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Recovery Plus that patients will become and stay involved in these organisations. One early study found that, when therapists actively linked patients with current 12-step group members by having them speak over the phone during a session and make arrangements to attend a meeting, every patient attended at least one meeting in the month after referral. In contrast, when patients were simply given information and encouraged to attend, not one person did. In Project Match, participants in TSF treatment attended AA at a significantly higher rate than those in the CBT and motivational enhancement therapy conditions in treatment and during the first three months of follow-up. Another RCT compared standard 12-step referral, in which patients were given a schedule of meetings and encouraged to attend, to intensive referral, which included directly linking the patient with a current AA/NA member and addressing patient concerns about attendance. At sixmonth follow-up, those in the intensive referral condition became more involved in several aspects of the 12-step programme. For example, they were more likely to have a sponsor. Importantly, studies have shown that TSF has a positive impact on patients’ substance use outcomes. In Project Match, for example, TSF was as effective as more empirically supported CBT and MET at reducing alcohol use posttreatment and at one-year follow-up – and more effective at the three-year follow-up. Moreover, TSF was superior to CBT and MET at increasing rates of continuous abstinence. Similar findings have been demonstrated in several other RCTs using various forms of TSF. These studies consistently show that TSF interventions produce outcomes superior to control conditions. As a result of this growing empirical support, TSF was recently recognised as a “well supported treatment” by the Division of Clinical Psychology of the American Psychological Association and added to SAMHSA’s National Registry of Evidence- Based Practices and Programmes in 2008. Where the research is now. The often-passionate debate about the pros and cons of mutual-help organisations seldom references the accumulating body of scientific literature amassed over the past 25 years. This “empirical awakening” and related science base supports the effectiveness of 12-step mutualhelp organisations and the efficacy of TSF interventions for reducing substance-related problems. Other non-12-step mutual-help groups such as Smart might provide similar benefits, but await more extensive empirical study. The chief strength of community mutual-help organisations might lie in their ability to provide effective, easily accessible, free, long-term recovery support which is responsive to undulating relapse risk. As we move to improve quality and healthcare efficiency and effectiveness, awareness of the important role mutual-help organisations and related professional interventions can play in a recovery-oriented system of care will enhance the proficiency of our overall response to the burden imposed by substance-related harms. your library’s essential reference Feb 2016 19


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