Substance abuse is widely recognized as one of the top healthcare problems in the US, and alcohol dependence is the by far the most prevalent addictive disorder. While psychosocial treatments have been shown to be beneficial, the majority of clients treated in abstinence based treatments relapse in the year following treatment. A growing body of research suggests that aftercare services and post-treatment Alcoholics Anonymous (AA) involvement improve drinking outcomes. Despite this optimism, two problems stand as barriers to improved outcomes relying on these two strategies: (1) regarding the former strategy, the US DHHS Reports shortages in treatment capacity and it is unlikely that substantial professionally led aftercare services can be expanded at this time, and, (2) regarding the latter, research suggests that involvement in AA following twelve-step facilitative treatment is minimal or nonexistent in the most cases. This study seeks to improve treatment outcomes by improving post-treatment AA involvement using a newly developed intervention. The grant team relies on the Rounsaville and colleagues (2001) model for new intervention development and proposes to conduct a small stage lb randomly controlled pilot study (N=60) of this newly developed intervention. Alcohol dependent subjects meeting inclusion / exclusion will be recruited from a large inpatient treatment facility in the Louisville, KY area and randomly assigned to an experimental condition (N=30) or a treatment as usual control group (N=30) and followed up at three- and six-months post-treatment. The intervention consists of two motivational sessions that will be delivered by the PI at or near the end of treatment. During the second motivational session, the subject will be introduced to a randomly-assigned and gender-matched AA mentor and agree to meet at six meetings in the three weeks following treatment with an express goal of advancing AA socialization processes. Primary aims are to advance knowledge on how to increase post-treatment AA utilization by (1) pilot testing the intervention in a small randomly controlled trial to establish benefits, if any; (2) advance a theoretical model that identifies causes and mechanisms of long-term AA affiliation and or disaffiliation; and (3) publish treatment, training, and research compliance guides to assist with future research and knowledge transfer. A secondary aim of the application involves increasing knowledge of how to utilize the AA recovery community by evaluating methods used to recruit, screen, train and engage the recovering community for provision of mentoring services.
