Socioecological Model of Coping with Adversity during Substance Use Disorder Treatment and Recovery

The current review presents an overview of behavioral coping mechanisms common among individuals with substance use disorders (SUDs) using a socioecological framework. We identify individual-, interpersonal-, community-, and societal-levels of adversity and match them with corresponding levels of coping responses.

Problem-focused coping is often regarded as the "ideal" form of coping, which has led behavioral interventions to prioritize teaching problem-focused coping skills. While these practices have shown efficacy, they may be overly focused on individual control and less effective for coping with adversity that is outside of one's control. Collective coping practices may be an effective tool, especially for individuals with trauma, high lifetime adversity, and those that experience high rates of systematic adversity.

Our review highlights the importance of acknowledging lifetime and systemic adversity among those with SUD and building coping skills specifically designed to respond to adversity occurring in the community and at societal levels. Future research is needed to test interactions between types of adversity and types of coping to create an evidence-based guide for personalized coping strategies.