Self-directed change or specialist help? Understanding the pathways to changing drinking in heavy drinkers

Description/Abstract

This article uses qualitative methods to compare two groups of heavy drinkers - those who had recently sought specialist help, and those who were currently 'self-directing' change in drinking. Thirty-six heavy drinkers, selected from a larger cohort in the English West Midlands, took part in semi-structured interviews on drinking change. Key themes for the 'self-directed change' group were: confidence in self-sufficiency to change, internalised social pressure for change, and social collaboration with other drinkers for changing drinking. In contrast, themes for the 'specialist help' group were: feeling 'out of control', lacking confidence in the decision to change drinking, external social pressure for change, and alienation from social collaboration in changing drinking. Results suggest that specialist help might exploit or develop opportunities for collaboration with others. To maintain change, specialist help may need to take more into account those social roles that appear to encourage the stabilisation of drinking in the long term.