What is the nature of the recovery processes underlying twelve step fellowships? A constructivist grounded theory study

Aims: This study aimed to explore the nature of recovery processes underlying twelvestep fellowships. The introduction gave an overview of addiction theory, fellowship principles and quantitative efficacy studies. I outlined my rationale for the necessity for research into the mechanisms of change that members experience during their journeys to recovery utilising the fellowships. Methods: Constructivist theory laid out by Charmaz (2006) was deemed to be the most appropriate method for doing this given the research focus and my position as a researcher. Nine qualitative interviews, consisting of six sampling, two theoretical and one negative case, were conducted and analysed using Nvivo computer software. Findings: Seven main categories were uncovered which crystallised around a core category of ‘striving for and maintaining recovery’. Problems with the fellowships and alternative perspectives were also outlined. A model of the theory was presented, as well as models for each of the main categories and their sub-category interactions. Discussion: This study has demonstrated that there are several implicit and explicit mechanisms of change involved in fellowship recovery: Working a Programme, Connecting With Other Addicts, Creating Change, Going to Any Lengths, Understanding Addiction and Coming to Believe. Problems with the fellowships include: coping with unhelpful members, the concept of ‘God’, old-fashioned concepts and lack of awareness of the fellowships. This theory brings together the elements of recovery into a cohesive whole. An evaluation and implications of the study are explored. My conclusions are supported by similar findings from other well-respected researchers and have shown that the fellowship programme is based on valid psychological principles