10 Jan The Role of 12 Step Programs in Improved Treatment Outcomes
The Role of 12 Step Programs in Improved Treatment Outcomes
At South Pacific Private we support the 12 Step philosophy that addiction is a disease with emotional, physical and psycho social components, and that this disease can be arrested, but not cured, through abstinence. Wherever it is appropriate for clients, we actively encourage them to engage in 12 Step programs and we do as much as we can to facilitate their entry into this world.
But why do we do this?
Well, at SPP we have known for a long time that this holds the key to successful recovery – and offers our client’s the best chance of a healthy future. We’ve known this through the personal experience of the founders and owners (Bill and Lorraine Wood) and other staff, as well as though seeing the results for our clients with our own eyes. More than that though, ongoing research into the efficacy of 12 step programs provides a growing body of evidence that supports this belief.
We recently undertook a review of some of the most relevant research into this area to confirm our commitment to these programs, and we’d like to share this.
We should point out that this is not to examine the value of abstinence as a treatment goal, but rather to look at pathways to achieving this if it is the goal.
Do 12 step programs work?
Firstly, it is worth a brief look at what the journey to recovery looks like. Research suggest that it takes an average of 8 years from the point of seeking treatment for addiction, to the being able to maintain a year of continuous abstinence. This 8 year time frame is beset with periods of relapse, and ongoing support is required. By their very nature, 12 step organisations are the most widely, and freely available means of support imaginable. The barriers to entry are very low, making them extremely accessible, and they welcome back people who are locked in the ongoing struggle with relapse.
The Cochrane study (2006) showed that engagement with 12 step programs is as effective as other treatments (CBT and Motivational Enhancement). The Match study also showed no difference in outcomes between 12 step / CBT / Motivational enhancement at 1 or 3 year mark (so 12 step programs were at least as effective) – and showed that 12 step programs showed much better outcomes for continuous abstinence. Merton’s (2012) supports this by showing that attending fewer 12 step meetings was associated with higher odds of relapse. The longest known cohort study followed adolescents /emerging adults for 60 years and found that for individuals with alcohol use disorder, one of the strongest predictors of abstinence was AA attendance (Vallant 2003).
The Cochrane study further suggested that individuals seeking treatment for addiction who are in 12 step programs incur on average $8,000 (US) less per year in healthcare costs than those who are not. Fascinatingly, further analysis shows that they actually incur on average $145 (US) less per year, per meeting attended! This means that, not only do 12 step programs provide the best chance of achieving long term abstinence, but that they make for much healthier individuals too.
If we accept the idea that addiction is a chronic disease, then we must manage it as such and accept that the treatment pathways are long term. 12 step programs, by nature, are best positioned to afford this ongoing, long term support.
Why do 12 step programs work?
There are now hundreds of studies that support the common notion that participating in recovery supportive social organisations, like AA and other mutual-help organizations, predict current and long-term remission and recovery. But these effects have now been explained.
12 step fellowships provide a supportive community. Consistently, it has been found that engagement within a peer support community is associated with a lower risk of relapse (Boisvert, Martin, Grosek, & Clarie, 2008).
Participation tends to help people find new social contacts and friends that can facilitate new sober activities which lower exposure to high risk cues and triggers and boosts an individual’s confidence in their ability to cope with high risk relapse contexts (Emrick, Tonigan, Montgomery, & Little, 1993; Ferri, Amato, & Davoli, 2006; Litt, Kadden, Kabela-Cormier, & Petry, 2009; Longabaugh, Wirtz, Zweben, & Stout, 1998; Walitzer, Dermen, & Barrick, 2009).
Simply put, 12 step fellowships provide people with a number of sober friends, a level of social support, and a level of spiritual support. Participation builds (or changes) social networks, builds confidence, facilitates stress management, instils hope (by hearing from others) and a sense of belonging…all top reasons that people cite for successful recovery.
This also explains why participation in organisations such as AA and NA also help reduce expression symptoms and increase psychological and emotional well-being which boost the chances for continued recovery.
If research into this or other areas of Recovery interests you, we recommend the Harvard Medical School – Recovery Research Institute website – Recoveryanswers.org.
About South Pacific Private:
Established in 1993, SPP is Australia’s leading treatment centre, specialising in the integrated medical, psychiatric and psychotherapeutic treatment of mental illness and addiction. All treatment programs are tailored by a multidisciplinary team of
psychiatrists, psychologists, general practitioners, registered nurses, psychotherapists and counsellors. In addition to being a registered Acute Care Psychiatric Hospital fully licensed by the NSW Department of Health, SPP is also accredited by the Australian Council on Health Care Standards (ACHS).
www.southpacificprivate.com.au / 1800 063 332