The Transtheoretical Model of Change: Toward a Comprehensive, Transtheoretical Model of Change: Stages of Change and Addictive Behaviors C.C. DiClemente, J.O. Prochaska. The Transtheoretical Model: A Critical Overview R. Davidson. Comments, Criteria, and Creating Better Models J.O. Prochaska, C.C. DiClemente. Understanding Change-Five Perspectives: Readiness, Importance, and Confidence: Critical Conditions of Change in Treatment S. Rollnick. Self-Regulation and the Addictive Behaviors J.M. Brown. Alcohol Motivations as Outcome Expectancies B.T. Jones, J. McMahon. Preparing for Change: Enhancing Motivation for Change W.R. Miller. Using Brief Opportunities for Change in Medical Settings N. Heather. Working Through the Concerned Significant Other R.J. Meyers, et al. Facilitating Change: Guiding Self-Change M.B. Sobell, L.C. Sobell. A Wealth of Alternatives: Effective Treatments for Alcohol Problems W.R. Miller, et al. Sustaining Change: What Predicts Success? V.S. Westerberg. Continuing Care: Promoting the Maintenance of Change D.M. Donovan. 11 Additional Chapters. Index.

Treating addictive behaviors

Objective: The objective of this research was to ascertain whether geographical accessibility (in conjunction with other patient characteristics) reduced the probability of participating in alcoholism aftercare treatment. Methods: A sample of 4,621 United States male veterans discharged with an outpatient appointment from one of 33 Department of Veterans Affairs inpatient Alcohol Dependency Treatment Programs was identified. The outpatient records of each patient were obtained to determine whether aftercare services were utilized following discharge. Binary choice analysis was used to model the decision to enter aftercare treatment as a function of travel distance, age, marital status, ethnicity, severity of illness, and urbanization. Results: Travel barriers significantly reduced aftercare participation, especially for elderly and rural veterans. Both younger and older veterans were less likely to keep their aftercare appointment than middle-aged veterans. Married patients were more likely to utilize out...

The Effects of Travel Barriers and Age on the Utilization of Alcoholism Treatment Aftercare

Objective Peer support can be defined as the process of giving and receiving nonprofessional, nonclinical assistance from individuals with similar conditions or circumstances to achieve long-term recovery from psychiatric, alcohol, and/or other drug-related problems. Recently, there has been a dramatic rise in the adoption of alternative forms of peer support services to assist recovery from substance use disorders; however, often peer support has not been separated out as a formalized intervention component and rigorously empirically tested, making it difficult to determine its effects. This article reports the results of a literature review that was undertaken to assess the effects of peer support groups, one aspect of peer support services, in the treatment of addiction. Methods The authors of this article searched electronic databases of relevant peer-reviewed research literature including PubMed and MedLINE. Results Ten studies met our minimum inclusion criteria, including randomized controlled trials or pre-/post-data studies, adult participants, inclusion of group format, substance use-related, and US-conducted studies published in 1999 or later. Studies demonstrated associated benefits in the following areas: 1) substance use, 2) treatment engagement, 3) human immunodeficiency virus/hepatitis C virus risk behaviors, and 4) secondary substance-related behaviors such as craving and self-efficacy. Limitations were noted on the relative lack of rigorously tested empirical studies within the literature and inability to disentangle the effects of the group treatment that is often included as a component of other services. Conclusion Peer support groups included in addiction treatment shows much promise; however, the limited data relevant to this topic diminish the ability to draw definitive conclusions. More rigorous research is needed in this area to further expand on this important line of research.

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Benefits of peer support groups in the treatment of addiction.

https://psycnet.apa.org/journals/ccp/51/6/900.pdf

Length of Stay, Neuropsychological Performance, and Aftercare: Influences on Alcohol Treatment Outcome.

1. BackgroundThe concept of recovery lies at the core of the Substance Abuse and Mental Health Services Administration's (SAMHSA's) mission, and fostering the development of recovery- oriented systems of care and services is a Center for Substance Abuse Treatment (CSAT) priority. In support of that commitment, in 2005, SAMHSA's CSAT convened a National Summit on Recovery. Participants at the Summit represented a broad group of stakeholders, policymakers, advocates, consumers, clinicians, and administrators from diverse ethnic and professional backgrounds. Although the substance use problems and disorders treatment and recovery field has discussed and lived recovery for decades, the Summit represented the first broad-based national effort to reach a definition of recovery and a common understanding of the guiding principles of recovery and the elements of recovery-oriented systems of care.Through a multistage process, key stakeholders formulated guiding principles of recovery and key elements of recovery-oriented systems of care. Summit participants then further refined the guiding principles and key elements in response to two questions: 1) What principles of recovery should guide the field in the future? and 2) What ideas could help make the field more recovery oriented?A working definition of recovery, 12 guiding principles of recovery, and 17 elements of recovery-oriented systems of care emerged from the Summit process; these are subsequently defined in this paper and in the National Summit on Recovery: Conference Report. [1] These principles and elements can now provide a philosophical and conceptual framework to guide SAMHSA/CSAT and other stakeholder groups and offer a shared language for dialog.Summit participants agreed on the following working definition of recovery:Recovery from alcohol and drag problems is a process of change through which an individual achieves abstinence and improved health, wellness, and quality of life.The guiding principles that emerged from the Summit are broad and overarching. They are intended to give general direction to SAMHSA/CSAT and other stakeholder groups as the treatment and recovery field moves toward operationalizing recovery-oriented systems of care and developing core measures, promising approaches, and evidence-based practices. The principles also helped Summit participants define the recovery-oriented elements and guided recommendations for the field.Following are the 12 guiding principles identified by participants (defined in this paper):* There are many pathways to recovery.* Recovery is self-directed and empowering.* Recovery involves a personal recognition of the need for change and transformation.* Recovery is holistic.* Recovery has cultural dimensions.* Recovery exists on a continuum of improved health and wellness.* Recovery emerges from hope and gratitude.* Recovery involves a process of healing and self-redefinition.* Recovery involves addressing discrimination and transcending shame and stigma.* Recovery is supported by peers and allies.* Recovery involves (re)joining and (re)building a life in the community.* Recovery is a reality.Participants at the Summit agreed that recovery-oriented systems of care are as complex and dynamic as the process of recovery itself. They are designed to support individuals seeking to overcome substance use problems and disorders across their lifespan. Participants at the Summit declared, "There will be no wrong door to recovery" and also recognized that recovery-oriented systems of care need to provide "genuine, free and independent choice" among an array of treatment and recovery support options. Services should optimally be provided in flexible, unbundled packages that evolve over time to meet the changing needs of recovering individuals. Individuals should also be able to access a comprehensive array of services that are fully coordinated to provide support to individuals throughout their unique journeys to sustained recovery. …

Guiding Principles and Elements of Recovery-Oriented Systems of Care: What Do We Know from the Research?*

Participation in aftercare activities during the first 3 months following discharge from inpatient treatment had a positive effect on outcome at 3 months and 6 months, but participation decreased between 3 and 6 months as patients who were doing best began to drop out of the aftercare system.

M Vannicelli

Papers

Impact of aftercare in the treatment of alcoholics: a cross-lagged panel analysis.