Chronic and relapsing physical conditions require some level of continual care despite an apparent cessation of symptoms. Experience suggests that the same is true of alcohol and other drug abuse, but little systematic research has been done on the cost-effectiveness of aftercare. This paper reports on the effectiveness of alternative aftercare interventions as measured by outcomes such as employment and subsequent substance use. The study data come from randomized trials at the Philadelphia VA and Spectrum in Massachusetts (N=410). Relapse prevention (RP) aftercare was compared to referred aftercare (minimal aftercare), standard care and self-help aftercare. Questions from the Treatment Services Review (TSR) instrument on Alcoholics Anonymous (AA), Narcotics Anonymous (NA) or Cocaine Anonymous (CA) sessions in the past week were used to measure self-help aftercare, and were administered at 7 points over a two-year follow-up. Preliminary analysis of Spectrum data indicates that the amount of self-help aftercare was a powerful determinant of subsequent outcomes and was as efficacious overall as the professionally delivered aftercare interventions. Additionally, the self-help-only group received substantially more aftercare than the intervention groups. At the Spectrum site, averaging across all follow-up points, the RP group received 0.19 NA or CA self help sessions per week versus 0.34 sessions for the control group (p<.05). Subsequent multivariate analyses will address the relationship of different amounts of self-help aftercare to outcomes, controlling for program and client characteristics. This study will then examine whether a combination of professional services and regular self-help sessions are a promising approach for improving treatment outcomes.
Learning Objectives: At the conclusion of the session the participant (learner) will understand the impact of different amounts and combination of relapse prevention and self-help aftercare on treatment outcomes
Keywords: Substance Abuse Treatment, Outcomes Research
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.