Timko Christine, Debenedetti Anna, Billow Rachel
Center for Health Care Evaluation, Department of Veterans Affairs Health Care System and Stanford University Medical Center, Palo Alto, CA 94025, USA.
Addiction. 2006 May;101(5):678-88. doi: 10.1111/j.1360-0443.2006.01391.x.
This study implemented and evaluated procedures to help clinicians make effective referrals to 12-Step self-help groups.
Randomized controlled trial. Setting Out-patient substance use disorder treatment. Participants Individuals with substance use disorders (SUDs) entering a new treatment episode (n = 345) who were assigned randomly to a standard referral- or an intensive referral-to-self-help condition.
Self-reports of 12-Step group attendance and involvement and substance use at baseline and a 6-month follow-up.
The intensive referral intervention focused on encouraging patients to attend 12-Step meetings by connecting them to 12-Step volunteers.
Among patients with relatively less previous 12-Step meeting attendance, intensive referral was associated with more meeting attendance during follow-up than was standard referral. Among all patients, compared with those who received standard referral, those who received intensive referral were more likely to be involved with 12-Step groups during the 6-month follow-up (i.e. had provided service, had a spiritual awakening and currently had a sponsor). Intensive referral patients also had better alcohol and drug use outcomes at 6 months. Twelve-Step involvement mediated part of the association between referral condition and alcohol outcomes.
The brief intensive referral intervention was associated with improved 12-Step group involvement and substance use outcomes even among patients with considerable previous 12-Step group exposure and formal treatment. Future 12-Step intensive referral procedures should focus on encouraging 12-Step group involvement in addition to attendance to benefit patients most effectively.
本研究实施并评估了一些程序，以帮助临床医生有效地将患者转介至12步自助小组。
随机对照试验。设置门诊物质使用障碍治疗。参与者为进入新治疗阶段的物质使用障碍（SUD）患者（n = 345），他们被随机分配至标准转介组或强化转介至自助组。
在基线和6个月随访时，对12步小组的出席率、参与度以及物质使用情况进行自我报告。
强化转介干预侧重于通过将患者与12步志愿者联系起来，鼓励他们参加12步会议。
在之前参加12步会议相对较少的患者中，与标准转介相比，强化转介与随访期间更多的会议出席率相关。在所有患者中，与接受标准转介的患者相比，接受强化转介的患者在6个月随访期间更有可能参与12步小组（即提供过服务、有过精神觉醒且目前有担保人）。强化转介患者在6个月时的酒精和药物使用结果也更好。12步参与介导了转介条件与酒精结果之间关联的一部分。
即使在之前有相当多12步小组接触经历和正规治疗的患者中，简短的强化转介干预也与12步小组参与度的提高和物质使用结果的改善相关。未来的12步强化转介程序除了关注出席率外，还应侧重于鼓励患者参与12步小组，以最有效地使患者受益。
