quote: "boosted two-year sobriety rates by 30 percent compared to cognitive-behavioral (CB)" How did you came up with 30%. quote from the study: "As had been the case in the 1-year follow-up of this sample, the only difference in clinical outcomes was a substantially higher abstinence rate among patients treated in 12-step (49.5%) versus CB (37.0%) programs." http://focus.psychiatryonline.org/cgi/content/abstract/5/2/193

Gene, this is an explanation of the math. The study showed a 12.5 percentage point benefit to the 12 step programs. (49.5%-37%=12.5%) To show the relative size of the benefit, that 12.5% difference is divided by 37% [12.5%/37%=.337 (or 33.7%)] This shows that the 12 step approach has a 30% (actually 33.8%) greater benefit compared to the CB program.

Susan, unfortunately you are juggling with the numbers. If you want to compare the relative effectiveness of 2 groups applying your methodic, then you should create a new sample sizes, which are 12 steps n(12 steps)= 49.5% out of 887 (original sample size)= 439, n(CBT) = 37% out of 887 =328 After applying the necessary adjustment because you are comparing different sample sizes, you will get the 12.5%. To illustrate your mistake I would use your method: 12.5% / 49.5% X 100%=25.25% CBT is only 25% less effective than 12 steps.

And I want to illustrate the right way to do it: n(12steps)+ n(CBT)= n(new sample size) 439+328=767 n(12 steps) 439 0ut of n(767) =57% n(CBT)328 out of 0f n (767)=43% 57%-43%=14%

12-Step oriented and/or twelve-step facilitation programs have been historically quite effective regarding long-term sobriety. I've been sober for over 20 yrs now and had been actively involved with A.A. applying the 12 steps, changing from within. A.A. is effective because it is a living program teaching you how to live without the use of alcohol. Alcohol is the symptom of a much larger issue which A.A. addresses in the 12 steps. Complexity of simplicity!~

I don't have the full text article so perhaps some of you can help me with these questions and interpretations. First of all the comparison of the 2 "treatments" may not even be a fair one. Since abstinence was the only outcome where there was a significant difference between the 2 treatments then one would have to ask if "abstinence" from substances was even a goal or emphasized in both treatments? We know it is for 12 step based programs but it is not necessarily so for cognitive behavioral therapy. The other question is about the dose of treatment. Did clients in treatments receive the same frequency, amount and intensity of treatments? The difference in outcomes may be due to dosing effects. In other words if one set patients received a higher dose of tx. than the other then you will get different outcomes! That does not prove that 12 step based treatment is superior to CBT. And there is more to consider!

To continue with a few more thoughts on this research article….Also this is a quasi-experimental design so if you really want to do a fair and definitive study comparing two bonafide treatments then you need to do a Random Controlled Clinical Trial (RCT) or do a meta-analytic study of multiple previous RCT studies. This was done with Project Match and other studies and guess what; the results show no difference among treatment approaches. This is the problem with research based treatments by the way, many of the studies are poorly or improperly designed, and the interpretation of results is often biased for numerous reasons. Just from a cursory look at the sponsors of the research I would suspect that research bias and/or researcher allegiance may also have swayed the outcomes because some of these organizations paying for the study or performing the study are traditionally proponents of a 12 step based abstinence only disease model of treatment. Plus with funding cuts being the order of the day then making a case for self help being "effective and cheaper" than a more expensive treatment model might have influenced the study as well.

12 step philosophy is a personal choice of support, IT IS NOT THE TREATMENT OR TREATMENT PHILOSOPHY. This study does not reveal the harm that 12 step professionals, unwittingly, create to treatment and the need for treatment to evolve. It does not offer any immediate help in a treatment setting. For instance, do any of the existing 12 step rehabs teach skills about how not to use? No, they have people work on the first step. If we have only one thing to teach wouldnt it be how to work through using and craving experiences? The counselors in 12 step recovery, have a hard time not disclosing their recovery, it is based on a false assumption that it will "join" them with the patient faster.In reality it robs them of opportunities to develop skills. PS--take a look at SMART RECOVERY.COM, AND SEE HOW EFFECTIVE THAT INFORMATION IS, BUT IT IS IGNORED. Be Well, Andrew Park LCSW-ATOD, Program Case Manager, NFL substance abuse program and addiction practice specialist.

I agree with Andrew Park - the disclosure issue has always appeared to be a "short-cut" by recovering 12 step counselors that takes the place of counseling skills. Also, the only people who can be helped by 12 programs are those who buy into the whole spiritual thing - I've had a number of clients who simply find the approach, emotionally and spiritually, too detached from their individual issues and concerns.