What Do Young Adults Think of 12-step Groups? Why Should We Care What They Think?

Community-based groups that promote and facilitate recovery such as 12-step mutual-help organizations (MHO) are becoming increasingly more valuable in the current paradigm of cost-efficient, evidence-based care

Although there are well-vetted strategies that can help patients engage with mental health organizations (MHOs), young adults are not only the largest group of substance use disorder (SUD) treatment seekers, but they are a developmentally unique, and different from their older and younger counterparts in several ways.

Relative to adolescents, they have far less monitoring and natural daily structure (i.e., high school) and, compared to older adults, they have access to fewer recovery-supportive people and environments. Also, of note, only about 15% of Alcoholics Anonymous and Narcotics Anonymous members are under 30.

Optimal strategies to help young adults engage in mental health organizations (MHOs) remains unclear.

As an important preliminary step, using qualitative analyses, Labbe and colleagues sought to determine what young adults found most helpful and least helpful about 12-step MHO attendance in the year following residential treatment, as well as the most common reasons for discontinuing attendance, or never attending, in order to inform developmentally-tailored 12-step-facilitation approaches for this age group.

Participants cited the most helpful aspects of 12-step meetings as feelings of:

• belonging
• validation
• hope for recovery
• optimistic outlook on one’s future

Participants cited the least enjoyable aspects of 12-step meetings as:

• the structure of the meetings (length & repetitiveness)
• other group members
• age differences

IN CONTEXT

Young adults have garnered increased attention in clinical and recovery-related research due to their disproportionately high rates of substance use disorder, their comparatively higher rates of treatment seeking, and their developmentally unique life stage.

Labbe and colleagues’ study adds to this growing literature with several evidence-based suggestions to help inform efforts at linking young adults with 12-step mutual help organizations. These include reassuring prospective attendees who may be concerned about 12-step content, that attending meetings may help them feel less isolated, alone, and boost their confidence that recovery is not only possible but likely. In addition, we need to look more closely at logistical barriers to attendance, which may be more related to drop-out than for adolescents or adults.

Also, although not discussed in this article, parents or caregivers may be able to influence young adults’ mutual health organizations engagement either through verbal encouragement or contingency management (e.g., providing a reward, such as use of the car).

Authors also highlight the potential role of “camaraderie” in the young adults’ favorite aspects of meeting attendance. These ideas seems reminiscent of the psychological sense of community construct– membership, influence, fulfillment of needs, and shared emotional connection – and may deserve more attention in future studies of MHO recovery.

CITATIONS

Labbe, A. K., Slaymaker, V., & Kelly, J. F. (2014). Toward enhancing 12-step facilitation among young people: a systematic qualitative investigation of young adults’ 12-step experiences. Substance abuse, 35(4), 399-407.