Reducing Adolescent Substance Use with Mutual Aid Groups

Background:

While several studies have identified specific risk and protective factors for substance use during adolescence, few studies have examined mutual aid groups as an effective way to reduce substance use and related risk factors among at-risk high school students and to enhance group engagement. The purpose of this study was to evaluate the influence of implementing mutual aid groups in decreasing perceived risk of substance use, favorable attitudes toward substance use, and reducing substance use while increasing group engagement. The study hypothesized that utilizing mutual aid groups with at-risk high school students would: (1) decrease favorable attitudes toward substance use compared to the control group; (2) decrease substance use compared to the control group; and (3) create group engagement among members.

Methods:

The study included youth in parochial high schools serviced by a community agency. The community agency provided social work services in 14 schools in the Northeast. A quasi-experimental clinical design approach was applied to a total of 242 adolescents where every other adolescent was assigned to either the intervention or the control group. The groups were conducted over 10 weekly, 45-min sessions that met during the school day. In order to ensure uniformity in group intervention, the 14 female and 2 male counselors facilitating the groups were trained on the basic principles and leader skills needed to foster mutual aid. Weekly supervision was also conducted by a clinician experienced in the model of mutual aid in groups. The baseline survey was self-administered by the youth and designed to gather information about their experiences with substance use. Each participant received a posttest after the intervention was finished. The group facilitator completed a Group Engagement Measure for each of the youth in the group after the second and seventh sessions. As the surveys were collected, they were entered into an SPSS 20.0 dataset.

Results:

General linear mixed-effects models were used to detect significant differences between treatment and control conditions. There was a significant decrease in alcohol (p=0.013) and marijuana use (p=0.023) between baseline and posttest for the youth in mutual aid groups compared to the control group. Perceived risk of substance use did not increase compared to the control group. As hypothesized, favorable attitudes toward substance use decreased compared to the control group (p=0.028). The results showed that group engagement increased in all of the five domains: contributing to group; relating to worker; relating with other group members; working on own problems; and working on others’ problems (p<0.001).

Implications:

The results suggested that mutual aid groups can be a useful approach for youth to bring about meaningful change in substance use. Mutual aid principles are consistent with social work’s professional values, allowing the group to reduce both stigma and isolation of its members and allowing group members to assist in the helping process. The findings demonstrate the effectiveness of interventions that promote group engagement, that is, which increases members’ contributing to the group, relating to the worker and members, and working on their own problems, and others’ problems.