Loading…

Protocol - Mutual-help Group Involvement and Treatment Attendance

Add to My Toolkit
Description

The Peer Alternatives for Addiction (PAL) Mutual-help Group Involvement and Treatment Attendance Questionnaire consists of self-administered items designed to assess involvement in mutual-help groups (7 items) and treatment participation (2 items) for individuals with substance use disorder (SUD). It evaluates lifetime and recent mutual-help group meeting attendance, presence of a regular group, availability of a sponsor/close friend, and involvement in volunteer activities. Respondents indicate which groups they have attended, the number of meetings attended, and their level of involvement. Scoring involves recoding involvement items to 0 (no) or 1 (yes) and summing them with the number of meetings attended in the past 30 days, also recoded to 0 (less than weekly) or 1 (at least weekly), to yield a 5-item involvement scale that measures engagement in mutual-help group activities. Treatment participation is assessed separately, with an additional 2 items.

Specific Instructions

The PhenX Substance Use and Recovery Working Group (WG) suggests keeping the list of mutual-help groups in Meeting Attendance Screener updated (e.g., include Celebrate Recovery or Dharma/Refuge Recovery).

Terminology related to substances, substance use, and recovery is fluid. Updates in protocol language may be appropriate based on circumstance. Suggestions for revision have been offered to update answer responses or other components of the questionnaires to account for the constantly changing landscape. These suggestions have not been tested or validated in research studies but may be considered by investigators to enhance relevance.

The Peer Alternatives for Addiction (PAL) measure can be used for substances other than alcohol or can be tailored to ask about involvement in a specific group for alcohol or other drugs. Although the primary study that employed this protocol was focused on individuals with alcohol use disorder, the Substance Use and Recovery WG considers use of this tool appropriate for individuals with any substance use disorder.

The PAL measure provides questions about involvement that are generalizable across various types of mutual help organizations and thus allow for comparison; 12-step meetings are one type of mutual help organization and have the highest prevalence of use. For a customized measure of 12-step involvement, see 12-Step Group Participation

Protocols may include terms and language that could be triggering to respondents. Investigators are encouraged to have resources in place to help respondents cope with triggers as needed.

Availability

This protocol is freely available; permission not required for use.

Protocol

Peer Alternatives for Addiction (PAL) Mutual-help Group (MHG) Involvement and Treatment Attendance Questions

MHG MEETING ATTENDANCE SCREENER

1.    Think about your entire lifetime. Please indicate which of the following mutual-help groups you have ever attended for an alcohol/drug problem of your own. (Select all that apply.)  
[ ] Alcoholics Anonymous (AA)
[ ] Narcotics Anonymous (NA)
[ ] Cocaine Anonymous (CA)
[ ] Marijuana Anonymous (MA)
[ ] LifeRing Secular Recovery (LifeRing)
[ ] SMART Recovery (SMART)
[ ] Women for Sobriety (WFS)
[ ] Other (specify)* 

*One might add Celebrate Recovery and Recovery Dharma/Refuge Recovery, based on responses to “Other.”

MHG MEETING COUNTS

1.    Approximately how many [in-person/online/in-person and online][mutual-help group]* meetings have you attended in your lifetime? Just give us your best guess even if you aren’t sure of the exact number.
2.    Approximately how many [in-person/online/in-person and online][mutual-help group]* meetings have you attended in the past 30 days?

*PAL separately assessed in-person and online meeting attendance for each target group type, then summed, but theoretically these could be tailored to study needs. E.g., one could ask about in-person and online MHG meeting attendance globally.

ADDITIONAL MHG INVOLVEMENT QUESTIONS

INTRO: Consider now all of the [mutual-help group]* meetings you attended in the past 30 days for an [alcohol/drug/alcohol or drug]* problem of your own, whether in person or online. For any of these meetings…

1.    Do you currently have a regular or “home” group? By this, we mean a meeting that you usually attend weekly and where you know many of the people. 
[ ] 0 No
[ ] 1 Yes

2.    Do you currently have at least one close friend or “sponsor” who you can call on for help when you need it? 
[ ] 0 No
[ ] 1 Yes

3.    In the past 30 days, have you convened or led any meetings? 
[ ] 0 No
[ ] 1 Yes

4.    In the past 30 days, have you done volunteer work or “service” at a meeting? For example, this might include helping newcomers, setting up chairs, making coffee, or cleaning up after a meeting. Do not include leading meetings. 
[ ] 0 No
[ ] 1 Yes

*PAL asked about all mutual-help groups and alcohol problems, so created a summary measure of involvement for alcohol problems. Again, though, these theoretically could be tailored. E.g., one could ask about involvement in a specific group for alcohol or drugs.

•    For a total involvement score, involvement items should be recoded to 0 (no)/1 (yes) and summed with meetings attended in the past 30 days, also recoded to 0 (less than weekly, or <4)/1 (at least weekly, or 4 plus) to yield a 5-item scale.

TREATMENT QUESTIONS

1a.    Have you ever received inpatient or outpatient treatment for an alcohol or drug problem? 
[ ] No
[ ] Yes

1b.    Did you receive any of this treatment in the past 12 months? 
[ ] No
[ ] Yes

 

Personnel and Training Required
None
Equipment Needs
None
Requirements
Requirement CategoryRequired
Major equipment No
Specialized training No
Specialized requirements for biospecimen collection No
Average time of greater than 15 minutes in an unaffected individual No
Mode of Administration

Self-administered questionnaire

Lifestage

Adult, Senior

Participants

Adults aged 18 and over with a history of alcohol use disorder.

Selection Rationale

This protocol from Peer Alternatives for Addiction (PAL) study was selected because it provides a comprehensive and comparative analysis of mutual help groups for alcohol use disorder (AUD), including 12-step programs and alternative groups.

Language

English, Spanish

Standards
StandardNameIDSource
Derived Variables

None

Process and Review

Not Applicable

Protocol Name from Source

Peer Alternatives for Addiction (PAL) Mutual-Help Group Involvement and Treatment Attendance Questions

Source

Zemore, S. E., Lui, C., Mericle, A., Hemberg, J., & Kaskutas, L. A. (2018). A longitudinal study of the comparative efficacy of Women for Sobriety, LifeRing, SMART Recovery, and 12-step groups for those with AUD. Journal of Substance Abuse Treatment, 88, 18–26.
https://doi.org/10.1016/j.jsat.2018.02.004

General References

Humphreys, K., Barreto, N. B., Alessi, S. M., Carroll, K. M., Crits-Christoph, P., Donovan, D. M., Kelly, J. F., Schottenfeld, R. S., Timko, C., & Wagner, T. H. (2020). Impact of 12 step mutual help groups on drug use disorder patients across six clinical trials. Drug and Alcohol Dependence, 215, 108213.
https://doi.org/10.1016/j.drugalcdep.2020.108213

Timko, C., Mericle, A., Kaskutas, L. A., Martinez, P., & Zemore, S. E. (2022). Predictors and outcomes of online mutual-help group attendance in a national survey study. Journal of Substance Abuse Treatment, 138, 108732.
https://www.jsatjournal.com/article/S0740-5472(22)00014-9/abstract

Protocol ID

590602

Variables
Export Variables
Variable Name Variable IDVariable DescriptiondbGaP Mapping
Substance Use Recovery
Measure Name

Treatment and Recovery Support Services

Release Date

January 30, 2025

Definition

Psychosocial treatment is psychotherapy, pharmacological treatment is medication, and recovery support services are nonclinical interventions.

Purpose

Recovery may include use of a variety of treatment and recovery support services that people may utilize to mobilize and/or maintain adaptive and salutary recovery-related change. This measure can be used to assess lifetime and past 30-day use of “assisted” (i.e., formal treatment/medications, mutual help organizations/recovery community centers, recovery housing, recovery coaching, etc.) versus “unassisted” resolution pathways.

Keywords

addiction, substance use disorder, substance use, recovery, SUD, alcohol use disorder (AUD), peer support, Women for Sobriety, WFS, LifeRing, Self-Management and Recovery Training Recovery, SMART Recovery, Peer Alternatives for Addiction, PAL, 12-step programs, Mutual help groups

Measure Protocols
Protocol ID Protocol Name
590601 Use of Treatment and Recovery Support Services
590602 Mutual-help Group Involvement and Treatment Attendance
590603 12-Step Group Participation
590604 Future Service Needs - Self-Help Involvement