Social Support Mediates the Effects of Dual‐Focus Mutual Aid Groups on Abstinence from Substance Use

Laudet, Alexandre B.; Cleland, Charles M.; Magura, Stephen; Vogel, Howard S.; Knight, Edward L.

doi:10.1007/s10464-004-7413-5

Cited by 76 publications

(75 citation statements)

References 55 publications

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“…The reasons for the inconsistency between our fi ndings and predictions based on 12-step ideology are not clear. It is clear that 12-step programs' social networks encourage complete abstinence, which is an important factor in previous attempts to explain 12-step program-related benefi t (Bond et al, 2003;Kaskutas et al, 2002;Laudet et al, 2004). We think it is unlikely that the use of alcohol or illicit drugs breaches the social contract between a 12-step program member and the 12-step program social network, at least initially.…”

Section: Discussionmentioning

confidence: 99%

Twelve-Step Program Attendance and Polysubstance Use: Interplay of Alcohol and Illicit Drug Use

Tonigan

Beatty²

2011

J. Stud. Alcohol Drugs

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ABSTRACT. Objective:The primary aim of this study was to advance understanding of the effi cacy of 12-step programs by determining the temporal relationships between alcohol and illicit drug use among 12-step program affi liates. Method: A total of 253 early 12-step affi liates without extensive histories of Alcoholics Anonymous (AA) attendance were recruited from substance use treatment and community-based AA. A majority of the sample met criteria for a diagnosis of alcohol dependence, reported lifetime use of illicit drugs, and reported illicit drug use in the 90-day period before recruitment. After informed consent, participants were interviewed at intake and in 3-month increments for 1 year. Results: Preliminary analyses indicated that 12-step attendance was predictive of reductions in substance use and that such reductions were not moderated by illicit substance use disorder diagnosis or alcohol problem severity. Lagged hierarchical linear models indicated that illicit drug use was a robust predictor of later use of alcohol, although the frequency and intensity of drinking were contingent on whether participants sustained 12-step program affi liation. Alcohol use did not predict later illicit drug use among participants who sustained 12-step program participation. Conclusions: Findings suggest that 12-step participation may serve as a protective factor after substance use occurs. Although our results suggest that the initiation of illicit drug use may undermine efforts to achieve and sustain abstinence from alcohol, our fi ndings do not suggest that alcohol use necessarily mobilizes relapse across different substances among 12-step program affi liates. (J. Stud. Alcohol Drugs, 72, 864-871, 2011)

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Section: Discussionmentioning

confidence: 99%

Twelve-Step Program Attendance and Polysubstance Use: Interplay of Alcohol and Illicit Drug Use

Tonigan

Beatty²

2011

J. Stud. Alcohol Drugs

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“…The support of peers is a key element facilitating recovery from mental illness (19), and high level of social support has been associated with decreased substance use among persons participating in DTR (48). DTR is structured to create an accepting, non-judgmental environment where persons with active addictions and psychiatric diagnoses can identify with other members and explore their dual recovery needs (42).…”

Section: Discussionmentioning

confidence: 99%

Dual-Focus Mutual Aid for Co-Occurring Disorders: A Quasi-Experimental Outcome Evaluation Study

Magura

Rosenblum

Villano

et al. 2008

The American Journal of Drug and Alcohol Abuse

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Previous observational research has indicated the effectiveness of a 12-step, dual-focus mutual aid group, Double Trouble in Recovery (DTR), for assisting individuals to recover from co-occurring substance use and psychiatric disorders. The current study extends this line of research by evaluating DTR with a quasi-experimental design; controlled designs are rare in studies of mutual aid. Patient outcomes in the same psychiatric day treatment program were compared for two consecutive admission cohorts characterized by high rates of co-occurring disorders. The first cohort did not have DTR available while the second cohort was exposed to DTR after it was established at the program. Both cohorts were assessed at program admission and at a six month follow-up. Using intent to treat analysis, the Post-DTR cohort as compared with the Pre-DTR cohort had significantly fewer days of alcohol and drug use, more frequent traditional 12-step groups outside of the program and higher psychiatric medication adherence. There were no differences in psychiatric symptoms or program retention, however. This study helps demonstrate the benefits of introducing 12-step, dual-focus mutual aid into psychiatric treatment programs that serve patients with co-occurring disorders.

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“…Higher social support at the one year follow-up had a unique association with lower on substance use during the second year and partially mediated the effect of DTR attendance on substance use. The mediation effect seemed to be attributable to the maintenance of high social support for those with greater DTR attendance over time (Laudet, 2004b).…”

Section: Social Support In Relation To Outcomes For Dtrmentioning

confidence: 94%

Effectiveness of Dual Focus Mutual Aid for Co-Occurring Substance Use and Mental Health Disorders: A Review and Synthesis of the “Double Trouble” in Recovery Evaluation

Magura

2008

Substance Use & Misuse

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Over five million adults in the U.S. have a co-occurring substance use disorder and serious psychological distress. Mutual aid ("self-help") can usefully complement treatment, but people with co-occurring substance use and psychiatric 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 recovering from cooccurring disorders. An evaluation of DTR was conducted by interviewing 310 persons attending 24 DTR meetings in New York City in 1998 and following them up for two years, in 1999 and 2000. The evaluation produced 13 articles in 12 peer reviewed journals, the main results of which are summarized here. The sample's characteristics were: mean age, 40 years; women, 28%; black, 59%; white, 25%; Hispanic, 14%; never married, 63%; live in supported community residence, 53%; high school graduate or GED, 60%; arrested as adult, 63%; diagnoses of: schizophrenia, 39%; major depression, 21%; or bipolar disorder; 20%; currently prescribed psychiatric medication, 92%; primary substance used, current or past: cocaine/crack, 42%; alcohol 34%; or heroin, 11%. Overall, the findings indicate that DTR participation has both direct and indirect effects on several important components of recovery: drug/alcohol abstinence, psychiatric medication adherence, self-efficacy for recovery, and quality of life. The study also identified several "common" therapeutic factors (e.g., internal motivation, social support) and unique mutual aid processes (helper-therapy, reciprocal learning) that mediate the influence of DTR participation on recovery. For clinicians, these results underline the importance of fostering stable affiliation with specialized dual focus 12-step groups for their patients with co-occurring disorders, as part of a comprehensive recovery-oriented treatment approach.

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Social Support Mediates the Effects of Dual‐Focus Mutual Aid Groups on Abstinence from Substance Use

Abstract: Background-Specialized 12-step based groups have emerged to address the needs of persons recovering from both substance abuse and psychiatric illness.

Cited by 76 publications

References 55 publications

Twelve-Step Program Attendance and Polysubstance Use: Interplay of Alcohol and Illicit Drug Use

Twelve-Step Program Attendance and Polysubstance Use: Interplay of Alcohol and Illicit Drug Use

Dual-Focus Mutual Aid for Co-Occurring Disorders: A Quasi-Experimental Outcome Evaluation Study

Effectiveness of Dual Focus Mutual Aid for Co-Occurring Substance Use and Mental Health Disorders: A Review and Synthesis of the “Double Trouble” in Recovery Evaluation

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