Combined Alcoholics Anonymous and professional care for addicted physicians.
ABSTRACT The authors studied 100 impaired physicians who were successfully treated in a program that combined professionally directed psychotherapeutic treatment and peer-led self-help. An average of 33.4 months after admission they all reported being abstinent and rated Alcoholics Anonymous (AA) as more important to their recovery than professionally directed modalities. Feelings of affiliativeness to AA, which were very high, were strong predictors of the respondents' perceived support for their recovery. These feelings, and an identification with the role of care giver in addiction treatment, appeared to be central to their recovery process.
- SourceAvailable from: Leonard A Jason[Show abstract] [Hide abstract]
ABSTRACT: Alcoholics Anonymous (AA) is the most commonly used program for substance abuse recovery and one of the few models to demonstrate positive abstinence outcomes. Although little is known regarding the underlying mechanisms that make this program effective, one frequently cited aspect is social support. In order to gain insight into the processes at work in AA, this paper reviewed 24 papers examining the relationship between AA and social network variables. Various types of social support were included in the review such as structural support, functional support, general support, alcohol-specific support, and recovery helping. Overall, this review found that AA involvement is related to a variety of positive qualitative and quantitative changes in social support networks. Although AA had the greatest impact on friend networks, it had less influence on networks consisting of family members or others. In addition, support from others in AA was found to be of great value to recovery, and individuals with harmful social networks supportive of drinking actually benefited the most from AA involvement. Furthermore, social support variables consistently mediated AA's impact on abstinence, suggesting that social support is a mechanism in the effectiveness of AA in promoting a sober lifestyle. Recommendations are made for future research and clinical practice.Clinical Psychology Review 04/2008; 28(3):430-50. DOI:10.1016/j.cpr.2007.07.014
- [Show abstract] [Hide abstract]
ABSTRACT: The literature addressing substance use patterns among medical professionals suggests that specialty, gender, age, familial substance abuse, and access/familiarity with prescription drugs are associated with particular chemical dependencies. These studies have rarely compared nurses and physicians directly, thereby making if difficult to tailor interventions to the potentially unique needs of each group. This paper reports a study to compare the initial clinical presentations, service utilization patterns, and post-treatment functioning of nurses and physicians who received services in an addiction treatment programme. This exploratory study combined data collected through retrospective record reviews and prospective questionnaires. There were three types of dependent variables: initial clinical characteristics, treatment utilization patterns, and post-treatment functioning. The independent variable was membership of either professional group. Time both in treatment and between discharge and follow-up were covariates. Nurses and physicians showed comparable results in most domains. Among the statistically significant differences between groups, a subset was particularly noteworthy. Prior to participating in the programme nurses showed significantly less personality disturbance than physicians, although they tended to work and live in environments with more triggers to relapse, such as other substance users. After the index hospitalization, nurses received less primary treatment, worked longer hours, and were more symptomatic than physicians. Furthermore, nurses reported more frequent and severe work-related sanctions as a consequence of their behavioural disorders. In most areas of study, nurses and physicians demonstrated comparable results; however, a series of statistically significant differences suggest that these groups may have unique clinical needs. The policy implications of these findings are discussed.Journal of Advanced Nursing 10/2004; 47(5):561-71. DOI:10.1111/j.1365-2648.2004.03133.x
- [Show abstract] [Hide abstract]
ABSTRACT: The purpose of the study was to examine the effectiveness of a preventive peer-led stress management intervention, based on stress inoculation procedures, on physiological and psychological variables in college students. College students were randomly assigned to either a six-session treatment intervention or a wait-list control group. Blood pressure, heart rate, perceived severity of physical symptoms, and state-anxiety levels were assessed at pretreatment, posttreatment, and a 6-month follow-up. At posttreatment, the treatment participants had lower heart rate and state-anxiety levels than did controls. At follow-up, the difference in heart rate level between the groups was maintained. The protective aspect of stress inoculation training and the applicability of a peer-led treatment intervention at the college level are discussed.Journal of Applied Biobehavioral Research 12/1998; 4(1):45 - 63. DOI:10.1111/j.1751-9861.1999.tb00054.x