1. Mutual aid and its facilitation Steve Taylor, Alcohol & Drugs, PHE
10 April 2013

2. Why social networks matter
Meta analysis: comparative odds of decreased mortality
Social relationships have as great an impact as smoking cessation, and more than physical activity and issues to address obesity
Source: Holt-Lundstad et al 2010
Mutual aid April 2013

3. Five ways to wellbeing 5 ways to well-being important to all.
May be especially lacking in drug users and needing attention during recovery, to support recovery.
Mutual aid can contribute to most of the 5 ways – even ‘be active’ if people walk or cycle to meetings!
Mutual aid April 2013

4. NICE
“routinely provide people who misuse drugs with information about self-help groups.”
“consider facilitating the person’s initial contact with the group, for example by making the appointment, arranging transport, accompanying him or her to the first session and dealing with any concerns.”
NICE CG51, 2007
Echoed in quality standard (QS23, 2012)
And similar for alcohol (CG115, 2011)
Mutual aid April 2013

5. Recovery Orientated Drug Treatment
What? “Strengthen or develop patients’ social networks, involving families where appropriate and facilitating access to mutual aid by, for example, providing information, transport, or premises for meetings, and by bringing local recovery champions into the service to meet patients.” When? In every phase of treatment and beyond
Mutual aid April 2013

6. NTA/PHE recovery resource
Helping clients to access and engage with mutual aid “Treatment providers and keyworkers who actively help service users to access and engage with mutual aid are likely to see better outcomes. But it means doing more than simply providing information or hosting meetings…”
This resource – one in a series supporting practical implementation of the Strang report – forms the basis for much of what follows.
Mutual aid April 2013

7. Who recovers? Everyone CAN recover Not everyone WILL recover
We don’t know WHO will recover
So, give everyone EVERY a chance
We also don’t know HOW people will recover so try to engage everyone with mutual aid
Mutual aid April 2013

8. Is it effective? Effectiveness
Improves substance misuse outcomes (NICE, 2007, 2011, 2012)
Extra effect when combined with structured treatment (Fiorentine & Hillhouse, 2000)
The addition of just one abstinent person to a drinker’s social network increased the probability of abstinence in the next year by 27% (Litt et al., 2009).
Cost-effectiveness
Over 3 years per-person treatment costs for AA group:
45% lower than ‘professional’ treated groups with similar outcomes
Mutual aid (AA) reduces on-going treatment costs (Humphreys, 2004)
Mutual aid April 2013

9. Mediators of effectiveness
How specific are the mediators of AA's effectiveness? "Changes in active coping behaviours, cognitive appraisal of the advantages and disadvantages of drinking, and self-efficacy may seem more the stuff of cognitive-behavioral psychotherapy than of a 12-step self-help organization. But even the most spiritually minded AA meetings and texts offer extensive practical advice, which any cognitive-behavioral theorist would endorse even though the jargon would be unfamiliar” Circles of Recovery, Keith Humphreys
Mutual aid April 2013

10. Mediators of effectiveness
How specific are the mediators of AA's effectiveness? Circles of Recovery, Keith Humphreys
CBT
12-step
monitor for relapse-promoting cognitive distortions
no stinking thinking
adopt behavioural changes that are congruent with more positive mood
fake it until you make it
use stimulus-control methods to eliminate alcohol consumption
avoid slippery people, places, and things
Mutual aid April 2013

11. What can you do? Learn about it
“There is a principle which is a bar against all information, which is proof against all arguments, and which cannot fail to keep a man in everlasting ignorance - that principle is contempt prior to investigation.”
Attributed to Herbert Spencer (in Alcoholics Anonymous: The Story of How More Than One Hundred Men Have Recovered From Alcoholism), after William Paley 1794
Read
Watch
Learn
GO!
Mutual aid April 2013

12. What can you do? Host/promote/support meetings Provide space
Provide literature
Bring in speakers
Use peer mentors and recovery champions
Remind people about their meetings
Escort them
Mutual aid April 2013

13. What can you do? Synergise attendance Include in care planning
Reflect in keywork
Journal
Maps
‘3-Step Referral Method’:
Handouts, worksheets, research and guides available from
Mutual aid April 2013

14. Recovery Resources
Helping clients to access and engage with mutual aid: _jan2013[0].pdf
Mutual aid April 2013