Self-Help Groups for Alcohol Dependency: A Scoping Review

Alcohol Abstinence Self-Efficacy and Recovery Using Alcoholics Anonymous® An Integrative Review of the Literature

Alcohol use disorder (AUD) is a chronic health problem in the United States, with social, economic, and personal consequences. The purpose of the current integrative review was to examine recovery from AUD in adult Alcoholics Anonymous^® (AA) members working the 12 steps. Databases were searched using a combination of search terms with inclusion criteria of human adult studies published in English between 2010 to 2020. Searching the references of retained records also identified other relevant studies for inclusion. Through the process of two searches and examination of retained records' reference lists, 20 articles were retained. AA outcomes frequently cited are abstinence, improved self-efficacy, improved psychosocial well-being, and improved social networks. These positive outcomes are linked to attendance and participation in AA. There is a deficiency of research specific to how AA works to achieve the ascribed outcomes. This identified gap in the state of the science lays the foundation for future research. [Journal of Psychosocial Nursing and Mental Health Services, xx(xx), xx-xx.].

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

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.

Engagement in a Novel Internet Intervention for Alcohol Reduction: A Qualitative Study of User Motivations and Experiences

Internet interventions are effective in reducing alcohol consumption, but little is known regarding their acceptability. We aimed to inform recruitment and retention strategies by exploring users' motivations and experiences in using a novel, Internet intervention, the Hello Sunday Morning (HSM) program. We conducted one-to-one, telephone-enabled qualitative interviews with 24 adult users of HSM (50 percent female; M_age = 42.42 years), purposively selected to ensure diversity in demographics and drinking levels. Data were analyzed using thematic analysis. Two themes, each with two subthemes were identified: (1a) pathway to HSM: HSM attracted participants seeking help for alcohol-related problems, and those not yet seeking help; (1b) format and framing: the positive, nonthreatening framing and anonymous, convenient format enabled participants to join out of interest, curiosity, or desire for a challenge; (2a) support and normalization: participants gained social support from other users, and their problems with alcohol and desire to seek help were normalized; (2b) goal setting and self-monitoring: setting goals and monitoring progress provided participants with motivation and self-accountability. We conclude that evidence-based behavior change techniques, including social support, normative strategies, goal setting, and self-monitoring, were appealing to users. These aspects could be incorporated into other programs to recruit participants who might otherwise avoid or delay seeking help.

Modeling variables associated with personal recovery among service users with mental disorders using community-based services

BACKGROUND

Mental health research is evolving toward the identification of conceptual models and associated variables, which may provide a better understanding of personal recovery, given its importance for individuals affected by mental disorders (MDs).

AIMS

This article evaluated personal recovery in a sample of adults with MDs using an adapted conceptual framework based on the Andersen behavioral model, which evaluates predisposing, enabling and needs factors in service use.

METHODS

The study design was cross-sectional and included 327 mental health service users recruited across four local health service networks in Quebec (Canada). Data were collected using seven standardized instruments and participant medical records. Structural equation modeling was performed.

RESULTS

Quality of life (QOL), an enabling factor, was most strongly associated with personal recovery. Health behavior variables associated with recovery included the following: use of alcohol services, having a family physician, consulting a psychologist, use of food banks, consulting fewer professionals and not using drug services. Regarding needs factors, higher numbers of needs, lower severity of unmet health, social and basic needs and absence of mood disorders were also associated with personal recovery. No predisposing factors emerged as significant in the model.

CONCLUSION

Findings suggest that QOL, needs variables and comprehensive service delivery are important in personal recovery. Services should be individualized to the health, social and basic needs of service users, particularly those with mood disorders or co-occurring mental health/substance use disorders.

Identity in recovery from problematic alcohol use: A qualitative study of online mutual aid

AIM

To explore how engagement with online mutual aid facilitates recovery from problematic alcohol use, focusing on identity construction processes.

DESIGN

Qualitative in-depth interview study of a maximum variation sample.

SETTING

Telephone interviews with UK-based users of Soberistas, an online mutual aid group for people who are trying to resolve their problematic alcohol use.

PARTICIPANTS

Thirty-one members, ex-members and browsers of Soberistas (25 women, 6 men): seven currently drinking, the remainder with varying lengths of sobriety (two weeks to five years).

FINDINGS

Three key stages of engagement were identified: 1) 'Lurking' tended to occur early in participants' recovery journeys, where they were keen to maintain a degree of secrecy about their problematic alcohol use, but desired support from likeminded people. 2) Actively 'participating' on the site and creating accountability with other members often reflected an offline commitment to make changes in drinking behaviour. 3) 'Leading' was typically reserved for those securely alcohol-free and demonstrated a long-standing commitment to Soberistas; leaders described a sense of duty to give back to newer members in early recovery and many reported an authentic identity, defined by honesty, both on- and off-line.

CONCLUSIONS

Engagement with online mutual aid might support recovery by affording users the opportunity to construct and adjust their identities in relation to their problematic alcohol use; individuals can use the parameters of being online to protect their identity, but also as a mechanism to change and consolidate their offline alcohol-related identity.