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Addiction. 2002 Jun;97(6):677-89.

Process and outcome changes with relapse prevention versus 12-Step aftercare programs for substance abusers.

Author information

1
Douglas Hospital Addiction Research Program, McGill University, Verdun, Quebec, Canada. brotho@douglas.mcgill.ca

Abstract

AIMS:

Presumptive support was sought for mechanisms of action whereby two conceptually distinct aftercare programs, relapse prevention (RP) and 12-Step facilitation (TSF), impact upon substance abusers.

PATIENTS AND DESIGN:

Adults who had just completed intensive treatment were assigned randomly to either RP (n=61) or TSF (n=70) aftercare programs.

SETTING:

Three residential treatment facilities.

INTERVENTIONS:

Trained counselors delivered to small groups a manualized aftercare program which focused either upon the utilization of cognitive-behavioral processes to orchestrate change through an individualized treatment plan (i.e. RP) or which sought to facilitate utilization of AA's 12 Steps (i.e. TSF).

MEASUREMENTS:

Process measures developed specifically to quantify either: (a) the changes in self-efficacy process in RP or (b) the utilization of AA's principles in TSF, as well as psychosocial and substance abuse indices were administered to all patients pre- and post-aftercare and at 6-month follow-up.

FINDINGS:

A significant relationship between changes in measures of self- efficacy for RP participants as well as a trend for a relationship between process-specific change for TSF participants partially satisfied the first condition for presumptive support. The fact that the intervention-specific mediators covaried with several outcome indices, and that removal of such mediators attenuated prediction of outcome met, respectively, the second and third conditions for presumptive support.

CONCLUSION:

Carefully orchestrated RP and TSF aftercare programs yield process changes that are related positively to improved outcome.

PMID:
12084137
[Indexed for MEDLINE]

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