Effects of “Dual Focus” Mutual Aid on Self-Efficacy for Recovery and Quality of Life

Abstract

Four million adults in the U.S. have co-occurring serious mental illness and a substance use disorder. Mutual aid can usefully complement treatment, but people with co-occurring disorders often encounter a lack of empathy and acceptance in traditional mutual aid groups. Double Trouble in Recovery (DTR) is a dual focus fellowship whose mission is to bring the benefits of mutual aid to persons with dual diagnoses. Three hundred and ten persons attending 24 DTR groups in New York City during 1998 were interviewed and followed-up for two years. A mediational model was specified and results across time were summarized with generalized estimating equations (GEE). Degree of DTR affiliation (attendance and involvement) was significantly associated with Self-efficacy for Recovery and three quality of life measures: Leisure Time Activities, Feelings of Well-Being and Social Relationships. Self-efficacy fully mediated the effects of DTR Affiliation on Leisure Time and Feelings and partially mediated DTR's effect on Social Relationships. The association of DTR involvement with self-efficacy is consistent with the processes inherent in mutual aid, although the observational nature of these data preclude causal inference. To improve outcomes, clinicians should facilitate affiliation with dual focus groups among persons with dual diagnoses as part of a comprehensive treatment approach.

Integrating Wellness, Recovery, and Self-management for Mental Health Consumers

“…Recovery involves the development of new meaning and purpose in one's life as one grows beyond the catastrophic effects of mental illness.'' Drawing from the principles utilized in addiction recovery, the mental health community recognized that there are multiple outcomes associated with mental health and one could certainly move beyond just stability (Harding et al 1987;Magura et al 2007;Sullivan 1997).…”

Mutual-Help Groups for Dually Diagnosed Individuals: Rationale, Description, and Review of the Evidence

“…As a consequence of this, however, a further potential barrier to AA participation by DDIs is AA members' potential uncertainty and confusion about which psychiatric symptoms lie along a typical developmental course of alcoholism recovery, and, thus, are likely to respond to application of the 12 steps and AA group support and which may require professional intervention. Perhaps for reasons of perceived group unity and cohesion, AA attendees who are overly focused on the topic of mental illness and frequently talk about it at meetings may be viewed as broaching issues that lie outside of the realm of AA's intended purpose and may be implicitly or explicitly discouraged from talking about it by other members (Bogenschutz & Akin, 2000;Magura, Cleland, Vogel, Knight, & Laudet, 2007).…”

“…A single research group has used a prospective, longitudinal design to study participation outcomes in a sample of approximately 300 DTR members in 24 groups in New York City (Laudet et al, 2000a;Laudet et al, 2000b;Laudet, Cleland, Magura, Vogel, & Knight, 2004;Laudet, Magura, Cleland, Vogel, & Knight, 2003;Magura et al, 2007;Magura, Laudet, Mahmood, Rosenblum, & Knight, 2002;.…”

“…A further explanatory study with the same sample of DTR participants examined the effects of DTR affiliation on self-efficacy for recovery and quality of life using a mediational model (Magura et al, 2007). Using sophisticated longitudinal procedures (i.e., Generalized Estimating Equations [GEE]) with age, gender, and psychiatric symptoms as covariates, results showed significant, positive correlations between DTR affiliation and self-efficacy for recovery, and between DTR affiliation and all three quality of life measures: leisure-time activities, feelings of well-being, and social relationships.…”

Consumer Evaluation of Dual Focus Mutual Aid

“…Past research on the effectiveness of DTR among mainly long-term members demonstrated that DTR affiliation was associated with increased abstinence from drugs/alcohol (Laudet et al, 2004), better psychiatric medication adherence (Magura et al, 2002), and improved coping and quality of life (Magura, Cleland, Vogel, Knight, & Laudet, 2007). Specific self-help processes in DTR groups - helping others and mutual learning - were associated with a higher rate of abstinence (Magura et al, 2003).…”