Does the effectiveness of mutual aid depend on compatibility with treatment philosophies offered at residential rehabilitation services?

D. Best, V. Manning, S. Allsop, D. I. Lubman

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Background: Residential rehabilitation treatment (including both Therapeutic Communities (TC) and non-TC rehabs) is a key component of service delivery for people seeking treatment for substance use disorders in Australia and globally. While mutual aid is often associated with better long-term outcomes, there is little evidence about whether inconsistencies between residential rehabilitation philosophies and particular types of mutual aid influence subsequent engagement and treatment outcomes. Objective: To assess the uptake of mutual aid groups (12-step and other) on individuals leaving TC (n = 58) or non-TC (n = 78) residential treatment, and measure its impact on substance use outcomes. Methods: Using secondary analysis of existing data, the current paper reports on 12-month outcomes from a prospective cohort study of 230 individuals entering specialist alcohol and other drug residential rehabilitation treatment in two Australian states. Results: Participants who attended TC settings were more likely to attend non-spiritual mutual aid groups (i.e., SMART Recovery) than non-TC residents. Engaging in mutual aid groups was associated with significantly improved outcomes for the non-TC residents only, where it significantly predicted abstinence (OR = 5.8, CI = 1.5–18.46) and reduced frequency of use of participants’ primary drug of concern (OR = 8.6, CI = 2.6–28.6). Conclusions/Importance: Although 12-step is the most readily available and accessible form of mutual aid in Australia and benefited those attending non-TC residential rehabilitation, individuals exiting a TC program (whether they have completed treatment or not) may benefit from other forms of post-treatment recovery support, including alternative forms of peer-based support. The findings suggest treatment outcomes may be enhanced when the philosophies of residential treatment and post-discharge mutual aid are more compatible.

Original languageEnglish
Article number106221
Number of pages6
JournalAddictive Behaviors
Volume103
DOIs
Publication statusPublished - Apr 2020

Keywords

  • 12-step
  • Aftercare
  • Alcohol
  • Drugs
  • Mutual aid
  • Outcomes
  • Relapse
  • Residential rehabilitation
  • Therapeutic Community

Cite this

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title = "Does the effectiveness of mutual aid depend on compatibility with treatment philosophies offered at residential rehabilitation services?",
abstract = "Background: Residential rehabilitation treatment (including both Therapeutic Communities (TC) and non-TC rehabs) is a key component of service delivery for people seeking treatment for substance use disorders in Australia and globally. While mutual aid is often associated with better long-term outcomes, there is little evidence about whether inconsistencies between residential rehabilitation philosophies and particular types of mutual aid influence subsequent engagement and treatment outcomes. Objective: To assess the uptake of mutual aid groups (12-step and other) on individuals leaving TC (n = 58) or non-TC (n = 78) residential treatment, and measure its impact on substance use outcomes. Methods: Using secondary analysis of existing data, the current paper reports on 12-month outcomes from a prospective cohort study of 230 individuals entering specialist alcohol and other drug residential rehabilitation treatment in two Australian states. Results: Participants who attended TC settings were more likely to attend non-spiritual mutual aid groups (i.e., SMART Recovery) than non-TC residents. Engaging in mutual aid groups was associated with significantly improved outcomes for the non-TC residents only, where it significantly predicted abstinence (OR = 5.8, CI = 1.5–18.46) and reduced frequency of use of participants’ primary drug of concern (OR = 8.6, CI = 2.6–28.6). Conclusions/Importance: Although 12-step is the most readily available and accessible form of mutual aid in Australia and benefited those attending non-TC residential rehabilitation, individuals exiting a TC program (whether they have completed treatment or not) may benefit from other forms of post-treatment recovery support, including alternative forms of peer-based support. The findings suggest treatment outcomes may be enhanced when the philosophies of residential treatment and post-discharge mutual aid are more compatible.",
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Does the effectiveness of mutual aid depend on compatibility with treatment philosophies offered at residential rehabilitation services? / Best, D.; Manning, V.; Allsop, S.; Lubman, D. I.

In: Addictive Behaviors, Vol. 103, 106221, 04.2020.

Research output: Contribution to journalArticleResearchpeer-review

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T1 - Does the effectiveness of mutual aid depend on compatibility with treatment philosophies offered at residential rehabilitation services?

AU - Best, D.

AU - Manning, V.

AU - Allsop, S.

AU - Lubman, D. I.

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N2 - Background: Residential rehabilitation treatment (including both Therapeutic Communities (TC) and non-TC rehabs) is a key component of service delivery for people seeking treatment for substance use disorders in Australia and globally. While mutual aid is often associated with better long-term outcomes, there is little evidence about whether inconsistencies between residential rehabilitation philosophies and particular types of mutual aid influence subsequent engagement and treatment outcomes. Objective: To assess the uptake of mutual aid groups (12-step and other) on individuals leaving TC (n = 58) or non-TC (n = 78) residential treatment, and measure its impact on substance use outcomes. Methods: Using secondary analysis of existing data, the current paper reports on 12-month outcomes from a prospective cohort study of 230 individuals entering specialist alcohol and other drug residential rehabilitation treatment in two Australian states. Results: Participants who attended TC settings were more likely to attend non-spiritual mutual aid groups (i.e., SMART Recovery) than non-TC residents. Engaging in mutual aid groups was associated with significantly improved outcomes for the non-TC residents only, where it significantly predicted abstinence (OR = 5.8, CI = 1.5–18.46) and reduced frequency of use of participants’ primary drug of concern (OR = 8.6, CI = 2.6–28.6). Conclusions/Importance: Although 12-step is the most readily available and accessible form of mutual aid in Australia and benefited those attending non-TC residential rehabilitation, individuals exiting a TC program (whether they have completed treatment or not) may benefit from other forms of post-treatment recovery support, including alternative forms of peer-based support. The findings suggest treatment outcomes may be enhanced when the philosophies of residential treatment and post-discharge mutual aid are more compatible.

AB - Background: Residential rehabilitation treatment (including both Therapeutic Communities (TC) and non-TC rehabs) is a key component of service delivery for people seeking treatment for substance use disorders in Australia and globally. While mutual aid is often associated with better long-term outcomes, there is little evidence about whether inconsistencies between residential rehabilitation philosophies and particular types of mutual aid influence subsequent engagement and treatment outcomes. Objective: To assess the uptake of mutual aid groups (12-step and other) on individuals leaving TC (n = 58) or non-TC (n = 78) residential treatment, and measure its impact on substance use outcomes. Methods: Using secondary analysis of existing data, the current paper reports on 12-month outcomes from a prospective cohort study of 230 individuals entering specialist alcohol and other drug residential rehabilitation treatment in two Australian states. Results: Participants who attended TC settings were more likely to attend non-spiritual mutual aid groups (i.e., SMART Recovery) than non-TC residents. Engaging in mutual aid groups was associated with significantly improved outcomes for the non-TC residents only, where it significantly predicted abstinence (OR = 5.8, CI = 1.5–18.46) and reduced frequency of use of participants’ primary drug of concern (OR = 8.6, CI = 2.6–28.6). Conclusions/Importance: Although 12-step is the most readily available and accessible form of mutual aid in Australia and benefited those attending non-TC residential rehabilitation, individuals exiting a TC program (whether they have completed treatment or not) may benefit from other forms of post-treatment recovery support, including alternative forms of peer-based support. The findings suggest treatment outcomes may be enhanced when the philosophies of residential treatment and post-discharge mutual aid are more compatible.

KW - 12-step

KW - Aftercare

KW - Alcohol

KW - Drugs

KW - Mutual aid

KW - Outcomes

KW - Relapse

KW - Residential rehabilitation

KW - Therapeutic Community

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