Intensity of acute services, self-help attendance and one-year outcomes among dual diagnosis patients

Abstract

Objective: This study of dual diagnosis patients examined the associations of the intensity of acute care services and 12-step self-help group attendance with substance use and mental health outcomes.

Method: Participants (n = 230; 96% men) received treatment in one of 14 residential programs and were evaluated with the Addiction Severity Index at discharge (98%) and at 1-year follow-up (80%).

Results: High service intensity in acute treatment was associated with better substance use and family/social outcomes both at discharge and at 1 year when patients' intake status was controlled. More attendance at 12-step self-help groups was also associated with better patient substance use and psychiatric outcomes, both during and following treatment. The benefits of more 12-step group attendance, however, depended on whether acute treatment was of low or high service intensity. More 12-step group attendance during treatment was associated with better alcohol and drug outcomes at discharge only among patients treated in low-service-intensity programs; and more attendance postdischarge was associated with better psychiatric and family/social functioning at 1 year only among patients receiving low-service-intensity care.

Conclusions: We suggest potential means by which high-service-intensity acute care programs might better facilitate patients' postdischarge use of 12-step self-help groups to benefit outcomes.