One-Year Outcomes among Members of a Dual-Recovery Self-Help Program.

Research Objective: Self-help is gaining increased acceptance among treatment professionals as empirical support for of its effectiveness is growing and the advent of managed care warrants the use of cost-effective modalities. Traditional “one disease-one recovery” self-help programs cannot serve adequately the needs of the dually-diagnosed.

This paper presents one-year outcome data from a longitudinal study of the effectiveness of self-help for the dually-diagnosed.

Subjects are members of Double Trouble in Recovery (DTR), a 12-step self-help program designed to meet the special needs of those diagnosed with both a mental health disorder and a chemical addiction.Study.

Design: The study uses a 12-month prospective longitudinal design with follow-ups at 12 and 24 months after baseline. Subjects (N = 310) were recruited at 25 DTR meeting sites throughout New York City. Semi-structured instruments assess history and current status of mental health and substance abuse, treatment in both areas, and self help participation (DTR as well as traditional 12-step groups such as AA and NA).

Population Studied: Community-based individuals dually-diagnosed with a mental health disorder and substance abuse.

Principal Findings: S’s are mostly members of underserved minority groups with long histories of substance abuse and mental health disorders.

Most S’s attend outpatient treatment (for drug use, mental health or dual-diagnosis – 77%) and take psychotropic medications (87%).

At the 12 months follow-up,

• 76% were still attending DTR;
• 68% were also attending AA or NA.

Mean number of symptoms S’s. experienced in the past year decreased significantly;

• two-thirds (69%) of S’s reported that their mental health was “better” in the past month than it was at baseline.
• One-third (29%) reported substance use in the past year, compared to 42% at baseline (p = .002).

Substance use (less) was significantly associated with DTR attendance:

• Total time abstinent was related to lifetime length of DTR attendance (r = .25, p = .002) and
• past year substance use was related to number of months of DTR attendance in the past year (r = -.17, p = .02).

Conclusions: For dually-diagnosed individuals, continued participation in dual recovery self-help groups plays a significant role in the recovery process, particularly in the area of substance use.

Implications for Policy, Delivery or Practice: Participation in dual-recovery self-help groups, both during and after formal treatment, should be encouraged as part of an integrated lifelong recovery plan for dually-diagnosed individuals.

Research; One-Year Outcomes among Members of a Dual-Recovery Self-Help Program. Laudet A, Magura S, Vogel H, Knight E, Staines G; Abstr Acad Health Serv Res Health Policy Meet. 2000; 17.

More at; Double Trouble in Recovery

See also;

• 12-Step Treatment More Effective than Alternative
• AA and Treatment Work Better Together
• Subscribe to Twelve Step Facilitation by e-Mail

Dual Diagnosis; Counseling the Mentally Ill Substance Abuser by Katie Evans, J. Michael Sullivan Read more about this title…

On any given day in the United States, one million people are in treatment for alcoholism or drug addiction. It is not getting into treatment, however, that makes the difference. Instead, it is what a person gets out of treatment. The fact that many people do not find success in treatment on their first attempt is due in part to a lack of understanding about what makes effective treatment.

The ten effective elements of treatment are;

1. There is no treatment formula that will work for everyone.

2. Medically supervised withdrawal is only one step in addiction treatment; alone it will do little.

3. Length of treatment counts

4. Drug addiction is a multidimensional problem, and treatment needs to address all of an individual’s needs

5. Counseling (individual and/or group) is a critical part of effective addiction treatment.

6. Medications are an important part of treatment for many people.

7. Drug testing during treatment is important.

8. Alcoholics and addicts with mental health disorders should be treated for both at the same time.

9.Addiction Treatment works even for people who don’t choose it of their own free will.

10. Don’t give up.

As with other chronic illnesses, relapses can occur during or after successful treatment episodes. Addicted individuals may need lengthy treatment and more than one time in treatment before they can enjoy long-term abstinence and full restoration to a drug free life. The period after treatment is just as important as being in treatment. Finding support and continuous work to stay drug free will be necessary. A slip or relapse is just an indicator that more work, and possibly more treatment, is necessary. Don’t give up.

Full story at Recovery Today

See also;

• AA and Treatment Work Better Together
• AA Offers Recovery Not Religion
• If you have healthcare training this manual may help.

What can be confidently said about AA in general and about the role of spirituality in AA in particular?

• First, there is convincing evidence that alcoholism severity predicts later AA attendance.
• Second, atheists are less likely to attend AA, relative to individuals who already hold spiritual and/or religious beliefs. However, belief in God before AA attendance does not offer any advantage in AA-related benefits, and atheists, once involved, are at no apparent disadvantage in deriving AA-related benefits.
• Third, the spiritually-based principles of AA appear to be endorsed in AA meetings regardless of the perceived social dynamics or climate of a particular meeting, eg, highly cohesive or aggressive.
• Fourth, significant increases in spiritual and religious beliefs and practices seem to occur among AA-exposed individuals.
• Fifth, in spite of much discussion to the contrary there is little evidence that spirituality directly accounts for later abstinence.

We are finding, however, that spirituality has an important indirect effect in predicting later drinking reductions. Specifically, in the past 20 years a number of effective methods have been developed to facilitate initial AA attendance. Such as Brief-TSF.

Interventions that lead to initial increases in spirituality appear to lead to sustained AA affiliation, which, in turn, produces sustained recovery over time.

Research; Tonigan JS. Spirituality and alcoholics anonymous. South Med J. 2007 Apr;100(4):437-40.

See also;

• What About This Spiritual Awakening Thing?
• 12-Step Treatment More Effective than Alternative
• Bill W.Biography
• 12 Steps and Post Traumatic Stress
• Psychology Books

Biomarkers in Alcohol Misuse: Their Role in the Prevention and Detection of Thiamine Deficiency

In Western countries alcohol misuse is the most frequent cause of thiamine (vitamin B1) deficiency (TD) and consequent neuro-impairment.

Studies have demonstrated that between 30 and 80% of alcoholics are thiamine deficient, and this puts them at risk of developing the Wernicke–Korsakoff (WK) syndrome.

The relative roles of alcohol and TD in causing brain damage remain controversial and it is important to try to determine the role played by each factor.

Animal studies support an additive effect of alcohol exposure and TD, and indicate the potential for interaction between alcohol and TD in human alcohol-related brain damage.

Early diagnosis of alcohol-related TD is therefore an important aspect of effective intervention and treatment.

Alcohol biomarkers provide a direct and indirect way of estimating the amount of alcohol being consumed, the duration of ingestion and the harmful effects that long-term alcohol use has on body functions.

Appropriate use of these markers is very helpful when considering a diagnosis of alcohol-related TD.

Research report; Rosanna Mancinelli, and Mauro Ceccanti. Biomarkers in Alcohol Misuse: Their Role in the Prevention and Detection of Thiamine Deficiency. Alcohol and Alcoholism 2009 44(2):177-182;

See also;

• 12-Step Treatment More Effective than Alternative
• AA Offers Recovery Not Religion
• AA and Treatment Work Better Together

I’ll Quit Tomorrow: A Practical Guide to Alcoholism Treatment

Nine Elements of Effective Alcohol Treatment for Adolescents

In evaluating a broad spectrum of treatment programs and approaches, researchers have identified common themes among the treatments that are most effective in helping teens. Drug Strategies, a Washington-based nonprofit research institute that promotes more effective approaches to the nation’s drug problems, found these key elements in an extensive review.

http://www.ensuringsolutions.org/resources/resources_show.htm?doc_id=336617&cat_id=989

Publisher

• Ensuring Solutions to Alcohol Problems
• George Washington University Medical Center
• Website: http://www.ensuringsolutions.org/

Dr Harry M. Tiebout

One of the first psychiatrists to describe alcoholism as a disease rather than a moral failing or criminal activity.

Harry M. Tiebout was also one of the first to wholeheartedly endorse Alcoholics Anonymous as an effective force in the struggle against compulsive drinking.

This volume brings together, for the first time, some of Tiebout’s most influential writings. Many of these pieces–from explorations of the therapeutic approach to alcoholism to instructive discussions of the act of surrender so crucial to recovery–are seminal documents in the history, treatment, and understanding of alcoholism.

Together, they represent the significant contribution of one man to the countless lives shaken by alcoholism and steadied with the help of Alcoholics Anonymous, psychiatric intervention, and the foresight and commitment of doctors like Harry Tiebout.

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Harry Tiebout Buy Now!

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Al-Anon offers new life

AA’s 12-Step Recovery Program

Alcohol and Anxiety

Alcohol Problems Database

Alcoholic Defence Mechanisms

Alcoholics Anonymous and Nursing

An Introduction to Medication for Alcohol Dependence

Anti-craving Drugs

Binge Drinking & Brain Damage

Brain Damage & Cirrhosis

Brief-TSF Description

Brief-TSF Learning Objectives

Characteristics of Children of Alcoholic

Controlled drinking?

Counselling and the 12 Steps of AA

Counsellor Characteristics

Craving Reduction

Depression & 12-Step Programs

Effects of Gambling Addiction

Elderly Substance Abuse

Families, Mental Health & Alcohol abuse

Female Victims of Child Abuse

Five Alcoholism Subtypes

Free Training Alcoholism Anti-craving Medications

Gender Matching Hypothesis in Alcohol Treatment

Healing through Social and Spiritual Affiliation

How Alcoholics Anonymous is changing

How do alcoholics get to AA?

Humility and Surrender

Nutritional Therapy in Alcoholic Liver Disease

Painkiller abuse

Phases of Recovery from Alcoholism

Readiness to Change Profiles

Recovery through the Twelve Steps

Research Evidence for TSF

Risky Partners and Domestic Violence

Slogans for everyday life in AA

Spiritual Assessment

Spirituality in Alcoholism Recovery

Stages of an Eating Disorder

Strategies for Dealing With Denial

Symptoms of alcoholism

The 12-Steps Promote Acceptance of Addiction

The Personality Traits of Alcoholics

Treating Alcoholism as a Chronic Disease

TSF Description

Twelve step programs

What about partners of alcoholics?

Women and the Twelve Steps of AA

World view change in Adult Children of Alcoholics

• Subscribe to Twelve Step Facilitation by e-Mail

By Mary Cook, MA

Whether clients or counselors, students or teachers, we are all imperfect human beings. We are here because we have a yearning to grow.

And the strongest motivator for growth is pain. When we are significantly harmed or deprived mentally, emotionally or physically and have no safe people or role models to help us understand and rebound or heal, our mind creates defense mechanisms and coping strategies to hide our real pain and vulnerability.

This may serve us well over a short time period, but backfires in a longer time frame. When we become habituated to our means to hide painful reality, we forget our true self behind the fabrications.

More at; Anonymous One website

See also;

• TWELVE STEPS TO RECOVERY FROM BURNOUT
• Emotional Sobriety

Recovery doesn’t usually change addicts’ core beliefs about God and religion, but measures of spirituality appear to increase along with sobriety, according to researchers from the University of Michigan Addiction Research Center.

Researchers assessed 10 measures of spirituality among 154 adults in an outpatient treatment program for alcohol dependence and abuse. Measures included patients’ views of God, religious practices such as prayer or church attendance, forgiveness, spiritual experiences, using religion or spirituality to cope, and existential meaning.

The study found that half of the measures of spirituality changed over the six-month study period, including daily spiritual experiences, the use of religious practices, forgiveness, positive use of religion for coping, and feeling of purpose in life.

“While people’s actual beliefs don’t seem to change during recovery, the extent they have spiritual experiences, and are open to spirituality in their lives, does change,” said lead researcher Elizabeth A.R. Robinson, Ph.D. “This effect was also independent of their participation in Alcoholics Anonymous which has a strong spiritual aspect.”

Use of alcohol also declined, with 72 percent of participants successfully avoiding heavy drinking for the six-month study period. Participants whose spirituality increased were less likely to drink heavily, researchers found.

Reference:: Robinson, E.A.R., Cranford, J.A., Webb, J.R., Brower, K.J. (2007) Six-Month Changes in Spirituality, Religiousness, and Heavy Drinking in a Treatment-Seeking Sample. J. Stud. Alcohol Drugs, 68(2): 282-290.

Spiritual Connections: How to Find Spirituality Throughout All the Relationships in Your Life by Sylvia Browne Read more about this title…

Twelve-step facilitation (TSF) in non-specialty settings.

Participation in the twelve-step mutual-help organization, Alcoholics Anonymous, has proven to be an effective means of helping individuals with alcohol dependence achieve lasting sobriety.

Although many patients choose to attend AA of their own accord, clinicians’ facilitation of AA involvement ("Twelve-Step Facilitation" [TSF]) has shown to substantially increase the likelihood that patients will become engaged with these freely available resources.

Importantly, many individuals with alcohol dependence never seek help from addiction specialists, yet often encounter other health professionals due to alcohol-related physical or psychological problems providing an opportunity for intervention.

However, for clinicians who do not specialize in addiction treatment, knowledge about what AA actually is and does is often lacking, and confidence in implementing TSF strategies is low.

This chapter provides essential information for clinicians working in non-specialty settings who have little knowledge of, or experience with, AA or TSF, but who may wish to utilize proven strategies to augment existing interventions by helping educate, link, and engage patients with AA.

Detailed information on the origins and specific elements of AA is provided along with recommended TSF approaches and strategies to aid the non-specialist in building effective interventions for patients with alcohol dependence.

Kelly JF, McCrady BS. Twelve-step facilitation in non-specialty settings. Recent Dev Alcohol. 2008;18:321-46.

See also;

• Brief-TSF can assist people cease alcohol consumption.
• Twelve Step Facilitation
• AA and Treatment Work Better Together