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Randomized Controlled Trial
. 2014 May;109(5):766-73.
doi: 10.1111/add.12471. Epub 2014 Feb 16.

Motivational intervention to enhance post-detoxification 12-Step group affiliation: a randomized controlled trial

John-Kåre Vederhus  1 , Christine Timko, Oistein Kristensen, Bente Hjemdahl, Thomas Clausen
Affiliations
Randomized Controlled Trial

Motivational intervention to enhance post-detoxification 12-Step group affiliation: a randomized controlled trial

John-Kåre Vederhus et al. Addiction. 2014 May.

Abstract

Aims: To compare a motivational intervention (MI) focused on increasing involvement in 12-Step groups (TSGs; e.g. Alcoholics Anonymous) versus brief advice (BA) to attend TSGs.

Design: Patients were assigned randomly to either the MI or BA condition, and followed-up at 6 months after discharge.

Setting and participants: One hundred and forty substance use disorder (SUD) patients undergoing in-patient detoxification (detox) in Norway.

Measurements: The primary outcome was TSG affiliation measured with the Alcoholics Anonymous Affiliation Scale (AAAS), which combines meeting attendance and TSG involvement. Substance use and problem severity were also measured.

Findings: At 6 months after treatment, compared with the BA group, the MI group had higher TSG affiliation [0.91 point higher AAAS score; 95% confidence interval (CI) = 0.04 to 1.78; P = 0.041]. The MI group reported 3.5 fewer days of alcohol use (2.1 versus 5.6 days; 95% CI = -6.5 to -0.6; P = 0.020) and 4.0 fewer days of drug use (3.8 versus 7.8 days; 95% CI = -7.5 to -0.4; P = 0.028); however, abstinence rates and severity scores did not differ between conditions. Analyses controlling for duration of in-patient treatment did not alter the results.

Conclusions: A motivational intervention in an in-patient detox ward was more successful than brief advice in terms of patient engagement in 12-Step groups and reduced substance use at 6 months after discharge. There is a potential benefit of adding a maintenance-focused element to standard detox.

Keywords: Alcoholics Anonymous; Norway; Twelve-Step facilitation; detoxification; patient education; randomized controlled trial; self-help groups.

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