Evidence for 12-step facilitation and combining evidence based therapies: Use of TSF with Suboxone treatment.

The first part of this 2008 NIDA Blending Conference session featured a presentation by Dennis Donovan, PhD, looking at the evidence supporting, and methods of implementing, 12-step facilitation in substance abuse treatment programs. It begins by providing a sampling of the data that supports the potential positive benefits of 12-step program involvement for people with substance use disorders, and describes results from previous research on 12-step involvement. From there, it looks at factors that contribute to greater 12-step involvement, such as offering active encouragement and referral during treatment. Using more intensive methods of promoting self-help or 12-step group involvement has been empirically demonstrated to be effective at lowering relapse in patients, and a variety of methods to increase 12-step involvement have been found effective. Three of those methods are described: Twelve Step Facilitation (Project MATCH), Group Drug Counseling plus Individual Drug Counseling, and Systematic Encouragement and Community Access/Intensive Referral. Dr. Donovan concludes his presentation with a description of the the STAGE-12 protocol of the CTN (NIDA-CTN-0031: “Stimulant Abuser Groups to Engage in 12-Step (STAGE-12): Evaluation of a Combined Individual-Group Intervention to Reduce Stimulant and Other Drug Use by Increasing 12-Step Involvement”).

The second presentation in this session, by Mimmie Byrne, offers a discussion of the Chestnut Ridge Suboxone clinic model, which combines the use of Twelve-Step Facilitation (TSF) with Suboxone treatment. The clinic adapted standard TSF to include other drugs of choice in addition to alcohol and the use of a treatment group to increase comfort with sharing in self-help. Clinic demographics and data are presented.

Related protocols: CTN-0031