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Practical support aids addiction recovery: the positive identity model of change.

ABSTRACT: BACKGROUND:There is a need for studies that can highlight principles of addiction recovery. Because social relationships are involved in all change processes, understanding how social motivations affect the recovery process is vital to guide support programs. METHODS:The objective was to develop a model of recovery by examining addicted individuals' social motivations through longitudinal assessment of non-professional support dyads. A qualitative, longitudinal study design was used, combining focus groups and in-depth interviews with addicted individuals and their sponsors. Data were analyzed using the principles of grounded theory: open coding and memos for conceptual labelling, axial coding for category building, and selective coding for theory building. The setting was an addiction recovery social support program in Oslo, Norway. The informants included nine adults affected by addiction, six sponsors, and the program coordinator. The participants were addicted to either alcohol (2), benzodiazepines (1), pain killers (1) or polydrug-use (5). The sponsors were unpaid, and had no history of addiction problems. RESULTS:Support perceived to be ineffective emerged in dyads with no operationalized goal, and high emotional availability with low degree of practical support. Support perceived to be effective was signified by the sponsor attending to power imbalance and the addict coming into position to help others and feel useful. CONCLUSIONS:The findings appear best understood as a positive identity-model of recovery, indicated by the pursuit of skill building relevant to a non-drug using identity, and enabled by the on-going availability of instrumental support. This produced situations where role reversals were made possible, leading to increased self-esteem. Social support programs should be based on a positive identity-model of recovery that enable the building of a life-sustainable identity.

SUBMITTER: Johansen AB

PROVIDER: S-EPMC3751355 | biostudies-literature | 2013 Jul

REPOSITORIES: biostudies-literature

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Practical support aids addiction recovery: the positive identity model of change.

Johansen Ayna B AB Brendryen Håvar H Darnell Farnad J FJ Wennesland Dag K DK

BMC psychiatry 20130731

<h4>Background</h4>There is a need for studies that can highlight principles of addiction recovery. Because social relationships are involved in all change processes, understanding how social motivations affect the recovery process is vital to guide support programs.<h4>Methods</h4>The objective was to develop a model of recovery by examining addicted individuals' social motivations through longitudinal assessment of non-professional support dyads. A qualitative, longitudinal study design was us ...[more]

PMID: 23898827

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Project description:Problematic substance use and addiction is a growing crisis in the United States. As a result, identifying factors that effectively promote addiction recovery is, currently, of particular societal importance. Informed by evidence that-while addiction can be perpetuated by stress-related impulsivity and decreased self-regulation-perceived social support is protective against addiction, we test a model for addiction recovery as a form of posttraumatic growth (PTG), focused specifically on close relationships and personal strength-two domains of PTG. In an initial study, we found that perceived social support and impulsivity predicted number of relapses in individuals in a substance use disorder recovery program. Using experience sampling, we then observed that experiencing a stressful event predicted impulsive behavior. However, experiencing closeness with others-a domain of PTG-was directly associated with perceived social support, and both predicted positive emotional states, which were, in turn, inversely associated with experiencing a stressful event. Further, when experiencing a stressful event, personal strength-also a domain of PTG-was inversely associated with impulsive behavior and was predicted by both perceived social support and positive emotional states. Finally, in a follow-up experiment, we found that an ecological momentary intervention targeting perceived social support decreased impulsivity and increased self-regulation-an aspect of personal strength-in a dose-dependent fashion. Taken together, our findings: (1) support a PTG model for recovery; (2) provide evidence for processes by which close supportive relationships are protective against addiction and relapse; and (3) indicate that self-regulation is responsive to a short in-the-moment perceived social support intervention. We suggest that these findings support the theory that addiction is a social disease in the sense that close personal interactions and supportive relationships: (a) buffer against stress-related impulsivity, thereby protecting against addiction and relapse; and (b) increase personal strength, thereby decreasing the probability of impulsive-including addictive-behavior and promoting recovery.

Project description:BackgroundFood addiction has a long history; however, there has been a substantial increase in published literature and public media focus in the past decade. Food addiction has previously demonstrated an overlap with overweight and obesity, a risk for cardiovascular disease. This increased focus has led to the establishment of numerous support options for addictive eating behaviors, yet evidence-based support options are lacking.ObjectiveThis study aimed to evaluate the availability and content of support options, accessible online, for food addiction.MethodsA standardized Web search was conducted using 4 search engines to identify current support availability for food addiction. Through use of a comprehensive data extraction sheet, 2 reviewers independently extracted data related to the program or intervention characteristics, and support fidelity including fundamentals, support modality, social support offered, program or intervention origins, member numbers, and program or intervention evaluation.ResultsOf the 800 records retrieved, 13 (1.6%, 13/800) websites met the inclusion criteria. All 13 websites reported originating in the United States, and 1 website reported member numbers. The use of credentialed health professionals was reported by only 3 websites, and 5 websites charged a fee-for-service. The use of the 12 steps or traditions was evident in 11 websites, and 9 websites described the use of food plans. In total, 6 websites stated obligatory peer support, and 11 websites featured spirituality as a main theme of delivery. Moreover, 12 websites described phone meetings as the main program delivery modality, with 7 websites stating face-to-face delivery and 4 opting for online meetings. Newsletters (n=5), closed social media groups (n=5), and retreat programs (n=5) were the most popular forms of social support.ConclusionsThis is the first review to analyze online support options for food addiction. Very few online support options include health professionals, and a strengthening argument is forming for an increase in support options for food addiction. This review forms part of this argument by showing a lack of evidence-based options. By reviewing current support availability, it can provide a guide toward the future development of evidence-based support for food addiction.

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Practical support aids addiction recovery: the positive identity model of change.

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Practical support aids addiction recovery: the positive identity model of change.

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