title: Alcohol and drug treatment involvement, 12-step attendance and abstinence: 9-year cross-lagged analysis of adults in an integrated health plan.
abstract: This study explored causal relationships between post-treatment 12-step attendance and abstinence at multiple data waves and examined indirect paths leading from treatment initiation to abstinence 9-years later. Adults (N = 1945) seeking help for alcohol or drug use disorders from integrated healthcare organization outpatient treatment programs were followed at 1-, 5-, 7- and 9-years. Path modeling with cross-lagged partial regression coefficients was used to test causal relationships. Cross-lagged paths indicated greater 12-step attendance during years 1 and 5 and were casually related to past-30-day abstinence at years 5 and 7 respectfully, suggesting 12-step attendance leads to abstinence (but not vice versa) well into the post-treatment period. Some gender differences were found in these relationships. Three significant time-lagged, indirect paths emerged linking treatment duration to year-9 abstinence. Conclusions are discussed in the context of other studies using longitudinal designs. For outpatient clients, results reinforce the value of lengthier treatment duration and 12-step attendance in year 1.
authors.affiliation: Alcohol Research Group, 6475 Christie Avenue, Suite 400, Emeryville, CA 94608-1010, USA. Electronic address: jwitbrodt@arg.org.
authors.forename: Jane
authors.initials: J
authors.lastname: Witbrodt
authors.affiliation: Alcohol Research Group, 6475 Christie Avenue, Suite 400, Emeryville, CA 94608-1010, USA. Electronic address: jbond@arg.org.
authors.forename: Yu
authors.initials: Y
authors.lastname: Ye
authors.affiliation: Alcohol Research Group, 6475 Christie Avenue, Suite 400, Emeryville, CA 94608-1010, USA.
authors.forename: Jason
authors.initials: J
authors.lastname: Bond
authors.affiliation: Kaiser Permanente Division of Research, 2000 Broadway, 3rd floor, Oakland, CA 94612, USA.
authors.forename: Felicia
authors.initials: F
authors.lastname: Chi
authors.affiliation: Kaiser Permanente Division of Research, 2000 Broadway, 3rd floor, Oakland, CA 94612, USA; Department of Psychiatry, University of California, San Francisco, 401 Parnassus Ave, Box F-0984, San Francisco, CA 94143, USA.
authors.forename: Constance
authors.initials: C
authors.lastname: Weisner
authors.affiliation: Kaiser Permanente Division of Research, 2000 Broadway, 3rd floor, Oakland, CA 94612, USA.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Mertens
mesh_terms: D000328:Adult; D000437:Alcoholism / Q000534:rehabilitation*; D000553:Ambulatory Care / Q000458:organization & administration*; D019033:Delivery of Health Care, Integrated / Q000458:organization & administration; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance / Q000706:statistics & numerical data; D012657:Self-Help Groups; D019966:Substance-Related Disorders / Q000534:rehabilitation*; D013997:Time Factors; D016896:Treatment Outcome
keywords: 12-Step attendance; Alcohol and drug treatment; Longitudinal data; Managed care; Path model