title: End-of-treatment outcomes in cognitive-behavioral treatment and 12-step substance use treatment programs: do they differ and do they predict 1-year outcomes?
abstract: This study examined changes in treatment-related proximal outcomes from intake to follow-up, associations between continuing care and maintenance of proximal outcome gains, correlations between specific proximal outcomes and substance use outcomes, and potential mediators of treatment effects for 12-step versus cognitive-behavioral (CB) substance use disorder (SUD) treatment. The participants were 1,873 male veterans seeking SUD treatment at five CB-oriented and five 12-step-oriented VA inpatient/residential SUD programs. Patterns of change in proximal outcomes were similar across the two program types. After discharge, attendance at 12-step groups, but not outpatient treatment, was associated with greater maintenance on most proximal outcomes. Only a few proximal outcomes at discharge were associated with 1-year substance use; most 1-year proximal outcomes were associated with 1-year substance use. Having a sponsor, reading 12-step materials, attending 12-step meetings, and having an abstinence goal appeared to mediate the greater effects of 12-step programs (relative to CB programs) on abstinence.
authors.affiliation: Center for Health Care Evaluation, Department of Veterans Affairs, Menlo Park, CA 94025, USA. jennifer_johnson@brown.edu
authors.forename: Jennifer E
authors.initials: JE
authors.lastname: Johnson
authors.forename: John W
authors.initials: JW
authors.lastname: Finney
authors.forename: Rudolf H
authors.initials: RH
authors.lastname: Moos
mesh_terms: D000328:Adult; D000437:Alcoholism / Q000534:rehabilitation; D015928:Cognitive Behavioral Therapy; D003627:Data Interpretation, Statistical; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D019966:Substance-Related Disorders / Q000534:rehabilitation*; D013695:Temperance; D016896:Treatment Outcome; D014481:United States; D014493:United States Department of Veterans Affairs