The interplay between help-seeking and alcohol-related outcomes: divergent processes for professional treatment and self-help groups.
This study examined the influence of self-selection, as reflected in alcohol-related functioning, on the duration of professional treatment and Alcoholics Anonymous (AA), and the influence of social causation, as reflected in the duration of treatment and AA, on alcohol-related outcomes. A sample of alcoholic individuals was surveyed at baseline and 1, 3, and 8 years later. At each point, participants completed an inventory that assessed participation in treatment and AA since the last assessment and alcohol-related functioning. There were divergent processes of self-selection and social causation with respect to the duration of participation in professional treatment and AA. Individuals with more severe alcohol-related problems obtained longer episodes of professional treatment, but this self-selection process was much less evident for AA. Longer participation in professional treatment in the first year predicted better alcohol-related outcomes; however, the duration of subsequent treatment was not associated with better subsequent outcomes. In contrast, longer participation in AA consistently predicted better subsequent alcohol-related outcomes. These findings are consistent with a need-based model of professional treatment, in which more treatment is selected by and allocated to individuals with more severe problems, and an egalitarian model of self-help, in which need factors play little or no role in continued participation.
Center for Health Care Evaluation, Department of Veterans Affairs and Stanford University, Palo Alto, CA 94075, USA. bmoos@stanford.edu
Rudolf H
RH
Moos
Bernice S
BS
Moos
D000328:Adult; D000437:Alcoholism / Q000523:psychology / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D012044:Regression Analysis; D012657:Self-Help Groups; D012944:Social Support; D016320:Substance Abuse Treatment Centers / Q000379:methods / Q000706:statistics & numerical data; D016896:Treatment Outcome