The “doing” or the “being”? Understanding the roles of involvement and social identity in peer‐led addiction support groups

Unveiling the psychological mechanisms of mutual help groups for addiction recovery: The role of social identity factors

The effectiveness of mutual help groups (MHGs) in promoting addiction recovery has been widely acknowledged. However, the psychological mechanisms underlying the impact of MHGs remain somewhat uncertain. Drawing on a social identity perspective, this study investigated a sequential mediation model in which social support is posited as a driving factor that enhances abstinence maintenance through group identification, recovery identity, and self-efficacy. A sample of 820 smokers, participating in a 6-month collective smoking cessation programme which included access to an online help group, completed measures of social support, group identification, smoker/ex-smoker identity, and self-efficacy at the programme's outset. Smoking abstinence was assessed 6 and 9 months later. The findings supported the proposed model, indicating that social support was positively associated with MHG identification, which, in turn, was related to a stronger recovery identity. Subsequently, recovery identity was associated with increased self-efficacy, and indirectly, with smoking abstinence at both measurement times. Additional analyses testing alternative mediation models further supported the validity of the proposed model. These findings suggest that social identity factors play significant roles in accounting for the effectiveness of MHGs for addiction recovery.

A realist review of residential treatment for adults with substance use disorder

ISSUES

Completion of residential treatment for substance use disorder (SUD) relates to improvements in substance use and mental health. Findings from systematic reviews have been equivocal about which interventions work best for clients. There has been limited attention to the theories that explain the effectiveness of residential treatment.

APPROACH

We conducted a realist review of the literature to identify program theories that would explain successful and unsuccessful outcomes from residential treatment for SUD. The unit of analysis was context-mechanism-outcome (CMO). Inclusion criteria were studies of residential treatment of more than 30 days for adults with SUD. Pharmacological studies were excluded.

KEY FINDINGS

We identified 24 studies from 5748 screened. The studies were from settings comprising Indigenous programs, faith-based programs, psycho-social interventions and therapeutic communities and were conducted in North America, Scandinavia, Continental Europe and Australasia. We chose six CMO configurations as the best explanations for outcomes from residential treatment. Theories that best explained the mechanisms of change were the need to belong, meaning in life, and self-determination theory.

IMPLICATIONS

Previous research has noted similar outcomes from different residential treatment interventions, but has not been able to explain these similarities. In contrast, our findings suggest that the outcomes can be explained by causal mechanisms that apply across all programs, regardless of the philosophy of treatment.

CONCLUSION

We identified six CMO configurations whose mechanisms of change could be explained by three overarching theories-the need to belong, meaning in life and self-determination theory. The findings apply across ethnicities and genders.

"It's Not the Same": A Comparison of the Psychological Needs Satisfied by Musical Group Activities in Face to Face and Virtual Modes

According to the social identity approach to health, group memberships influence people’s mental health to the extent that they identify with their group. Emerging evidence suggests that music groups, such as choirs, enhance mental health via group identification and the satisfaction of various psychological needs; however, more research is required to understand these processes in other types of music groups. Furthermore, the coronavirus disease 2019 (COVID-19) social distancing restrictions in 2020 prevented music groups from meeting face to face (F2F). Some music groups adapted virtually, but the rate of adaptation of various music activities is unknown, as is the impact of such adaptations on participants’ group identification, psychological need satisfaction, and mental health. We explored these questions using a cross-sectional survey with 257 participants (M_age = 46 years, 78% female) of singing (n = 172), instrumental (n = 48), and dance groups (n = 37). Participants rated group identification and psychological needs satisfaction retrospectively for their music group in F2F mode and then for the group in adapted mode, along with mental health 12-item short form health survey (SF-12). Results showed that instrumental groups (60%) were less commonly adapted to virtual mode than singing (83%) and dance (86%) groups. Group identification and average psychological needs satisfaction (M = 4.04 and 3.50 out of 5) scores were significantly lower for groups in virtual mode than in F2F mode (M = 4.53 and 4.14, respectively). Psychological needs satisfaction did not mediate the relationship between group identification and SF-12 mental health. Despite this, values on group identification and psychological need satisfaction remained high, which suggests that virtual music groups may be beneficial during the COVID-19 pandemic and in contexts where F2F groups are less accessible.

Identifying the Main Components of Substance-Related Addiction Recovery Groups

OBJECTIVES

Mutual-aid groups are a central part of many individuals' recovery journeys from substance addiction, and this research aimed to identify the key ingredients of a diverse range of recovery groups.

METHODS

Individuals from 30 different substance addiction recovery groups across the UK (N = 151, 66% male, M age = 42.5 years) completed a survey, which asked participants to provide a narrative about their recovery group experiences. Participants were also asked to rate the extent to which theorized ingredients of addiction recovery groups were offered by their group, and how important each was to them. Both qualitative and quantitative data were collected and analyzed.

RESULTS

The results indicated that the recovery group components suggested in previous literature were both present and rated as important. Component ratings did not differ depending on the type of group, the length of time the person had been in recovery, nor the length of time they had been involved in the group. The qualitative results identified other important components of recovery groups that had not been identified in the previous literature: presence of like-minded individuals and developing self-awareness and reflection skills. An updated list of recovery group components was thereby created.

CONCLUSIONS

Overall, the findings provide an in-depth, person-focused perspective on what makes an addiction recovery group successful. Asking group members directly about their experiences allowed us to refine and expand on previously theorized components. The updated components can be used as a template for developing future mutual-aid groups.