A longitudinal qualitative exploration of identity transitions in long-term recovery from problematic substance use

Cornwall, Paul (2025) A longitudinal qualitative exploration of identity transitions in long-term recovery from problematic substance use. Doctoral thesis (PhD), Manchester Metropolitan University.

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Abstract

Background In the United Kingdom (UK) the recovery movement has become a key feature of problematic substance use services, and evidence has proposed that social identity and group membership are essential aspects in the early stages of an individual’s recovery. Many studies have been conducted that have investigated the expressed needs and experiences of people in their early recovery processes, and a significant factor in the change in lifestyle from problematic substance use to non-substance use consists of transitions of personal identity. Therefore, recovery is considered to be a ‘journey’ of the transitions of change in an individual’s identity that cultivates a new social identity and is an essential factor for recovery. Although there is a large amount of research on recovery from problematic substance use it is apparent that there is a gap in the research literature regarding the efficacy and the sustainability of underpinning factors that facilitate sustained long-term recovery from substance use. Aims The thesis aimed to explore at a contextual level and to build on previous research to gain an in-depth insight into the facilitators that sustain long-term recovery and to gain knowledge and understanding of the facilitators concerning personal identity transitions within a person’s recovery. Methodology To address the aim of the thesis, three approaches to analysis were conducted. The first approach explored the latent constructs which underpinned individuals’ perceptions of long-term recovery (Chapter 6). The second approach used an idiographic approach to explore people’s experiences of their long-term recovery (Chapter 7). The final study used a longitudinal qualitative design to explore the experiences of persons in their long-term recovery (Chapter 8). Each of the approaches utilised the use of semi-structured interviews in combination with an inductive reflexive thematic analysis conducted at the latent level (Chapter 6) and using Interpretative Phenomenological Analysis (Chapters 7 and 8). Findings Consistently across the approaches, several key findings were identified which centred upon the importance of the sustainability of introspection, the importance of connection, the capability of embracing vulnerability, and the importance of achieving authenticity. These overarching factors manifested differently across all the data. Within Chapters 6 and 7 these factors conversed and allowed access to gain insight into the participant’s past and current perceptions through introspection of their identity and maintaining close connections with others that permitted them with a sense of authenticity. Chapter 8 revealed these factors to be static across time which resulted in gaining knowledge and understanding that these factors are key aspects of the underpinning sustainability of people’s long-term recovery. Participants made sense of this through their capability of introspection. Conclusion The thesis presents several novel contributions to the existing literature focusing on the sustaining factors that help support and facilitate sustained long-term recovery from problematic substance use. This included the focus on the lived experiences of those who are experts in this field. The findings of the thesis also suggest that there is a convergence of these factors of sustainability in long-term recovery over time and therefore could have a significant positive impact on policy, practice, and future research.