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Is Level of Exposure to a 12-Step Facilitation Therapy Associated with Treatment Outcome?

Journal of Substance Abuse Treatment2014;47(4):265-274. [doi: 10.1016/j.jsat.2014.06.003]

Elizabeth A. Wells, PhD (University of Washington, PN Node), Dennis M. Donovan, PhD (University of Washington, PN Node), Dennis C. Daley, PhD (Western Psychiatric Institute and Clinic, AT Node), Suzanne R. Doyle, PhD (University of Washington, PN Node), Gregory S. Brigham, PhD (Maryhaven, Inc., OV Node), Sharon B. Garrett, MPH, MA (University of Washington, PN Node), Michelle H. Ingalsbe, MSW (University of Washington, PN Node), Mary A. Hatch-Maillette, PhD (University of Washington, PN Node), Harold I. Perl, PhD (NIDA), N. Robrina Walker, PhD (University of Texas Southwestern Medical Center, TX Node).

This ancillary investigation of data from National Drug Abuse Treatment Clinical Trials Network protocol CTN-0031 ("Stimulant Abuser Groups to Engage in 12-Step (STAGE-12)"), examined whether level of exposure to the STAGE-12 intervention, a 12-step facilitative therapy, is related to treatment outcome. The original study compared STAGE-12 combined with treatment-as-usual (TAU) to TAU alone. These analyses include only those randomized to STAGE-12 (n=234). Assessments occurred at baseline and 30, 60, 90, and 180 days following randomization. High-exposure patients (n=158; attended at least 2 of 3 individual and 3 of 5 group sessions), compared to those with less exposure (n=76), demonstrated: (1) higher odds of self-reported abstinence from, and lower rates of, stimulant and non-stimulant drug use; (2) lower probabilities of stimulant-positive urines; (3) more days of attending and lower odds of not attending 12-Step meetings; (4) greater likelihood of reporting no drug problems; (5) more days of duties at meetings; and (6) more types of 12-Step activities. Many of these differences declined over time, but several were still significant by the last follow-up.

Conclusions: Although outpatient substance use disorder treatment is thought to be characterized by high drop-out rates and low rates of treatment completion, exposure to STAGE-12 treatment was relatively high for this 8-session intervention embedded within intensive outpatient treatment as usual. Over two-thirds of patients met criteria for high exposure to the intervention, and there was relatively low early attrition. Those achieving high exposure to STAGE-12 demonstrated more positive outcomes, though the design of this secondary analysis cannot demonstrate a causal relationship between STAGE-12 exposure and positive outcomes. However, the current study demonstrates that it is feasible to interest people entering intensive outpatient treatment in a 12-Step oriented intervention and that individuals who agree to participate can be retained in the intervention at relatively high rates.

See Also: Counselor Magazine piece based on this article.

(Article (Peer-Reviewed), PDF, English, 2014)

Keywords: Behavior therapy | Community health services | CTN platform/ancillary study | Group therapy | Retention - Treatment | Stimulant abuse | Treatment compliance | Twelve-Step Facilitation (TSF) | Twelve-step programs | Journal of Substance Abuse Treatment (journal)

Document No: 1070, PMID: 25064421, PMCID: PMC4138275 (available 10/1/2015).

Submitted by Jack Blaine, MD, NIDA, 6/18/2014.

AUTHORS SEARCH LINK
Brigham, Gregory S. search mail
Daley, Dennis C. search mail
Donovan, Dennis M. search mail
Doyle, Suzanne R. search mail
Garrett, Sharon B. search mail
Hatch-Maillette, Mary A. search mail
Ingalsbe, Michelle H. search mail
Perl, Harold I. search
Walker, N. Robrina search mail
Well, Elizabeth A. search
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Supported by a grant from the National Institute on Drug Abuse to the University of Washington Alcohol and Drug Abuse Institute.
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