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Efficacy of Group Therapy Based on 12-Step Approach of Narcotics Anonymous on Self

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Efficacy of Group Therapy Based on 12-Step Approach of Narcotics Anonymous on Self January 2020, Volume 8, Number 1 Research Paper: Efficacy of Group Therapy Based on 12-step Approach of Narcotics Anonymous on Self- control and Quality of Life in People With Substance Use Disorder Diagnosis During Recovery Sayed Mostafa Abdollahi1 , Sayed Abbas Haghayegh1* 1. Department of Psychology, Faculty of Humanities, Najafabad Branch, Islamic Azad University, Najafabad, Isfahan, Iran. Use your device to scan and read the article online Citation: Abdollahi, S. M., & Haghayegh, S. A. (2020). Efficacy of Group Therapy Based on 12-step Approach of Narcotics Anonymous on Self-control and Quality of Life in People With Substance Use Disorder Diagnosis During Recovery. Journal of Practice in Clinical Psychology, 8(1), 17-26. https://doi.org/10.32598/jpcp.8.1.19 : https://doi.org/10.32598/jpcp.8.1.19 A B S T R A C T Objective: The substance use disorder is a debilitating and often chronic problem. The present Article info: study was conducted to investigate the effectiveness of group therapy based on the 12-step Received: 22 May 2019 approach of Narcotics Anonymous (NA) on self-control and Quality of Life in people with Accepted: 04 Nov 2019 substance use disorder diagnosis during recovery. Available Online: 01 Jan 2020 Methods: The design of the study was two-way quasi-experimental (an experimental group and a control group) in the form of a pre-test, post-test, and follow up. A total of 60 subjects were recruited as the prototype among the patients who were referred to the Narcotics Anonymous Fellowship in Isfahan and were divided into experimental and control groups (30 people in each group). To measure the pre-test step, the participants in both groups completed Tangney’s self-control scale questionnaire (Tangney, 2004) and the World Health Organization Quality of Life questionnaire (WHO, 1991). Then, the experimental group received 12 sessions of group- therapy intervention based on the 12-step approach of NA (NA step working guides, 2013), and the control group received no intervention. After completing the intervention, the post-test and follow up test (two months later) were implemented in both groups. The obtained data were analyzed with a multivariate analysis of covariance in SPSS V. 22. Results: The results indicated significant differences between the experimental group and the control group in self-control and Quality of Life domains (physical, social, and psychological Keywords: domains) scores in the pre-test and follow-up (P<0.05). However, regarding the environment Group therapy, 12-step domain of Quality of Life, no significant difference was observed between the experimental approach, Narcotics, and the control group. Anonymous, Self-control, Conclusion: The group therapy based on the 12-step approach of NA can be considered an Quality of Life, Substance use effective treatment to reduce the likelihood of substance re-use and improve the Quality of Life disorder of these people. * Corresponding Author: Sayed Abbas Haghayegh, PhD. Address: Department of Psychology, Faculty of Humanities, Najafabad Branch, Islamic Azad University, Najafabad, Isfahan, Iran. Tel: + 98 (913) 1946550 E-mail: [email protected] 17 January 2020, Volume 8, Number 1 Highlights ● Group therapy based on the 12-step approach of NA increases the self-control of addicted people. ● Group therapy based on the 12-step approach of NA improves the Quality of Life of addicted people. Plain Language Summary Substance use disorder is a chronic problem with behavioral consequences. The 12-step approach of NA is a known therapeutic approach based on a series of principles proposed to recover from the addiction. The present research was conducted to examine the effectiveness of this approach on self-control and Quality of Life in people with substance use disorder diagnosis during recovery. The results showed the 12-step approach of NA could be an effective treatment to increase the self-control and most domains of Quality of Life of these people. 1. Introduction According to WHO definition, the Quality of Life has four domains: physical health (including the ability to ccording to the fifth edition of ‘Diag- perform daily tasks), psychological health (including the nosis and Statistical Manual of Mental satisfaction and imagination of the person of self and his/ Disorders’ (DSM-5), substance use dis- her appearance), social relationships (including personal order is characterized by a set of cogni- relations, social support, and extra activities), and en- tive, behavioral, and physical symptoms vironmental health (including financial resources, free- A leading to a need to repeatedly use a dom, and safety) (Bjelic-Radisic, Cardoso, Cameron, specific substance despite the considerable problems Brain, 2020; Frisch, 2010). The Quality of Life is one made for the person. These consequences may be shown of the crucial variables in the treatment or improvement in the form of frequent returns and an intense passion for of addiction (Emamipoor, Shams, Sadr-al-Sadat, & Na- taking drugs (American Psychiatric Association, 2013). deri, 2009). Hoseinifar et al. (2011) found that Quality of Life and mental health are lower among addicts. They Self-control has been defined as a coping strategy or also found a significant positive relationship between the skill protecting people against their internal demands Quality of Life and mental health in addicts. leading to more desirable consequences (Clinton, Con- way, Sturges, Hewett, 2020; Hatami, 2011). The self- In another study,Muller, Skurtveit, and Clausen (2016) control helps adolescents and young people to reduce showed that factors associated with poor Quality of Life risky behaviors (e.g. drug abuse and smoking) (Ford are also related to social disorder, physical well-being, & Blumenstein, 2013). Chauchard, Levin, Copersino, and psychological distress. Over the past three decades, Heishman, and Gorelick (2013) concluded that self-con- attention has been paid to the Quality of Life as an es- trol is an essential factor in avoiding people after quitting sential factor in the assessment of therapeutic outcomes drugs. Fox, Hong, and Sinha (2008) found a significant and the effectiveness of treatment in physical and psy- difference between alcohol users and non-users in the chological disorders (Karow, Reimer, Schäfer, Krausz, ability to control impulses. Doran, McCharque, and Co- Haasen, & Verthein, 2010). Traditional approaches to hen (2007) showed in their study that people who cannot the evaluation of treatment outcomes mainly focused on control their impulses are probably permanent substance the symptoms of the disease. They paid little attention users. Taylor, Hiller, and Taylor (2013) showed positive to the concept of Quality of Life and factors affecting it. relationships between the likelihood of substance use However, changes in the severity of symptoms do not disorder, low self-control, and high levels of impulsiv- necessarily reflect improvement (Palad, Snyder, 2019; ity. Visser, de Winter, Veenstra, Verhulst, and Reijneveld Maremmani, Pani, Pacini, & Perugi, 2007). (2013) reported that alcohol users have lower levels of self-control compared to non-users. Shapiro, Astin, Narcotics Anonymous (NA) is an international non- Bishop, and Cordova (2005) explained that strengthen- profit social organization that is active in 132 countries ing self-control increases a smoker’s readiness to avoid (Burns & Grove, 2008). Members of NA are recovering smoking despite external stimuli. addicts who not only want to stop using drugs but also to seek recovery from addiction disease. NA is a pro- 18 Abdollahi, S. M., & Haghayegh, S. A. (2020). Group Therapy in Substance Users Based on NA Self-control Approach. JPCP, 8(1), 17-26. January 2020, Volume 8, Number 1 gram of complete abstinence from all drugs. The core etc.) by physicians and based on the results of new diag- and heart of the NA program comprise twelve steps. The nostic kits (i.e. opiates-heroin-morphine rapid test [strip] twelve steps are based on a series of principles proposed and thin-layer chromatography [TLC]), and the patients to recovery from the addiction disease (Sanches, John, had already passed the detoxification process successfully 2019; Wilson, 2009). The Twelve-Step Groups (TSGs) and been in the process of recovery. They referred to the offer a continuous and easily reached recovery program fellowship of NA in Isfahan to continue the treatment. Of to support patients with substance use disorders (Hum- them, 60 patients who were willing to participate in the phreys, 2004; Fiorentine, 1999). Addicts in these groups present study were selected from April to May 2016 and are supposed to improve themselves through personal- divided into the experimental and control groups (30 pa- ized techniques (Aliverdinia, 2009). tients in each group). In the control group, 4 participants were excluded at the post-test stage (one passed away, and In a study on 128 American NA members, Delucia, three did not want to continue), and eight were excluded Bergman, Formoso, and Weinberg (2015) investigated at the follow-up stage (due to relapse). In the experimental various correlates of recovery from addiction, such as group, 6 participants were excluded at the post-test stage psychological well-being. The results showed that the (4 for being absent more than three sessions and 2 for re- duration of abstinence and the continuation of recovery lapse), and 4 were excluded at the follow-up stage (for not could predict the psychological well-being of NA mem- completing the questionnaires). bers. In a study on 322 patients undergoing Methadone Maintenance Treatment (MMT) in North American cit- Study instruments ies, White, Campbell, Spencer, Hoffman, Crissman, and Dupont (2014) showed that attending the TSG-based Tangney’s Self-control Scale interventions can lead to drug abstinence and reduced feelings of helplessness in patients undergoing MMT. The Tangney’s Self-control Scale (SCS) is a 36-item Kelly, Greene, and Bergman (2014) examined 1706 scale examining self-control. Higher SCS scores indicate people attending Alcoholics Anonymous (AA) meetings higher levels of self-control.
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