Center for Addiction Medicine

01/07/2009 - Integration of Twelve-Step Programs and Professional Treatment

While I am a firm believer in the role of professional treatment programs and am
particularly proud of the Intensive Treatment Program at The Center for Addiction
Medicine, it is important to recognize the positive benefits of the twelve-step self-help
programs. According to the literature and my 27 years of experience as a treatment
provider, many substance abusers do not affiliate or do so for a short period of time
before dropping out.

These groups, which include Alcoholics Anonymous(AA), Narcotics Anonymous(NA),
Cocaine Anonymous(CA) and others are accessible and available throughout the world.
Many formal treatment programs include on-site twelve-step meetings as a means to
integrate and encourage continued involvement following professional treatment.

Despite the acknowledged benefits, approximately 60%-70% of substance abusers have
never attended a twelve-step meeting. In an article appearing in The Journal of Studies
on Alcohol, Harris, et al. noted that while about 75% of alcoholics reported they had
attended AA meetings previously, only 16% indicated that they had ever worked on any
of the twelve-steps. Individuals who fail to become involved at all, have sporadic and
inconsistent attendance, or delay involvement tend to have poorer outcomes.

Involvement, rather than attendance, appears to be the better predictor of substance use
outcomes: the greater the level of involvement in twelve-step activities, the better the
outcome. Kelly, et al. found a dose-response relationship between the extent of twelve-step
involvement and the benefits: even small amounts of participation were helpful in
increasing abstinence but higher levels of participation were necessary to reduce relapse.

At the Center for Addiction Medicine, involvement in self-help is encouraged from the
onset of treatment with progressive emphasis as program intensity levels rise. It is clearly
a tool to be utilized in relapse prevention and discharge planning. The timing of
attendance is crucial. Substance abusers who participate concurrently in professional
treatment and twelve-step programs had higher rates of abstinence than those who
participate only in professional treatment or only in self-help.

Twelve-step meeting participation is a cost-effective resource that complements and
supports the cognitive and behavioral changes emphasized in professional treatment.
 

• previous news item
• back to news list