More support for the Twelve Steps as treatment tools comes from the work of Fiorentine. For one study, he and colleague Maureen P. Hillhouse, PhD, followed 356 clients entering outpatient treatment in Los Angeles. The researchers interviewed and assessed each client twice – within one week of entering treatment and again about eight months later.
Fiorentine was especially interested in answering these questions:
Do people join Twelve Step groups (such as Alcoholics Anonymous and Narcotics Anonymous) as an alternative to treatment?
Why do people who are currently active in a Twelve Step group choose to enter treatment?
When people are involved in a Twelve Step group before entering treatment, are they more likely to complete treatment?
Are longer stays in treatment associated with higher levels of involvement in Twelve Step groups?
When people take part in treatment and Twelve Step groups, do they experience an ‘additive effect’ – higher rates of abstinence due to both kinds of participation?
The data provided answers to each question:
Two-thirds of the outpatient clients were attending a Twelve Step group when they entered treatment.
Most clients entered treatment to support a ‘global lifestyle change’ – not to simply stay off drugs or comply with a court order.
Clients who attended Twelve Step meetings at least once per week before treatment stayed in treatment longer – an average of four weeks more – and were also more likely to complete treatment.
The longer clients stayed in treatment, the more likely they were to contact a sponsor at least once per week.
Clients who stayed in treatment longer, completed treatment, and attended Twelve Step groups weekly had significantly higher rates of abstinence than those who did not meet these three criteria.
Fiorentine concluded that people used Twelve Step groups and outpatient treatment as ‘integrated recovery activities,’ not mutually exclusive options.
When clients combine treatment and Twelve Step groups, they experience a powerful advantage over using treatment or groups alone.
In summary, treatment and Twelve Step groups are best viewed as a ‘both-and’ proposition, not ‘either or’.
Treatment tends to be of a limited duration, whereas Twelve Step participation recommends lifelong, regular participation and a sponsorship relationship.
Fiorentine speculates that ‘this regular, continuous, and personal affiliation may be one reason why Twelve Step membership is more effective than treatment in promoting long-term recovery.’
Another reason is that Twelve Step philosophy accurately depicts the nature of addiction, particularly the notion of powerlessness over alcohol and other drugs, adds Fiorentine.
In other research, Fiorentine determined that those who accept the fact that they are powerless over alcohol and other drugs are significantly more likely to maintain long-term abstinence.