Al-Anon Intensive Referral to facilitate concerned others' participation in Al-Anon Family Groups: a randomized controlled trial

Christine Timko; Kathleen M Grant; Xiaotong Han; Lance Brendan Young; Michael A Cucciare

doi:10.1111/add.15670

Al-Anon Intensive Referral to facilitate concerned others' participation in Al-Anon Family Groups: a randomized controlled trial

Addiction. 2022 Mar;117(3):590-599. doi: 10.1111/add.15670. Epub 2021 Oct 3.

Authors

Christine Timko^{1

2}, Kathleen M Grant^{3

4}, Xiaotong Han^{5

6}, Lance Brendan Young⁷, Michael A Cucciare^{5

6}

Affiliations

¹ Department of Veterans Affairs Health Care System, Center for Innovation to Implementation, Palo Alto, CA, USA.
² Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA.
³ Mental Health and Behavioral Science Department, VA Nebraska-Western Iowa Health Care System, Omaha, NE, USA.
⁴ Pulmonary Section, Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE, USA.
⁵ Department of Psychiatry, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
⁶ Center for Mental Healthcare and Outcomes Research, Central Arkansas Veterans Affairs Healthcare System, North Little Rock, AR, USA.
⁷ Department of Preventive & Community Dentistry, The University of Iowa, Iowa City, USA.

Abstract

Aims: To test the effectiveness of an intervention, Al-Anon Intensive Referral (AIR), to facilitate participation in Al-Anon Family Groups (Al-Anon).

Design, setting and participants: Multi-site, randomized controlled trial of AIR versus usual care (UC), with follow-up assessments at 3, 6 and 12 months. The 12-month follow-up rate was 74%. Residential alcohol use disorder (AUD) treatment programs in three US locations. Concerned others (COs) of patients in treatment for AUD. COs were mainly women (77%) who were patients' spouses (33%) or parents (25%).

Intervention and comparator: AIR (n = 128) consisted of four sessions over 3 months with an Al-Anon coach. UC (n = 151) was the treatment program's offer of educational sessions for COs.

Measurements: Primary outcome: COs' self-reports of any Al-Anon attendance (yes or no) at 3 months.

Secondary outcomes: number of Al-Anon meetings and the CO-patient relationship (stressors, resources). Potential predictors of outcomes examined in generalized linear mixed models were their baseline value, time, CO-patient relationship type (marital or non-marital), treatment program and condition.

Findings: There was no effect of condition for the primary outcome (28% in AIR, 21% in UC; Bayes factor = 1.86). Relationship stressors at follow-ups were more severe for COs in a marital relationship with the patient than for COs in a non-marital relationship [β = 2.19, 95% confidence interval (CI) = 1.07, 3.32]. For CO-patient relationship resources at follow-ups, the main effect for condition was significant (β = 1.33, 95% CI = 0.04, 2.61). COs assigned to the AIR condition had more resources than COs who were in the UC condition.

Conclusions: Relative to usual care, Al-Anon Intensive Referral was not associated with increases in participation of concerned others in Al-Anon, but was associated with more resources in the concerned other-patient relationship.

Trial registration: ClinicalTrials.gov NCT04018560.

Keywords: Al-Anon; Alcohol; Concerned other; intensive referral; relationship resources; relationship stressors; treatment.

Publication types

Randomized Controlled Trial
Research Support, N.I.H., Extramural
Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

Alcohol Drinking
Alcoholics Anonymous*
Alcoholism* / therapy
Bayes Theorem
Female
Humans
Referral and Consultation

Associated data

ClinicalTrials.gov/NCT04018560

Abstract

Publication types

MeSH terms

Associated data

Grants and funding