Alcoholism and identity: How an alternative framing of identity can facilitate Alcoholics Anonymous research

Abstract

Motivational interviewing (MI), cognitive-behavioral therapy (CBT), and Alcoholics Anonymous (AA) are the most common therapeutic approaches for alcoholism recovery. Whereas the former two are clinical treatments grounded in scientific theory, AA emerged as a peer-led program grounded in an array of scientific, social, and spiritual concepts. Researchers have failed to comprehensively identify AA's therapeutic mechanisms or to definitively link them to recovery outcomes. This failure may result from the false assumption that AA frames identity in the same way evidence-based psychological treatments do. This article explores the significance of identity to recovery from alcoholism. MI presumes a personal identity and CBT presumes a social identity. Measures of personal and social attributes are appropriate to these interventions. AA, however, promotes a relational identity which cannot be fully captured using measures of individual attributes. The implications for this shortcoming are presented, along with several suggestions to enhance future research.

• Alcoholism
• addiction
• self-help
• recovery
• identity
• alcoholics anonymous

Acknowledgments

This article is based upon the work supported by the Department of Veterans Affairs, Veterans Health Administration, Office of Research and Development, Health Services Research and Development, and the VA Midwest Rural Health Resource Center.

Declaration of interest: The views expressed in this article are those of the authors and do not necessarily reflect the views or policy of the Department of Veterans Affairs or the United States government.