Stimulant abuser groups to engage in 12-Step: A multisite trial in the National Institute on Drug Abuse Clinical Trials Network

Abstract

Aims The study evaluated the effectiveness of an 8-week combined group plus individual 12-step facilitative intervention on stimulant drug use and 12-step meeting attendance and service. Design Multisite randomized controlled trial, with assessments at baseline, mid-treatment, end of treatment, and 3- and 6-month post-randomization follow-ups (FU). Setting Intensive outpatient substance treatment programs. Participants Individuals with stimulant use disorders (n = 471) randomly assigned to treatment as usual (TAU) or TAU into which the STAGE-12 intervention was integrated. Measurements Urinalysis and self-reports of substance use and 12-step attendance and activities. Intervention Group sessions focused on increasing acceptance of 12-step principles; individual sessions incorporated an intensive referral procedure connecting participants to 12-step volunteers. Findings Compared to TAU, STAGE-12 participants had significantly greater odds of self-reported stimulant abstinence during the active 8-week treatment phase; however, among those who had not achieved abstinence during this period, STAGE-12 participants had more days of use. STAGE-12 participants had lower ASI Drug Composite scores at and a significant reduction from baseline to the 3-month FU, attended 12-step meetings on a greater number of days during the early phase of active treatment, engaged in more other types of 12-step activities throughout the active treatment phase and the entire FU period, and had more days of self-reported service at meetings from mid-treatment through the 6-month FU. Conclusions The present findings are mixed with respect to the impact of integrating the STAGE-12 intervention into intensive outpatient drug treatment compared to TAU on stimulant drug use. However, the results more clearly indicate that individuals in STAGE-12 had higher rates of 12-step meeting attendance and were engaged in more related activities throughout both the active treatment phase and the entire 6-month follow-up period than did those in TAU.

Religious coping in patients with severe substance use disorders receiving acute inpatient detoxification

“…The Brief Addiction Monitor has demonstrated good test-retest reliability and strong predictive validity. 24 A brief 8-item self-help questionnaire, a modification of a questionnaire used in previous studies by our group 23,25 and others 26 was used to assess mutual-help group attendance and other mutual-help activities (e.g., speaking at meetings, meeting with sponsor, reading 12-step literature) in the past year.…”

The relationship of therapeutic alliance and treatment delivery fidelity with treatment retention in a multisite trial of twelve-step facilitation.

“…This study examined associations of therapeutic alliance and treatment delivery fidelity with treatment retention in Stimulant Abusers to Engage in Twelve-Step (STAGE-12; Donovan et al, 2013), a community-based trial of 12-Step Facilitation (TSF) conducted within the National Drug Abuse Treatment Clinical Trials Network (CTN).…”

“…Stimulant Abusers to Engage in Twelve Step (STAGE-12), the parent study for the current analysis, examined the efficacy/effectiveness of TSF for stimulant abusers conducted in community treatment programs (Donovan et al, 2013). The study trained outpatient counselors in 10 treatment centers to deliver a group-plus-individual TSF treatment that was integrated into treatment as usual (TAU) and compared to a TAU-only condition.…”

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Objective This study examined associations of therapeutic alliance and treatment delivery fidelity with treatment retention in Stimulant Abusers to Engage in Twelve-Step (STAGE-12; Donovan et al, 2013), a community-based trial of 12-Step Facilitation (TSF) conducted within the National Drug Abuse Treatment Clinical Trials Network (CTN).

Method The STAGE-12 trial randomized 234 stimulant abusers enrolled in 10 outpatient drug treatment programs to an 8-session, group and individual TSF intervention. During the study, TSF participants rated therapeutic alliance using the Helping Alliance questionnaire-II.

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Decision-making processes as predictors of relapse and subsequent use in stimulant-dependent patients

“…The STAGE-12 trial was designed to evaluate the efficacy of a modified 12-Step facilitation intervention integrated into intensive outpatient treatment, relative to substance abuse intensive outpatient treatment as usual without the integrated 12-step facilitation intervention, in improving outcomes in stimulant-dependent individuals (24). Following the 8-week Stage-12 or Treatment-as-Usual (TAU) intervention, participants were further assessed at three and six months post-randomization.…”