Defining Characteristics Of The 12 Step Approach

The majority of research that exists on 12-step programs often focus on determining the success rate of 12-step programs such as AA. There is little to no research on problems associated with 12-step programs or problematic areas of 12-step programs. The little research that does exist argue that 12-step programs are not structured for comorbid individual, they may not be the best option for mild substance use disorder, and the central theme of powerlessness can conflict with a therapist’s theoretical orientation and be harmful to the therapeutic alliance. (Kelly & Myers, 2007, Laudet et al., 2004, L, Ingvarson, Richard, 1995). The National Institute of Mental Health (2013) has found that 43.6 million adults aged 18 and older have at least one mental illness and 45 percent of individuals with one mental disorder met criteria for two or more disorders. The presence of comorbid disorders can severely affect the treatment and outcome of individuals (Terra et al., 2006). Many studies have found that clients with a dual diagnosis experience increased rates of hospitalization and increased use of emergency services (Helzer & Pryzbeck, 1998). It is easy to imagine how hospitalization can interrupt treatment by making it difficulty for individuals to attend.

The provision of health care services being informed by principles of evidence-based care, integration and patient engagement has mixed outcomes for mental health care. Evidence-based care focuses heavily on psychopharmaceuticals compared to psychotherapy in terms of funding because it is easier to present results of different drugs (quantitative data) than to present results of therapy (ex. CBT → qualitative data).

Hennessy, K. D., & Green-Hennessy, S. (2011). A review of mental health interventions in SAMHSA 's national registry of evidence-based programs and practices. Psychiatric Services (Washington, D.C.), 62(3), 303-305. doi:10.1176/ps.62.3.pss6203_0303

The study was a systematic review of scientific papers selected by a search of the SciELO, Cochrane, MEDLINE, and LILACS-BIREME databases. Among the 2169 articles found, 12 studies proved relevant to the issue and presented an evidence strength rating of B. No publications rated evidence strength A. Seven of the studies analyzed were prospective cohorts and 5 were cross-sectional studies.

Brief Description: Due to the chicken and egg dilemma surrounding co-occurring disorders, for years researchers have faced the challenge of what to treat first, in other words identifying the main issue. Now after twenty years and being given the title of an evidence-based practice, researchers have come up with a holistic approach in treating co-occurring disorders. Researches coined this evidence-based practice as integrated treatment, which is basically a marriage between health and mental health services/treatment/interventions.

Twelve step programs are commonly used in drug and alcohol treatment. Alcoholics Anonymous and Narcotics Anonymous both utilize the twelve steps, along with many other treatment centers. The twelve steps are used as a tool to stay sober and overcome addictions to substance abuse. The first step involves admitting one is powerless over the drug. It also involves admitting that due to the drug, one is no longer in control of his or her life. The second step is coming to the belief that there is a greater power that can restore one to sanity. The greater power can be anything from God to a higher power such as nature. The third step is making the decision to turn one’s will and life over to the higher power. This is when an individual fully commits oneself to the belief in something greater than him or her self. The fourth step is a moral inventory of oneself. Many individuals make a list of all the wrongs he or she has done while in the fourth step. (Alcoholics Anonymous Publishing, 1981)

There are some limitations to this literature review. One limitation is some of these studies may be outdated being that they are from the 1990s (i.e: Dulit et. al, 1990; Miller et. al, 1993; and Dougherty et. al, 1999). Another limitation is some of the studies were not randomized samples (i.e: Miller et. al, 1993 and Tragesser et. al, 2013). If samples are not random this could mean the results are bias.

Bauer MS. 2002. A review of quantitative studies of adherence to mental health clinical practice guidelines. Harvard Review of Psychiatry 10(3):138–153.

Staggs, V. S., Mion, L. C., & Shorr, R. I. (2015). Consistent Differences in Medical

How this chapter makes a unique contribution This chapter presented several different research studies that illustrated what interventions actually help clients to get well. It also could assist mental health professionals in implementing these interventions. The CBT research study presented in this chapter was the only study illustrated (in this chapter) that met some of the high standards of research efficacy. This project had a control group, randomly assigned participants to control groups and participants were observed over-time. These standards are important for mental health professionals who want to evaluate these research studies so they can decide if they want to implement them into their treatment programs.

Interventions ideally should be long-term and include a range of psychosocial approaches, including cognitive behavioral therapy, conflict management, and substance abuse treatment. However, this sort of idyllic treatment may be increasingly difficult to accomplish in the real world, given reductions in reimbursements for mental health services, ever-shorter hospital stays, inadequate discharge planning, fragmented care in the community, and lack of options for patients with a dual diagnosis. The Schizophrenia Patient Outcomes Research Team (PORT) guidelines, for example, outlined the type of multimodal treatment necessary to increase chances of full recovery. Most patients with schizophrenia do not obtain the kind of treatment outlined in the PORT guidelines. Answers to these challenges will arise not from clinicians, but from policy makers. (Siever, L

Outpatient and residential treatment programs require the client to participate in individual therapy, group therapy, and attend 12-step group meetings. Frequency of therapy vary with each program. A treatment plan is developed between the therapist and client with goals, steps to reach the goals, and monitoring the progress. The

I have personally designed a 12 Step Program to help with addiction. Our main goals are to help the individuals re-connect with themselves, and help them gain the understanding needed to cope with everyday stress in a healthy way.

A randomized double blind study by (Ciodaro et al,. 2014) has been chosen to illustrate

Data Source: Sources included Medline, Embase, Cochrane Library, Scopus and Non-Indexed Citations from inception through January 2016.