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Mutual Support Groups in Recovery

By Dr. Bouldin

Mutual Support Groups are an essential part of working a successful recovery program. One such support group is the AA Twelve Step Programs. These programs have more than 70 years of experience in helping alcoholics, addicts, and their family members recover from addiction. I have seen first-hand that most alcoholics and addicts do in fact have a more rewarding and successful recovery if they actively participate in a Twelve Step program.

Healthcare providers especially physicians can and will play an important role by helping the struggling addict or alcoholic. Being a fiduciary, providers must understand these programs, be willing to share these programs and encourage their patients to participate these support group meetings. Statistics show that by integrating the 12 Steps into a patient's treatment plan, the program will prove more efficacious and long after the patient is discharged. “In the 1996 triennial AA member survey, only 8% of newcomers reported coming to meetings through a physician's referral.”(.” (, pg 918).

However unfortunate this finding is, it is still quite common that providers fail to properly refer patients or provide oversight for effective treatment utilization. It is proven and supported with short term and long-term data that AA and other self-help support groups are a valuable resource for physicians in helping their patients suffering from addiction. Physicians and other providers must do a better job integrating these programs into their treatment programs when referring their patients. There are several ways to refer patients as provided by our literature. In the example of Alcoholics Anonymous there a few ways a provider may refer a patient to AA. One is to provide a listed phone number in most cities and will provide volunteers to contact the patient and explain AA. Two, after obtaining the patient's permission, the physician should initiate contact with the self-help group in the patient's presence. Three, Giving the patient the telephone number with a recommendation to call usually is not successful. (PoA, pg 919)

In the case of proof, allowing a patient to make contact has shown futile. This was shown in cohort by Sisson and Mallams who randomly assigned newly diagnosed alcoholics to two types of referrals. The first group was told to call AA and go to a meeting and the second group was put in direct contact with an AA member while in the physician's office. Not shockingly, none of the first group attended a meeting; the entire second group attended a meeting. (PoA P.919)

There are other effective methods proven successful. The counselor or other healthcare provider may find it helpful to keep a list of AA members willing to do step work with their new patients and some physicians may even accompany patients to AA meetings. Though such attendance is a time consuming and expensive for the counselor or provider, it does demonstrate to a provider's sincere and genuine belief in the importance of mutual support groups such as AA to the overall recovery process.

Additionally, providers might obtain a current list of nearby AA meetings from the local intergroup or central office where these lists include a brief description of the type of meeting its location and most importantly, whether it is a special interest group.

A knowledgeable, empathetic addiction provider can and will prepare and support their patient in overcoming the initial fear and apprehension about attending a support group like the Twelve Step meeting. It is of the up most importance the healthcare addiction specialist should acknowledge the patient's ambivalence to ceasing use of their DOC or Drug of Choice.

Additionally, the listing and review of the referral guidance it imperative the process and ultimate success in a program. I can and will attest to the truth and effectiveness to these very suggestions given to me when entering my Twelve Step Program.

The following suggestions will help the referral work, they are as I remember: (PoA, 918) · Know the meetings in your area and refer each patient to a meeting that will meet his or her needs and If they are unhappy with a meeting do you best to help them find another. · Help patients make direct contact with members of the group. · Give patients a prescription to attend a meeting. · Tell them what is going to happen at the meeting and how meetings are structured. · Encourage them to socialize by arriving early and staying late after the meeting. · Encourage them to attend frequent meetings, but initially do not push or coerce them. · Encourage patients to pick a temporary sponsor early to increase their chances of staying clean and sober and tell them to pick someone of the same gender with at least 1 year of sobriety. · Tell them it's ok to not like a sponsor and that it is okay to change if necessary. · Talk about any fears and apprehensions about attending a meeting and dispel any inaccurate myths or beliefs they may have about Twelve Step support groups. · Schedule them for a follow-up visit to discuss their experience at meetings. If they have been attending regularly, encourage them to pick a “home” group and become more active. Being actively involved in the program is a better predictor of a successful outcome than the number of meetings attended.

In my opinion, professionals need to be familiar with recovery support groups, especially the Twelve Step programs to be able to help patients with addiction. The addiction provider can and should work as a facilitator to help patients attend meetings.

The statistics prove the long-term success rates for recovery program treatment plans. In one case, ““Project Match showed that trained professionals who support meeting attendance in a positive noncoercive way could improve their patient's acceptance of Twelve Step programs.” (PoA,pg 918)

In so doing there are proven advantages to referring patients to Twelve Step programs: · Meetings are free of cost and accessible · They are autonomous and no records are kept · Participants do not have to be sober to attend a meeting. · Persons from all racial and ethnic backgrounds and socioeconomic groups are always welcome · Attending group meetings helps overcome the patient's feelings of identity and isolation. · Groups will educate patients about the disease process of addiction and the hope of recovery · Groups help members learn basic social skills and can become less self-obsessed · Groups provide a reality based CBT type approach for addicts in recovery, overcoming behaviors · Groups may offer new support to help members with setbacks experienced in early recovery · Groups may help members constructively use their time better than in their addiction

Clearly and especially in my case, the attitudes and behavioral norms are much more in conformity with the values of the larger. The expectation of avoiding drunkenness in AA is paramount but more importantly and, normative in our culture we as people are highly distressed over the consequences of addiction!

This is precisely whey candidates to respond to the strong ideologic and philosophic orientations of AA and toward recovery as a whole where the conditioning is not only reinforced by the group's ideology but the changing of behaviors are observed as well. The norms are restored especially those related to the abstinence of the DOD, drug of choice. Most importantly the restoration of a spiritually grounded self and life is an actual result. I am living proof.

References: Principles of Addiction

Jacobson S. The 12-step program and group therapy for adult children of alcoholics. J Psychoactive Drugs 1987;19(3):253–255.

Miller WR, Rollnick S. Motivational interviewing: preparing people to change addictive behavior. New York: The Guilford Press, 1991.

27. Tonigan S, Ashcroft F, Miller W. AA group dynamics and 12-step activity. J Stud Addict 1995;56:616–621.

Montgomery HA, Miller WR, Tonigan JS. Does Alcoholics Anonymous involvement predict treatment outcome? J Subst Abuse Treat 1995;2(4): 241–246.

Anonymous. AA as a resource for the medical profession. New York: Alcoholics Anonymous World Service, Inc., 1982


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