How Does Patient Satisfaction Affect Substance Treatment and 12-Step Results?

Substance treatment programs and 12-step mutual assistance groups are two widely used options for addressing the harmful impact of diagnosable substance problems. While some people choose just one of these options, they also work quite well when used together. In a study scheduled for publication in 2014 in the journal Addictive Behaviors, a team of American researchers examined the importance of patient/client satisfaction in producing positive results for substance treatment and 12-step program participants. These researchers concluded that program satisfaction can substantially improve the outcomes of both approaches.

Substance Treatment Programs

A substance treatment program is a multidimensional approach that typically addresses diagnosable substance problems with some combination of supportive care, medication and counseling or psychotherapy. Medications used in any given program may be targeted at the symptoms of withdrawal that commonly appear when a physically dependent/addicted person ceases his or her substance intake. In addition, medication may help correct some of the lasting brain imbalances produced by addiction and/or reduce the intensity of the cravings for further substance use that commonly contribute to the risks for a relapse. Counseling and psychotherapeutic techniques used in substance treatment include motivational interviewing, cognitive behavioral therapy, contingency management and family therapy. Goals of these techniques include such things as increasing the willingness to participate actively in treatment, providing an improved understanding of the nature of substance addiction and providing the mental/emotional tools necessary to understand the underlying reasons for substance abuse and establish a durable, substance-free lifestyle.

12-Step Programs

Twelve-step programs rely on the mutual support of other people dealing with substance problems to help the individual learn how to gradually create a lasting, substance-free daily routine. As the name of these programs implies, progress is marked by passage through 12 sequential steps that address various aspects of recovery from an established pattern of substance abuse or addiction. There are several potential advantages to 12-step involvement, including the ability to get assistance from peers who are further along in the recovery process, the ability to get help quickly during moments of crisis, the ability to get help regardless of one’s financial resources and the ability to get help without having to reveal personal details to other program participants or staff members. In the U.S., 12-step programs play a particularly prominent role as a resource for people dealing with alcohol abuse/alcoholism.

Impact of Patient Satisfaction

Enrollment in a substance treatment program is not necessarily the same as active involvement in that program. Similarly, attendees at 12-step meetings don’t necessarily commit themselves equally to the goals of those meetings. In the study scheduled for publication in Addictive Behaviors, researchers from Stanford University, the Department of Veterans Affairs and the University of Arkansas used an assessment of 345 adults to explore the importance of patient/client satisfaction in substance treatment and 12-step success. All of these adults received treatment in a substance program run by the Department of Veterans Affairs and also had access to a 12-step program. The researchers asked all of the study participants to report their level of satisfaction after six months of involvement in these programs; six months later, they compared these reports to the subsequent outcomes for each individual.

The researchers specifically addressed the issue of alcohol consumption. They concluded that the participants who expressed satisfaction with substance treatment and 12-step involvement at the six-month mark had significantly higher chances of abstaining from alcohol use half a year later. In addition, satisfied participants who did not remain abstinent experienced a substantial reduction in their alcohol intake. Satisfaction with each type of program also produced unique benefits. Those individuals satisfied with their substance treatment program experienced a substantial decline in their physical symptoms of abuse/addiction, while those individuals satisfied with their 12-step program experienced a substantial decline in their emotional/psychological symptoms. Finally, the study participants satisfied with their 12-step program had an increased likelihood of attending more 12-step meetings and involving themselves more actively in the program’s goals.

The study’s authors concluded that general satisfaction with a substance treatment program or 12-step program is more important than satisfaction with any particular aspects of these programs. They believe that program administrators may greatly improve the effectiveness of their efforts if they take general participant satisfaction into account.


Posted on October 29th, 2014

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