Research
The science behind
the PRISM Model.
An executive summary of Dr. Carly Button's doctoral dissertation at the University of Arizona — a qualitative study exploring the essential components of sustained recovery and human flourishing.
Doctoral Dissertation
Exploring Essential Components of Addiction Recovery Through the PRISM Model of Wellness
Carly Button, Ph.D., LPC · University of Arizona, 2026
Introduction
Substance use disorder remains one of the most significant public health challenges worldwide. Despite advances in treatment and billions invested annually in addiction services, relapse rates remain high, and many individuals struggle to sustain long-term recovery.
Traditional approaches focus on pathology, symptom reduction, and abstinence. While valuable, they often leave a deeper question unanswered:
What helps people build a life they actually want to stay sober for?
This dissertation explores that question through the development and study of the PRISM Model of Wellness — an integrative framework grounded in existential psychotherapy, logotherapy, positive psychology, and recovery capital research.
The PRISM Model
Five interrelated domains
The story we tell ourselves about who we are. Recovery often begins when narratives of shame or defectiveness are replaced with empowering interpretations of personal history — narrative identity, cognitive reframing, meaning-making, agency, and hope.
Social connection is one of the strongest predictors of long-term well-being. Family, friendships, mentorship, therapeutic relationships, and recovery communities provide accountability, belonging, and opportunities for service.
Living in alignment with one's values and engaging in purposeful action. Values-guided living, goal setting, behavioral activation, and personal responsibility move recovery beyond avoidance toward becoming.
Resilience, courage, adaptability, and self-efficacy. PRISM views clients through a strengths lens, recognizing that suffering is inevitable but people can develop the capacity to keep moving toward meaningful goals.
The existential foundation of the model. Drawing from Viktor Frankl's logotherapy, meaning may emerge through relationships, service, spirituality, faith, nature, creativity, or personal growth — and gives people compelling reasons to remain engaged in life.
Purpose & Methodology
The study explored whether the PRISM framework accurately captures the lived experiences of individuals who have successfully maintained recovery from substance use disorders.
Two research questions guided the work:
- What recovery themes are captured by the PRISM model?
- What important recovery themes fall outside of the PRISM framework?
Using a qualitative design with deductive thematic analysis, participant narratives describing addiction, relapse, and recovery were systematically coded through the lens of the five PRISM domains.
Major Findings
Ten themes across five domains
Every PRISM domain appeared consistently across participant recovery narratives, strongly supporting the model. Ten primary subthemes emerged.
Perspective
- Narrative identity — rewriting one's personal story
- Cognitive reframing — interpreting setbacks differently
Relationships
- Positive impact from others — family, sponsors, recovery communities
- Positive impact on others — service as a source of meaning
Intention
- Purposeful action — careers, education, parenting, service
- Values-guided living — decisions rooted in values, not impulses
Strength
- Resilience — continuing forward despite challenges
- Personal responsibility — ownership of choices and future
Meaning
- Existential meaning — a reason to live and a meaningful future
- Spirituality — connection to something larger than oneself
Key Insight
Recovery is multidimensional.
Perspective influenced relationships. Relationships reinforced meaning. Meaning strengthened resilience. Resilience supported intentional action. Intentional action reinforced perspective. Recovery emerged as a dynamic, interconnected process — not a collection of isolated interventions.
Clinical Implications
From symptom reduction to flourishing
Move beyond symptom reduction
Treatment should help clients build purpose, identity, connection, resilience, and meaning — not only eliminate substance use.
Integrate meaning-centered interventions
Helping clients answer Why do I want to live? and What matters most? may strengthen recovery outcomes.
Strength-based treatment
Clinicians are encouraged to identify and cultivate strengths rather than focus solely on pathology and deficits.
Holistic recovery planning
Assess all five PRISM domains to identify areas of strength and vulnerability across the whole person.
Conclusion
Recovery is not merely the cessation of substance use. It is the cultivation of a meaningful life.
PRISM positions recovery as a process of human flourishing — strengthened by empowering narratives, supportive relationships, purposeful action, resilience, and a deep sense of meaning. The model serves as both a theoretical framework and a practical roadmap for helping individuals move beyond addiction toward lives of purpose, connection, and flourishing.