STAGE 4. Selecting the theoretical approach

What steps should be completed?

Step 1: Select the theoretical approach or approaches on which the intervention will be based


Social inclusion programmes for people with drug dependence have little theoretical-conceptual development, and often do not include references to the theoretical model (approach) on which they are based or to the evidence that justifies the use of certain intervention strategies. This is explained by difficulties in conceptualising the processes of social exclusion-inclusion, by the absence of the programme’s own models (approaches) to explain the processes behind the situations of drug addicts’ social exclusion and factors that facilitate or impede their social inclusion, and also because social inclusion is considered by many institutions and professionals to be inherent in the treatment. This does not preclude identifying certain conceptual references implicit in these programmes, as follows:

  • Conceptualising exclusion processes. Exclusion is a multidimensional phenomenon resulting from a certain social, political, cultural and economic structure. It is also relative and occurs in a particular society, which  is why it has to be judged in its context. It is also dynamic, the result of a set of processes and, above all, it is a political issue, and it is therefore possible to address strategically through policies that promote inclusion practices.1
  • Exclusion-generating mechanisms. People with drug addiction problems are particularly affected by social fragmentation, unemployment in the post-industrial economy and weakening of the inclusive capacity of State social policies.
  • Factors associated with exclusion processes. Exclusion is a multidimensional, multifaceted process, which is generated by various parameters and is embodied in various interconnected areas of life. This makes it necessary to consider the multiple dimensions and generating factors of exclusion. +
  • Relationship between social exclusion and drug dependence. There is no causal relationship between drug dependence and exclusion, since social exclusion does not affect all drug users2 and, in some cases (particularly among certain alcohol, cocaine, marijuana, etc. users), substance abuse or dependence is compatible with social integration. However, there is a relationship between social exclusion and drug abuse/dependence to the extent that exclusion sometimes acts as a risk factor for abuse, and drug dependence constitutes a risk factor for social exclusion. +

Development of the theoretical approaches to the processes of exclusion and social inclusion of  socially disadvantaged collectives or social groups can be summarised in the transition from models (approaches) based on total segregation (where isolation of people with integration difficulties in closed institutions is the prototypical response), towards psychosocial and sociostructural models (approaches). This transition towards proposals for community integration implies recognition of the fact that it is not enough to put integration policies in place that induce change in people, but that change is also necessary in the social organisation that facilitates people’s active social participation.3 The theoretical models (approaches) that have the greatest influence in support of social inclusion programmes include:

  • The Ecosystem Model. +
  • The Biopsychosocial Model applied to social inclusion programmes. +



1 Subirats J, Gomà R, Brugué J. (2005). Análisis de los factores de exclusión social. Madrid: Fundación BBVA e Instituto de Estudios Económicos de la Generalitat de Cataluña.

2 Tomas B. (2001). Möglichkeiten und Grenzen sozialer Integration von SuchtmittelkonsumentInnen –Erfahrungen aus der Praxis. Tagungsband der Enquete Wirkungskreise – Was wirkt in der ambulanten Suchttherapie? Was braucht ambulante Suchttherapie um zu wirken? Viena: Verein Dialog : 56–64.

3 Sánchez L. (1992). Los límites de la intervención social. Revista Intervención Psicosocial, 2: 73-82.