ABSTRACT
This chapter provides an overview of twelve-step mutual-help organizations (TSMHOs), the new science pertaining to them, and their relationship to addiction recovery. Most of the research conducted on TSMHOs has examined their effectiveness by studying attendance rates and substance use outcomes as they naturally occur. Other naturalistic effectiveness studies have used even stronger analytic approaches to establish a true causal impact of TSMHO on substance use disorders (SUD) recovery. In contrast to studies of effectiveness, which examine the clinical utility and impact of interventions under real-world conditions, “efficacy” studies examine interventions under tightly controlled, optimal, conditions. Studies have also found that Twelve-Step Facilitation (TSF) treatments that engage patients with TSMHOs not only produce significantly higher rates of abstinence post-treatment compared with comparison treatments, but result in lower health-care costs. A relatively novel and intriguing area of investigation in the realm of treatment and TSMHO participation has revealed noteworthy results regarding how TSMHOs confer benefits.
