Circles of Recovery: Self-help Organizations for Addictions (International Research Monographs in the Addictions)

Self-help organizations across the world have attracted millions of individuals seeking to address addiction problems with drugs or alcohol. This book provides an integrative, international review of research that focuses on how these organizations affect individual members and whether self-help groups and formal health care systems can work together to combat substance abuse. In addition, it offers practical strategies for individual clinicians and treatment systems on how to interact with self-help organizations. Cover......Page 1 Half-title......Page 3 Series-title......Page 4 Title......Page 5 Copyright......Page 6 Contents......Page 7 Acknowledgements......Page 12 Points of departure......Page 13 Goal 1: to describe addiction-related self-help organizations......Page 14 Goal 2: to evaluate how self-help group involvement affects members......Page 15 Goal 3: to provide guidelines for clinical and policy interaction with self-help groups......Page 16 The passion of individuals who have been helped to overcome substance abuse......Page 17 In-group professional bias......Page 18 The scope of this book......Page 19 Range of societies examined......Page 20 Benefits and challenges of an international scope......Page 21 Range of addiction-related and non-addiction-related self-help organizations addressed......Page 23 Nomenclature......Page 24 Members share a problem or status......Page 25 Self-directed leadership......Page 26 Norm of reciprocal helping......Page 27 Voluntary association......Page 28 Developed philosophy and program of change......Page 29 Groups nested within a larger organizational structure......Page 30 Membership by relations of the substance-abusing participant......Page 31 Defined role for professionals......Page 32 Self-help books......Page 33 Professionally operated treatments, support groups, and patient-education programs......Page 34 Generic factors behind the development of the self-help group movement in the modern world......Page 36 Improved public health and wealth......Page 38 Weakening of familial ties......Page 39 Professional shortcomings......Page 40 Realistic limitations on professional help......Page 41 The rise of consumerism in health care......Page 42 Benefits of participation......Page 43 Background and context......Page 45 Origins and history......Page 47 Philosophy and approach......Page 50 Membership......Page 53 Origins and history......Page 55 Philosophy and approach......Page 56 Membership......Page 57 Origins and history......Page 58 Philosophy and approach......Page 60 Membership......Page 62 Origins and history......Page 63 Philosophy and approach......Page 64 Membership......Page 65 Origins and history......Page 66 Philosophy and approach......Page 67 Origins and history......Page 69 Philosophy and approach......Page 70 Origins and history......Page 72 Membership......Page 74 Origins and history......Page 75 Philosophy and approach......Page 76 Origins and history......Page 77 Philosophy and approach......Page 78 Origins and history......Page 79 Philosophy and approach......Page 81 Origins and history......Page 82 Philosophy and approach......Page 84 Membership......Page 85 Origins and history......Page 86 Philosophy and approach......Page 87 Membership......Page 88 Membership......Page 89 Origins and history......Page 90 Membership......Page 91 Origins and history......Page 92 Membership......Page 93 Philosophy and approach......Page 94 Membership......Page 95 Philosophy and approach......Page 96 Philosophy and approach......Page 98 Membership......Page 99 Philosophy and approach......Page 100 Comparisons and contrasts......Page 102 The case for evaluating whether addiction self-help groups “really work”......Page 106 Evaluating self-help groups as analogous to professional healthcare interventions......Page 107 Randomized trials are not necessarily the best guide to useful knowledge......Page 108 Randomized trials have additional shortcomings specific to self-help group evaluation......Page 109 Correlational studies and quasi-experiments are no panacea either......Page 110 Outcome studies of specific addiction-related mutual-help organizations......Page 111 Al-Anon Family Groups......Page 112 All Nippon Sobriety Association and the Sobriety Friends Society (Danshukai)......Page 114 Double Trouble in Recovery......Page 115 Narcotics Anonymous......Page 116 Nicotine Anonymous......Page 118 Oxford Houses......Page 119 Rational Recovery......Page 120 Outcome studies of AA......Page 121 The Ditman et al. (1967) trial......Page 123 The Brandsma, Maultby, & Welsh (1980) trial......Page 124 The Walsh et al. (1991) trial......Page 125 The Humphreys and Moos (1996) quasi-experiment......Page 126 Longitudinal studies of AA’s effectiveness in combination with treatment......Page 127 Mediators of AA’s influence on drinking outcomes......Page 131 How specific are the mediators of AA’s effectiveness?......Page 134 AA’s potential for population-level benefits......Page 135 Weaknesses and possible harms of AA......Page 137 Summary......Page 138 Moving beyond the treatment-outcome perspective......Page 140 Scope and background......Page 142 Definition of spiritual change......Page 143 Is it possible and appropriate to study spiritual change in self-help organizations?......Page 144 Spiritual change in AA and NA......Page 145 Spiritual change in Al-Anon-affiliated ACA......Page 147 Spiritual change in Women for Sobriety......Page 148 Contrasts in spiritual change across AA/NA, Al-Anon, and Women for Sobriety......Page 149 Are spiritually based self-help organizations cults?......Page 150 Are spiritually based self-help organizations religions?......Page 151 Domain 2: identity and life-story transformation......Page 153 Domain 3: friendship-network composition......Page 156 Domain 4: politicization and empowerment......Page 158 Summary......Page 160 Direct health benefits......Page 161 Healthcare cost reductions......Page 162 Risks to self-help organizations......Page 164 Risks to society......Page 165 Strategies for governmental support of addiction-related self-help organizations......Page 166 Legitimating rhetoric......Page 167 In-kind resource provision......Page 168 Investments in self-help support organizations......Page 169 Media and information campaigns......Page 171 Training and education for professional helpers......Page 172 Needs assessments of self-help organizations......Page 173 Stakeholder-based evaluations of self-help groups and self-help supportive policies......Page 174 Strategies for individual clinicians and treatment agencies......Page 175 Professionals’ attitudes toward self-help groups......Page 176 A venues for collaboration......Page 178 Empirically supported referral strategies......Page 179 Consultation and an experimental attitude over a priori matching......Page 180 Common worries about referral......Page 181 Dual-diagnosis patients......Page 182 Patients on medications and 12-step programs......Page 183 Patients who are averse to 12-step spirituality......Page 184 Adolescents......Page 185 Technical assistance, lectures, research help, and media referral person......Page 186 The addicted professional as a group member......Page 187 The non-addicted professional as a visitor......Page 188 What are addiction-related self-help organizations and where do they come from?......Page 189 What effects do self-help organizations have?......Page 191 Toward a better tomorrow......Page 192 References......Page 194 Index......Page 231 Self-help organizations across the world, such as Alcoholics Anonymous, Croix D'Or, The Links, Moderation Management, Narcotics Anonymous, and SMART Recovery, have attracted tens of millions of individuals seeking to address addiction problems with drugs or alcohol. This book, originally published in 2004, provides an integrative, international review of research on these organizations, focusing in particular on the critical questions of how they affect individual members and whether self-help groups and formal health care systems can work together to combat substance abuse. Keith Humphreys reviews over 500 studies into the efficacy of self-help groups as an alternative and voluntary form of treatment. In addition to offering a critical review of the international body of research in this area, he provides practical strategies for how individual clinicians and treatment systems can interact with self-help organizations in a way that improves outcomes for patients and for communities as a whole Includes bibliographical references (p. 182-217) and index.Definitions, scope, and origin of the health-related self-help group movement -- An international tour of addiction-related mutual help organizations -- Does self-help group participation produce positive substance abuse, psychiatric, and medical outcomes? -- A different perspective on change in self-help organizations: spirituality, identity, life stories, friendship networks, and politicization -- Government, health care organization, and clinical interactions with self-help organizations -- Epilogue: Summing up, moving forward.Electronic reproduction.Boulder, Colo. :NetLibrary,2004.Available via World Wide Web.Access may be limited to NetLibrary affiliated libraries. Circles of Recovery provides an integrative, international review of self-help organizations, focusing on efficacy, effect on individual members, and practical strategies for how individual clinicians and treatment systems can interact with self-help organizations to improve outcomes.