12-step Alternatives and Recovery Outcomes in a Large National Study

大型全国性研究中的 12 步替代方案和恢复结果

基本信息

批准号：
8924892
负责人：
SARAH E. ZEMORE
金额：
$ 21.52万
依托单位：
PUBLIC HEALTH INSTITUTE
依托单位国家：
美国
项目类别：
财政年份：
2014
资助国家：
美国
起止时间：
2014-09-10 至 2017-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8924892
关键词：
Abstinence Address Aftercare Alcohol abuse Alcohol or Other Drugs use Alcohols Attitude Behavior Therapy Clinical Communities Data Dependence Dimensions Drops Drug usage Effectiveness Female Friends General Population Group Homes Growth Health Health Services Research Income Individual Intervention Lead Legal Literature Longitudinal Studies Measures Motivation National Institute on Alcohol Abuse and Alcoholism Nature Outcome Patients Pharmaceutical Preparations Pharmacological Treatment Policy Maker Provider Published Comment Quality of life Recording of previous events Recovery Recruitment Activity Religion and Spirituality Reporting Research Research Design Research Personnel Respondent Self Management Services Severities Social Network Source Subgroup Substance abuse problem Surveys Testing Time Training Woman Work addiction alcohol use disorder court demographics evidence based guidelines follow-up improved infancy knowledge base meetings member mortality peer networks programs randomized trial satisfaction sobriety substance abuse treatment treatment planning volunteer

项目摘要

DESCRIPTION (provided by applicant): It is now generally accepted that AA and other 12-step groups contribute to better substance use outcomes for those who are addicted to alcohol and/or drugs and choose to attend them. Nevertheless, most individuals do not sustain regular involvement in 12-step groups, even when 12-step participation is the focus of treatment. Meanwhile, involvement in 12-step alternatives is substantial and appears to be growing. The largest such alternatives include Women for Sobriety (WFS), Self-Management and Recovery Training (SMART), LifeRing, and Secular Organization for Sobriety (SOS). Yet, research relating to the effectiveness of 12-step alternatives is almost non-existent, and there are no known longitudinal studies on group members. Research on the effectiveness of the various alternatives is important to enhancing the integration of formal treatment with appropriate alternatives, improving referral practices, and informing courts and other legal bodies (e.g., EAP programs) involved in mandating substance abuse treatment, as well as the general population. The current study will thus capitalize on a very large, recent, national study of individuals in recovery from an alcohol and/or drug problem to follow respondents recruited from 12-step groups (N=261) and their alternatives (N=390; total N=651) and measure mutual help group involvement and recovery outcomes. Respondents will complete a First Follow-up survey and additional follow-ups at 6 and 12 months (Second and Third Follow-ups). Our primary aim is to test whether associations between mutual help group involvement and recovery outcomes (such as abstinence and quality of life) differ across mutual help groups (Aim 2). We will also compare respondents identifying WFS, SMART, LifeRing, and SOS as their primary mutual help group to 12-step members on demograpcharhics, clinical severity, and nature of involvement (Aim 1), and examine predictors of group satisfaction and drop-out/declining involvement across mutual help groups (Aim 3). Despite some small subgroups, we expect generally sufficient numbers within each group to facilitate comparisons between individual 12-step alternatives and AA. The current study should, in the short term, contribute to the knowledge base on the benefits and limits of specific mutual help groups, and may lead to more focused study of one or more promising alternative(s) to AA and to study designs that can best address questions of effectiveness, such as randomized trials. Ultimately, the current line of research could support both the growth of effective mutual help groups and the recovery of the many individuals who may be willing to use them. This proposal responds to PA-13-161 (Alcohol Use Disorders: Treatment, Services Research, and Recovery, NIAAA), soliciting research on behavioral and pharmacological treatment for alcohol use disorders.

描述（由申请人提供）：现在人们普遍认为，AA 和其他 12 步小组有助于那些酗酒和/或吸毒成瘾并选择参加这些小组的人获得更好的药物使用结果。然而，大多数人并没有持续定期参与 12 步小组，即使 12 步参与是治疗的重点。与此同时，12步替代方案的参与度很高，而且似乎还在不断增长。此类最大的替代组织包括女性清醒组织 (WFS)、自我管理和恢复培训 (SMART)、LifeRing 和世俗清醒组织 (SOS)。然而，与 12 步骤替代方案的有效性相关的研究几乎不存在，也没有针对小组成员的已知纵向研究。对各种替代方案有效性的研究对于加强正规治疗与适当替代方案的整合、改善转诊实践、向法院和其他参与强制药物滥用治疗的法律机构（例如 EAP 计划）以及一般治疗方法提供信息非常重要。人口。因此，当前的研究将利用最近一项针对从酒精和/或毒品问题中恢复的个人的大型全国性研究，跟踪从 12 步组 (N=261) 及其替代方案 (N=390；总计N=651）并衡量互助小组的参与和恢复结果。受访者将在 6 个月和 12 个月时完成第一次跟踪调查和其他跟踪（第二次和第三次跟踪）。我们的主要目的是测试互助小组参与与康复结果（例如禁欲和生活质量）之间的关联是否因互助小组而异（目标 2）。我们还将比较将 WFS、SMART、LifeRing 和 SOS 作为主要互助小组的受访者与 12 步成员的人口特征、临床严重程度和参与性质（目标 1），并检查小组满意度和退出的预测因素/互助团体的参与度下降（目标 3）。尽管有一些小小组，但我们预计每个小组内通常有足够的人数，以便于在各个 12 步替代方案和 AA 之间进行比较。在短期内，当前的研究应该有助于建立有关特定互助团体的好处和局限性的知识库，并可能导致对一种或多种有希望的 AA 替代方案进行更集中的研究，并研究可以最好解决有效性问题，例如随机试验。最终，当前的研究路线可以支持有效互助团体的发展以及许多可能愿意使用互助团体的个人的康复。该提案响应 PA-13-161（酒精使用障碍：治疗、服务研究和恢复，NIAAA），征求对酒精使用障碍的行为和药物治疗的研究。