• Finlay Katherine A KA Department of Psychology, School of Science and Postgraduate Medicine, University of Buckingham, UK. and James Elander.
• Department of Psychology, School of Science and Postgraduate Medicine, University of Buckingham, UK.
• Br J Health Psychol. 2016 Sep 1; 21 (3): 660-76.

ObjectivesTransitioning from clinical care to community-based self-management represents a significant challenge, throughout which social support can facilitate health adjustment and quality of life. However, community-centred, peer-led support structures are often underused. This study aimed to investigate the decision-making processes involved in the choice to attend a chronic pain support group (CPSG) following discharge from a Pain Management Programme.DesignAn in-depth, qualitative analysis was undertaken using interpretative phenomenological analysis, exploring participants' subjective experiences, decision-making, and rationale for initial CPSG attendance.MethodsTwelve participants (four males, eight females) were recruited from a regional CPSG and completed semi-structured interviews lasting between 45 and 120 min. Interviews were transcribed verbatim and analysed idiographically before a cross-case analysis was completed.ResultsAnalysis of transcripts resulted in three superordinate themes: (1) The thirst for comparative friendship; (2) conjecture and the imminent choice; (3) progressive pain management. These themes reflect a desire for empathic, socially comparative friendships and the search for a forum in which to enhance pain self-management strategies, yet also internal conflict over initial CPSG attendance.ConclusionSocial support and associated friendships are attractive to prospective CPSG members and are conceptualized as opportunities to engage in social comparison and nurture self-care. The first visit to the support group presents a significant hurdle, but can be facilitated by managing the transition between therapeutic care and CPSG attendance. Clinicians can challenge preconceptions, foster positive viewpoints regarding the group and support collective decision-making to attend. Following initial attendance, psychosocial well-being was enhanced. Statement of contribution What is already known on this subject? Social support functions as a protective buffer against declining health. Joining a peer-led support group can be initially intimidating and the first visit presents a significant hurdle. What does this study add? Participants are predominantly attracted to support groups due to the opportunity to develop new friendships. Health-related peer groups function as fora for social comparison, enhancing self-esteem and self-efficacy. Experience of pain management programmes primes willingness to attend support groups. The initial decision to attend is difficult but facilitated by collective, group decision-making processes. Health care professionals dynamically prime the transition towards peer support structures.© 2016 The British Psychological Society.

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