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AA's motivational benefits.

Substance abuse treatment in the United States consists mainly of 12-step self-help programs such as Alcoholics Anonymous (AA). Nonetheless, few studies have examined the factors that make or break recovery for those who complete a typical 12-step program in a hospital or private clinic.

A new investigation, directed by Jon Morgenstern of Mount Sinai School of Medicine in New York, suggests that when the AA approach works, it does so for much the same reasons as other drug abuse treatments or even self-initiated quitting without formal treatment. These common factors consist of determination to pursue a particular treatment (or self-defined goals), confidence in one's ability to resist drug use in various social situations, and embrace of strategies to avoid drug consumption (such as talking regularly with a trusted friend).

Morgenstern's group studied 93 men and women who completed treatment for alcohol or illicit drug abuse, or both, at one of two private hospital-based programs grounded in the 12-step approach. Treatment, which lasted about 3 weeks, stressed overcoming denial of addiction, fostering a sense of belonging to self-help groups, and thinking of addiction as a disease.

Self-reported substance use declined most sharply, both I month and 6 months after completing treatment, for those who had initially expressed a strong desire to attend a 12-step program, the researchers report in the October Journal of Consulting MD Clinical Psychology. The same participants often attended self-help meetings after leaving formal treatment, felt confident that they could abstain from drug use, and devised strategies to minimize or halt drug use.

On the other hand, individuals who had reported scant motivation to enter a 12-step program remained uninspired when treatment ended and returned to their accustomed levels of alcohol and drug consumption.

Clinicians who use the 12-step model frequently try to induce motivation in people referred to their programs by challenging them to overcome denial of their addiction and to heed a higher spiritual power.

The new findings indicate that more effective ways are needed to light a motivational fire under substance abusers receiving formal treatment, Morgenstern and his coworkers hold.
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Title Annotation:study finds motivation is vital factor in the success of Alcoholics Anonymous and other 12-step programs
Author:Bower, Bruce
Publication:Science News
Article Type:Brief Article
Date:Nov 8, 1997
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