title: The effects of continuing care on emerging adult outcomes following residential addiction treatment.
abstract: BACKGROUND
  Professional continuing care services enhance recovery rates among adults and adolescents, though less is known about emerging adults (18-25 years old). Despite benefit shown from emerging adults' participation in 12-step mutual-help organizations (MHOs), it is unclear whether participation offers benefit independent of professional continuing care services. Greater knowledge in this area would inform clinical referral and linkage efforts.
  
  
  METHODS
  Emerging adults (N=284; 74% male; 95% Caucasian) were assessed during the year after residential treatment on outpatient sessions per week, percent days in residential treatment and residing in a sober living environment, substance use disorder (SUD) medication use, active 12-step MHO involvement (e.g., having a sponsor, completing step work, contact with members outside meetings), and continuous abstinence (dichotomized yes/no). One generalized estimating equation (GEE) model tested the unique effect of each professional service on abstinence, and, in a separate GEE model, the unique effect of 12-step MHO involvement on abstinence over and above professional services, independent of individual covariates.
  
  
  RESULTS
  Apart from SUD medication, all professional continuing care services were significantly associated with abstinence over and above individual factors. In the more comprehensive model, relative to zero 12-step MHO activities, odds of abstinence were 1.3 times greater if patients were involved in one activity, and 3.2 times greater if involved in five activities (lowest mean number of activities in the sample across all follow-ups).
  
  
  CONCLUSIONS
  Both active involvement in 12-step MHOs and recovery-supportive, professional services that link patients with these community-based resources may enhance outcomes for emerging adults after residential treatment.
authors.affiliation: Massachusetts General Hospital, Boston, MA, United States; Harvard Medical School, Boston, MA, United States. Electronic address: bgbergman@mgh.harvard.edu.
authors.forename: Brandon G
authors.initials: BG
authors.lastname: Bergman
authors.affiliation: Massachusetts General Hospital, Boston, MA, United States; Harvard Medical School, Boston, MA, United States.
authors.forename: Bettina B
authors.initials: BB
authors.lastname: Hoeppner
authors.affiliation: Hazelden Betty Ford Foundation's Butler Center for Research, Center City, MN, United States.
authors.forename: Lindsay M
authors.initials: LM
authors.lastname: Nelson
authors.affiliation: Hazelden Betty Ford Foundation's Butler Center for Research, Center City, MN, United States.
authors.forename: Valerie
authors.initials: V
authors.lastname: Slaymaker
authors.affiliation: Massachusetts General Hospital, Boston, MA, United States; Harvard Medical School, Boston, MA, United States.
authors.forename: John F
authors.initials: JF
authors.lastname: Kelly
mesh_terms: D000293:Adolescent; D016739:Behavior, Addictive / Q000628:therapy*; D003156:Community Mental Health Services / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D015233:Models, Statistical; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D012114:Residential Treatment; D012657:Self-Help Groups; D019966:Substance-Related Disorders / Q000628:therapy*; D016896:Treatment Outcome; D055815:Young Adult
keywords: 12-Step mutual-help organizations; Continuing care; Emerging adulthood; Substance use disorders