Exploring the Impact of a Gratitude-Based Group on Flourishing in Individuals with Substance Use
Recovery from substance use involves more than behavioral change. Internalized stigma—manifesting as shame, self-blame, and diminished self-worth—can persist long after substance use decreases, undermining psychological well-being and complicating sustained recovery. At the same time, recovery involves more than reducing distress; it also includes cultivating well-being, connection, and a sense of purpose. These broader dimensions highlight the need for interventions that address identity, self-perception, and relational connection alongside symptom management.
Many recovery-oriented spaces understandably emphasize stabilization—helping individuals “get through the day,” reduce harm, and maintain progress. While these goals are essential, fewer interventions explicitly focus on what it means to flourish: to experience connection, meaning, and psychological well-being. This study aims to explore whether a gratitude-based group can support not only recovery, but also thriving.
In an MRI-funded project led by Jeevanjot “JJ” Kapur (University of Iowa), the focus shifts toward these relational and intrapersonal foundations of recovery. The study evaluates a six-week, gratitude-based group intervention, pioneered by Dr. Joel Wong (Indiana University) designed to be feasible in community and clinical settings and accessible to adults with lived experience of substance use at any stage of recovery, without requiring abstinence.
The intervention is grounded in research demonstrating that structured gratitude practices are associated with improvements in mood, life satisfaction, and psychological well-being. Theoretically, gratitude may function as a mechanism for both identity repair and well-being enhancement by redirecting attention from self-critical cognitions toward supportive relationships and personal strengths. For individuals navigating internalized stigma, this shift may foster self-compassion, strengthen social connection, and reinforce a more coherent, strength-based self-concept.
Methodologically, the project employs an 18-week interrupted time series design consisting of a six-week baseline phase, a six-week intervention phase, and a six-week follow-up. Participants complete repeated self-report assessments of flourishing, well-being, loneliness, and state gratitude, allowing examination of within-person change relative to individual baseline trajectories. With an anticipated sample of approximately 10 participants, the design emphasizes sensitivity to individual change patterns in early-stage intervention testing.
Weekly 60-minute sessions integrate psychoeducation with structured reflective exercises, including gratitude journaling, gratitude letters, guided interpersonal exchanges, and facilitated discussion. Emphasis is placed on psychological safety, autonomy, and boundaries; participation in sharing is voluntary, and the aim is not enforced positivity but intentional attention to relational support and personal growth.
Outcomes will be analyzed using Baseline-Corrected Tau-U, a nonparametric effect size approach suited for small-sample longitudinal designs. Visual time-series analyses and aggregated effect summaries will allow transparent evaluation of magnitude and consistency of change.
If findings indicate improvements in flourishing and well-being, this intervention may offer a scalable adjunct to recovery-oriented services and peer support programs. By conceptualizing recovery as a relational and identity-based process, this MRI-supported work advances a strengths-focused model in which psychological healing emerges through practices that cultivate recognition, connection, self-compassion, and the capacity to not only survive, but to flourish.