Meta-analysis of the literature on Alcoholics Anonymous: sample and study characteristics moderate findings.

Tonigan, J. Scott; Toscova, Radka T.; Miller, William R.

doi:10.15288/jsa.1996.57.65

Cited by 312 publications

(210 citation statements)

References 48 publications

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“…These findings agree with existing evidence suggesting a role for 12-step involvement in recovery (Bond et al, 2003;Emrick et al, 1993;Humphreys et al, 1999;Kaskutas et al, 2002;McIntire, 2000;Tonigan, J.S., 2001;Tonigan, J. Scott et al, 2003;Tonigan, J.S. et al, 1996) and with evidence suggesting stronger relationships between better treatment outcomes and voluntary (vs. coerced) 12-step participation (Brandsma, Maultsby, & Welsh, 1980;Ditman, Crawford, Forgy, Moskowitz, & MacAndrew, 1967;Kownacki & Shadish, 1999;Walsh et al, 1991).…”

Section: Discussionsupporting

confidence: 87%

“…The research also investigates effects for informal peer socialization and supplemental psychiatric, family, medical, and legal services. The forgoing research, together with a substantial evidence base revealing associations between better treatment outcomes and both greater 12-step involvement (Emrick, Tonigan, Montgomery, & Little, 1993;McIntire, 2000;Tonigan, J.S., 2001;Tonigan, J. Scott, Connors, & Miller, 2003;Tonigan, J.S., Toscova, & Miller, 1996;Witbrodt et al, 2006;Zemore & Kaskutas, 2006) and larger social networks of sober friends (Bond, Kaskutas, & Weisner, 2003;Humphreys, Mankowski, Moos, & Finney, 1999;Kaskutas, Bond, & Humphreys, 2002), suggests the following predictions: Hypothesis 1. Higher odds of sobriety at 6 months should be predicted by greater: a.…”

Section: Services Received and Client Outcomesmentioning

confidence: 99%

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Services received and treatment outcomes in day-hospital and residential programs

Zemore

Kaskutas

2008

Journal of Substance Abuse Treatment

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This longitudinal health services study (N=733) 1) examines the impact of services received on 6-month outcomes and 2) compares day hospital to residential programs on services received. Services were measured at 2, 4, and 8 weeks post-baseline using a version of the Treatment Services Review (TSR). Higher odds of total sobriety at 6 months were associated with greater participation in a) extracurricular (but not curricular) 12-step meetings, b) sober recreational events, and c) educational sessions. Program effects also emerged. Unexpectedly, extracurricular 12-step meeting attendance and odds of having a sponsor were lower among residential (vs. day hospital) participants through 4 weeks-despite higher participation in curricular 12-step meetings among residential participants at 2 weeks. Still, residential participants reported higher involvement in sober recreation and informal peer socialization across most analyses. Findings suggest that residential and day hospital programs might maximize outcomes by facilitating optional 12-step involvement and sober recreation, respectively.

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Section: Discussionsupporting

confidence: 87%

Section: Services Received and Client Outcomesmentioning

confidence: 99%

Services received and treatment outcomes in day-hospital and residential programs

Zemore

Kaskutas

2008

Journal of Substance Abuse Treatment

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“…Prior studies have focused on participation in AA as a dichotomous variable and on the amount of participation in relation to short-term outcomes (Emrick, Tonigan, Montgomery, & Little, 1993;Kownacki & Shadish, 1999;Tonigan, Toscova, & Miller, 1996), but there is relatively little prospective information about the duration of initial and subsequent episodes of participation, the effect of duration on long-term psychosocial as well as alcohol-related outcomes, or the extent to which AA has effects on outcomes that are independent of treatment.…”

Section: Introductionmentioning

confidence: 99%

Participation in treatment and Alcoholics Anonymous: A 16‐year follow‐up of initially untreated individuals

Moos¹,

Moos²

2006

J Clin Psychol

214

122

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This study focused on the duration of participation in professional treatment and Alcoholics Anonymous (AA) for previously untreated individuals with alcohol use disorders. These individuals were surveyed at baseline and 1 year, 3 years, 8 years, and 16 years later. Compared with individuals who remained untreated, individuals who obtained 27 weeks or more of treatment in the first year after seeking help had better 16-year alcohol-related outcomes. Similarly, individuals who participated in AA for 27 weeks or more had better 16-year outcomes. Subsequent AA involvement was also associated with better 16-year outcomes, but this was not true of subsequent treatment. Some of the association between treatment and long-term alcohol-related outcomes appears to be due to participation in AA.*

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“…Twelve-step fellowships such as Alcoholics and Narcotics Anonymous are the most frequently used form of aftercare in the United States (Tonigan, Toscova, and Miller, 1996). Twelve-step fellowships are particularly well-suited to provide ongoing recovery support from chronic substance abuse and dependence because, unlike formal services that are limited in time, these groups are widely and consistently available throughout the US and free of charge.…”

Section: Nih-pa Author Manuscriptmentioning

confidence: 99%

“…Most research has been conducted on 12-step fellowships, perhaps because other organizations are more recently established and less geographically widespread. Attendance at 12-step meetings fosters reductions in alcohol and illicit drug use (Fiorentine, 1999;Gossop, Harris, Best, Man, Manning, Marshall, Strang, 2003;Humphreys and Moos, 2001;Moos, Schaefer, Andrassy and Moos, 2001;Morgenstern, Labouvie, McCray, Kahler and Frey, 1997;Morgenstern, Bux, Labouvie, Morgan, Blanchard, and Muench, 2003;Project MATCH Research Group, 1997; for review Tonigan et al, 1996). Among individuals concurrently attending treatment, 12-step meeting attendance produces independent and additive effects on treatment outcomes (Fiorentine and Hillhouse, 2000).…”

Section: Research On 12-step Participationmentioning

confidence: 99%

An Exploration of the Effect of On-Site 12-Step Meetings on Post-Treatment Outcomes among Polysubstance-Dependent Outpatient Clients

Laudet

Stanick²,

Sands

2007

Eval Rev

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Rates of return to active substance use after addiction treatment tend to be high; participation in 12-step fellowships (e.g., Alcoholics Anonymous) reduces relapse rates but many clients do not attend or attend for a short period only. This quasi-experimental study uses repeated measurement to explore the role of presence/absence of onsite 12-step meetings during treatment on post-treatment outcomes. Polysubstance-dependent clients (N = 219) recruited at a program with and one without 12-step onsite, were followed for one year post-treatment. Onsite 12-step enhanced 12-step attendance, especially during treatment, and predicted continuous abstinence for the post treatment year. Holding 12-step meetings onsite is a low-cost strategy that programs should consider to foster post-treatment remission maintenance. Keywords 12-step; treatment; recovery; self-helpSubstance use disorders (SUD) are conceptualized as chronic (e.g., McLellan, Lewis, O'Brien, C., and Kleber, 2000); the chronicity of SUD is empirically supported by findings on addiction and treatment 'career' indicating that most SUD-affected individuals, especially those with severe dependence, make multiple attempts at remission often involving several treatment episodes prior to resolving their alcohol or drug dependence (e.g., Dennis, Scott, Funk, and Foss, 2005;Hser, Anglin, Grella, Longshore and Prendergast, 1997; Laudet, Stanick, Carway, and Sands, 2004). Because of the multiple costs of long chronic addiction 'careers' that include the acquisition/transmission of infectious diseases (e.g., HIV, HepC), deterioration in mental and physical health and other functioning impairments (e.g., Smith and Larson, 2003), it is critical to identify strategies that contribute to sustaining remission, thus shortening addition careers and resulting nefarious effects to the individual and to society. A number of therapeutic modalities have proven effective at addressing drug and alcohol dependence and improving related functioning but treatment gains are often short lived (Hser, Grella, Hsieh and Anglin, 1999). Participation in post-treatment 'stepped down' continuing (or after) care is associated with sustained treatment gains (McKay, Alterman, Cacciola, Rutherford and O'Brien, 1997;Mckay 2001). In the currently austere fiscal context of health services provision, few drug and alcohol treatment programs offer continuing care, NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript especially following outpatient treatment, the most prevalent treatment modality in the US. Twelve-step fellowships such as Alcoholics and Narcotics Anonymous are the most frequently used form of aftercare in the United States (Tonigan, Toscova, and Miller, 1996). Twelve-step fellowships are particularly well-suited to provide ongoing recovery support from chronic substance abuse and dependence because, unlike formal services that are limited in time, these groups are widely and consistently available throughout the US and free of charge. As with treatment, 12-st...

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Meta-analysis of the literature on Alcoholics Anonymous: sample and study characteristics moderate findings.

Cited by 312 publications

References 48 publications

Services received and treatment outcomes in day-hospital and residential programs

Services received and treatment outcomes in day-hospital and residential programs

Participation in treatment and Alcoholics Anonymous: A 16‐year follow‐up of initially untreated individuals

An Exploration of the Effect of On-Site 12-Step Meetings on Post-Treatment Outcomes among Polysubstance-Dependent Outpatient Clients

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