Aftercare/relapse prevention and the self-help movement.

This paper presents the background and initial experiences of a treatment evaluation involving self-help techniques and principles as a means of providing aftercare services for stabilized methadone maintenance patients. It describes the Clinically Guided Self-Help (CGSH) model, which focuses on community reintegration and places emphasis on social network components following a period of primary treatment and demonstrated client stability. From our experiences, we have identified needs and issues that are of concern to stabilized clients, and we have distilled a paradigm for responding to these in a self-help group format. The model permits clients to establish their own agenda of interests and, guided by staff, to engage in a process geared toward maximum participation of their part. The model is clinically based in that staff and participants are engaged in working on present adjustment concerns. The overall goal of the investigators is to generate the prerequisite skills for successful adaptation of self-help concepts and techniques to the particular needs and interests of individual methadone maintenance programs and clients.