Integrating Addiction Treatment and Mutual Aid Recovery Resources

Abstract

The most widely used source of help for alcohol problems is Alcoholics Anonymous (AA), and much formal treatment has adapted AA's methods and concepts. Usually many people seek help from AA at the recommendation of a treatment professional. Even treatment programs that historically have not been 12-step-oriented, such as Therapeutic Communities, may recommend AA or mutual help alternatives post-treatment. Because evidence shows that individuals are more likely to attend these groups after treatment if they are introduced to them during treatment interventions to facilitate 12-step involvement are needed. Twelve-step facilitation can vary, focusing on introducing clients to the 12-step philosophy, helping them work the intial steps of the program, or helping them connect with the fellowship of individuals they encounter in AA. Randomized trials of 12-step facilitation consistently demonstrate abstinence rates 10% higher (or more) than the usual care conditions at 1-year follow-up, with even stronger results in particular subgroups such as those with prior treatment episodes. Manuals are available that guide counselors through these 12-step facilitation interventions, increasing the likelihood that treatment programs will incorporate evidence-based practices which increase clients' AA involvement during and post-treatment, and reduce relapse. This chapter describes these interventions and summarizes the trial results. Unfortunately, there has been less progress in developing ways to facilitate the utilization of non-12-step alternatives such as Women For Sobriety, Life Ring, or SMART Recovery, which are less widely available yet offer another supportive environment. This is an important area of future research.