Dual-Focus Mutual Aid for Co-Occurring Disorders: A Quasi-Experimental Outcome Evaluation Study

Abstract

Previous observational research has indicated the effectiveness of a 12-step, dual-focus mutual aid group, Double Trouble in Recovery (DTR), for assisting individuals to recover from co-occurring substance use and psychiatric disorders. The current study extends this line of research by evaluating DTR with a quasi-experimental design; controlled designs are rare in studies of mutual aid. Patient outcomes in the same psychiatric day treatment program were compared for two consecutive admission cohorts characterized by high rates of co-occurring disorders. The first cohort did not have DTR available while the second cohort was exposed to DTR after it was established at the program. Both cohorts were assessed at program admission and at a six month follow-up. Using intent to treat analysis, the Post-DTR cohort as compared with the Pre-DTR cohort had significantly fewer days of alcohol and drug use, more frequent traditional 12-step groups outside of the program and higher psychiatric medication adherence. There were no differences in psychiatric symptoms or program retention, however. This study helps demonstrate the benefits of introducing 12-step, dual-focus mutual aid into psychiatric treatment programs that serve patients with co-occurring disorders.

Risk factors for medication non-adherence among psychiatric patients with substance misuse histories

“…For patients with both psychiatric illness and current substance misuse, a practical approach to increasing social support is to encourage participation in “dual focus” self-help groups that provide support for recovery from both problems. Recent research has shown that such dual focus group participation can reduce both substance misuse and increase adherence to psychiatric medication (Magura et al, 2002; Magura, Rosenblum, Villano, Vogel, Fong, & Betzler, 2008a; Magura, Villano, Rosenblum, Vogel, & Betzler, 2008b). Thus, participation in such groups should be encouraged by mental health and addiction treatment clinicians who work with patients with co-occurring disorders.…”

“…The latter may require a clinic to take the initiative in helping patients establish such a group, since knowledge of this option is still limited and since patients may not be able to negotiate the logistics of setting up a group on their own. Once established, however, dual focus groups such as Double Trouble in Recovery have been shown to operate successfully according to standard 12-step principles (Magura et al, 2008a). …”

First-Person Perspectives on Dual Diagnosis Anonymous (DDA): A Qualitative Study

“…Although some literature has described the effectiveness of specialized 12-step groups similar to DDA (Rosenblum et al, 2014;Timko, Sutkowi, & Moos, 2010;Aase, Jason, & Robinson, 2008;Magura et al, 2008;Magura, 2008), minimal information exists regarding first-person experiences in 12-step programs due to the required anonymity of traditional 12-step fellowships. Tradition 11 of AA states, "Our public relations policy is based on attraction rather than promotion; we need always maintain personal anonymity at the level of press, radio and films" (Alcoholic Anonymous…”

Alcoholism and mental illness: overlapping diseases requiring a renewed focus

“…Double Trouble in Recovery is a 12 step-based dual-focus mutual aid group designed for adults with dual diagnoses. The results from this study report improvement in substance abuse outcome but not in psychiatric outcome (Magura et al, 2008). Seeking Safety and Creating Change are two group behavioral therapy models for individuals suffering from both PTSD and substance abuse disorders.…”