Reviews of the research literature suggest that some clients of AOD services will benefit from joining a self-help group such as Alcoholics Anonymous, Narcotics Anonymous, SMART Recovery, or alternative self-help groups [725, 809, 810]. ‘Dual diagnosis’ support groups are also an option, specifically for people with co-occurring mental and AOD use disorders [811, 812]. One recent Cochrane review concluded that there is high quality evidence to suggest that manualised forms of self-help groups (such as Alcoholics Anonymous and 12-step facilitation) are more effective than established treatments, such as CBT, at increasing abstinence [809]. As with other psychosocial groups, there is also evidence that longer attendance at self-help groups and higher levels of social support have a positive impact on outcome [813–817].
As with all interventions, it may take a few attempts to find the group that suits a person’s needs and it is possible that one group may not suit the client but the next will—even in the same type of self-help group. As mentioned with regard to psychosocial groups, it is important to assess whether the client experiences social anxiety or impairments in social judgement and social skills, as they may appear and feel awkward in group settings [769]. It should be noted that some groups, particularly those that adopt a 12-step philosophy, may be disapproving of the use of any medication [818]; yet clients with co-occurring mental disorders are often prescribed medication to help treat their mental health condition [819]. Some clients with co-occurring conditions, particularly those who experience religious delusions, may also have difficulty with the strong spiritual focus of many self-help groups [820].