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Recovery Plus 18 Feb 2016 Among more severely alcohol-impaired people, AA also appears to work by enhancing spiritual/ religious practices, reducing depression and increasing peoples’ confidence in their ability to cope with negative affect. Thus, AA appears to work through diverse mechanisms and might work differently for different people. Mutual-help group participation can reduce healthcare costs and could enhance outcomes. Substance dependence is recognised as a chronic, relapsing condition which typically requires multiple episodes of care over long periods of time. Sadly, individuals’ access to professional healthcare resources is often limited to short periods of time by insufficient funds. In the US and UK, government policies have an ever-increasing impetus to reduce healthcare costs and create a more cost-effective system. Mutual-help groups are a crucial adjunct to professional treatment, as they can be attended for as long as necessary at no cost except for voluntary contributions. Not only are 12-step organisations self-supporting and inexpensive to attend, but research shows that involvement in 12-step organisations can reduce the need for more costly professional treatments – while improving outcomes. One study found that people who attended only AA had overall treatment costs substantially lower than people in outpatient treatment, at no detriment to their substance use outcomes and despite experiencing more drinkingrelated consequences at the start of the study. Similarly, a large prospective study of over 1,700 substance-dependent males found that those in professional 12-step treatment participated in community-based AA and NA meetings much more after treatment than those from professional cognitive behavioural therapy treatment programmes, who relied more heavily on professional services. This translated into a two-year saving of over $7,000 per patient, again without compromising abstinence rates. In fact, patients treated in the 12-step programmes had one-third higher rates of abstinence than those treated in the CBT programmes at two-year follow-up (demographic and clinical severity indicators were equivalent at baseline). Clinical interventions can grow participation in mutual-help groups and enhance outcomes. Since AA and related organisations appear to be effective and cost-effective recovery resources, the question arises as to how clinicians can best facilitate their patients’ engagement with them. Many SUD counsellors report that they refer their patients to 12-step meetings, but the degree to which they provide facilitation efforts beyond a simple referral is unclear. Growing research on TSF interventions suggests that taking a more intensive and proactively encouraging approach to facilitating attendance can be beneficial for patients. Clinicians monitor and discuss patients’ reactions to meetings and explore reasons for nonattendance. TSF can be delivered in many formats, including as a standalone treatment, brief intervention or part of another treatment. Studies show that clinicians using these more intensive facilitation efforts can substantially increase the likelihood The online issue of Recovery Plus will also link you to the author’s presentation at Recovery Plus 2015 – just click the logo shown below when you access us online: Click for presentation Click


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