Building New Pathways for Well-Being and Recovery: A Positive Intervention for Filipinos with Substance Use Disorders
- Posted on
Sixtus Dane A. Ramos, PhD, RPSy, ICAP I
Postdoctoral Research Fellow
Department of Psychology, De La Salle University
How can people recover from substance use disorder (SUD) and flourish in life? Research suggests that boosting positive psychological resources can scaffold the person’s capacity to recover from SUD. Contemporary scholars argue that treating SUD symptoms isn’t the complete story—improving people’s positive qualities and strengths are important but is often neglected in orthodox SUD treatment. One positive psychological resource is hope, or the person’s ability to create important life goals, and to think of strategies to attain these goals despite difficulties. Hope is not just a feeling—it is the cognitive-motivational capacity related to people’s goals. Later understandings of hope argue that positive beliefs on one’s peers, families, and a higher being serve as additional co-agents in goal-pursuit or external locus-of-hope. How can current SUD treatment approaches tap into hope as a positive psychological strength in promoting recovery and well-being? I pondered upon this question which guided the development of my dissertation composed of three interrelated and complementary studies that (1) examined the theoretical framework, (2) assessed the feasibility, and (3) tested the efficacy and mechanisms of a brief positive intervention for Filipino people with SUD.
In the Philippines, SUD remains a critical social health issue given its impact in the lives of people and communities. One of the widely used treatment approaches for SUD is the therapeutic community (TC), an intensive, in-patient program that relies on “community as method” to promote behavioral and lifestyle change. Within TCs, people recover through the social relationships built throughout the program. Decades of research support the TC’s efficacy and applicability as an intervention for SUD. However, there remains a gap in understanding its treatment process and the role of people’s positive psychological resources in this mechanism. What is clear is that the TC acts as the external crucible which initiates the SUD recovery process through the working alliances built among people undergoing treatment. I argue that people’s hope capacity can interact with this process, wherein hope in oneself and their peers may be more relevant within TC treatment, and hope from their families and a higher being come secondary. Depending on the person’s level of hope, they may experience the TC mechanism differently—hope may bolster or dampen the TC’s effects for people’s recovery and well-being. These notions make up the theoretical framework which guided the development and testing of a positive intervention based on locus-of-hope.
Using cross-sectional data from 406 people with SUD from public and private TCs, I tested this theoretical framework and found nuances on how locus-of-hope interacts with the TC treatment process for Study 1**. Surprisingly, people with high internal and external-peer locus-of-hope reported non-significant pathways from their TC treatment process experience to recovery capital and psychological well-being through group working alliance, different from my hypotheses. It appears that these people with high internal and peer hope did not benefit as much from the TC process. On the other hand, people with high external-family and external-spiritual locus-of-hope reported significant pathways of TC treatment process to recovery capital and psychological well-being through group working alliance. Individuals with high family and spiritual hope appear to benefit more from the TC mechanism. The findings offer preliminary evidence to the proposed theoretical framework grounded on the locus-of-hope model, albeit different from what was expected.
Meanwhile, I developed the brief intervention grounded on locus-of-hope based on how dimensions of locus-of-hope interact with the TC treatment process. Its active components were derived from contemporary hope-based programs but were specifically redesigned to activate the relational dimensions of hope, making the intervention applicable within the TC context. At its core, the Locus-of-Hope Enhancement Program (LEAP) for Well-Being and Recovery (Figure 1) aims to boost locus-of-hope dimensions of people with SUD. As people’s goal-pursuit capacities are strengthened, their goals become aligned to the TC process, and they start to perceive their TC peers as instrumental and supportive of their recovery goals, thus promoting better psychological well-being and recovery capital.
Next, I examined LEAP’s acceptability, appropriateness, and feasibility by interviewing five TC professionals, and four TC clients serving as peer counselors for Study 2. The participants found that LEAP was an acceptable intervention, appropriate for the needs of people with SUD, and it can feasibly be implemented within the TC context, without significant differences in the perspectives of the two participant groups. The participants noted some limitations, particularly the brief nature of the program which is only composed of two sessions done seven days apart, and the challenge of involving recovering TC staff as facilitators of the intervention. The participants also suggested increasing LEAP’s number of sessions and its target goals can go beyond the TC program’s duration. The results offer evidence supporting LEAP’s acceptability, appropriateness, and feasibility as a positive intervention for people with SUD within the TC context.
In Study 3**, a total of 136 patients with SUD from TCs were recruited and randomly allocated to receive LEAP or a stress management control condition to test the brief intervention’s efficacy and mechanisms using a randomized controlled trial with pre-treatment, post-treatment, and 1-month follow-up assessments. The findings show that the participants who received LEAP reported an increase in their internal locus-of-hope, external-peer locus-of-hope, community process experienced and group working alliance compared to the control group across time. There were no significant effects on external-family locus-of-hope, external-spiritual locus-of-hope, recovery capital, and psychological well-being. Upon closer inspection of the psychological mechanisms, it was found that LEAP indirectly predicted recovery capital and psychological well-being through community process experience and group working alliance at post-treatment. LEAP’s indirect pathway at 1-month follow-up was only maintained for recovery capital, and not for psychological well-being. Study 3’s findings support the efficacy and the underlying mechanisms that allow LEAP to contribute to people’s psychological well-being and recovery capital by enhancing their locus-of-hope dispositions.
Overall, the collated evidence from the three interrelated and complementary studies that compose this dissertation support locus-of-hope enhancement through a feasible and efficacious positive psychological intervention that can complement the TC. The current study expands understanding of how external dimensions of locus-of-hope contribute to the recovery and well-being of Filipino people with SUD. The findings suggest that external-family and external-spiritual locus-of-hope remain vital resources that Filipinos with SUD rely on while in recovery, and their internal and external-peer locus-of-hope are cognitive dimensions that can be targeted by positive interventions, thus leading to improvements in recovery capital and psychological well-being. More importantly, LEAP as a novel positive psychological intervention for people with SUD indicates the role of strengths-based approaches in promoting recovery. LEAP’s efficacy is one of the first experimental support for how locus-of-hope directly enhances positive treatment outcomes for a vulnerable population like people with SUD. LEAP can possibly augment current TC modalities and complement “community as method”. The findings open possibilities towards integrating LEAP within contemporary rehabilitation approaches in the Philippines, thus giving rise to a hope-oriented TC framework grounded on the importance of positive dispositions of people with SUD. Through the study, research-informed policies can upscale recovery-oriented treatment approaches to adhere to the specific needs of Filipino communities. But fostering flourishing and recovery from SUD remains a gargantuan task for social scientists, public health practitioners, and clinical psychologists. I hope that the current work carved new pathways for strengths-based SUD treatment and rehabilitation approaches, thus building a more hopeful future for Filipinos recovering from SUD.
** These studies have been previously published, please see details below to access the articles:
Ramos, S.D.A., & Bernardo, A.B.I. (2025a). Leap for well-being and recovery: Effects and mechanisms of a locus-of-hope enhancement program for people with substance use disorders. International Journal of Applied Positive Psychology, 10(1). https://doi.org/10.1007/s41042-025-00218-0
Ramos, S.D.A., & Bernardo, A.B.I. (2025b). The path of therapeutic community process experience to recovery capital and psychological well-being as mediated by group working alliance: The role of locus-of-hope. Journal of Ethnicity in Substance Abuse, 1–27. https://doi.org/10.1080/15332640.2025.2468295
Sixtus Dane A. Ramos, PhD, RPSy, ICAP I
Postdoctoral Research Fellow
Department of Psychology, De La Salle University
How can people recover from substance use disorder (SUD) and flourish in life? Research suggests that boosting positive psychological resources can scaffold the person’s capacity to recover from SUD. Contemporary scholars argue that treating SUD symptoms isn’t the complete story—improving people’s positive qualities and strengths are important but is often neglected in orthodox SUD treatment. One positive psychological resource is hope, or the person’s ability to create important life goals, and to think of strategies to attain these goals despite difficulties. Hope is not just a feeling—it is the cognitive-motivational capacity related to people’s goals. Later understandings of hope argue that positive beliefs on one’s peers, families, and a higher being serve as additional co-agents in goal-pursuit or external locus-of-hope. How can current SUD treatment approaches tap into hope as a positive psychological strength in promoting recovery and well-being? I pondered upon this question which guided the development of my dissertation composed of three interrelated and complementary studies that (1) examined the theoretical framework, (2) assessed the feasibility, and (3) tested the efficacy and mechanisms of a brief positive intervention for Filipino people with SUD.
In the Philippines, SUD remains a critical social health issue given its impact in the lives of people and communities. One of the widely used treatment approaches for SUD is the therapeutic community (TC), an intensive, in-patient program that relies on “community as method” to promote behavioral and lifestyle change. Within TCs, people recover through the social relationships built throughout the program. Decades of research support the TC’s efficacy and applicability as an intervention for SUD. However, there remains a gap in understanding its treatment process and the role of people’s positive psychological resources in this mechanism. What is clear is that the TC acts as the external crucible which initiates the SUD recovery process through the working alliances built among people undergoing treatment. I argue that people’s hope capacity can interact with this process, wherein hope in oneself and their peers may be more relevant within TC treatment, and hope from their families and a higher being come secondary. Depending on the person’s level of hope, they may experience the TC mechanism differently—hope may bolster or dampen the TC’s effects for people’s recovery and well-being. These notions make up the theoretical framework which guided the development and testing of a positive intervention based on locus-of-hope.
Using cross-sectional data from 406 people with SUD from public and private TCs, I tested this theoretical framework and found nuances on how locus-of-hope interacts with the TC treatment process for Study 1**. Surprisingly, people with high internal and external-peer locus-of-hope reported non-significant pathways from their TC treatment process experience to recovery capital and psychological well-being through group working alliance, different from my hypotheses. It appears that these people with high internal and peer hope did not benefit as much from the TC process. On the other hand, people with high external-family and external-spiritual locus-of-hope reported significant pathways of TC treatment process to recovery capital and psychological well-being through group working alliance. Individuals with high family and spiritual hope appear to benefit more from the TC mechanism. The findings offer preliminary evidence to the proposed theoretical framework grounded on the locus-of-hope model, albeit different from what was expected.
Meanwhile, I developed the brief intervention grounded on locus-of-hope based on how dimensions of locus-of-hope interact with the TC treatment process. Its active components were derived from contemporary hope-based programs but were specifically redesigned to activate the relational dimensions of hope, making the intervention applicable within the TC context. At its core, the Locus-of-Hope Enhancement Program (LEAP) for Well-Being and Recovery (Figure 1) aims to boost locus-of-hope dimensions of people with SUD. As people’s goal-pursuit capacities are strengthened, their goals become aligned to the TC process, and they start to perceive their TC peers as instrumental and supportive of their recovery goals, thus promoting better psychological well-being and recovery capital.
Next, I examined LEAP’s acceptability, appropriateness, and feasibility by interviewing five TC professionals, and four TC clients serving as peer counselors for Study 2. The participants found that LEAP was an acceptable intervention, appropriate for the needs of people with SUD, and it can feasibly be implemented within the TC context, without significant differences in the perspectives of the two participant groups. The participants noted some limitations, particularly the brief nature of the program which is only composed of two sessions done seven days apart, and the challenge of involving recovering TC staff as facilitators of the intervention. The participants also suggested increasing LEAP’s number of sessions and its target goals can go beyond the TC program’s duration. The results offer evidence supporting LEAP’s acceptability, appropriateness, and feasibility as a positive intervention for people with SUD within the TC context.
In Study 3**, a total of 136 patients with SUD from TCs were recruited and randomly allocated to receive LEAP or a stress management control condition to test the brief intervention’s efficacy and mechanisms using a randomized controlled trial with pre-treatment, post-treatment, and 1-month follow-up assessments. The findings show that the participants who received LEAP reported an increase in their internal locus-of-hope, external-peer locus-of-hope, community process experienced and group working alliance compared to the control group across time. There were no significant effects on external-family locus-of-hope, external-spiritual locus-of-hope, recovery capital, and psychological well-being. Upon closer inspection of the psychological mechanisms, it was found that LEAP indirectly predicted recovery capital and psychological well-being through community process experience and group working alliance at post-treatment. LEAP’s indirect pathway at 1-month follow-up was only maintained for recovery capital, and not for psychological well-being. Study 3’s findings support the efficacy and the underlying mechanisms that allow LEAP to contribute to people’s psychological well-being and recovery capital by enhancing their locus-of-hope dispositions.
Overall, the collated evidence from the three interrelated and complementary studies that compose this dissertation support locus-of-hope enhancement through a feasible and efficacious positive psychological intervention that can complement the TC. The current study expands understanding of how external dimensions of locus-of-hope contribute to the recovery and well-being of Filipino people with SUD. The findings suggest that external-family and external-spiritual locus-of-hope remain vital resources that Filipinos with SUD rely on while in recovery, and their internal and external-peer locus-of-hope are cognitive dimensions that can be targeted by positive interventions, thus leading to improvements in recovery capital and psychological well-being. More importantly, LEAP as a novel positive psychological intervention for people with SUD indicates the role of strengths-based approaches in promoting recovery. LEAP’s efficacy is one of the first experimental support for how locus-of-hope directly enhances positive treatment outcomes for a vulnerable population like people with SUD. LEAP can possibly augment current TC modalities and complement “community as method”. The findings open possibilities towards integrating LEAP within contemporary rehabilitation approaches in the Philippines, thus giving rise to a hope-oriented TC framework grounded on the importance of positive dispositions of people with SUD. Through the study, research-informed policies can upscale recovery-oriented treatment approaches to adhere to the specific needs of Filipino communities. But fostering flourishing and recovery from SUD remains a gargantuan task for social scientists, public health practitioners, and clinical psychologists. I hope that the current work carved new pathways for strengths-based SUD treatment and rehabilitation approaches, thus building a more hopeful future for Filipinos recovering from SUD.
** These studies have been previously published, please see details below to access the articles:
Ramos, S.D.A., & Bernardo, A.B.I. (2025a). Leap for well-being and recovery: Effects and mechanisms of a locus-of-hope enhancement program for people with substance use disorders. International Journal of Applied Positive Psychology, 10(1). https://doi.org/10.1007/s41042-025-00218-0
Ramos, S.D.A., & Bernardo, A.B.I. (2025b). The path of therapeutic community process experience to recovery capital and psychological well-being as mediated by group working alliance: The role of locus-of-hope. Journal of Ethnicity in Substance Abuse, 1–27. https://doi.org/10.1080/15332640.2025.2468295
Sixtus Dane A. Ramos, PhD, RPSy, ICAP I
Postdoctoral Research Fellow
Department of Psychology, De La Salle University
How can people recover from substance use disorder (SUD) and flourish in life? Research suggests that boosting positive psychological resources can scaffold the person’s capacity to recover from SUD. Contemporary scholars argue that treating SUD symptoms isn’t the complete story—improving people’s positive qualities and strengths are important but is often neglected in orthodox SUD treatment. One positive psychological resource is hope, or the person’s ability to create important life goals, and to think of strategies to attain these goals despite difficulties. Hope is not just a feeling—it is the cognitive-motivational capacity related to people’s goals. Later understandings of hope argue that positive beliefs on one’s peers, families, and a higher being serve as additional co-agents in goal-pursuit or external locus-of-hope. How can current SUD treatment approaches tap into hope as a positive psychological strength in promoting recovery and well-being? I pondered upon this question which guided the development of my dissertation composed of three interrelated and complementary studies that (1) examined the theoretical framework, (2) assessed the feasibility, and (3) tested the efficacy and mechanisms of a brief positive intervention for Filipino people with SUD.
In the Philippines, SUD remains a critical social health issue given its impact in the lives of people and communities. One of the widely used treatment approaches for SUD is the therapeutic community (TC), an intensive, in-patient program that relies on “community as method” to promote behavioral and lifestyle change. Within TCs, people recover through the social relationships built throughout the program. Decades of research support the TC’s efficacy and applicability as an intervention for SUD. However, there remains a gap in understanding its treatment process and the role of people’s positive psychological resources in this mechanism. What is clear is that the TC acts as the external crucible which initiates the SUD recovery process through the working alliances built among people undergoing treatment. I argue that people’s hope capacity can interact with this process, wherein hope in oneself and their peers may be more relevant within TC treatment, and hope from their families and a higher being come secondary. Depending on the person’s level of hope, they may experience the TC mechanism differently—hope may bolster or dampen the TC’s effects for people’s recovery and well-being. These notions make up the theoretical framework which guided the development and testing of a positive intervention based on locus-of-hope.
Using cross-sectional data from 406 people with SUD from public and private TCs, I tested this theoretical framework and found nuances on how locus-of-hope interacts with the TC treatment process for Study 1**. Surprisingly, people with high internal and external-peer locus-of-hope reported non-significant pathways from their TC treatment process experience to recovery capital and psychological well-being through group working alliance, different from my hypotheses. It appears that these people with high internal and peer hope did not benefit as much from the TC process. On the other hand, people with high external-family and external-spiritual locus-of-hope reported significant pathways of TC treatment process to recovery capital and psychological well-being through group working alliance. Individuals with high family and spiritual hope appear to benefit more from the TC mechanism. The findings offer preliminary evidence to the proposed theoretical framework grounded on the locus-of-hope model, albeit different from what was expected.
Meanwhile, I developed the brief intervention grounded on locus-of-hope based on how dimensions of locus-of-hope interact with the TC treatment process. Its active components were derived from contemporary hope-based programs but were specifically redesigned to activate the relational dimensions of hope, making the intervention applicable within the TC context. At its core, the Locus-of-Hope Enhancement Program (LEAP) for Well-Being and Recovery (Figure 1) aims to boost locus-of-hope dimensions of people with SUD. As people’s goal-pursuit capacities are strengthened, their goals become aligned to the TC process, and they start to perceive their TC peers as instrumental and supportive of their recovery goals, thus promoting better psychological well-being and recovery capital.
Next, I examined LEAP’s acceptability, appropriateness, and feasibility by interviewing five TC professionals, and four TC clients serving as peer counselors for Study 2. The participants found that LEAP was an acceptable intervention, appropriate for the needs of people with SUD, and it can feasibly be implemented within the TC context, without significant differences in the perspectives of the two participant groups. The participants noted some limitations, particularly the brief nature of the program which is only composed of two sessions done seven days apart, and the challenge of involving recovering TC staff as facilitators of the intervention. The participants also suggested increasing LEAP’s number of sessions and its target goals can go beyond the TC program’s duration. The results offer evidence supporting LEAP’s acceptability, appropriateness, and feasibility as a positive intervention for people with SUD within the TC context.
In Study 3**, a total of 136 patients with SUD from TCs were recruited and randomly allocated to receive LEAP or a stress management control condition to test the brief intervention’s efficacy and mechanisms using a randomized controlled trial with pre-treatment, post-treatment, and 1-month follow-up assessments. The findings show that the participants who received LEAP reported an increase in their internal locus-of-hope, external-peer locus-of-hope, community process experienced and group working alliance compared to the control group across time. There were no significant effects on external-family locus-of-hope, external-spiritual locus-of-hope, recovery capital, and psychological well-being. Upon closer inspection of the psychological mechanisms, it was found that LEAP indirectly predicted recovery capital and psychological well-being through community process experience and group working alliance at post-treatment. LEAP’s indirect pathway at 1-month follow-up was only maintained for recovery capital, and not for psychological well-being. Study 3’s findings support the efficacy and the underlying mechanisms that allow LEAP to contribute to people’s psychological well-being and recovery capital by enhancing their locus-of-hope dispositions.
Overall, the collated evidence from the three interrelated and complementary studies that compose this dissertation support locus-of-hope enhancement through a feasible and efficacious positive psychological intervention that can complement the TC. The current study expands understanding of how external dimensions of locus-of-hope contribute to the recovery and well-being of Filipino people with SUD. The findings suggest that external-family and external-spiritual locus-of-hope remain vital resources that Filipinos with SUD rely on while in recovery, and their internal and external-peer locus-of-hope are cognitive dimensions that can be targeted by positive interventions, thus leading to improvements in recovery capital and psychological well-being. More importantly, LEAP as a novel positive psychological intervention for people with SUD indicates the role of strengths-based approaches in promoting recovery. LEAP’s efficacy is one of the first experimental support for how locus-of-hope directly enhances positive treatment outcomes for a vulnerable population like people with SUD. LEAP can possibly augment current TC modalities and complement “community as method”. The findings open possibilities towards integrating LEAP within contemporary rehabilitation approaches in the Philippines, thus giving rise to a hope-oriented TC framework grounded on the importance of positive dispositions of people with SUD. Through the study, research-informed policies can upscale recovery-oriented treatment approaches to adhere to the specific needs of Filipino communities. But fostering flourishing and recovery from SUD remains a gargantuan task for social scientists, public health practitioners, and clinical psychologists. I hope that the current work carved new pathways for strengths-based SUD treatment and rehabilitation approaches, thus building a more hopeful future for Filipinos recovering from SUD.
** These studies have been previously published, please see details below to access the articles:
Ramos, S.D.A., & Bernardo, A.B.I. (2025a). Leap for well-being and recovery: Effects and mechanisms of a locus-of-hope enhancement program for people with substance use disorders. International Journal of Applied Positive Psychology, 10(1). https://doi.org/10.1007/s41042-025-00218-0
Ramos, S.D.A., & Bernardo, A.B.I. (2025b). The path of therapeutic community process experience to recovery capital and psychological well-being as mediated by group working alliance: The role of locus-of-hope. Journal of Ethnicity in Substance Abuse, 1–27. https://doi.org/10.1080/15332640.2025.2468295
Join our Newsletter
Sign up to receive news on the Philippine Social Science Council and its member associations.
