Community Mental Health Journal

, Volume 41, Issue 1, pp 7–20 | Cite as

Specialized 12-Step Programs and 12-Step Facilitation for the Dually Diagnosed



The role of 12-step programs and 12-step-oriented treatments for dually diagnosed individuals (DDI) remains unclear. Here are presented the results of a pilot study in which 10 seriously mentally ill patients received a modified 12-step facilitation (TSF) therapy emphasizing engagement of DDI in a specialized 12-step program for DDI. Participants significantly increased their 12-step attendance and decreased their substance use during the 12 weeks of treatment. Larger and longer-term studies are needed to assess the efficacy of modified TSF for DDI relative to other treatments, and to determine what forms of TSF are most effective in this population.


Public Health Pilot Study Health Psychology Dually Diagnose 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. Alcoholics Anonymous (1976). Alcoholics Anonymous (3rd ed.). New York, Alcoholic Anonymous World Services, Inc.Google Scholar
  2. Blankertz, L. E., Cnaan, R. A. 1994Assessing the impact of two residential programs for dually diagnosed homeless individualsSocial Service Review68536560CrossRefGoogle Scholar
  3. Bogenschutz, M. P., Akin, S. J. 200012 step participation and attitudes toward 12 step programs in dual diagnosis patientsAlcoholism Treatment Quarterly183146Google Scholar
  4. Bogenschutz, M. P., Vigil, J., Arenella, P. 2002Attitudes of dually diagnosed patients toward double trouble in recovery and traditional 12-step programsAmerican Academy of Addiction Psychiatry Annual Meeting December 12–15, 2002Las Vegas, NVGoogle Scholar
  5. Brooks, A. J., Penn, P. E. 2003Comparing treatments for dual diagnosis: Twelve-step and self-management and recovery trainingAmerican Journal of Drug and Alcohol Abuse29359383PubMedGoogle Scholar
  6. Chatlos, J. C. 1989Adolescent dual diagnosis: A 12-step transformational modelJournal of Psychoactive Drugs21189201PubMedGoogle Scholar
  7. Chiauzzi, E. 1994Brief inpatient treatment of dual diagnosis patientsNew Directions for Mental Health Services634757PubMedGoogle Scholar
  8. Crits-Cristoph, P., Siqueland, L., Blaine, J., Frank, A., Luborsky, L., Onken, L. S., Muenz, L., Thase, M. E., Weiss, R. D., Gastfriend, D. R., Woody, G., Barber, J. P., Butler, S. F., Daley, D., Bishop, S., Najavits, L. M., Lis, J., Mercer, D., Griffin, M. L., Moras, K., Beck, A. 1999Psychosocial treatments for cocaine dependence: National institute on drug abuse collaborative cocaine treatment studyArchives of General Psychiatry56493502Google Scholar
  9. DTR Inc.1998Double trouble in recovery: How to start and run a double trouble in recovery groupMental Health Empowerment ProjectAlbany, NYGoogle Scholar
  10. DTR Inc.2000Double trouble in recovery basic guideMental Health Empowerment ProjectAlbany, NYGoogle Scholar
  11. Edens, J. F., Peters, R. H., Hills, H.A. 1997Treating prison inmates with co-occurring disorders: An integrative review of existing programsBehavioral Sciences & The Law15439457Google Scholar
  12. Franco, H., Galanter, M., Castaneda, R., Patterson, J. 1995Combining behavioral and self-help approaches in the inpatient management of dually diagnosed patientsJournal of Substance Abuse Treatment12227232PubMedGoogle Scholar
  13. Galanter, M. 2000Self-help treatment for combined addiction and mental illnessPsychiatric Services51977979PubMedGoogle Scholar
  14. Galanter, M., Dermatis, H., Egelko, S., Leon, G. 1998Homelessness and mental illness in a professional- and peer-led cocaine treatment clinicPsychiatric Services49533535PubMedGoogle Scholar
  15. Guy, W. E. 1976National Institute of Mental Health, ECDEU assessment manual for psychopharmacology: Publication ADM 76-338National Institutes of HealthRockville, MD17222Google Scholar
  16. Hazelden Publishing1993The dual disorders recovery book: A twelve step program for those of us with addiction and an emotional or psychiatric illnessHazelden FoundationCenter City, MNGoogle Scholar
  17. Jerrell, J. M., Ridgely, M. S. 1995Comparative effectiveness of three approaches to serving people with severe mental illness and substance abuse disordersJournal of Nervous and Mental Disease183566576PubMedCrossRefGoogle Scholar
  18. Jerrell, J. M., Ridgely, M. S. 1997Dual diagnosis care for severe and persistent disordersA comparison of three methods. Behavioral Healthcare Tomorrow62633Google Scholar
  19. Jerrell, J. M., Ridgely, M. S. 1999Impact of robustness of program implementation on outcomes of clients in dual diagnosis programsPsychiatric Services50109112PubMedGoogle Scholar
  20. Jordan, L. C., Davidson, W. S., Herman, S. E., BootsMiller, B. J. 2002Involvement in 12-step programs among persons with dual diagnosesPsychiatric Services53894896PubMedGoogle Scholar
  21. Katz, R. I. 1999The Addiction treatment unit: A dual diagnosis program at the California medical facility-a descriptive reportJournal of Psychoactive Drugs314146PubMedGoogle Scholar
  22. Kay, S. R., Fiszbein, A., Opler, L. A. 1987The positive and negative syndrome scale (PANSS) for schizophreniaSchizophrenia Bulletin13261276PubMedGoogle Scholar
  23. Kelly, JF, McKellar, JD, Moos, R 2003Major depression in patients with substance use disorders: Relationship to 12-Step self-help involvement and substance use outcomesAddiction98499508PubMedGoogle Scholar
  24. Laudet, A. B., Magura, S., Vogel, H. S., Knight, E. L. 2000Support, mutual aid and recovery from dual diagnosisCommunity Mental Health Journal36457476PubMedGoogle Scholar
  25. Magura, S., Laudet, A. B., Mahmood, D., Rosenblum, A., Knight, E. L. 2002Adherence to medication regimens and participation in dual-focus self-help groupsPsychiatric Services53310316PubMedGoogle Scholar
  26. Magura, S., Laudet, A. B., Mahmood, D., Rosenblum, A., Vogel, H. S., Knight, E. L. 2003Role of self-help processes in achieving abstinence among dually diagnosed personsAddictive Behaviors28399413PubMedGoogle Scholar
  27. Magura, S., Knight, E. L., Vogel, H. S., Mahmood, D., Laudet, A. B., Rosenblum, A. 2003Mediators of effectiveness in dual-focus self-help groupsAmerican Journal of Drug and Alcohol Abuse29301322PubMedGoogle Scholar
  28. McLeIlan, A.T, Luborsky, L, Woody, GE, O’Brien, CP 1980An improved diagnostic evaluation instrument for substance abuse patients The Addiction Severity IndexJournal of Nervous and Mental Disease1682633Google Scholar
  29. Meissen, G., Powell, T. J., Wituk, S. A., Girrens, K., Arteaga, S. 1999Attitudes of AA contact persons toward group participation by persons with a mental illnessPsychiatric Services5010791081PubMedGoogle Scholar
  30. Miller, W.R, Tonigan, JS 1996Assessing drinker’s motivation for change: The stages of change readiness and treatment eagerness scale (SOCRATES)Psychology of Addictive Behaviors108189Google Scholar
  31. Minkoff, K. 1989An integrated treatment model for dual diagnosis of psychosis and addictionHospital and Community Psychiatry4010311036PubMedGoogle Scholar
  32. Minkoff, K. 2001Program components of a comprehensive integrated care system for seriously mentally ill patients with substance disordersNew Directions Mental Health Services911730Google Scholar
  33. Moggi, F. P., Ouimette, C., Moos, R. H., Finney, J. W. 1999Dual diagnosis patients in substance abuse treatment: Relationship of general coping and substance-specific coping to I-year outcomesAddiction9418051816PubMedGoogle Scholar
  34. Moos, R.H, Moos, BS, Andrassy, JW 1999Outcomes of four treatment approaches in community residential programs for patients with substance use disordersPsychiatric Services5015771583PubMedGoogle Scholar
  35. Mowbray, CT., Solomon, M, Ribisl, KM, Ebejer, MA, Deiz, N, Brown, W, Bandla, H, Luke, DA, Davidson, WS,2nd, Herman, S 1995Treatment for mental illness and substance abuse in a public psychiatric hospital Successful strategies and challenging problemsJournal of Substance Abuse Treatment12129139PubMedGoogle Scholar
  36. Noordsy, D. L., Schwab, B., Fox, L., & Drake, R. E. (1996). The role of self-help programs in the rehabilitation of persons with severe mental illness and substance use disorders. Community Mental Health Journal, 32, 71–81; discussion 83–86.Google Scholar
  37. Nowinski, J., Baker, S 1992The twelve-step facilitation handbook: A systematic approach to early recovery from alcoholism and addictionLexington BooksNew YorkGoogle Scholar
  38. Ouimette, P. C., Girna, K., Moos, R. H., Finney, J. W. 1999A comparative evaluation of substance abuse treatment IV The effect of comorbid psychiatric diagnoses on amount of treatment continuing care, and 1-year outcomesAlcoholism—Clinical and Experimental Research23552557Google Scholar
  39. Pristach, C. A., Smith, C. M. 1999Attitudes towards alcoholics anonymous by dually diagnosed psychiatric inpatientsJournal of Addictive Diseases186976PubMedGoogle Scholar
  40. Project MATCH1997Matching alcoholism treatments to client heterogeneity: Project MATCH posttreatment drinking outcomesJournal of Studies on Alcohol58729Google Scholar
  41. Project MATCH1998Matching alcoholism treatments to client heterogeneity: Treatment main effects and matching effects on drinking during treatment Project MATCH Research GroupJournal of Studies Alcohol59631639Google Scholar
  42. RachBeisel, J., Scott, J., Dixon, L. 1999Co-occurring severe mental illness and substance use disorders: A review of recent researchPsychiatric Services5014271434PubMedGoogle Scholar
  43. Ridgely, M. S., Jerrell, J. M. 1996Analysis of three interventions for substance abuse treatment of severely mentally ill peopleCommunity Mental Health Journal32561572PubMedGoogle Scholar
  44. Ritsher, J. B., McKellar, J. D., Finney, J. W., Otilingam, P. G., Moos, R. H. 2002Psychiatric comorbidity, continuing care and mutual help as predictors of five-year remission from substance use disordersJournal of Studies on Alcohol63709715PubMedGoogle Scholar
  45. Swindle, R. W., Phibbs, C. S., Paradise, M. J., Recine, B. P., Moos, R. H. 1995Inpatient treatment for substance abuse patients with psychiatric disorders: A national study of determinants of readmissionJournal of Substance Abuse77997PubMedGoogle Scholar
  46. Taylor, S. M., Galanter, M., Dermatis, H., Spivack, N., Egelko, S. 1997Dual diagnosis patients in the modified therapeutic community: Does a criminal history hinder adjustment to treatmentJournal of Addictive Diseases163138CrossRefPubMedGoogle Scholar
  47. Tonigan, J. S., Connors, G., Miller, W. R. 1996The alcoholic anonymous involvement scale (AAI): Reliability and normsPsychology of Addictive Behaviors107580Google Scholar
  48. Vogel, H. S. 1993Double trouble in recoveryMental Health Empowerment ProjectAlbany, NYGoogle Scholar
  49. Vogel, H. S., Knight, E., Laudet, A. B., Magura, S. 1998Double trouble in recovery: Self-help for people with dual diagnosesPsychiatric Rehabilitation Journal21356364PubMedGoogle Scholar
  50. Westermeyer, J. J., Schneekloth, T. D. 1999Course of substance abuse in patients with and without schizophreniaAmerican Journal of Addictions85564Google Scholar

Copyright information

© Springer Science+Business Media, Inc. 2005

Authors and Affiliations

  1. 1.Department of Psychiatry University of New Mexico Health Sciences CenterAlbuquerqueUSA

Personalised recommendations