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Substance Abuse Treatment - Single Subject Design

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Cassidy Meehan, BSW

This presentation is concerning a single-subject design research project about substance abuse disorders treated with 12-step programs.

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Substance Abuse Treated with 12-Step Programs Single Subject Design Cassidy Meehan Metropolitan State University of Denver
Introduction – Substance Abuse & 12 Step Programs •Annual national costs and deaths that result from alcohol and other drug abuse (AODs) is on the rise. •In 2014, over 25,000 people died from alcohol and drug overdose •In 2014, $417 billion were lost from health expenses, lost work productivity and crime costs. •Only 14.6% of people with AODs ever seek treatment. (Bowen & Walton, 2015).
Client - Dallas • 26 year old male. • Battled with substance abuse and alcohol dependence since he was 16 years old. • Recently arrested with a DUI. • Court Ordered to a 90-day treatment program. • 12-Step programs are not currently part of his treatment plan. • Goals: • More peaceful state of mind. • More satisfied with his life. • Come to terms with his alcohol and drug abuse.
Literature Review • AA and other 12-step programs are at the forefront of treatment research. • AA is hard to study, because outside variables cannot be controlled for. • Research concludes that treatments need to be more long term. How can treatment be made less expensive? What is the best way to deliver long-term treatment? Gap: Success = Relapse rates & Length of sobriety This research: Success = Life Satisfaction. How effective are 12-step programs in treating alcoholism, as a long-term method and cheap alternative? (Hueber & Kantor, 2011), (Mundt, Parthsarathy, Chi, Sterling & Campbell, 2012), (Sifers & Peltz, 2013), Gustafson, McTavish, Chih, Atwood, Johnson, Boyle, Levy, Driscoll, Chisholm, Dillenburn, Isham, & Shah, 2014), (Kaufmann, Chen, Crum & Mojtabai, 2014), (Laudet, 2008).
Methodology – Intent, Purpose, Hypothesis Intent  Determine if there is a positive correlation between AODs treatment and 12-step program participation.  Social Workers are trained to work with the most marginalized and vulnerable populations: this includes addicts and alcoholics.  12-Step programs offer an inexpensive and accessible treatment option. Purpose  Quantitative research – Evaluating the effectiveness of a 12-step supported intervention. Hypothesis  If 12-step program participation is incorporated into addiction treatment, life satisfaction levels will increase. (Huebner & Kantor, 2011), (Rubin & Babbie, 2013).
Methodology – Definitions/Measurements & Population Substance Abuse: A problematic pattern of substance use leading to clinically significant impairment or stress. 12 Step Programs: Programs that follow a 12-step recovery process based on Alcoholics Anonymous (AA). Life Satisfaction: Being generally content and happy in life. • Survey used from The Happiness Center – 10 questions • Based on client self-reporting. Recovery: Holistic benefits of mind, body, spirit when someone suffering from addiction receives the help they need. Target of Research: Actively seeking treatment for AODs. • Availability Sampling (American Psychiatric Association, 2013, p. 233), (AA World Services, 1976), (The Happiness Center, 2008), (National Counsil on Alcoholism & Drug Dependence, Inc, 2015), (Rubin & Babbie 2013).
Methodology – Data Collection Who: Dallas’ counselor would collect data twice per month during two of their biweekly sessions. Instructions: Throughout the year: Dallas would complete a total of 24 Life Satisfaction Surveys during his sessions. For a designated 6 months: Dallas would also attend a minimum of two 12-step meetings per week. He would be given all the resources to do so.
Research Design Rationale ABAB Design: Increases the reliability of the findings. oEasier to conclude that the treatment may have had an effect on survey outcomes. Single-Subject Design: Evaluating whether current treatment interventions are effective. o Looking at one client’s results may help conclude whether it is effective. Generalizability: Not generalizable to all clients. o Individuals are highly influenced by their environment. (Rubin & Babbie, 2013)
Results 0 5 10 15 20 25 30 35 0 5 10 15 20 25 SurveyScore Observation # 12-Step Programs & Life Satisfaction (A) Baseline (B) Intervention (A) Baseline (B) Intervention Mean: 12.708 Standard Deviation: 6.477 Minimum: 4 Median: 11 Maximum: 29 For Dallas, 12-step program participation significantly improved his life satisfaction rate, while Dallas maintained is sober time.
Limitations – Reliability & Validity • Variables (12-step programs & life satisfaction scores) are not be diligently controlled for during this research. • Client may not participate in 12-step work and only attend meetings. • Client may choose to continue attending 12-step meetings even when it is not required. • Client self-reporting and interpretation of life events – results may not be congruent if study was performed twice. • This research CANNOT conclude whether 12-step programs have a positive effect on life satisfaction rates. • Lack of triangulation
Discussion • 12-Step Programs have a positive effect on recovery rates. • Individuals in recovery find that 12-step programs are very important in their lives and helped them to get sober. • Rating it an 8.7 out of a 10 point scale. • Members of AA have an average of 7 years sober. • It may be difficult to conclude the actual effects AA has on recovery rates, because there are so many outside factors that cannot always be accounted for. (Kaskutas, 2009), (Krentzman, et al., 2011), (Sifers & Peltz, 2012), (Mudnt, et al., 2012).
Conclusion Future Research:  Conducting study over multiple years – Change takes time  Triangulation Implications for Dallas:  His life satisfaction and sobriety increased while doing this study. Implications for Social Work:  12-step programs can be an inexpensive, accessible resource to refer clients to. Overall, 12-step programs may be correlated with longer sobriety time and more satisfying life styles.
References AA World Services (1976). Alcoholics Anonymous. New York, NY: Bill W. American psychiatric association. (2013). Substance related disorders. In Desk reference to the diagnostic criteria from DSM-V (pp. 230-284). Arlington, Virginia: American Psychiatric Association. Bowen, E., & Walton, Q. (2015). Disparities and the social determinants of mental health and addictions: opportunities for a multifaceted social work response. Health & Social work, 40 (3), 59-65. doi: 10.1093/hsw/hlv034 Gustafson, D., McTavish, F., Chih, M., Atwood, A., Johnson, R., Boyle, M., Levy, M., Driscoll, H., Chisholm, S., Dillenburn, L., Isham, A. & Shah, D. (2014). A smartphone application to support recovery from alcoholism. JAMA Psychiatry, 71 (5), 566-572. doi: 10.1001/jamapsychiatry.2013.4642 The Happiness Center. (2008). Life Satisfaction Survey. Retrieved from http://www.thehappinesscenter.com/survey/survey.php Huebner, R. & Kantor, L. (2011). Advances in alcoholism treatment. Alcohol Research & Health, 33(4). Retrieved from http://pubs.niaaa.nih.gov/publications/arh334/295- 299.pdf Kaskutas, L. (2009). Alcoholics anonymous effectiveness: faith meets science. Journal of Addictive Diseases, 28, 145-157. doi: 10.1080/10550880902772464 Kaufmann, C., Chen, L., Crum, R. & Mojtabai, R. (2014). Treatment seeking and barriers to treatment for alcohol use in persons with alcohol use disorders and comorbid mood or anxiety disorders. Soc Pyschiatry Eipedmiol, 24, 1489-1499. doi: 10.1007/s00127-013-0740-9 Krentzman, A., Robinson, E., Moore, B., Kelly, J., Laudet, A., White, W., Zemore, S., Kurtz, E., Strobe, S. (2011). How alcoholics anonymous (AA) and narcotics anonymous (NA) work: cross-disciplinary perspectives. Alcoholism Treatment Quarterly, 29(1), 75-84. doi: 10.1080/07347324.2011.538318 Laudet, A. (2008). The road to recovery: where are we going and how do we get there? Empirically-driven conclusions and future directions for service development and research. Substance use & Misuse, 43(12), 2001-2020. National Council on Alcoholism and Drug Dependence, Inc. (2015). Retrieved from https://ncadd.org/people-in-recovery/recovery-definition/definition-of-recovery National Institute on Drug Abuse. (2015). Retrieved from https://www.drugabuse.gov/publications/drugfacts/nationwide-trends Mundt, M., Parthasarath, S., Chi, F., Sterling, S., & Campbell, C. (2012). 12-step participation reduces medical use costs among adolescents with a history of alcohol and other drug treatment. Drug and Alcohol Dependence, 126, 124-130. Retrieved from http://dx.doi.org/10.1016/j.drugalcdep.2012.05.002 Rubin, A. & Babbie, E. (2013). Research methods for social work (3rd ed). Belmont, CA: Brooks/Cole Sifers, S. & Peltz, K. (3013). What members of alcoholics anonymous really believe. Mental Health, Religion & Culture, 16 (7), 711-718. doi: 10.1080/13674676.2012.715630

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Substance Abuse Treatment - Single Subject Design

  • 1. Substance Abuse Treated with 12-Step Programs Single Subject Design Cassidy Meehan Metropolitan State University of Denver
  • 2. Introduction – Substance Abuse & 12 Step Programs •Annual national costs and deaths that result from alcohol and other drug abuse (AODs) is on the rise. •In 2014, over 25,000 people died from alcohol and drug overdose •In 2014, $417 billion were lost from health expenses, lost work productivity and crime costs. •Only 14.6% of people with AODs ever seek treatment. (Bowen & Walton, 2015).
  • 3. Client - Dallas • 26 year old male. • Battled with substance abuse and alcohol dependence since he was 16 years old. • Recently arrested with a DUI. • Court Ordered to a 90-day treatment program. • 12-Step programs are not currently part of his treatment plan. • Goals: • More peaceful state of mind. • More satisfied with his life. • Come to terms with his alcohol and drug abuse.
  • 4. Literature Review • AA and other 12-step programs are at the forefront of treatment research. • AA is hard to study, because outside variables cannot be controlled for. • Research concludes that treatments need to be more long term. How can treatment be made less expensive? What is the best way to deliver long-term treatment? Gap: Success = Relapse rates & Length of sobriety This research: Success = Life Satisfaction. How effective are 12-step programs in treating alcoholism, as a long-term method and cheap alternative? (Hueber & Kantor, 2011), (Mundt, Parthsarathy, Chi, Sterling & Campbell, 2012), (Sifers & Peltz, 2013), Gustafson, McTavish, Chih, Atwood, Johnson, Boyle, Levy, Driscoll, Chisholm, Dillenburn, Isham, & Shah, 2014), (Kaufmann, Chen, Crum & Mojtabai, 2014), (Laudet, 2008).
  • 5. Methodology – Intent, Purpose, Hypothesis Intent  Determine if there is a positive correlation between AODs treatment and 12-step program participation.  Social Workers are trained to work with the most marginalized and vulnerable populations: this includes addicts and alcoholics.  12-Step programs offer an inexpensive and accessible treatment option. Purpose  Quantitative research – Evaluating the effectiveness of a 12-step supported intervention. Hypothesis  If 12-step program participation is incorporated into addiction treatment, life satisfaction levels will increase. (Huebner & Kantor, 2011), (Rubin & Babbie, 2013).
  • 6. Methodology – Definitions/Measurements & Population Substance Abuse: A problematic pattern of substance use leading to clinically significant impairment or stress. 12 Step Programs: Programs that follow a 12-step recovery process based on Alcoholics Anonymous (AA). Life Satisfaction: Being generally content and happy in life. • Survey used from The Happiness Center – 10 questions • Based on client self-reporting. Recovery: Holistic benefits of mind, body, spirit when someone suffering from addiction receives the help they need. Target of Research: Actively seeking treatment for AODs. • Availability Sampling (American Psychiatric Association, 2013, p. 233), (AA World Services, 1976), (The Happiness Center, 2008), (National Counsil on Alcoholism & Drug Dependence, Inc, 2015), (Rubin & Babbie 2013).
  • 7. Methodology – Data Collection Who: Dallas’ counselor would collect data twice per month during two of their biweekly sessions. Instructions: Throughout the year: Dallas would complete a total of 24 Life Satisfaction Surveys during his sessions. For a designated 6 months: Dallas would also attend a minimum of two 12-step meetings per week. He would be given all the resources to do so.
  • 8. Research Design Rationale ABAB Design: Increases the reliability of the findings. oEasier to conclude that the treatment may have had an effect on survey outcomes. Single-Subject Design: Evaluating whether current treatment interventions are effective. o Looking at one client’s results may help conclude whether it is effective. Generalizability: Not generalizable to all clients. o Individuals are highly influenced by their environment. (Rubin & Babbie, 2013)
  • 9. Results 0 5 10 15 20 25 30 35 0 5 10 15 20 25 SurveyScore Observation # 12-Step Programs & Life Satisfaction (A) Baseline (B) Intervention (A) Baseline (B) Intervention Mean: 12.708 Standard Deviation: 6.477 Minimum: 4 Median: 11 Maximum: 29 For Dallas, 12-step program participation significantly improved his life satisfaction rate, while Dallas maintained is sober time.
  • 10. Limitations – Reliability & Validity • Variables (12-step programs & life satisfaction scores) are not be diligently controlled for during this research. • Client may not participate in 12-step work and only attend meetings. • Client may choose to continue attending 12-step meetings even when it is not required. • Client self-reporting and interpretation of life events – results may not be congruent if study was performed twice. • This research CANNOT conclude whether 12-step programs have a positive effect on life satisfaction rates. • Lack of triangulation
  • 11. Discussion • 12-Step Programs have a positive effect on recovery rates. • Individuals in recovery find that 12-step programs are very important in their lives and helped them to get sober. • Rating it an 8.7 out of a 10 point scale. • Members of AA have an average of 7 years sober. • It may be difficult to conclude the actual effects AA has on recovery rates, because there are so many outside factors that cannot always be accounted for. (Kaskutas, 2009), (Krentzman, et al., 2011), (Sifers & Peltz, 2012), (Mudnt, et al., 2012).
  • 12. Conclusion Future Research:  Conducting study over multiple years – Change takes time  Triangulation Implications for Dallas:  His life satisfaction and sobriety increased while doing this study. Implications for Social Work:  12-step programs can be an inexpensive, accessible resource to refer clients to. Overall, 12-step programs may be correlated with longer sobriety time and more satisfying life styles.
  • 13. References AA World Services (1976). Alcoholics Anonymous. New York, NY: Bill W. American psychiatric association. (2013). Substance related disorders. In Desk reference to the diagnostic criteria from DSM-V (pp. 230-284). Arlington, Virginia: American Psychiatric Association. Bowen, E., & Walton, Q. (2015). Disparities and the social determinants of mental health and addictions: opportunities for a multifaceted social work response. Health & Social work, 40 (3), 59-65. doi: 10.1093/hsw/hlv034 Gustafson, D., McTavish, F., Chih, M., Atwood, A., Johnson, R., Boyle, M., Levy, M., Driscoll, H., Chisholm, S., Dillenburn, L., Isham, A. & Shah, D. (2014). A smartphone application to support recovery from alcoholism. JAMA Psychiatry, 71 (5), 566-572. doi: 10.1001/jamapsychiatry.2013.4642 The Happiness Center. (2008). Life Satisfaction Survey. Retrieved from http://www.thehappinesscenter.com/survey/survey.php Huebner, R. & Kantor, L. (2011). Advances in alcoholism treatment. Alcohol Research & Health, 33(4). Retrieved from http://pubs.niaaa.nih.gov/publications/arh334/295- 299.pdf Kaskutas, L. (2009). Alcoholics anonymous effectiveness: faith meets science. Journal of Addictive Diseases, 28, 145-157. doi: 10.1080/10550880902772464 Kaufmann, C., Chen, L., Crum, R. & Mojtabai, R. (2014). Treatment seeking and barriers to treatment for alcohol use in persons with alcohol use disorders and comorbid mood or anxiety disorders. Soc Pyschiatry Eipedmiol, 24, 1489-1499. doi: 10.1007/s00127-013-0740-9 Krentzman, A., Robinson, E., Moore, B., Kelly, J., Laudet, A., White, W., Zemore, S., Kurtz, E., Strobe, S. (2011). How alcoholics anonymous (AA) and narcotics anonymous (NA) work: cross-disciplinary perspectives. Alcoholism Treatment Quarterly, 29(1), 75-84. doi: 10.1080/07347324.2011.538318 Laudet, A. (2008). The road to recovery: where are we going and how do we get there? Empirically-driven conclusions and future directions for service development and research. Substance use & Misuse, 43(12), 2001-2020. National Council on Alcoholism and Drug Dependence, Inc. (2015). Retrieved from https://ncadd.org/people-in-recovery/recovery-definition/definition-of-recovery National Institute on Drug Abuse. (2015). Retrieved from https://www.drugabuse.gov/publications/drugfacts/nationwide-trends Mundt, M., Parthasarath, S., Chi, F., Sterling, S., & Campbell, C. (2012). 12-step participation reduces medical use costs among adolescents with a history of alcohol and other drug treatment. Drug and Alcohol Dependence, 126, 124-130. Retrieved from http://dx.doi.org/10.1016/j.drugalcdep.2012.05.002 Rubin, A. & Babbie, E. (2013). Research methods for social work (3rd ed). Belmont, CA: Brooks/Cole Sifers, S. & Peltz, K. (3013). What members of alcoholics anonymous really believe. Mental Health, Religion & Culture, 16 (7), 711-718. doi: 10.1080/13674676.2012.715630