Self-Help Group Meeting Attendance among Clients with Dual Diagnoses

Abstract

This study explores factors associated with self-help group meeting attendance in the aftercare of 81 clients with dual diagnoses of severe mental illness and chemical dependency following their discharge from an inpatient chemical dependency treatment program. It also explores the association between self-help group meeting attendance and treatment outcomes. Data were collected from patient records and results of the Addiction Severity Index (ASI) administered as part of an earlier experiment that evaluated the effectiveness of the treatment program. Collaterals also provided follow-up information. Of thirteen variables examined, only two were associated with increased self-help group meeting attendance: having more years of education and having a major substance problem that did not include alcohol. No association was found between self-help group meeting attendance and treatment outcome regarding psychiatric problem severity or five other domains of the ASI. A moderate association was found indicating that more self-help group meeting attendance was related to improvements in the legal problems domain of the ASI. Implications are discussed for future research and for improving self-help group meeting attendance and its influence on treatment outcomes for individuals with dual diagnoses.

Effectiveness of Dual Focus Mutual Aid for Co-Occurring Substance Use and Mental Health Disorders: A Review and Synthesis of the “Double Trouble” in Recovery Evaluation

“…In one study, after discharge from hospital, dually diagnosed patients attended 12 step groups about as often as patients with substance disorders only, although patients with schizophrenia and schizoaffective disorder attended least (Jordan et al, 2002). Two studies have reported higher rates of mutual aid attendance among dually-diagnosed persons than have previously been indicated in the literature (DiNitto et al, 2001;Bogenschutz & Akin, 2000). However, both of these studies also raised questions about the effective use of traditional 12-step fellowships by this population.…”

“…DTR provides an opportunity for dually diagnosed patients to receive peer support for taking prescribed psychiatric medication, which can be as crucial for recovery as abstinence from drugs and alcohol. However, DTR is not conceptualized as a replacement for traditional 12-step groups, which are also attended by many dually diagnosed persons despite their limitations (e.g., DiNitto, et al, 2001), but rather as serving a special need for peer support that otherwise would not be met. As noted in the Double Trouble in Recovery (1998) Manual, "DTR creates a safe environment where a person can discuss the issue of mental disorders, medication, medication side-effects, psychiatric hospitalizations and experiences with the mental health system openly without shame or stigma."…”

“…It also provides a source of strategies to cope with the problem and, as a person's recovery progresses, the opportunity to become a role model. Many mutual aid groups follow some version of the 12-step model of recovery originally developed by the founders of Alcoholics Anonymous (AA) (Alcoholics Anonymous, 1939/2001/1952. Growing evidence indicates that 12-step groups are useful in maintaining abstinence from "substances of abuse" (e.g., Devine et al, 1997;Humphreys et al, 1994;Timko et al, 2000;Timko et al, 2006;Thurstin et al, 1987;Tonigan et al, 2002;;Humphreys and Moos, 2007;Kaskutas et al, 2005;Kelly et al, 2006;McCrady & Miller, 1993), especially for those who attend regularly or become affiliated (e.g., Fiorentine et al, 1999;Kingree, 1995;McKay et al, 1994;Montgomery et al, 1991;Watson et al, 1997).…”

12‐Step Approaches for the Dually Diagnosed: Mechanisms of Change

“…Two exceptions were found to this general pattern. One study reported no association between 12‐step attendance and improvement in ASI scores (other then legal problems) (Dinitto et al., 2001). Another found a smaller effect of 12‐step on substance use in patients with major depression and substance use disorder than in patients with substance use disorder alone (Kelly et al., 2003) .…”

The Role of Twelve‐Step Approaches in Dual Diagnosis Treatment and Recovery

“…Psychiatric comorbidity was not a significant predictor of self‐help group participation, and patients with a history of psychosis were excluded from this study. Dinitto et al explored the characteristics associated with self‐help participation among 81 dually diagnosed patients 23 . Only two of the thirteen factors investigated were associated with increased use of self help: higher education level and a major substance abuse problem that did not include alcohol.…”