All twelve step faciliation is not equal

Not a surprising outcome if you know much about twelve step facilitation:

Important findings from the current investigation of the relationship between services received and outcomes of chemical dependency treatment were that higher participation in optional or extracurricular 12-step meetings was associated with better treatment outcomes, whereas curricular involvement in 12-step groups (i.e., groups required as part of treatment) showed no association with treatment outcomes.

Get people to meetings does not necessarily equal connecting them with the community. All meetings are not equal. Getting them to a meeting where a thriving, welcoming community of recovery is essential for effective twelve step facilitation. It takes a kind of recovery cultural competence to effectively attend to these matters.

Other findings:
  • …weak effects for supplemental psychiatric, family, medical, and legal services: We found null associations between delivery of these services and the odds of 6-month sobriety across the board.
  • The study also found associations between participation in sober recreational events at 2 and 4 weeks and better treatment outcomes at 6 months
Finally, another finding emphasizes the importance of recovery-oriented services, rather than treatment-oriented services:

We found that residential participants showed higher participation in curricular 12-step meetings at 2 weeks, relative to day-hospital participants and as expected; however, this effect was not maintained throughout follow-ups, and residential participants actually showed relatively lower rates of extracurricular 12-step meeting attendance and working with a sponsor through 4 weeks. These latter differences may be the consequence of residential clients’ tightly scheduled time, intensive involvement in curricular 12-step meetings, and/or restrictions on leaving the treatment site.