230 Personality and Social Psychology Review 18(3) deteriorate,but carly,this isa proposition that remains to good theoretical reasons for thinking that this is be empirically tested. Second,conceptualizing deficits in social relationships as We need to recognize,though,that,as yet,health profes iden tity-driven phenomen rather than sionals have be atively to endorse group-base tion acts fo nity spheres,and so interventions that explicitly target this individual-based interventions.There are a number of rea may therefore show sustained benefits in terms of mood sons for this,including (a)a conviction that group-based venons tha are someh tific,(b)th sions of depression and hence.leave the individual yulnera ble to relapse once treatment concludes.As we noted above, and systems.Applied research is therefore needed to address in contrast to many other relevant psychol his impasse and find ways in which (g.cognitive style,per ons are he en y the SIA e en dent(e.g.,Doosje,Ellemers,&Spea s.1995:S.A.Haslam Several such studies already exist and provide a blueprint Turer,1992;van Rijswijk Ellemers,2002)and thus for future research to tackle the practica question of hov particularly well s ited as targets of inter ention ind others to d (f case for these assertions remains to be made al..2005:Perese Wolf.2005).Although these have not peen designed as treatments for depression per se,they pro Clinically Oriented Research Questions a pl t al 2005)In addition much can he learnt from the serie 2012),only a small m unority gain access to best-practice an for nursing m residents (as revie ve d o hav effective evidence-based treatment and to devise ways of conclusions of thes studies These and other studies have making this widely accessible.Interventions that promote lso revealed several high-risk times for social isolation an emely pron (lye reg t cularly if the Haslam resources (e.g..Jones&Jetten.2011).One way in which this (C.Haslam et al 2008:Jones et al2012).It is at these time has already been util ugh thaltnstitutioneevelitS to promote group mem y mapp proce thei s in sch matic form etten et al. 2010;after Eggins et a 2008).More specifically,this has on Although,overall,there is a clea en ued as a erson group nem hips, the re pote n p individual behavior (Cialdini.Reno.Kallgren.1990 (e.g. stroke,Jetten et al.,2010;recovery from substanc sch Gerard,1955),and this content does not necess ly support adaptiv mple,we migh mined mat tized than either anti-depr t medication or many ind behavioral treatment.because it is perceived as irrelevant to vidual-based psych heir condition (see also Crabtree et a 2010). cot memb where an C Haslam letten Haslam.2012).Yet,regardless on recovery it will he important for future r arch to dete whether it is practically plausible to address the epidemic of mine whether this risk is non-trivial,and,if so,how it might depression one person at a time,we would argue that there be circumvented.230 Personality and Social Psychology Review 18(3) deteriorate, but clearly, this is a proposition that remains to be empirically tested. Second, conceptualizing deficits in social relationships as identity-driven phenomena, rather than individual deficits, has important implications for treatment. Social identifica￾tion acts across both individual (clinical) and social/commu￾nity spheres, and so interventions that explicitly target this may therefore show sustained benefits in terms of mood— particularly relative to pharmaceutical interventions that fail to address the social-structural and psychological dimen￾sions of depression and hence, leave the individual vulnera￾ble to relapse once treatment concludes. As we noted above, in contrast to many other relevant psychological constructs (e.g., cognitive style, personality) social identifications are understood to be highly malleable and contextually depen￾dent (e.g., Doosje, Ellemers, & Spears, 1995; S. A. Haslam & Turner, 1992; van Rijswijk & Ellemers, 2002) and thus seem particularly well suited as targets of intervention. Again, although forays in this direction are encouraging (as noted in relation to H6 above), a clinically robust empirical case for these assertions remains to be made. Clinically Oriented Research Questions As we have already noted, although around 20% of people will experience clinical depression in their lifetime (WHO, 2012), only a small minority gain access to best-practice and affordable treatment (Goldman et al., 1999; Simon et al., 2004). A key research priority is therefore to identify cost￾effective, evidence-based treatment and to devise ways of making this widely accessible. Interventions that promote social group memberships are extremely promising in this regard (see H6). Social identities make good targets for treat￾ment, particularly if they are conceptualized as concrete resources (e.g., Jones & Jetten, 2011). One way in which this has already been utilized in therapeutic contexts is through social identity mapping—a structured process that takes individuals through the process of reporting and displaying their group memberships in schematic form (Jetten et al., 2010; after Eggins et al., 2008). More specifically, this has been used as a stimulus to uncover a person’s key social identities that can then be drawn on therapeutically in the process of identifying ways to use group memberships as resources to help people adjust to significant life change (e.g., stroke, Jetten et al., 2010; recovery from substance abuse, Best et al., in press). Importantly too, joining social groups is likely to be less resource-intensive, more widely accessible, and less stigma￾tized than either anti-depressant medication or many indi￾vidual-based psychological therapies. Furthermore, social group membership has other benefits for health and fewer health risks, making it suitable for a broad-base intervention (C. Haslam, Jetten, & Haslam, 2012). Yet, regardless of whether it is practically plausible to address the epidemic of depression one person at a time, we would argue that there are good theoretical reasons for thinking that this is sub-optimal. We need to recognize, though, that, as yet, health profes￾sionals have been relatively slow to endorse group-based treatment strategies that might deliver a “social cure,” and most psychologists are inclined to retain a preference for individual-based interventions. There are a number of rea￾sons for this, including (a) a conviction that group-based treatments (and research) are somehow unscientific, (b) ther￾apist and patient expectations (or prejudices) about appropri￾ate treatment, and (c) the structure of existing clinical training and systems. Applied research is therefore needed to address this impasse and find ways in which social interventions of the form envisioned by the SIA might be effectively pro￾moted by and to health professionals and institutions. Several such studies already exist and provide a blueprint for future research to tackle the practical question of how health practitioners and others might effectively facilitate identity formation. Interventions that specifically target loneliness have been developed (for reviews, see Cattan et al., 2005; Perese & Wolf, 2005). Although these have not been designed as treatments for depression per se, they pro￾vide evidence of the effectiveness of enhanced social interac￾tion of a form likely to facilitate social identification (Postmes et al., 2005). In addition, much can be learnt from the series of small-scale studies that have effectively improved the quality of life for nursing home residents (as reviewed above). However, as we have already noted, large-scale, ran￾domized control trials are sorely needed to drive home the conclusions of these studies. These and other studies have also revealed several high-risk times for social isolation and group membership loss, such as transition to university (Iyer et al., 2009), entry into residential care (McCloskey, Haslam, Haslam, & Mewse, 2014), or following a significant injury (C. Haslam et al., 2008; Jones et al., 2012). It is at these times that institution-level interventions to promote group mem￾bership might be particularly effective. In line with H3, one important area of research to explore is whether there are any risks to enhancing social identities for people with depression. Although, overall, there is a clear benefit from social group memberships, there are potential exceptions. In particular, as we have noted, the normative content of group memberships exerts a strong influence over individual behavior (Cialdini, Reno, & Kallgren, 1990; Deutsch & Gerard, 1955), and this content does not necessar￾ily support adaptive health behaviors. For example, we might speculate that a group that coheres around essentialized con￾ceptions of depression as biologically determined may resist behavioral treatment, because it is perceived as irrelevant to their condition (see also Crabtree et al., 2010). Therefore, there are circumstances where an intervention that facilitates group membership might potentially have a negative effect on recovery. It will be important for future research to deter￾mine whether this risk is non-trivial, and, if so, how it might be circumvented. Downloaded from psr.sagepub.com at Remen University of China on September 6, 2015