Department of Social Work, Education and Community Wellbeing, Faculty of Health and Life Sciences, Northumbria University, Coach Lane Campus, Newcastle Upon Tyne NE7 7QA, UK.
Department of Sociology, Durham University, Old Elvet, Durham DH1 3HN, UK.
Int J Environ Res Public Health. 2024 Sep 28;21(10):1297. doi: 10.3390/ijerph21101297.
Self-help groups are increasingly utilised by communities of interest and shared experience, services, and government departments as platforms for supporting and improving health and social care outcomes for drug and alcohol users. Traditional 12-step self-help groups like Narcotics Anonymous and Alcoholics Anonymous (NA and AA) are worldwide organisations and each have their own programme of change, language, criteria for membership, processes for problem resolution, and self-transformation. Within these types of groups, members are openly encouraged to identify with and adopt an (diseased) identity that is consistently invoked to work on the self. In the self-help recovery literature, it is widely recognised that individuals can benefit by thinking about themselves as "diseased" and then acting and behaving in a manner which is congruent with their reframed "identity". Less is known about the processes involved in this and social-, psychological-, and health-related implications for individuals in drug- and alcohol-specific self-help groups. A thematic analysis of data from (n-36) in-depth qualitative interviews with long-term (6 months-10 years) self-help users identified four themes associated with the adoption of a diseased identity and self-help group processes: (1) normalising the disease and illness; (2) identifying as diseased; (3) living as a diseased individual; and (4) one addict helping another addict. The results of this research should not be interpretated as a critique of the 12-step approach or groups. Instead, it should be recognised that whilst improvements to individual wellbeing are reported, identifying as diseased can exacerbate negative self-perceptions that individuals hold about themselves, their character, capabilities, and ability. Being diseased, accepting disease, and identifying as diseased also has the potential to inhibit their engagement with wider social networks and professional services outside of their own fellowship or group. We conclude this paper by exploring the implications of a "diseased identity" and self-help processes for individuals who access self-help groups, and health and social care practitioners who support self-help users as they engage with services and self-help groups.
自助小组越来越多地被利益共同体、服务机构和政府部门用作支持和改善药物和酒精使用者的健康和社会关怀成果的平台。像匿名戒毒者和匿名酗酒者（NA 和 AA）这样的传统 12 步自助小组是全球性组织，每个组织都有自己的变革计划、语言、会员标准、问题解决流程和自我转变。在这些类型的小组中，成员被公开鼓励认同和采用一种（患病的）身份，这种身份不断被用来自我改变。在自助康复文献中，人们普遍认识到，个体可以通过将自己视为“患病”并以与重新定义的“身份”一致的方式行事和表现来从中受益。对于药物和酒精特定自助小组中的个体来说，对于这一过程涉及的社会、心理和健康相关影响知之甚少。对（n=36）名长期（6 个月至 10 年）自助使用者的深入定性访谈数据进行的主题分析，确定了与采用患病身份和自助小组过程相关的四个主题：（1）使疾病正常化；（2）自我认同为患病者；（3）作为患病个体生活；（4）一个瘾君子帮助另一个瘾君子。这项研究的结果不应被解释为对 12 步方法或小组的批评。相反，应该认识到，虽然报告了个人幸福感的提高，但自我认同为患病者可能会加剧个人对自己、自己的性格、能力和能力的负面看法。患病、接受疾病和自我认同为患病者也有可能抑制他们与自己的联谊会或团体之外的更广泛的社交网络和专业服务的接触。我们通过探讨“患病身份”和自助过程对求助于自助小组的个人以及支持自助使用者与服务和自助小组互动的健康和社会保健从业者的影响，结束了本文。
