Research

OUR RESEARCH

Central to our approach at Breaking Free Group is the systematic research and evaluation we undertake in collaboration with colleagues at academic institutions including the University of Oxford, University of Manchester, King’s College London, Keele University, University of Toronto, Carleton University (Ottawa) and the Center for the Study of Addictions and Recovery (New York).

This research is guided by the UK Medical Research Council’s framework for developing and evaluating complex healthcare interventions. As well as demonstrating the clinical effectiveness of our interventions, it includes studies that explore their mechanisms of action and explain the behavioural science that underpins them.

Beyond this, however, we seek to inform the wider digital health community by examining the processes involved in implementing and diffusing digital interventions in real-world settings and identifying the most effective ways to drive adoption.

We are committed to disseminating the findings of our research by publishing in peer-reviewed scientific journals and presenting at leading conferences, including those of the King’s Fund, UCL Centre for Behaviour Change, Society for the Study of Addictions, and International Corrections and Prisons Association.

Below is a list of our publications in British, American, Canadian and Australian journals, with links to the abstracts. To request any of these papers or discuss potential research collaboration, please contact Dr Sarah Elison-Davies (Research Director):

OUR LATEST PUBLICATIONS

ASSOCIATIONS BETWEEN BASELINE OPIOID USE DISORDER SEVERITY, MENTAL HEALTH AND BIOPSYCHOSOCIAL FUNCTIONING, WITH CLINICAL RESPONSES TO COMPUTER-ASSISTED THERAPY TREATMENT

Elison-Davies, S., Märtens, K., Yau, C., Davies, G. & Ward, J.

EXAMINING CORRELATES OF CANNABIS USERS’ ENGAGEMENT WITH A DIGITAL INTERVENTION FOR SUBSTANCE USE DISORDER: AN OBSERVATIONAL STUDY OF CLIENTS IN UK SERVICES DELIVERING BREAKING FREE ONLINE

Elison-Davies, S., Wardell, J., Quilty, L., Ward, J. & Davies, G.

Two papers have recently been published examining the mechanisms of action of the Breaking Free from Substance Use digital intervention for different substance using populations.

The first of these papers has been published in the American Journal of Drug and Alcohol Abuse and has been written in collaboration with Kaspar Martens (University of Oxford) and Prof Christopher Yau (University of Manchester).

This study reports data for 2,571 clients who engaged with Breaking Free to address Opioid Use Disorder. Significant improvements from baseline to post-treatment measures in opioid use, opioid dependence, mental health difficulties, quality of life and biopsychosocial functioning were found. Numerous baseline client characteristics, including severity of opioid use dependence, mental health and biopsychosocial impairment, were found to be associated with these post-treatment measures. Additionally, an aggregated consensus measure of baseline clinical impairment was found to be associated with changes in opioid use and post-treatment biopsychosocial functioning, with participants with greater baseline clinical impairment demonstrating a greater magnitude of improvement from baseline to post-treatment than those with lower clinical impairment.

The second of these papers has been published in the Journal of Substance Abuse Treatment and has been written in collaboration with Dr Lena Quilty (Centre for Addictions and Mental Health; University of Toronto) and Dr Jeffrey Wardell (York University, Toronto).

This study reports data for 1,830 clients who engaged with Breaking Free to address Cannabis Use Disorder. Moderate-to-severe depression and anxiety were identified in half of clients at baseline, in addition to elevated severity of cannabis dependence in over a third. Women demonstrated greater clinical complexity at baseline than men. Significant improvements from baseline to post-treatment were found in cannabis use and dependence, mental health, quality of life and biopsychosocial functioning. Additionally, the number of behavioural change techniques in Breaking Free that were completed by clients was positively associated with quality of life and biopsychosocial functioning at post-treatment, demonstrating a dosage effect.

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ASSOCIATIONS BETWEEN PARTICIPANT CHARACTERISTICS, DIGITAL INTERVENTION ENGAGEMENT AND RECOVERY OUTCOMES FOR PARTICIPANTS ACCESSING ‘BREAKING FREE ONLINE’ AT ‘CHANGE, GROW, LIVE’

Elison-Davies, S., Hayhurst, K., Jones, A., Welch, Z., Davies, G. & Ward, J.

A paper has recently been published in the Journal of Substance Use, which has been written in collaboration with Dr Andy Jones and Dr Karen Hayhurst from the University of Manchester and ZoeWelch from Change, Grow, Live (CGL).

This study reports data for 5,792 clients engaging with the Breaking Free from Substance Use programme via CGL’s substance misuse services and compares those who did and did not complete a post-treatment assessment.

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PROTOCOL FOR A RANDOMIZED-CONTROLLED TRIAL OF THE BREAKING FREE ONLINE HEALTH AND JUSTICE PROGRAM FOR SUBSTANCE MISUSE IN PRISON SETTINGS

Elison-Davies, S., Davies, D., Ward, J., Dugdale, S., Weston, S., Jones, A., Brides, M. & Weekes, J.

Breaking Free Group’s most recent paper has been co-authored with Dr Samantha Weston (University of Keele), Dr Andrew Jones (University of Manchester), Michelle Brides (Spectrum Community Health Services) and Dr John Weekes (McMaster University, Canada).

The paper, which has been published in the journal Health and Justice, describes the methodology for a randomized-controlled trial (RCT) which is currently underway at HMP Kirkham. This RCT is the first of its kind to be conducted in the UK and will examine outcomes for men who are serving sentences and working on their recovery from alcohol and drug dependence within the prison.

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The role of technology in offender rehabilitation

Elison-Davies, S., Davies, G., Ward, J., Dugdale, S., & Weekes, J.

Co-authored with Professor John Weekes (Carleton University, Ottawa), this commentary paper was published in the Canadian journal Advancing Corrections and discusses the increasing importance of digital technologies in offender rehabilitation.

With the increasing prevalence of prison self-service kiosks and in-cell technologies that can give offenders greater control over their lives during their sentence, these technologies are rapidly changing the criminal justice system.

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Davies, G., Ward, J., Elison, S., Weston, S., Dugdale, S., & Weekes, J. (2017). Implementation and evaluation of the Breaking Free Online and Pillars of Recovery treatment and recovery programmes for substance-involved offenders: Reflections from the North-West Prisons ‘Gateways’ pathfinder. Advancing Corrections, (3), 95-113.

Davies, G., Elison, S., Ward, J., & Laudet, A. (2015). The role of lifestyle in perpetuating substance dependence: A new explanatory model, The Lifestyle Balance Model. Substance Abuse, Treatment, Prevention and Policy, 10(2).

Dugdale, S. (2016). Reflections on using online qualitative interviews for data collection. Qualitative Methods in Psychology Bulletin, (21), 27-32.

Dugdale, S. (2018). The development of a group smoking cessation intervention for offenders. Health Psychology Update, 26(1).

Dugdale, S., Elison, S., Davies, G., & Ward, J. (2017a). Applying behaviour change theories and qualitative methods in substance misuse implementation research: Conceptualising the adoption of Breaking Free Online in real world clinical practice. Qualitative Health Research, 27(7), 1049-1059.

Dugdale, S., Elison, S., Davies, G., Ward, J., & Dalton, M. (2017b). A qualitative study investigating the continued adoption of Breaking Free Online across a national substance misuse organisation: Theoretical conceptualisation of staff perceptions. The Journal of Behavioral Health Services and Research, 44(1), 89-101.

Dugdale, S., Elison, S., Davies, G., Ward, J., & Jones, M. (2016a). The use of digital technology in substance misuse recovery. Cyberpsychology: Journal of Psychosocial Research on Cyberspace, 10(4), Article 5.

Dugdale, S., Elison-Davies, S., Davies, G., Ward, J., & Jones, M. (2018). An exploration of lived experience in a digital world. In C. Costa & J. Condie (Eds.), Doing Research In and On the Digital: Research Methods across Fields of Inquiry. Abingdon: Routledge.

Dugdale, S., Elison-Davies, S., Semper, H., Ward, J., & Davies, G. (2019). Are computer-based treatment programs effective at reducing symptoms of substance misuse and mental health difficulties within adults? A systematic review. Journal of Dual Diagnosis, 15(4), 291-311.

Dugdale, S., Elison, S., Ward, J., Davies, G., & Dalton, M. (2016b). Using the Transtheoretical Model to explore the impact of peer mentoring on peer mentors’ own recovery from substance misuse. Journal of Groups in Addiction and Recovery, 11(3), 166-181.

Dugdale, S., Semper, H., Povey, R., Elison-Davies, S., Davies, G., & Ward, J. (2019). Offenders’ perceptions of the UK prison smoking ban. International Journal of Prisoner Health, 15(2), 114-125.

Dugdale, S., Ward, J., Elison-Davies, S., Davies, G. & Brown, E. (2018). Breaking Free from Smoking: A novel digital smoking cessation intervention for offenders in UK prisons. Journal of Smoking Cessation, early online.

Dugdale, S., Ward, J., Hernen, J., Elison, S., Davies, G., & Donkor, D. (2016c). Using the Behavior Change Technique Taxonomy v1 to conceptualize the clinical content of Breaking Free Online: a computer-assisted therapy program for substance use disorders. Substance Abuse Treatment, Prevention, and Policy, 11(1), 26.

Easton, S. (2014). Community Learning and Digital Inclusion. National Institute of Adult Continuing Education. Skills Funding Agency, Case Study 1

Elison, S., Davies, G., & Ward, J. (2015a). An outcomes evaluation of computerised treatment for problem drinking using Breaking Free Online. Alcoholism Treatment Quarterly, 33(2), 185-196.

Elison, S., Davies, G., & Ward, J. (2015b). Effectiveness of Computer-Assisted Therapy for substance dependence using Breaking Free Online: Subgroup analyses of a heterogeneous sample of service users. Journal of Medical Internet Research, 2(2), e13.

Elison, S., Davies, G., & Ward, J. (2016a). Initial development and psychometric properties of a new measure of substance misuse ‘recovery progression’: The Recovery Progression Measure (RPM). Substance Use and Misuse, 51(9), 1195-1206.

Elison, S., Davies, G., Ward, J., Weston, S., Dugdale, S., & Weekes, J. (2017a). Using the “recovery” and “rehabilitation” paradigms to support desistance of substance-involved offenders: exploration of dual and multi-focus interventions. Journal of Criminological Research, Policy and Practice, 2(4), 274-290.

Elison-Davies, S., Davies, G., Ward, J., Dugdale, S., & Weekes, J. (2018). The role of technology in offender rehabilitation. Advancing Corrections, 5, 104-116.

Elison-Davies, S., Davies, G., Ward, J., Dugdale, S., Weston, S., Jones, A., Brides, M. & Weekes, J. (2018). Protocol for a randomized controlled trial of the Breaking Free Health and Justice programme for substance misuse in prison settings. Health and Justice, 6(20).

Elison-Davies, S., Hayhurst, K., Jones, A., Welch, Z., Davies, G., & Ward, J. (2020). Associations between participant characteristics, digital intervention engagement and recovery outcomes for participants accessing ‘Breaking Free Online’ at ‘Change Grow Live’. Journal of Substance Use.

Elison-Davies, S., Märtens, K., Yau, C., Davies, G., & Ward, J. (2021). Associations between baseline opioid use disorder severity, mental health and biopsychosocial functioning, with clinical responses to computer-assisted therapy treatment. American Journal of Drug and Alcohol Abuse, 47(3), 360-372.

Elison-Davies, S., Wardell, J., Quilty, L., Ward, J., & Davies, G. (2021). Examining correlates of cannabis users’ engagement with a digital intervention for substance use disorder: An observational study of clients in UK services delivering Breaking Free Online. Journal of Substance Abuse Treatment, 123(4).

Elison, S., Humphreys, L., Ward, J., & Davies, G. (2013). A pilot outcomes evaluation for computer-assisted therapy for substance misuse: an evaluation of Breaking Free Online. Journal of Substance Use, 19(4), 1-6.

Elison, S., Jones, A., Ward, J., Davies, G., & Dugdale, S. (2017b). Examining effectiveness of tailorable computer-assisted therapy programmes for substance misuse: Programme usage and clinical outcomes data from Breaking Free Online. Addictive Behaviors, 74, 140-147.

Elison, S., Ward, J., Davies, G., Lidbetter, N., Dagley, M., & Hulme, D. (2014a). An outcomes study of eTherapy for dual diagnosis using Breaking Free Online. Advances in Dual Diagnosis, 7(2), 52-62.

Elison, S., Ward, J., Davies, G., & Moody, M. (2014b). Implementation of computer-assisted therapy for substance misuse: a qualitative study of Breaking Free Online using Roger's diffusion of innovation theory. Drugs and Alcohol Today, 14(4), 207-218.

Elison, S., Ward, J., Dugdale, S., & Davies, G. (2017c). The ‘Rapid Recovery Progression Measure’ (Rapid-RPM): a brief assessment of psychosocial functioning change during problematic substance use recovery progression. Substance Use and Misuse, 52(9), 1160-1169.

Elison, S., Ward, J., Williams, C., Espie, C., Davies, G., Dugdale, S., Ragan, K., Chisnall, L., Lidbetter, N., & Smith, K. (2017d). Feasibility of a UK community-based, eTherapy mental health service in Greater Manchester: repeated-measures and between-groups study of ‘Living Life to the Full Interactive’, ‘Sleepio’ and ‘Breaking Free Online’ at ‘Self-Help Services’. British Medical Journal - Open, 7(7), 1-10.

Elison, S., Weston, S., Davies, G., Dugdale, S., & Ward, J. (2015c). Findings from mixed-methods feasibility and effectiveness evaluations of the “Breaking Free Online” treatment and recovery programme for substance misuse in prisons. Drugs: Education, Prevention and Policy, 23(2), 1-10.

Elison, S., Weston, S., Dugdale, S., Ward, J., & Davies, G. (2016b). A qualitative exploration of UK prisoners’ experiences of substance misuse and mental health difficulties, and the Breaking Free Health and Justice interventions. Journal of Drug Issues, 46(3), 198-215.

Hogan, L., Elison, S., Davies, G., & Ward, J. (2015). Effectiveness of the Pillars of Recovery group and keyworking program for service users with a dual diagnosis of substance dependence and concurrent mental health problems: An initial outcomes evaluation. Journal of Groups in Addiction & Recovery, 10(2), 125-140.

Neale, J., & Stevenson, C. (2013). The use of computer assisted therapy by homeless drug users living in hostels: An explorative qualitative study. Drugs: Education, Prevention and Policy, 21(1), 80-87.

Ward, J. (2016). Making Transforming Rehabilitation a reality: The role of technology innovation. Criminal Law and Justice Weekly, 180(3), 4-5.

Ward, J., Davies, G., Dugdale, S., Elison, S., & Bijral, P. (2017). Achieving digital health sustainability: Breaking Free and CGL. International Journal of Health Governance, 22(2), 72-82.

Ward, J., Elison-Davies, S., Davies, G., Dugdale, S., & Jones, A. (2019). Clinical and demographic patient characteristics, alcohol treatment goal preference and goal attainment during computer-assisted therapy with Breaking Free Online. Journal of Substance Use, 24(6), 681-687.

Weekes, J., Elison, S., De Moor, C., & de Loe, K. (2017). Technology-enhanced innovations for addressing substance-misusing offenders' treatment needs. In J. Ireland, C. Ireland, M. Fisher, & N. Gredecki (Eds.), The Routledge International Handbook of Forensic Psychology in Secure Settings. London: Routledge.

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