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Changes in 12-Step Cognitions Among Treatment-Seeking Adolescents.

Poster presented at the College on Problems of Drug Dependence (CPDD) annual meeting, San Juan, Puerto Rico, June 14-19, 2008.

J. Scott Tonigan, PhD, Alyssa A. Forcehimes, PhD, Michael P. Bogenschutz, MD (all from Center on Alcoholism, Substance Abuse, and Addictions (CASAA), University of New Mexico, SW Node).

Twelve-step therapy is the dominant therapeutic model in the USA and studies have demonstrated that changes in patient 12-step beliefs, cognitions, and practices can be produced during treatment. Some of these 12-step related changes have accounted for reductions in substance use, while other cognitive shifts have not. This ancillary study tested whether changes in positive and negative beliefs about 12-step practices occurred during adolescent outpatient treatment and, if so, whether such changes predicted subsequent substance use. A total of 154 opiate-dependent adolescents were randomized to one of two pharmacotherapy conditions as part of their participation in CTN trial investigating the effects of buprenorphine (protocol CTN-0010, "Buprenorphine/Naloxone-Facilitated Rehabilitation for Opioid Dependent Adolescents/Young Adults"). All participants received group and individual drug counseling, emphasizing 12-step principles and participation. The 40-item Addiction Recovery Scale was administered at intake and at the end of treatment (week 12). Items on the ARS contained positive and negative statements about 12-step practices and beliefs. Urine toxicology screens were conducted weekly. A positive UA screen was conservatively assumed in the absence of a weekly result.

At intake, adolescents reported generally favorable attitudes about 12-step practices and beliefs, and the relationship between positive and negative views of AA practices was predictably negative. Paired t-tests indicated that significant pre-post increases in positive attitudes about AA occurred during treatment, but that negative views about AA were relatively unaffected during treatment. Four hierarchical regressions showed that changes in positive and negative beliefs about AA practices did not predict the use of opioids during the 12 weeks of treatment. In conclusion, findings suggest that negative beliefs about 12-step programs are relatively unaffected during treatment among adolescents and that substance use during treatment is largely unrelated to AA beliefs and practices regardless of the valance of such beliefs. (Poster, PDF, English, 2008)

Keywords: Addiction Recovery Scale (ARS) | Adolescents | Buprenorphine/Naloxone | CTN platform/ancillary study | Opioid dependence | Opioid detoxification | Pharmacological therapy | Suboxone | Twelve-step programs | Young adults | College on Problems of Drug Dependence (CPDD) annual meeting, 2008

Document No: 305

Submitted by J. Scott Tonigan, PhD, CASAA, University of New Mexico, SW Node.

Bogenschutz, Michael P. search mail
Forcehimes, Alyssa A. search mail
Tonigan, J. Scott search mail
NIDA-CTN-0010 search www

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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