou, N. & Akers, A. (2008). Substance use: A position statement prepared for the Australian psychological society. Melbourne: The Australian Psychological Society

Ries, R., Miller, S. & Fiellin, D. (2009). Principles of addiction medicine. Philadelphia: Lippincott Williams & Wilkins

Roizen, R., Cahalan, D., & Shanks, P. (1978). Spontaneous remission among untreated problem drinkers. In D. B. Kandel (Ed.), Longitudinal research on drug
use: Empirical findings and methodological issues (pp. 197–221). Washington, DC: Hemisphere Publishing

Smith, B., Molina, B. & Pelham, W. (2012). The clinically meaningful link between alcohol use and attention deficit hyperactivity disorder. Alcohol Research & Health, 26(2), 122-129

Tucker, J. & Simpson, C. (2008). The Recovery Spectrum: From Self-Change to Seeking Treatment. Alcohol Research & Health, 33(4),

Tucker, J. & Simpson, C. (2011). The recovery spectrum: From self-change to seeking treatment. National Institute on Alcohol Abuse and Alcohomism. Retrieved: <http://pubs.niaaa.nih.gov/publications/arh334/371-379.htm>

Tucker, J., Donovan, D. & Marlatt, A. (2001). Changing Addictive Behavior: Bridging Clinical and Public Health Strategies. New York: Gulford Press

Vanderplasschen, W., Colpart, K. & Broekaert, E. (2009). Determinants of relapse and re-admission among alcohol abusers after intensive residential treatment. Arch Public Health, 67, 194-211

Waldorf, D. (1983). Natural Recovery from Opiate Addiction: Some Social-Psychological Processes of Untreated Recovery. Journal of Drug Issues, 237-247

White, W. (2012). Recovery/remission recovery/remission from substance use disorders from substance use disorders an analysis of reported outcomes an analysis of reported outcomes in 415 scientific reports, 1868-2011. Philadelphia: Philadelphia Department of Behavioral Health and Intellectual Disability Services

White, W.& Evans, A. (2012). The recovery agenda: The shared role of peers and professionals. Public Health Reviews, 35(2), 1-15