Center for Innovation to Implementation, Department of Veterans Affairs Health Care System, Palo Alto, California.
Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California.
J Stud Alcohol Drugs. 2023 Sep;84(5):762-771. doi: 10.15288/jsad.22-00378. Epub 2023 May 18.
This study aimed to inform clinical practice by identifying subgroups of patient-concerned other (CO) dyads. Patients with alcohol use disorders (AUDs) were characterized on Alcoholics Anonymous (AA) involvement and substance use together with COs' Al-Anon involvement. Predictors and recovery maintenance outcomes of subgroup membership were examined.
Participants were 279 patient-CO dyads. Patients were in residential treatment for AUD. Parallel latent class growth model analysis characterized 12-step involvement and substance use at treatment entry and 3-, 6-, and 12-month follow-ups.
Three classes were as follows: 38% Low AA/Low Al-Anon (patients' low AA and COs' low Al-Anon involvement, and patients' high-to-moderate substance use), 10% High AA/High Al-Anon (patients' high AA and COs' high Al-Anon involvement, and patients' moderate-to-low substance use), and 52% High AA/Low Al-Anon (patients' high AA and COs' low Al-Anon involvement, and patients' moderate-to-low substance use). At follow-up, the Low AA/Low Al-Anon classes' patients were less likely to have spirituality as recovery support, confidence about staying abstinent, and satisfaction with recovery progress. The High AA classes' COs had less concern about patients' drinking and scored higher on positive aspects of relationships with patients.
Clinicians should encourage patients' and COs' 12-step group involvement (12-step practices' engagement). Among patients treated for AUD, AA involvement was related to better outcomes, and to COs' lessened concern about the patients' drinking. COs' Al-Anon involvement was associated with having a more positive view of their relationship with the patient. That more than one third of dyads had low 12-step group involvement suggests that treatment programs may need to facilitate involvement in non-12-step mutual-help groups.
本研究旨在通过确定关注患者的其他（CO）对子的亚组，为临床实践提供信息。对同时参与匿名戒酒会（AA）和物质使用的酒精使用障碍（AUD）患者以及 CO 参与戒酒互助会（Al-Anon）的情况进行了描述。检查了亚组成员资格的预测因素和康复维持结果。
参与者为 279 对患者-CO 对子。患者正在接受酒精使用障碍的住院治疗。平行潜在类别增长模型分析描述了治疗开始时的 12 步参与情况和物质使用情况，以及 3、6 和 12 个月的随访情况。
发现了以下三个亚组：38%的低 AA/低 Al-Anon（患者低 AA 和 CO 低 Al-Anon 参与度，以及患者高至中度物质使用）、10%的高 AA/高 Al-Anon（患者高 AA 和 CO 高 Al-Anon 参与度，以及患者中至低度物质使用）和 52%的高 AA/低 Al-Anon（患者高 AA 和 CO 低 Al-Anon 参与度，以及患者中至低度物质使用）。在随访中，低 AA/低 Al-Anon 类患者更有可能缺乏作为康复支持的灵性，对保持戒断的信心，以及对康复进展的满意度。高 AA 类的 CO 对患者的饮酒问题关注较少，并且对与患者的关系有积极的看法。
临床医生应鼓励患者和 CO 参与 12 步团体（12 步实践的参与）。在接受 AUD 治疗的患者中，AA 参与与更好的结果相关，并且 CO 对患者饮酒的关注减少。CO 参与戒酒互助会与对与患者关系的更积极看法有关。超过三分之一的对子的 12 步团体参与度较低，这表明治疗计划可能需要促进参与非 12 步互助团体。
