Chapter 36. Outcome Research on 12-Step and Other Self-Help Programs

Rudolf H. Moos, Ph.D.; Christine Timko, Ph.D.
DOI: 10.1176/appi.books.9781585623440.354949



Twelve-step self-help groups (SHGs), often called mutual help or support groups, are an important component of the system of informal care for patients with substance use disorders (SUDs). Individuals make more visits to SHGs for help with their own or family members' substance use and psychiatric problems than to all mental health professionals combined. As many as 9% of adults in the United States have been to an Alcoholics Anonymous (AA) meeting at some time in their lives, and more than 3% have been to a meeting in the prior year (Room and Greenfield 1993). Moreover, many SUD treatment service providers have adopted 12-step techniques in treatment, and most of them refer patients to SHGs.

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Table Reference Number

Sustained attendance at self-help groups (SHGs) is associated with a higher likelihood of abstinence and better substance use outcomes.

Involvement in SHGs may accrue benefits over and above those of attendance itself.

Delay in participation and dropout from SHGs foreshadows poorer substance use outcomes.

Participation in SHGs can substitute for, bolster, and help to explain the benefits of treatment; it can also reduce health care utilization and costs.

Less religious individuals appear to benefit from SHGs as much as do individuals who are more religious.

Individuals who are court mandated to participate in SHGs benefit as much from them as do nonmandated patients.

Women and older adults engage in and benefit from SHGs as much as or more than men and younger adults do.

SHGs contribute to better substance use outcomes by providing support, goal direction, and structure; exposure to abstinent role models; reward for substance-free activities; and a focus for building self-confidence and coping skills.


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CME Activity

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Sample questions:
Which of the following statements summarizes findings from the National Institute on Drug Abuse Collaborative Cocaine Treatment study?
Which of the following characterizes individuals who are likely to affiliate with self-help groups (SHGs) and more likely to continue self-help group attendance?
Many patients with substance use disorders also have co-occurring psychiatric disorders. Which of the following characterizes these dually diagnosed patients?
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).
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