How Do Support Groups Help with Treatment?

Addiction is a disease that requires deep commitment, medical attention, and support from many people to overcome.

When people decide to enter treatment, they have dedicated themselves to overcoming this chronic illness and learning a new way to live. Through multifaceted approaches to treatment, many people can overcome their substance abuse and addiction problems. Support groups are a key part of recovery, as they extend social support outside of rehabilitation therapy for years.

What Are Support Groups, and How Do They Work?

When most people think of support groups, they think of organizations like Alcoholics Anonymous (AA). These peer support groups are generally member-led. Whereas a therapist leads group therapy sessions, members themselves operate support groups. Usually, more seasoned members of the group lead meetings and deal with organizational aspects of the group. Support groups are available to address a number of different issues, ranging from grief and eating disorders to addiction and substance abuse.

The dynamic involves a member leading group discussions, during which individual members may discuss their current situations, especially their struggles or concerns. Discussion helps put each member’s issues into perspective and provides insight and advice on how to move forward. Knowing that other people have gone through the same thing often helps people deal with strong emotions and reduces the potential for relapse.

After a person leaves their rehabilitation program, which should last at least 90 days according to the National Institute on Drug Abuse (NIDA), support groups are generally a vital part of a robust aftercare plan.

It is also useful for family and close friends of the person struggling with addiction to find their own support groups, so they can better support the individual’s recovery.

According to the American Society of Addiction Medicine, self-help groups have been useful for many people overcoming addiction or substance abuse, and they offer social support structures. This can be useful from a personal perspective; however, since self-help groups are not led by certified clinicians, there is no specific treatment plan. The group will not refer the individual to other services, and the individual is not required to check in during the therapy process. Since the structure is less focused on therapy and more focused on social bonds, some people may not find this as helpful at first, and it is not considered therapy. As a result, 12-Step and peer support groups can be important complements to therapy but they are not treatment in and of themselves.

The Benefits of Support Groups in Addiction Recovery

The US Department of Health and Human Services Quick Guide for Clinicians states that support groups, as an aspect of an overall treatment plan, can strengthen members’ abilities to manage their thoughts and emotions, and also aid in the development of better interpersonal skills as members work on recovering from their addiction and maintaining sobriety. They are most effective during the early stages of recovery, although many members can remain in the group for months or years, depending on the program and its usefulness to the individual.

The Treatment Improvement Protocol (TIP) from the Substance Abuse and Mental Health Services Administration (SAMHSA) on group therapy elaborates on many of the benefits of support groups and group therapy. Some of these benefits include:

• Positive peer pressure and support: Support groups gather several people at a similar stage in their recovery together, and there is consistent, positive pressure to be on time and to treat this meeting time as special. There is strong positive pressure to adhere to the rules of the group.
• Reducing isolation: Support groups reduce one’s sense of being alone with a problem like substance abuse. Many individuals struggling with addiction and substance abuse socially isolate themselves for a variety of reasons, but during recovery, it is important for everyone to know that they are not alone in their recovery process, that there are many people in the world who understand their struggle, and that these individuals support their sobriety.
• Witnessing others’ recovery: Maintaining abstinence requires work, even with strong social support and therapy. One of the biggest benefits of attending support groups is seeing others who have gone through the same recovery process, who are making positive changes in their lives.
• Learning new coping mechanisms: Members often have suggestions on how group members can cope with cravings, life stress, or triggers that might affect their ability to stay sober. Members can talk to each other about how effective certain methods were for them and the positive impacts of different coping strategies.
• Information on changing relationships: Not only do new members see how other people make changes during their recovery process, they will also learn more about how relationships with their friends, family, employers, coworkers, and other people in their lives will grow and change.
• Accountability: When people struggle with addiction, relapse is an ongoing concern. If and when relapse does occur, group members can hold each other accountable. Instead of chastising perceived bad behavior, members support the individual in taking all steps necessary to stop using the substance again and to continue their recovery.
• Support and encouragement outside the group: AA recommends that each member have a sponsor whom they can contact outside of regular group sessions for support. Support groups often encourage members to become friends and support each other through the recovery process outside of the scheduled meetings.

Types of Support Groups

There are several types of support groups, so anyone who is working to overcome an addiction or substance abuse problem has options for help. The most famous, of course, are the 12-Step programs, particularly Alcoholics Anonymous; however, there are many other types of support groups, both in the 12-Step model and those that intentionally deviate from it.

12-Step Programs

Alcoholics Anonymous is one of the very first substance abuse recovery programs, started in the 1930s, and it changed how many people viewed addiction by showing that it is possible to overcome this disease. Based on the religious self-improvement organization, the Oxford Group, the philosophy of AA and other Anonymous groups is that self-examination, admitting wrongdoings, prayer, making amends, and meditation can help a person overcome various personal issues. Since then, many other programs have based their mission and philosophy on this approach, and this family is known as the 12-Step program groups.

The 12 Steps in the process are:

1. We are powerless in our addiction, and our lives have become unmanageable.
2. We believe a Power greater than ourselves can restore our sanity.
3. We turn our will and our lives over to God’s care, as we understand “God.”
4. We make a searching, fearless inventory of ourselves and our morals.
5. We admit to ourselves, to God, and to another human being the nature of our wrongs.
6. We are ready for God to remove these character flaws.
7. We ask God to remove our shortcomings.
8. We make a list of people we harmed, and we are willing to make amends.
9. We make direct amends with people when possible, unless it would injure ourselves or others.
10. We continue our personal inventory of our flaws, and we promptly admit when we’re wrong.
11. We seek thought, prayer, and meditation to improve our conscious contact with God and ask for knowledge.
12. We carry the message of help to others struggling with addiction.

Here are a few examples of 12-Step programs:

• Alcoholics Anonymous (AA)
• Adult Children of Alcoholics (ACA)
• Narcotics Anonymous (NA)
• Dual Recovery Anonymous (DRA)
• Heroin Anonymous (HA)
• Marijuana Anonymous (MA)
• Cocaine Anonymous (CA)
• Gamblers Anonymous (GA)
• Al-Anon family groups

Support Groups beyond 12-Step Programs

Because the 12-Step family of programs is overtly religious, specifically Christian, other religious groups, secular organizations, and clinical therapy groups have created support groups that offer structure and socialization to support recovery, without the emphasis on a higher power, God, and prayer.

Here are some examples of non-12-Step support groups:

• LifeRing Secular Recovery: As a secular organization, LifeRing is devoted to helping members with a nonreligious philosophy. There are three basic points, rather than 12 Steps, which are: sobriety, which in the context of recovery means abstinence; secularity, so regardless of religious beliefs or lack thereof, the program aims to help with social support; and self-help, meaning the key to recovery is the individual’s motivation and effort.
• Secular Organizations for Sobriety (S.O.S.): Founded in 1985, this nonprofit helps those who need help recovering from addiction or substance abuse find autonomous, nonprofessional local support groups. Since the focus in on secular philosophies rather than Christian-based steps, anyone can use the organization to find help.
• Self-Management and Recovery Training (SMART Recovery): There are 4 points to the SMART Recovery program that help people recover from substance abuse and addictive behaviors. These steps are (1) building and maintaining motivation; (2) coping with urges; (3) managing thoughts, feelings, and behaviors; and (4) living a balanced life.
• Moderation Management (MM): There are four basic steps in Moderation Management: self-management, balance, moderation, and personal responsibility. MM specifically focuses on problem drinking, and the support groups and treatment programs are free.

The Effectiveness of Support Groups

Conducting studies on support groups and their positive outcomes is difficult, since most of them insist on maintaining member anonymity, and there is no real way to set up a control group to compare to the support group members. The National Center on Addiction and Substance Abuse (CASA-Columbia) discusses this problem and the lack of literature, and supports the need to integrate addiction medicine into healthcare systems and medical practices in order to collect better information.

The National Institute on Alcohol Abuse and Alcoholism published research into several studies involving 12-Step support groups, which they refer to as mutual help groups (MHGs). One study, conducted over a 16-year period, examined individuals who attended regularly AA after formal treatment, those who received formal treatment only, and untreated problem drinkers. By the eight-year follow-up mark, 49 percent of those who went only to the AA support groups remained abstinent, compared to 46 percent who only went through a formal rehabilitation program. Those who went to both formal treatment and then self-selected into AA did better than other members of the group at maintaining sobriety for the long-term.

Another study involving 3,018 veterans receiving treatment for substance abuse found that the patients who attended a 12-Step MHG for one year after outpatient treatment were more successful at maintaining sobriety than those who received only outpatient treatment, based on a one-year follow-up.

Later findings found that AA involvement helped decrease alcohol consumption and resulted in fewer alcohol-related problems.

How to Find a Support Group

National support groups like AA and others can be found by searching online. There are chapters all over the US in most locales. People seeking support groups after a rehabilitation program should also consider speaking with their doctor, social worker, or therapists in their rehabilitation program. There are many ways to find a support group that works for your unique situation. This support can prove vital in continuing the journey to maintain sobriety after successfully completing a rehabilitation program.