A Comparative Evaluation of Substance Abuse Treatment: V. Substance Abuse Treatment Can Enhance the Effectiveness of Self‐Help Groups

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Abstract
Affiliation with Alcoholics Anonymous (AA) and other 12‐Step self‐help groups is becoming more common at the same time as professional substance abuse treatment services are becoming less available and of shorter duration. As a result of these two trends, patients’ outcomes may be increasingly influenced by the degree to which professional treatment programs help patients take maximum advantage of self‐help groups. The present study of 3018 treated veterans examined how the theoretical orientation of a substance abuse treatment program affects (1) the proportion of its patients that participate in self‐help groups, and, (2) the degree of benefit patients derive from participation in self‐help groups. Patients treated in 12‐Step and eclectic treatment programs had higher rates of subsequent participation in 12‐Step self‐help groups than did patients treated in cognitive behavioral programs. Furthermore, the theoretical orientation of treatment moderated the outcome of self‐help group participation: As the degree of programs’ emphasis on 12‐Step approaches increased, the positive relationships of 12‐Step group participation to better substance use and psychological outcomes became stronger. Hence, it appears that 12‐Step oriented treatment programs enhance the effectiveness of 12‐Step self‐help groups. Findings are discussed in terms of implications for clinical practice and for future evaluations of the combined effects of treatment and self‐help groups.