Twelve Step Facilitation as Behavioural Approach in Addiction Treatment

Abstract

Hazardous and harmful alcohol use, illicit drug use, and the misuse of prescription medications represent major public health concerns that affect a large segment of the population. These highly prevalent conditions are associated with medical, social, and psychiatric comorbidities that bring them to the attention of practitioners in a variety of health-care and social service settings. While many such individuals will benefit from brief interventions or more formal specialty substance abuse treatment, many also might choose to engage in a mutual support program to seek assistance or gain additional support in their communities to help them achieve and maintain their goal of reducing or discontinuing their substance use. The present chapter reviews 12-step mutual support programs that serve as widely available, no-cost resources in substance abuse recovery. It reviews evidence about the effectiveness of such support groups and of specific interventions designed to facilitate engagement in them. It also describes the physician�_Ts role in educating patients and families in promoting 12-step programs. Important steps for physicians include understanding 12-step mutual support programs, preparing patients or family members to engage in a mutual support program, monitoring attendance and engagement, exploring patient resistances to mutual support programs, knowing the components and �_otools�__ of the program, and being aware of alternatives for patients who will not use 12-step programs