Twelve Step

The present study compared methadone maintenance alone to methadone maintenance in combination with 16 weeks of either Intensive Twelve-Step Facilitation (ITSF) or Acceptance and Commitment Therapy (ACT) in a preliminary efficacy trial with polysubstance-abusing opiate addicts who were continuing to use drugs while on methadone maintenance. Results showed that the addition of ACT was associated with lower objectively assessed opiate and total drug use during follow-up than methadone maintenance alone, and lower subjective measures of total drug use at follow-up. An intent-to-treat analysis which assumed that missing drug data indicated drug use also provided support for the reliability of objectively assessed total drug use decreases in the ACT condition. ITSF reduced objective measures of total drug use during follow-up but not in the intent-to-treat analyses. Most measures of adjustment and psychological distress improved in all conditions, but there was no evidence of differential improvement across conditions in these areas. Both ACT and ITSF merit further exploration as a means of reducing severe drug abuse.

Objectives:
Alcoholics Anonymous (AA) is a well-known, widely available recovery programme. Although the programme has been in use for many decades, there has been limited qualitative research into the spiritual focus of AA, which many adherents see as the cornerstone of their recovery. This study was aimed at examining how those recovering from alcoholism through AA view their spiritual development before and after joining AA and the extent to which they believed spirituality helped them to maintain sobriety.
Design:
The study involved a qualitative design.
Methods:
Interviews were conducted with four men recovering from alcoholism and data were examined using Interpretative Phenomenological Analysis (IPA). Participants needed to have been sober for more than a year, sponsoring at least one AA member, and had at least one spiritual experience while in recovery.
Results:
Analyses uncovered three superordinate themes - ‘Trust’, ‘Self-Awareness’ and ‘Community’ - and 10 subordinate themes. Four subordinate themes were chosen for deeper analysis and discussion - ‘Higher Power’, ‘Cleansing and Maintaining’, ‘Realisations and Revelations’, and ‘Giving Back’. This study has shown that spirituality was perceived by participants as pivotal to recovery. Participants viewed AA recovery as having had a spiritual impact for becoming and staying sober. The cultivation of a spiritual focus also appears to have helped the participants with their attitude towards themselves and relationships with others.
Conclusions:
Implications for addiction recovery programmes are discussed, particularly with enhancing spiritually focused behaviours, including self-awareness, humility, prayer and meditation, identification with others’ experiences, and willingness to provide service.