The role of social identity in addiction treatment
We all have multiple identities, relating to our ethnicity,
our gender, our work groups, or the social groups we belong to. However, as researchers
belonging to LSBU’s Addictive and Health Behaviours are showing, our identities
around being an addict, or a recovering addict, are particularly strong.
In the last few years the group’s work (assisted by a number
of PhD, MSc and undergraduates) has shown consistently that these identities can
predict an enormous amount of variance in a client’s treatment success.
Identity seems to be particularly important when predicting how well a person
does in treatment, how long they go without relapsing, or the longevity of their
The Social Identity Model of Cessation Maintenance
Bringing together their respective expertise in social
identity and dual process, Dr Dan Frings and Prof. Ian Albery have spent the last four
years conducting studies and developing the cessation maintenance model, which
describes the processes that underpin how identities affect treatment outcomes.
Ian describes how their complimentary expertise have been
instrumental in developing the model: “What we did was take the best of Dan’s
knowledge in terms of group processes, and my knowledge of how people attend to
things in their environment, and dual process; implicit vs explicit processing.
We put these things together and said 'Do you know what? This could actually
make some sense.' The whole identity issue, the whole self-identity issue; how
we use identities in groups would benefit hugely from exploring a dual process
Which is exactly what they have done. Their Social Identity
Model of Cessation Maintenance (SIMCM) proposes that when people are
experiencing the world from the perspective of a group membership they are
affected by that group membership in two distinct ways: via one set of
processes that a person is aware of (explicit processes) and via another set of processes which operate
underneath the radar (implicit processes).
The role of implicit processes
These implicit processes predict actual behaviour. They
don’t just to predict how people say they’re going to behave - they actually
predict what they do in the moment, as they experience a sort of ‘identity
Ian explains further: “What we’ve found is that in a
situation where a person sitting alone is asked to pour themselves an alcoholic
beverage and then drink as much of that as they want, the best predictor of
that in-the-moment drinking activity is not how they see themselves in
terms of their explicit awareness of being a social drinker, but the implicit
identity that they hold as being a social drinker.”
The implications of the model for practitioners
The researchers argue that both sets of processes need to be
taken into account when treating addiction, the more you can get an individual to
come out of their automatic mode of thinking and into a more conscious reflective state, the better
they should do.
The model obviously has implications for practitioners but, as
Dan is careful to point out, “There’s no magic bullet.”
It’s not like you can
use identity and just say, “We’ll get an identity and we’ll fix people and it
will all be good,” but our findings consistently show that identity is linked to
relapse … it’s important that we understand how people conceive themselves and
how they should be conceiving themselves as part of the treatment process.
Dr Dan Frings
SIMCM is helpful in that it works well with more established
models commonly used in practice, such as the Stages of Change model. As Dan
explains, “When people go through certain transitions their identity needs to
be in a certain way. There’s no point getting people to move from preparation
to action if really their identity is still bedded down as being an addict - they’re not going to get very far.”
The group continue to explore and develop the model in
applied setting with partners like Turning Point and Adfam. They also plan to undertake
further research looking at how people become smokers, drinkers or e-cigarette
users and how those identities are established.
Ian is excited about the future: “We’re writing theoretical bits and
pieces about that at the moment, but we need to do experimental
work in that area to make sure the model becomes accounts for the ways these
identities change before becoming an addict, and what happens to these
identities before, during and after treatment.”
If you are working in the sector and would like to help or
become involved with the group, get in touch.