A comprehensive programme of research into the effectiveness of Breaking Free Online, Staying Free and Pillars of Recovery is currently being conducted. This is following the Medical Research Council framework for developing and evaluating complex healthcare interventions.

Led by Dr Sarah Elison, the primary objective of this research is to examine the effectiveness of the Breaking Free programmes in a diverse range of settings. In addition, however, it is seeking to provide new insights into how digital interventions are diffused throughout healthcare systems, and how the wider adoption of such innovations can be facilitated.

The studies that have been published to date in UK and US peer-reviewed journals, including those currently under review, are as follows:

  • 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).

  • Davies, G., Ward, J., Elison, S., Weston, S., & Dugdale, S. (under review). 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. Prison Service Journal.

  • Dugdale, S., Elison, S., Davies, G., & Ward, J. (under review). Applying behaviour change theories and qualitative methods in substance misuse implementation research: Conceptualising the adoption of Breaking Free Online in realworld clinical practice. Qualitative Health Research.

  • Dugdale, S., Elison, S., Davies, G., & Ward, J. (under review). The use of digital technology in substance misuse recovery. Cyberpsychology: Journal of Psychosocial Research on Cyberspace.

  • Dugdale, S., Elison, S., Davies, G., Ward, J., & Dalton, M. (2016a). 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, 1-12.

  • 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., Ward, J., Hernen, J., Elison, S., Davies, J., & Donkor, D. (2016c). Using the behavior change technique (BCT) taxonomy to conceptualize the clinical content of Breaking Free Online: A computer-assisted therapy program for substance use disorders. Substance Abuse Treatment, Prevention and Policy, 11-26.

  • Easton, S. (2014). CLIF impact project: Community learning and digital inclusion. National Institute of Adult Continuing Education.

  • 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). Sub-group analyses of a heterogeneous sample of service users accessing computer-assisted therapy (CAT) for substance dependence using Breaking Free Online. 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., 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., 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. (under review). The ‘Rapid Recovery Progression Measure’ (rapid-RPM) a brief assessment of psychosocial functioning change during problematic substance use recovery progression. Substance Use and Misuse.

  • Elison, S., Ward, J., Williams, C., Espie, C., Davies, G., Dugdale, S., Ragan, K., Chisnall, L., Lidbetter, N., & Smith, K. (under review). An outcomes evaluation of the implementation of ‘Living Life to the Full Interactive’, ‘Sleepio’ and ‘Breaking Free Online’ at an innovative eTherapy service, ‘Self-Help Services’. BMJ Open.

  • 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), 176-185.

  • Elison, S., Weston, S., Dugdale, S., Ward, J., & Davies, G. (2016b). A Qualitative Exploration of U.K. 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.

  • Neale, J., & Stevenson, C. (2014). Positive and negative features of a computer assisted drug treatment program delivered by mentors to homeless drug users living in hostels. Journal of Substance Abuse Treatment, 47(4), 258-264.

  • 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. (under review). Achieving digital health sustainability: Breaking Free and CGL. International Journal of Health Governance.

Below you can download the latest summary of the Breaking Free research programme, which includes the key findings of each completed study. This summary is updated regularly.

If you have an enquiry about our research programme or you are interested in collaborating with us on a study, either in the UK or in other countries, please contact Dr Sarah Elison (Head of Research) at or on +44 (0) 161 834 4647.

Find out more

Download the latest overview of our programme of research and evaluation: