CHIME and Addiction Recovery: Understanding What Helps People Build Recovery

When we talk about recovery, we no longer look at only stopping substance use, abstinence or sobriety alone. The remission of symptoms is only one aspect of the process, and even that is sometimes debated in the research. Recovery is described as a meaningful and spiritual experience. It is about rebuilding life, reconnecting with the self and others, embracing hope, finding purpose and regaining a sense of self and identity. Recovery is powerful because it extends beyond the individual to our relationships with others and our place in the wider community.

The CHIME Framework was developed by a team of researchers, led by Dr Mary Leamy in 2011.  They systematically analysed scientific data and stories of how people describe recovery from mental illness. They analysed 97 papers from 13 countries – ranging from qualitative research to narrative reviews, book chapters, consensus documents, opinion pieces, and small quantitative studies. The goal was to capture the essence of how recovery was experienced and lived.

By looking at the collective experiences of individuals in recovery, they identified five core recovery processes. Each element of the CHIME highlights an important aspect of recovery.

Connectedness refers to a sense of belonging, feeling part of something with supportive relationships, peer support, community involvement and participation and social inclusion.

Hope and optimism are the belief that change and recovery are possible, being inspired by other recovery role models, having the motivation to make changes, having a positive mindset and valuing effort. It is about having hopes and dreams to aspire to.

Identity is about moving beyond a problem-focused or stigmatised sense of self and developing a more positive identity that challenges stigma.

Meaning in life involves striving to live purposefully, guided by personal values and spirituality. It encompasses the pursuit of a meaningful and fulfilling existence through positive social roles and contributions. Having a sense of purpose, along with values, spirituality, and engaging in worthwhile activities, enhances the overall significance of life.

Empowerment involves having the agency, autonomy and sense of control to determine the kind of life one chooses to live; to have the confidence and ability to live a self-directed life by recognising and utilising one’s personal strengths and qualities.

Adapting CHIME Into Addiction And Recovery Practice

Although CHIME was originally developed in the context of mental health recovery, it is highly applicable to addiction recovery. Recovery researchers emphasise the importance of adopting a strengths-based community recovery system that provides long-term support. Many of these systems incorporate elements of the CHIME framework, such as community resources, positive social networks, healthy relationships, and meaningful work.

The CHIME model offers a helpful framework to ensure that recovery-promoting components are included in programs.

• Connectedness may involve peer groups, mutual aid, family support, recovery communities, or supportive services.
• Hope may be fostered by seeing recovery in others, by being treated with dignity, or by experiencing small but meaningful progress.
• Identity may shift as a person moves away from a stigmatised identity and towards a broader, more hopeful and self-directed sense of self.
• Meaning can be found in work, service, caregiving, spirituality, creativity, education, advocacy, or participation in ordinary community life.
• Empowerment grows when people have a voice, choice, and genuine opportunities to make decisions about their own future.

The concept of recovery capital – the internal and external resources that help to initiate and subsequently support recovery – overlaps strongly with the components of the CHIME model. In actual practice of addiction recovery, this means including elements of service that:

• Prioritise the importance of building supportive, pro-recovery networks and environments (Connectedness)
• Fostering realistic expectations of recovery and change with the support of recovery role models who have lived experience (Hope)
• Building new narratives and identities of the self that are aligned with one's best version of themselves (Identity)
• Creating opportunities for service and contributions that are value-driven (Meaning)
• Ensuring joint-decision making and person-centred recovery goals that allow for autonomy (Empowerment)

Together, CHIME and recovery capital offer a complementary, person-centred lens for understanding and supporting addiction recovery as a long term goal.

Reference: Leamy M, Bird V, Boutillier CL, Williams J, Slade M. Conceptual framework for personal recovery in mental health: systematic review and narrative synthesis. British Journal of Psychiatry. 2011;199(6):445-452. doi:10.1192/bjp.bp.110.083733