What Influences Referral to 12-Step Mutual Self-Help Groups by Treatment Professionals?

Abstract

Background/Aims: Twelve-step mutual self-help groups provide cost-effective support for recovery from substance misuse problems. Evidence suggests they are successful as an adjunct to formal treatment and that referral from clinicians is important in fostering engagement. Methods: This study surveyed substance misuse treatment professionals employed within two agencies in Birmingham (UK). Results: A total of 92 clinicians (79.3%) eligible to participate completed a questionnaire that explored their attitudes, knowledge and referral practices with regard to 12-step groups (TSGs). Most (74%) had a positive attitude, and almost 80% referred at least some of their clients to TSGs. However, 30% had not referred any clients in the past month, and multivariate analysis showed that referral was associated with greater objective knowledge about TSGs when other factors were controlled for. Conclusions: These results have implications for linking professional treatment to mutual self-help groups, and potential strategies to increase referral are discussed.

Surrender to win: Constructions of 12-step recovery from alcoholism and drug addiction

“…At a time of cuts to services, AA and NA are both free, widely available and recommended for the treatment of alcohol and substance misuse by the National Institute for Clinical Excellence (NICE, 2011;Public Health England, 2013). Yet studies have found only between 46% (Day et al, 2005) and 33% of practitioners (Wall et al, 2014) regularly consider referring patients/clients into 12-Step programmes. This relatively low referral rate is despite evidence that 12-Step involvement is predictive of both better engagement with professionals (Ferri et al, 2006) and improved abstinence rates (Pagano et al, 2013).…”

Intensive referral to mutual-help groups: A field trial of adaptations for rural veterans

“…Patients entering treatment were assigned to an addiction therapist (AT), half of whom had been trained in RAIR. Those not trained in RAIR provided their standard referral (SR), typically a recommendation to find and attend MHG meetings upon completing residential/intensive outpatient treatment, although referral practices vary [11]. Patents were pretested at baseline and followed-up six months later on measures of mutual-help group affiliation, substance use, and PTSD.…”

“…Social support provided by MHGs like Alcoholics Anonymous and other 12-step groups improves outcomes [6, 9], even for those with concurrent PTSD and SUD [10], and efforts to promote participation reduce continuing care costs [7]. Post-treatment referral to mutual-help groups has been described as “an effective, low-cost option” [8] but treatment providers vary in consistency and methods of referral [11].…”

Assessment and management of alcohol use disorders

“…Long term cohort studies show that people who actively participate in mutual aid are more likely to sustain their recovery, 23 Clinicians should be aware of the range of mutual aid groups available locally and how to access them. Level of clinician knowledge about Alcoholics Anonymous groups has been positively correlated with levels of referral, 24 and attending a meeting is an invaluable learning experience. Evidence from randomised controlled trials suggests that proactive efforts to engage patients with mutual aid groups increase attendance, particularly introducing the patient to a group member in advance of a meeting.…”