| Dedication | 5 |
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| Acknowledgments | 6 |
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| Foreword Considering the Unimaginable: Challenges to Accepting Self- Change or Natural Recovery from Addiction | 7 |
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| References | 11 |
| Preface | 12 |
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| References | 15 |
| Contents | 16 |
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| Contributors | 18 |
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| The Phenomenon of Self-Change: Overview and Key Issues | 21 |
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| Introduction | 21 |
| The Respondents Speak | 22 |
| Is What We Call the Phenomenon Important? | 23 |
| Defining Treatment and How Little Is Too Much | 24 |
| Mixing Treated and Untreated Respondents | 25 |
| State-of-the-Art in Self-Change | 26 |
| Advantages of Survey and Other Methods for Studying the Process of Self- Change | 27 |
| Why Has Self-Change as an Area of Study Been So Long Overlooked or Ignored? | 27 |
| Nonabstinent Outcomes and Natural Recovery | 28 |
| What Can Be Gained by Studying the Process of Self- Change? | 29 |
| Barriers to Treatment or Help-Seeking for Racial/Ethnic Minorities and Women | 31 |
| Models of Change | 33 |
| Conflict Theory | 33 |
| Transtheoretical Model of Change | 34 |
| Crystallization of Discontent | 35 |
| Becoming an Ex | 35 |
| Major Findings from Self-Change Studies | 36 |
| Self-Change: A Major Pathway to Recovery | 36 |
| Can We Believe What They Tell Us? | 36 |
| Stability of Natural Recoveries | 37 |
| What Triggers Self-Change? Thinking about Changing | 38 |
| Maintaining Recoveries | 39 |
| Conclusions and Future Directions | 39 |
| References | 40 |
| Self-Change from Alcohol and Drug Abuse: Often- Cited Classics | 51 |
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| The Setting | 51 |
| The “Pioneering Studies” | 52 |
| Subsequent Research on Self-Change | 53 |
| Studies of Drug Use and Drug Addiction | 54 |
| Studies of Alcoholism, Drinking Patterns, and Drinking Problems | 60 |
| Summing Up: Conclusions and Implications | 73 |
| References | 74 |
| Natural Recovery or Recovery without Treatment from Alcohol and Drug Problems as Seen from Survey Data | 78 |
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| Early Drinking Survey Results | 78 |
| Specialized Survey Studies of Natural Recovery | 79 |
| Community Studies of Self-Change | 81 |
| Drug Users and Natural Recovery | 82 |
| Advantages of Survey and Other Methods for Studying Natural Recovery | 83 |
| Snowball, Media-Derived, and Convenience Samples in Self- Change Studies | 84 |
| Do Those Who Recover Naturally Have Fewer Problems Than Those Who Seek Treatment? | 86 |
| What Can We Conclude about Self-Change? | 87 |
| References | 88 |
| Remission without Formal Help: New Directions in Studies Using Survey Data | 91 |
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| Methodological Issues | 91 |
| Sampling Methods | 92 |
| Definition of the Substance Use Problem | 92 |
| Definition of Treatment | 93 |
| Occurrence of Natural Remission in the General Population | 93 |
| Stability of Untreated Remission | 94 |
| Factors Supporting Remission | 95 |
| Media-Recruited or Other Nonrepresentative Samples | 96 |
| General Population Samples | 98 |
| Conclusion and Suggestions for Future Research | 101 |
| References | 101 |
| Natural Recovery from Alcohol and Drug Problems: A Methodological Review of the Literature from 1999 through 2005 | 104 |
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| Introduction | 104 |
| Method | 105 |
| Results | 106 |
| Discussion and Conclusions | 112 |
| References | 115 |
| Appendix Primary References | 117 |
| Secondary References | 118 |
| Self-Change in a Broader Context: Beyond Alcohol and Drugs | 119 |
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| Self-Change: The Rule among Smokers | 120 |
| Epidemiology of Smoking and Quitting | 120 |
| Self-Quitting | 121 |
| Success in a Given Self-Quit Attempt | 122 |
| Reduction as Outcome | 122 |
| Reasons for Quitting | 123 |
| Predictors of Successful Self-Quitting | 124 |
| References | 124 |
| Natural Recovery from Problem Gambling | 127 |
| References | 130 |
| The Natural Course and Outcome of Eating Disorders and Obesity | 133 |
| References | 138 |
| Spontaneous Desistance from Crime | 141 |
| What Is to Stop Crime Spontaneously? | 142 |
| Correlates of Desistance and the Desistance Process | 144 |
| Maturation and Morality | 145 |
| Growing Aversion for Risk | 146 |
| Changes in Adult Life | 146 |
| Turning Points: Inside and Outside Views | 147 |
| Against All Odds | 148 |
| Family Violence and Question of Change without Treatment | 148 |
| Conclusion | 150 |
| References | 150 |
| Self-Change from Stuttering: An Overview | 152 |
| What Is Stuttering? | 152 |
| Natural Recovery during Early Childhood Stuttering | 152 |
| Treatment Approaches for Managing Stuttering After Childhood | 153 |
| The Phenomenon of Untreated Recovery after Childhood | 154 |
| Findings from Late Recovery Research Methodological Challenges | 155 |
| Mechanisms of Self-change | 156 |
| Are These Accounts of Self-Change Credible? | 157 |
| Outcomes of Self-Managed Late Recovery | 157 |
| Recent Findings and Future Directions | 158 |
| References | 159 |
| One Way to Leave Your Lover: The Role of Treatment in Changing Addictive Behaviors | 163 |
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| Meaningful Explanations of Change in Addictive Behavior | 163 |
| Fifty Ways to Leave Your Lover | 164 |
| Factors Influencing Route of Change | 167 |
| The Role of Treatment in Changing Addictive Behavior | 170 |
| Stepped-Care Approach | 170 |
| Multiple Functions of Treatment | 171 |
| Summary: Many Ways to Leave Your Lover | 172 |
| References | 172 |
| Promoting Self-Change: Taking the Treatment to the Community | 175 |
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| Self–Change Approaches | 176 |
| Tailored Nontraditional Messages<
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