The role of twelve-step approaches in dual diagnosis treatment and recovery.
The authors reviewed the empirical literature concerning the use of twelve-step programs and treatments by patients with co-occurring substance use disorders and other psychiatric disorders. Strong evidence was found that dually diagnosed individuals (DDI), with the possible exception of those with psychotic disorders, attend twelve-step programs at rates comparable to non-DDI. Twelve-step involvement is consistently associated with improved substance use outcomes. Although there have been numerous clinical trials involving twelve step-oriented interventions for DDI, most of the studies suffered from substantial methodological limitations. More work is needed to determine what kinds of twelve-step treatments and programs are effective for various types of patients and elucidate the mechanisms by which these approaches facilitate recovery.
Bogenschutz
Michael P
MP
Department of Psychiatry, University of New Mexico School of Medicine, Albuquerque, New Mexico 87131, USA. mbogenschutz@salud.unm.edu.
Geppert
Cynthia M A
CM
George
Jennifer
J
D000328:Adult; D000436:Alcoholics Anonymous; D002986:Clinical Trials as Topic; D015897:Comorbidity; D017831:Diagnosis, Dual (Psychiatry); D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000534:rehabilitation*; D010043:Outcome and Process Assessment, Health Care / Q000706:statistics & numerical data; D010352:Patient Dropouts / Q000706:statistics & numerical data; D012657:Self-Help Groups / Q000706:statistics & numerical data*; D013223:Statistics as Topic; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000534:rehabilitation*; D014600:Utilization Review