Abnormal Psychology

Substance Use Disorders 429

effectively, and general support groups to decrease shame and isolation as members

change their substance abuse patterns.

Self-Help Groups

Self-help groups (sometimes called support groups), such as the twelve-step pro-

grams of Alcoholics Anonymous and Narcotics Anonymous, hold regular meet-

ings. Attending such a group might supplement other treatment or might be the

only treatment a person pursues. As noted earlier, such groups often view be-

lief in God or some other “higher power” as crucial to recovery, and even peo-

ple who are not religious can improve through AA meetings (Humphreys &

Moos, 2007; Moos & Timko, 2008; Timko, DeBenedetti, & Billow, 2006;

Winzelberg & Humphreys, 1999). AA also provides social support, both from other

group members and a sponsor—an individual with years of sobriety who serves as a

mentor and can be called up when the newer member experiences cravings or temp-

tations to drink again.

Other self-help organizations, such as Secular Organizations for Sobriety and

Women for Sobriety, do not include spirituality or a religious component. Still other

organizations offer groups that are led by trained professionals and so are techni-

cally not self-help groups; Rational Recovery and Smart Recovery are examples.

These are based on cognitive-behavioral principles and do not use a twelve-step

approach (Nowinski, 2003).

A meta-analysis showed that attending a self-help group at least once a week is

associated with drug or alcohol abstinence (Fiorentine, 1999). Other research con-

fi rms that longer participation in AA is associated with better outcomes (Moos &

Moos, 2004). Just like group therapy, a self-help group can be invaluable in de-

creasing feelings of isolation and shame. In general, self-help groups can be valuable

sources of information and support, not only for the substance abuser but also for

his or her relatives.

Family Therapy

To the extent that family interactions lead to or help sustain substance abuse, chang-

ing family patterns of interaction can modify these factors (Saatcioglu, Erim, &

Cakmak, 2006; Stanton & Shadish, 1997). Among adolescents treated for substance

abuse, outpatient family therapy appears to help them to abstain (Smith et al., 2006;

Szapocznik, Hervis, & Schwartz, 2003; Williams & Chang, 2000), which suggests

that changes in how parents and adolescents interact can promote and maintain ab-

stinence. In fact, family therapy is usually a standard component of treatment for

adolescents with substance use disorders (Austin, Macgowan, & Wagner, 2005). The

goals of this type of therapy are tailored to the specifi c problems and needs of each

family, but such therapy typically addresses issues related to communication, power,

and control (see the discussion of family therapy in Chapter 4; Hogue et al., 2006).

Various types of treatment for

substance use disorders can

be offered in the community,

including day-treatment

programs, methadone clinics

(such as the one shown here),

group therapy, and self-help

groups.

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