Dropout from 12-step self-help groups: Prevalence, predictors, and counteracting treatment influences

The prevalence, predictors, and treatment-related factors affecting dropout from 12-step self-help groups in the first year following professional substance abuse treatment were assessed in 2,778 male patients.

The patients were asked to complete an inventory at baseline, at discharge, and 1 year after discharge.

Attendance at 12-step groups either in the 90 days before treatment or during treatment was reported by 91% (2,518).

Forty percent had dropped out at the 1-year follow-up.

Logistic regression analysis revealed that the odds of having used substances by the time of the 1-year follow-up were almost three times higher for those who had dropped out of 12-step self-help groups than for those who had continued attendance (odds ratio = 2.84; 95% confidence interval, 2.29-3.23; p < 0.0001).

Dropout was predicted by a number of baseline factors. Patients who began 12-step participation during treatment were less likely to drop out.

Other findings suggest that patients at highest risk for dropout may be at lower risk if treated in a more supportive environment.

Clinicians may decrease the likelihood of dropout directly by screening for risk factors and focusing facilitation efforts accordingly, and indirectly by increasing the supportiveness of the treatment environment and facilitating 12-step involvement during treatment.

Research report; Kelly, J.F.; Moos, R. Dropout from 12-step self-help groups: Prevalence, predictors, and counteracting treatment influences. Journal of Substance Abuse Treatment, 24(3):241-250, 2003. (169991)