Behavior, Treatment and Prevention
Youth Recovery Contexts: The Incremental Effects of 12-Step Attendance and Involvement on Adolescent Outpatient Outcomes
Article first published online: 17 APR 2012
Copyright © 2012 by the Research Society on Alcoholism
Alcoholism: Clinical and Experimental Research
Volume 36, Issue 7, pages 1219–1229, July 2012
How to Cite
Kelly, J. F. and Urbanoski, K. (2012), Youth Recovery Contexts: The Incremental Effects of 12-Step Attendance and Involvement on Adolescent Outpatient Outcomes. Alcoholism: Clinical and Experimental Research, 36: 1219–1229. doi: 10.1111/j.1530-0277.2011.01727.x
- Issue published online: 10 JUL 2012
- Article first published online: 17 APR 2012
- Manuscript Accepted: 25 OCT 2011
- Manuscript Received: 25 JUL 2011
- National Institute on Alcohol Abuse and Alcoholism. Grant Number: 5R01AA015526-04
- Alcoholics Anonymous;
- Narcotics Anonymous;
- Mutual Help;
- Substance Use Disorder
A major barrier to youth recovery is finding suitable sobriety-supportive social contexts. National studies reveal most adolescent addiction treatment programs link youths to community 12-step fellowships to help meet this challenge, but little is known empirically regarding the extent to which adolescents attend and benefit from 12-step meetings or whether they derive additional gains from active involvement in prescribed 12-step activities (e.g., contact with a sponsor and other fellowship members). Greater knowledge in this area would enhance the efficiency of clinical continuing care recommendations.
Adolescent outpatients (N = 127; M age 16.7; 75% male; 87% white) enrolled in a naturalistic study of treatment effectiveness were assessed at intake and 3, 6, and 12 months later using standardized assessments. Mixed-effects models, controlling for static and time-varying confounds, examined the concurrent and lagged effects of 12-step attendance and active involvement on abstinence over time.
The proportion attending 12-step meetings was relatively low across follow-up (24 to 29%), but more frequent attendance was independently associated with greater abstinence in concurrent and, to a lesser extent, lagged models. An 8-item composite measure of 12-step involvement did not enhance outcomes over and above attendance, but separate components did; specifically, greater contact with a 12-step sponsor outside of meetings and more verbal participation during meetings.
The benefits of 12-step participation observed among adult samples extend to adolescent outpatients. Community 12-step fellowships appear to provide a useful sobriety-supportive social context for youths seeking recovery, but evidence-based youth-specific 12-step facilitation strategies are needed to enhance outpatient attendance rates.