Timko Christine, Halvorson Max, Kong Calvin, Moos Rudolf H
Center for Innovation to Implementation, Department of Veterans Affairs Health Care System.
Psychol Addict Behav. 2015 Dec;29(4):856-63. doi: 10.1037/adb0000067.
This study examined social processes of support, goal direction, provision of role models, and involvement in rewarding activities to explain benefits of participating in Al-Anon, a 12-step mutual-help program for people concerned about another person's substance use. Newcomers to Al-Anon were studied at baseline and 6 months later, at which time they were identified as having either sustained attendance or dropped out. Among both newcomers and established Al-Anon members ("old-timers"), we also used number of Al-Anon meetings attended during follow-up to indicate extent of participation. Social processes significantly mediated newcomers' sustained attendance status versus dropped out and outcomes of Al-Anon in the areas of life context (e.g., better quality of life, better able to handle problems due to the drinker), improved positive symptoms (e.g., higher self-esteem, more hopeful), and decreased negative symptoms (e.g., less abuse, less depressed). Social processes also significantly mediated newcomers' number of meetings attended and outcomes. However, among old-timers, Al-Anon attendance was not associated with outcomes, so the potential mediating role of social processes could not be examined, but social processes were associated with outcomes. Findings add to the growing body of work identifying mechanisms by which 12-step groups are effective, by showing that bonding, goal direction, and access to peers in recovery and rewarding pursuits help to explain associations between sustained Al-Anon participation among newcomers and improvements on key concerns of Al-Anon attendees. Al-Anon is free of charge and widely available, making it a potentially cost-effective public health resource for help alleviating negative consequences of concern about another's addiction.
本研究考察了支持、目标导向、榜样示范以及参与有益活动等社会过程，以解释参与嗜酒者互诫协会（Al-Anon）的益处。Al-Anon是一个针对关注他人药物使用问题的人的12步互助项目。对Al-Anon的新成员在基线期和6个月后进行了研究，此时他们被确定为持续参加或退出。在新成员和已加入Al-Anon的成员（“老成员”）中，我们还使用随访期间参加Al-Anon会议的次数来表明参与程度。社会过程显著介导了新成员持续参加与退出的状态以及Al-Anon在生活背景方面的结果（例如，生活质量提高、更有能力处理因饮酒者导致的问题）、积极症状改善（例如，自尊增强、更有希望）和消极症状减轻（例如，更少受虐待、更少抑郁）。社会过程也显著介导了新成员参加会议的次数和结果。然而，在老成员中，参加Al-Anon与结果无关，因此无法检验社会过程的潜在中介作用，但社会过程与结果相关。研究结果进一步丰富了关于12步团体有效的机制的研究，表明在康复和有益追求中建立联系、目标导向以及与同伴接触有助于解释新成员持续参与Al-Anon与Al-Anon参与者关键问题改善之间的关联。Al-Anon免费且广泛可得，使其成为一种潜在的具有成本效益的公共卫生资源，有助于减轻因担心他人成瘾而产生的负面后果。
