Self-help Group Meetings Research Articles

The trials of Alcoholics Anonymous

The trials of Alcoholics Anonymous

Herbal medicine use and quality of life among people living with HIV/AIDS in northeastern Thailand

Many people living with HIV/AIDS (PHA) use herbal medicine as one of alternative therapies, where curative options are limited. This study aimed to examine the association between the herbal medicine use and quality of life (QOL) among PHA in northeastern Thailand. Participants were 132 HIV-positive Thai adults who attended the PHA's self-help group meetings from June to July 2002. Health-related QOL scores were measured by self-administered questionnaire from the Medical Outcomes Study-HIV Health Survey. Dimensions of physical function (PF) and mental health (MH) in QOL were assessed. Additional data were collected on herbal medicine use, socio-demographic, psychosocial and HIV-related characteristics. The herbal medicine users had significantly better MH scores than the non-users, while the herbal medicine use was not statistically associated with PF scores. When stratified, herbal medicine users with the following characteristics had significantly better MH scores than the non-users: female, widowed, having no income, reporting any HIV-related symptom, having no instrumental support or receiving subsidies. In conclusion, herbal medicine use was associated with better MH especially among socially vulnerable PHA. This study suggests that herbal medicine has a potential to improve the MH aspect of QOL among socially vulnerable PHA who cannot easily receive antiretroviral therapy in Thailand.

The Effectiveness of an Integrated Treatment Approach for Clients With Dual Diagnoses

Objective: A randomized experiment tested the effectiveness of adding a psychoeducationally oriented group therapy intervention, Good Chemistry Groups, to standard inpatient chemical dependency services for clients dually diagnosed with mental and substance dependence disorders. Method: Ninety-seven clients were randomly assigned to an experimental group (n = 48) and a control group (n = 49). Outcome variables included drug and alcohol use, participation in self-help support group meetings, incarceration days, psychiatric symptoms, psychiatric inpatient admissions, compliance with prescribed psychotropic medication plans, and composite scores on the Addiction Severity Index. Results: No significant treatment effects were found on any of the outcome variables. The findings were generally consistent with those of prior controlled studies. Conclusion: Good Chemistry Groups did not add to the effects of standard treatments for dually diagnosed clients. Practitioners should continue to develop and evaluate alternative integrated treatment approaches that might prove to be more effective than this one.

One hundred alcoholic doctors: a 21-year follow-up.

This paper reports the long-term recovery rate among 100 alcoholic doctors over a 21-year period. Included are 20 doctors who relapsed and re-recovered, 10 who died of non-alcohol related causes and eight who died of alcohol-linked causes. Also reported are abstinence, attendance at self-help group meetings, mortality and employment. Selected doctors were the first 100 consecutive alcoholic doctors to become members of the North West Doctors and Dentists Group (NWDDG) between 1980 and 1988. Information sources combine prospective data obtained from each doctor at the time of first contact with the results of questionnaires distributed in 1988 and 2001 and continuing prospective reporting of mortality by relatives. There is a 9% incidence of oral or oesophagopharyngeal cancer. Reported mortality, mostly by relatives, revealed that 24 doctors died directly of their alcoholism. We observed a 73% recovery rate for a 17-year average duration, over a 21-year period. Comparison of recovery with abstinence showed a strong correlation. For the first 6 months of recovery, there was also a strong relationship between recovery and attending meetings of self-help groups. This relationship is not sustained in the long term, though 14 doctors with an average recovery of 20 years still attend meetings regularly. Of 56 doctors currently known to have survived, 29 have retired and 27 are still working as doctors. Three doctors have been drinking normally for an average of 17 years.

Core Heritable Personality Characteristics and Relapse in Alcoholics

This article represents the proceedings of a symposium at the 2000 ISBRA Meeting in Yokohama, Japan. The chairs were David S. Janowsky and Jan Fawcett. The presentations were (1) The tridimensional personality questionnaire: Predictor of relapse in detoxified alcoholics, by Kurt Meszaros; (2) Novelty seeking predicts clinical trial attrition in alcoholics, by Jan Fawcett; (3) Personality and alcohol/substance use disorder patient relapse and attendance at self-help group meetings, by David S. Janowsky; and (4) A three-pathway psychobiological model for craving for alcohol, by Roel Verheul.

Outpatient mental health care, self-help groups, and patients' one-year treatment outcomes.

To examine the association between the duration and amount of outpatient mental health care, participation in self-help groups, and patients' casemix-adjusted one-year outcomes. A total of 2,376 patients with substance use disorders, 35% of whom also had psychiatric disorders, were assessed at entry to treatment and at a one-year follow-up. Information about the duration and amount of outpatient mental health care was obtained from a centralized health services utilization database. Patients who obtained regular outpatient mental health care over a longer interval and patients who attended more self-help group meetings had better one-year substance use and social functioning outcomes than did patients who were less involved in formal and informal care. The amount of outpatient mental health care did not independently predict one-year outcomes. The duration of outpatient mental health care and the level of self-help involvement are independently associated with less substance use and more positive social functioning. The provision of low intensity treatment for a longer time interval may be a cost-effective way to enhance substance abuse and psychiatric patients' long-term outcomes.

Before-Discharge Intervention Method in the Treatment of Alcohol Dependence

Background: Alcoholics have the fundamental problem of denying dependence on alcohol and minimizing their alcohol-related problems. Therapeutic interventions often fail to help alcoholics become aware of their drinking problem and remain in long-range treatment programs, which is a prerequisite for recovery from alcohol dependence. Methods: Inpatients were assigned to either group 1 or 2 depending on which day of the week they were admitted to the hospital. A newly developed structured intervention method (Before-Discharge Intervention Method, or BDIM) was employed with select (nonrandomized) hospitalized alcoholics in group 1 and their family members before the patients were discharged from the hospital. None of the patients in group 2 received the BDIM. With this intervention method, the alcoholic's family members delivered to him or her verbal messages that conveyed concern about the alcoholic's problem drinking, their observations of the alcoholic's past episodes of drinking problems, and wishes and support for abstinence. Unless patients died during hospitalization or would not be able to attend the hospital follow-up clinic and local self-help groups (Danshukai) after discharge, outcome evaluations were carried out on all patients in groups 1 and 2 during two calendar months, 3 months after the last BDIM patient left the hospital. Outcome measures included patient's and family members' attendance at hospital outpatient follow-up sessions and self-help group meetings, and patient's abstinence. Results: Family members' attendance at hospital follow-up sessions and/or self-help group meetings was significantly higher in group 1 than in group 2. Among the three subgroups of discharged patients in either group 1 or 2—that is, those who lived with their spouse, those who lived with someone other than their spouse, and those who lived alone—only those in group 1 who lived with their spouse did significantly better than their counterparts in group 2 in three treatment outcome measures. However, patients' maintenance of abstinence was significantly better only when they and their family members both attended hospital outpatient follow-up sessions and/or self-help group meetings. We noted no other statistically significant difference between groups 1 and 2 in any of the other two subgroups of discharged or patients in any of the three treatment outcome variables. Irrespective of the BDIM, patients who lived alone did significantly more poorly than either those who lived with their spouse or those who lived with someone other than their spouse in terms of attendance at hospital follow-up sessions and local self-help group meetings and abstinence. Conclusions: This intervention method can help the alcoholic face the reality of his or her drinking problems and alcohol dependence and thus remain longer in long-range rehabilitation programs, which is a prerequisite for successful recovery from alcohol dependence.

Before-Discharge Intervention Method in the Treatment of Alcohol Dependence

Alcoholics have the fundamental problem of denying dependence on alcohol and minimizing their alcohol-related problems. Therapeutic interventions often fail to help alcoholics become aware of their drinking problem and remain in long-range treatment programs, which is a prerequisite for recovery from alcohol dependence. Inpatients were assigned to either group 1 or 2 depending on which day of the week they were admitted to the hospital. A newly developed structured intervention method (Before-Discharge Intervention Method, or BDIM) was employed with select (nonrandomized) hospitalized alcoholics in group 1 and their family members before the patients were discharged from the hospital. None of the patients in group 2 received the BDIM. With this intervention method, the alcoholic's family members delivered to him or her verbal messages that conveyed concern about the alcoholic's problem drinking, their observations of the alcoholic's past episodes of drinking problems, and wishes and support for abstinence. Unless patients died during hospitalization or would not be able to attend the hospital follow-up clinic and local self-help groups (Danshukai) after discharge, outcome evaluations were carried out on all patients in groups 1 and 2 during two calendar months, 3 months after the last BDIM patient left the hospital. Outcome measures included patient's and family members' attendance at hospital outpatient follow-up sessions and self-help group meetings, and patient's abstinence. Family members' attendance at hospital follow-up sessions and/or self-help group meetings was significantly higher in group 1 than in group 2. Among the three subgroups of discharged patients in either group 1 or 2-that is, those who lived with their spouse, those who lived with someone other than their spouse, and those who lived alone-only those in group 1 who lived with their spouse did significantly better than their counterparts in group 2 in three treatment outcome measures. However, patients' maintenance of abstinence was significantly better only when they and their family members both attended hospital outpatient follow-up sessions and/or self-help group meetings. We noted no other statistically significant difference between groups 1 and 2 in any of the other two subgroups of discharged or patients in any of the three treatment outcome variables. Irrespective of the BDIM, patients who lived alone did significantly more poorly than either those who lived with their spouse or those who lived with someone other than their spouse in terms of attendance at hospital follow-up sessions and local self-help group meetings and abstinence. This intervention method can help the alcoholic face the reality of his or her drinking problems and alcohol dependence and thus remain longer in long-range rehabilitation programs, which is a prerequisite for successful recovery from alcohol dependence.

The development and assessment of valid measures of service delivery to enhance inference in outcome-based research: Measuring attendance at self-help group meetings.

The development and assessment of valid measures of service delivery to enhance inference in outcome-based research: Measuring attendance at self-help group meetings.

The development and assessment of valid measures of service delivery to enhance inference in outcome-based research: measuring attendance at self-help group meetings.

The article focuses on the validity of measures of service delivery; any attempt to establish a linkage between service and outcomes follows the assumption that services have been given and received. Claims relating to the benefits of attending self-help groups on the mental health functioning of individuals with depression or manic depression were examined in the context of a well-controlled study and a validated measure of individual attendance. A test was conducted to probe the conjecture that the greater the degree of involvement in self-help groups, the greater the improvement in functioning. Additional questions related to individual patterns of attendance, generalization of the intervention's effects, and migration from "home" to other meeting sites.

Intrapersonal Resources and the Effectiveness of Self-Help Groups for Bereaved Older Adults

The relative impact of three intrapersonal resources (self-esteem, competencies and life satisfaction) and the duration of a self-help group intervention on levels of depression and grief were examined over time among a sample of 295 recently bereaved older adults. In general, the resources examined had a greater direct influence on outcomes than the intervention. Also, those with lower competencies reported reduced depression and grief with greater meeting attendance, whereas the opposite was at first true for those with high competencies. Depression eventually decreased, however, among those with high competencies who continued to attend self-help group meetings for more than 8 weeks. Although bereavement self-help groups can aid those who may be deficient in selected skills, it is equally important to emphasize ways the bereaved can more effectively use those strengths that they may already possess in order to facilitate adaptation.

EDUCATIONAL STRATEGIES FOR CLINICIANS

Largely because of a lack of training, many primary care physicians are unaware of how they can prevent, detect, or manage substance abuse within their clinical practice. The educational process used to develop a teaching unit can be simplified by initially asking a few directed questions. The answers to these questions determine what needs to be taught while facilitating the subsequent steps of determining learning goals and objectives and selecting appropriate teaching materials and strategies. Evaluating the teaching unit on at least a cursory level provides useful information for future planning. A variety of curriculum manuals and clinical text parts can be readily incorporated into teaching units. These same sources can alternatively be adapted to an individual's own self-directed course of study. Incorporation of experimental educational strategies is especially useful in substance abuse instruction. Including recovering individuals, attendance at self-help group meetings, and role play exercises are all useful experimental strategies for engaging the learner. Tapping into organizational resources and networking with others involved in similar activities enhances one's potential through the sharing of information and through the synergism created by networking with others.

Work site group meetings and the effectiveness of a televised smoking cessation intervention.

At the work site, smoking accounts for increased health care expenses and worker absenteeism due to smoking-related illness and reduced productivity and lost wages. Developing comprehensive and accessible smoking cessation programs at the work site is an important objective for health care professionals. In this study, employees of 43 corporations participated in a televised smoking cessation program accompanied by self-help manuals. The media component involved presenting a smoking cessation program on a network television affiliate station during the 4:30 p.m. and 10:00 p.m. news for 20 days. Employees at half the corporations also had access to semiweekly self-help group meetings. Adding self-help support groups to a program involving self-help manuals and the media reports was found to significantly increase abstinence and its maintenance over time. The implications of using the media, self-help groups, and work site locations in large-scale community-based interventions are discussed.

Enhancing the efficacy of behavior therapy for obesity: Effects of aerobic exercise and a multicomponent maintenance program.

Tested whether the efficacy of behavior therapy for obesity might be improved by the programmatic additions of an aerobic exercise regimen during treatment and a multicomponent maintenance program following treatment. 14 male and 76 female obese 22–60 yr olds were randomly assigned to 2 treatment conditions (behavior therapy or behavior therapy plus aerobic exercise) and 2 posttreatment conditions (no further contact or a multicomponent maintenance program). The exercise regimen consisted of 80 min/week of brisk walking or stationary cycling. The maintenance program included therapist contact by telephone and mail and peer self-help group meetings. At posttreatment, Ss in the behavior therapy plus aerobic exercise condition lost significantly more weight than those who received behavior therapy only. Over an 18-mo follow-up period, maintenance program participants demonstrated significantly better weight-loss progress than Ss in the no-further-contact condition.

REINFORCING SELF‐HELP GROUP ACTIVITIES OF WELFARE RECIPIENTS1

The attendance rates of welfare recipients at self-help group meetings was compared when supplementary reinforcement was given for attending and when it was not. Reinforcers included donated items, such as clothing and household goods, and information about welfare services. It was found that the attendance at meetings averaged three recipients per meeting without reinforcement and 15 recipients per meeting with reinforcement. There was evidence that attendance was associated with participation in other self-help activities. It was concluded that practical forms of reinforcement can be found to maintain the participation of severely disadvantaged populations in self-help groups.