The Value of 12-Step Programs and Other Peer Support Groups in Dual Diagnosis Treatment

The high rate of substance use disorders amongst people with mental illness can be attributed to a wide variety of causes, including shared environmental and biological underpinnings and increased motivation to alter one’s mental state. However, while people with mental illness are more likely to abuse harmful substances, they are also more likely to be harmed by them; drugs and alcohol can augment symptoms of mental health disorders while simultaneously diminishing treatment efficacy.

Substance abuse can also complicate mental health diagnosis and follow-up monitoring due to difficulties differentiating between symptoms of mental illness and the effects of drug and alcohol use, making your loved one vulnerable to inaccurate diagnosis and incorrect or incomplete treatment. Meanwhile, the unresolved symptoms of mental illness can strengthen the impetus for substance abuse, increasing the severity of substance use disorders.

Due to the complex relationship between mental illness and substance use disorders, treating one in isolation from the other is unlikely to produce lasting recovery from either disorder. Dual diagnosis treatment programs offer expert assessments by clinicians who can properly diagnose and treat your loved one even in the presence of co-occurring disorders. Their treatment will most likely include a variety of empirically-based modalities, including pharmacotherapy, cognitive behavioral therapy, mindfulness-based therapies, coping skills development, and relapse prevention.

Through these modalities, your loved one can explore the roots of their disorders and the relationship between them while developing meaningful strategies for emotional and behavioral change. Throughout treatment, your loved one will be monitored by expert clinicians who understand the special challenges faced by those with co-occurring disorders and who can continuously modulate their care to meet their needs in the moment.

While dual diagnosis treatment relies heavily on the expertise of clinicians who can deploy cutting-edge interventions, peer support programs often play a central role in healing for those struggling with mental illness and a co-occurring mental health disorder. The most well-known of these programs are, of course, 12-step programs such as Alcoholics Anonymous and Narcotics Anonymous. However, there are also newer formats, like SMART Recovery, that offer a different structure and philosophy than traditional 12-step groups. The wide variety of groups available today gives your loved one the freedom to connect with a program that speaks to them based on their own needs and beliefs.

While the details of peer support programs may differ, all are built on the basic premise of people in substance use disorder recovery giving and receiving support while sharing their struggles and wisdom in a safe, non-clinical environment. Your loved one will be drawn out of isolation and invited to join a community of people who understand what they are going through. Here, your loved one can explore their experiences and follow a shared path of recovery while staying accountable to and learning from others who are on the same journey. As one research cohort writes in Social Work in Public Health:

[These groups] encourage bonding with other members, providing structure and a sense of goal directedness; the provision of behavioral norms about and role models for how to work toward abstinence; the development and engagement in non-substance-related activities that are rewarding and can take the place of substance-related activities; and the development of more effective coping skills with an associated increase in self-efficacy.

Seeing that recovery is possible, seeing how it is made possible, and being supported by peers to create a clear path to recovery in one’s own life can be an extraordinarily powerful experience.

The value of peer support programs has been proven in numerous studies over the years. Participation in peer support programs during formal treatment is “associated with better outcomes” and higher levels of participation correspond to lower relapse rates. However, peer support groups don’t only impact substance use itself; they can also improve treatment outcomes for the primary mental health disorder. For example, according to the Social Work in Public Health study, peer support group attendance by people with schizophrenia is associated with “better medication compliance, as well as reductions in substance use and psychiatric symptoms and improved quality of life and self-efficacy.” This is particularly true for those attending peer support groups specifically geared toward people who have dual diagnoses, as participants may feel more comfortable disclosing psychiatric struggles.