Helping other Alcoholics and Relapse

The specific mechanisms of Alcoholics Anonymous (AA) that mobilize and sustain behavior change are poorly understood.

This study examined the relationship between helping other alcoholics in AA and relapse in the year following treatment for alcohol use disorders. Data were derived from a longitudinal investigation of the efficacy of three behavioral treatments for alcohol abuse and dependence (Project MATCH). Probabilities of time to alcohol relapse were calculated using Kaplan-Meier survival estimates. Proportional hazards regressions, with control for number of AA meetings attended, were conducted to determine whether the likelihood of relapse was lower for those who were helping other alcoholics.

those who were helping other alcoholics . . . were significantly less likely to relapse in the year following treatment

Age was the only demographic characteristic that distinguished participants involved in helping other alcoholics; those who were helping other alcoholics were, on average, 3 years older than those who were not helping alcoholics and were significantly less likely to relapse in the year following treatment, independent of the number of AA meetings attended.

Thus recovering alcoholics who help other alcoholics (mutual-help) maintain long-term sobriety after formal treatment are better able to maintain their own sobriety.

The authors conclude that clinicians who treat substance abuse disorders should encourage their clients to help other recovering alcoholics to stay sober.

Research report; Pagano ME, Friend KB, Tonigan JS, and Stout RL. Helping other alcoholics in alcoholics anonymous and drinking outcomes: Findings from Project MATCH. Journal of Studies on Alcohol 65(6):766-773, November 2004.

ACOA Mutual help groups, perceived status benefits, and well-being: A test with adult children of alcoholics with personal substance abuse problems.

A field experiment was conducted to examine the potential effects of mutual help group participation on perceived status benefits, depression, and substance use among 82 adult children of alcoholics (ACOA’s; aged 22-60 yrs) with personal substance abuse problems.

Participants were randomly assigned to attend either ACOA-specific mutual help group meetings or substance abuse education classes during the initial month that they were enrolled in a residential treatment program for low-income substance abusers.

Analyses were based on assessments made at baseline, a 1-month posttest, and a 6-month follow-up.

Results indicate that participation in the mutual help group promoted perceived status benefits, which in turn led to reductions in depression and substance use.

These findings have clear implications for consumers of ACOA groups and can inform research on the social psychological underpinnings of different types of mutual help groups.

Kingree, J. B; Thompson, Martie. Mutual help groups, perceived status benefits, and well-being: A test with adult children of alcoholics with personal substance abuse problems. American Journal of Community Psychology. Vol 28(3), Jun 2000, 325-342.

The Complete ACOA Sourcebook: Adult Children of Alcoholics at Home, at Work and in Love by Janet Woititz Read more about this title…

Social support networks have been identified as one factor that can help people resolve their problem drinking.

A relatively new phenomenon is online support groups, such as the one provided on the Alcohol Help Center (AHC; http://www.alcoholhelpcenter.net).

Preliminary use of the AHC support group will be summarized and lessons learned in the initial development of an online support group will be discussed.

METHODS: The AHC support group can be viewed by anyone interested in its content. However, only registered users of the AHC can make postings and trained professional staff moderates all support group content.

The amount and content of traffic on this support group were recorded. Qualitative analyses were conducted to identify the types of message content.

RESULTS: There were 674 posts on the AHC during the first 10 months of operation, including those made by the professional moderators.

Content analyses of these postings identified common themes, including;

• introductions,
• greetings,
• general supportive statements,
• suggested strategies,
• success stories, and
• discussion of difficulties.

In addition, it appeared that the amount of traffic on the support group varied over time and clustered around nodes that consisted of one or more active users.

This variation in traffic may disappear over time as overall use of the AHC support group increases.

CONCLUSIONS: Online support groups are developing into a new venue of support for those with drinking problems and other addictions concerns.

PRACTICE IMPLICATIONS: Consider referring clients to an online, professionally moderated, support group as another means to help problem drinkers.

Research; Patient Educ Couns. 2008 Feb;70(2):193-8. Epub 2007 Nov 19. An online support group for problem drinkers: AlcoholHelpCenter.net. Cunningham JA, van Mierlo T, Fournier R.

See also;

• A Problem Shared is a Problem Halved
• Brief-TSF professional training is complimentary to online help.
• Subscribe to BriefTSF by e-Mail

Relapse Prevention Counseling Workbook: Managing High-Risk Situations by Terence T. Gorski Read more about this title…

Role of Self Help Programs in Brief-TSF

Participation in self-help groups is central to Brief-TSF and is regarded as the primary agent of change.

Specific objectives within Brief-TSF include attending regular AA meetings, getting and using members’ phone numbers, getting a peer sponsor, and assuming responsibilities within a meeting.

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Mutual-aid support groups play a vital role in substance abuse treatment.

In 2005, a national survey of participants in mutual-aid support groups for addiction was conducted to identify key differences between participants in various recovery groups. Extensive data was collected from survey respondents on many aspects of recovery.

In their recently published article, researchers focus on the impact of survey respondents’ level of spirituality on their recovery and their participation in mutual-aid support groups.

Key findings include:

• Active involvement in groups significantly improves the chances of remaining clean and sober, regardless of the group (Save Our Souls, SMART, Women For Sobriety, and 12-step such as Alcoholics Anonymous) in which one participates.
• Respondents whose individual beliefs better matched those of their primary support groups showed greater levels of group participation, resulting in better outcomes as measured by increased number of days clean and sober.
• Spiritual respondents were more likely to actively participate in 12-Step groups and WFS, both of which have spiritual components in their programs.
• Non-religious respondents were significantly less likely to participate in 12-Step groups.
• Respondents with low levels of spirituality were more likely to actively participate in groups with secular programs, such as SOS and SMART Recovery.

This study provides more evidence that in recovery “one size does not fit all.” These results have important implications for treatment planning and implementation, indicating that matching clients to appropriate support groups according to their individual beliefs can have a positive impact on their program involvement and, ultimately, on their treatment outcomes.

When participants in recovery groups feel more comfortable with the philosophies of the groups they attend, they are more likely to become actively involved in these groups, which often results in longer periods of remaining abstinent from the use of alcohol and other drugs.

This research was funded by a grant from the National Institute on Drug Abuse. The survey was conducted with the assistance of The Center for Survey Research at the University of Virginia, Secular Organizations for Sobriety (SOS), SMART Recovery, and Women for Sobriety (WFS).

Reference: Atkins, R.G., Hawdon, J.E. (2007) Religiosity and participation in mutual-aid support groups for addiction. Journal of Substance Abuse Treatment, 33(3): 321-331.

The Spirituality of Imperfection: Storytelling and the Search for Meaning by Ernest Kurtz, Katherine Ketcham Read more about this title…

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Helping other alcoholics in Alcoholics Anonymous and drinking outcomes: findings from project MATCH.

OBJECTIVE: Although Alcoholics Anonymous (AA) is the largest mutual-help organization for alcoholics in the world, its specific mechanisms that mobilize and sustain behavior change are poorly understood. The purpose of this study is to examine prospectively the relationship between helping other alcoholics and relapse in the year following treatment for alcohol use disorders.

METHOD: Data were derived from Project MATCH, a longitudinal prospective investigation of the efficacy of three behavioral treatments for alcohol abuse and dependence. Kaplan-Meier survival estimates were used to calculate probabilities of time to alcohol relapse. To identify the unique value of helping other alcoholics when controlling for the number of AA meetings attended, proportional hazards regressions were conducted to determine whether the likelihood of relapse was lower for those who were helping other alcoholics.

RESULTS: There were no demographic differences that distinguished participants in regard to involvement in helping other alcoholics, with the exception of age; those who were helping other alcoholics were, on average, 3 years older than those who were not helping alcoholics.

Those who were helping were significantly less likely to relapse in the year following treatment, independent of the number of AA meetings attended.

CONCLUSIONS: These findings provide compelling evidence that recovering alcoholics who help other alcoholics maintain long-term sobriety following formal treatment are themselves better able to maintain their own sobriety. Clinicians who treat persons with substance abuse disorders should encourage their clients to help other recovering alcoholics to stay sober.

Research; Pagano ME, Friend KB, Tonigan JS, Stout RL. Helping other alcoholics in alcoholics anonymous and drinking outcomes: findings from project MATCH. J Stud Alcohol. 2004 Nov;65(6):766-73.

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Religiosity and participation in mutual-aid support groups for addiction

Mutual-aid support groups, such as the 12-Step fellowship Alcoholics Anonymous play a vital role in substance abuse treatment in the United States.  In 2005, The Walsh Group conducted a national survey of participants in mutual-aid support groups for addiction to identify key differences between participants in various recovery groups.  The survey was conducted with the assistance of The Center for Survey Research at the University of Virginia, Secular Organizations for Sobriety (SOS), SMART Recovery, and Women for Sobriety (WFS).  Extensive data was collected from survey respondents on many aspects of recovery.  This paper focuses on the impact of survey respondents’ level of religiosity on their recovery and their participation in mutual-aid support groups.

Key findings from the survey on mutual-aid support groups discussed in this paper include:

• Active involvement in groups significantly improves the chances of remaining clean and sober, regardless of the group (SOS, SMART, WFS, 12-step) in which one participates.
• Respondents whose individual beliefs better matched those of their primary support groups showed greater levels of group participation, resulting in better outcomes as measured by increased number of days clean and sober.
• Religious respondents were more likely to actively participate in 12-Step groups and WFS, both of which have spiritual components in their programs.
• Non-religious respondents were significantly less likely to participate in 12-Step groups. 
• Respondents with low levels of religiosity were more likely to actively participate in groups with secular programs, such as SOS and SMART Recovery.  

These results have important implications for treatment planning and implementation, indicating that matching clients to appropriate support groups according to their individual beliefs can have a positive impact on their program involvement and, ultimately, on their treatment outcomes.  When participants in recovery groups feel more comfortable with the philosophies of the groups they attend, they are more likely to become actively involved in these groups, which often results in longer periods of remaining abstinent from the use of alcohol and other drugs.

Research; Randolph G. Atkins, Jr, and James E. Hawdon. Religiosity and participation in mutual-aid support groups for addiction. Journal of Substance Abuse Treatment, Volume 33, Issue 3, October 2007, Pages 321-331

Alcoholics Anonymous: The Story of How Many Thousands of Men and Women Have Recovered from Alcoholism by AA Services Read more about this title…

Review of the book ’Alcoholics Anonymous’

From; The NEW ENGLAND JOURNAL OF MEDICINE, Vol. 221(15), October 12, 1939

ALCOHOLICS ANONYMOUS: The story of how more than one hundred men have recovered from alcoholism. 400 pp. New York Works Publishing Co., 1939, $3.50.

The psychological aspect of alcoholism taxes the entire skill and intuition of the therapist, and the authors of this book claim that in the long run the ex-alcoholic patient who is properly trained in psychological method is an extremely effective person to bring about the cure of the neurotic alcoholic individual.

The first part of the book discusses methods, with particular stress on twelve steps in the recovery program. This program includes the general principles of psychotherapy found in such books as those by Durfee and Peabody. There is, however, an essentially new note, namely, that the alcoholic individual should be helped to admit to God, to himself and to another human being (preferably an ex-alcoholic patient) the exact nature of his personality deficit Some will perhaps shy from the emphasis on God and religion until it is realized that the alcoholic patient is asked in this relation to believe sincerely in a power greater than himself. He then sees that his life is really unmanageable without this power.

The second part contains the stories of twenty-nine individuals who were cured by the method of working out their character problems in relation to God, themselves and another human being. All these individuals were "convinced by an ex-alcoholic therapist" Those who at some time must deal with the problem of alcoholism are urged to read this stimulating account

The authors have presented their case well, in fact, in such good style that it may be of considerable influence when read by alcoholic patients.

Bloggers note; Its now sold over 25 million copies and has helped over 100 million people recover from alcoholism and about 500 other maladies - not just alcoholism.

High effectiveness of self-help programs after drug addiction therapy in Norway

BACKGROUND: The self-help groups Alcoholics Anonymous (AA) and Narcotics Anonymous (NA) are very well established.

AA and NA employ a 12-step program and are found in all communities around the world.

Although many have argued that these organizations are valuable, substantial scepticism remains as to whether they are actually effective.

Few treatment facilities give clear recommendations to facilitate participation, and the use of these groups has been disputed.

The purpose of this study was to examine whether the use of self-help groups after addiction treatment is associated with higher rates of abstinence.

METHODS: One hundred and fourteen patients, 59 with alcohol dependency and 55 with multiple drug dependency, who started in self-help groups after addiction treatment, were examined two years later using a questionnaire. Return rate was 66%. Six (5%) of the patients were dead.

RESULTS: Intention-to-treat-analysis showed that 38% still participated in self-help programs two years after treatment.

Among the regular participants, 81% had been abstinent over the previous 6 months, compared with only 26% of the non-participants.

Logistic regression analysis showed OR = 12.6, 95% CI (4.1-38.3), p < 0.001, for participation and abstinence.

CONCLUSION: The study has several methodological problems; in particular, correlation does not necessarily indicate causality. These problems are discussed and

we conclude that the probability of a positive effect is sufficient to recommend participation in self-help groups as a supplement to drug addiction treatment.

Vederhus JK, Kristensen Ø. High effectiveness of self-help programs after drug addiction therapy in Norway. BMC Psychiatry. 2006 Aug 23;6:35.