title: Role of self-help processes in achieving abstinence among dually diagnosed persons.
abstract: The effectiveness of participation in dual-focus groups (i.e., focusing on both mental health and substance use) has not been studied empirically. The study examined whether three hypothesized active ingredients of self-help (helper-therapy, reciprocal-learning, and emotional-support processes) are associated with drug/alcohol abstinence outcomes for members of a 12-step dual-focus fellowship, Double Trouble in Recovery (DTR). The study was able to control for member attitudes and behaviors at baseline, which might be related to both self-help processes and outcomes, i.e., extent of participation in DTR and traditional 12-step groups, prior drug/alcohol use, severity of psychiatric symptoms, motivation for change, stressful life events, perceived coping, self-efficacy for recovery, and social support. Members of 24 DTR groups in New York City were recruited, interviewed, and reinterviewed after 1 year. Drug/alcohol abstinence in the past year increased from 54% at baseline to 72% at follow-up. Helper-therapy and reciprocal-learning activities were associated with better abstinence outcomes, independent of other attitudes and behaviors of the members. However, emotional support was not related to outcome. We conclude that specific elements of self-help participation contribute substantially to progress in recovery for members of dual-focus groups; facilitating such self-help processes should be encouraged by clinicians and senior fellowship members.
authors.affiliation: Institute for Treatment and Services Research, National Development and Research Institutes, Inc., 71 West 23rd St., 8th flr., New York, NY 10010, USA. smaugra@aol.com
authors.forename: Stephen
authors.initials: S
authors.lastname: Magura
authors.forename: Alexandre B
authors.initials: AB
authors.lastname: Laudet
authors.forename: Daneyal
authors.initials: D
authors.lastname: Mahmood
authors.forename: Andrew
authors.initials: A
authors.lastname: Rosenblum
authors.forename: Howard S
authors.initials: HS
authors.lastname: Vogel
authors.forename: Edward L
authors.initials: EL
authors.lastname: Knight
mesh_terms: D000328:Adult; D017831:Diagnosis, Dual (Psychiatry); D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000523:psychology / Q000534:rehabilitation*; D008875:Middle Aged; D011446:Prospective Studies; D011615:Psychotherapy, Group; D012044:Regression Analysis; D020377:Self Efficacy; D012657:Self-Help Groups; D012944:Social Support; D019966:Substance-Related Disorders / Q000523:psychology / Q000534:rehabilitation*; D016896:Treatment Outcome