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Effects of “Dual Focus” Mutual Aid on Self-Efficacy for Recovery and Quality of Life

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Abstract

Four million adults in the U.S. have co-occurring serious mental illness and a substance use disorder. Mutual aid can usefully complement treatment, but people with co-occurring disorders often encounter a lack of empathy and acceptance in traditional mutual aid groups. Double Trouble in Recovery (DTR) is a dual focus fellowship whose mission is to bring the benefits of mutual aid to persons with dual diagnoses. Three hundred and ten persons attending 24 DTR groups in New York City during 1998 were interviewed and followed-up for two years. A mediational model was specified and results across time were summarized with generalized estimating equations (GEE). Degree of DTR Affiliation (attendance and involvement) was significantly associated with Self-efficacy for Recovery and three quality of life measures: Leisure Time Activities, Feelings of Well-Being and Social Relationships. Self-efficacy fully mediated the effects of DTR Affiliation on Leisure Time and Feelings and partially mediated DTR’s effect on Social Relationships. The association of DTR involvement with self-efficacy is consistent with the processes inherent in mutual aid, although the observational nature of these data preclude causal inference. To improve outcomes, clinicians should facilitate affiliation with dual focus groups among persons with dual diagnoses as part of a comprehensive treatment approach.

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Acknowledgements

The authors thank Dr. Sharon Carpinello for making the Mental Health Confidence Scale available prior to its publication and for encouraging the study. Dr. Jean Endicott kindly provided documentation on the Quality of Life Enjoyment and Satisfaction Questionnaire. We also gratefully acknowledge the cooperation of the DTR membership in New York City and the help of the agencies where many of the DTR meetings were held. The study was supported by grant no. R01 DA11240 from the National Institute on Drug Abuse.

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Authors and Affiliations

  1. National Development and Research Institutes, Inc., 71 W. 23rd St., 8th floor, New York, NY, 10010, USA

    Stephen Magura, Charles Cleland & Alexandre B. Laudet

  2. Double Trouble in Recovery, Inc., New York, NY, USA

    Howard S. Vogel

  3. Value Options, Colorado Springs, CO, USA

    Edward L. Knight

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  1. Stephen Magura
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  2. Charles Cleland
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  3. Howard S. Vogel
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  4. Edward L. Knight
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  5. Alexandre B. Laudet
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Correspondence to Stephen Magura.

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Magura, S., Cleland, C., Vogel, H.S. et al. Effects of “Dual Focus” Mutual Aid on Self-Efficacy for Recovery and Quality of Life. Adm Policy Ment Health 34, 1–12 (2007). https://doi.org/10.1007/s10488-006-0091-x

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