Identity Reconstruction as a Coping Mechanism in Addiction Recovery: A Pilot Stratified Randomized Controlled Trial of Narrative Therapy Group Intervention

Relapse in substance use disorders remains a persistent clinical challenge. Identity reconstruction, the psychological transition from an internalized “addict” identity to a recovery-oriented self, may be a core coping mechanism for abstinence maintenance. This exploratory pilot stratified randomized controlled trial examined the feasibility and preliminary effects of a Narrative Therapy (NT) group intervention, delivered within an evidence-based practice framework. Forty-five male residents of a closed rehabilitation facility were randomly assigned (n = 15 each) to an 8-week NT intervention, standard psychoeducation (TAU), or waitlist control (WLC). The Self-Identity Scale and an abbreviated four-item Stimulant Relapse Risk Scale served as outcomes. The Self-Concept Clarity Scale assessed a candidate process variable. A 3 (group) × 3 (time) repeated-measure ANOVA showed significant group × time interactions for self-identity (F = 64.215, p < 0.001, and η2p = 0.754) and relapse-risk indicators (F = 62.131, p < 0.001, and η2p = 0.747). For self-identity, only the NT group showed significant within-group gains. For relapse-risk indicators, NT scores were significantly lower than both control groups at post-test and follow-up (all pairwise p ≤ 0.008), with these reductions maintained at two-month follow-up. Within-group self-concept clarity gains emerged for NT, though between-group differences were nonsignificant. Because the study was conducted in a custodial setting, the relapse-risk findings reflect psychological vulnerability rather than observed behavior. Larger adequately powered trials are needed.