Motivational Interventions Increase Participation In 12-Step Programs
Twelve-step programs are mutual self-help programs that use a combination of gradual goals (i.e., steps) and peer support to help recovering substance addicts establish and maintain a long-term commitment to avoiding further substance use. However, not all people who join these programs attend regularly or successfully abstain from substance intake. In a study published in May 2014 in the journal Addiction, researchers from the U.S. and Norway assessed the effectiveness of a technique called motivational intervention in helping 12-step participants increase their program involvement and their ability avoid substance relapses.
The 12-step approach was initiated in the 1930s with the formation of Alcoholics Anonymous. Participants in 12-step-based programs commit to a progressive series of actions designed to help them recover from active involvement in the use of alcohol or other substances of abuse. These actions including admitting a lack of self-control over addictive behaviors, making a call to a higher or greater power to assist in the recovery process, examining and atoning for damaging conduct while under the influence of drugs or alcohol, and eventually providing assistance to others not as far along the path of recovery. As a rule, 12-step programs rely heavily on peer sponsorship provided by longer-term members. The 12-step approach is widely used and has proven effective as an aid to the substance recovery efforts carried out in treatment centers that deal with problems such as alcohol addiction, cocaine addiction and opioid narcotic addiction.
Many people who enter substance recovery programs do so with mixed feelings about the recovery process. In fact, significant numbers of program participants enter treatment only at the urging of others. People with ambivalent or hostile feelings toward substance recovery commonly fail to participate fully in their programs, meet the specific objectives that programs set for their clients/patients or successfully complete their program involvement. Motivational interventions are designed to help program participants uncover the mixed or negative feelings they may have about substance recovery, and also to help them change their minds and become more willing and proactive in their treatment. As a rule, practitioners of motivational interventions work cooperatively with clients/patients in an interactive process that strives to avoid a confrontational or antagonistic atmosphere. While a motivational intervention can help at almost any stage of treatment, it typically has its biggest impact in the initial stages of recovery.
Usefulness In 12-Step Programs
In the study published in Addiction, researchers from Stanford University, the Department of Veterans Affairs and Norway’s University of Oslo and Sorlandet Hospital used an examination of 140 Norwegians receiving treatment for alcoholism to assess the usefulness of motivational interventions in promoting involvement in 12-step programs. All of these study participants were in inpatient facilities for alcohol detoxification. Half of the participants received a motivational intervention called 12-step facilitation in two 30-minute sessions. This form of intervention is designed to increase clients’/patients’ level of comfort with 12-step involvement. The facilitation sessions provided during the study included detailed explanations of how substance addicts lose control over their behaviors, a DVD on the 12-step process created by Alcoholics Anonymous and immediately available resources for making direct contact with 12-step groups. The other half of the study participants received only basic advice on 12-step resources in a brief informational session.
Six months after the study participants concluded their involvement in inpatient detoxification, the researchers compared the level of 12-step involvement among the people who received motivational interventions to the level of involvement among the people who only received brief advice on 12-step resources. They concluded that the participants who received motivational interventions were significantly more likely to attend 12-step meetings than those who received only brief advice. They also concluded that the motivational intervention group used both alcohol and drugs on fewer total days than the brief advice group.
Despite the increased 12-step involvement and fewer days of substance use, the authors of the study published in Addiction concluded that the recovering alcoholics who received motivational interventions did not remain abstinent from substance use any more often than their counterparts who received brief advice on available 12-step resources. In addition, motivational intervention did not lead to a decrease in the severity of alcohol-related symptoms. Still, the authors note that, since motivational intervention recipients do attend 12-step meetings more often and use drugs and alcohol on fewer days, the technique may prove useful as part of the recovery process for alcoholics who go through alcohol detoxification.