Selfhelp Groups And Dually Diagnosed Individuals

As in other substance-using populations (Miller, Ninonuevo, Klamen, Hoffmann, & Smith, 1997; Ritsher et al., 2002), self-help group attendance has been associated with improved substance use outcomes in dually diagnosed populations (Brooks & Penn, 2003; Ritsher et al., 2002). Whether this is a reflection of self-help groups' improving outcomes directly or a self-selection bias (i.e., patients attending self-help groups may be more likely to remain abstinent because they are more motivated) is unclear.

Despite the fact that self-help groups are both free of charge and geographically accessible (Kurtz, 1997), many dually diagnosed patients do not attend these meetings (Noordsy, Schwab, Fox, & Drake, 1996). Some clinicians may be reluctant to recommend self-help groups to dually diagnosed patients because of concerns that self-help group members might express negative attitudes toward psychotropic medication (Humphreys, 1997). However, recent research indicates that, while this sometimes occurs (Noordsy et al., 1996), it is not prevalent (Meissen, Powell, Wituk, Girrens, & Arteaga, 1999). Moreover, official AA literature states that psychiatric medication, when legitimately prescribed, is appropriate (Alcoholics Anonymous, 1984). When educating patients about the interaction between psychiatric symptoms, drug and alcohol use, and medications, clinicians should inform patients that while some self-help group members may criticize the use of medications, this contradicts official AA policy.

Clinicians may also be concerned that these groups only focus on SUDs (Humphreys, 1997) and may therefore not be as helpful to patients who are struggling with other psychiatric disorders. Recent research suggests that some patients and AA contacts (i.e., persons listed in the AA directories as experienced members) agree (Meissen et al., 1999; Noordsy et al., 1996). However, by encouraging patients to focus on obtaining what AA and similar groups offer, and not expecting AA to provide services outside of its stated mission, clinicians can help dually diagnosed patients to take advantage of these groups.

To address some of these concerns, several dual-focus self-help groups have emerged for participants with co-occurring SUDs and psychiatric disorders (e.g., Double Trouble in Recovery, Dual Recovery Anonymous, and Dual Disorders Anonymous) (Magura et al., 2003). Similar to the literature on self-help groups in the SUD population, positive associations have been found between attendance at dual-focus self-help groups and abstinence (Magura et al., 2003) as well as psychiatric/quality-of-life (Magura, Laudet, Mahmood, Rosenblum, & Knight, 2002) outcomes. Again, whether this is a result of self-selection bias regarding the characteristics of patients who attend these meetings or not is unclear. It is important to consider that the literature on dual-focus self-help groups is an emerging one and is even slimmer than the literature on integrated psychosocial treatments. Further study is needed before conclusions regarding their effectiveness can be drawn.

Alcohol No More

Alcohol No More

Do you love a drink from time to time? A lot of us do, often when socializing with acquaintances and loved ones. Drinking may be beneficial or harmful, depending upon your age and health status, and, naturally, how much you drink.

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