Mutual-Help Groups

Rediscovering fire: Small interventions, large effects.

“…Erich Fromm (1956) drew on the concept of agape in his classic treatise, The Art of Loving. Agape bears conceptual resemblance to the critical conditions for change outlined by Rogers (1957, 1959), a parallelism recognized in his dialogue with theologian Paul Tillich (“Paul Tillich and Carl Rogers,” 1966). In his exegesis of client-centered therapy, Rogers (1959) postulated that the therapist is not the author of change in clients so much as a witness to its emergence.…”

“…In a large randomized trial, for example, alcohol-dependent clients who faithfully took a placebo medication were found to show substantially better outcomes relative to less compliant clients (Fuller et al, 1986). The degree of involvement in Alcoholics Anonymous (AA) is correlated with more favorable outcomes (Tonigan & Toscova, 1998). More generally, doing something to get better is a good predictor of change (e.g., Miller, Westerberg, Harris, & Tonigan, 1996), as is the initial level of motivation for change when the definition of motivation includes taking action (e.g., Project MATCH, 1997).…”

The development and evaluation of the Harm Reduction Self-Efficacy Questionnaire.

“…American substance abuse treatment programs for IDUs typically employ either a “12-step” approach emphasizing reliance on a higher power and participation in mutual-help group meetings (Tonigan & Toscova, 1991) and/or a cognitive-behavioral relapse prevention approach that emphasizes using coping skills in high-risk situations, building self-efficacy, reducing positive outcome expectancies for drug consumption, and recognizing the difference between a slip and a relapse (Marlatt & Gordon, 1985; Witkiewitz & Marlatt, 2004). Although abstinence-focused interventions are effective for some people, given the frequency of relapse and the unwillingness of some drug takers to undertake treatment, many clinicians and policy makers are coming to recognize the value of harm reduction as both a treatment goal and set of interventions designed to reduce the unhealthy medical, psychological, and social outcomes of ongoing drug use by those unwilling or unable to abstain (MacCoun, 1998).…”