The effects of continuing care on emerging adult outcomes following residential addiction treatment

Abstract

Background Professional continuing care services enhance recovery rates among adults and adolescents, though less is known about emerging adults (18-25 years old). Despite benefit shown from emerging adults’ participation in 12-step mutual-help organizations (MHOs), it is unclear whether participation offers benefit independent of professional continuing care services. Greater knowledge in this area would inform clinical referral and linkage efforts. Methods Emerging adults (N = 284; 74% male; 95% Caucasian) were assessed during the year after residential treatment on outpatient sessions per week, percent days in residential treatment and residing in a sober living environment, SUD medication use, active 12-step MHO involvement (e.g., having a sponsor, completing step work, contact with members outside meetings), and continuous abstinence (dichotomized yes/no). One generalized estimating equation (GEE) model tested the unique effect of each professional service on abstinence, and, in a separate GEE model, the unique effect of 12-step MHO involvement on abstinence over and above professional services, independent of individual covariates. Results Apart from SUD medication, all professional continuing care services were significantly associated with abstinence over and above individual factors. In the more comprehensive model, relative to zero 12-step MHO activities, odds of abstinence were 1.3 times greater if patients were involved in one activity, and 3.2 times greater if involved in five activities (lowest mean number of activities in the sample across all follow-ups). Conclusions Both active involvement in 12-step MHOs and recovery-supportive, professional services that link patients with these community-based resources may enhance outcomes for emerging adults after residential treatment.

Testing a Matching Hypothesis for Emerging Adults in Project MATCH: During-Treatment and One-Year Outcomes

“…Taken together with other studies focused on 12-step mutual-help participation among emerging adults (Bergman et al, 2015;Hoeppner et al, 2014;Labbe et al, 2013), the current study suggests that a more developmentally sensitive approach may be needed to bolster emerging adults' initial response to TSF. This might include deployment of additional therapeutic strategies (e.g., CBT) and linkage to young person's meetings.…”

Change in psychosocial factors connected to coping after inpatient treatment for substance use disorder: a systematic review

“…Coping, thus, involves responses or actions taken in a given situation, or, coping behaviour [25]. Examples of facilitating psychosocial factors are social support and housing [24, 26–31], employment and education [6, 24, 26–28, 30, 32], treatment completion and commitment to continued care discharge plans [27, 32, 33]. However, these findings are mostly related to recovering from substance abuse after outpatient treatment, inpatient treatment with a duration of less than 3 months (short-term), peer-support or no treatment, while we know less about change in psychosocial factors after inpatient SUD treatment exceeding 3 months (long-term).…”

Psychosocial factors associated with coping behaviour after inpatient treatment for substance use disorder: a systematic review study protocol

“…Much is known about factors associated with coping with abstinence from substance abuse. Examples of such factors are social support and appropriate housing conditions,1–7 meaningful activity (eg, employment or education),1–4 6 8 9 treatment completion and commitment to continued care discharge plans 3 8 10. In the 10th edition of the International Statistical Classification of Diseases and Related Health Problems (ICD-10), substance use disorder (SUD) is described as ‘A cluster of physiological, behavioural, and cognitive phenomena in which the use of a substance or a class of substances takes on a much higher priority for a given individual than other behaviours that once had greater value’ (p. 75) 11…”