August 07, 2017
2 min read
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Intervention improves 12-step attendance in adolescents with addiction

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John Kelly
John F. Kelly

An integrated 12-step facilitation treatment for adolescent substance use disorder was not more effective than motivational enhancement therapy plus cognitive behavioral therapy; however, it did improve 12-step attendance and abuse consequences.

“While all adolescents can improve when they receive well-articulated substance-use disorder treatment, we showed that adding a 12-step component to standard cognitive behavioral and motivational strategies produced significantly greater reductions in substance-related consequences during and in the months following treatment,” John F. Kelly, PhD, of Massachusetts General Hospital and Harvard Medical School, said in a press release. “It also produced higher rates of 12-step meeting participation, which was associated with longer periods of continuous abstinence.”

To assess efficacy of an integrated 12-step facilitation treatment specific for adolescents, researchers conducted an explanatory, parallel-group, randomized clinical trial among 59 adolescents with a mean age of 16.8 years. Study participants were randomly assigned to receive the integrated 12-step treatment with motivational and cognitive behavioral strategies (n = 29) or state-of-the-art motivational enhancement therapy (MET)/CBT (n = 30) for substance use disorders.

Percent days abstinent did not significantly differ between treatment groups.

Twelve-step meeting attendance was significantly higher among participants who received integrated treatment during treatment, but declined thereafter (P = .03).

Integrated treatment was superior for substance-related consequences at all follow-up points, with effect sizes ranging from 0.26 to 0.71 (Ps < .05).

Other secondary outcomes did not significantly differ between treatment groups, though effect sizes tended to favor integrated treatment, according to researchers.

Overall, greater 12-step meeting attendance was associated with significantly longer abstinence during (P = .008) and early following (P = .049) treatment.

“In countries like the U.S., the greatest health risks for young people by far are from alcohol or other drug use. Cognitive behavioral and motivational programs are evidence-based, popular approaches for addressing youth substance-use disorder, and now these data suggest that integrating these approaches with 12-step philosophy and practices can further help reduce the impact of substance use in their lives and potentially facilitate higher rates of abstinence,” Kelly said in the release. “Given the prevalence of substance-use disorders among young people, having treatments that are both effective and cost-effective — linking patients to free and ubiquitous community resources — is needed and welcome.” – by Amanda Oldt

Disclosure: Please see the study for a full list of relevant financial disclosures.