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…

Injury Risk Highest Among Binge Drinkers

Binge drinkers have a higher risk of alcohol-related injury than chronic, heavy drinkers, the Health Behavior News Service reported Feb. 22.

Binge-drinking women who otherwise drink in moderation had seven times the risk of injury as nondrinkers, while binge-drinking men increased their injury risk sixfold.

“It’s not only the amount of alcohol consumed that shapes the risk for injury, but also the usual consumption pattern,” said study author Gerhard Gmel of the Swiss Institute for the Prevention of Alcohol and Drug Problems. “At highest risk are those who usually consume moderately but sometimes binge drink. This is true for both sexes.”

The study was based on records from 8,736 people admitted to hospital emergency departments; researchers examined the relationship of injuries to average weekly alcohol consumption, binge-drinking episodes, and the amount of alcohol consumed prior to admission.

Gmel warned against prevention that focuses only on chronic drinkers, saying that many binge drinkers will be missed.

The research appears in the March 2006 issue of the journal Alcoholism: Clinical and Experimental Research. From; Join Together Online

• See also;
• Abstinence Solves Thinking Problems
• Adolescents have deficits in frontal brain activation
• Brain Damage & Cirrhosis

Mental health professional

Rethink – A guide for mental health professionals

This is the first in a series of Rethink reports on mental health recovery. It identifies 100 ways in which people working across the mental health sector can support the recovery of people with mental health problems. It highlights four key tasks:

• Developing a positive identity
• Framing the ‘mental illness’
• Self managing the mental illness
• Developing valued social roles

The author Dr Mike Slade says: “Recovery is an idea which has developed out of the experience of people living with, and beyond, mental illness. The mental health system already helps many people to live meaningful and purposeful lives, but we can do better.”

Free download available at; Mental Health Rethink

• See also;
• 12th Step Works
• Alcoholic, Addictive Behaviors
• What is AA?
• Brief-TSF can assist patients cease alcohol consumption.

Mutuality is a feature of many ‘self-help groups’ for people with mental health and/or substance misuse needs.

These groups are diverse in terms of membership, aims, organisation and resources.

Collectively, in terms of the pathways for seeking help, support, social capital or simply validation as people, mutual aid groups figure at some time in the life story of many psychiatric and/or substance misuse patients.

From the viewpoint of clinical services, relations with such groups range from formal collaboration, through incidental shared care, via indifference, to incomprehension, suspicion, or even hostility.

How should mental health and substance misuse clinicians relate to this informal care sector, in practice?

Aims: To synthesise knowledge about three aspects of the relationship between psychiatric/substance misuse services and mutual aid groups:

• profile groups’ engagement of people with mental health and/or substance misuse needs at all stages of vulnerability, illness or recovery;
• characterise patterns of health benefit or harm to patients, where such outcome evidence exists;
• identify features of mutual aid groups that distinguish them from clinical services.

Method: A search of both published and unpublished literature with a focus on reports of psychiatric and substance misuse referral routes and outcomes, compiled for meta-synthesis.

Results: Negative outcomes were found occasionally, but in general mutual aid group membership was repeatedly associated with positive benefits.

Conclusions: Greater awareness of this resource for mental health and substance misuse fields could enhance practice.

Mutual aid groups in psychiatry and substance misuse. Alex Baldacchino;  Woody Caan; Carol Munn-Giddings. Mental Health and Substance Use: dual diagnosis, Volume 1, Issue 2 June 2008 , pages 104 – 117

See also;

• 12-Step Treatment More Effective than Alternative
• AA Offers Recovery Not Religion
• Brief-TSF can assist patients cease alcohol consumption.
• Subscribe to Twelve Step Facilitation by e-Mail